Browsing by Author "Suri, Vikas"
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Item Concurrent infection with dengue and malaria.(2006-08-26) Bhalla, Ashish; Sharma, Navneet; Sharma, Aman; Suri, VikasItem The effectiveness of extended postpartum comprehensive health care bundle selected outcomes of women with preeclampsia at 6 months: protocol of a randomized controlled trial(2024-03) V., Venkadalakshmi; Dhandapani, Manju; Gainder, Shalini; Suri, Vikas; Das, Karobi; Vejeyvergiya, Rajesh; Ghosh, Abhishek; Khanna, Poonam; Chellappa, Rajan; BabinaBackground: Women who have experienced pre-eclampsia (PE) may also face additional health problems in later life, as the condition is associated with an increased risk of death from 2-fold increased risk of long-term cardiovascular disease (CVD), hypertension, stroke, an approximate 5-12-fold increased risk of end-stage renal disease (ESRD), metabolic syndrome, and diabetes. Methods: Method was randomized controlled trial. Women with PE who delivered in PGIMER will be enrolled and will be allocated into experimental ad control group using a computer random table with allocation concealment. Enrolment will be done at the time of discharge; baseline assessment will be done 6 weeks and the intervention bundle will be implemented to the women in experimental group. The women in control group will receive routine care. Women in both the groups will be followed up at 6 months. Conclusions: This study aims to determine the effectiveness of “extended postpartum comprehensive health care bundle (EP CHC bundle)” on selected outcomes of women with preeclampsia at 6 months. The comprehensive health care bundle will be designed with the inputs from all stakeholders, has the potential to suit the dynamic nature of management of women with preeclampsia after delivery. CTRI registration number: CTRI/2021/04/032749 ON 12/4/2021Item Hydroxychloroquine in Treatment of Asymptomatic and Mildly Symptomatic COVID-19: A Multi-Centre Cohort Study(Association of Physicians of India, 2022-01) Jain, Siddharth; Sharma, Shefali K; Suri, Vikas; Yaddanapudi, Narayana; Malhotra, Pankaj; Bhalla, Ashish; Singh, Mini P; Koushal, Vipin; Kajal, Kamal; Jakulla, Roopesh Sai; Marrapu, Sudheer; Guru, Rashmi Ranjan; Bora, Ishani; Chopra, Vishal; Sibia, RPS; Puri, Goverdhan DuttBackground: Although hydroxychloroquine (HCQ) lacks benefit in patients with moderate-to-severe COVID-19, its role in asymptomatic and mildly symptomatic disease needs better elucidation. Methods: This multi-centre cohort study included asymptomatic and mildly symptomatic, RT-PCR confirmed COVID-19 cases between 30 March and 20 May, 2020. Patients were categorized into two groups (HCQ-treated and untreated) based on exposure to HCQ. Dose of HCQ used was 400 mg twice daily (day one) followed by once daily for seven days. HCQ-untreated patients were managed supportively without any active antiviral or immunomodulatory therapy.h Nasopharyngeal SARS-CoV-2 clearance by RT-PCR (primary outcome) was compared between HCQ-treated and untreated patients using Kaplan-Meier analysis and Cox proportional-hazards regression. Clinical efficacy and safety profile of HCQ were assessed (secondary outcomes). Results:162 patients [84 (51·9%) males; mean age 38·2 (15·2) years] were included. Forty-four (27·2%) patients had mild disease, rest 118 (72·8%) were asymptomatic. Seventy-five (46·3%) patients received HCQ. Median time to virological negativity was lesser in HCQ-treated (13 days) versus untreated patients (15 days) (log- rank<0·001) in both asymptomatic and mildly symptomatic patients. Treatment with HCQ was the only independent predictor of virological negativity (hazard- ratio=2·24; adjusted p-value<0·001). Two (5·4%) mildly symptomatic patients progressed to severe disease within 24 hours (two doses) of HCQ initiation, compared to none in the HCQ-untreated group. Five HCQ-treated patients developed minor gastrointestinal side effects, not requiring drug discontinuation. Conclusion: HCQ reduced the time to virologic negativity (by 2 days) in asymptomatic and mildly symptomatic COVID-19, without any serious adverse events. However, no obvious clinical benefit was noted.Item Imaging in adult patients with acute febrile encephalopathy: What is better computerized tomography or magnetic resonance imaging.(2011-05) Bhalla, Ashish; Suri, Vikas; Singh, Paramjeet; Varma, Subhash; Khandelwal, NiranjanContext: Imaging techniques are commonly used by emergency physicians in a febrile comatose patient. Their utility requires judicious use of the available resources. In this study, we have compared the efficacy of cranial imaging techniques in adult patients with acute febrile encephalopathy. Materials and Methods: This prospective observational study enrolled 101 patients presenting to the emergency with fever of less than 15 days duration and altered sensorium. All the patients were subjected to routine investigations, detailed cerebrospinal fluid analysis, computerized tomograms (noncontrast followed by contrast enhanced), and magnetic resonance imaging of the brain. Final diagnosis was reached after considering the clinical, biochemical findings, imaging results, and response to therapy. The positive yield of radiological investigations was compared against the final diagnosis. Results: The patients were divided into three groups. Forty-eight had evidence of meningoencephalitis, 22 patients had pyogenic meningitis, and 20 were combined together in other group. In 12 patients, a definitive diagnosis could not be made. Only 37% patients were detected to have abnormal computerized tomograms and the most common abnormality was diffuse edema, which failed to point to an etiological diagnosis. Magnetic resonance imaging was abnormal in 62.75% cases and was able to suggest an etiological diagnosis in 100% cases of cerebral venous thrombosis, tubercular meningitis, 95% cases of meningoencephalitis, and 45% patients with meningitis. Conclusions: We can conclude that magnetic resonance imaging provides better information than computerized tomography in adult patients with acute febrile encephalopathy.Item Nurse-led Cardiovascular Diseases Risk Assessment and Communication using WHO/ISH Risk Prediction Chart in a Tertiary care Hospital of North India(Wolters Kluwer – Medknow, 2022-09) Ankita, Ankita; Kavita, Kavita; Thakur, J. S.; Suri, Vikas; Arora, PankajCardiovascular diseases (CVDs) contribute to most of the potentially preventable burden through early risk assessment. Nurse-led CVD risk assessment is an effective strategy to address the human resource crisis for CVD prevention. An interventional study was conducted in medicine wards of a tertiary care hospital in North India to train nurses in CVD risk assessment and its communication. All bedside nurses (n = 30) of selected wards were enrolled and trained in CVD risk assessment and communication using WHO/ISH risk prediction charts. Once fully trained, each nurse enrolled patients (>40 years of age) from their respective wards to assess and communicate CVD risk. To calculate the reliability of risk assessment, investigator simultaneously assessed CVD risk with nurses. The mean age of nurses was 32.07 ± 6.31 years. The results revealed that training significantly increased the knowledge of nursing personnel (P < 0.001). There was perfect inter?rater reliability agreement (Cohen’s k = 0.929) between nurses and investigators while assessing CVD risk. Nurses demonstrated good communication skills. The study concluded that nurses can be trained successfully in CVD risk assessment and communication. The study recommends the task shifting of CVD risk assessment to nurses after providing proper trainingItem Presence of diarrhea associated with better outcomes in patients with COVID-19 – A prospective evaluation(Indian Association of Medical Microbiologists, 2022-09) Singh, Seerat; Samanta, Jayanta; Suri, Vikas; Bhalla, Ashish; Puri, Goverdhan Dutt; Sehgal, Rakesh; Kochhar, RakeshPurpose: Gastrointestinal (GI) manifestations have been well documented in patients with coronavirus disease 2019 (COVID-19), but its clinical impact on the course of the disease is debatable. Majority of the available data is retrospective, and hence this prospective study was planned to study the impact of GI symptoms on COVID-19 outcome. Methods: All COVID-19 patients admitted in a tertiary care centre from August–October 2020 were screened and patients without pre-existing GI diseases were included. A detailed history of the various symptoms including duration was documented. Various baseline laboratory investigations and inflammatory markers were conducted as per the protocol. Patients with and without diarrhea were compared for the various disease outcome parameters. Results: Of the 244 patients screened, 203 patients (128 males; 63.1%) were included. Respiratory symptoms alone were present in 49 (24.1%), GI symptoms alone in 20 (9.9%) and 117 (57.6%) had both. Overall GI symptoms was noted in 137 (67.5%) cases with the commonest being diarrhea (61; 30.0%). Patients with both respiratory and any GI symptoms showed a lower trend towards need for mechanical ventilation (12.2% vs 7.7%; p ¼ 0.35) and mortality (10.2% vs 4.3%; p ¼ 0.14) compared to respiratory symptoms alone, although not statistically significant. Patients with diarrhea (n ¼ 61) had no mortality (0% vs 7.7%; p ¼ 0.036) or need for mechanical ventilation and shorter hospital stay compared to those who did not have diarrhea. Conclusion: GI symptoms are frequent in patients with SARS-CoV-2 infection and the commonest is diarrhea. Diarrhea is a harbinger of better outcome with lower mortality among COVID-19 positive patients.Item Scrub typhus masquerading as puerperal sepsis(Medip Academy, 2024-03) Singh, Anju; Khastgir, Gaurav; Saha, Pradip Kumar; Bagga, Rashmi; Suri, VikasScrub typhus is a zoonotically transmitted febrile illness caused by Orientia tsutsugamushi and transmitted by the larval stage of the leptotrombiculid mite. It is the most common rickettsial illness worldwide and has re-emerged as a major cause of Acute Undiffrentiated Febrile Illness (AUFI). It has a varied presentation ranging from a mild self-limiting illness to a life threatening condition with multi organ failure in 35 to 50% cases. Acute onset fever with pain abdomen, rashes, lymphadenopathy and eschars are the usual manifestations. The presentation, however, may be varied in pregnancy and the postpartum period due to altered immunological response of the body. A 33 year old lady presented on day 13 post-partum with high grade fever and hypotensive shock. An initial diagnosis of puerperal sepsis was made and empirical antibiotics started. Due to persistent high grade fever, with fluid refractory hypotension, a complete septic work up including Scrub typhus serology was sent which was found to be positive. Injection doxycycline was added to the treatment regimen following which the fever and rashes subsided and general condition improved.