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Acharya Shri Chander College of Medical Sciences and Hospital

Hospital / health systemJammu, India

Research output, citation impact, and the most-cited recent papers from Acharya Shri Chander College of Medical Sciences and Hospital (India). Aggregated across the NobleBlocks index of 300M+ scholarly works.

Total works
448
Citations
5.1K
h-index
28
i10-index
117
Also known as
Acharya Shri Chander College of Medical Sciences and Hospital

Top-cited papers from Acharya Shri Chander College of Medical Sciences and Hospital

Lifestyle management of hypertension: International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension
Fadi J. Charchar, Priscilla R. Prestes, Charlotte Mills, Siew Mooi Ching +4 more
2023· Journal of Hypertension238doi:10.1097/hjh.0000000000003563

Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools.

Childhood obesity: prevention is better than cure
Aaakash Pandita, Deepak Sharma, Dharti Pandita, Smita C. Pawar +2 more
2016· Diabetes Metabolic Syndrome and Obesity216doi:10.2147/dmso.s90783

Obesity and its associated comorbidities have emerged as a major health problem garnering interests from both public health agencies and mainstream media consumers. With increasing awareness on its impact on health, finances, and community at large, it has come to the forefront for scientific research and development of health plans. The need for better strategies and novel interventions to manage obesity is now being recognized by the entire health care system. Obesity and overweight is now the fifth leading global risk factor for mortality. Strategic investment is thus urgently needed to implement population-based childhood obesity prevention programmes which are effective and also culturally appropriate. Population-based prevention is crucial to stem this rising tide of childhood obesity which is fast reaching epidemic proportions. Obesity has its onset very early in life; therefore, children constitute a major group of this disease. It is thus imperative to lay utmost importance on prevention of obesity in children and herald its progress, if present already. Furthermore, treatment is still in preliminary stage, so early prevention holds better than treatment at later stages. This article is an attempt to lay emphasis on childhood obesity as a problem that needs to be recognized early and measures for its prevention.

In vitro antifungal activity of hydroxychavicol isolated from Piper betle L
Intzar Ali, Farrah G Khan, K. A. Suri, B. D. Gupta +4 more
2010· Annals of Clinical Microbiology and Antimicrobials173doi:10.1186/1476-0711-9-7

BACKGROUND: Hydroxychavicol, isolated from the chloroform extraction of the aqueous leaf extract of Piper betle L., (Piperaceae) was investigated for its antifungal activity against 124 strains of selected fungi. The leaves of this plant have been long in use tropical countries for the preparation of traditional herbal remedies. METHODS: The minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of hydroxychavicol were determined by using broth microdilution method following CLSI guidelines. Time kill curve studies, post-antifungal effects and mutation prevention concentrations were determined against Candida species and Aspergillus species "respectively". Hydroxychavicol was also tested for its potential to inhibit and reduce the formation of Candida albicans biofilms. The membrane permeability was measured by the uptake of propidium iodide. RESULTS: Hydroxychavicol exhibited inhibitory effect on fungal species of clinical significance, with the MICs ranging from 15.62 to 500 microg/ml for yeasts, 125 to 500 microg/ml for Aspergillus species, and 7.81 to 62.5 microg/ml for dermatophytes where as the MFCs were found to be similar or two fold greater than the MICs. There was concentration-dependent killing of Candida albicans and Candida glabrata up to 8 x MIC. Hydroxychavicol also exhibited an extended post antifungal effect of 6.25 to 8.70 h at 4 x MIC for Candida species and suppressed the emergence of mutants of the fungal species tested at 2 x to 8 x MIC concentration. Furthermore, it also inhibited the growth of biofilm generated by C. albicans and reduced the preformed biofilms. There was increased uptake of propidium iodide by C. albicans cells when exposed to hydroxychavicol thus indicating that the membrane disruption could be the probable mode of action of hydroxychavicol. CONCLUSIONS: The antifungal activity exhibited by this compound warrants its use as an antifungal agent particularly for treating topical infections, as well as gargle mouthwash against oral Candida infections.

T-Cell Assays for Tuberculosis Infection: Deriving Cut-Offs for Conversions Using Reproducibility Data
Anandharaman Veerapathran, Rajnish Joshi, Kalyan Goswami, Sandeep Dogra +4 more
2008· PLoS ONE104doi:10.1371/journal.pone.0001850

BACKGROUND: Although interferon-gamma release assays (IGRA) are promising alternatives to the tuberculin skin test, interpretation of repeated testing results is hampered by lack of evidence on optimal cut-offs for conversions and reversions. A logical start is to determine the within-person variability of T-cell responses during serial testing. METHODOLOGY/PRINCIPAL FINDINGS: We performed a pilot study in India, to evaluate the short-term reproducibility of QuantiFERON-TB Gold In Tube assay (QFT) among 14 healthcare workers (HCWs) who underwent 4 serial QFT tests on day 0, 3, 9 and 12. QFT ELISA was repeated twice on the same sets of specimens. We assessed two types of reproducibility: 1) test-retest reproducibility (between-test variability), and 2) within-person reproducibility over time. Test-retest reproducibility: with dichotomous test results, extremely high concordance was noticed between two tests performed on the same sets of specimens: of the 56 samples, the test and re-test results agreed for all but 2 individuals (kappa = 0.94). Discordance was noted in subjects who had IFN-gamma values around the cut-off point, with both increases and decreases noted. With continuous IFN-gamma results, re-test results tended to produce higher estimates of IFN-gamma than the original test. Within-person reproducibility: when continuous IFN-gamma data were analyzed, the within-person reproducibility was moderate to high. While persons with negative QFT results generally stayed negative, positive results tended to vary over time. Our data showed that increases of more than 16% in the IFN-gamma levels are statistically improbable in the short-term. CONCLUSIONS: Conservatively assuming that long-term variability might be at least twice higher than short-term, we hypothesize that a QFT conversion requires two conditions to be met: 1) change from negative to positive result, and 2) at least 30% increase in the baseline IFN-gamma response. Larger studies are needed to confirm our preliminary findings, and determine the conversion thresholds for IGRAs.

Menopause and Sleep Disorders
VishalR Tandon, Sudhaa Sharma, Annil Mahajan, Akhil Mahajan +1 more
2022· Journal of Mid-life Health76doi:10.4103/jmh.jmh_18_22

Women are likely to suffer from sleep disorders more in comparison to men during menopause and with advancing age. The incidence of sleep disorders ranges from 16% to 47% at peri-menopause and 35%-60% at postmenopause. Insomnia with or without associated anxiety or low lying depression and Mood disorder is most common associated manifestations. Sleep disorders and insomnia largely remain a clinical diagnosis based on the subjective complaints of patients. Benzodiazepines remain the mainstay of the treatment in majority of the sleep disorders including chronic or acute insomnia. Treatment of associated anxiety, depression, or psychosis is most important. Tricyclic antidepressant, Selective Serotonin Reuptake Inhibitors (SSRI), Melatonin, Duloxetine, Fluoxetine, Imipramine, Nortriptyline or Amitriptyline and other drugs such as Eszopiclone, Escitalopram, Gabapentin, Quiteiapine, Citalopram, Mirtazapine followed by long-acting Melatonin and Ramelteon, also are very useful for the management of various sleep disorders. Hormone replacement therapy presently lacks concrete evidence to be used in menopausal women for sleep disorder. Sleep hygiene practices, self-hypnosis, meditation, and exercise play a very important role.

Desmoplastic Small Round Blue Cell Tumor: A Review of Treatment and Potential Therapeutic Genomic Alterations
Ajaz Bulbul, Bridget N. Fahy, Joanne Xiu, Sadaf Rashad +3 more
2017· Sarcoma66doi:10.1155/2017/1278268

Desmoplastic small round blue cell tumors (DSRCTs) originate from a cell with multilineage potential. A molecular hallmark of DSRCT is the EWS-WT1 reciprocal translocation. Ewing sarcoma and DSRCT are treated similarly due to similar oncogene activation pathways, and DSRCT has been represented in very limited numbers in sarcoma studies. Despite aggressive therapy, median survival ranges from 17 to 25 months, and 5-year survival rates remain around 15%, with higher survival reported among those undergoing removal of at least 90% of tumor in the absence of extraperitoneal metastasis. Almost 100% of these tumors contain t(11;22) (p13;q12) translocation, and it is likely that EWS-WT1 functions as a transcription factor possibly through WT1 targets. While there is no standard protocol for this aggressive disease, treatment usually includes the neoadjuvant HD P6 regimen (high-dose cyclophosphamide, doxorubicin, and vincristine (HD-CAV) alternating with ifosfamide and etoposide (IE) chemotherapy combined with aggressively attempted R0 resection). We aimed to review the molecular characteristics of DSRCTs to explore therapeutic opportunities for this extremely rare and aggressive cancer type.

Evaluation of Diagnostic Accuracy, Feasibility and Client Preference for Rapid Oral Fluid-Based Diagnosis of HIV Infection in Rural India
Nitika Pant Pai, Rajnish Joshi, Sandeep Dogra, Bharati Taksande +4 more
2007· PLoS ONE65doi:10.1371/journal.pone.0000367

BACKGROUND: Oral fluid-based rapid tests are promising for improving HIV diagnosis and screening. However, recent reports from the United States of false-positive results with the oral OraQuick ADVANCE HIV1/2 test have raised concerns about their performance in routine practice. We report a field evaluation of the diagnostic accuracy, client preference, and feasibility for the oral fluid-based OraQuick Rapid HIV1/2 test in a rural hospital in India. METHODOLOGY/PRINCIPAL FINDINGS: A cross-sectional, hospital-based study was conducted in 450 consenting participants with suspected HIV infection in rural India. The objectives were to evaluate performance, client preference and feasibility of the OraQuick Rapid HIV-1/2 tests. Two Oraquick Rapid HIV1/2 tests (oral fluid and finger stick) were administered in parallel with confirmatory ELISA/Western Blot (reference standard). Pre- and post-test counseling and face to face interviews were conducted to determine client preference. Of the 450 participants, 146 were deemed to be HIV sero-positive using the reference standard (seropositivity rate of 32% (95% confidence interval [CI] 28%, 37%)). The OraQuick test on oral fluid specimens had better performance with a sensitivity of 100% (95% CI 98, 100) and a specificity of 100% (95% CI 99, 100), as compared to the OraQuick test on finger stick specimens with a sensitivity of 100% (95% CI 98, 100), and a specificity of 99.7% (95% CI 98.4, 99.9). The OraQuick oral fluid-based test was preferred by 87% of the participants for first time testing and 60% of the participants for repeat testing. CONCLUSION/SIGNIFICANCE: In a rural Indian hospital setting, the OraQuick Rapid- HIV1/2 test was found to be highly accurate. The oral fluid-based test performed marginally better than the finger stick test. The oral OraQuick test was highly preferred by participants. In the context of global efforts to scale-up HIV testing, our data suggest that oral fluid-based rapid HIV testing may work well in rural, resource-limited settings.

Overdiagnosis and overtreatment; how to deal with too much medicine
Puneeta Gupta, Meeta Gupta, Neeraj Koul
2020· Journal of Family Medicine and Primary Care53doi:10.4103/jfmpc.jfmpc_433_20

The past few decades have seen medical science making rapid strides in the field of diagnostic technologies, thus making it possible to detect some conditions at a very early stage. An unwanted effect of these developments is overdiagnosis which occurs when a true abnormality is discovered, but detection of that abnormality and its treatment does not benefit the patient. Overdiagnosis is encountered as a result cancer screening, in genetic diseases and in some chronic conditions when disease definition is broadened. There is urgent need of development of evidence based decision-making tools for clinicians which will help patients understand the benefits and harms of different screening and treatment methods. And the treating physician has to play a important role to convince the patient that watchful waiting, for some of the lesions may be the best option available in some circumstances.

Profile of lymphadenopathy: An institutional based cytomorphological study
Aneeta Singh Malhotra, Mega Lahori, Arti Nigam, Arvind Khajuria
2017· International Journal of Applied and Basic Medical Research39doi:10.4103/2229-516x.205812

INTRODUCTION: Lymphadenopathy is one of the most common clinical presentations of patients attending the outdoor department of a hospital. Lymph node aspiration is of great value for the diagnosis of lymphadenitis, lymphomas, and metastatic carcinoma. MATERIALS AND METHODS: In this study, we have reported the pattern of cytological diagnosis on fine-needle aspiration cytology (FNAC) of lymphadenopathy cases in Jammu region of Jammu and Kashmir state of India. The mean age of all the patients in this study was 21.67 years. The most common site of lymphadenopathy was cervical region (71.79%) followed by axillary region (11.11%). RESULTS: Tubercular lymphadenitis (44.02%) was the single most common cause of lymphadenopathy followed by reactive lymphadenitis (42.64%), metastatic lesions (9.40%), and malignant lymphoma (4.70%). The sensitivity of 94.49%, positive predictive value of 96.26%, and diagnostic accuracy of 91.15% was achieved in our study. CONCLUSION: This study highlights the role of FNAC as a simple, inexpensive, relatively painless, rapid, repeatable, and reliable method of investigation for lymphadenopathy, especially in outpatient departments, peripheral hospitals, and dispensaries.

Prevalence of vitamin d deficiency among Indian menopausal women and its correlation with diabetes: A first Indian cross sectional data
VishalR Tandon, Sudhaa Sharma, Shagun Mahajan, Kaplia Raina +3 more
2014· Journal of Mid-life Health36doi:10.4103/0976-7800.141188

AIM AND OBJECTIVE: To evaluate prevalence of Vitamin D deficiency and establish any correlation between diabetes and vitamin D deficiency among postmenopausal women. MATERIALS AND METHODS: The 25-hydroxy vitamin D [25 (OH) D] concentrations were measured by competitive in-vitro quantitative immunoassay. The subjects were classified as vitamin D-deficient, insufficient or sufficient on the basis of 25 (OH) D concentrations of < 20 ng/mL, 20-30 ng/mL or > 30 ng/mL respectively. The apparently normal postmenopausal women (PMW) were subjected to fasting blood sugar levels to analyse any correlation between vitamin D deficiency and diabetes. RESULTS: Vitamin D deficiency was observed in 53.35% of the population, 19.48% had insufficiency and 26.83% had adequate Vitamin D levels. In 12.14% of the study population fasting blood glucose was > 110 mg/dl and rest of the subjects were between the normal range which is 70-110mg/dl. Correlation between raised blood sugar levels and Vitamin D deficiency among PMW was non-significant (P = 0.324). CONCLUSION: High prevalence of vitamin D deficiency exists among apparently healthy Indian PMW. However, the current study failed to show any statistical correlation between vitamin D deficiency and existence of diabetes, which may be due to small sample size.

Comparative evaluation of probing depth and clinical attachment level using a manual probe and Florida probe
Ashish Kumar, Amandeep Kour, Komal Puri, Manish Khatri +2 more
2016· Journal of Indian Society of Periodontology32doi:10.4103/0972-124x.181241

BACKGROUND: To compare and evaluate the intra- and inter-examiner efficacy and reproducibility of the first-generation manual (Williams) probe and the third-generation Florida probe in terms of measuring pocket probing depth (PD) and clinical attachment level (CAL). MATERIALS AND METHODS: Forty subjects/4000 sites were included in this comparative, cross-sectional study. Group- and site-wise categorizations were done. Based on gingival index, PD, and CAL, patients were divided into four groups, i.e., periodontally healthy, gingivitis, mild to moderate periodontitis, and severe periodontitis. Further, based on these parameters, a total of 4000 sites, with 1000 sites in each category randomly selected from these 40 patients, were taken. Full mouth PD and CAL measurements were recorded with two probes, by Examiner 1 and on Ramfjord teeth by Examiner 2. RESULTS: Full mouth and Ramfjord teeth group- and site-wise PD obtained with the manual probe by both the examiners were statistically significantly deeper than that obtained with the Florida probe. The full mouth and Ramfjord teeth mean CAL measurement by Florida probe was higher as compared to manual probe in mild to moderate periodontitis group and sites, whereas in severe periodontitis group and sites, manual probe recorded higher CAL as compared to Florida probe. CONCLUSION: Mean PD and CAL measurements were deeper with the manual probe as compared to the Florida probe in all the groups and sites, except for the mild-moderate periodontitis group and sites where the CAL measurements with the manual probe were less than the Florida probe. Manual probe was more reproducible and showed less interexaminer variability as compared to the Florida probe.

Role of Neck Flexion in Facilitating Nasogastric Tube Insertion
Rajesh Mahajan, Rahul Gupta, Anju Sharma
2005· Anesthesiology32doi:10.1097/00000542-200508000-00034

Nasogastric tube insertion during anesthesia is often difficult. Many techniques have been proposed to aid insertion, including forward displacement of the larynx, use of a split endotracheal tube, and various kinds of forceps.1–3The most common sites for impaction of the nasogastric tube are pyriform sinuses and the arytenoid cartilage.4Maneuvers to keep the nasogastric tube along the lateral or posterior pharyngeal wall encourages the smooth passage into the esophagus.5,6Our experience of using a gloved finger to steer the nasogastric tube along the posterior pharyngeal wall supports this premise.7Our current effort was intended to determine whether neck flexion would facilitate nasogastric tube passage.We recruited 60 consecutive patients with normal airways and neck movements who required intubation and nasogastric tube insertion as a part of their surgery. After obtaining informed consent from the patients, general anesthesia and muscle relaxation was achieved. The patients were then randomized to either the neck flexion or the neutral group using a sealed-envelope method. After tracheal intubation, both nares were vasoconstricted with 0.05% oxymetazoline. A well-lubricated 16-French gastric tube was inserted via one nostril for a length of 8–9 cm for females and 9–11 cm for males, with concave side hugging the floor of nasal passage. We selected this arbitrary length on the basis of distance of the upper cervical vertebrae from the anterior nares, which is 8–9 cm in females and 9–11 cm in males. We determined these distances manually during our digital method to facilitate insertion of the nasogastric tube.7In the neutral group, the gastric tube was then further passed with the patient’s head in the neutral position. In the flexion group, the patient’s neck was flexed as far forward as possible, and the gastric tube was then advanced. After two unsuccessful attempts in the assigned position, the anesthesiologist was allowed to perform any additional maneuvers desired to aid the successful passage of the tube. The number of attempts required for successful insertion was recorded for each patient.Thirty patients were allocated to the neutral group, and 30 were allocated to the flexion group. Passage of the nasogastric tube was successful during the first attempt in 24 patients (80%) in the flexion group versus 15 (50%) in the neutral position (table 1). Three patients (10%) in the flexion group required additional maneuvers depending on the preference of the anesthesiologist to pass the tube. In contrast, 9 patients (30%) in the neutral group required additional maneuvers to pass the nasogastric tube.These results support the observation that passage of the nasogastric tube with neck flexion is associated with a higher success rate than with the neutral position. We believe that neck flexion, in combination with the curve of the nasogastric tube, tends to keep the tube in close proximity to the posterior pharyngeal wall, facilitating its smooth passage into the esophagus. This is a simple but a useful technique and has proved useful in both the intensive care unit and the operating room.* Acharya Shri Chander College of Medical Sciences (Ascoms), Jammu (J&K), India. drmahajanr@rediffmail.comor drmahajanr@yahoomail.com

Prevalence of dementia among Kashmiri migrants
Sujeet Raina, Sunil Kumar Raina, Sushil Razdan, K K Pandita
2008· Annals of Indian Academy of Neurology28doi:10.4103/0972-2327.41878

BACKGROUND: Neurological diseases are common disorders resulting in the loss of productive life and disability. Dementia is becoming a major public health problem in the developing world also. AIM: To ascertain the prevalence of dementia among Kashmiri Pandit population aged 60 years and above. MATERIALS AND METHODS: A cross-sectional survey was conducted among the elderly population of the Kashmiris living in a migrant camp. We developed and used a Kashmiri version of the Mini-Mental State Examination as the test instrument, and a score below 24 was considered indicative of dementia. A functional ability questionnaire was also administered to the subjects. A neurologist carried out the examinations. RESULTS: A sample comprising 200 subjects (95 males and 105 females) were evaluated. The prevalence of dementia is 6.5% among the Kashmiri Pandit population aged 60 years and above, which is higher than that reported from other parts of India.

A Systematic Review and Meta-analysis of Diabetes Associated Mortality in Patients with COVID-19
Puneeta Gupta, Meeta Gupta, Neena KAtoch, Ketan Garg +1 more
2021· International Journal of Endocrinology and Metabolism27doi:10.5812/ijem.113220

CONTEXT: Coronavirus disease 2019 (COVID-19) has been one of the deadliest pandemics in recent decade. The virus has specifically targeted the comorbid population in terms of mortality. The present systematic review and meta-analysis aimed to determine the overall mortality and diabetes-associated mortality in COVID-19 patients. METHODS: To obtain the related data, six databases, including Pubmed, Embase, MEDLINE, Web of Science, Google Scholar, and DOAJ, were searched. The full-texts of articles presenting the data of COVID-19 mortality and diabetes-associated mortality were screened and retrieved. Statistical analysis was performed using the Stata (version 13). The odds ratio (OR) of mortality in diabetic patients was calculated with 95% confidence interval (CI). Random-effects model was used to synthesize data for the relevant outcomes. Heterogeneity was evaluated using I2 statistic. Forest plots visually showed the effect estimates of the included studies. We used funnel plots to evaluate potential publication bias. A two tailed P < 0.05 was considered as statistically significant. RESULTS: A total of 35 studies with 25,934 patients were finally included for meta-analysis. The pooled prevalence of diabetes mellitus in patients with COVID-19 was 16.8% (n = 4381). The overall mortality seen in all the studies was 12.81% (n = 3159), and diabetes-associated mortality was 22.14% (n = 970). The pooled analysis of included studies showed that diabetes mellitus had a significantly higher mortality rate (22.14% vs. 12.81%, P < 0.05) with higher odds of death (pooled OR 1.83, 95% CI: 1.61 - 2.05). The funnel plot was symmetric, thereby indicating a low risk of publication bias. CONCLUSIONS: In conclusion, the presence of diabetes was associated with a significantly increased risk of mortality in patients admitted to the hospital with COVID-19. Thus, this subpopulation must be continuously monitored for glycemic levels, coagulation abnormalities, and inflammatory surge.

Clinical Uses of Ketamine in Children: A Narrative Review
Anoushka Bali, Ashujot Kaur Dang, Daniel A Gonzalez, Rajeswar Kumar +1 more
2022· Cureus27doi:10.7759/cureus.27065

Ketamine is a phencyclidine derivative that acts as a noncompetitive N-methyl-D-aspartate as well as a glutamate receptor antagonist. It also has other minor mechanisms that contribute to its extensive drug profile. Ketamine is a bronchodilator and maintains normal airway reflexes and, thus, permits spontaneous respiration. This, coupled with the fact that it produces potent analgesia, makes it highly suitable for children. Despite its many merits, the drug's side effects, along with its cultural image of being a drug of abuse, a drug used in veterinary medicine, or a "date-rape drug" have sullied its reputation within the armamentarium of medicine. Even though it is widely used in developing countries, its use in Western nations has diminished. We have strived to explore the various clinical uses of ketamine in children through this article. In addition, the article also highlights how some of the fears associated with using the drug are unfounded and provides ways by which the drug's side effects can be prevented and managed.

The Development and Impact of Anxiety With Migraines: A Narrative Review
Rajeswar Kumar, Saba Asif, Anoushka Bali, Ashujot Kaur Dang +1 more
2022· Cureus27doi:10.7759/cureus.26419

Migraine is a chronic, disabling neurological disorder characterized by recurrent episodes of headache. Psychiatric disorders have been reported to arise due to a patient's physical and emotional stress caused by migraine episodes, with anxiety disorders being one of the most commonly associated psychiatric disorder with migraine. This association poses the question of similar or shared pathogenesis between the two disorders and raises a concern for the diagnosis and management of situations when these disorders present together. In this review, we discuss the possible shared mechanism for the development of anxiety disorders in the presence of migraine, such as the vascular, nervous, and genetic factors that might hold the key to their association. We also discuss the number of clinical features shared by these conditions and provide evidence for the higher degree of association between these conditions. A focused evaluation of anxiety disorders in migraine might benefit patients with earlier diagnoses and improve their quality of life with effective pharmacotherapy and psychotherapy. This review also emphasizes the importance of preventing future migraine episodes with effective prophylactic medications to reduce the risk of developing anxiety disorders, and the need to discuss the medical and psychiatric management of anxiety disorders in patients suffering from migraines on an acute and long-term basis. ​​​​​​.

Sepsis and Thrombocytopenia: A Nowadays Problem
Daniel A Gonzalez, Rajeswar Kumar, Saba Asif, Anoushka Bali +1 more
2022· Cureus27doi:10.7759/cureus.25421

Sepsis is a life-threatening organ failure produced by a dysregulated host response to infection that involves 15.6% of hospital mortality. The most common signs and symptoms of sepsis are hypotension, tachypnea, fever, and leukocytosis, whether suspected or confirmed. Including a major one, thrombocytopenia is a sign that is an independent predictor of poor outcomes in patients with sepsis, increasing their mortality rate and their length of stay in the intensive care unit (ICU). So far, the ongoing treatment for this problem is securing the airway, treating hypoxemia, and providing vascular access for hydration, antibiotic delivery, and vasopressors, if needed. This article has reviewed the different possible mechanisms found for sepsis-associated thrombocytopenia, going from the most acknowledged one as decreased platelet production to the potential aftermath of sepsis itself as disseminated intravascular coagulation (DIC). This article has also discussed the future treatment for patients suffering from thrombocytopenia and sepsis, going from phase I and II trials as GI antagonists to the well-known drug aspirin as a possible treatment for this problem.

Association of ESR1 (rs2234693 and rs9340799), CETP (rs708272), MTHFR (rs1801133 and rs2274976) and MS (rs185087) polymorphisms with Coronary Artery Disease (CAD)
Jyotdeep Kour Raina, Minakashee Sharma, Rakesh Kumar Panjaliya, Vikas Dogra +2 more
2020· BMC Cardiovascular Disorders27doi:10.1186/s12872-020-01618-7

BACKGROUND: Coronary artery disease (CAD) is a complex disease resulting from the cumulative and interactive effects of large number of genes along with environmental exposure. Therefore, the present study was envisaged as an effort to study the association of candidate genes ESR1 (rs2234693 and rs9340799), CETP (rs708272), MTHFR (rs1801133 and rs2274976) and MS (rs185087) polymorphisms with the risk of CAD, targeting the populations of Jammu (JandK). METHOD: A total of 400 confirmed CAD patients and 400 healthy controls were enrolled for the present study. Genotyping was done by polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP). RESULTS: ESR1 gene (rs9340799) polymorphism was found to be associated with CAD in all the genetic models. The haplotype analysis of ESR1 (rs2234693 and rs9340799) gene revealed that C-G haplotype was conferring approximately 5-fold risk and T-A haplotype was adding 1.4-fold risk towards the disease. 'T' allele of MTHFR rs1801133 SNP was observed to be responsible for development of CAD in our study population (p < 0.0001). In case of MTHFR (rs1801133 and rs2274976) gene, the haplotype T-G was observed to confer 4.7-fold risk towards CAD whereas haplotype C-G provided nearly a 1.7 fold protection towards development of CAD. For MS gene, rs185087 was also found to be associated with CAD in a co-dominant (p = 0.003 and p = 0.03), dominant (p = 0.001) and allelic models (p = 0.001). The gene-gene interaction revealed strong epistasis between single nucleotide polymorphisms (SNPs), ESR1 rs9340799 and MTHFR rs2274976. Furthermore, the dendrogram for gene-environment dataset indicated moderately synergistic interaction between CETP rs708272 and physical inactivity. CONCLUSION: In the study under reference, a significant association of ESR1-XbaI (rs9340799), MTHFR C677T (rs1801133) and MS A2756G (rs185087) gene polymorphisms with the susceptibility of CAD in the population of Jammu region (JandK) has been observed.

Active Epilepsy as Indicator of Neurocysticercosis in Rural Northwest India
Sunil Kumar Raina, Sushil Razdan, K K Pandita, Rajesh Sharma +2 more
2012· Epilepsy Research and Treatment27doi:10.1155/2012/802747

Objective. To determine the contribution of neurocysticercosis as a cause for active epilepsy and to establish Neurocysticercosis as major definable risk of epilepsy in our setup. Methods. We conducted a door-to-door survey of 2,209 individuals of Bhore Pind and Bhore Kullian villages in Chattah zone of district Jammu (Jumma and Kashmir, Northwest India) to identify patients with symptomatic epilepsy. Patients with active epilepsy were investigated with neuroimaging techniques to establish diagnosis of NCC (neurocysticercosis). Results. Among 25 patients with epilepsy 10(40%) had CT/MR evidence of past or recent NCC infection. This gave us the point prevalence of 4.5/1000 for Neurocysticercosis in our study population. Interpretation. The study shows a high prevalence of NCC accounting for symptomatic epilepsy in our part of India.

Prevalence of Cerebral Palsy in Children &lt;10 Years of Age in R.S. Pura Town of Jammu and Kashmir
Sunny Raina, S Razdan, Rachita Nanda
2010· Journal of Tropical Pediatrics26doi:10.1093/tropej/fmq095

OBJECTIVE: To determine the prevalence of cerebral palsy in children aged <10 years. METHODS: The study was conducted in the framework of a population-based, single-centre, cross-sectional surveillance at R.S. Pura town, 22 km south-west of Jammu city. RESULTS: A total of 11 cases of cerebral palsy were ascertained yielding a crude prevalence rate of 2.27/1000 in the age group of <10 years. The proportion of cerebral palsy occurring in males was higher than that in females. INTERPRETATION: The prevalence rates of cerebral palsy among children <10 years of age in R.S. town compare favorably with studies from developed countries.