IMSEAR Repository :: Browsing by Author "Kumar, Ajay"

Browsing by Author "Kumar, Ajay"

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Acute pancreatitis with hemobilia following percutaneous liver biopsy.
(2002-03-07) Sood, Ajit; Midha, Vandana; Kumar, Ajay; Sood, Neena
Hemobilia following liver biopsy is rare and acute pancreatitis associated with hemobilia in such a situation is rarer. We report a 55-year-old man with ulcerative colitis and hepatitis C-positive liver disease who developed acute pancreatitis following liver biopsy. Surgical removal of blood clots from the biliary tree led to recovery.
Acute viral hepatitis in third trimester of pregnancy.
(2005-05-26) Dahiya, Mona; Kumar, Ashok; Kar, P; Gupta, R K; Kumar, Ajay
Airway management: High flow nasal oxygenation.
(2016-10) Kumar, Ajay; Patel, Malay Hemantlal; Mehta, Yatin
Anterior lens capsule vascularity in evaluating gestation in small for gestation neonates.
(2004-08-07) Nagpal, Jitender; Kumar, Ajay; Ramji, Siddharth
This study evaluated the role of anterior lens capsule vascularity in assessing gestation in small for gestational age (SGA) neonates in a prospective manner. Neonates with birth weight less than 2000 g were recruited. Those with gross congenital malformations, including corneal opacity or cataract and evidence of TORCH infection were excluded from the study. A total of 139 subjects were enrolled into the study (60-appropriate for gestational age (AGA) and 79 small for gestational age (SGA) neonates). Clinical gestational age assessment and ophthalmoscopic examination for anterior lens capsule vascularity grading were done within 24 hours of birth by independent blinded observers. The correlation of lens capsule grading with clinical gestation in AGA neonates (r2 = 0.75) was stronger compared to SGA neonates (r2 = 0.50). Gestational age assessment by lens capsule grading had a better agreement with clinical gestation in AGA subjects (Kappa Index - 0.56 in AGA vs. 0.26 in SGA). The lens capsule grading under-estimated the gestation of SGA subjects by an average of three weeks compared to AGA neonates.
Ash leaf macules.
(2002-06-27) Kumar, Ajay; Sharma, Sarla
Aspergillus niger as a new allergic agent associated with bindis and its efficacy against homeopathic drugs.
(2006-10-05) Shrivastava, J N; Kumar, Ajay; Bhatnagar, V P
Aspergillus was found as a dominant fungi to associate with brands of bindis. Among three potencies of four homeopathic drugs, Lycopodium 1M, Sulphur 1M, and Sepia 30 showed maximum inhibition zone of Aspergillus niger in inhibition zone technique. In poison food technique, Sepia 30M, Tellurium 30M, Sulphur 1M and Lycopodium 200 showed maximum percentage inhibition against A. niger
Assessment of Clinical Response to Multimodality Approach in Advanced Carcinoma Breast
(Society for Health Care & Research Development, 2019-05) Walia, Bhupinder Singh; Kapoor, Venita; Singh, Rahul; Kumar, Ajay; Neki, N. S.
Cases of carcinoma breast with TNM stage 3 are considered as locally advanced breast cancer. This study was done to demonstrate the effect of multimodal treatment approach in cases of stage 3 technically inoperable breast cancer. Its effect on clinical response was studied. Methods: This prospective study was carried out in department of general surgery, government Medical College, Amritsar, Punjab. Main part of multimodal approach is neoadjuvant chemotherapy, so in collaboration with department of radiotherapy, relevant data was collected. 25 cases of locally advanced breast carcinoma were studied. These patients were studied on treatment with FAC regimen (as neoadjuvant chemotherapy), then underwent surgical excision (MRM) followed by chemotherapy, radiotherapy and hormonal therapy wherever indicated, and response was assessed. Results: Initially assessment of lump was done after 3 cycle of chemotherapy. 2 patients (8%) have reduction <50%, 22 patients (88%) have reduction in size which ranges between 51- 75% of the initial, remaining 1 patient (4%) has reduction >75% of the initial. Thus making them operable therefore after this they all had undergone modified radical mastectomy. During follow up period no lump was detected clinically, ultrasonographically or radiologically. There was no any loco-regional recurrence in any case. Conclusion: The study demonstrated the effectiveness of neoadjuvant chemotherapy in down staging the tumor enabling definitive surgery with less morbidity.
Assessment of Hand Grip Strength and Pinch Grip Strength among Healthy Embroidery Workers: Cross-Sectional Study
(Portico, 2024-06) Solanki, Shraddha; Shivdikar, Rutika; Kumar, Ajay
Background: Embroidery is a craft that decorates fabric or other materials by using a needle to apply thread or yarn. Hand and finger strength is essential during embroidery design to minimize discomfort and risk of upper extremity injuries Aims and objective: This study aims to assess hand grip strength and pinch grip strength among healthy embroidery workers. Methodology: 100 embroidery workers were recruited. Demographic details including BMI were taken in self-designed form. Hand grip strength was assessed by Jamar Hand Held Dynamometer. Pinch grip strength was assessed by a Pinch Guage Dynamometer. Statistical analysis was done using the Python software. Results: The study included 100 subjects that involved all female subjects aged 20 to 40 yrs. with 4 or more than 4 years of experience. The study showed that the hand grip strength of embroidery workers was more affected than the pinch grip strength. This study also showed that age is not related to the hand grip and pinch grip strength. It also showed that an increase in the years of experience increases hand grip and pinch grip strength (p< 0.05) as well as grip strength was more in the dominant hand(p<0.0001).Conclusion: Hand grip strength was found to be affected more than the pinch grip strength. They found no correlation with the age and there was a correlation with years of experience.
Biological control of dermatophytic fungus Trichophyton species by Bacillus subtilis.
(2005-2006--14) Kumar, Ajay; Saini, Pragati; Shrivastava, J N
A potent Bacillus subtilis-2 isolated from soil samples, showed 14 mm inhibition zone by spot inoculation method and 22 mm inhibition zone by well agar diffusion method against pathogenic test fungii. i.e. Trichophyton species. Among four media tested, the maximum growth and antibiotic production was found in trypticase soya broth (TSB) medium at 37 degrees C, pH 7 and 48 hrs of incubation. The MIC of antifungal substance was 35 microl/ml. The isolated Bacillus subtilis -2 has strong antifungal activity against dermatophytic fungi Trichophyton sp. and requires chemical characterization for its bioactive principle.
A case report of a pediatric patient with Hirschsprung’s disease
(Medip Academy, 2023-04) Kumar, Ajay; Agarwal, L. D.; Singh, Rajveer; Kumar Gupta, Abhishek; Hritika; Kumari, Priyanka; Hussain, Md Sadique
The objective is to describe an uncommon case of Hirschsprung's disease (HD), also called congenital megacolon. The lack of neuronal ganglion cells from the submucosal and muscular nerve plexuses throughout a segment of varied length characterizes HD. Approx 94% of HD cases are diagnosed below the age of 5 years. A 3 years old male patient was admitted to the male surgery ward under a pediatric surgeon with the chief complaints of chronic constipation since birth with a history of delayed passage of meconium. The patient was diagnosed with a case of HD at the age of 1 year for which he was operated on colostomy was performed with multiple biopsies from narrowed rectosigmoid, from the transitional zone, and from colostomy stoma which confirmed the decision to make colostomy at the ganglionated segment of the colon based on the clinical picture during surgery. Biopsy report of narrowed rectosigmoid segment showed the absence of ganglion cells, while colostomy stoma and dilated proximal colon showed the presence of ganglion cells. The patient underwent a surgical procedure named pull-through surgery for HD, a martin's modification of the Duhamel operation.
Characterization of Degradation Products of Guanfacine Hydrochloride API: Development and Validation of a Stability-indicating Reversed Phase UHPLC Method
(MRI Publication Pvt. Ltd., 2023-02) Kumar, Ajay; Chalannavar, Raju K.
Guanfacine Hydrochloride API was subjected to forced degradation studies under various conditions of hydrolysis (acidic, alkaline, and neutral/water), oxidation, photolysis, and thermal. A short and simple, reverse phase UHPLC method was developed on a Shimadzu, Shimpack GIST, C18, (100 × 2.1) mm, 3.0 ?m column. The gradient method consisted of 0.1% orthophosphoric acid as mobile phase A and acetonitrile as mobile phase B. The flow rate of the mobile phase was 0.3 mL/min. The method was validated using ICH guidelines considering the parameters solution stability, specificity, DL/QL, linearity, accuracy, precision and robustness. The drug was found highly sensitive to alkaline conditions and showed significant degradation. The drug was found sensitive to acidic degradation conditions. Slight degradation was observed in oxidative and water conditions. The drug was found to be stable in thermal and photolytic conditions. The mass compatible UHPLC method was prepared by simply substituting the orthophosphoric acid with formic acid in the mobile phase. Characterization of two major degradation products (DPs) was done. DP1 was characterized with LC–Q-TOF-MS/MS in combination with accurate mass measurements. DP2 was isolated and characterized with NMR, IR and HRMS spectroscopic techniques. The mechanisms of the formation of DPs were proposed.
Characterization of Shiga-toxigenic Escherichia coli isolated from cases of diarrhoea & haemolytic uremic syndrome in north India.
(2014-12) Kumar, Ajay; Taneja, Neelam; Bharti, Bhavneet; Sharma, Meera
Background & objectives: Shiga toxin producing Escherichia coli (STEC) is an important zoonotic foodborne pathogen, capable of causing haemorrhagic colitis (HC) and haemolytic uremic syndrome (HUS). As data from India on human infections caused by STEC are limited, this study was carried out for hospital based surveillance for STEC as a causative agent of diarrhoea, bloody diarrhoea and HUS at a tertiary care centre and to study the virulence gene profile and strain relatedness by multi locus variable tandem repeat analysis (MLVA). Methods: A total of 600 stool samples were studied. Stool samples of every fifth patient presenting with non-bloody diarrhoea, all cases of bloody diarrhoea and diarrhoea associated HUS (D+HUS) were collected from October 2009 to September 2011. Stool samples were cultured for STEC and characterization of STEC was done by serogrouping, virulence genes analysis, and MLVA typing. Results: STEC were isolated as a sole pathogen from 11 stool samples [5 of 290 (1.7%) non-blood diarrhoea and 5 of 300 (1.6%) blood diarrhoea cases]. STEC was also isolated from one fatal case of HUS who was an eight month old child. Only six of 11 isolates were positive for stx2 gene, whereas stx1 was present in all 11 isolates. Only one isolate was positive for eae. Other adhesion genes present were iha in five isolates, followed by toxB and efa1 in two each and saa gene in one, isolate. Among the plasmid encoded genes, espP, hly and etpD were each present in one isolate each. In the MLVA typing, diverse profiles were obtained except two untypeable isolates from different patients shared the same MLVA profile. Both these isolates were not epidemiologically linked. Interpretation & conclusions: This study demonstrated that STEC could be a causative agent of diarrhoea, bloody diarrhoea and sporadic HUS. However, further work needs to be done to study and explore the prevalence of these organisms in the food chain in this region.
A clinical trial of treatment of uncomplicated typhoid fever: efficacy of ceftriaxone-azithromycin combination.
(2015-07) Giri, Vishal P; Giri, Om P; Srivastava, Anshuman; Mishra, Chandan; Kumar, Ajay; Kanodia, Shubhra
Background: Typhoid fever is a systemic infection caused by Gram-negative bacterium Salmonella enterica serovar typhi (S. typhi). It is a major health problem in India. It carries significant morbidity and mortality. Antimicrobial therapy is critical for the management of typhoid fever. Emergence of multidrug-resistant (MDR) and nalidixic acid-resistant (NAR) strains of S. typhi has complicated therapy by limiting treatment options. Hence, this study was conducted to evaluate the efficacy and safety profile of ceftriaxone and azithromycin combination therapy in uncomplicated typhoid fever. Methods: Adults patients of blood culture proven uncomplicated typhoid fever admitted in the medicine ward of Teerthanker Mahaveer Medical College and Research Centre were treated with ceftriaxone intravenously (2 g daily for 14 days) and azithromycin orally (500 mg daily for 7 days). Patients were clinically and bacteriologically evaluated during the study period and follow-up. Results: 96% cure rate was observed. No relapse was recorded. Conclusion: Ceftriaxone-azithromycin combination may be considered as an empirical therapy for treatment of uncomplicated typhoid fever in view of the emergence of MDR and NAR strains of S. typhi.
Clinico-etiological and EEG profile of neonatal seizures.
(2007-01-01) Kumar, Ajay; Gupta, Ashish; Talukdar, Bibek
OBJECTIVE: To evaluate clinical, etiological and EEG profile of neonatal seizures. METHODS: In all the neonates enrolled in the study baseline information recorded was sex, gestational age, weight, ponderal index etc. Clinical profile of seizure episode included age at onset of seizure, type and duration of seizure, associated autonomic changes, medication given, response time to medication and possible cause. Relevant maternal history including antenatal and peripartum history was recorded. Relevant history and examination of newborn were noted. Essential investigations done in all subjects included blood glucose, serum calcium, serum sodium and arterial pH. USG cranium and EEG were done at earliest in all the subjects wherever feasible. Additional investigations were done as guided by history, physical examination and essential investigations. RESULTS: Ninety babies with clinical seizures were enrolled into the study over one year period with an overall incidence of 1.17% (0.69% in term babies and 6.14% in preterm babies). Abnormal EEG's were found in one third cases out of 60 EEG's done in 90 babies. 26.7% of babies with perinatal asphyxia had abnormal EEG's (8/30). While 60% of babies with HIE II had abnormal discharges, background activity was suppressed in 66.66% EEG's in babies with HIE III. CONCLUSIONS: Overall incidence of neonatal seizures was 11.7/1000 live births, majority being preterm very low birth weight babies before 5 days of life. Perinatal asphyxia was responsible in 44.44% babies followed by metabolic abnormalities (23.33%). EEG abnormalities were present in 33.34% babies.
Comparative lipid profile study between ischemic and haemorrhagic stroke
(Medip Academy, 2020-02) Singh, Vijaiendre; Bajia, Kamalesh Kumar; Ram, Chaina; Kumar, Ajay; Mathur, Ajay; Bansal, Pradeep Kumar
Background: Stroke is one of the major global health problems. Stroke is the most common clinical manifestation of cerebrovascular disease of which more than 99% are due to arterial involvement and less than 1% due to venous involvement in the form of Cerebral Venous Thrombosis (CVT). Among arterial causes 85% are due to infarction and 15% due to haemorrhage.1,2 There is difference in serum lipid levels in subtypes of strokes to guide lipid-lowering therapy which can reduce incidence of stroke and stroke related mortality by adapting primary and secondary preventive measures.3,4 Authors have endeavoured to correlate severity of lipid derangement and stroke.Methods: In this study 64 consecutive eligible ischaemic stroke cases and 64 eligible hemorrhagic stroke cases would be included. Cases of strokes will be divided into ischaemic and hemorrhagic as per clinical features and with help of brain imaging by CT scan and MRI at the time of admission and 8 hour fasting lipid profile was collected from all cases. All this information will be filled in preformed format.Results: Serum lipid profile of two categories of stroke showed raised serum total cholesterol in 39.1% patients of ischaemic stroke in contrast to 18.8% patients with haemorrhagic stroke (p=0.019).Stroke patients showed raised in LDL cholesterol in 29.7% patients of ischaemic stroke in contrast to 9.4% patients with haemorrhagic stroke, (p=0.007).Conclusions: Based on the finding of our study we conclude that ischemic stroke patient had higher lipid derangement as compare to haemorrhagic stroke in terms of raise total cholesterol, LDL cholesterol and decrease HDL cholesterol.
Comparison of body mass index and intraocular pressure
(Medip Academy, 2019-02) Kumar, Ajay; Sharma, Nikhil; Rathee, Anjani; Pradhan, Nitesh
Background: Raised intaocular pressure is considered as a major risk factor for developing optic neuropathy. Intraocular pressure (IOP) depends on various systemic and local factors and it has been postulated that IOP increases proportionately with increase in systolic blood pressure and increase in degree of obesity. The aim of this study was to compare the Body Mass Index (BMI) and Intraocular Pressure (IOP) in adult population.Methods: Four hundred ninety nine participants (284 male, 215 female) aged between 20 to 70 years were included in the cross-sectional study. On the basis of BMI subjects were divided into four categories i.e. underweight, normal weight, overweight and obese as per revised body type classification for Indian population recommended by Ministry of Health and Diabetes foundation of India. The mean IOP difference was 14.6±1.8 as compared amongst the four categories.Results: The participants were divided into six categories according to age and the mean IOP of different age groups was calculated. The changes in the mean IOP of males was 15.8±2.5 mm of Hg and the mean IOP of females was 14.7±2.2 mm of Hg. The results of the current study were statistically significant p<0.01.Conclusions: By concluding the current study as well as in the previous published literature, the findings of the current study were statistically significant. IOP was positively correlated with BMI. However, the clinical significance cannot be confirmed by the minor deviation in the IOP as well as BMI of the participants.
Congenital hypoplasia of the internal carotid artery.
(2009-10) Yadav, Padam; Kumar, Ajay; Saili, Arvind; Datta, Vikram
A newborn presented at 14 hrs of age with right sided clonic seizures and shrill cry. Magnetic Resonance Imaging of the brain showed left cerebral hemiatrophy with cystic changes in left fronto-parietal lobe and parasylvian region. The Magnetic Resonance Angiography revealed hypoplasia of left supraclinoid Internal Carotid Artery and hypoplasia and irregularity of vessel wall affecting the left Middle Cerebral Artery. Such an early presentation of this rare disorder has not been reported previously. Recognition of this anomaly has important implications during carotid and trans-sphenoidal surgery, in thromboembolic disease, and in the surveillance and detection of associated cerebral aneurysms.
Cushing’s Syndrome in a Young Woman: A Rare Presentation of Adrenocortical Carcinoma.
(2008-01) Talwar, Nikhil; Andley, Manoj; Ravi, Bina; Kumar, Ajay
Cushing’s Syndrome is rarely caused by a malignant adrenal tumor. We report the case of a 24-year-old female patient with Cushing’s syndrome caused by a functioning adrenocortical carcinoma and recovered after adrenalectomy.
Death due to ruptured ectopic pregnancy natural death or negligence.
(2010-07) Kumar, Ajay; Chavali, K H; Singh, Amandeep; Kumar, Ashwini; Dasari, Harish
A young adult female of low socio-economic status, and a labourer by profession, was brought dead to the Government Medical College & hospital, Chandigarh. History provided by her husband revealed that she had pain abdomen for the last five days for which she was getting treatment from a private practitioner. She had been prescribed NSAIDs and antispasmodics for the same. However, she was not investigated upon and no attempt was made by the practitioner to arrive at any diagnosis. The autopsy was conducted on the next day and at autopsy, about two-and-a-half liters of blood was present in the abdomen and pelvic cavity. Careful internal examination revealed a ruptured ectopic pregnancy as the source of bleeding. The case is discussed with regard to establishing whether the death could have been natural, due to the negligence of the treating doctor or due to contributory negligence. However, even in cases of contributory negligence, the “last chance doctrine” may not save the physician.
A Descriptive Study of Various Causes and Treatment Modalities of Mastalgia in Females of all Age Groups in Guru Nanak Dev Hospital, Amritsar
(Society for Health Care & Research Development, 2019-05) Walia, Bhupinder Singh; Kapoor, Venita; Singh, Rahul; Kumar, Ajay; Neki, N. S.
Mastalgia or Breast pain, is a common symptom which women may experience at different time in their lives. Many women worry that pain in their breasts is caused by breast cancer. Breast cancer rarely causes breast pain, however a thorough history and clinical examination by clinician appreciates it. Methods: A descriptive study was carried out in department of general surgery, Govt. Medical College in Guru Nanak Dev Hospital, Amritsar. there is 500 cases of mastalgia collected in Guru Nanak Dev Hospital and diagnosis was made on basis of clinical history and local examination of both breasts. All the quadrants of the breast were examined. Treatment of each patient was done as per the diagnosis. Results: Among 500 Patients 449 patients had cyclical mastalgia were as 51 patients has non cyclical mastalgia. Conclusion: In our study 89.8% of the patients experienced cyclical mastalgia and 10.2% non cyclical mastalgia.

Browsing by Author "Kumar, Ajay"

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