Browsing by Author "Kumar, Santosh"
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Item Adbominal Compartment Syndrome: Need for an early recognition of entity often unidentified.(2000-07) Kumar, Santosh; Angral, Ravi; Sharma Ajay., AjayItem Assessment of Depression in Patients of Type-2 Diabetes Mellitus Attending a Tertiary Care Centre(International Society for Contemporary Medical Research, 2019-06) Sharma, Preeti; Kumar, Santosh; Sharma, C.S.; Dixit, Vidhata; Rathi, Harsh; Arya, ViddurIntroduction: Type-2 diabetes mellitus is a common, chronic metabolic disorder with multiple complications if not well controlled. Depression is a very common psychiatric comorbidity in these patients. Multiple environmental and patient related factors are linked with this co-morbidity. It is important to address depression and related factors in these patients for a better outcome. This study aimed to assess depression and distribution of various socio-demographic and clinical details in patients of type-2 diabetes mellitus. Material and Methods: Using a purposive sampling technique, a total of 118 patients of type-2 diabetes mellitus who fulfilled the inclusion and exclusion criteria of this study were enrolled. They were administered Hamilton Depression Rating Scale to assess depression. Overall 66.1% of the patients had co-morbidity of depression. Results: Significantly more number of patients of type-2 diabetes mellitus with co-morbid depression were unmarried (41% vs 15%, χ2=9.029, df=2, p<.05), unemployed/unskilled workers (21.8% vs 5% / 73.1% vs 55%, χ2=24.893, df=2, p<.01), from lower socio-economic status (71.8% vs 52.5%, χ2=4.342, df=1, p<.05), joint family (33.3% vs 7.5%, χ2=9.519, df=1, p<.05) and rural background (82.1% vs 62.5%, χ2=5.453, df=1, p<.05), and had poor control of the level of HbA1c (55.1% vs 2.5%, χ2=41.022, df=2, p<.01) than those without co-morbid depression. There was a significant negative correlation of years in education with HAM-D total score (r=-.471, p<0.01). Conclusion: A co-morbidity of depression is very common in patients of type-2 diabetes mellitus and various sociodemographic and clinical factors are linked to this comorbidity. It is important to address these issues for the sake of overall better outcome in type-2 diabetes mellitus.Item Assessment of serum cardiac troponin-I over serum CPK-MB in early diagnosis of acute myocardial infarction (AMI)(Medip Academy, 2018-05) Kumar, Santosh; Patil, SachinBackground: The early mortality rate from AMI is 30% with about half of them occurring within 1hour of disability. Although the mortality rate after admission for AMI has declined by 30% over the past decades, approximately 1 of every 25 patients who survive the initial hospitalization die in the first year after AMI. The gold standard for diagnosis of MI has been an elevated serum level of creatinine kinase – myocardial band (CK- MB), the cardiac-specific isoenzyme of CK. However, elevated CK-MB may not detect all myocardial necrosis. In patients who die suddenly after severe or silent episodes of ischemia, autopsies frequently reveal micronecrosis that was not reflected in routine CK-MB measurements. The present study was undertaken to know that serum Cardiac Troponin-I is more sensitive marker than serum CPK-MB in early diagnosis of acute myocardial infarction (AMI).Methods: The study was carried out in tertiary care hospital in Gulbarga. The study was undertaken with an aim to study that serum cardiac troponin-I (cTnl) is more sensitive than serum CK-MB in early diagnosis of acute myocardial infarction (AMI). The study was conducted on patients admitted with history of chest pain suggestive of AMI as diagnosed by WHO criteria to medicine ward of Basaveshwar Teaching and General Hospital, Gulbarga. The period of study was from June 2012 to June 2014. The sample size included 100 patients with history of chest pain suggestive of AMI, selected by simple random method.Results: Our results revealed that cardiac troponin I was more sensitive (62%) than CK-MB in overall cases admitted in between 6-24 hrs from the onset of chest pain. Maximum number (41%) of AMI patients were affected on the anterior wall followed by Inferior wall of AMI. 11 percent were affected with Antero lateral wall wereas 5 to 6 percent were affected with anteroseptal and global acute and right ventricular AMI was seen among 2 percent of patients. Anterior wall AMI was the significantly affected site with AMI (ʎ2:12.5, P:0.0004). The maximum number of acute myocardial infarctions were ST elevation myocardial infarctions. 28% of cases where CKMB is normal, the cTnI detects the AMI cases indicating its sensitivity.Conclusions: Cardiac troponin-I (cTnI) was more sensitive serum marker than CKMB in the early diagnosis of acute myocardial infarction (AMI). Anterior wall was the most significantly affected site of AMI. In the future, further improvements in analytical performance may open additional diagnostic windowsItem Assessment of the efficacy of olopatadine 0.1% in the treatment of vernal keratoconjunctivitis in terms of clinical improvement based on total ocular symptom score and ocular surface disease index(All India Ophthalmological Society, 2023-05) Mohan, S; Kumar, Santosh; Kumar, G Pawan; Maheswari, Anjali; Bhatia, Agrima; Sagar, AnandPurpose: The main objective of this study is to explore the efficacy of olopatadine 0.1% treatment in the resolution of symptoms of vernal keratoconjunctivitis (VKC) among the Indian population. Methods: This single?center, prospective cohort study involved 234 patients with VKC. Patients were treated with olopatadine 0.1%, twice daily for a period of 12 weeks and then followed up in 1st week, 4th week, 3rd month, and 6th month. The extent of relief in the symptoms of VKC was measured using total ocular symptom score (TOSS) and ocular surface disease index (OSDI). Results: In the present study, the dropout rate was 5.6%. Total of 136 males and 85 females with a mean age of 37.68 ± 11.35 years completed the study. TOSS score reduced from 58.85 to 5.06 and the OSDI score reduced from 75.41 to 11.2 with statistical significance (P < 0.01) from 1st week to 6th week after olopatadine 0.1% treatment. The data showed relief in subjective symptoms of itching, tearing, and redness, and relief in discomfort in functions related to ocular grittiness, visuals like reading, and environmental like tolerability in dry conditions. Further, olopatadine 0.1% was effective in both males and females, and patients across ages 18–70 years. Conclusion: Based on TOSS and OSDI scores, the findings of this study validate safety and tolerability as revealed by low adverse effects and moderate efficacy of olopatadine 0.1% in reducing VKC symptoms in a broader age group (18–70 years) of both genders.Item Assessment of Tooth Movement with Piezocision and Its Periodontal Transversal Effects in Class II Malocclusion Patients: A Clinical Study(Society for Health Care & Research Development, 2018-09) Pandey, Vijayendra; Chandra, Subhash; Biswas, Nitubroto; Kumar, Santosh; Singh, Shweta; Kumar, MukeshBackground: There are considerable amount of population suffering from malocclusion. An increasing number of patients are demanding orthodontic treatment for improved esthetics and a better mastication system. The present study was conducted to assess tooth movement with piezocision and its periodontal transversal effects in class II malocclusion patients. Methods: The present study was conducted in the department of Orthodontics. It comprised of 120 patients with class II malocclusion. Before canine distalization and after the alignment and leveling phases, piezocision was performed on experimental side (Group I). Tooth mobility and gingival index was assessed on both sides. Results: In group I, there was 3.56± 1. 4 months and in group II there was 5.61± 1.2 months for distalization. There was 1.54± 1.3 mm and 0.80± 1.1 mm distalization in group I and group II. The difference was significant (P< 0.05). The mobility score was 1.2 and 1.4 before and after distalization in group I and 1.3 and 1.5 before and after distalization in group II. The difference was non- significant. Gingival index score was 1.4 and 1.3 before and after distalization in group I and 1.5 and 1.6 before and after distalization in group II. The difference was non- significant (P> 0.05). Conclusion: Piezocision-assisted distalization accelerates tooth movement, decreases the anchorage loss for posterior teeth, and does not induce any maxillary transversal change. This technique does not have any adverse effects on periodontal health.Item Auto-amputation of penis due to carcinoma: Still a threat in the era of modern medicine: Report of two cases.(2013-03) Ghosh, Bastab; Manikandan, Ramanitharan; Dorairajan, Lalgudi N; Kumar, SantoshIncidence of penile carcinoma is decreasing worldwide. Nevertheless, the incidence of penile cancer is still significant in various tropical countries, and it often presents in advanced stage. We report two unique cases of penile auto-amputation due to advanced cancer and review relevant literature. Both the patients presented with ulcerative lesion replacing penile base following automatic sloughing of the whole penis and voiding dysfunction. In addition, the first patient had metastatic inguinal lymph nodes. Supra-pubic urinary diversion was the initial management in both the patients. The first patient was treated with combined chemo-radiation, but he succumbed to death following two cycles of chemotherapy. The second patient was successfully treated with total penectomy and perineal urethrostomy. He recovered well but was lost to follow-up.Item Awareness Regarding Child Abuse and Neglect among Dental Professionals of Telangana(International Society for Contemporary Medical Research, 2020-04) Archana, Ramunigari; V, Krishn Priya; G, Shilpa; Kumar, Santosh; Murthy, VV Ramakrishna; Mayuri, GaneshIntroduction Dental erosion is defined as a non-carious lesionhaving superficial tooth loss initiated by a chemical processeither intrinsic or extrinsic, without involvement of bacteria.The incentive of this study was to assess and compare dentalerosion associated with the intake of carbonated drinks amongdental students; day scholars and hostel residents of theUniversity College of dentistry, Lahore.Materials and Methods: A cross-sectional descriptive studywas carried out on 183 dental students. Dental erosion wasestimated using the index of Basic Erosive Wear Examination(BEWE).Results: 31.6% hostel residents and 11.2% day scholarsconsumed carbonated drinks multiple times daily. Highererosion index values were seen in hostel residents than dayscholars. 48.6% was the prevalence of dental erosion amongthe study participants.Conclusion: Hostel residents consume more carbonateddrinks than day scholars. Erosion of teeth by carbonated drinksis influenced by the frequency, quantity, type, carbonateddrinks temperature and persons drinking habits.Item Bioassay of three sulphur containing compounds as rat attractant admixed in cereal-based bait against Rattus rattus Linn.(2002-08-25) Veer, Vijay; Gopalan, N; Kumar, Santosh; Prakash, ShriThree sulphur containing compounds, carbon disulphide, dimethyl disulphide and dimethyl sulphide were bioassayed for preference after admixing them in cereal base as ready bait block for use against commensal rat, R. rattus (wild type) in four way choice chamber system. Rat preference for different baits was also studied with automatic recording animal activity meter. Rats exhibited attractancy to the baits at 0.005% concentration of all the three compounds while at 0.01% concentration they have showed repellency. Dimethyl sulphide at 0.005% concentration showed better attractancy towards both sexes of rat.Item Cemented monoblock hemiarthroplasty: a dependable option in femoral neck fracture in elderly(Medip Academy, 2019-04) Kumar, Santosh; Verma, Vikas; Kumar, SanjeevBackground: Femoral neck fracture in elderly continues to pose a treatment dilemma. Associated co-morbidities and high mortality (1-year mortality of 25–30% and only 25% survivorship at 10 years) often skews the surgical decision. The underlying treatment goal is minimum revision and maximum functional outcome. Lack of clear guidelines is reflected by the continued debates regarding their management namely osteosynthesis vs arthroplasty; hemiarthroplasty vs total hip arthroplasty, unipolar vs bipolar and cemented vs uncemented. A review of joint registries, uniformly suggest that cemented fixation in elderly patient results in early mobilization, less residual pain and the lowest risk of revision. We analyzed clinical outcome of cemented monoblock hemi-arthroplasty (modified design) in femoral neck fracture in elderly.Methods: Total 94 cemented hemiarthroplasty, performed since January 2009, with a minimum follow up of 3 years are included in the study. Mean modified Haris Hip score at 2 years, 3 years and in the last follow up was 88 (72-91), 84 (70-89) and 81 (65-86) respectively. Acetabular erosion was noted in three patients (3.19%) (one was symptomatic) and aseptic loosening in another two patients (2.12%). Major complications such as deep wound infection, dislocation or peri-prosthetic fracture were not noted in any patient.Results: Result of the present study is consistent to marginally superior when compared to cemented Thompson monoblock and the cemented bipolar prostheses. We attribute this to routine use of cement in the elderly osteoporotic bone along with design modification of the monoblock stem. Long term result of THA is marginally (not statistically significant) better compared to hemiarthroplasty. However, it is associated with prolonged surgery, more blood loss and higher dislocation rate. The rates of dislocation following THA, bipolar and unipolar arthroplasty were 11%, 3%, and 2% respectively.Conclusions: Cemented monoblock hemiarthroplasty is effective and viable option in displaced femoral neck fracture in elderly in terms of excellent functional outcome, low reoperation without adversely affecting morbidity and mortality. Being cost effective procedure this may be considered as first line surgical option especially in socio-economically disadvantaged section of the society.Item Characterization of succinic semialdehyde dehydrogenase from Aspergillus niger.(NISCAIR-CSIR, India, 2015-02) Kumar, Santosh; Kumar, Sunil; Punekar, Narayan SThe catabolism of fungal 4-aminobutyrate (GABA) occurs via succinic semialdehyde (SSA). Succinic semialdehyde dehydrogenase (SSADH) from the acidogenic fungus Aspergillus niger was purified from GABA grown mycelia to the highest specific activity of 277 nmol min-1 mg-1, using phenyl Sepharose and DEAE Sephacel chromatography. The purified enzyme was specific for its substrates SSA and NAD+. The substrate inhibition observed with SSA was uncompetitive with respect to NAD+. While product inhibition by succinate was not observed, NADH inhibited the enzyme competitively with respect to NAD+ and noncompetitively with respect to SSA. Dead-end inhibition by AMP and p-hydroxybenzaldehyde (pHB) was analyzed. The pHB inhibition was competitive with SSA and uncompetitive with NAD+; AMP competed with NAD+. Consistent with the kinetic data, a sequential, ordered Bi Bi mechanism is proposed for this enzyme.Item Chronic Nonhealing Ulcers ‒ Garhwal Region (Etiopathology, Microbiology with Susceptibility, Managements & Outcomes)(SCIENCEDOMAIN international, 2020-06) Keshri, Amit; Bhatt, Mukul P.; Kumar, Santosh; Punita, K.Introduction:Chronic nonhealing ulcers, with varied etio-pathologies, are difficult to manage and warrant meticulous, early and prolonged directed treatment to prevent their development and complications.Methods:Patients of chronic ulcers (>3 months’ duration), having undergone surgical management at our Institute, VCSGGMS&RI-UT, between January 2018 –August 2019, numbering one hundred twenty five (N= 125), were included in this concurrent observational study, aimed at identifying implicated microrganism(s) and their antibiotic susceptibility, for promoting wound healing, along with surgical measures Results:Male patients (M:F :: 87:38; 69.6% males) in the “20-50 year” age-group (74; 59.2%), with diabetic ulcers (35;28.0%), burns etc. (21;16.8%) and traumatic ulcers (18;14.4%) etc. predominated in the chronic non-healing state. Gram positive (68; 54.4%) organisms (including Staphylococcus) were the major isolates from the ulcers; organisms showing higher sensitivity to the newer generations/groups of antibiotics. Uncontrolled Diabetes, other prolonged illnesses &/or under-nutrition were important causative factors, requiring their remediations and also debridements ± skin/flap coverage (45; 36.0%) with prolonged course of antibiotics and occasional amputations (18; 14.4%) for adequate treatment.Conclusion:Skilled intensive multidisciplinary effort is essential to achieve satisfactory healing and prevent disfigurement and to limit disability and death (11; 8.8%) among the patients.Item Clinical profile of patients presented with esophageal carcinoma in tertiary care teaching medical college of Gujarat, India(Medip Academy, 2019-03) Kumar, Santosh; Shah, Amit; Pandya, Hetal; Shah, MeeraBackground: Esophageal cancer is associated with multiple risk factors and associated with poor prognosis. Incidence of Esophageal cancer is increases now a days and it became a sixth leading cause of cancer related death in world. The purpose of this study was to know the clinical profile of patients of esophageal cancer in a tertiary care teaching hospital of Gujrat, India.Methods: This is a retrospective hospital record based study for a period of 2015 to 2018 in which 103 patients with endoscopic biopsy confirmed cases of esophageal cancer were analyzed for clinical profile.Results: Esophageal cancer was most common in low socioeconomic men (66%) of 5th decades (26.21%) associated with tobacco chewing (64.07%) as a major risk factor and dysphagia (86.76%) as most common presenting feature. Most common type and involvement were sqamous type (72.81%) and distal third (50.48%) part of the esophagus respectively.Conclusions: Primordial prevention and screening of patients may decrease mortality related to esophageal carcinoma.Item Comparative account of certain enzymes in the serum of homo-iothermal vertebrates subjected to production of myocardial infarction by isoproterenol hydrochloride.(2003-10-14) Gaur, Madhavi; Kumar, SantoshMyocardial infarction was produced by subcutaneous administration of isoproterenol hydrochloride (85 mg/kg b.w. for two consecutive days). The myocardial damage was proved by observing increase in the activity of SGOT and SGPT in serum whereas AChE activity was inhibited by increasing Km, without affecting Vmax. The inhibition of AChE and inhibitory kinetic may be useful in the diagnosis and management of salvage of myocardium.Item Comparative Evaluaton of Root Fracture Resistance Using Different Root Canal Sealers(Society for Health Care & Research Development, 2019-11) Kumar, Santosh; Shashank, Saurav; Rashmi, Issar; Kumari, Khushboo; Prasad, Rekha; Kumar, AlokBackground: Endodontically treated teeth are widely considered to be more susceptible to fracture than vital teeth. To reinforce the instrumented teeth against fracture; sealers are used in conjugation with a core filling material. Methods: The 120 prepared teeth were randomly divided into four experimental groups and two control group of 20 teeth each. One control group of 20 teeth where access opened and left unistrumented and unobturated. Group- I: Teeth obturated with gutta percha and epoxy resin based sealer. Group- II: Teeth obturated with polymer based core and methacrylate based Sealer. Group- III: Teeth obturated with gutta percha and calcium silicate based sealer. Group IV: Teeth obturated with gutta percha and zinc oxide eugenol based sealer. Group V: Teeth instrumented and obturated with gutta percha without use of sealer (Positive control). Group VI – Teeth with no instrumentation or obturation (Negative control). Results: The mean fracture resistance values (in N) are Group I i.e. Epoxy resin root canal sealer – 286.06 N, Group II i.e. Methacrylate resin root canal sealer - 328.77N, Group III i.e. Calcium silicate based root canal sealer - 265.05N, Group IV i.e. Zinc oxide eugenol based root canal sealer - 269.85N, Group V i.e. Positive control (Obturated without root canal sealer) - 258.91N, Group VI i.e. Negative control (No instrumentation and obturation) - 285.41N. Conclusion: Among the root canal sealers; resin based root canal sealers showed higher resistance to fracture than non adhesive sealersItem A Comparative Study of Fentanyl and Dexmedetomidine in Attenuating Haemodynamic Response of Laryngoscopy and Intubation.(2015-04) Das, Bikramjit; Palaria, Urmila; Sinha, Ajay K; Kumar, Santosh; Pandey, VijitaBackground: Dexmedetomidine is a centrally acting alpha-2 adrenoceptor agonist. In this study, we compared dexmedetomidine to fentanyl in attenuating sympathetic response to laryngoscopy and tracheal intubation. Methods: Eighty ASA grade I-II patients requiring tracheal intubation were included in this prospective study and were randomly assigned to the dexmedetomidine (Group D) and fentanyl group (Group F) (40 patients in each group). Both the drugs were given at 1 μg/kg dose prior to laryngoscopy. We assessed heart rate, blood pressures and complications (bradycardia, hypotension and sedation). Results: The two groups were comparable in demographic parameters. The baseline mean heart rate (P=0.94) was not significantly different between Group F and Group D. Increase in heart rate after laryngoscopy and intubation was significantly lower in Group D compared to Group F (P=0.039). Mean heart rate remained lower at one minute after intubation in Group D but it was not statistically significant (94.64 s vs 86.28 sec). The difference in mean heart rate between two groups was comparable at three, five, ten and fifteen minutes after intubation. The baseline Mean arterial pressure was comparable between the groups (P=0.83) and remained similar throughout 15 minutes after intubation. Group D showed significant hypotension compared to Group F (P=0.03), whereas there was no significant bradycardia between these groups (P=0.19). Mean sedation score is higher in Group D compared to Group F. Conclusion: At 1 μg/kg dose, both dexmedetomidine and fentanyl cause partial attenuation of sympathetic response to laryngoscopy and intubation but dexmedetomidine blunts this response more effectively than fentanyl.Item Diagnostic Accuracy of Cartilage Oligomeric Matrix Protein (COMP), for Cartilage Damage in Rheumatoid Arthritis(SCIENCEDOMAIN international, 2020-09) Qabulio, Shabana; Shaikh, Fouzia; Mirza, Ahmad Iqbal; Moazzam, Ali Shahid; Kumar, SantoshBackground:Cartilage oligomeric matrix protein (COMP), is an extracellular matrix (ECM) non-collagenous glycoprotein that is mainly localized within the cartilage, and also be found in tendon and synovium.RecentstudiesinwestandAsiaPacificregionhasshownthatCOMP, is a prognostic marker in Rheumatoid arthritis(RA).Objective:To correlate serum COMP levels with disease severity and cartilage destruction in rheumatoid arthritis.Methods:The study was conducted in Department of Pathology and Rheumatology, Ziauddin University Hospital, Karachi from June 2018 to May 2019. Patients were recruited as per American College of Rheumatology (ACR) 2010 classification criteria. The study populationconsists of 88 healthy subjects and 88 RA patients. Sandwich ELISA technique was used to assess serum COMP level. Other inflammatory markers such as erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) antibodies like rheumatoid factor, and anti-cyclic citrullinated protein (anti-CCP) were also assessed. Results were analyzed using SPSS-20 and P-value ≤0.05 was considered as significant.Results: Serum COMP levels were significantly higher in RA patients 51.35ng/ml than controls 21.454ng/ml with significant p value=<0.0001. There was strong positive correlation between COMP level and disease severity in RA patients with moderate as well as high disease activity score (DAS) with significant p value. Serum COMP showed 96% sensitivity and 83% specificity at level of 27.01ng/ml for diagnosis of RA.Conclusions:COMP has significant positive correlation with severity of RA. Serum COMP can be utilized as a biomarker to quantify cartilage destruction in RA patientsItem Diagnostic utility of cytospin, cell block and immunocytochemistry in pleural effusion cytology(Medip Academy, 2020-07) Miachieo, Nounechutuo; Kumar, Madhu; Sagar, Mala; Maurya, Malti Kumari; Kumar, Santosh; Kushwaha, R. A. S.; Goel, Madhu MatiBackground: With the introduction of cytospin, the sensitivity of diagnosing malignancies has increased mainly due to the increase in cellular yield. Cell block also gives the advantage of ancillary testing and allows for retrospective studies. Immunocytochemical markers are used to differentiate and subtype various malignancies in body effusions.Aim of the study was to compare the morphological features of both technique and to assess the diagnostic utility of cell block methods in the cytodiagnosis of pleural effusions.Methods: This was a Prospective observational comparative study of two cytopreparatory techniques. All samples were examined and processed by cytospin and cell block techniques. Continuous data were expressed as Mean±SD (standard deviation) while categorical data were expressed in number, percentage and compared by chi-square (χ2) test.Results: The final diagnosis of both cytospin (147 cases) and cell block (150 cases) techniques was divided into four broad categories: Inadequate, Benign, Suspicious and Malignant. The significant diagnostic cytospin (AUC=0.857, p<0.001) in discriminating positive and negative malignant cases with 75.00% sensitivity (95% CI=53.3-90.2) and 100.00% specificity (95% CI=86.7-100.0) and with 100.0% positive predictive value and 81.2% negative predictive value. In contrast, cell block also showed significant diagnostic but with higher accuracy (AUC=1.000, p<0.001) and sensitivity 100.00% (95% CI=86.7-100.0) and specificity 100.00% (95% CI=86.7-100.0) and 100.0% positive predictive value and 100.0% negative predictive value than cytospin technique.Conclusions: Cell block as a technique should be used in routine practice as it not only increases the diagnostic yield but ancillary test can also be done.Item Drug compliance after stroke and myocardial infarction: A comparative study.(2007-04-15) Arif, Hiba; Aijaz, Bilal; Islam, Muhammad; Aftab, Unber; Kumar, Santosh; Shafqat, SaadBACKGROUND: Stroke and myocardial infarction (MI) are both life-threatening diseases of vascular origin with a tendency to recur. In both conditions, risk of recurrence is reduced through similar drug regimens. AIM: To determine if compliance with prescribed medication after stroke or MI was similar in the two populations. SETTING AND DESIGN: Retrospective data collection and cross-sectional telephonic survey of patients discharged from a single academic medical center. MATERIALS AND METHODS: Adult patients consecutively discharged over a two-year period with a diagnosis of first-ever stroke (ischemic or hemorrhagic) or first-ever MI (ST-elevation) were identified through ICD-9 codes. Clinical details were abstracted from hospital records. Medication compliance was assessed through a structured telephone interview. STATISTICAL ANALYSIS: Bivariate analysis using Chi-square and Fisher exact tests, to determine the prevalence of noncompliance in stroke versus MI patients and differences in baseline characteristics and multivariate analysis with logistic regression to determine independent predictors of noncompliance. RESULTS: Follow-up data was collected for 298 stroke and 275 MI patients. Compliance was lower in stroke patients (68% stroke patients compliant with at least half their discharge prescriptions versus 90% MI patients; P < 0.001). Literacy and post-discharge follow-up were associated with greater compliance (P < 0.05 for both). Compliance was highest with anti-hypertensive drugs (98% after MI, 78% after stroke), followed by anti-platelet agents (94% after MI, 75% after stroke) and anti-lipid agents (70% after MI, 59% after stroke). Patients reported simply not feeling the need, acquiring fresh medical advice or a perceived lack of benefit, as reasons for not complying with their discharge prescriptions. Conclusions: Although similar drugs are involved, compliance with prescribed regimens is appreciably lower after stroke than after MI. Our findings underscore the need for better patient education regarding secondary prevention after stroke.Item Drug utilization audit of antipsychotics using WHO methodology: recommendations for rational prescribing(Medip Academy, 2018-10) Shaifali, Iram; Karmakar, Rajib; Chandra, Shalini; Kumar, SantoshBackground: Utilization pattern of antipsychotics has undergone a major shift as the newly introduced atypical antipsychotics have heralded the market. Hence continuous studies on current prescribing trends are needed to provide most updated, effective and rational treatment of psychoses.Methods: This cross-sectional prospective study was conducted at Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India. OPD tickets of the department of psychiatry for the year 2016-2017 were evaluated for a total of 310 cases. These prescriptions were used to determine the drug utilization of antipsychotics and for their appropriateness against the WHO recommended core prescribing indicators.Results: A total of 310 patients satisfied the inclusion criteria and a male predominance was seen (male:female= 1.3:1). The most common psychotic disorder diagnosed was schizophrenia (44%). Majority of the patients (76%) received monotherapy and the prescribing trend showed a higher use of atypical antipsychotics (89%) over typical ones (11%). The most commonly prescribed anti-psychotic drugs were olanzapine (31%), followed by risperidone (26%). On analysing prescriptions according to the WHO core prescribing indicators it was observed that average number of antipsychotics prescribed per prescription was 1.32. 24% of drugs were prescribed by generic name and 5.2% were administered via injectable route. Drugs prescribed from National list of Essential Medicine, 2015 constituted 46%.Conclusions: The high inclination towards the use of atypical antipsychotics observed in our study correlates with the global changing trends in the treatment of schizophrenia. WHO prescribing indicators should be adhered to, to impart rational prescribing.Item Estimation of lymphocyte apoptosis in patients with chronic, non healing diabetic foot ulcer.(2013-10) Kumar, Arya Awadhesh; Garg, Sunny; Kumar, Santosh; Meena, Lalit P; Tripathi, KamlakarBackground: Lymphocytes play an important role in wound healing and the removal of circulating T lymphocytes inhibits the healing cascade. Decreased stimulation of survival factors and increased levels of dead signals may lead to the malfunction of many cells, including lymphocytes. Aims & Objective: To explore lymphocytes involvement in wound healing. Material and Methods: Study participants were divided into three groups: group A, group B and group C (30 participants each). Annexin-V-FITC+CD-3-PE kit were used for the lymphocyte apoptosis estimation in diabetic foot patients by florescent activated cell sorter (FACS). Results: We find out significantly higher total T cell apoptosis in type 2 diabetes mellitus patients having chronic, non healing diabetic foot ulcer as compared with healthy individuals. CD-3 + Annexin-V-FITC positive lymphocytes were statistically significant in group C (P<0.01) and group B (p<0.001) when compared from group A. Conclusion: This study suggests the importance of T-lymphocytes in wound healing. From the present study we can suggest diabetic patients to maintain their immune system for the normal wound healing.
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