Browsing by Author "Agrawal, N"
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Item Can ranitidine induce porphyria.(1988-03-01) Pratap, D; Agrawal, N; Arya, T VItem Correlating lipid profile with age, gender, and body mass index of patients with type 2 diabetes mellitus: A single-center prospective study(International Journal of Medical Science and Public Health, 2019-04) Rana, S; Singh, A; Agrawal, NBackground: Diabetes mellitus is a group of metabolic disorder characterized by chronic hyperglycemia with disturbances in carbohydrate, fat, and protein metabolism due to defects in insulin secretion, insulin action, or both. Diabetic dyslipidemia is characterized by increases low-density lipoprotein cholesterol (LDL-C), decreased high-density lipoprotein cholesterol (HDL-C) level, and elevated triglyceride (TG) levels. Objectives: The objectives of this study were to correlate the lipid profile with age, gender, and body mass index (BMI) of type 2 diabetes mellitus (T2DM) patients. Materials and Methods: A total of 76 T2DM patients were studied at Diabetes, Obesity, and Thyroid Center, Gwalior, Madhya Pradesh, between May 2016 and May 2017. After detailed demographic details including age, sex, weight, height, and BMI, total cholesterol (TC), TG, LDL-C, very LDL-C (VLDL-C), and HDL-C were estimated for all the patients. Results: The mean age of diabetes patients was 54.80 ± 11.07 years. The mean duration of diabetes was 5.38 ± 4.90 years. Lipid profile of T2DM patients was similar across the different age and BMI groups (P > 0.05). Except HDL-C (P < 0.001) which was significantly low among males other lipid parameters such as TC, TG, LDL-C, and VLDL-C were comparable between genders (P > 0.05). TC, TG, LDL‑C, and VLDL-C were showed positive correlation with fasting plasma glucose and postprandial glucose, whereas HDL-C showed negative correlation (P > 0.05). Conclusion: There was no significant difference in TC, TG, HDL-C, LDL-C, and VLDL-C level between different age and BMI groups. We found a significantly lower HDL-C level among the male population.Item Effectiveness of 12 weeks of practice of heartfulness meditation on depression, anxiety, stress, and cognitive functions in Type 2 diabetic patients(Mrs Dipika Charan of MedScience (India) Publications, 2023-04) Agrawal, N; Kote, N; Parapurath, S; A, R; Goothy, SSK; Choudhary, A; Chouhan, RS; Awasthi, PP.Background: Regular practice of heartfulness meditation causes a balanced mental state and releases stress. Due to this action, meditation can improve the cognitive functions of individuals. Aims and Objectives: The study determines the effectiveness of 12 weeks of practice of heartfulness meditation on depression, anxiety, stress, and cognitive functions in Type 2 diabetic patients. Materials and Methods: The study involved 40 patients with Type 2 diabetes including both males and females and age groups from 30 to 60 years. After recruiting, the participants were randomly divided into two groups with 20 participants in each group. All the participants of Group 1 were given training about practicing heartfulness meditation for initial 3 days. From then, they started practicing meditation under the supervision of experts from 6:30 to 7:30 am in the morning. Outcome measures were recorded by standard tools. Results: Significant decrease was observed in the depression, anxiety, and stress scores and significant improvement in spatial and verbal memory was observed. Conclusion: Heartfulness meditation practice has a positive impact on the management of psychological disorders and improving cognitive functions. There is a need for a detailed study.Item Evaluation of oxidative stress before and after haemodialysis in chronic renal failure.(2000-10-24) Chugh, S N; Jain, S; Agrawal, N; Sharma, AOBJECTIVE: To evaluate the oxidative stress before and after haemodialysis in chronic renal failure patients. METHODS: A prospective study comprising of 22 patients of CRF who have to receive their first haemodialysis. All patients were subjected to standard four hours haemodialysis. The parameters of oxidative stress i.e. erythrocyte malonaldehyde (MDA), reduced glutathione (GSH) and superoxide dismutase (SOD) were measured before and after haemodialysis. RESULTS: The value of mean erythrocyte MDA (9.40 +/- 3.36 mumol/L) and SOD (617 +/- 64.33 units/ml) were significantly higher in patients of CRF before haemodialysis than in controls (p < 0.001). The mean GSH levels were significantly lower (451 +/- 63.91 micrograms/ml) in patients than in controls before haemodialysis (p < 0.001). After haemodialysis MDA levels further increased (12.27 +/- 4.38 mumol/L), SOD levels decreased (458 +/- 69.58 EU/ml) and GSH levels further decreased (396 +/- 41.41 micrograms/ml) (p < 0.001). CONCLUSIONS: There was an evidence of oxidative stress in patients of CRF before haemodialysis which increased further after haemodialysis, the mechanisms of which is not delineated. The procedural factors may be contributing in the increased oxidative stress after haemodialysis.Item Light chain myeloma: A brief report from India(Indian Association of Pathologists and Microbiologists, 2019-09) Singh, N; Agrawal, N; Sekhri, R; Mehta, A; Kumar, D; Vishwakarma, G; Ahmed, R; Bhurani, DLight chain myeloma (LCM) has a reported worldwide incidence of approximately 15%–20% among all multiple myeloma (MM) patients. Few western studies have shown strong correlation of LCM with anemia, higher International Staging System scores, proclivity to renal failure, elevated lactate dehydrogenase levels, raised serum-free light chain ratio, higher frequency of extramedullary plasmacytomas, and poorer overall survival, attributable probably to lack of differentiation and skeletal destruction. The primary aim of this retrospective observational study was to define the clinical and hematological characteristics as well as prognostic outcome of Indian LCM patients in comparison with the IgG and IgA subtypes. Patients were defined according to the International Myeloma Working Group diagnostic criteria 2016 and staged as per the International Staging System. Out of 104 patients of newly diagnosed MM in which results of serum immunofixation (IFE) were available, 65 were of IgG isotype (62.5%), 15 had IgA (14.4%), and 24 had light chain myelomas (LCMs) (23.1%). It was observed that LCM patients significantly correlated with hypercalcemia and higher serum-free light chain ratios, whereas IgA patients were strongly associated with anemia and lower serum albumin levels. However, no difference was found among the three subgroups in terms of serum lactate dehydrogenase levels, proclivity to renal failure, presence of lytic bone lesions, prognostic scoring, pretransplant chemosensitivity, and progession-free survival (1 year). Thus, it may be concluded that Indian LCM patients have significantly different clinico-hematological profile in comparison with other published studies worldwide. Also, their prognostic outcomes are not worse when compared with patients of other protein isotypes, probably due to standardized treatment regimens applied.Item Occupational Exposure to Needle Stick Injuries among Health Care Workers in a Tertiary care hospital: A KAP study(MRI Publication Pvt. Ltd., 2022-06) Agrawal, T; Agrawal, N; Gupta, V; Patel, BB.Background: Needle stick injuries (NSIs) are serious occupational health problem related to accidental exposure of health care workers (HCWs) while involved in patient care services. The percutaneous exposure to potentially contaminated blood and body fluids with blood borne pathogens are responsible for significant prevalence of Hepatitis B, C & HIV infections amongst HCWs. Methods: This is a descriptive cross sectional study conducted in hospital settings over a period of one year. 178 HCWs were selected for study using systematic random sampling after proportional allocation for each professional category in the hospital. Collected data was processed on SPSS ver 24. The association between needle stick and associated factors were measured using the odds ratio at a 95% confidence interval. The statistical significance was made at a p-value of less than 0.05. Results Total of 62 incidences of sustaining a needle stick injury in a year was recorded amongst 178 HCWs. In this study, statistically significant results with p value less than 0.05 was obtained with association with variables like gender [AOR=1.36 (0.64 - 2.68)], experience in years as HCWs [AOR=1.23 (0.32 - 2.12)], profession [AOR=0.063 (0.001- 0.43)], observance of universal precautions as wearing gloves [AOR=0.33 (0.169 – 0.631)] or any training on PEP or universal precautions [AOR=2.29 (1.320 - 4.696)]. Conclusion: NSIs have the potential to affect the health system both directly and indirectly. To lessen the dangers and impacts of NSIs stringent training should coordinate the endeavors toward preparing of health care workers, utilization of wellbeing designed gadgets, and diminishing patient burden per health care workers.Item Role of multidetector CT virtual bronchoscopy in the evaluation of post-tracheostomy tracheal stenosis--a preliminary study.(2003-09-09) Joshi, Anagha R; Khanna, P C; Merchant, S A; Khandelwal, A; Agrawal, N; Karnik, N DAIM: To study the technique and utility of virtual bronchoscopy (virtual reality endobronchial simulation, VRES) as a tool to evaluate post-tracheostomy tracheal stenoses and to correlate the findings of virtual and invasive bronchoscopy and to follow-up treated lesions or those currently under treatment that were initially diagnosed with VRES. METHODOLOGY: This prospective study comprised nine patients in the age group 13 to 65 years presenting with breathlessness and stridor following one or multiple tracheostomies. They underwent plain CT using a multidetector CT (MDCT) scanner (Siemens Volume Zoom) using narrow (1 mm) collimation. These thin slice images were post-processed using an Irix-based workstation with a 'Fly-Through' endoscopy application. These patients also underwent a rigid (three patients) or fiberoptic (six patients) bronchoscopy. RESULTS: Of the nine patients that underwent VRES, five were found to have stenoses, three had obstructing granulation tissue, one had an obstructing membrane and one had synechiae. The invasive bronchoscopic findings supported the VRES diagnosis in all but one case of stenosis, one of granulation tissue and the case with synechiae. Membranes and synechiae were relatively difficult to diagnose without the corresponding axial and multiplanar images. VRES achieved a higher sensitivity, while invasive bronchoscopy a higher specificity. CONCLUSIONS: VRES proved to be comparable to invasive bronchoscopy in the depiction of post-tracheostomy tracheal stenoses, with a notable advantage in critical stenoses in that the airway distal to the stenosis could be assessed with VRES but not with invasive bronchoscopy. A preliminary VRES was found to be of assistance in the selection of patients for the more invasive therapeutic procedures such as laser ablation of granulation tissue and its follow-up.Item A study on estimate of Iodine Deficiency Disorders and adequacy of Iodized Salt Consumption in Begusarai district of Bihar, India(Indian Association of Preventive and Social Medicine, 2019-03) Kumar, P; Agrawal, N; Ranjan, A; Lohani, P; Nirala, S; Pandey, S; Singh, CMBackground: Iodine Deficiency Disorder is major public health problem causing increased perinatal mortality, mental retardation and goiter and all these morbidities are preventable. Most effective and inexpensive mode to prevent IDD is consumption of iodized salt. Objectives: To estimate the proportion of households using adequately iodized salt in Begusarai district, to assess the knowledge of households on consumption and storage of salt and to estimate Total Goitre Rate (TGR). Material and Methods: Community- based cross sectional study carried out on 412 household from 30 cluster in Begusarai district using cluster sampling technique. Children (6-12 years) were examined clinically for goitre status and sample of household salt was collected for testing iodine content. Iodine content estimation was done both quantitatively by titration and qualitatively by MBI kit. Statistical analysis was performed using SPSS version 22. Result: The respondents were mainly female (92.8%) of mean age 34 years. Three- fifth (61.6%) participants used packaged crushed salt for cooking purpose, followed by packaged crystal (30.5%). Only 12.1 % of the respondents gave affirmative answer for presence of label and logo. Storage of salt in container with lid was 78.5%. The proportion of household using adequately iodized salt was 78%. The sensitivity MBI kit was 61% and the Total goiter rate was 9.3%. Conclusion: The Begusarai district falls in mild public health problem for IDD as TGR is more than 5% and even after many decades of effort towards achieving an adequately salt iodization of more than 90%, it is 79% only.Item Tuberculous thyroiditis.(1999-03-22) Singh, S; Agrawal, J K; Kumar, M; Agrawal, N; Gupta, A; Srivastava, S KItem Types of Rotavirus Causing Acute Diarrhea among Children in Western India, their Demographic Pattern and Disease Severity.(2014-07) Mohanty, N C; Agrawal, N; Kadam, N N; Shamim, A; Thakur, MBackground: Rotavirus infection is a major cause of severe acute gastroenteritis among infants and children all over the world1 with winter out-breaks of diarrhea in temperate and cooler parts almost round the year. However, this varies in different part of India.2-6 Diarrhea is a major cause of under-5 mortality, contributing to approximately over 1,50,000 infant deaths in our country per year.15,16 Different genotypes have been identified and many more are emerging by way of mutation, genetic shift and genetic drifts. Rotavirus are classified antigenically as A (Most common), B, C, D, E by ELISA and genotypically as G (1 through 12) and P (1 through 8) by Reverse Trans criptase PCR, in combinations. Materials and methods: Stool samples of 110 infants and children from 6 to 60 months of age, with suspected viral diarrhea over one year period were studied for serotypes and genotypes; and compared for their respective disease severity. Results: Thirty-four percent were found positive for Rotavirus-A by ELISA. Of the positive, 33.4% were found to be of G9 genotype, much higher than reported from other parts of the country. On the other hand, merely 13.6% of G1 and G4 each were detected, contrary to high prevalence elsewhere. On electro-pherotyping, the long-arm types were associated with more severe disease (64.6% showing moderate to severe dehydration) than their short-arm types (Only 16.6% showed moderate dehydration only) p < 0.009. No difference in incidence of severe dehydration between AD positive for Rotavirus (11.7%) and those found nega tive (11.8%), presumably due to other viruses, after excluding invasive diarrhea. Conclusion: Emergence of diverse strains, i.e. more of G9 and G12 genotypes than earlier reports of G1 and G2 types indicate considerable genetic shift in the region. Such trend could have significant implication on degree of seroconversion from currently used live vaccines, using G1 or bovine reassortant G1-3 strains only, seen in recent studies from Africa and Malayi.29 Contrary to claims that Rotavirus diarrhea usually threatened severe diarrhea, no significant difference in incidence of severe diarrhea was observed between Rotavirus positive and Rotavirus negative acute diarrhea.Item Utility of morphologic assessment of bone marrow biopsy in diagnosis of lysosomal storage disorders(Wolters Kluwer - Medknow, 2023-03) Nishith, N; Siddiqui, SH; R. Raja, S K; Agrawal, N; Phadke, S; Sharma, S.Introduction: Lysosomal storage disorders (LSDs) are rare disorders and pose a diagnostic challenge for clinicians owing to their generalized symptomatology. In this study, we aim to classify LSDs into two broad categories, namely, Gaucher disease (GD) and Niemann–Pick/Niemann–Pick-like diseases (NP/NP-like diseases) based on the morphology of the storage cells in the bone marrow (BM) aspiration smears and trephine biopsy sections. Materials and Method: This retrospective study includes 32 BM specimens morphologically diagnosed as LSDs at our institute, in the last 10 years. Subsequently, they were subclassified into GD and NP/NP-like diseases. Further, we have compared and analyzed the clinical, hematological, and biochemical parameters for the two groups of LSDs. Results: Based on BM morphology, 59.4% (n = 19) cases were diagnosed as NP/NP-like diseases and 40.6% (n = 13) cases as GD. Abdominal distension and failure to thrive were the most common clinical manifestations in both groups of LSDs. Anemia and thrombocytopenia were frequently seen in either of the LSDs. On the assessment of metabolic profile, elevated total/direct bilirubin and liver enzymes were more commonly seen in NP/NP-like diseases when compared with GD. Conclusion: We have classified LSDs into GD and NP/NP-like diseases based on the morphology of the storage cells in the BM specimen. The hallmark findings on BM biopsy annexed with the comparative features of the two proposed categories can aid the clinician in clinching the diagnosis. Formulation of such a methodology will prove instrumental for patient care in an underresourced setting.