Browsing by Author "Gupta, Sanjay"

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    Acute viral hepatitis in children: a prospective hospital based study
    (Medip Academy, 2020-08) Sharma, Chandra Madhur; Gupta, Sanjay; Aggarwal, Bindu; Chaudhary, Piyush
    Background: Viral hepatitis is a major public health issue throughout the world affecting millions of children despite the availability of vaccines, prophylactic measures and improved sanitation. The objective of the study was to analyze the etiology, clinical features, laboratory parameters and sonological findings of Acute Viral Hepatitis in pediatric population.Methods: A total of 88 children admitted in paediatric department and gastroenterology unit of medicine department with confirmed acute viral hepatitis from June 2016 to July 2018 at tertiary health care teaching hospital of north India were included. The patients were divided in 3 age groups; 1-5, 6-10 and 11-18 years. Clinical features, laboratory parameters, ultrasound findings were compared in three age groups.Results: Out of 88 cases 48 were boys and 40 girls. In the present study hepatitis A was the most common (85.2%) etiology. Jaundice (90.9%) is the most common symptoms followed by dark colored urine (86.3%), loss of appetite (83.3%) and fever (68.2%) reported in this study. Icterus (90%) is the most common sign reported followed by hepatomegaly (86%). Out of 88 cases 4 cases died. Out of 4 deaths, 2 cases of hepatitis A and 2 cases positive for Hepatitis B. The cause of death was hepatic encephalopathy in both the cases.Conclusions: Majority of cases in children were hepatitis A cases. Most of the cases were aged above 5 years with slight male predominance. Those cases with elevated liver enzymes (SGOT >5000) and those with PT INR >3.5 at admission has higher mortality.
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    Additional cash Incentive within a conditional cash transfer scheme: A 'controlled before and during' design evaluation study from India.
    (2011-04) Lahariya, Chandrakant; Mishra, Ashok; Nandan, Deoki; Gautam, Praveen; Gupta, Sanjay
    Background : Conditional Cash Transfer (CCT) schemes have shown largely favorable changes in the health seeking behavior. This evaluation study assesses the process and performance of an Additional Cash Incentive (ACI) scheme within an ongoing CCT scheme in India, and document lessons. Material and Methods: A controlled before and during design study was conducted in Madhya Pradesh state of India, from August 2007 to March 2008, with increased in institutional deliveries as a primary outcome. In depth interviews, focus group discussions and household surveys were done for data collection. Results: Lack of awareness about ACI scheme amongst general population and beneficiaries, cumbersome cash disbursement procedure, intricate eligibility criteria, extensive paper work, and insufficient focus on community involvement were the major implementation challenges. There were anecdotal reports of political interference and possible scope for corruption. At the end of implementation period, overall rate of institutional deliveries had increased in both target and control populations; however, the differences were not statistically significant. No cause and effect association could be proven by this study. Conclusions: Poor planning and coordination, and lack of public awareness about the scheme resulted in low utilization. Thus, proper IEC and training, detailed implementation plan, orientation training for implementer, sufficient budgetary allocation, and community participation should be an integral part for successful implementation of any such scheme. The lesson learned this evaluation study may be useful in any developing country setting and may be utilized for planning and implementation of any ACI scheme in future.
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    Adult intussusception.
    (2005-03-10) Gupta, Sanjay; Kaushik, Robin; Sharma, Rajeev; Attri, Ashok K
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    Age at initiation & prevalence of tobacco use among school children in Noida, India: A cross-sectional questionnaire based survey.
    (2011-03) Narain, Raj; Sardana, Sarita; Gupta, Sanjay; Sehgal, Ashok
    Background & objectives: Tobacco use among school children is becoming a serious problem in developing countries. The early age of initiation underscores the urgent need to intervene and protect this vulnerable group from falling prey to this addiction. The present study was thus undertaken to assess the prevalence of tobacco habits among school children, determine the age of initiation of these habits, and compare the age of initiation between students who were more than 15 and ≤ 15 yr of age. Methods: Data on tobacco use were collected from 4786 students of class 7 to 12 (age: 11-19 yr) studying in different private and government schools of Noida city during July- December 2005, through cluster and random sampling using a self-administered questionnaire. Results: Any kind of tobacco use was found in 537 (11.2%) students; 419 (8.8%) were ‘ever smokers (including current smokers)’ 219 (4.6%) were ‘ever tobacco chewers (including current chewers)’, 179 (3.7%) were ‘exclusive smokers’ and 118 (2.5%) were ‘exclusive tobacco chewers’. The mean age of initiation of these habits was around 12.4 yr. More than 50 per cent of tobacco chewers reported use of khaini at least once. Nearly 70 per cent of boys and 80 per cent of girls ≤ 15 yr initiated the habit of tobacco before the age of 11 yr. A significant early uptake of tobacco chewing was reported from private school students as compared to government school students (P<0.05). Interpretation & conclusions: Tobacco addiction is emerging as a big threat among children. Our findings indicate a recent downward shift in the age at initiation of tobacco uptake and rising prevalence among girls. Such data need to be collected from different parts of the country to develop anti-tobacco campaigns and take policy decision.
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    An approach to sudden natural deaths in medicolegal autopsies at karamsad, Gujarat.
    (2011-01) Gupta, Sanjay; Panchal, Ravi; Sondarva, Divyesh
    The Forensic autopsy is a medical procedure. Unfortunately, it is too often thought of only in reference to violent or unnatural deaths. The present prospective study was aimed to know the effectiveness of post-mortem examination to find out cause of death and its correlation with histopathological examination. It was also intended to deduce various epidemiological parameters and their logical relevance. Total 825 autopsy cases were performed during January 2007 to December 2009 (3 years), out of which 63 (7.64%) were of sudden natural deaths. Most of cases were found in 31-50 years age group and male preponderance was seen in all age groups. A majority of deceased were married. Cardiovascular diseases were the most important cause contributing 58.73% in sudden natural deaths. These cardiac cases were mainly due to coronary artery disease, coronary thrombosis and acute myocardial infarction. The 90.49% cases were brought dead to the hospital. In majority of cases (95.24%) postmortem was performed within 24 hours of death.
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    Assessment of death registration coverage and its delays in district Faridkot: an urban rural comparison
    (Medip Academy, 2019-05) Anupamdeep; Padda, Preeti; Gupta, Sanjay; Gupta, Vishal; Devgan, Shalini; Monga, Shamim
    Background: Death registration has been made compulsory under the RBD Act 1969 as it acts as a back bone for planning services and formulates policies. According to CRS 2013, at national level, 70.9% of deaths were registered which is far from magic figure of 100% despite of concerted efforts of government. So this study was conducted to assess the coverage of death registration and its delays. Methods: A cross sectional study was conducted over a period of one year where 332 households(166 each from urban and rural area reporting deaths in last two years were included in study after taking informed written consent. Relevant information was collected using a predesigned and pretested questionnaire by house to house survey. Coverage was calculated with possession of death certificate. Data was compiled and analyzed using EpiInfo07 (CDC, Atlanta, USA). Results: Out of 332 deaths, 245 (74%) out of which only140 (57%) possessed the death certificate. The main cause of death was cardiac diseases. Maximum coverage was seen in the age group 41-60 years. Delay in registration was seen in 48% with significantly higher proportion in rural area (59%) than in urban area (40%). Reasons for delay were time constraints, lack of knowledge and financial constraints. Socio demographic variables like religion, caste, type of family, family size and SES were not found to be associated with delay. Conclusions: The coverage of death registration was comparatively higher than national data and delay was observed in about half of the death registration coverage
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    Association of neonatal hyperbilirubinemia with cord albumin among term appropriate for gestational age neonates
    (Medip Academy, 2023-12) Shah, Shweta K.; Jha, Anand K.; Sharma, Satish; Gupta, Sanjay
    Background: Neonatal hyperbilirubinemia (NH) is the most common abnormality seen during the neonatal period. It affects nearly 60% of term and 80% of preterm neonates during the first week of life. Early discharge of healthy term and late preterm newborns after normal vaginal delivery is a common practice however there are reports of bilirubin induced brain damage (kernicterus) occurring in these infants. Therefore, to ascertain whether cord albumin can be used as a reliable indicator for predicting neonatal hyperbilirubinemia.Methods: A tertiary care hospital-based cross-sectional study was conducted in 142 healthy late preterm and term newborns of either gender with icterus appearing only after 24 hour of life with no other illness using a non-probability sampling method. Data analysis was done using statistical package for the social sciences (SPSS) version 16. Chi-square was used to determine the association between cord albumin and hyperbilirubinemia.Results: There is a significant negative correlation between cord albumin and serum bilirubin at 72-96 hours of life (p=0.001). A total of 142 healthy late preterm and term neonates included. The study group based on Cord serum albumin (CSA) levels ?2.8 g/dl, 2.9-3.3 g/dl, and ?3.4 g/dl shows 77.27%, 22.7% and none respectively developed NH requiring phototherapy. According to receiver operating curve (ROC) analysis, the cutoff point of 2.75 g/dl provides the best sensitivity and specificity result.Conclusions: Cord serum albumin level ?3.4 g/dl are probably safe for early discharge whereas cord serum albumin level <3.4 g/dl will need a close follow-up to check for the development of jaundice.
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    Bilateral Complete Ossification of the Superior Transverse Scapular Ligament.
    (2013-10) Soni, Gargi; Malik, Vivek singh; Gupta, Sanjay
    The ossification of the superior transverse scapular ligament either partial or complete has been identified as one of the predisposing factors in suprascapular nerve entrapment syndrome since long. In the present case we found a bilateral completely ossified superior transverse scapular ligament, which is a rare finding. The Knowledge of this anatomical variation where the ossified superior transverse ligament converts the suprascapular notch into a foramen is important for clinicians in diagnosis and treatment of patients with suprascapular nerve entrapment.
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    Bullet injury to the atlanto-axial region.
    (2006-06-29) Gupta, Sunil K; Gupta, Sanjay; Bajaj, Ajay; Mohindra, Sandeep; Khosla, Virendra K
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    Cancer awareness & its association with demographic variables & mobile phone usage among the rural population of a district in north India
    (Wolters Kluwer – Medknow, 2022-07) Yadav, Kavita; Hariprasad, Roopa; Gupta, Ruchika; Upadhayay, Shravan; Sharma, Vishwas; Kumari, Malasha; Mehrotra, Ravi; Kumar, Sanjeev; Gupta, Sanjay; Singh, Shalini
    Background & objectives: Lack of awareness is one of the major reasons for the high morbidity and mortality associated with cancers. The present study was aimed to evaluate the awareness of prevalent cancers among the rural population in a district of north India and its association specifically with mobile phone usage. Methods: Using a stratified random sampling technique, households in three villages of Gautam Buddh Nagar district of India were selected. A house-to-house survey on cancer awareness was conducted among adults in selected households and data were analyzed to check for the association of such an awareness with sociodemographic factors and internet usage. Results: The study included 59 males and 145 females, with majority (115) being in the age group of 18-30 yr. Although most (96.5%) of the participants were aware of cancer, the common risk factors and warning signs of cancer were known to only a few. Specific risk factors for cervical and breast cancers were, however, not known to a majority (79.9% and 72.2%). A significant association between the awareness of general risk factors and warning signs as well as specific aspects including risk factors for breast, cervical and oral cancer, HPV vaccine and the education level of the participants (P<0.05 for all). Knowledge of risk factors, warning signs and cancer prevention modalities was higher among mobile phone users who accessed internet for health information. There was no significant association between age group and cancer risk factor awareness, though females were more aware of the risk factors for breast cancer (P=0.002). Interpretation & conclusions: The findings of this study highlight the existing low level of awareness of cervical and breast cancers among the rural population. The association of cancer awareness with education level and mobile phone-based internet usage suggests the potential utility of internet-based platforms such as m-health programmes for cancer prevention activities
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    A Case for Horizontal Distribution of Activities between General Surgery and Surgical Super Specialties
    (Thieme Medical and Scientific Publishers Pvt. Ltd, 2023-04) Minocha, Vivek R.; Gupta, Sanjay; Gupta, Arun
    Under the current practice in organizing surgical services, proportionate representation of disciplines is provided in the curricular planning and in corresponding clinical functions. This is based on the level of competence expected by the end of training period. The disciplines as a “whole” are placed in general surgery or super specialty. The system of vertical arrangement has some serious concerns. Paradoxically, patients with diseases of simple and routine nature of discipline categorized as super specialty are neglected. Super specialist is unable to attend on account of preoccupation with serious challenging problems. The general surgeon hesitates because of privileging issues, fear of allegations of negligence and litigation. The system of vertical division is based on premise that some disciplines deal with complex procedures and others with only simple and routine nature. This premise is incorrect. Each discipline is a mix of simple and complex cases requiring specialized treatment. Alternate modified organization of surgical service is proposed. Activities of all disciplines are scrutinized according to the level of expected competence by the end of training. Categorization is shifted from the “discipline' to “activities.” Criteria applied for classification of activities are as follows: on completion, the trainee is capable to assume full responsibility-category 1; has gained sufficient experience-category 2; and is conversant with broad understanding of management-category 3. Activities of category 1 from all disciplines are assigned to general surgery and those of category 3 from all disciplines are assigned to respective super specialty. Those in the middle, comprising difficult cases but not requiring specialized training or heavy inputs in equipment, are in category 2. They are assigned to general surgery as additional/optional items, or super specialty, guided by local factors. The scope and practice of general surgery are broadened with a shift from “residual” to “comprehensive” discipline. Advantages, concerns, collateral issues of horizontal distribution of activities, its positive impact on research and education are discussed. It is concluded that the proposed organization of surgical services is a rational, logical, and practical strategy for good-quality surgical care in the society. The super specialists need to be convinced that “taking load off” is good for the specialty.
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    A case of Kartagener's syndrome: Importance of early diagnosis and treatment.
    (2012-05) Gupta, Sanjay; Handa, Kumud K; Kasliwal, Ravi R; Bajpai, Pankaj
    Kartagener's syndrome is a very rare congenital malformation comprising of a classic triad of sinusitis, situs inversus and bronchiectasis. Primary ciliary dyskinesia is a genetic disorder with manifestations present from early life and this distinguishes it from acquired mucociliary disorders. Approximately one half of patients with primary ciliary dyskinesia have situs inversus and, thus are having Kartagener syndrome. We present a case of 12 year old boy with sinusitis, situs inversus and bronchiectasis. The correct diagnosis of this rare congenital autosomal recessive disorder in early life is important in the overall prognosis of the syndrome, as many of the complications can be prevented if timely management is instituted, as was done in this in this case.
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    A case of Kartagener’s syndrome: Importance of early diagnosis and treatment.
    (2013-04) Gupta, Sanjay; Handa, Kumud K; Kasliwal, Ravi R; Bajpai, Pankaj
    Kartagener’s syndrome is a very rare congenital malformation comprising of a classic triad of sinusitis, situs inversus and bronchiectasis. Primary ciliary dyskinesia is a genetic disorder with manifestations present from early life and this distinguishes it from acquired mucociliary disorders. Approximately one half of patients with primary ciliary dyskinesia have situs inversus and, thus are having Kartagener syndrome. We present a case of 12 year old boy with sinusitis, situs inversus and bronchiectasis. The correct diagnosis of this rare congenital autosomal recessive disorder in early life is important in the overall prognosis of the syndrome, as many of the complications can be prevented if timely management is instituted, as was done in this in this case.
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    Chemical analysis of ground water of Sanganer area, Jaipur in Rajasthan.
    (2004-01-03) Gupta, Sanjay; Kumar, Akhalesh; Ojha, C K; Seth, Gita
    The chemical analysis of ground water quality of Sanganer area, Jaipur in Rajasthan is presented in this paper. It is important from this point of view to observe the suitability of water for safe drinking and irrigation. The different parameters measured are pH, conductivity, TDS, calcium, magnesium, total hardness, COD, alkalinity, Cl-, F-, PO4(3-), Na+, K+, SO4(2-), NO3-, Cd2+, Pb2+ and Fe2+. From the observed data it is found that parameters like conductivity, TDS, alkalinity, F- have high values in this area whereas other parameters are approximately with in the limits or below limit.
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    A comparative study of fascial sheath interposition versus no fascial sheath interposition in No Scalpel Vasectomy.
    (2015-03) Bansal, Satish Kumar; Singla, Sham; singal, Gopal; Gupta, Sanjay
    Background: Since the introduction of male sterilization by surgery on deferens, several techniques have emerged to improve the results in terms of time, invasiveness, post operative infection, complications and success rate. Introduction: Vasectomy was introduced by Sharp in 1897. No scalpel vasectomy was introduced in China by Dr. Li Shun-Qiang in 1974. Intact fascial sheath helps in restoration of vas lumen and fascial sheath interposition prevents recanalization of vas by prevention of meeting of epithelialization from cut end of vas. Material and methods: The study was performed at PGIMS, Rohtak by performing surgery and follow-up up to one year of 326 subjects of no scalpel vasectomy. Clients were allocated in two groups. Group - A (155) with fascial sheath interposition and Group - B (171) without fascial sheath interposition. Surgeries were performed as a routine surgical procedure after full preparation of client including consent. Results: Majority of clients (56.1%) in Group - A were in age group 31-40 years followed by 22-30. years (28.4%), 41-50 years (14.8%) and 0.7% in age group more than 50 years. in Group - B, majority were also in age group 21-30 years (63.7%), followed by 31-40 years (29.8%), 41-50 years(5.9%) and 0.6% were of above 50 years. In Group - A, fascial sheath interposition was not possible in 17.2% clients due to non separation of sheath from vas. Sperm granuloma formation was observed in 8.6% in Group - A and 5.6% in Group-B. In comparison of 100% success rate in Group - A failure rate of 1.8% was observed in Group - B. Conclusion: The present study supports the existing literature that fascial sheath interposition adds a little more to the operating time of vasectomy, increases chances of wound infection and granuloma but has a less failure rate of vasectomy.
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    A comparative study of the health record cards in primary schools of Delhi.
    (2008-11-26) Handa, Ajay; Gupta, Sanjay; Tiwari, V K
    A comparative study was undertaken to understand the various measures required to strengthen and improve the health record cards (HRC) of various schools that subsequently help in improving the medical examination of children. By using a multi stage stratified random sampling method, 24 schools from Delhi, eight each from three broad categories of (i) corporation schools, (ii) other government schools, (iii) private schools were included in the study. The study finding revealed that in most of the government schools the health record cards were properly developed and structured as per the recommendations of various committee, though they are always in short supply.
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    Comparison of interferon gamma release assay & tuberculin skin tests for diagnosis of latent tuberculosis in patients on maintenance haemodialysis.
    (2015-04) Agarwal, Sanjay K; Singh, Urvashi B; Zaidi, Sabahat H; Gupta, Sanjay; Pandey, Ravinder M
    Background & objectives: Tuberculosis (TB) is a common infection in patients on haemodialysis. There is a definite role of treatment of latent TB (LTB) in these patients. However, diagnosis of LTB in these patients by tuberculin skin test (TST) is unreliable. There is suggestion that interferon gamma release assay (IGRA) will be more reliable test for diagnosis of LTB in this setting. Thus, we evaluated value of IGRA and TST for the diagnosis of LTB in patients on dialysis in an Indian setting. Methods: Patients with end stage kidney disease on dialysis were included. Patients with active TB were excluded. Each patient was subjected to TST (induration of ≥10 mm was taken as positive) and QuantiFERON TB Gold In-Tube test (QFT-GIT) for diagnosis of LTB. Results: A total of 185 patients were included; 129 (69.7%) were males and mean age was 36.7 ± 12.3 yr. Past history of TB was present in 18 (9.7%) patients. One hundred and thirty four (72.4%) patients had scar of BCG vaccination. QFT-GIT test was positive in 66 (36%), TST in 32 (17%) and both in 13 (7%) patients. Of the 66 patients positive with QFT-GIT, only 13 (19.6%) were positive for TST. Of the 32 patients positive with TST, only 13 (40.6%) were positive with QFT-GIT; 100 (54%) patients were negative for both the tests. Overall, 85 (45.9%) patients were positive for either of the two tests. Poor agreement was shown between the two methods. On logistic regression analysis, odds of QFT-GIT to be positive in patients with BCG vaccination was 1.23 and with history of TB 0.99, both being insignificant. odds of tuberculin skin test to be positive in patients with BCG vaccination was 1.04 and with history of TB 0.99, both again being insignificant. Interpretation & conclusions: Our findings showed that more number of patients (36%) on haemodialysis were positive for QuantiFERON Gold In-Tube test as compared to TST (17%). There was poor agreement between the two tests. no significant effect of BCG vaccination and history of TB in past was observed on both tests.
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    Contribution of iron deficiency to anemia in chronic renal failure.
    (2003-10-18) Gupta, Meenal; Kannan, M; Gupta, Sanjay; Saxena, Renu
    Prevalence of iron deficiency in anemia of chronic renal failure (CRF) has long been the subject of interest, because the patients of CRF with coexistent iron deficiency anemia need to be treated with iron preparations before starting erythropoietin therapy. Prevalence of iron deficiency in CRF is higher in Indian patients as compared to the West. Diagnosis of iron deficiency in patients with CRF is difficult. Bone marrow iron which is considered to be the gold standard is a painful and invasive procedure. In the present study we used serum transferrin receptor and serum ferritin levels, since not much Indian data is available on this.
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    Cranial Anthropometry in 600 North Indian Adults.
    (2013-07) Gupta, Sanjay; Gopichand, Patnaik V V; Kaushal, Subhash; Chhabra, Sudha; Garsa, Vipin
    The present study was conducted on 600 adults, comprising of equal number of males and females, within the age group of 18 year and above and of North Indian origin. The purpose of study was to access the head length, head width and to find out the relationship of these parameters with each other. Cephalic Index was calculated. The data so obtained was compiled and analysed statistically to observe baseline data and then compared with previous available data. This data can be useful for experts in forensic and allied surgical branches. The average head breadth and head length found in study were 139.51 mm, 186.88 mm respectively in males and 136.19 mm, 177.74 mm respectively in females. On the basis this study it was concluded that North Indian males have dolichocephalic type of head and females have mesocephalic type of head.
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    Cranial Index In North Indian Crania (Predominantly Haryanavi).
    (2014-04) Rathee, S K; Gupta, Sanjay; Shelja; Dhall, Usha; Raghavan, P
    Shape of crania is seen by measuring cranial index in 150 (115 male and 35 female) crania. Crania were obtained from the department of Anatomy, Pt. B.D. Sharma PGIMS Rohtak. In males, 91.07 % crania were found dolichocephalic while in females 97.14% crania were dolichocephalic. Few crania were found mesocephalic (6.25% in males and 2.85% in females) in both sexes. None of female crania was seen as brachycephalic. Percentage obtained in present study is quite different from any other population studied as most of the crania were dolichocephalic. So it can be used as a tool to identify crania of this region.