Browsing by Author "Singh, V"
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Item Acetylsalicylic acid-induced biochemical changes in gastric juice: a failure of adaptation?(1998-01-18) Nain, C K; Kaur, U; Singh, V; Dhawan, V; Singh, KBACKGROUND: Acetylsalicyclic acid (ASA) causes gastric mucosal damage which diminishes with continued use due to adaptation. METHODS: To determine the net effect of these processes on the gastric juice, we estimated acid, osmolality, bicarbonate concentration in nonparietal gastric juice, calcium, potassium and sodium in 18 patients (9 men; mean age 32 years, range 20-46) with irritable bowel syndrome, before and after 600 mg of ASA taken post-cibum thrice daily for 4 weeks. Osmolality was determined by an osmometer, acidity by titration, and Na+, K+ and Ca++ using a sodium-potassium-calcium analyzer; bicarbonate was derived from the two-component model of Feldman. RESULTS: Gastric juice K+ and Na+ increased significantly from mean (SE) 14.6 (0.5) and 197.5 (16.3) to 16.7 (0.4) and 256.8 (18.1) mEq/L, respectively. The other parameters remained unchanged. CONCLUSION: After four weeks of ASA ingestion there is a dichotomy of gastric mucosal injury and adaptation, with preservation of acid secretion but continued loss of Na+ and K+.Item Acute intermittent porphyria: an unusual cause of malignant hypertension.(2003-02-03) Singh, V; Sud, Kamal; Kohli, H S; Gupta, K L; Sakhuja, VHypertension is a rare complication of acute intermittent porphyria (AIP) and is related to the sympathetic over-activity seen in this condition. We report a patient with AIP with malignant hypertension that recurred with a subsequent episode. Mechanisms of hypertension and renal damage are discussed.Item Addressing healthcare needs of people living below the poverty line: A rapid assessment of the Andhra Pradesh Health Insurance Scheme.(2011-11) Rao, M; Ramachandra, S S; Bandyopadhyay, S; Chandran, A; Shidhaye, R; Tamisettynarayana, S; Thippaiah, A; Sitamma, M; George, M Sunil; Singh, V; Sivasankaran, S; Bangdiwala, S IBackground. Families living below the poverty line in countries which do not have universal healthcare coverage are drawn into indebtedness and bankruptcy. The state of Andhra Pradesh in India established the Rajiv Aarogyasri Community Health Insurance Scheme (RACHIS) in 2007 with the aim of breaking this cycle by improving the access of below the poverty line (BPL) families to secondary and tertiary healthcare. It covered a wide range of surgical and medical treatments for serious illnesses requiring specialist healthcare resources not always available at district-level government hospitals. The impact of this scheme was evaluated by a rapid assessment, commissioned by the government of Andhra Pradesh. The aim of the assessment was to explore the contribution of the scheme to the reduction of catastrophic health expenditure among the poor and to recommend ways by which delivery of the scheme could be improved. We report the findings of this assessment. Methods. Two types of data were used for the assessment. Patient data pertaining to 89 699 treatment requests approved by the scheme during its first 18 months were examined. Second, surveys of scheme beneficiaries and providers were undertaken in 6 randomly selected districts of Andhra Pradesh. Results. This novel scheme was beginning to reach the BPL households in the state and providing access to free secondary and tertiary healthcare to seriously ill poor people. Conclusion. An integrated model encompassing primary, secondary and tertiary care would be of greater benefit to families below the poverty line and more cost-effective for the government. There is considerable potential for the government to build on this successful start and to strengthen equity of access and the quality of care provided by the scheme.Item Adenosine deaminase activity in leprosy (a preliminary study).(1988-01-01) Chaudhary, S D; Gupta, V; Saini, A S; Singh, V; Lal, HAdenosine deaminase (ADA) activity was studied in 25 patients having different types of leprosy and 25 healthy volunteer as control. There was definite rise of ADA activity in BL (72.9 +/- 6.85), LL (56.7 +/- 3.35) and BT (39.1 +/- 8.28) which was statistically significant when compared to ADA activity in healthy control (9.7 +/- 0.53).Item Adenosine deaminase activity in pleural fluids--a diagnostic aid in tuberculous pleural effusion.(1985-04-01) Raj, B; Chopra, R K; Lal, H; Saini, A S; Singh, V; Kumar, P; Bihari, K; Chawla, R KItem Adequacy assessment of oxygen therapy.(2000-07-29) Singh, V; Kothari, K; Khandelwal, ROBJECTIVES: Oxygen administration in the wards is usually not according to prescription and therefore the patients requiring oxygen therapy does not get optimal benefits. We planned to assess the need and adequacy of oxygen therapy as was given in wards of SMS Hospital, Jaipur. METHODOLOGY: We studied sixty-six patients in medical and surgical wards who were receiving oxygen therapy through various modes of delivery. Oxygen therapy system was checked in detail and oxygen saturation (SaO2) was measured by pulse oximetery. RESULTS: In our study, we found that no oxygen was flowing from cylinder head in 24 cases (35.5%) while in another 23 cases (35.2%) oxygen was flowing at lower than prescribed flow rates. Leakage in tubes and connections were found in nine cases (13.4%). None of our case was receiving oxygen as per prescription. After correction of faults, all patients showed improvement in SaO2. The criteria of starting oxygen therapy were met only in 47 patients (69%) as per American College of Chest Physicians (ACCP). CONCLUSIONS: Oxygen therapy should be administered according to guidelines. Proper monitoring of oxygen therapy is recommended to ensure adequate oxygenation and to save precious oxygen from wastage. Pulse oximeter is a simple, noninvasive and reliable method to assess it.Item Airway response to acid instillation in esophagus in bronchial asthma.(1995-04-01) Chakrabarti, S; Singh, K; Singh, V; Nain, C K; Jindal, S KOBJECTIVE: An increased incidence of gastroesophageal reflux has been reported in patients with bronchial asthma. We studied the pulmonary effects of acid instillation in the esophagus. METHODS: Fifteen patients with bronchial asthma and 15 healthy adults in the age group 15-50 years were studied. The control subjects were first screened for bronchial hyperreactivity by a methacholine challenge test. Patients and controls were both subjected to modified Bernstein test. Spirometry was done at baseline and after each instillation of either acid or saline. Respiratory and reflux symptoms were noted after each infusion and antacid administration. RESULTS: Five patients and one control subject had history of reflux symptoms (p < 0.05) and six patients had nocturnal asthma. There was a significant fall in FEV1/FVC after acid infusion patients; this improved significantly after antacid administration. All six patients with nocturnal asthma had respiratory signs or symptoms and had more than 20% fall in FEV1 on acid instillation in the esophagus, while none in the control group developed the same. CONCLUSIONS: Gastroesophageal reflux occurs more frequently in patients with bronchial asthma and acid instillation in the esophagus triggers bronchoconstriction.Item Alkaptonuria--a rare presentation.(1988-05-01) Sharma, J K; Dhawan, S N; Singh, V; Bhandari, V WItem Aminoglycoside resistance in enterococci isolated from paediatric septicaemia in a tertiary care hospital in north India.(2004-05-03) Randhawa, V S; Kapoor, L; Singh, V; Mehta, GBACKGROUND & OBJECTIVES: Enterococci are important nosocomial agents and serious infections caused by them are often treated with a combination of cell wall inhibitor and aminoglycoside. However, the presence of high level aminoglycoside resistance in these isolates makes this treatment combination ineffective. The prevalence of such isolates in a tertiary care set up has important diagnostic and therapeutic implications. The present study was carried out to find out the occurrence of high level aminoglycoside resistant isolates of enterococci in paediatric septicaemia cases in a tertiary care set up in north India. METHODS: Blood of paediatric cases with a clinical diagnosis of septicaemia was cultured to isolate and identify enterococci. Agar screen method was used to detect high level streptomycin and gentamicin resistance in these isolates. Vancomycin susceptibility of these isolates were determined as per the National Committee for Clinical Laboratory Standards (NCCLS) recommendations. RESULTS: Fifty one enterococcal strains were isolated from 21 neonates, nine infants and 21 children with a clinical diagnosis of septicaemia. Sixty eight per cent of these isolates had high level gentamicin resistance and forty three per cent had high level streptomycin resistance. All the isolates with high level streptomycin resistance also had high level gentamicin resistance. More than ninety five per cent of these isolates were sensitive to vancomycin. INTERPRETATION & CONCLUSION: The occurrence of high level gentamicin and high level streptomycin resistance in enterococcal isolates in our set up was high. This would require routine testing of the enterococcal isolates for high level aminoglycoside resistance. Alternative treatment regimes need to be sought, besides prudent use of antibiotics.Item An analysis of underlying factors for seasonal variation in gonorrhoea in India: A 6-year statistical assessment.(2015-04) Kakran, M; Bala, M; Singh, VPurpose: A statistical assessment of a disease is often necessary before resources can be allocated to any control programme. No literature on seasonal trends of gonorrhoea is available from India. Objectives: The objectives were (1) to determine, if any, seasonal trends were present in India (2) to describe factors contributing to seasonality of gonorrhoea (3) to formulate approaches for gonorrhoea control at the national level. Materials and Methods: Seasonal indices for gonorrhoea were calculated quarterly in terms of a seasonal index between 2005 and 2010. Ratio-to-moving average method was used to determine the seasonal variation. The original data values in the time-series were expressed as percentages of moving averages. Results were also analyzed by second statistical method i.e. seasonal subseries plot. Results: The seasonally adjusted average for culture-positive gonorrhoea cases was highest in the second quarter (128.61%) followed by third quarter (108.48%) while a trough was observed in the first (96.05%) and last quarter (64.85%). The second quarter peak was representative of summer vacations in schools and colleges. Moreover, April is the harvesting month followed by celebrations and social gatherings. Both these factors are associated with increased sexual activity and partner change. A trough in first and last quarter was indicative of festival season and winter leading to less patients reporting to the hospital. Conclusion: The findings highlight the immediate need to strengthen sexual health education among young people in schools and colleges and education on risk-reduction practices especially at crucial points in the calendar year for effective gonorrhoea control.Item Anti microbial activity of dimercaptosuccinic acid (DMSA): a new chelating agent.(2001-12-25) Vineeta, N; Singh, V; Makkar, SSuccessful outcome of endodontic treatment depends on elimination of bacteria and their products present in the root canal. It has been reported that after careful chemicomechanical preparation, smear layer is formed on the walls of canal, which contains bacteria and their products. Chelating agents, when used during chemicomechanical preparation, remove the smear layer. DMSA--a new chelating agent, when used in root canals, removes the smear layer more than EDTA when used as irrigant in root canals. This study was conducted to determine whether DMSA has anti microbial activity and compare it with EDTA. The results show that EDTA (10% & 15%) had marked anti microbial activity, both on culture plates and in broth. DMSA (10% & 15%) did not show anti microbial activity on culture plates while in broth it had marked activity.Item Antibodies to hepatitis C virus (anti-HCV) in children.(1991-12-01) Singh, V; Yachha, S K; Thapa, B R; Mehta, SItem Antioxidant potential in serum and liver of albino rats exposed to benzene.(1994-03-01) Ahmad, S; Singh, V; Rao, G SAdministration of benzene (ip, 0.5 ml/kg body wt or sc, 1 ml/kg body wt) consecutively for 10 days to male and female rats resulted in decrease in antioxidant potentials in serum. Serum uric acid and albumin showed significant decrease in all groups exposed to benzene. alpha-Tocopherol levels did not exhibit significant change in any of the groups when compared to control. Increase in liver lipid peroxidation and decrease in content of free sulphydryl group were observed in rats exposed to benzene. Serum ferroxidase activity, total iron content (TIC) and total iron binding capacity (TIBC) in female rats exposed to benzene showed significant decrease in ferroxidase activity without any change in TIC or TIBC when compared to control. The decrease in antioxidant potentials observed may be due to oxidation reactions exhibited by benzene metabolites, particularly, hydroquinone and 1, 2, 4-benzenetriol, resulting in oxidative stress in treated rats.Item Antral diaphragm with achalasia cardia.(1994-10-01) Singh, K; Singh, V; Nagi, B; Banerjee, C KA 50-year-old woman presented with gastric inlet and outlet obstruction due to achalasia cardia and antral mucosal diaphragm, respectively. The diagnosis was based on typical radiological features, endoscopy and full-thickness histology of biopsy at postmortem.Item Application of Thyroid Peroxidase (TPO) and Hector Battifora Mesothelial-1 (HBME-1) immunohistochemical markers in the diagnosis of papillary thyroid carcinoma of the thyroid(Siddharth Health Research and Social Welfare Society, 2020-02) Singh, V; Bagga, PK; Singh, B; JaideepBackground: Thyroid cancer is the most common endocrine malignancy accounting for >90% of malignancies of endocrine glands. The inter and intraobserver variation in the histomorphological diagnosis of Papillary Thyroid Carcinomas may sometimes pose a diagnostic difficulty. Application of IHC biomarkers may play an active or complementary role in their accurate classification. Aim: The present study was conducted to evaluate if HBME-1 and TPO immunohistochemical analysis can reliably differentiate papillary carcinomas from other thyroid lesions. Material and Methods: 50 cases of benign and malignant thyroid lesions were taken. Immunohistochemical staining for HBME-1 and TPO was performed. HBME-1 and TPO score was interpreted as absent and positive. Medical records were retrieved and their clinical data, surgical treatment, and pathological findings were noted. Results: Out of 50 cases, 19 (73.1%) cases were diagnosed PTC, 4 (15.4%) cases were FTC, 3(11.5%) cases were of MTC and 24 cases of benign thyroid lesions. TPO expression was found positive in 91.7% of cases of Benign thyroid lesions. In malignant thyroid lesions, negative expression of TPO was seen in 63.16%, 0% and 33.33% of PTC, FCT, and MCT respectively. HBME-1 showed negative expression in 83.3% of cases of benign thyroid lesions. Whereas, in malignant thyroid lesion HBME-1 expression was positive in 78.95%, 50% and 0% cases of PTC, FCT, and MCT respectively. Conclusion: Testing for expression of HBME-1 has been shown to improve the diagnostic accuracy for thyroid malignant nodules. The combination of HBME-1, and TPO may contribute to an accurate diagnosis of papillary thyroid carcinoma.Item Assessment of efficacy of pyridoxine in control of radiation induced sickness.(1998-03-26) Mahajan, M K; Singh, VA randomised prospective study to evaluate the role of adjuvant administration of pyridoxine hydrochloride was carried out in 104 patients undergoing radiation therapy. In study group 52 patients received tablet pyridoxine (controlled release) 100 mg daily one hour before the radiation therapy, for a period of 7 days, while the control group was treated by irradiation alone. Reduced radiation induced sickness was observed in study group (32.6% versus 48.1%). Loss of appetite (0% versus 1.9%), nausea (11.5% versus 21.1%) and vomiting (21.1% versus 28.8%) were lower for pyridoxine treated patients than for control patients. The above observed reduction in radiation induced sickness was found to be statistically insignificant (p > 0.05). The present data also did not reveal a statistical correlation between integral dose and radiation sickness.Item Assessment of Knowledge, Attitude and Practice related to Tuberculosis among Rural and Urban Community of North India(MRI Publication Pvt. Ltd., 2023-06) Mittal, V; Singh, V; Kumar, H.Tuberculosis is known as one of the long-standing and dominating health problems affecting people and the extent further escalates in a developing country like India. A pre-evaluated feedback structured questionnaire was validated and adopted to get their quantitative data from 424 respondents. In the present study urban respondents (60.8%) gave affirmative responses regarding awareness of TB, especially with mobile media as their major source of information, followed by information from healthcare workers. Rural respondents were less expressed and deficient on knowledge of TB transmission and preventive methods. Prevention practices toward TB are claimed to be high in urban population because 79.48% believed that early diagnosis, prompt treatment and avoiding poor hygiene and crowded environment are effective strategies to cease the transmission of TB. Effective preventive and informative strategies should be employed in rural border areas to make up for the knowledge gap found among rural and urban populations in this study.Item Assessment of reactivity of three treponemal tests in non-treponemal non-reactive cases from sexually transmitted diseases clinic, antenatal clinic, integrated counselling and testing centre, other different outdoor patient departments/indoor patients of a tertiary care centre and peripheral health clinic attendees.(2013-07) Bala, M; Singh, V; Muralidhar, S; Ramesh, VIn India, many state reference centres for sexually transmitted infections perform only a single screening assay for syphilis diagnosis. In this study, Treponema pallidum haemagglutination (TPHA) was performed on 1115 Venereal Disease Research Laboratory (VDRL)/rapid plasma regain (RPR) non-reactive and 107 reactive sera out of 10,489 tested by VDRL/RPR according to the National AIDS Control Organisation syphilis testing protocol. A total of 47 Specimens reactive in TPHA and non-reactive with VDRL test were subjected to fluorescent treponemal antibody absorption and enzyme-immunoassay. Seroprevalence considering both VDRL and TPHA positivity was highest (4.4%) in sexually transmitted diseases clinic attendees than in other subject groups. Positivity by two treponemal tests in 24 (2.2%) cases non-reactive by VDRL/RPR was representative of the fully treated patients or latent or late syphilis cases. The findings highlight that a suitable treponemal confirmatory test should be performed in all the diagnostic laboratories.