Browsing by Author "Kant, Surya"
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Item Association of cytokines levels with epidermal growth factor receptor mutation in lung cancer patients(Wolters Kluwer India Pvt. Ltd., 2020-09) Gaur, Priyanka; Bhattacharya, Sandeep; Kant, Surya; Kushwaha, R A. S.; Singh, Gaurav; Pandey, SarikaBackground: Lung cancer is one of the most frequent types of cancer and the leading cause of cancer-related deaths. Epidermal growth factor receptor (EGFR) is a receptor tyrosine kinase (TK) being highly expressed in lung cancers. Activation of EGFR through oncogenic mutations leads to upregulation of gene expression that may heighten the inflammatory response in certain situations. EGFR acts as a key regulator and a cellular hub for inflammatory cytokine signaling, thereby promoting tumor cell proliferation, invasion, migration, metastases, and survival. The aim of the present study is to determine the serum cytokines levels and EGFR mutation status in lung cancer patients to investigate the association between the EGFR mutation status and cytokines levels with lung cancer patients. Materials and Methods: Blood and tissue samples of lung cancer patients were collected. The EGFR mutations of lung cancer patients were determined by the immunohistochemistry (IHC) and serum cytokines levels of lung cancer patients were determined using ELISA. Results: Statistically significant association of EGFR mutations with adenocarcinoma subtypes and non-smokers were found (P < 0.05). Lung cancer patients with EGFR mutations had significantly higher tumor necrosis factor-alpha levels when compared to lung cancer patients without EGFR mutations (P < 0.01), and EGFR mutation status was not significantly associated with interleukin-6 levels (P = 0.24). Conclusion: EGFR mutation detection by the IHC method is a potentially useful tool to guide clinicians for personalized treatment of lung cancer patients of adenocarcinoma subtype, and cytokines are good biomarkers for the diagnosis, prognosis, and prediction of treatment responses in lung cancer patients as well as act as therapeutic targets. This study will provide biomarkers for lung cancer diagnosis and treatmentsItem Coexistence of carcinoma cheek with tuberculosis: a rarity.(2015-03) Mishra, Ashwini Kumar; Kant, Surya; Verma, Laxmi; Nagaraju, Karthik; Upadhyay, Noopur; Singh, Anubhuti; Kumar, AnkitCoexistence of tuberculosis and cheek malignancy is a rare phenomenon and it has never been reported to the best of our knowledge. Here, we present a case of carcinoma cheek with tuberculosis in a 50 year old male patient who was successfully managed by multimodality approach by combining anti-tubercular therapy with chemotherapy and radiotherapy.Item A comparative study to evaluate the role of inhaled steroid versus lowdose oral steroid in patients of chronic obstructive pulmonary disease.(2015-03) Kant, Surya; Ahmad, Jawed; Siddiqui, Mohammed Javed; Singh, Arpita; Verma, Ajay Kumar; Bhatia, AnkitBackground: Chronic obstructive pulmonary disease (COPD) is a leading cause of death and disability worldwide. Its prevalence is increasing globally, especially in countries with high frequencies of smoking combined with signifi cant environmental exposures to pollutants and biomass smoke. Currently COPD is the third leading cause of death worldwide, after ischemic heart disease and stroke. Efforts have been made to design a standard protocol for treatment of the disease, and these efforts are still in the process. Methods: The study was done on 100 subjects to assess whether steroid (inhaled or oral) actually have any role in decreasing the decline in forced expiratory volume in 1 sec and to compare the effect of both to fi nd out which one is superior. Patients were divided into two arms, inhaled steroids group (according to GOLD guidelines), and the other group was oral prednisolone 10 mg in addition to standard treatment except inhaled steroid. The effects were studied with appropriate statistical tests. Results: Our study data showed that oral steroids are more effective on symptom control as compared to inhaled steroids. Symptoms such as cough (64% vs. 82%) and breathlessness (76% vs. 94%) signifi cantly improved in the oral corticosteroids group. The rate of exacerbation also improved (22% vs. 12%) in the test group. Conclusion: The use of steroids has ever been a subject of divergence of views ever since its role in the treatment of COPD was fi rst described. Although, overall steroid in any form is benefi cial in symptomatic/subjective and objective improvements in COPD, oral steroids stand a better chance as compared to inhaled steroids.Item A comparison of toxicity profi le of gemcitabine monotherapy versus etoposide/cisplatin in the treatment of locally advanced or metastatic non-small cell lung cancer.(2015-01) Prakash, Ved; Singh, Arpita; Kant, Surya; Verma, Ajay K; Saxena, Prachi; Bhatia, AnkitBackground: Lung cancer is the leading cause of cancer deaths globally in which about 40% patients reporting in advanced stage disease. Both platinum and non platinum combinations have been shown to be equally effi cacious as initial fi rst-line treatment of advanced non-small cell lung cancer (NSCLC), however because of the toxicity of cisplatin, combination treatment can only be administered to a minority of patients in good general health. Gemcitabine could be combined with one of the other new agents to create novel non-platinum-doublet combinations with effi cacy and/or toxicity profi le superior to that of standard platinum based combinations. Hence, this study was conducted to compare the toxicity profi les of gemcitabine monotherapy and the cisplatin/etoposide combination therapy. Methods: This was a randomized prospective study, which included 96 patients selected on the basis of histologically or cytologically confi rmed Stage III B or IV of NSCLC. Study was divided into two arms-Arm A received gemcitabine monotherapy in a dose of 1000 mg/m2 on day 1 and 5 of the cycle and repeated after every 3 weeks while Arm B received cisplatin (25 mg/m2 on day 1, 2 and 3) + etoposide (100 mg/m2). Patient were evaluated for adverse events by following World Health Organization grading of toxicity. Results: Out of the 96 patients enrolled in the study, 74 (77.0%) patients were eligible and were analyzed. Of these, 36 (37.5%) patients belonged to Arm A and 38 (39.5%) to Arm B. Transient vomiting (45.8% vs. 37.5%), leukopenia (33.3% vs. 8.3%) were seen more in Arm A, while thrombocytopenia (33.3% vs. 12.5%), patchy hair loss (68.4% vs. 16.6%) was seen more in Arm B. Nephrotoxicity was seen almost similarly in both the groups. Conclusions: Single-agent gemcitabine appears to have a safer toxicity profi le than the combination cisplatin-etoposide in the fi rst-line chemotherapy of advanced NSCLC. With less toxic anticancer drugs like gemcitabine, the physician now has greater choice in choosing treatment, which can have better effect on the patients concerned.Item COVID Management Strategy for Third Wave / Omicron Variant in India(Indian Medical Association, 2022-03) Kant, Surya; Royson, AnmaryCOVID-19, the worst Pandemic of this decade caused significant morbidity and mortality in the past 3 years and still continue to hit the human kind with it’s evil skills. After the first and second COVID-19 wave the third wave has emerged with new variants and with high transmission rate and reduced efficiency of treatments and vaccines. The main treatment strategy remain same as symptomatic and supportive treatments. Oxygen therapy, Steroid, Antivirals and some repurposed drugs like Ivermectin and newer drugs including monoclonal antibodies are used in this fight against COVID-19. Ivermectin is being the game changer in many states of India, they kept this medicine in their new treatment protocol also. Vaccination including additional Booster/Precautionary Dose along with the COVID appropriate behaviours, if we are able to maintain Physical distance, Wear mask properly, Wash our hands and Prevent crowd from gathering then we will not allow the virus to spread and prevent the emergence of another waveItem Evaluation of an immunochromatographic test for discrimination between Mycobacterium tuberculosis complex & non tuberculous mycobacteria in clinical isolates from extra-pulmonary tuberculosis.(2012-06) Maurya, Anand Kumar; Nag, Vijaya Lakshmi; Kant, Surya; Kushwaha, Ram Aawadh Singh; Kumar, Manoj; Mishra, Vikas; Rahman, W; Dhole, Tapan N; Tuberculosis --bloodBackground & objectives: Accurate diagnosis of tuberculosis (TB) is crucial to facilitate early treatment of the patients, and to reduce its spread. Clinical presentation of Mycobacterium tuberculosis complex (MTBC) and non tuberculous mycobacteria (NTM) may or may not be the same, but the treatment regimen is always different for both the infections. Differentiation between MTBC and NTM by routine laboratory methods is time consuming and cumbersome. This study was aimed to evaluate an immunochromatographic test (ICT), based on mouse monoclonal anti-MPT64, for simple and rapid discrimination between MTBC and NTM in clinical isolates from extra-pulmonary tuberculosis cases. Methods: A total of 800 clinical samples were collected from patients suspected to have extra-pulmonary tuberculosis. Preliminary diagnosis has been done by direct Ziehl–Neelsen (ZN) staining followed by culture in BACTEC system. A total of 150 clinical isolates, which were found positive in BD 460 TB system during September 2009 to September 2010 were selected for the screening by ICT test. p-nitro-α-acetylamino- β-hydroxy propiophenone (NAP) test was performed for differentiation of MTBC and NTM. M. tuberculosis complex was further confirmed by IS6110 PCR of BACTEC culture positive isolates, this served as the reference method for MTBC identification and comparative evaluation of the ICT kit. Results: Of the 150 BACTEC culture positive isolates tested by ICT kit, 101 (67.3%) were found positive for MTBC and remaining 49 (32.7%) were considered as NTM. These results were further confirmed by IS6110 PCR that served as the reference method for detection of MTBC. H37Rv reference strain was taken as a control for ICT test and IS6110 PCR. The reference strain showed the presence of MPT64 antigen band in the ICT test. Similar bands were formed in 101 of 102 MTBC isolates tested, proving 99.1 per cent sensitivity and no bands were detected in 48 (100%) NTM isolates tested, proving 100 per cent specificity of the ICT kit. Interpretation & conclusions: Our findings show that ICT test can be used on direct culture positive specimens. It does not require any special equipment, is simple and less time consuming. It can easily discriminate between MTBC and NTM and thus can help in appropriate management of tuberculosis.Item Evaluation of GenoType® MTBDRplus assay for rapid detection of drug susceptibility testing of multi-drug resistance tuberculosis in Northern India.(2013-04) Maurya, Anand Kumar; Umrao, Jyoti; Singh, Amresh Kumar; Kant, Surya; Kushwaha, Ram Awadh Singh; Dhole, Tapan NBackground: The problem of multi-drug resistance tuberculosis (MDR-TB) is growing in several hotspots throughout the world. Rapid and accurate diagnosis of MDR-TB is crucial to facilitate early treatment and to reduce its spread in the community. The aim of the present study was to evaluate the new, novel GenoType® MTBDRplus assay for rapid detection of drug susceptibility testing (DST) of MDR-TB cases in Northern India. Materials and Methods: A total of 550 specimens were collected from highly suspected drug resistant from pulmonary and extra-pulmonary TB cases. All the specimens were processed by Ziehl- Neelsen staining, culture, differentiation by the GenoType® CM assay, fi rst line DST using BacT/ALERT 3D system and GenoType® MTBDRplus assay. The concordance of the GenoType® MTBDRplus assay was calculated in comparison with conventional DST results. Results: Overall the sensitivity for detection of rifampicin, isoniazid and MDR-TB resistance by GenoType® MTBDRplus assay was 98.0%, 98.4% and 98.2% respectively. Out of 55 MDR-TB strains, 45 (81.8%), 52 (94.5%) and 17 (30.9%) strains showed mutation in rpoB, katG and inhA genes respectively (P < 0.05). The most prominent mutations in rpoB, katG and inhA genes were; 37 (67.3%) in S531L, 52 (94.5%) in S315T1 and 11 (20%) in C15T regions respectively (P < 0.05). Conclusions: Our study demonstrated a high concordance between the GenoType® MTBDRplus assay resistance patterns and those were observed by conventional DST with good sensitivity, specifi city with short turnaround times and to control new cases of MDR-TB in countries with a high prevalence of MDR-TB.Item Hospital-based study on demographic, hematological, and biochemical profile of lung cancer patients(Wolters Kluwer India Pvt. Ltd., 2020-09) Gaur, Priyanka; Bhattacharya, Sandeep; Kant, Surya; Kushwaha, RA S.; Garg, Rajiv; Pandey, Sarika; Dubey, AbhishekBackground: Lung cancer is considered as the most commonly diagnosed cancer. It is the leading cause of cancer-related mortality. Smoking and environmental pollutants act as important risk factors in majority of lung cancer cases (80%–90%). Material and Methods: This is a hospital-based study carried on in lung cancer patients of North India. Demographic profile of lung cancer patients was recorded. Hematological and biochemical profiles of lung cancer patients and healthy controls were compared. Results: Highest proportion of lung cancer was found in the age group of 46–60 years. Lung cancer was seen in highest number in male gender (76.63%) and also in those patients belonging to the rural category (84.58%). In this study, only 3.98% lung cancer patients having the past history of cancer and 5.47% showing the family history of cancer. Significant differences were found in weight and body mass index (BMI) of lung cancer patients when compared to healthy control (P < 0.0001). Hemoglobin (Hb) was found lower in lung cancer patients as compared with healthy controls. Significant difference was also observed in Hb levels of these two groups (P < 0.000). The serum protein level was lower in lung cancer patients than healthy controls. A significant difference was also observed in the protein levels of these two groups (P < 0.0001). Serum alkaline phosphatase (ALP) levels were higher in lung cancer patients in comparison to healthy controls. A significant difference was also observed in serum ALP levels in lung cancer patients as compared with healthy controls (P < 0.0001). Conclusions: Significant difference between BMI, Hb, serum albumin, and total protein was found in this study. These biomarkers may be helpful in the diagnosis of lung cancer at early stage and also in the follow-up assessment of the effects of treatmentItem Initial drug resistance pattern among Pulmonary Tuberculosis patients.(2013-07) Gupta, Harshita; Kant, Surya; Jain, Amita; Natu, S M; Ahluwalia, SavitaBackground: Drug resistant tuberculosis (DRTB) is an emerging problem that adversely affects treatment outcomes and public health in the developing world. Objective: To determine the initial drug resistance pattern among pulmonary tuberculosis patients registered under the Revised National Tuberculosis Control Programme. Study Design: A cross-sectional study design. Setting: Two urban Directly Observed Treatment Supervised (DOTS) centres in Lucknow District of Uttar Pradesh. Methods: The present study consisted of newly diagnosed sputum smear-positive for acid-fast bacilli (AFB) cases at the time of registration under the tuberculosis control programme. All sputum smear positive cases were subjected to culture and drug-susceptibility testing by 1% proportion method on Lowenstein-Jensen (LJ) medium. Results: A total of 185 newly diagnosed sputum smear positive for AFB in pulmonary tuberculosis patients were subjected to culture and drug sensitivity test. Among 185 isolates, 170 (91.4%) isolates were culture positive. Of these 170 isolates, 169 (99.4%) were M. tuberculosis and one (0.5%) was Mycobacterium other than tuberculosis (MOTT). Out of 99.4% M. tuberculosis positive isolates, 21.3% were resistant to at least one drug. Resistance pattern of 21.3% strains of M. tuberculosis showing resistance to single, double, triple, and quadruple drugs were 5.9%, 10.7%, 2.4% and 2.4% respectively. Multi-drug resistance (MDR) was observed in 4.7% isolates. Conclusion: The present study highlights the high rate of drug resistance pattern among the new sputum smear positive pulmonary tuberculosis patients and also high MDR tuberculosis. Routine surveillance of drug resistance profile of patients provides useful information for adopting new strategies of effective treatment within National Tuberculosis Control Programmes in order to combat the threat of MDR-TB in the general population.Item Interpreting Mortality in COVID Associated Mucormycosis (CAM) : A Learning Experience from a Tertiary Care Centre(Indian Medical Association, 2022-11) Bharathi, Guna; Bhavana, Kranti; V, Vishnudas T; Kumar, Vijay; Bharti, Bhartendu; Srinivaasan, Arun; Ouseph, Sheelia; Pillai, Suraj; Sadhukhan, Kaushik; Kumar, Vijay; Kant, Surya; Mandal, AnkitaMucormycosis has emerged as an important fungal infection with high associated mortality rates. Mucormycosis causes devastating angio-invasive fungal infections, primarily in patients with underlying risk factors. The prevalence of mortality associated with invasive Mucormycosis is high (>30-50%), with 90% mortality contributed by disseminated disease. Sudden rise in Mucormycosis cases during the COVID-19 pandemic came as a surprise to all. Lowered immunity due to COVID and associated conditions like diabetes, made the population susceptible to this dreaded disease. This disease led to both increase in morbidity and mortality among the general population. Aim of the Study : To interpret in detail the causes of mortality of patients presenting with COVID Associated Mucormycosis (CAM-19) at AIIMS Patna between May-November, 2021. Materials and Methods : An observational study of all patients who were treated for mucormycosis during the period of May 2021-Nov 2021 in ENT Department, AIIMS, Patna. During the period of study, 219 patients of RhinoOrbital-Cerebral Mucormycosis (ROCM) were admitted for treatment. Five patients had gone on Leave Against Medical Advice (LAMA). So, 214 patients were included in the study. Results : Among the 214 patients, 165 patients were treated surgically through both endoscopic and open approaches along with antifungal therapy management. 41 patients died during the hospital course of the treatment. The mortality rate of ROCM stood at 19.15% in our series. Pulmonary Mucormycosis had high mortality (100%). Diabetes is the most common risk factor. Multiple co-morbidities and extensive intracranial involvement had a strong association with mortality. Conclusion : The advanced stage of ROCM was associated with more deaths. Our series mortality rate of 19.15% is lower than most of the other documented mortality rates. Our results support that early aggressive surgical approach, antifungal therapy and multidisciplinary approach has reduced the mortalityItem Maxillary sinus tuberculosis various presentations.(2013-07) Kant, Surya; Srivastava, R; Verma, A K; Singh, H P; Singh, S; Ranganath, T G; Anand, ShipraTuberculosis (TB) of the maxillary sinus is rare. We describe the clinical presentation, management and outcome in two human immunodeficiency virus (HIV) seronegative patients with histopathologically confirmed maxillary sinus TB. One of the patients who presented earlier in the course of the disease could be managed with antituberculosis treatment alone, while the other who presented late required surgical intervention as well.Item An observational study to analyze predisposing factors, causality, severity and preventability of adverse drug reactions among multidrug resistant tuberculosis patients treated under RNTCP program in Northern India(Medip Academy, 2019-03) Lakhani, Preet; Singh, Divya; Barua, Shireen; Jain, Suchi; Kant, Surya; Verma, Ajay; Sachan, Amod K.; Nath, Rajendra; Dixit, Rakesh K.Background: There were 4.1% of all new cases and 19% of previously treated patients were diagnosed with either multidrug resistant or rifampicin resistant tuberculosis in 2016. In the state of Uttar Pradesh, there were 2.16 new cases and 44,531 previously treated cases. The objectives of the study were to assess the predisposing factors, causality assessment, severity grading and avoidability of the adverse drug reactions (ADRs) of the antitubercular drugs in MDR-TB patients in a tertiary care hospital of northern India.Methods: This prospective observational study was conducted for 12 months at a tertiary care hospital. The patients with MDR tuberculosis on treatment with DOTS Plus regimen under RNTCP and who met the inclusion exclusion criteria were recruited after informed consent. ADRs were monitored daily till the patients remained admitted and thereafter monthly. Predisposing factors were recorded. Causality assessment was performed by Naranjo scale and WHO UMC scale, severity by Hartwig’s scale and avoidability by Halla’s scale.Results: There were 115 patients were recruited, 70 developed at least one ADR. 98 ADRs were reported. The commonest ADR reported were – gastrointestinal (38.76%), neurological (21.24%) and hepatobiliary (8.16%). Diabetes and HIV predisposed to development of ADRs. 58.18% ADRs were classified as possible and 37.5% as probable by Naranjo’s scale. 51.02% ADRs were classified as probable and 42.83% as possible by WHO-UMC. 56% were classified as mild, 36% moderate, and 6% severe via Hartwig’s scale. 51 ADRs were classified as avoidable and 40 ADRs were possibly avoidable.Conclusions: Monitoring and assessment of ADRs is necessary to promote awareness, curb resistance and maintain adherence.Item An observational study to find out incidence and pattern of adverse drug reactions among multidrug resistant tuberculosis patients treated under revised national TB control program of India(Medip Academy, 2019-02) Lakhani, Preet; Barua, Shireen; Singh, Divya; Jain, Suchi; Kant, Surya; Verma, Ajay; Sachan, Amod K.; Nath, Rajendra; Dixit, Rakesh K.Background: Between 2006 and 2015, the prevalence of MDR-TB has been found to be as high as 39.9% in some states. Approximately 35.8% of all previously treated patients developed MDR-TB. The objective of the present study was to identify demographic and health characteristics of patients as well as incidence and pattern of the adverse drug reactions caused by antitubercular drugs in MDR-TB patients in a tertiary care hospital of northern India.Methods: This 12 months study of observational study was conducted at a DOTS centre. MDR-TB diagnosed patients treated with DOTS Plus regimen were enrolled after getting informed consent. Patient information was recorded. Patient follow-up was conducted to identify the incidence and pattern of ADRs.Results: A total of 115 patients were enrolled. Maximum number of cases were in the 31-40 age group (25.21%) followed by the 41-50 age group (20.86%). 76 (66.08%) were males and 39 (33.91%) were females. 52 patients (45.21%) had concomitant diseases, out of which 15 (13.04%) were HIV positive and 21 (18.26%) were diabetic. 70 patients (60.86%) developed ADRs. The adverse drug reaction that were seen are -38 (38.76%) cases of gastrointestinal adverse drug reactions, 8 (8.16%) jaundice/hepatitis, 7 (7.14%) impaired hearing/vertigo, 21 (21.24%) central nervous system adverse drug reaction, 6 (6.12%) peripheral neuropathy, 6 (6.12%) rash and itching, 5 (5.10%) arthralgia, 3 (3.06%) renal impairment, 2 (2.04%) hypothyroidism and 2 (2.04%) blurred vision.Conclusions: Determining which population groups are affected most by ADRs can help physicians to better monitor and make an early diagnosis to reduce ADR-related morbidity and mortality.Item Predictors of co-morbidities in chronic obstructive pulmonary disease patients at a tertiary care centre in north India(Medip Academy, 2019-11) Narayan, Kaushlendra Pratap; Verma, S. K.; Kant, Surya; Kushwaha, R. A. S.; Kumar, Santosh; Garg, Rajiv; Srivastava, Anand; Bajaj, Darshan K.; Sonkar, SatyendraBackground: Chronic obstructive pulmonary disease (COPD) is a common preventable and treatable disease that is characterised by persistent respiratory symptoms and airflow limitation. COPD is characterised by an intense inflammatory process in the airways, parenchyma, and pulmonary vasculature. It is possible in some cases that the inflammatory process may overflow into the systemic circulation, promoting a generalised inflammatory reaction. Patient with COPD often have concomitant chronic illness (co-morbidities). The aim of this study is to know the pattern of co-morbidities in COPD patients.Methods: This study was a cross sectional observational study conducted on 172 COPD patients (IPD and OPD) diagnosed on the basis of GOLD guideline 2017. Co morbidities were diagnosed as per standard defined criteria laid down in the respective guidelines.Results: 55.3% of the patients with COPD had co morbidities. 18/88(20.5%) patients presented with multiple co-morbidities. 49/88, 55.7% COPD patients were affected with cardiac (either only cardiac or had multiple organs affected besides cardiac), the commonest co-morbidity. Amongst cardiac, hypertension and congestive heart failure (CHF) was the commonest (n=19/49, 38.8% each) followed by CAD/CSA/IWMI/IHD/AF. Others were metabolic (n=14/88, 15.9%), GERD (n=13/88, 14.8%), Depression (n=11/88, 12.5%). Less prevalent co-morbidities were Osteoporosis (n=8/88, 9.1%), Lung cancer (n=6/88, 6.8%), Bronchiectasis (n=5/88, 5.6%) and OSA (n=3/88, 3.4%).Conclusions: Urban indwelling, advancing age and duration of illness, presentation with low mood, loss of pleasure/ interest, appetite disturbances and heart burn with relief on taking proton pump inhibitor can be predictors of co-morbidities in COPD patients. Chance of finding co-morbidities may be multifactorial. Thus, it is important to look out for co morbidities in each and every COPD patients.Item Primary tubercular submandibular abscess: a rare presentation in two years old girl(Medip Academy, 2018-03) Bajpai, Jyoti; Kant, Surya; Verma, Ajay Kumar; Bajaj, Darshan Kumar; Pradhan, AkshyayaRetroperitoneal Lymphangiomas are rare and account for only 1% of lymphangiomas. They usually present in infancy, rarely they may present symptomatically in adulthood. We present a case of a 19-year old female with a symptomatic retroperitoneal lymphangioma. It was treated with complete surgical excision. Retroperitoneal lymphangiomas are rare. Imaging alone cannot differentiate them from other retroperitoneal cystic masses. Surgical excision is the treatment of choice and required for final diagnosis.Item A Questionnaire-based Survey on Treatments and Practices of Antibiotics in URTI and Fever of Unknown Origin in India(IJCP Group, 2023-03) Kant, Surya; Tripathi, PranjalIndia is the largest consumer of antibiotics in the world. High antibiotic consumption is linked to the emergence and community spread of multidrug-resistant bacteria. It is well-established that antibiotic overuse is one of the leading causes of antibiotic resistance, which is a major global public health challenge. Optimizing antibiotic usage is, thus, an essential issue. Before promoting and defining judicious antibiotic prescribing, it is crucial to analyze practitioners' diagnostic and prescribing practices. Hence, a nationwide retrospective questionnaire-based survey was conducted among 950 Indian doctors. This survey aimed to describe the approaches and practices of Indian doctors towards antibiotic use in upper respiratory tract infections (URTIs) and pyrexia of unknown origin (PUO) and compare practices with national guidelines. These are the most common reasons for primary health care consultations and significantly contribute to the overuse of antibiotics. According to the survey, amoxicillin-clavulanic acid remains the first-line antibiotic for URTI treatment. Third-generation cephalosporins were found to be the most prescribed antibiotics for PUO, uncomplicated typhoid and infections during pregnancy. Our survey results show that most of the clinicians in our study were well aware of the guidelines for antimicrobial use issued by Indian Council of Medical Research (ICMR) and the nationwide problem of antimicrobial resistance. This study provides an important insight into the prescribing practices of antibiotics among Indian doctors.Item Ragi Traditional But Nutritional Especially in the Era of COVID-19(IJCP Group, 2022-03) Sinha, Neha Mohan; Kumari, Neelam; Dikshit, Nandini; Kant, SuryaFinger millet is the name commonly used to denote the crop Eleusine coracana. It is known as Ragi in many parts of India, which is an important member of the family of cereals. In fact, it is superior to many cereals like wheat and rice in terms of its micronutrient content and bioavailability. Several indigenous processing techniques may be applied to finger millets allowing it to be processed into various value-added products, which may be better in appearance, taste, flavor and acceptability. Development of value-added products that contain Ragi as one of their major components can be beneficial for food and nutrition security of Indians. Ragi may contribute to solving the issue of micronutrient deficiency and nutrition security as it is an important source of micronutrients and can be easily incorporated in various recipes and value-added products. It can therefore be a part of various nutritional programs to enhance the nutritional density of foods.Item Role of adipokines in obstructive airway disease and diabetes mellitus(Society for research and Development in Education, 2019-10) Singh, Seema; Singh, Sunita; Kumar, Santosh; Verma, S K; Kant, SuryaThis review summarizes the state of the current literature relating to the associations of lung disease and adipokines (proteins produced by adipose tissue) in humans. The mechanistic basis for these associations in humans is not established, although a possible role for adipokines has been invoked. Leptin, a pro-inflammatory adipokine, and adiponectin, an anti-inflammatory adipokine, are causally associated with asthma in mice. Although human studies are currently inconclusive, high-serum leptin and low-serum adiponectin concentrations predict asthma, independent of obesity, in select population groups, such as premenopausal women in the United States. In contradistinction, low-serum leptin and high-serum adiponectin concentrations are associated with stable COPD, although these associations are likely confounded by fat mass. Interestingly, leptin may promote systemic and airway inflammation in stable COPD patients. On the other hand, COPD may upregulate systemic and lung adiponectin expression. The precise mechanism and significance of the associations between these adipokines and lung disease at the current stage are confusing and frankly paradoxical in places. It is now known that adipose tissue is not an inert organ simply for energy storage, but regulates systemic inflammation via a variety of secreted proteins (called adipokines). While the associations of obesity and adipokines with cardiovascular, endocrine, and rheumatological diseases are well described, the respiratory effects of obesity and adipokines are less well known. This review will focus on the effect of obesity and adipokines on asthma and chronic obstructive pulmonary disease (COPD) in humans. This area of research needs additional study that may open up novel therapeutic strategies for these lung diseases.Item Socio-economic dynamics of asthma.(2013-10) Kant, SuryaItem Spontaneous expulsion of foreign body from airway.(2008-05-09) Prasad, Rajendra; Kant, Surya; Verma, S K