Browsing by Author "Raina, V K"
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Item Arterial pH and arterial oxygenation are not essential for risk stratification in perforation peritonitis.(1999-01-04) Agrawal, S; Sharma, D; Raina, V KBACKGROUND: The Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system is widely used for assessing the severity of disease and prognostication in cases of perforation peritonitis. Investigations like arterial pH and oxygenation (PaO2), which are considered important in APACHE II, are not available in most hospitals. We therefore attempted to validate a modified APACHE II (without arterial pH and oxygenation) in cases of perforation peritonitis. METHODS: Fifty consecutive patients with perforation peritonitis admitted in the general surgical ward were prospectively analyzed vis-a-vis risk factors and mortality according to the modified APACHE II. RESULTS: The mean modified APACHE II score of those who died was 15.3 (SD 5.7) as compared to 6.6 (4.7) (p < 0.001) in those who survived. As the score increased, mortality rate rose (p < 0.001). When the score was greater than 15, mortality was 88.9%; there was 100% mortality with score greater than 17. CONCLUSION: The modified APACHE II, excluding arterial pH and oxygenation, is simplified, reliable and objective for prediction of outcome in perforation peritonitis.Item Bangalore slums free of filarial infection ?(2005-12-07) Raina, V K; Dhariwal, A C; Ralhan, P K; Tripathi, V C; Wattal, S; Singh, S; Lal, SItem Congenital diaphragmatic hernia "occulta".(2000-01-01) Sharma, D; Saxena, A; Raina, V KCongenital diaphragmatic hernia usually presents with cyanotic attacks, dyspnoea and dextrocardia, a typical triad which is almost considered pathognomonic. The case records of 10 patients (out of a total of 20) of congenital diaphragmatic hernia presenting beyond the neonatal period were reviewed retrospectively. Age and symptoms at presentation and signs elicited were paid special attention. All the patients underwent operative repair of hernia under general anaesthesia. Given below is an explanation for such a high incidence of late presentation in our series. This nomenclature (Congenital Diaphragmatic Hernia "Occulta") will help clinicians in remembering this entity if and when such patients present to the clinicians.Item Control of bancroftian filariasis by diethylcarbamazine medicated common salt in Karaikal, Pondicherry, India.(1989-09-01) Narasimham, M V; Sharma, S P; Sundaram, R M; Reddy, G S; Raina, V K; Sambasivam, V; Das, MA trial of diethylcarbamazine (DEC) mixed in crystal common salt at a concentration of 0.15 to 0.2 per cent was carried out for 46 months (1982 to 1986) in Karaikal town and five commune panchayats of Pondicherry for control of bancroftian filariasis. Comparison of pre and post trial surveys showed 97.6 per cent reduction of microfilaria rate. No microfilaria or disease case was found in less than 5 years age group in the post trial survey. There was about 72 per cent reduction of disease rate. In the post trial substantial reduction of disease manifestation was found in 40 years and below age groups. Vector Culex quinquefasciatus density, filaria infection and infectivity rates were monitored only in Karaikal town. Infective vector mosquitoes were found in 1982 and 1983 only but afterwards no infective mosquito was encountered.Item Correlation of trauma scoring systems with abdominal septic complications in abdominal trauma.(2002-09-06) Agrawal, Vikesh; Sharma, Dhananjaya; Raina, V KINTRODUCTION: Anatomical trauma scoring systems can predict the occurrence of postoperative abdominal septic complications (ASC) after major abdominal trauma; however, this has not been validated in any Indian study. We attempted such an evaluation in patients attending a teaching hospital in central India. METHOD: A retrospective analysis of data from 169 patients who had undergone emergency laparotomy for penetrating or blunt abdominal injury between August 1996 and July 2001 was done. Every patient was scored using three trauma severity indices and the occurrence of ASC was identified. RESULTS: Patients who developed ASC had higher trauma severity scores than those who did not. Thirty-eight patients had isolated small bowel injury; trauma scores underestimated the occurrence of ASC in these patients. CONCLUSIONS: Trauma severity indices may serve as useful tools to predict the occurrence of postoperative ASC in patients with abdominal trauma, except in those with isolated small bowel injury. There is thus a need to modify the weight of small bowel injury in these scoring systems.Item Dengue/DHF: an emerging disease in India.(2000-09-16) Sharma, S N; Raina, V K; Kumar, ADengue/DHF is an emergent disease in India and some parts of country are endemic and periodically contributing annual outbreaks of dengue/DHF. Dengue infection manifests as undifferentiated fever, dengue haemorrhagic fever (DHF) which leads to hospitalization large number of people in a localized area. There is high mortality and morbidity associated with the onset of each dengue outbreak leading to great socio-economic impact. The prevention and control of dengue outbreak depends upon the proper monitoring of the disease case through disease surveillance so as to ensure timely management of cases. Vector surveillance helps in the proper and timely implementation of emergency control measures against dengue vector i.e. Aedes aegypti. There is an urgent need for an effective diagnostic strategy for early diagnosis to shorten the illness duration, hospitalization time and the associated complications.Item Effectiveness of membrane feeding method in relation to development of filarial infective larvae in Culex quinquefasciatus.(1986-12-01) Rao, P K; Kala, G S; Raina, V K; Ghosh, T KItem Efficacy of diethylcarbamazine medicated salt in interrupting Brugia malayi transmission in hill tribe settlements in Kerala State.(1992-03-01) Kaul, S M; Raina, V K; Joshi, R D; Koya, C N; Kumar, A; Verghese, TA filariasis survey carried out about eight years after achieving zero microfilaria (mf) rates following administration of diethylcarbamazine (DEC) medicated salt in the Kani hill tribe settlements in Quilon and Thiruvananthapuram districts of Kerala State revealed that there was no reappearance of Brugia malayi infection in the experimental areas. Mf rates were maintained at zero level in the experimental villages, while in the control villages, 2.9 per cent mf positives were observed. Mansonia (Mansonioides) uniformis dissected did not reveal filarial infection. It is concluded that DEC medicated salt regime in the experimental areas of Kani hill tribe settlements has been successful in effectively interrupting B. malayi transmission. Pilot studies in other B. malayi endemic areas of India using DEC medicated salt regime with the objective of eliminating B. malayi transmission are advocated, since the parasite has a restricted distribution in India and is already showing a declining trend.Item Epidemiology of Brugia malayi infection and its co-existence with Wuchereria bancrofti in and around Sillaberia PHC, District Midnapur, West Bengal.(1990-09-01) Raina, V K; Joshi, M C; Singh, S; Joshi, R D; Bhattacharjee, K K; Kumar, A; Verghese, TOf 2186 persons investigated in thirteen villages of Sillaberia PHC, 19 were found to be infected with Brugia malayi and only one person harboured microfilaria (mf) of Wuchereria bancrofti. Similarly 41 persons exhibited signs and symptoms of chronic filariasis. The mf and disease rates percent worked out to be 0.914 and 1.87 respectively. The earliest ages showing mf and disease manifestations were 3 and 11 respectively. The mean mf density ranged from 2 to 12.2 per 20 cumm of blood. The male and female ratio in terms of mf carriers and chronic cases worked out to be 1.4:1 and 1:2 respectively. The entomological collections revealed a high ten man hour density (163.20) in case of Culex quinquefasciatus and comparatively much lower in case of Mansonia (Mansonioides) annulifera (47.51) and Mansonia (Mansoni oides) uniformis (23.83) respectively. The infection and infectivity rates in case of Mansonia (Mansonioides) annulifera were 6.1 and 1.2 per cent respectively.Item Filaria situation in the Union Territory of Dadra & Nagar Haveli.(1991-09-01) Raina, V K; Joshi, M C; Joshi, R D; Singh, S; Yadava, R L; Kumar, AA resurvey conducted 8 years later in the Union Territory of Dadra & Nagar Haveli revealed the persistence of filariasis amongst its residents. Though no control measures have been in operation since the detection of filariasis in Dadra and Nagar Haveli in 1982, the parasitological indices, microfilaria (mf) and disease rates as well as mf count have remained static. The entomological studies revealed five times increase in density of Culex quinquefasciatus both in Silvassa and Naroli towns.Item A filariasis survey among the migratory labourers at Alwar, Rajasthan.(1986-12-01) Sharma, R S; Raina, V K; Rao, C KItem "Filopin" efficacy in the treatment of lymphatic filariasis.(1991-12-01) Patnaik, S K; Narayana, M V; Rao, P K; Kanhekar, L J; Raina, V K; Biswas, G; Kumar, AItem Hypertonic saline enema in gastrointestinal ascariasis.(1999-09-08) Tondon, A; Choudhury, S P; Sharma, D; Raina, V KMany dangerous surgical complications like intestinal obstruction, acute appendicitis with perforation, ileal perforation in a typhoid patient, Meckel's diverticulitis, disruption of post operative intestinal anastomosis, volvulus, and intussusception are known to occur due to ascariasis, with considerable morbidity and mortality. In this retrospective study of 250 cases of gastrointestinal ascariasis admitted in paediatric surgical wards of Govt. Medical College, Jabalpur (MP), the authors analysed the results of conservative (especially the use of hypertonic saline enema-given just like an ordinary soap water enema but substituting freshly made hypertonic saline in place of soap water) and surgical treatment. The success rate of conservative treatment was 95.6%. Hypertonic saline passes through the incompetent ileo-caecal valve (present in 80% of children) and irritates the worm bolus commonly situated in the terminal ileum, causing it to disintegrate. It also helps to increase the intestinal motility and passage of worms into the colon. The use of hypertonic saline enema is safe and effective in the conservative treatment of gastrointestinal ascariasis. Authors feel that it is the most grossly under utilized part of conservative treatment and deserves to be known and used on wider scale.Item Impact of diethylcarbamazine treatment of selective microfilaria carriers and filarial cases under rural filaria control project in Valsad district, Gujarat.(1984-09-01) Raina, V K; Kosare, G J; Ras, M; Rao, C KItem Is prognostication in congenital diaphragmatic hernia possible without sophisticated investigations?(1999-07-08) Sharma, D; Saxena, A; Raina, V KCongenital diaphragmatic hernia is a complex disorder, in which the anatomical defect is only one part of the spectrum of disease. Hypoplasia of lung complicated by pulmonary hypertension and right to left shunting results in serious hypoxemia. Many factors, based on degree of alterations in respiratory physiology and involving analysis of blood gases and acid base systems, have been used in an attempt to prognosticate the outcome. Majority of these investigations are not available in a modest set up like ours. The case records of all 20 patients admitted and operated for congenital diaphragmatic hernia in pediatric surgery unit of Government Medical College Hospital, Jabalpur from 1978 to 1997 were reviewed retrospectively in an attempt to prognosticate without the sophisticated investigations. It was found that even in a very modestly equipped hospital it is possible to prognosticate--to some extent--the outcome in these cases. Major prognosticators found were APGAR score (if child born in hospital), late age of presentation, location of stomach and identification of hernial sac.Item Lymphatic filariasis in Bilaspur district, Chhattisgarh.(2005-06-06) Singh, Sukhvir; Raina, V K; Bora, D; Dhariwal, A C; Lal, ShivAs per earlier reports only Ratanpur PHC of the district Bilaspur of Chattisgarh was endemic for filariasis. During the present survey microfilaria infection and disease manifestations were detected in two more PHCs namely Bilha and Bilaspur. 3426 Night blood smears were collected from 24 randomly selected localities (13 rural and 11 urban) covering 25% known endemic areas and 75% reportedly non-endemic areas. Sample size was calculated taking 12% prevalence rate using standard statistical formula. Sixty-two indigenous residents (mf rate 1.80%) were found positive for W. bancrofti infection. Males (2.17%) were more affected than females (1.19%). The mf carriers were 2.05% in rural and 1.45% in urban communities, which indicates that lymphatic filariasis is prevalent in rural areas also. The mean mf density was 5.06. No infective or infected mosquitoes could be detected in Culex quinquefasciatus (544 nos.), M. annulifera (13 nos.) and M. uniformis (2 nos.). Comparing the earlier studies, in Bilaspur district the infection has been showing a declining trend and Brugia malayi infection has disappeared.Item Monitoring of temephos (abate) application as a cyclopicide under the guineaworm eradication programme in India.(1990-03-01) Kaul, S M; Saxena, V K; Sharma, R S; Raina, V K; Mohanty, B; Kumar, ATemephos application in unsafe water sources at a dose of 1ppm, which started in 1986, is an important activity of the guineaworm eradication programme in India. During March 1989, monitoring of temephos application was carried out in six villages in each of the five guineaworm endemic districts: Kurnool (Andhra Pradesh), Gulbarga (Karnataka), Dhar (Madhya Pradesh), Thane (Maharashtra) and Jhalawar (Rajasthan), selected for the study. Out of 62 unsafe water sources targeted in the sampled villages for temephos treatment, 43 were treated during 1989 in the five districts (coverage 69.35 per cent). Out of these 43 treated sources 79.1 per cent were free of cyclops and the rest 20.93 per cent showed a variable cyclops count. 117 adult cyclops identified from these sources included Mesocyclops byalinus (82) and M. leuckarti (35). People's perception of utility of chemical treatment of water sources varied from negligibly low to moderate levels. Those areas which received timely application of temephos during the preceding year, al sharp decline in the number of cases in 1989 was observed. However, in those villages where no temephos was applied or where application was started as late as April or May, there was no impact on prevalence of the disease.Item Natural vertical transmission of dengue virus in peak summer collections of Aedes aegypti (Diptera: Culicidae) from urban areas of Jaipur (Rajasthan) and Delhi.(2008-06-24) Bina, Pani Das; Katyal, R; Abhay, Sharma; Raina, V K; Saxena, V K; Lal, SItem Neonatal Surgical Emergencies in a Tertiary Care Center.(2015-09) Yadav, Prashant; Mishra, Arpan; Raina, V KBackground: Congenital anomalies those are incompatible with life unless they are corrected. They constitute the primary justification for pediatric surgery specialty because they demand experienced judgment in early diagnosis, expeditious management as well as highly refined operative technique and post-operative care. Materials and Methods: The clinical material in the present study consists of 124 neonates admitted to pediatric surgical ward of Medical College hospital, Jabalpur from 1st January 2011 to 31st July 2012. Results: Incidence of neonatal surgical emergency was 12.3% among all pediatric surgical admission, i.e. 124 cases in 1007 admissions. The most common neonatal emergency was constituted by gastrointestinal group observed in 49.1% cases. Next in order of frequency was skin defect, i.e., in 25.8% cases followed by respiratory emergency observed in 13.7% cases. Anorectal malformation was the most common cause of gastrointestinal emergency (63.5%). Out of total 35 cases gastrostomy alone was performed in 2 cases, gastrostomy along with ligation and division of trachea-esophageal fistula was performed in 1 case. Transverse colostomy alone in 26 (74.2%) cases and along with gastrostomy in 1 case. Ileostomy and nephrostomy were performed in 1 case each. Ligation and division of tracheoesophageal fistula and end to end anastomosis was done in 5 cases, in which general condition, of patient was good. Excision and repair of meningomyelocele and meningoencephalocele was possible only in 9 (45%) cases out of 20 cases. The mortality in surgical treated patients was (30%), i.e., 27 out of 90 patient treated surgically. Conclusion: There is a need to improve on neonatal surgical diagnosis and care at both primary and secondary health facilities to promote early referral of neonates to these centers. Skilled and dedicated staff with improved infrastructural facilities such as ventilators, a specialized neonatal surgeon, and operating theater and intensive care unit (NICU) will greatly minimize complex problems.Item A note on chloroquine sensitivity in P. falciparum in Sonepat District (Haryana).(1981-12-01) Raina, V K; Roy, R G; Pattanayak, S