Browsing by Author "Singh, R. K."

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    Acute ischemic stroke: management approach
    (Medip Academy, 2023-04) Singh, R. K.; Sachin; Samanta, S.; Yunus, N.; Kumar, M.; Sinha, R. I.
    A stroke, or brain attack, happens when blood flow to the brain is stopped. It is an emergency situation. The brain needs a constant supply of oxygen and nutrients in order to work well. If blood supply is stopped even for a short time, this can cause problems. Brain cells begin to die after just a few minutes without blood or oxygen. Stroke is the second most common cause of death worldwide and the most important cause of physical weakness, with a growing occurrence in developing countries. Ischemic stroke is the most common type of stroke which occurs due to arterial block and managed by fast reperfusion with endovascular thrombectomy and intravenous thrombolysis. The first step in stroke management is initial identification of patients with stroke and triage to centers accomplished of transporting the suitable treatment, as fast as conceivable. Mobile stroke units, tele stroke and artificial intelligence are technologies playing an important role in recognizing and treating stroke. Stroke system-of-care models remain to streamline the distribution of definitive revascularization in the age of mechanical thrombectomy. Overall, in the present review, we emphasized the pathophysiology, diagnosis and management of acute ischemic stroke (AIS).
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    A Comparative Study Of Functional Outcome Of Capsulotomy And Volar Plate Release In Severe Post Burn Hand Deformity
    (Indian Society for Health and Advanced Research, 2024-12) Upadhyay, Vishal Kumar; Shanker, Prem; Singh, R. K.
    Introduction: Burn injuries are a leading cause of trauma-related deaths worldwide, with significant functional and aesthetic implications, particularly when affecting the hands. Contractures and scarring from burns can severely impair joint and tissue function, causing long-term disability and deformity. This study aims to evaluate the functional outcomes of capsulotomy and volar plate release in managing severe post-burn hand deformities. Material And Method: This is a hospital-based prospective study conducted over 24 months at the LLR Hospital GSVM Medical College, Kanpur, including 50 patients with male and female patients of all age groups with Grade 3 and Grade 4 burn contractures. Excluded those with infection or re-contracture at the same site after previous surgeries. Functional and aesthetic satisfaction scores, Total active motion and post-operative complications were recorded. In this study the mean TAM for all fingers of the hand was <180° at preoperativeResults: assessment. This is clearly a significant functional loss, and surgical reconstruction had a significant impact on the improvement in the score to 253.6° in capsulotomy and 243.2° in volar plate release group after 1 year, which is a good outcome .Functional Outcomes-Both procedures resulted in significant improvements in functional and aesthetic satisfaction, with mean scores of 4.6±0.75 and 4.84±0.88 for functional satisfaction, and 4.16±0.78 and 4.48±0.81 for aesthetic satisfaction, respectively. Both capsulotomy and volar plate releaseConclusion: significantly improve functional and aesthetic outcomes in severe post-burn hand deformities. Early surgical intervention combined with supervised physiotherapy is crucial in mitigating the long-term impacts of burn injuries on hand functionality and appearance.
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    Comparison of I-gel and laryngeal mask airway classic in terms of ease of insertion and hemodynamic response: a randomised observational study
    (Medip Academy, 2023-07) Sahaya, A.; Singh, R. K.; Baser, N.; Sharda, S.
    Background: The gold standard technique for preserving a patent airway throughout anaesthesia is tracheal intubation. I-gel is a relatively new addition to the SADs. I-gel has combined the concept of the non-cuffed SADs like the SLIPA and gastric tube of the proseal LMA yet retaining the shape of laryngeal mask. Hence, we have compared ease of insertion, number and duration of insertion attempts among the two devices. Methods: This study was conducted on patients undergoing elective surgery under GA in Pacific Medical College and Hospital, Udaipur. Patients were divided into two groups: group A= LMA classic, a variant of supraglottic airway device and group B= I-gel, a variant of supraglottic airway device. The two devices were than compared with respect to success rate of insertion, time taken for insertion and ease of gastric tube placement (number of attempts) and post-operative airway morbidity. Results: Mean insertion time was 8.66±3.21 seconds in C-LMA and 6.49±1.92 seconds in I-gel (p<0.001). 97.14% was the success rate of single time attempt insertion with I-gel as compared to 88.57% in C-LMA. There was a failure rate of 11.43% in single attempt insertion with CLMA as compared to 2.86% with I-gel (p>0.05). Conclusions: We hereby concluded with our study that successful and shorter duration of insertion, with less hemodynamic response, makes I-gel™ a suitable alternative to LMA classic™ during general anesthesia.
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    Correlation between value of Hba1c and degree of sensorineural hearing loss in type 2 diabetics
    (Medip Academy, 2023-07) Kumar, P.; Mishra, S. K.; Prakash, V.; Singh, R. K.
    Background: Diabetes mellitus and hearing loss are common public health problems. Sensorineural hearing loss in Type 2 diabetes mellitus patients is an underestimated complication. The aim was to study the correlation between level of HbA1c and degree of sensorineural hearing loss. Methods: It was a cross sectional study carried on 130 known cases of T2DM, aged 25-50 years. Various confounding factors such as coexisting hypertension, ear disease, ototoxic drug intake, any neuropathic disorder was excluded in advance. All patients underwent clinical ear examination and pure tone audiometry test. Their level of HbA1c was measured. This value of HbA1c was correlated with the hearing threshold. Results: Out of 130, 58 subjects had normal hearing while 72 had hearing impairment. Among subjects (72 out of 130) having hearing impairment, significant correlation (p-value 0.035 for right ear and 0.029 for left ear) between hearing threshold and HbA1c was found. Also, level of HbA1c significantly (p-value 0.049) correlated with degree of hearing loss. Conclusions: Hearing loss is an underestimated complication of T2DM. This needs to be addressed with periodic hearing assessment of diabetes patients.
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    Immunosuppressive drugs in renal transplantation
    (Medip Academy, 2023-04) Singh, R. K.; Kishor, A.; Rishu, D. R.; Asha, R.; Sinha, K. K.; Sinha, R. I.
    A kidney transplant, sometimes known as a renal transplant, is the treatment of choice for kidney failure at end stage renal disease (ESRD). The renal transplant surgery is followed by a lifetime course of immunosuppressive agents, divided into initial induction phase and later maintenance phase. It is seen that the risk of acute rejection is maximum in the initial months after transplantation (induction phase) and then reduces later (maintenance phase). In induction phase there is use of high-intensity immunosuppression immediately after transplantation, when the risk of rejection is maximum and then the dose reduced for long- term therapy. The main challenge in the renal transplantation community is long- term transplant survival. Long-term graft loss is mainly due to acute and chronic graft rejection, and also due to complications of immunosuppressive therapy. Currently, there is triple therapy as conventional immunosuppressive protocol: a calcineurin inhibitor, an antimetabolite agent, and a corticosteroid. The main aim of development of new immunosuppressive agents is not only improvement of short- term outcomes but also to increase the long- term graft survival by less nephrotoxicity, and minimal side-effects.
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    Land Use Planning and Management in Jamrani Dam Command
    (Ms. M. B. Mondal, 2023-08) Singh, R. K.; Sharma, H. C.
    The Present study was conducted to assess the groundwater inventory in Jamrani Dam Command situated in Uttrakhand and Uttar Pradesh, India. Groundwater inventory was prepared for different blocks of Udhamsingh Nagar, Rampur, and Bareilly districts in Jamrani Dam Command from 1988 to 2010 at an interval of five years. Over-exploitation of groundwater has created an alarming situation in a few blocks of Rampur and Bareilly districts in Jamrani Dam Command. In the year 2010, the Bilaspur, Baheri, Gadarpur, and Rudrapur blocks of the study area were found under the safe category; Swar and Meerganj blocks were found under the critical category whereas Milak and Shergarh blocks were found under the over-exploited category. The maximum and minimum stages of development were found at 109.08% and 59.31% at Shergarh and Rudrarpur blocks, respectively. The overall stage of development for the study area was 68.44% and the area as a whole may be put under the semi-critical category for the year 2010. In the present study, the physical-chemical properties of groundwater in shallow aquifers and their suitability for drinking, irrigation, and industrial uses were studied. The physical-chemical properties of the groundwater of the study area were determined using standard methods of water quality analysis. A comprehensive and proper groundwater recharge plan for the identified landforms with their prevailing geomorphic features in the study area has been suggested to maintain the groundwater at a safe and desired level in the future in the Jamrani Dam Command. Various water recharging structures namely: a series of check dams, percolation tanks, farm ponds and nallah bunds are most possible techniques for recharging groundwater aquifers by utilizing excess water available during monsoon season in the form of runoff obtained from the land surface. Geographic information Systems (GIS) and Remote Sensing were applied to the study area to delineate different land uses from the satellite imageries (IRS-1D). The study area delineated from the S.O.I. toposheets was also classified into nine land use classes i.e. agricultural land, grassland, water body, scrubland, and forest etc.
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    A study of reporting pattern of adverse drug reactions in a tertiary care teaching hospital
    (Medip Academy, 2023-02) Kumar, S.; Singh, R. K.; Seth, R. N.; Sinha, R. I.
    Background: Adverse drug reactions (ADRs) are one of the prime causes of morbidity and mortality, increase in hospital stay and socioeconomic burden on the patients. Periodic monitoring aids in formulating methods for safe usage of medicines in hospitals. Identification of ADRs and their reporting pattern can provide useful information for their prevention. Hence this study was done to see the pattern of reported ADRs in Patna Medical College and Hospital, Patna in a 3 months of study., Methods: It was an observational and retrospective study carried out between July 2022 to September 2022. Both outpatients and inpatients were included in the study. The ADRs in the form of Individual Case Safety Reports (ICSRs) were sent to the nearby adverse drug reaction monitoring centre (AMC)., Results: The occurrence of ADRs was more common in females (56.25%) as compared to males (43.75%). Patients of age-group 21-40 years (40.625%) were most commonly involved. Medicine department (34.375%) reported the maximum percentage of ADRs. Antimicrobials (37.50%) was the most common drug-group causing ADRs. Maximum reported ADRs (81.25%) were probable, 9.375% were possible, 6.25% were certain, while 3.125% were unlikely with the suspected drug as per Naranjo scale., Conclusions: The pattern of ADRs reported in our hospital is comparable with the results of studies conducted in hospital setup elsewhere, along with a few differences. The study results revealed opportunities for interventions in ADR management especially for the preventable ADRs to ensure safer drug use.