Browsing by Author "Agarwal, S K"

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    The 1996 outbreak of dengue hemorrhagic fever in Delhi, India.
    (1998-09-07) Anuradha, S; Singh, N P; Rizvi, S N; Agarwal, S K; Gur, R; Mathur, M D
    A major outbreak of dengue hemorrhagic fever (DHF) affected more than 10,000 people in Delhi and neighboring areas in 1996. The outbreak started in September, peaked in October to November and lasted till early December. The clinical and laboratory data of 515 adult patients admitted to Lok Nayak Hospital, New Delhi were reviewed. Fever (100%), myalgias and malaise (96%), abdominal pain (10.2%) and vomiting (8.7%) were the prominent presenting features. Hemorrhagic manifestations were seen in all patients- a positive tourniquet test (21.2%), scattered petechial rash (23.07%), confluent rash (2.7%), epistaxis (38.4%), gum bleeds (28.06%) and hematemesis (22.86%) being the major bleeding manifestations. Hepatomegaly was observed in 96% of the patients. Laboratory investigations revealed thrombocytopenia, hemoconcentration and leukopenia. Serological confirmation with a microcapture ELISA technic was done in 143/515 patients. The mortality rate was 6.6% and, multiple bleeding manifestations, severe thrombocytopenia, hypoproteinemia and dengue shock syndrome (DSS) were associated with a higher mortality.
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    The 2003 outbreak of Dengue fever in Delhi, India.
    (2005-09-28) Singh, N P; Jhamb, Rajat; Agarwal, S K; Gaiha, M; Dewan, Richa; Daga, M K; Chakravarti, Anita; Kumar, Shailesh
    Dengue fever (DF) and Dengue hemorrhagic fever (DHF) are widespread in Southeast Asia. An outbreak of DF/DHF in Delhi in 2003 started during September, reached its peak in October-November, and lasted until early December. This study describes the clinical and laboratory data of the 185 cases of DF/DHF admitted to Lok Nayak Hospital, New Delhi. The mean age of the patients was 26 +/- 10 years. Fever was present in all the cases with an average duration of fever being 4.5 +/- 1.2 days with headache (61.6%), backache, (57.8%), vomiting (50.8%) and abdominal pain (21%) being the other presenting complaints. Hemorrhagic manifestations in the form of a positive tourniquet test (21%), gum bleeding and epistaxis (40%), hematemesis (22%), skin rashes (20%) and melena (14%) were also observed. Hepatomegaly and splenomegaly were observed in 10% and 5% of cases, respectively. Laboratory investigations revealed thrombocytopenia (with a platelet count of < 100,000/microl) in about 61.39% of cases, Leukopenia (WBC <3,000/mm2) and hemoconcentration (Hct >20% of expected for age and sex) were found in 68% and 52% of the cases, respectively. The mortality rate was 2.7%. Despite widespread measures taken to control outbreaks of DF, it caused major outbreaks. More stringent measures in the form of vector control, improved sanitation and health education are needed to decrease morbidity, mortality and health care costs caused by a preventable disease.
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    Aetiological profile of overt hypothyroidism in Indian population.
    (1991-10-01) Jangid, D R; Agarwal, S K; Jangid, V; Ram, B K
    We analysed the aetiology of hypothyroidism in 144 patients. In these hospital referral data, thyroid surgery and decompensated iodine deficiency were the major known causes of hypothyroidism (19.5% and 15.3% respectively), while in the majority of patients (45.14%) the aetiology was obscure. The idiopathic group had patients who were significantly younger (p less than 0.01), showed a gland size between 2 and 3 SD ranges in significantly higher preponderance (p less than 0.05), and presented with generally higher prevalence rates of signs and symptoms; however, only menstrual disturbances (p less than 0.01), loss/reduced appetite (p less than 0.01) and dry/thickened hair (p less than 0.25) reached statistical significance. Since hypothyroidism has definite and substantial morbidity, these results are of importance to public health and medical personnel for a Bayesian approach to the aetiological diagnosis of hypothyroidism and for ordering specific confirmatory laboratory investigations.
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    Anaphylaxis in pediatric practice.
    (1977-10-01) Agarwal, S K; Saha, K
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    Angiotensin and its inhibition: a nephrologist point of view.
    (2002-10-06) Kalra, V; Agarwal, S K; Wani, M
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    Appendicetomy. A surgicopathological study of 100 cases.
    (1968-07-16) Agarwal, S K; Nan, A K
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    Asymptomatic bacteriuria in school children at Lucknow.
    (1977-11-01) Rathi, A K; Agarwal, S K; Tulani, M K; Bajpai, P C
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    Asymptomatic bacteriuria in school children.
    (1977-07-01) Srivastava, V K; Agarwal, S K; Rathi, A K
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    Asymptomatic proteinuria in children: a functional and subcellular study.
    (1977-08-01) Rathi, A K; Bajpai, V K; Agarwal, S K; Shipstone, A C; Bajpai, P C
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    Ataxia and deafness in a young male: an unusual aetiology.
    (2006-12-23) Prakash, A; Singh, N P; Sikdar, S; Singh, A K; Agarwal, S K
    We report here a case of 18 year old male with tremors of hands, deafness, tendency to fall while walking, drowsiness and double vision of total duration 1(1/2) years. He had internuclear ophthalmoplegia, broken saccades, hypertonia and hyperreflexia of all four limbs, intention tremors, signs of gait and limb ataxia. Pupillary reactions and fundus examination were normal and signs of meningeal irritation or sensory neurological deficit were absent. MRI head and cervical spine with gadolinium enhancement revealed demyelination as evident from multiple oblong foci isointense on T1-weighted images and hyperintense on T2-weighted and fluid attenuated inversion recovery sequences in corpus callosum, sub-cortical white matter, right thalamus, pons and periaqueductal region of midbrain. Ill-defined linear hyperintense signals were observed in cervical spinal cord. No skeletal abnormality was noted in the skull or cervical spine. Oligoclonal bands were present in the cerebrospinal fluid. Brainstem auditory evoked potentials were abnormal, although visual evoked potentials were in normal range. A diagnosis of primary progressive multiple sclerosis (PPMS) was made fulfilling the revised criteria as laid down. In view of its presentation, it is a unique case of PPMS from India.
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    Auxotyping of Neisseria gonorrhoeae as an additional epidemiological marker.
    (1992-09-01) Agarwal, S K; Deb, M; Prakash, K; Sharma, A K
    Auxotypes and penicillin sensitivity of 102 strains of N. gonorrhoeae were studied. Ten distinct auxotypes on the basis of growth requirement to seven amino acids were observed. The commonest pattern seen was zero auxotype (33.3%), followed by auxotype requiring proline (18.6%). MIC of 72 (71.5%) strains ranged from < 0.003 IU/ml to 0.062 IU/ml of benzyl penicillin. MIC of the other 30 (29.5%) strains was found to be > or = 0.125 IU/ml, indicating penicillin resistance. None of the strains were penicillinase producers. A case of reinfection was also detected on the basis of change in auxotype pattern.
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    Barium sulfide poisoning.
    (1986-02-01) Agarwal, S K; Bansal, A; Mani, N K
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    Beta-thalassemia major surviving till 20 years without transfusion (a case report).
    (1981-05-01) Gupta, R K; Singh, T; Agarwal, S K; Dewan, R; Misra, R C
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    C-reactive protein in early detection of neonatal infection.
    (1987-11-01) Misra, P K; Kumar, R; Malik, G K; Agarwal, S K; Mehra, P
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    Candidemia--an under-recognized nosocomial infection in Indian hospitals.
    (2005-07-30) Sahni, V; Agarwal, S K; Singh, N P; Anuradha, S; Sikdar, S; Wadhwa, A; Kaur, R
    OBJECTIVE: To study the occurrence of candidemia as a nosocomial infection in a large Indian teaching hospital and to evaluate the predisposing factors for development of such infections. METHODS: One hundred and one hospitalized patients that developed signs and symptoms of nosocomial bloodstream infections were screened for candidemia and were analyzed for the various predisposing factors like the age of the patient, the duration of hospitalization before the development of fever, neutropenia, use of chemotherapeutic agents, central venous catheters, broad spectrum antibiotics, infection with HIV, diabetes mellitus, use of corticosteroids, administration of total parenteral nutrition, haemodialysis, use of mechanical ventilation, hematological or other malignancies, underlying disease, and any surgical procedure performed on the patient. Candidemic patients were followed up for outcome and the effect of nosocomial candidemia on mortality was assessed and analyzed statistically. RESULTS: Out of the 101 patients, seven patients had candidemia, an incidence in study population of 6.9%. Three (42.8%) were infected with albicans and the rest with non-albicans candidemia. All the patients with candidemia were admitted in the Intensive Care Units. Amongst the risk factors, the length of hospitalization (p = 0.018), broad-spectrum antibiotics (p = 0.045), central venous catheters (p = 0.005), mechanical ventilation (p = 0.0139) and total parenteral nutrition (p = 0.001) were found to be significantly related to acquisition of nosocomial candidemia. Mortality in the candidemic patients was influenced only by the age of the patients (p = 0.001). Although the mortality amongst the candidemic patients was twice as much as that of the patients not having this infection, still the difference did not reach significance (p = 0.117). CONCLUSION: Candidemia is an important problem in Indian hospitals. Diagnostic delays could be shortened by more active screening for candidemia especially in the intensive care settings. The rising incidence of non-albicans candidemia in the United States probably is true here as well. There should be a concerted effort to control known risk factors especially in intensive care units.
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    Carboline antifilarials: effects on carbohydrate metabolising enzymes in Litomosoides carinii female.
    (1994-06-01) Bose, C; Agarwal, S K; Chatterjee, R K; Srivastava, V M
    Two antifilarial compounds, viz., 90/55 (7-oxo-1-phenyl-8, 14-dihydropyrido (3,4-b) imidazo (1,2-c) quinazolo (4,5-g) and 87/639 (6-Nitro-1-phenyl-9H-pyrido (3,4-b) indole at 0.5 and 2.0 micron concentrations substantially inhibited glucose uptake and increased lactate production by L. carinii during in vitro incubation for 2 hr. The treated parasites, showed increased activities of glycogen phosphorylase, phosphofructokinase and pyruvate kinase. Hexokinase and fumarate reductase activities level in the worms were significantly lowered. Therefore it appears that both the compounds kill adult L. carinii by interfering with its carbohydrate metabolism.
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    The cardiovascular and hemodynamic effects of erythropoietin in chronic renal failure.
    (2000-03-07) Singh, N P; Chandrashekhar,; Nair, M; Anuradha, S; Kohli, R; Agarwal, S K
    OBJECTIVE: Left ventricular hypertrophy (LVH) has been identified as an independent risk factor for mortality in patients with chronic renal failure (CRF) and anemia has been proposed to contribute to LVH. The cardiovascular and hemodynamic effects of correction of anemia with recombinant human erythropoietin (rHU EPO) was assessed in a 12 week prospective study in patients with CRF. METHODS: Biochemical parameters and echocardiography were studied at the start and after three months therapy with EPO in 24 patients with CRF--11 predialysis (Group I) and 13 dialysis (Group II). RESULTS: The mean haemoglobin (Hb)--g/dl increased significantly from 7.5 +/- 1.0 to 10.1 +/- 1.1 in group I and from 6.7 +/- 0.6 to 9.4 +/- 0.8 in group II (p < 0.05) on EPO therapy. The left ventricular mass index (LVMi)--g/m2 reduced significantly from 185.6 +/- 44.6 to 158.3 +/- 4.1 in group I and from 158.0 +/- 26.9 to 131.6 +/- 22.1 in group II (p < 0.05 in both). The interventricular septal thickness (IVST) also showed a significant decline in both groups, 1.17 +/- 0.06 to 1.14 +/- 0.05 (group I) and 1.09 +/- 0.25 to 1.01 +/- 0.21 (group II), p < 0.05 in both. The thickness of the left ventricular posterior wall remained unchanged. The left ventricular end diastolic and systolic diameters (LVEDD and LVESD) significantly reduced from their baseline values in both the groups (p < 0.05). The diastolic filling parameters across the mitral valve remained unchanged in both the groups. The cardiac index (CI)--L/min/m2 decreased from 3.53 +/- 0.3 to 3.03 +/- 0.27 in group I and from 3.31 +/- 0.64 to 2.80 +/- 0.60 in group II (p < 0.05) and the total peripheral resistance (TPR)--dynes/cm5/sec increased from 1567 +/- 164.8 to 1883 +/- 190.7 in group I and from 1618 +/- 375.7 to 2004 +/- 437.3 in group II. The differences in all the parameters at the start and after 3 months of EPO were comparable in groups I and II. The mean arterial pressure (MAP) changed insignificantly in both the groups. CONCLUSIONS: To conclude, this study has shown that the decrease in LVMi with EPO reflects the role of anemia in the genesis of LVH and that the correction of anemia with EPO in CRF results in regression of LVMi and has a favourable effect on cardiovascular hemodynamics.
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    Changes in serum triiodothyronine, thyroxine, estradiol-17 beta, progesterone levels and egg production in hypocholesterolemia induced Japanese quails Coturnix coturnix japanica.
    (1996-10-01) Shambharkar, A V; Varshney, V P; Agarwal, N; Agarwal, S K; Sanwal, P C; Pande, J K
    Mature healthy female Japanese quails injected (i.p.) with gemfibrozil at two dose levels for 1,2,3 and 4 weeks induced hypocholesterolemia as observed by the serum cholesterol concentration which was more severe with the higher dose. Liver and ovarian cholesterol contents decreased in 3rd and 4th week of the treatment. Significant (P > 0.05) increase in serum triiodothyronine (T3) and thyroxine (T4) level were observed between 3rd and 4th week while serum estradiol-17 beta and progesterone levels declined continuously from Ist week till the termination of the treatment. The quantity and quality of the eggs produced by the treated quails were inferior. These results indicate that induction of hypocholesterolemia impaired the reproductive efficiency of quails.
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    Chronic suppurative otitis media in children.
    (1979-10-01) Srivastava, V K; Agarwal, S K; Malik, G K
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    Cimetidine in the treatment of duodenal ulcer.
    (1981-09-01) Misra, R C; Gupta, B B; Agarwal, S K; Gupta, P S