Browsing by Author "Bhardwaj, Vinay"

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    A comprehensive review of 53 gynae surgeries on the versius robotic system in a tertiary care hospital
    (Medip Academy, 2024-01) Manchanda, Rahul; Mirza, Hera; Iqbal, Mona; Bhardwaj, Vinay
    Background: Robotic-assisted surgery has attained widespread acceptance within clinical practice, emerging as the definitive standard for various medical indications. Within the realm of Gynae surgery, there has been a notable upsurge in the utilization of robotic and laparoscopic techniques. The Versius robotic system, developed by CMR Surgical, has demonstrated its efficacy on a global scale since its introduction in 2018, marking a significant stride in the landscape of robotic-assisted surgery. This review article was dedicated to providing an impartial assessment of robotic technology, elucidating our insights gleaned from 53 gynaecological surgeries conducted with the Versius robotic system.Methods: A meticulous examination of 53 cases was undertaken, wherein average operative time, estimated blood loss, postoperative hospital stay, Intraoperative and postoperative complications, and conversion rates were subjected to retrospective scrutiny.Results: The study conducted at a Tertiary care hospital involved the analysis of 53 gynecological cases using the Versius system. Results indicate the feasibility, efficiency, and patient-friendly nature of the Versius system, with notable advantages such as reduced hospital stay and smoother manipulation of tissues.Conclusions: We acknowledge the ongoing evolutionary trajectory of robotic surgery and it is evident that its merit has already been substantiated by the endorsement of numerous medical practitioners and patients worldwide. The Versius robotic system stands as a revolutionary force within the healthcare paradigm, distinguished not only by its favorability among medical professionals but also by its patient-friendly attributes. In the realm of minimally invasive gynecologic surgery, robot-assisted surgery emerges as a compelling alternative.
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    Incidence and determinants of left ventricular ejection fraction (LVEF) recovery in heart failure with reduced ejection fraction (HFrEF) of non-ischemic aetiology; a hospital-based prospective longitudinal registry study
    (Elsevier, 2025-06) Kumar, Sanjeev; Negi, Prakash Chand; Asotra, Sanjeev; Kumar, Jitender; Merwah, Rajeev; Sharma, Rajesh; Kumar, Ritesh; Bhardwaj, Vinay; Thakur, Preetam Singh
    Background: Heart failure with reduced ejection fraction (HFrEF) can show recovery in some patients, especially with non-ischemic causes, leading to better outcomes. Recovery varies due to factors like aetiology and severity of myocardial injury. This study examines the incidence and predictors of left ventricular ejection fraction (LVEF) recovery in non-ischemic HFrEF patients. Methods: This was a prospective observational study conducted at a tertiary care hospital, involving 500 patients with non-ischemic HFrEF (baseline LVEF <40 %). Patients were followed for a duration of 8 years (2011–2023) with periodic clinical assessments and annual echocardiographic evaluations. Data on comorbidities, baseline cardiac function, medication adherence, and clinical events were collected. The incidence rate of LVEF recovery was determined, and Kaplan–Meier survival analysis was used to identify recovery trends over time. Predictors of recovery were evaluated using Cox proportional hazards models. Results: Cumulative incidence of LVEF recovery was 27.4 % (95 % CI: 23.7–31.5) at 8 years, with an incidence rate of 4.5 per 100 person-years. Higher baseline LVEF (?30 %) strongly predicted recovery (HR: 2.17, p < 0.001), while dilated LV (LVEDD ?60 mm, HR: 0.6, p = 0.02) and diabetes (HR: 0.36, p = 0.01) were associated with lower recovery. Education (?Class 5) was linked to better recovery (HR: 1.45, p = 0.04). Beta-blockers showed a potential but nonsignificant benefit. Conclusion: Nearly one-fourth (27.4 %) of patients achieved LVEF recovery over 8 years, with higher baseline LVEF and education associated with better outcomes, while adverse cardiac remodeling and diabetes were linked to lower recovery.
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    Inflammatory cytokine levels in rheumatic heart disease and their association with use of benzathine penicillin: A case-control pilot study
    (Elsevier, 2025-04) Kumar, Sanjeev; Negi, Prakash Chand; Asotra, Sanjeev; Chandel, Meenakshi; Kumar, Jitender; Merwah, Rajeev; Sharma, Rajesh; Kumar, Ritesh; Bhardwaj, Vinay; Thakur, Preetam Singh
    Background: Valvular inflammation plays an important role in the progression of Rheumatic Heart Disease. We report the association between inflammatory markers and use of Benzathine Penicillin G in patients with Rheumatic mitral valve disease. Methods: The levels of inflammatory cytokines; IL-1?, IL-6, TNF-? and inflammatory marker hs- CRP were measured using ELISA method in 32 patients with RHD receiving Benzathine Penicillin as secondary prophylaxis and 31 patients not receiving secondary prophylaxis, in a case–control study. The severity and type of valvular dysfunction were assessed with echocardiogram. Results: The median level of IL-1? was significantly lower in patients on BPG (0.95 pg/ml vs. 5.47 pg/ml) p < 0.002. The median levels of IL-6, TNF-? and hs-CRP were not significantly different between study groups. The adjusted odds of raised IL-1? were lower in patients on BPG (odds ratio 0.40, 95 % C.I. 0.11, 1.45) p 0.16. There was a trend of inverse association between the use of BPG and mitral stenosis (odds ratio 0.42, 95 % C.I. (0.12, 1.46) p 0.17. Conclusion: Patients with RHD on BPG had lower levels of IL-1? and a trend toward a lower prevalence of mitral stenosis. Role of IL-1? in progression of incompetent to stenotic mitral valve dysfunction needs to be explored in future studies.
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    Oral health knowledge and practices among primary healthcare workers in Shimla District, Himachal Pradesh, India
    (Indian Society for Dental Research, 2018-11) Fotedar, Shailee; Fotedar, Vikas; Bhardwaj, Vinay; Thakur, Arun Singh; Vashisth, Shelja; Thakur, Purnima
    Primary healthcare workers being grassroot workers in rural areas can be effective in oral health promotion in these areas. Aim: To assess oral health knowledge and practices among primary healthcare workers in Shimla district in Himachal Pradesh. Setting and Design: A cross-sectional study. Subjects and Methods: A cross-sectional study was conducted to assess oral health knowledge and practices of primary healthcare workers in Shimla using a self-administered questionnaire. Statistical Analysis Used: Data were analyzed using SPSS package version 16. The tests used were t-test and Fisher's exact test. A P value < 0.05 was considered statistically significant. Results: Of 130 subjects, there were 60 (46.2%) males and 70 (53.8%) females. The mean age of the population was 48.4 ± 5.9 with a range of 25–57. The mean knowledge score percent of the population was 51.9 ± 18.2. It was higher for males (52.3 ± 15.0) when compared with females (51.5 ± 20.7). The mean knowledge score percent was positively associated with education and negatively associated with age. Tooth brush was used by 97.7% and tooth paste by 121 (93.1%). The frequency of brushing twice was reported by 79 (60.8%). Conclusion: Though the overall knowledge about oral health is good among primary healthcare workers, the understanding about various aspects is lacking. Therefore, it is recommended that health workers should be given education to enhance knowledge and practices toward oral healthcare and to increase their screening capacity for common dental problem which will serve the community in long way.
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    Serum magnesium levels in newly diagnosed type 2 diabetes mellitus and its relation with microvascular complications of diabetes
    (Medip Academy, 2020-05) Bhardwaj, Vinay; Kaushik, Madan Lal
    Background: Prevalence of hypomagnesaemia is significantly higher in diabetic patients with microvascular complications compared to diabetics with no microvascular complications. The aim of this study is to measure levels of serum magnesium in patients with newly diagnosed type 2 diabetes mellitus and study its association with the presenting microvascular complications.Methods: This was hospital based, one year cross-sectional study carried out in Department of Medicine, IGMC Shimla in patients with newly diagnosed type 2 diabetes mellitus. Total 53 patients were enrolled in this study who presented in medicine OPD or admitted in medicine ward.Results: Serum Magnesium value of the patients ranged from 1.20-3.0 mg/dl with mean value of 1.9±0.3 mg/dl. Fourteen patients (26.4%) had hypomagnesaemia. A total of 34 (64.2%) patients presented with complications of diabetes in which proteinuria was present in 34 (64.2%), retinopathy in 4 (7.5%) and neuropathy in 1 (1.9%). Fourteen (41.2%) patients with hypomagnesaemia presented with complications of diabetes (p value=0.003). 34 (64.2%) patients presented with proteinuria out of which 14 (41.2%) patients had hypomagnesaemia while 20 (58.8%) had normomagnesaemia (p=0.03). One (1.9%) patient had neuropathy and hypomagnesaemia was also present in this patient (p=0.6). Four patients (7.5%) presented with retinopathy out of which 3 (5.7%) had hypomagnesaemia while 1 (1.9%) had normomagnesaemia.Conclusions: Hypomagnesaemia is associated with microvascular complications of diabetes. Also there is statistically significant relationship between proteinuria and hypomagnesaemia in patients with newly diagnosed type 2 diabetes mellitus.