Browsing by Author "Kumar, Gaurav"

Now showing 1 - 20 of 30
  • No Thumbnail Available
    Item
    Amniotic membrane transplantation in ocular surface disorders.
    (2005-07-22) Chandra, Abhishek; Maurya, O P S; Reddy, Bhaskar; Kumar, Gaurav; Pandey, Kshama; Bhaduri, Gautam
    In this prospective study, 81 eyes of 70 patients diagnosed with various ocular surface disorders were enrolled to document the use of amniotic membrane transplantation in various ocular surface disorders. Detailed history and ocular examination was done. Ocular photographs and consent from all patients were taken. Fluorescein staining and impression cytology was done preoperatively and postoperatively in selected cases. Amniotic membrane was prepared from the placenta of a donor (consent taken and negative for infectious disorders), after separating amnion from chorion. It was washed with antibiotic solutions, transferred over nitrocellulose paper and stored in Dulbecco's modified Eagle's minimum essential medium at -80 degrees C. Recipient bed was prepared by removing the fibrovascular pannus and necrosed conjunctiva. Amniotic membrane was transplanted with the epithelial side up and sutured. Sixty-four eyes had good result by clinical evaluation or impression cytology findings, 5 eyes later required limbal stem cell culture and transplantation. All the 3 eyes had failure of the fornix reconstruction and 5 eyes had recurrence of the pterygium. Amniotic membrane provides lower recurrence rate in cases of recurrent pterygium. Alkali injuries are more dangerous but showed good response to amniotic membrane transplantation combined with limbal autografting or ex-vivo expansion and later transfer. Initial proper assessment of limbal involvement, conjunctival necrosis and corneal involvement is the key to the management of acute cases. Contracted sockets showed no improvement. Shield ulcers and persistent epithelial defect and ocular surface defects secondary to tumour excision showed excellent results.
  • No Thumbnail Available
    Item
    Antinociceptive action of FK506 in mice.
    (2003-12-24) Singh, Amanpreet; Kumar, Gaurav; Naidu, Pattipati S; Kulkarni, Shrinivas K
    Immunophilins are abundantly present in the brain as compared to the immune system. Immunophilin-binding agents like FK506 are known to inactivate neuronal nitric oxide synthase (nNOS) by inhibiting calcineurin and decrease the production of nitric oxide. Nitric oxide is involved in the mediation of nociception at the spinal level. In the present study, the effect of FK506 on the tail flick response in mice and the possible involvement of NO-L-arginine pathway in this paradigm was evaluated. FK506 (0.5, 1 and 3 mg/kg, ip) produced a significant antinociception in the tail flick test. Nitric oxide synthase (NOS) inhibitor L-NAME significantly and dose dependently (10-40 mg/kg, ip) potentiated the FK506 (0.5 mg/kg)-induced antinociception. On the other hand, NOS substrate L-arginine (100, 200 and 400 mg/kg) inhibited the FK506-induced antinociception in a dose-dependent manner. Concomitant administration of L-NAME (20 and 40 mg/kg) with L-arginine (200 mg/kg) blocked the inhibition exerted by L-arginine on the FK506-induced antinociception. Thus, it was concluded that NO- L-arginine pathway may be involved in the FK506-induced antinociception in tail flick test.
  • Thumbnail Image
    Item
    Comparative Evaluation of Efficacy of Interscalene Block vs. Interscalene Block and Superficial Cervical Plexus Block for Fixation of Clavicular Fractures
    (International Society for Contemporary Medical Research, 2019-03) Gupta, Neha; Gupta, Vishal; Kumar, Gaurav; Gupta, Veena; Gupta, D.K.
    Introduction: Regional anaesthesia is seldom used forclavicle fractures considering the anatomical location of thebone. We aim to compare the efficacy of two techniques ofregional anaesthesia as sole anaesthesia technique for fixationsof clavicular fractures.Material and methods: 60 Adult patients with claviclefractures were divided randomly in two groups (1 and 2) andwere administered interscalene block (ISB) only or interscaleneblock and superficial cervical plexus block(ISB+SCPB) assole anaesthetic, respectively. Patients were monitored forefficacy of block and adequacy of anaesthesia and analgesiaat the surgical site. Side effects and hemodynamic parameterswere also monitored.Results:. ISB+SCPB provides excellent anaesthesia forclavicle fixation. Only 1 patient in group 2 required GeneralAnaesthesia(GA) whereas in Group 1, 8 patients required someform of supplemental anaesthesia. There was no statisticallysignificant difference in side-effects and hemodynamic profilein both the groups.Conclusion: ISB+SCPB is significantly better than ISB onlyfor anaesthesia for fixation of clavicular surgeries.
  • Thumbnail Image
    Item
    Comprehensive molecular insights into the stress response dynamics of rice (Oryza sativa L.) during rice tungro disease by RNA-seq-based comparative whole transcriptome analysis
    (Indian Academy of Sciences, 2020-01) Kumar, Gaurav; Dasgupta, Indranil
    The nucleotide derivatives (p)ppGpp, comprising ppGpp and pppGpp, are important signalling molecules thatcontrol various facets of gene regulation and protein synthesis in Escherichia coli. Their synthesis is catalysedby RelA (in response to amino acid limitation) and by SpoT (in response to the limitation of carbon source orfatty acids). SpoT is also a hydrolase for degradation of both ppGpp and pppGpp, while GppA catalyses theconversion of pppGpp to ppGpp. Here we provide evidence to show that pppGpp exerts heightened toxicitycompared to that by ppGpp. Thus, gppA spoT double mutants exhibited lethality under conditions in which thesingle mutants were viable. The extent of RelA-catalysed (p)ppGpp accumulation in the gppA spoT strain wassubstantially greater than that in its isogenic gppA? derivative. The data is interpreted in terms of a model inwhich toxicity of pppGpp in the gppA spoT mutants is mediated by its activation of RelA so as to result in avicious cycle of (p)ppGpp synthesis.
  • Thumbnail Image
    Item
    Corneal endothelial changes following cataract surgery in hard nuclear cataract: Randomized trial comparing phacoemulsification to manual small-incision cataract surgery
    (All India Ophthalmological Society, 2022-11) Singh, Ritu; Sharma, Arun K; Katiyar, Vishal; Kumar, Gaurav; Gupta, Sanjiv K
    Purpose: To evaluate and compare endothelial cell changes in phacoemulsification and manual small- incision cataract surgery (MSICS) in patients with uncomplicated senile cataracts. Methods: This was a prospective, tertiary care hospital-based, randomized, double-blinded interventional study. In total, 152 patients with an uncomplicated senile cataract of nuclear grade III and above were recruited. Exclusion criteria included patients with preoperative endothelial cell density (ECD) less than 1500 cells/mm3, a history of previous ocular surgery, any other coexisting ocular disease, and intraoperative or postoperative surgical complications. Preoperative and postoperative values of ECD and central corneal thickness (CCT) were measured, analyzed, and correlated with various factors. Results: Patients were randomized into two interventional groups-MSICS and phacoemulsification. Factors associated with significant drop in postoperative ECD following phacoemulsification were patients with advanced age (P = 0.01), higher grades of cataract (P = 0.01), and longer effective phacoemulsification time (P = 0.007). Shallow anterior chamber depth (ACD) was strongly associated with greater ECD loss in both groups (P < 0.0001). A threshold value of 2.86 mm of ACD was defined for minimal endothelial cell loss following phacoemulsification. CCT was observed to slightly increase postoperatively in both groups but was insignificant (P > 0.05). Conclusion: Both MSICS and phacoemulsification have similar postoperative visual outcomes. An increase in postoperative CCT is insignificant following surgery. Greater postoperative ECD loss is associated with phacoemulsification with advanced age, hard nuclear cataracts, and longer effective phacoemulsification time. ACD can be used as an essential parameter preoperatively to determine the choice of surgical technique between MSICS and phacoemulsification
  • Thumbnail Image
    Item
    CRP Levels in Patients Attending a Tertiary Care Hospital
    (Society for Health Care & Research Development, 2019-01) Mishra, Neeti; Tripathi, Shailendra Mohan; Yadav, Rajesh; Abhishek, Jaiswal; Kumar, Gaurav
    It is an acute phase protein, which rises due to inflammation, infection and injury. It is synthesized by liver in response to IL-6 secreted by activated macrophages and T cells in acute and chronic inflammatory conditions. Changes in serum CRP concentration occur more quickly than ESR and therefore CRP may be a better reflection of current inflammation. Methods: Blood was collected by vene-puncture from the patients and separated sera were obtained from individuals elderly as well as young person’s were tested by quantitative & qualitative method. Results: In our study, two groups were included in this study, i.e. elderly group & young group.108 & 40 total cases were included in elderly group & young group respectively. In the elderly group out of 108 cases 35.2% were positive rest were negative for C - reactive protein as well as in young group 35% positive & 65% were negative found in the present study. Conclusion: In cases of joint pains CRP tests can give a better picture before going for higher and more expensive investigations.
  • Thumbnail Image
    Item
    Detection of Enterotoxin Genes (seg, seh and sei) in Staphylococcus aureus Milk Isolates from Cow with Subclinical Mastitis
    (Association of Mastitis, 2019-04) Kumar, Gaurav; Nathiya, Pragya; Diwakar; Bhati, Taruna; Kataria, Anil Kumar
    Enterotoxigenic Staphylococcus aureus can be isolated from various sources and are responsible for food poisoning in addition to many suppurative infections. In the present study, from 82 physically normal milk samples from cattle subclinical mastitis 33(40.24%) were isolated to S. aureus. Out of these, 22 (66.66%) S. aureus isolates had either one or more enterotoxin genes. Both seg and sei enterotoxin genes were carried by 19 (57.5%) S.aureus isolates while only three (9.09%) isolates were positive for seh gene. This study showed the evidence of presence of enterotoxin genes seg, seh, and sei in S. aureus isolates from subclinical mastitis. The presence of these enterotoxigenic S. aureus strains in milk indicates potential public health concern
  • Thumbnail Image
    Item
    Does intravenous sildenafil clinically ameliorate pulmonary hypertension during perioperative management of congenital heart diseases in children? – A prospective randomized study.
    (2015-10) Sharma, Vipul Krishen; Joshi, Saajan; Joshi, Ankur; Kumar, Gaurav; Arora, Harmeet; Garg, Anurag
    Background: Pulmonary hypertension (PHT), if present, can be a significant cause of increased morbidity and mortality in children undergoing surgery for congenital heart diseases (CHD). Various techniques and drugs have been used perioperatively to alleviate the effects of PHT. Intravenous (IV) sildenafil is one of them and not many studies validate its clinical use. Aims and Objectives: To compare perioperative PaO2 – FiO2 ratio peak filling rate (PFR), systolic pulmonary artery pressure (PAP) – systolic aortic pressure (AoP) ratio, extubation time, and Intensive Care Unit (ICU) stay between two groups of children when one of them is administered IV sildenafil perioperatively during surgery for CHDs. Materials and Methods: Patients with ventricular septal defects and proven PHT, <14 years of age, all American Society of Anesthesiologists physical status III, undergoing cardiac surgery, were enrolled into two groups – Group S (IV sildenafil) and Group C (control) – over a period of 14 months, starting from October 2013. Independent t‑test and Mann–Whitney U‑test were used to compare the various parameters between two groups. Results: PFR was higher throughout, perioperatively, in Group S. PAP/AoP was 0.3 and 0.4 in Group S and Group C, respectively. In Group S, mean group extubation time was 7 ± 7.34 h, whereas in Group C it was 22.1 ± 10.6. Postoperative ICU stay in Group S and Group C were 42.3 ± 8.8 h and 64.4 ± 15.9 h, respectively. Conclusion: IV sildenafil, when used perioperatively, in children with CHD having PHT undergoing corrective surgery, improves not only PaO2 – FiO2 ratio and PAP – AoP ratio but also reduces extubation time and postoperative ICU stay.
  • No Thumbnail Available
    Item
    Enhancing healthcare access and malaria management via mobile clinics and phone call services in Nuh district of Haryana, India
    (Wolters Kluwer – Medknow, 2024-07) Rahi, Manju; Nazmeen, Aarifa; Kumar, Sanjeev; Yadav, Chander Prakash; Kumar, Gaurav; Mittal, Peeyush; Joy, Sam; Sharma, Sachin; Baharia, Rajendra Kumar; Bhati, Gaurav; Goel, Pawan; Sharma, Amit
    Background & objectives: Malaria remains a complex challenge in India due to its diverse epidemiology, multi-ethnic population, and multiplicity of malaria vectors. While progress has been made in reducing malaria nationally, persistent pockets hinder elimination efforts. These challenges include hidden reservoirs, inadequate healthcare, suboptimal surveillance, non-compliance, and subclinical infections. Shortage of grassroot level and primary care health staff, transportation issues and general inaccessibility and unavailability of healthcare services are additional challenges. Methods: Mobile healthcare vans have been tried and found useful in enhancing healthcare availability in several health conditions in different settings. Nuh district in Haryana, India is a malaria endemic region; it is indeed one of the districts included by India’s NITI Aayog in the Aspirational Districts Programme, a government initiative that focuses on rapidly transforming and developing the most underdeveloped districts in country. With an aim to improve the healthcare seeking behavior of malaria-endemic community of selected villages of Nuh district, we carried out a study using interventions in two villages of the district, that had mobile malaria clinics and toll-free telephone services in enhancing healthcare access. Results: We found that Sangel village had higher literacy rates (60.6%) as compared to 39.4% in Naushera. Simi- larly, the unemployment rate was higher for Naushera. It the mobile malaria clinic was deployed from December 2019 to July 2020 and a total of 269 phone calls were received from both the villages. A similar number of rapid tests and microscopy smears were examined and all were negative for malaria. The febrile patients were referred to the nearest healthcare facility. Interpretation & conclusion: The study shows that the community is open to using these healthcare interventions. These initiatives of mobile malaria clinics and toll-free telephone services can bridge healthcare gaps, especially in malaria-endemic regions, aligning with India’s malaria elimination and equitable healthcare access goals.
  • No Thumbnail Available
    Item
    Impact Assessment of Iron and Folic Acid Supplementation with and Without Intensive Health Education in Pregnant Women of Rural Area of District Etawah: An Interventional Study
    (MRI Publication Pvt. Ltd., 2024-02) Kumar, Gaurav; Rani, Vidya; Singh, Naresh Pal; Shukla, Sushil Kumar; Kumar, Ajai; Goswami, Dolly
    Background: Low birth weight , post-partum haemorrhage still births and maternal deaths are associated with anaemia in pregnancy. If prevalence of anemia will be reduced then there will be improvement in maternal and child health and its outcome. Aim & Objectives: To evaluate the changes in the hematological profile of the study subjects and to determine the impact of intensive health education intervention on anemia status of pregnant women. Methodology: A Community based interventional study was conducted among 200 Pregnant women of selected villages in rural area of Etawah district (100 women in each interventional and non-interventional group) using a self-developed, pre designed, pretested, structured and validated questionnaire. statistical package for social sciences (SPSS) software was used to analyse the data. Result: After health education intervention there is significant increase in the haematological profile of study participants of interventional group (p<0.05) as before intervention values of mean Hb was 10.58±1.79 gm/dl which became 11.72±1.48 gm/dl There were 34 (73.9%) participants in the interventional group that were originally anaemic before the study, but after the intervention, they became non-anaemic. Conclusion: Health education sessions helped the pregnant women to improve their knowledge regarding anemia in pregnancy, as well as improve their ability to select iron rich foods, increase compliance with iron supplementation, and raise their haemoglobin levels.
  • Thumbnail Image
    Item
    Impact of Ban on Smokeless Tobacco (SLT) on Second Hand Smoke (SHS) Exposure among Males : Findings of a Community-based Survey in Delhi
    (Indian Association of Preventive and Social Medicine Gujarat Chapter, 2019-01) Kumar, Gaurav; Kumar, Pradeep
    Introduction: Ban on gutka/smokeless tobacco (SLT) in India beginning in 2011 raised apprehension of its users switching to smoking and thereby increased second-hand smoke (SHS) exposure to non-users. Delhi Government issued notification banning gutka and pan-masala containing tobacco and/or nicotine in 2012. To address circumvention of ban by SLT manufacturers, ban was revised and reissued in 2015 to explicitly ban all SLT products. Objectives: To assess change in second hand smoke (SHS) exposure in Delhi three years after gutka ban and one year after explicit ban on all SLT products. Method: Cross-sectional household survey was conducted in Delhi during March-December 2016 to assess SHS exposure at home, workplace and public places. Males aged 15 years and above living in urban Delhi were asked questions similar to Global Adult Tobacco Survey (GATS)-India, 2010. Survey data were compared with 2010 records to assess change in SHS exposure between 2010 and 2016. Results: As compared to 2010, 12.0% less non-smokers reported SHS exposure at home. Among those working outside home, 13.7% non-smokers reported SHS exposure at indoor workplace as compared to 19.3% in 2010. Less educated people are more likely to face SHS exposure at work. Chance of exposure at any public place during last one month has also decreased by 6.5%. Conclusion : Probability of coming across SHS exposure has decreased in urban Delhi at all places in 2016 as compared to 2010. Efforts to enforce SLT ban must sustain without fear of increase in SHS exposure.
  • No Thumbnail Available
    Item
    Impact of full coverage of population with Long-Lasting Insecticidal Nets (LLINs) on malaria vector density in Gadchiroli district of Maharashtra, India
    (Wolters Kluwer – Medknow, 2024-04) Kumar, Gaurav; Ojha, VP
    Background & objectives: Long-lasting insecticidal nets (LLINs) are a major weapon in the fight against malaria. But protection of each family member is not possible with current distribution system with 80% coverage. Therefore, we hypothesized that the distribution of LLIN to every member of a household will be more effective at reducing vector density and ultimately malaria in endemic areas like district Gadchiroli of Maharashtra, India. Methods: The three sub centers Kulbhati, Pannemara and Yerkad of Murumgaon Primary Health Center of Gadchiroli district were selected for the study based on malaria incidence and LLIN distribution. Pre-structured questionnaires were filled to know the distribution and use of LLIN as baseline, thereafter additional LLINs were distributed in selected villages for 100% coverage of population. Entomological surveys were undertaken to know the impact of LLIN on vector mosquito density. Results: A total of 250 houses were surveyed in these villages and questionnaires were filled regarding bednet distribution and their use. 507 LLIN were distributed in study villages (population 1270) of Murumgaon PHC. In four selected villages, additional 409 LLIN were distributed for 100% coverage of population with bed nets. Man hour density of vector mosquito in human dwellings in the experimental villages was significantly reduced, 0–19 in comparison to control (0–66). In cattle sheds, MHD of An. culicifacies was observed to be 1-243 in experimen- tal villages vis-à-vis 1-179 in control villages. During exit trap collection of mosquitoes, ~94 % mosquitoes were deterred from blood feeding. Interpretation & conclusion: In this study there was a significant impact of insecticide-treated nets on vector mosquito density in human dwellings. Thus, 100% coverage of human populations with LLINs may be an important tool in controlling malaria situation in endemic areas like Gadchiroli.
  • No Thumbnail Available
    Item
    Influence of climatic factors on the life stages of Aedes mosquitoes and vectorial transmission: A review
    (Wolters Kluwer – Medknow, 2024-04) Prasad, Pooja; Gupta, Sanjeev Kumar; Mahto, Kaushal Kumar; Kumar, Gaurav; Rani, Alka; Velan, Iyyappan; Arya, Deepak Kumar; Singh, Himmat
    Vector-borne diseases are rampant across the world. Studies have been conducted to assess the impact of climatic factors on the life stages of various mosquito species. In this study, the overall effect of climatic factors such as temperature and relative humidity on the life span, survivability, development, and vectorial capacity of Aedes mos- quito species has been evaluated. A literature survey was done through PubMed, Google Scholar, and Shodhganga databases using the keywords’ “Aedes”, “temperature”, and “humidity”. The search output was analyzed in terms of the impact of environmental factors on the life stages of Aedes species and it was observed that both temperature and relative humidity act as significant indicators for dengue vector propagation and virus transmission. A total of 86 research papers were selected for inclusion, and the study is divided into five criteria: (i) egg eclosion, (ii) larval development, (iii) pupal development, (iv) adult survival, and (v) vector transmission. A 95% Confidence Interval (CI) was estimated using SPSS software. Literature mining results revealed the most optimal temperatures for egg eclo- sion, larval development, pupal development, adult survival, and vector transmission were 24.03±3.79, 24.81±3.23, 26.18±3.96, 26.55±2.71, and 29.78±2.77, respectively. The study finds a knowledge gap regarding the impacts of relative humidity on Aedes biology. The outcomes of this work will contribute to a comprehensive understanding of the core behavioral patterns of Aedes mosquitoes under evolving climatic circumstances. Furthermore, these findings will play a pivotal role in shaping forthcoming strategies for mosquito control.
  • Thumbnail Image
    Item
    Insecticide susceptibility status of malaria vectors in Himachal Pradesh, India
    (Wolters Kluwer – Medknow, 2022-07) Kumar, Gaurav; Ojha, VP; Dhiman, Ramesh C
    Background & objectives: The state of Himachal Pradesh is one of the hilly forested states of India. Warming of climate has been evidenced in the state due to the ongoing climate change which may cause the upsurge/introduction of mosquito-borne diseases. To curb disease transmission, an effective vector control strategy will be required. Methods: Insecticide susceptibility status of available malaria vectors was determined using the standard WHO method in six districts Kangra, Una, Mandi, Bilaspur, Solan and Mandi of the state. An. culicifacies and An. fluviatilis were tested against DDT (4%), malathion (5%) and deltamethrin (0.05%) using WHO insecticide susceptibility kits. Results: Overall, An. culicifacies was found resistant to DDT in all the six districts, susceptible to malathion in all districts except Bilaspur and Solan where it showed possible resistance. It was susceptible to deltamethrin in all the study districts. An. fluviatilis was resistant to DDT and susceptible to malathion and deltamethrin in Kangra and Una districts. Interpretation & conclusion: At present, indoor residual spraying (IRS) is not being undertaken in Himachal Pradesh. However, with the information generated through the present study, the state government can plan evidence-based IRS at least for focal spray in limited foci reporting malaria incidence.
  • Thumbnail Image
    Item
    Laboratory evaluation of the efficacy of boric acid containing toxic sugar baits against Anopheles culicifacies, An. stephensi and Aedes aegypti mosquitoes
    (Wolters Kluwer – Medknow, 2022-01) Kumar, Gaurav; Sharma, Amit; Dhiman, Ramesh C.
    Background & objectives: Attractive toxic sugar baits (ATSB) is a novel tool which employs mosquito sugar feeding behaviour to kill them. The potential of ATSB against mosquito vectors has been demonstrated in limited scope around the world including Israel, some of the African countries and USA. But their efficacy against mosquito vectors of India is yet to be ascertained. Therefore, current study was planned to evaluate the efficacy of TSB (without attractant) against two important malaria vectors Anopheles culicifacies and An. stephensi along with major dengue vector Aedes aegypti. Methods: TSB solution was prepared by dissolving different concentrations of boric acid in glucose and tested against each of the mosquito species. Another experiment was done by spraying this boric acid sugar solution on to Calendula officinalis plant. It served as a sole source of mosquito feed and mortality of mosquitoes was counted after 24 hours. Results: The TSB resulted in 100% mortality of Ae. aegypti and An. stephensi at 4% concentration of boric acid while in An. culicifacies 100% mortality was achieved at 3% concentration TSB solution. TSB solution with 2% boric acid, resulted in 99.1% mortality in An. culicifacies while ~95 % mortality of An. stephensi and Ae. aegypti. When TSB solution with 2% boric acid was sprayed on plant, ~89-94% mortality was observed in both An. stephensi and An. culicifacies. Interpretation & conclusion: Based on the results, boric acid based toxic sugar bait solution could be a promising tool for vector control. Further studies are needed to find out its toxicity of TSB against non-target organisms and residual efficacy in field trials in different ecotypes.
  • Thumbnail Image
    Item
    Long term prognostic significance of thrombolysis in myocardial infarction risk score after revascularization in non-ST elevation acute coronary syndrome
    (Medip Academy, 2020-10) Sarda, Pawan; Kumar, Gaurav; Mathur, Rohit; Baroopal, Anil; Sanghvi, Sanjeev
    Background: Non-ST elevation acute coronary syndrome (NSTE-ACS) patients are complex and varied population. Primarily thrombolysis in myocardial infarction (TIMI) risk score was developed to guide therapy and assess the short term (14 days) prognosis of these patients. However, few studies have evaluated the long term prognostic significance of TIMI risk score after revascularization. This study aims at assessing the long term prognostic significance of TIMI risk score, 36 months after revascularization in NSTE-ACS.Methods: This was a retrospective observational cohort study of consecutive NSTE-ACS patients (n=150) treated by percutaneous coronary intervention between January 2017 to June 2017 in a tertiary care center. TIMI risk score was calculated for each patient at admission. The primary endpoint was a composite of MACE (death, repeat target-vessel revascularization, and non-fatal recurrent MI) at the end of 36 months of follow up. Clinical secondary endpoints included the individual components of the primary endpoint, death, nonfatal recurrent MI, and repeat target vessel revascularization.Results: Baseline characteristics for 150 participants were as follows, age 56±9.5 years, 78.7% male, 25% diabetics, 82% hypertensives, and 36% had hypercholesterolemia. The event rates of the primary endpoint and its components after 36 months were 26.6%. Event rates increased significantly as the TIMI risk score increased as determined by regression analysis (p=0.004). The relative risk increased by 66% as the TIMI risk score increased from low risk category (TIMI score 0-2) to high risk (TIMI score 5-6).Conclusions: TIMI risk score can be used for long term prognostication of NSTE-ACS patients after revascularization, and thus can be used by clinicians for therapeutic decision making.
  • Thumbnail Image
    Item
    A note on the insecticide susceptibility status of secondary malaria vector An. annularis in Jharkhand state of India
    (Wolters Kluwer – Medknow, 2022-07) Das, M K; Rahi, Manju; Kumar, Gaurav; Raghavendra, K
    Background & objectives: An. annularis van der Wulp (1884) is the secondary malaria vector of importance in India. In Jharkhand state it is present in almost all the districts abundantly and transmits malaria. The development of resistance to Dichlorodiphenyltrichloroethane (DDT) in An. annularis was reported from various parts of India. The main objective of this study was to generate information on insecticide susceptibility status of An. annularis to DDT, malathion, deltamethrin and permethrin in different districts of Jharkhand state. Methods: Adult An. annularis female mosquitoes were collected form villages of six tribal districts Simdega (Kurdeg and Simdega CHC), Khunti (Murhu and Khunti CHCs), Gumla (Bharno and Gumla CHCs), West Singhbhum (Chaibasa and Bada Jamda CHCs), Godda (Poraiyahat and Sunderpahari (CHCs) and Sahibganj (Borio and Rajmahal CHCs). Insecticide susceptibility status was determined by using WHO tube test method against prescribed discriminatory dosages of insecticides, DDT - 4.0%, malathion - 5.0%, deltamethrin - 0.05% and permethrin - 0.75%. Results: An. annularis was reported resistant to DDT in six districts, possible resistant to malathion in districts Gumla, Khuntiand Sahibganj and susceptible to deltamehrin (98% to100% mortality) and permethrin (100% mortality). Interpretation & conclusion: An. annularis, the secondary vector species is associated with the transmission of malaria reported resistant to DDT and susceptible to pyrerthroids deltamethrin and permethrin. In view of large-scale distribution of long-lasting insecticidal nets (LLINs) in all the districts, the response to synthetic pyrethroid needs to be periodically monitored to assess the effectiveness.
  • No Thumbnail Available
    Item
    Novel Peri-Operative Strategy for Sickle Cell Disease with Tetralogy of Fallot
    (Wolters Kluwer – Medknow, 2024-07) Khan, Naveed; Dhabe, Vaibhav; Kaskar, Ameya; Kuppusamy, Parthiban; Sen, Supratim; Kumar, Gaurav
    Peri?operative management of cyanotic congenital heart disease in a patient of sickle cell disease (SCD) can be challenging. We report a case of Tetralogy of Fallot and homozygous SCD with history of multiple blood transfusions and sickle cell crises who underwent intracardiac repair. Hemoglobin S level was reduced from 75% pre?operative to 21.8% postoperative with a combination of pre?operative blood transfusion, intraoperative exchange transfusion, and normothermic cardiopulmonary bypass (CPB). Pre?operative optimization and safe intraoperative conduct were essential to avoid sickling crises.
  • Thumbnail Image
    Item
    Nutritional quality enhancement of plants by improving its methionine content.
    (2014-02) Kumar, Gaurav; Chaurasia, Himanshu; Rai, Durg Vijay; Jayanand
    Human beings are only capable of synthesizing ten of twenty naturally occurring amino acids. The other essential amino acids are obtained from the diet. Cereal grains are often limiting for lysine, tryptophan and threonine, while the legume seeds have an adequate level of lysine but are limiting for the sulphurcontaining amino acids, methionine and cysteine. Animals can convert methionine into cysteine, but not the reverse. Low level of methionine in plants diminishes their value as a source of dietary protein for human and animals. There are several attempts to improve the methionine level in plants. This study gives an overview of various technology for enhancement of methionine level in plants, including traditional plant breeding methods and selection of mutant; synthesis an artificial gene rich in methionine and cysteine residue; genetic modification to increase methionine storage in protein; genetic modification to increase methionine biosynthesis and co-expressing methionine-rich storage proteins with enzymes that lead to high soluble methionine level, with minimal interference on plant growth, phenotype and productivity. The studies have resulted in the identification of steps important for the regulation of flux through the pathways and for the production of transgenic plants having increased free and protein bound methionine. The goal of increasing methionine content, and therefore nutritive value, of plant protein is presently being achieved and will no doubt continue to progress in the near future.
  • Thumbnail Image
    Item
    Prevalence of MRSA in ICU in a Tertiary Care Hospital
    (Society for Health Care & Research Development, 2019-07) Kumar, Gaurav; Yadav, Rajesh
    MRSA is a major nosocomial pathogen. It causes severe morbidity and mortality all over the world. MRSA strains are prevalent around the world. In India it is responsible for 25%–50%. Methods: The study included 379 samples from various critical care units. The study was conducted in the Department of Microbiology at Prasad Institute Of Medical Sciences, Lucknow. The duration of study was over a period of three months. Results: In our study, we found that out of total 379 samples ,200 were isolated as Staphylococcus aureus . The prevalence of MRSA cases in ICU was 10.2%. Conclusion: MRSA is an important pathogen for nosocomial infections so studying prevalence of this pathogen in various clinical samples and screening for MRSA colonization in health care workers will help in hospital infection control practices