Browsing by Author "Sharma, Vijay"

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    AgNOR counts in cervical lesions.
    (2003-04-17) Kaushik, Rajni; Sharma, Vijay; Gulati, Anchana; Sharma, B B
    Present study was undertaken with a view to assess the utility of AgNOR counts in differentiating cervical lesions. One hundred cases of cervical lesions including normal, chronic cervicitis, CIN (I, II, III) and carcinoma were taken up for study during the period December 1995 to November 1996. Three micron thick sections of paraffin were subjected to AgNOR staining as described by Crocker and Smith with a little modification of 0.01% safranin counterstain. Statistical counts of AgNORs were done. The mean AgNOR counts in cervical epithelium showed a progressive and statistically significant increase from normal to chronic cervicitis to CIN, I, II and III (P<0.001). Scores in carcinoma also exceeded that of CIN (P<0.05). This can prove to be a useful adjunct to routine histopathology to evaluate cervical lesions.
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    Antibiotic resistance pattern in Acinetobacter spp.--a retrospective anaysis.
    (2006-12-05) Thakur, Kamlesh; Sharma, Vijay
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    Cervical Spine Injury - A Rare Cause of Torticollis.
    (2011-12) Mittal, Ravi; Sharma, Vijay
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    Clinical resistance of Staphylococcus keratitis to ciprofloxacin monotherapy.
    (2004-12-08) Sharma, Vijay; Sharma, Savitri; Garg, Prashant; Rao, Gullapalli N
    PURPOSE: To review the in vitro susceptibility and the clinical response to 0.3% ciprofloxacin in Staphylococcus aureus keratitis. METHODS: This is a non-comparative case series derived from a prospectively collected database and analysed retrospectively. One hundred and twenty one patients presenting in the cornea service of LV Prasad Eye Institute, Hyderabad, India, between January 1993 and December 2000, and identified to have S. aureus keratitis were included in the study. All patients had received slitlamp evaluation of the cornea and diagnostic microbiologic workup. They were treated with topical antimicrobial therapy based on smear and culture results. All S. aureus isolates were tested for antibiotic susceptibility by disk diffusion and those resistant to ciprofloxacin were confirmed by testing for minimum inhibitory concentration. The patients' clinical response to the antimicrobial therapy was noted. RESULTS: Twenty-five (20.6%) of 121 isolates resistant to ciprofloxacin on in vitro susceptibility testing were further analysed in this study. Fifteen of these 25 (60%) patients were initially treated with topical ciprofloxacin. Twelve of 15 (80%) patients showed no clinical improvement (3-8 days). Based on antibiotic susceptibility results, the antibiotic therapy was modified to fortified cefazolin and gentamicin in seven (58.3%), to vancomycin in one and to chloramphenicol in four cases. The corneal infiltrate resolved in 11 (73.3%) of 15 cases. Two patients required penetrating keratoplasty (PK), one required evisceration, and one patient was lost to follow up. Nine of 25 patients were initially started on fortified cefazolin and gentamicin therapy based on smear positive for gram-positive cocci; this resulted in resolution of infiltrate in 44.4% (4/9) while three required change of antibiotics (vancomycin-2, chloramphenicol-1), one required PK and one patient was lost to follow up. One of 25 patients started and continued on chloramphenicol, showed no response and required PK. CONCLUSIONS: This study shows a significant resistance of S. aureus to many antibiotics including ciprofloxacin and highlights the need for an alternative to ciprofloxacin monotherapy for the treatment of staphylococcal keratitis.
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    A Comparative Assessment of Functional Outcome of Clavicular Fractures Treated by Conservative and Surgical Methods: An Institutional Based Study
    (Ibn Sina Academy of Medieval Medicine & Sciences, 2019-07) Bansal, Arun K; Sharma, Vijay
    Background: Clavicle fracture is a common condition mostlytreated conservatively. Newer operative modalities have comeup to obtain early fixation.Materials and Methods: The present study was conducted in30 patients of clavicle mid shaft fractures which were treatedsurgically and conservatively. Closed fresh fractures in themiddle third region, open fractures of grade 1 and 2 wereincluded and grade 3 open fractures were excluded from thestudy. Patients under the age of 18 and fractures in the medialand lateral third, Pathological fractures were excluded from thestudy. The patients are divided randomly in to operative andconservative group. Sutures removed at 10-12 days. Thefunctional outcome was assessed by Constant and Murleyscore.Results: In the present study total sample size was 30.Clavicular fractures were prevalent in males (60%). Unionoccur in maximum cases in conservative treatment in 21months whereas in operative treatment union occurs inmaximum cases in18 months. The functional outcome wasexcellent in 5 cases in conservative treatment whereas inoperative treatment it was excellent in 6 cases.Conclusion: The present study concluded that operativetreatment was better than conservative treatment for clavicularfractures.
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    Evaluation of an automated erythrocyte sedimentation rate analyzer as compared to the Westergren manual method in measurement of erythrocyte sedimentation rate.
    (2011-01) Subramanian, Arulselvi; Rangarajan, Kanchana; Pandey, Ravindra Mohan; Gandhi, Jatin S; Sharma, Vijay; Bhoi, Sanjeev Kumar
    Context: Monitor 100® (Electa Lab, Italy) is a newly developed automated method for measurement of erythrocyte sedimentation rate (ESR). Aims: The aim of our study was to compare the ESR values by Monitor 100® against the standard Westergren method. Patients and Methods: This cross-sectional study was conducted at a Level I trauma care center on 200 patients. The samples taken were as per the recommendations charted out by International Council for Standardization in Hematology (ICSH) for comparing automated and manual Westergrens method. Statistical Analysis Used: Bland and Altman statistical analysis was applied for evaluating Monitor 100® against the conventional Westergren method. Results: The analysis revealed a low degree of agreement between the manual and automated methods especially for higher ESR values, mean difference -11.2 (95% limits of agreement, -46.3 to 23.9) and mean difference -13.4 (95% limits of agreement-58.9 to 32.1) for 1 and 2 hours, respectively. This discrepancy which is of clinical significance was less evident for ESR values in the normal range <25 mm/hour (-7.7 mean of difference; -18.9 to 3.5 limits of agreement). Conclusions: The fully automated system Monitor 100® for ESR measurement tends to underestimate the manual ESR readings. Hence it is recommended that a correction factor be applied for the range of ESR values while using this equipment. Further studies and validation experiments would be required.
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    Implementation of a short course of prophylactic antibiotic treatment for prevention of postoperative infections in clean orthopaedic surgeries.
    (2013-01) Mathur, Purva; Trikha, Vivek; Farooque, Kamran; Sharma, Vijay; Jain, Neetu; Bhardwaj, Nidhi; Sharma, Satyapriya; Misra, M C
    Background & objectives: Perioperative antimicrobial prophylaxis constitutes the bulk of antimicrobial consumption in any hospital. This study was conducted at a level 1 Trauma Centre of a tertiary care hospital of India to assess the efficacy of a short (24 h) course of perioperative antibiotic prophylactic regimen in preventing surgical site infections (SSI) in open reduction and internal fixation (ORIF) of closed fractures of limbs and to assess if the same can be implemented as a general policy. Methods: Patients of either sex, aged 18 yr or more, who were scheduled for ORIF and were willing and able to give informed consent, were included in the study. Patients were randomly allocated into two groups. Group 1 (n=100) received 3 doses of 1 g i.v. cefuroxime perioperatively spaced 12 h apart and group 2 (n=97) received the conventional existing regimen [5 days of i.v. antibiotics (cefuroxime 1 g twice daily along with amikacin 15 mg/kg in 2 divided doses), followed by oral cefuroxime, 500 mg twice daily till suture removal]. Results: Of the 197 patients, four patients developed a surgical site infection (three with methicillin resistant Staphylococcus aureus and one Acinetobacter baumanii). Of these, two patients were in group 1 and the remaining two in group 2. These patients were treated with i.v. antibiotics based on the culture and antimicrobial sensitivity reports. The cost of the short course treatment was ` 150 per patient as compared to ` 1,900 per patient for conventional regimen. Interpretation & conclusions: There was no significant difference in rates of SSI among the two groups in our study. Cost evaluation revealed that shorter course was less expensive than conventional long course regimen. Implementation of a short course perioperative regimen will go a long way in reducing antimicrobial resistance, cost and adverse reactions to antimicrobials.
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    Radiologic Evaluation of Marginal Bone Loss in Delayed vs. Immediate Loaded Implants –18 Month Results of a Prospective Comparative Study.
    (2015) Bhattacharya, Anirudh; Sharma, Vijay
    Aim: To compare the amount of bone loss (if any) at the mesial and distal sides in delayed and immediate loaded dental implants. Study Design: Total 20 partially edentulous (anterior region of Maxilla) patients were randomized and equally divided into two groups. Group A received delayed loaded dental implants and group B received immediate loaded dental implants. Both the groups were monitored clinically and radiographically at 3, 6, 12 and 18 months. Methodology: We included 20 patients (11 men, 09 women; age range 20-48 years) with single or multiple edentulous areas in mouth. Clinical as well as all routine hematological examinations were done. Radiographs were taken sequentially as required for 18 months. Results: There was no significant statistical difference of bone loss mesially in both the groups at 3 (P=0.99) & 6 (P=0.25) months, but there was significant statistical difference of bone loss mesially seen in both the groups at 12 (P=0.03) & 18 (P=0.01) months. There was no significant statistical difference of distal bone loss in both the groups at 3 (P=0.22), 6 (P=0.38) and 12 (P=0.17) months, but there were significant statistical difference of distal bone loss seen in both the groups at 18 months (P=0.03). The bone loss was found more with the immediate loading type of implants at both mesial and distal sides of implant. Conclusion: The immediate loading implants may provide a lot of benefits over conventional delayed loading implants but the bone loss at Crestal (Marginal) level is higher as compared to delayed loading implants when seen in maxillary anterior impants which should be considered whenever selecting any particular method of dental implantation.
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    Salmonella enterica enteritidis arthritis following trauma in a child with thalassemia major.
    (2010-07) Behera, Bijayini; Mathur, Purva; Farooque, Kamran; Sharma, Vijay; Bhardwaj, Nidhi; Thakur, Yashwant K
    Osteoarticular infections caused by Non-typhi Salmonella are exceptionally encountered. We report a case of a bacteriologically documented knee joint infection due to Salmonella enterica serotype enteritidis, following trauma in a child with thalassemia major. Emergency arthrotomy combined with antimicrobial therapy was helpful in eradication of infection. Physicians should be aware of this rare manifestation of Non-typhi Salmonella infections in thalassemic patients.