Browsing by Author "Kaur, Navneet"
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Item Acute Kidney Injury in Dengue Fever: A One-year Hospital-based Prospective Cross-sectional Study(Association of Physicians of India, 2022-06) Batra, Nikhil; Kaur, Navneet; Pethekar, AkashBackground and objectives: Dengue fever is amongst the most cardinal arthropod-borne infection among humans. Around the world, an estimated 2.5 billion individuals are at peril of infection, of which approximately 975 million reside in urban areas of tropical and subtropical nations like Southeast Asia, the Pacific, and surprisingly Americas. Acute kidney injury (AKI) is so far not a well-studied dengue complication. The renal abnormalities, though not common, are AKI, proteinuria, glomerulonephritis, and hemolytic uraemic syndrome, which are considered complications of the disease. This study was designed to evaluate the prevalence of AKI in DF and find out the predictors of the development of AKI in patients with DI. Methodology: This one-year hospital-based cross-sectional study was performed in the Department of General Medicine, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala from March 2020 to April 2021. A total of 120 eligible patients with DI were enrolled. These patients were evaluated for AKI based on acute kidney injury network (AKIN) criteria. Results: The majority of the patients were males 57.5% and the male to female ratio was 1.35:1. Most of the patients were aged between 31 and 50 years (40.8%) and the mean age was 42.23 ± 16.28 years. The majority of the patients (72.5%) had DF, 13.3% of the patients had dengue fever with warning signs and 14.2% of the patients had severe dengue. The prevalence of AKI was 27.5% in patients with dengue fever. Other than AKI, Acute respiratory distress syndrome (ARDS) (11.7%), Multiple Organ Dysfunction Syndrome (MODS) (3.3%), and sepsis (0.8%) were the complications noted. The majority of the patients (83.3%) improved and were discharged and mortality was noted in 16.7% of the patients. Also, significant differences were noted in patients with and without AKI.Item Application of a stool antigen test to evaluate the burden of Helicobacter pylori infection in dyspepsia patients.(2016-01) Saha, Rumpa; Roy, Priyamvada; Das, Shukla; Kaur, Navneet; Kumari, Ankita; Kaur, Iqbal RajinderHelicobacter pylori (HP) is causally associated with peptic ulcer disease and gastric carcinoma. Determination of the prevalence of HP infection in dyspepsia patients’ in particular geographical area is imperative for the appropriate management of dyspepsia. HP antigen detection in stool is a noninvasive diagnostic test of HP infection. This prospective study was conducted to find out the prevalence of HP infection based on stool antigen testing in dyspeptic patients who had also undergone upper gastrointestinal (GI) endoscopy. This study highlights the high prevalence of HP infection in dyspeptic Indian patients, particularly males, and emphasizes the growing importance of the bacterium causing infection among children. We also found HP stool antigen testing to be superior to upper GI endoscopy for detecting HP infection. Hence, we recommend initial testing for HP stool antigen in dyspeptic patients before initiating treatment and before carrying out any invasive procedure such as endoscopy.Item Clinico-Cytological Spectrum Of Thyroid Mass Lesions Using FNAC And Corellating Biopsy.(2015-03) Chand, Nasib; Bedi, Sanjay; Kaur, Navneet; Gulati, Bhavna; Sharma, Jyoti; Bajwa, Dishvin; Garg, Laxmi NarayanAbstracts: Background: Fine needle aspiration technique generally applied, involves firm attachment of the aspiration needle to a syringe usually held in a specially designed syringe holder ie franzen’s handle, that enables single handed application of suction. The main aim of suction is to hold the cells against sharp cutting edge of the needle. It is the initial screening test for patients with thyroid lesions. Objective is 1) to find out diagnostic accuracy and role of fine needle aspiration cytology in the diagnosis of thyroid lesions, and to establish cyto-histopathological correlation. 2) to find out sensitivity, specificity, positive and negative predictive value, pitfalls and complications of fnac in the diagnosis of thyroid lesions. Methodology & Results: The present study was carried out on 110 patients presenting with thyroid lesions. FNA was conducted in cytology department of mmimsr mullana from July 2011 to Nov. 2013. In all cases, a thorough clinical examination including detailed history, general examination and local examination of thyroid gland was performed and findings recorded. FNA was performed in all cases without anesthesia keeping in view the clinical diagnosis. Equipments: included disposable syringe(10 ml), 2.5 cm long and 23-25 gauge disposable needles, Coplin jars , Cotton, and Clean glass slides. Chemicals and reagents included Spirit, Fixatives (alcohols) and Reagents for hematoxylin and eosin stain (H&E), Giemsa stain,and papanicolaou stain etc. Conclusion: FNAC is a well developed, cost effective and frequently used method carring low morbidity. It is also widely accepted as most accurate procedure to differentiate benign and malignant thyroid nodules and helps preoperatively in selecting patients for surgery. FNAC used together with other diagnostic modalities such as thyroid scanning, ultrasonography, thyroid hormone profile and antibody level measurements enhances diagnostic accuracy of the technique.Item A Comparative Study on Outcome of Amoebic Liver Abscess in Patients With and Without Alcoholic Liver Disease(All India Institute of Medical Sciences, 2022-03) Sharma, Kartik; Kaur, NavneetBackground: Amoebic liver abscesses (ALA) in the presence of Alcoholic liver disease (ALD) constitutes a high-risk group of patients who are prone to complications and may need more aggressive treatment. This study was aimed at evaluating disease course and outcomes in patients of ALA with ALD, in comparison to those without ALD. Material & Methods: This prospective observational study was conducted on 60 consecutive patients of ALA without ALD (Group-I) and 60 consecutive patients of ALA with ALD (Group II). Result: The patients ALA with ALD were older (47.2 ±13.3 years) than those without ALD (34.1±14 years). Mean size of the abscess cavity was significantly larger in patients with ALD (391.2± 208.7 cc in Group I and 594.3 ± 297.9 cc in Group II). In Group I, conservative management was most common (43.3%); while in Group II pigtail catheter insertion was the most frequently used modality of treatment (45%). Complications like empyema (6.6%), acute on chronic liver failure (8.3%) and impending liver failure (23.3%) manifesting as ascites and oedema were seen only in patients in Group II and they also had longer hospital stay. (4.87 days in Group I vs 8.37 in Group II). Conclusion: Patients of ALA with ALD have a more aggressive course of disease and should be managed with a lower threshold for abscess drainage.Item Evaluation Of Efficacy Of 0.2% Chlorohexidine Mouthwash As A Pre-Procedural Rinse In Reduction Of Streptococcal Colonies Following Ultrasonic Scaling: A Pilot Study.(2016-09) Arora, Sachit Anand; Chhina, Shivjot; Sahay, Divya; Puri, Gunjan; Kaur, Navneet; Bhardwaj, DeekshaObjectives: To evaluate the efficacy of chlorohexidine mouthrinse as a pre-procedural rinse in reducing streptococcal bacterial colonies.Study Design: A single-centre, double-masked, placebo-controlled randomised clinical trial conducted over a period of 15 days. 6 patients were included in the study, patients were first asked to rinse with the placebo (distilled water) for 1 minute before the scaling of control site followed by test site rinsing with chlorhexidine mouthwash for 1 minute. The microbial contamination was checked in the operatory, operator’s mouth mask, the patient’s chest, the operator’s chest and the patient’s breath with the help of agar plates. Results: The results revealed that there was statistically significant reduction in the Colony Forming Units (CFU's) formation. Paired sampled t test was used for checking the statistical significance, confidence interval (CI) was 95% and (p<0.05).There was statistical reduction in CFU's in breath sample, 30 minutes after scaling and less number of CFU’s were formed on the operator’s mask after the scaling of the patients with the use of chlorhexidine as the pre-procedural rinse compared to distilled water. Conclusion: The 0.2% chlorohexidine mouth rinse as a pre-procedural rinse has comparatively greater efficacy than distilled water in reduction of streptococcal colony forming units, however this finding was not statistically significant.[Sachit A NJIRM 2016; 7(5):46-52]Item Hormonal profile of survivors of breast cancer with fatigue: A pilot study(Wolters Kluwer – Medknow, 2023-04) Gupta, Shardool Vikram; Kaur, Navneet; Madhu, S.V.Background & objectives: One of the most common problems experienced by breast cancer survivors (BCSs) is fatigue. There has been little research about the status of hormones in breast cancer patients as an aetiology of cancer-related fatigue (CRF). Hence, a pilot study was conducted to assess the levels of hormones such as thyroid, cortisol, dehydroepiandrosterone sulphate (DHEAS), oestrogen and progesterone in BCSs with fatigue. Methods: BCSs with complaints of fatigue were assessed using the Brief Fatigue Inventory (BFI) tool and evaluation of the hormone profiles was done in moderate-to-severe fatigued survivors. Data collected were analyzed to look for any association between fatigue and altered hormonal levels. Results: In this study, 56 per cent (n=62) of survivors experienced moderate-to-severe fatigue out of 110 patients reporting fatigue. Thyroid functions were deranged in 22 patients (35.48%). The thyroid stimulating hormone (TSH) levels were found to have a significant negative association with the severity of fatigue, (P<0.05). Twelve patients (19.35%) had reduced DHEAS levels suggestive of impaired hormone synthesis in the adrenal gland. Twenty two postmenopausal survivors (35.48%) had raised oestradiol levels. Interpretation & conclusions: The findings of this study suggest that the hormonal milieu, especially thyroid hormone and DHEAS may have a role in CRF experienced by BCSs and needs further exploration.Item Improving outcome in patients of high output small bowel fistula.(2004-04-09) Kaur, Navneet; Minocha, Vivek Ratna; Mundu, MritunjayEarly and effective control of sepsis is the most important factor determining the outcome in patients with enterocutaneous fistulae (ECF). From a retrospective analysis of the hospital records (published data), ongoing contamination of the peritoneal cavity by the faecal stream was the most important factor leading to sepsis and occurred in 75% of patients. The mortality figure in patients with high-output ECF was 54.5% and in the presence of sepsis it was 63%. In an attempt to reduce these high mortality rates, we conducted a prospective study to evaluate the role of the routine use of ileostomy as an ancillary surgical procedure for diversion of the faecal stream in patients with high-output small bowel fistulae. Data were collected prospectively over a period of 3 years for 31 patients with high-output small bowel fistulae. On the appearance of the first signs of a leak, a laparotomy incision was opened in part or entirely and the abdominal collections were drained. Atthe time of exploration ileostomy was performed. There were 19 males and 12 females with a age range of 15-34 years (mean 30.1 years). All the fistulae were postoperative. Enteric fever was the most common aetiology (39%), followed by tuberculosis (35.5%). In 26 patients (84%), ileostomy could be done while 5 (16%) were received in moribund state and could not be operated on. Nine patients were operated on within 24 hours of the leak and 7 (77%) survived. Fifteen patients were operated on between 2 and 5 days, and 13 (87%) survived. The remaining 2 patients were operated on after 7 days of the leak and both died. All 5 patients who were not operated on died. The overall mortality in patients with high-output small bowel ECFwas 35.5%, which was significantly less than themortality figure of 54.5% in a similar group in our retrospective study. The mortality in patients undergoing ileostomy was 23%. In the postoperative period, surgical wound infection occurred in 100% of patients with partial or complete wound dehiscence. Two patients required secondary suturing while the remaining healed by secondary intention. Routine use of ileostomy for diverting the faecal stream in patients with high-output small bowel fistulae was effective in bringing down mortality rates.Item Large nodal metastases from carcinoid tumor causing bowel obstruction.(2003-03-17) Kaur, Navneet; Vijayaragavan, Paari; Aggarwal, SarlaA 39-year-old man presented with progressively increasing constipation and painful lumps in the abdomen. Exploration showed extensive nodal metastases but no primary lesion was seen. The masses were excised and sigmoid colostomy done. Histology revealed carcinoid tumor with small cell differentiation. A trial of chemotherapy gave no response. At follow up of 18 months he is leading a comfortable life with a colostomy and a billary stent in place (placed for obstructive jaundice due to porta node).Item Lateral sacral meningomyelocele as a gluteal swelling--an unusual presentation.(2005-10-28) Kaur, Navneet; Mishra, Satish Chandra; Vijayaragvan, Paari; Minocha, V RParavertebral meningoceles are rare examples of craniospinal dysraphism. A young boy presented with a cystic swelling over left gluteal region with lumbosacral scoliosis. On exploration, he was found to have a laterally placed sacral meningomyelocele. The presence of an unusually located meningocele should be suspected when a paravertebral mass is associated with neurological deficit or deformity of the spine.Item A needs assessment study of undergraduate surgical education.(2011-09) Kaur, Navneet; Gupta, Ankit; Saini, PradeepBackground. A needs assessment is the process of identifying performance requirements or ‘gaps’ between what is required and what exists at present. To identify these gaps, the inputs of all stakeholders are needed. In medical education, graduating medical students are important stakeholders who can provide valuable feedback on deficiencies in their training. Methods. To know the students’ perceptions about the effectiveness of their surgical training, an anonymous questionnaire seeking their opinion on the duration, content, methods of teaching and assessment was administered. Their responses were analysed using descriptive statistics. Results. The students were largely in favour of active methods of learning and there was very little preference for didactic lectures. For clinical teaching, involvement in ward rounds and patient care activities, in addition to case discussions, was considered to facilitate learning. A clerkship model of clinical training was favoured. Any teaching–learning activity in small groups of 8–10 students was preferred. As regards their evaluation, besides internal assessment, the students felt the need for direct constructive feedback from teachers on how to improve their performance. A large number (73.5%) were opposed to attendance being considered a qualifying criterion for taking the examination. Conclusion. Students’ feedback about their ‘perceived needs’ should be considered when revising training programmes.Item p16 promoter methylation, expression, and its association with estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 subtype of breast carcinoma(Wolters Kluwer India Pvt. Ltd., 2019-10) Goyal, Aditi; Sahu, Ram Krishna; Kumar, Mohit; Sharma, Sonal; Qayyum, Shariq; Kaur, Navneet; Singh, Usha Rani; Mehrotra, Ravi; Hedau, SureshObjectives: The purpose of the study is to investigate p16 protein expression and promoter methylation of p16 gene and their association with molecular subtypes based on parameter such as estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). Materials and Methods: A total of 114 breast cancer tissue biopsies were collected for methylation-specific polymerase chain reaction (MSP) and immunohistochemical (IHC) analysis. Results: Seven tissue microarrays were constructed. p16 protein expression was studied in 114 cases, of which 35/114 (30.7%) cases showed strong expression and the majority of them had ER-positive tumor (57.6%), and it was statistically significant (P < 0.0074). Similarly, p16 expression was reduced in the majority of PR-negative tumors (83.9%) and the association was statistically significant (P = 0.0026). p16 methylation was studied in 114 cases and was positive in 71.0% cases. Conclusion: High p16 protein expression was associated with ER-positive, PR-negative, and HER2-negative tumors which is associated with poor prognosis. p16 protein expression may be used as a prognostic indicator to predict treatment response to hormonal therapy.Item Paratubal Atypical Proliferative Serous Tumour in a Young Adolescent Female - A Diagnostic Dilemma(International Society for Contemporary Medical Research, 2020-03) Garg, Monika; Kaur, Navneet; Kaur, Kanwardeep; Kaur, Amrinder; ChandrikaIntrodcution: Paratubal atypical proliferative serous tumoursare rare usually arising from the mesothelium or from theremnants of mesonephric and paramesonephric ducts. Wepresent a rare case of paratubal borderline serous tumour in ayoung adolescent female presenting clinically as an omentalcyst.Case Report: A 14-year old unmarried female presentedwith abdominal pain in right iliac fossa. MRI revealed awell demarcated space occupying lesion in the pelvis almostin midline measuring 12x11x8cm. Lesion was abutting anddisplacing overlying bowel loops with likely adhesionssuggestive of complex omental cyst. The patient underwentcystectomy. The final histopathologic report confirmed thecyst as Paratubal atypical proliferative serous tumour.Conclusion: We experience a rare case of atypical proliferativeserous tumour of paratubal origin. The patient was youngestthan any of the other cases reported in the literature. Fertilitysparing surgery should be considered as a standard treatmentof borderline paratubal tumour, if patient desires futurefertility.Item Pattern of Pathological Lesions in Females of Age Less Than 30 Years Presenting With Palpable Breast Lump(Society for Health Care & Research Development, 2018-03) Kaur, Gurmanpreet; Kaur, Navneet; Walia, Darshanjit SinghBackground: Although breast cancer is extremely uncommon during childhood and adolescence, breast concerns and problems among females of this age group are a relatively common occurrence. Objective: The study is conducted to evaluate spectrum of lesions of breast in patients presenting with breast lump and evaluate role of FNAC in lesions of breast. Methods: In present study, fine needle aspiration cytology (FNAC) was done on hundred (100) female patients less than 30 years of age and these were later on operated and histopathology specimens were available for correlation. Results: Out of 100 patients 93% were benign and 7% were malignant. Fibroadenoma was most common present in 63% cases, fibrocystic disease in 11%, phyllodes tumor in 2 % cases, 2% of atypical cases, 1% as papilloma, 1% as mastitis, 7% as malignant. The sensitivity of FNAC was 85.7% specificity was 100%, accuracy was 99%. Conclusion: It was concluded from the present study that expertise of FNAC has reached high accurate levels, FNAC report can be of great value in young females presenting with breast lump.Item The Quantified Human Gracilis-A Guide to Improve Aesthetic and Functional Outcomes.(2015-07) Kaur, Navneet; Agnihotri, Gaurav; Sharma, RavikantBackground: A functioning gracilis muscle is considered the ideal flap to improve the functional/aesthetic outcome with minimal donor site morbidity. This graceful and slender muscle with special attributes is increasingly being used for covering soft tissue defects, repair of urogenital fistulas and restoration of anal function. Only some studies describing the quantification of this muscle are available and population attributes of the muscle have not been taken into consideration. The present study quantifies the human gracilis muscle in a North Indian population. Methods: The morphometry of gracilis was studied in 50 inferior extremities obtained from 25 phenol embalmed adult North Indian cadavers with known age and sex. The length and width of the aponeurotic origin, the length of the muscle belly, length of the distal tendon of insertion were measured. The muscle, tendon ratios were derived. Results: The mean estimates for various morphological features of gracilius muscle were standardized for North Indians. All the origins and insertions for the muscle correlated with the standard textbook descriptions. No variation was found from a standard textbook pattern in the present sample. The reconstructive procedures should take the local population profile into consideration. Conclusion: The results will aid the clinician in choosing an appropriate muscle and tendon lengths in surgeries. This definitely will lead to better functional and aesthetic outcomes in restorative procedures.Item Role of Non-stress Test and Vibroacoustic Stimulation Test in Prediction of Perinatal Outcome in High-risk Pregnancies(International Research Organization for Life & Health Sciences (IROLHS), 2020-04) Kaur, Navneet; Upasana; Sharma, SujataObjectives: The aim of the study was to evaluate the fetal well being by non-stress-test (NST) and vibroacoustic stimulationtest (VAST) in high-risk pregnancies, to assess the perinatal outcome, to study the ability of the VAST to convert a false-positive(non-reactive) NST to a reactive one.Materials and Methods: Atotal of 100 pregnant women with >32 weeks gestation having certain high-risk factors were subjectedto NST and if NST came out to be non-reactive, vibroacoustic stimulation was given with artificial larynx. Perinatal outcome wasassessed by various parameters (meconium stained liquor, Apgar score at 5 min, neonatal intensive care units admission). Theresults were analyzed by Chi-square test to find the association between NST, VAST results, and perinatal outcome.Results: It was found that VAST reduced the number of false-positive results by 31%. As compared to NST, VAST had lesssensitivity (78.05% vs. 80.48%), and better specificity (95.08% vs. 83.61%), better positive predictive valve (91.43% vs. 82.35%)in predicting perinatal outcome.Conclusion: The addition of vibroacoustic stimulation to the NST reduced significantly the number of non-reactive tests. NSTwhen reactive does represents a satisfactory indicator for fetal well-being but non-reactive test needs further evaluation beforeany active intervention.Item Streptococcus pneumoniae: An unusual and forgotten pathogen in neonatal sepsis.(2016-10) Arora, Shilpa; Kaur, Navneet; Galhotra, Shipra; Jindal, NeerjaItem A Study of Comprasion of Conventional Cytology with Liquid Based Cytology of Thyroid FNAC – A Study of 100 Cases(Society for Health Care & Research Development, 2018-03) Kaur, Navneet; Poonam; Singh, Harpal; Garg, Puneet; Gupta, R. K.; Kundal, Ramesh Kumar; Chawla, Inderjit; Kundal, ShivanshuBackground: Fine Needle Aspiration (FNA) cytology of the thyroid has been increasingly utilized for the investigation of thyroid lesions. FNA of the thyroid gland is considered to be most cost effective and accurate primary diagnostic procedure for thyroid nodules. In the recent years many approaches has been devised to improve the quality of thyroid FNA cytology because the conventional smear (CS) is subject to error in sample collection and slide preparation. The liquid based cytology (LBC) originally developed for the application of gynaecologic cervical smears, has progressively gained for application of both non gynaecologic and fine needle aspiration cytological material. According to the Wilcoxon signed ranked test for thyroid lesions LBC was not useful in goitre and infectious lesions. It gave better results in anaplastic and medullary carcinoma. So conventional smear is more sensitive, specific and accurate than LBC. Methods: in this prospective study, we had 100 cases of thyroid. In each case, two passes were performed. The first pass was for CS and the second pass yielded material for LBC. Both CS and LBC smears were compared for cellularity, background blood and necrotic cell debris, cell architecture, informative background, presence of a monolayer of cells and nuclear and cytoplasmic details and test on an for statistical analysis. Results: Diagnostic accuracy was better in CS compared withLBC smears as CS was most sensitive (93.18%) and accurate (91.75%) method for analysis of thyroid while LBC method is sensitive (89.04%) and accuracy (86.59%).Conclusion: Conventional smear is more sensitive, specific and accurate than LBC because LBC introduce more cytological artifacts to thyroid aspirates.Item A study of maternal outcome in first trimester bleeding(Medip Academy, 2020-05) Bala, Neerupham; Kaur, Navneet; Shifali, Anand; Wakhloo, Ajay; Tabassum, NaziaBackground: The outcome of first trimester vaginal bleeding is a matter of debate. Vaginal bleeding is common and potentially alarming symptom in early pregnancy. First trimester bleeding is a common occurrence. It has been estimated to occur in 15-25% of all pregnant women. Objective of this study was to evaluate the various maternal outcomes in women with first trimester bleeding.Methods: This prospective observational study was conducted in the postgraduate department of obstetrics and gynecology, SMGS Hospital, Government Medical College, Jammu, Jammu and Kashmir, India. The study included 200 pregnant women presented with first trimester bleeding. All the women were followed prospectively till delivery and early postpartum period for various outcomes such as preterm delivery, PROM, PPROM, anemia, oligohydramnios, placental abruption, placenta previa and postpartum hemorrhage.Results: Out of 200 patients studied, 19% patients aborted. Ectopic and molar pregnancy was seen in 5% and 1.5% patients respectively. Out of 74.5% patients who continued pregnancy, maternal complications included anemia (52%), PROM (14.09%), oligohydramnios (6.71%), placenta previa (5.37%), PPH (4.03%), PPROM (2.68%), preeclampsia (2.01%), gestational hypertension (1.34%), abruption and post-datism (0.67% each).Conclusions: From the results of this study, it can be concluded that first trimester bleeding can be a predicting factor in terms of mother and infant consequences of pregnancy and it is necessary to increase the knowledge of pregnant women in this regard for closer care.Item A Study To Assess The Effectiveness Of Assertiveness Training On Level Of Assertiveness Among Staff Nurses Working In Tertiary Care Hospital, Ludhiana, Punjab.(World Wide Journals, 2018-04) Kaur, Dilpreet; Thapar, Kanika; Kaur, NavneetItem A Study To Assess The Effectiveness Of Therapeutic Communication Training On Knowledge Of Staff Nurses Working In Tertiary Care Hospital, Ludhiana, Punjab.(World Wide Journals, 2018-04) Kaur, Bhupinder Jit; Thapar, Kanika; Kaur, Navneet