Browsing by Author "Sharma, Sunil"
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Item Assessment of insulin resistance and effect of metformin in nonalcoholic steatohepatitis--a preliminary report.(2004-01-27) Duseja, Ajay; Murlidharan, R; Bhansali, A; Sharma, Sunil; Das, Ashim; Das, Reena; Chawla, YogeshINTRODUCTION: Insulin resistance plays a major role in the pathogenesis of nonalcoholic steatohepatitis (NASH). Insulin-sensitizing drugs like metformin may have a role in the treatment of this disease. OBJECTIVE: To determine insulin resistance and the role of metformin in the treatment of NASH. METHODS: We prospectively studied 25 patients with NASH over a period of one and a half years. In addition to clinicopathological profile, we studied the insulin resistance by insulin tolerance test in 10 of them; seven of them, who did not respond to 3 months of low-calorie, low-fat diet, exercise, weight reduction and ursodeoxycholic acid (UDCA), were treated with metformin for six months. Results were compared with control groups. RESULTS: All 10 patients with NASH tested had low insulin sensitivity; there was significant difference in the rate constant for insulin sensitivity (Kitt) between patients with NASH and normal volunteers. Thirteen (52%) patients responded to dietary restriction, exercise, weight reduction and UDCA. Four of 7 patients treated with metformin had normalization of ALT. CONCLUSION: Patients with NASH have insulin resistance. Metformin may have a role in the treatment of these patients.Item Associative role of methylenetetrahydrofolate reductase and thymidylate synthase 6bp del gene polymorphism in preterm delivery(Wolters Kluwer – Medknow, 2023-01) Panikar, Surya AS; Sharma, Sunil; Sureshkumar, Krishna; Dubey, Shubhangi; Thakur, Mansee KapilObjective: Preterm delivery is a major adverse birth outcome, approximately 15 million babies are born prematurely every year. There are several causes for preterm deliveries. This study focuses on folate metabolic pathways. Dietary folate plays a crucial role in premature labor. We examined the relationship between methylenetetrahydrofolate reductase (MTHFR) (C677T) and thymidylate synthase (TYMS) 6bpdel polymorphism. Materials and Methods: A total number of 300 pregnant women were selected for this study; among which ( n = 150) were preterm and ( n = 150) were term delivery cases. The selected samples were further processed for molecular polymerase chain reaction-restriction fragment length polymorphism analysis. The demographic profile of birth status resulted significantly with ( P = 0.0001) proving chances of high infant mortality due to prematurity. Results: The genotype distribution of MTHFR C677T showed significant data ( P = 0.0021) whereas insignificant genotypic distribution was observed for the TYMS gene ( P = 0.067). Our results imply that genes that are involved in the folate pathway play a crucial role in early pregnancy. Conclusion: Advanced and better strategies can be brought to an improved intervention of folate at the time of pregnancy which will help to reduce the rate of premature deliveries.Item Clinical Profile in H. Pylori Positive Patients in Jammu(2006-07) Kumar, Rajesh; Bano, G; Kapoor, B; Sharma, Sunil; Gupta, YudhvirThe present prospective one year, study enrolled 265 symptomatic patients of acid peptic disease, out of which 92 patients were found H. pylori positive (by biopsy urease test and histopathological test) giving a prevalence of 34.71% . Among H. pylori positive patients, 64.13% were males and 35.86% were females. Age wise distribution showed maximum prevalence of H. pylori infection in the age group of 36-45 years and minimum in the age group of 66-75 years. Pain upper abdomen was the most frequent symptom in 49 (54.20%) patients followed by fullness after meals and retrosternal burning. Endoscopic and histopathological examination of H. pylori positive patients revealed chronic superficial gastritis in 87 (94.56%) patients followed by duodenitis in 11 (11.95%) and oesophagitis 8 (8.6%). All the positive patients were given anti-H. pylori treatment.Item Comparative study of proton pump inhibitors for triple therapy in H. pylori eradication.(2007-03-15) Kumar, Rajesh; Tandon, Vishal R; Bano, G; Kapoor, B; Sharma, Sunil; Gupta, YudhvirItem Diagnosis of common mental disorders by using PRIME-MD Patient Health Questionnaire.(2008-02-12) Avasthi, Ajit; Varma, Subash C; Kulhara, Parmanand; Nehra, Ritu; Grover, Sandeep; Sharma, SunilBACKGROUND & OBJECTIVE: Primary care physicians in their clinical settings usually fail to diagnose common mental disorders (CMDs). Primary Care Evaluation of Mental Disorders (PRIME-MD) Patient Health Questionnaire (PHQ) has been shown to facilitate diagnosis of most CMDs seen in primary health care. Its utility in Indian setting has not been evaluated. We carried out this study in Indian setting to evaluate the extent of psychiatric morbidity as measured by PRIME-MD PHQ. METHODS: A total of 500 consenting patients attending Medical outpatient department were recruited. All subjects were first assessed by the physician for presence of any physical illness and psychiatric disorder and their socio-demographic data were collected. Subjects were asked to fill the PRIMEMD PHQ. Illiterate subjects were assisted by the research worker in filling up the questionnaire. RESULTS: At initial evaluation physicians opined that 30.4 per cent of the subjects had psychological disorder, the most common diagnostic category was of anxiety disorders (15.8%), followed by depression (6%) and somatoform disorders (5.6%). On PHQ 42 per cent subjects had at least one psychiatric diagnosis. The most common psychiatric diagnosis was panic disorder (18.4%), followed by other anxiety disorders (16.6%). On comparing the diagnosis of physicians and PHQ, out of 152 cases (30.4%) suspected to have any psychological disorder by the physicians in the initial evaluation, 105 were found to have PHQ diagnosis. Of the 348 cases in which physicians did not suspect any psychiatric diagnosis, 243 were also negative in PHQ screening. There was a significant correlation between physicians and PHQ diagnosis. INTERPRETATION & CONCLUSION: There is a high psychiatric morbidity in the general medical practice and in many cases psychiatric morbidity is either missed or is misdiagnosed and by the physicians. Our results showed that PHQ could be a valuable screening instrument for psychiatric morbidity in primary care and general medical practice.Item Environmental aspects of wastewater reclamation.(2007-07-15) Sharma, Sunil; Choudhary, Mahendra PratapThe population is increasing rapidly and the demand for water by cities, industries and agriculture has tended to grow even faster than the population. Wastewater reclamation consists of a combination of conventional and advanced treatment processes employed to return a wastewater to nearly original quality, reclaiming the water. The environmental health aspects associated with reclamation of wastewater include quality aspects and public health aspects. An attempt has been made in the present paper to describe these aspects and to suggest appropriate solutions.Item Posterior reversible encephalopathy syndrome in pregnancy: A case series of 5 cases(Wolters Kluwer – Medknow, 2022-04) Birle, Vaibhavi; Dongargaonkar, Pradnya; Sharma, Sunil; Gaiwal, Aditi SandipPosterior reversible encephalopathy syndrome (PRES) is a rare clinic-radiological syndrome associated with acute changes in blood pressure during pregnancy. It is characterized symptomatically by headache, seizures, altered mental status, and visual blurring. Radiological changes are white matter vasogenic edema affecting the occipital and parietal lobes of the brain. It is being increasingly recognized due to increased institutional deliveries and advances in imaging particularly magnetic resonance imaging (MRI). Despite the increasing detection, the prediction of PRES and patient factors affecting susceptibility is still not clear. Hence, we conducted a retrospective study to analyze the factors associated with PRES at our tertiary care center.Item Pregnancies in anomalous uterus: series of three cases(Wolters Kluwer – Medknow, 2022-01) Mohite, Shravani; Harshitha, Bennur N.; Sharma, Sunil; Gupta, KalpanaUterine malformations can result from various alterations in the normal development of Mullerian ducts that make up a diverse category of congenital anomalies. In most cases, the defect remains undiagnosed and exhibits the normal number of chromosomes. Very few malformations require any intervention after thorough investigations. The most frequently used classification by the American Society for Reproductive Medicine is comprehensive, but does not include cervical or vaginal malformations. The European Society of Human Reproduction and Embryology has postulated a consensus that precisely shows independent cervical malformations.