Vatsala Khurana

William Harvey Research Institute

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Binita Goswami

Maulana Azad Medical College

Shailata Prisi

Maulana Azad Medical College

Binita Goswami

Maulana Azad Medical College

Elvia Jamatia

Maulana Azad Medical College

Rajni Saijpaul

Maulana Azad Medical College

S. Kaushik

Galgotias University

Smita Kaushik

Maulana Azad Medical College

Rashmi Verma

Maulana Azad Medical College

Aruni Ghose

Barts Health NHS Trust

Anup K. Kanodia

The Ohio State University Wexner Medical Center

Cooperative Institutions

Maulana Azad Medical College

University of Delhi

Institute of Medical Sciences

Institute of Post Graduate Medical Education and Research

University College of Medical Sciences

Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital

Queen Mary University of London

Lok Nayak Jai Prakash Narayan Hospital

All India Institute of Medical Sciences

Post Graduate Institute of Medical Education and Research

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Prevalence of dysmagnesemia among CKD patients in North India

Journal of Renal and Hepatic Disorders (2024)

Shailata Prisi Kajal Nandi Elvia Jamatia Biplob Kumar Biswas Vatsala Khurana

Magnesium is the second-most common intracellular cation after calcium with 99% of total body magnesium distributed intracellularly in bones, muscles, and soft tissues. Only 1% of total body magnesium is present extracellularly that contributes to the normal serum magnesium concentration of 1.8–2.6 mg/dL. Recently, many studies have focused on the role of magnesium homeostasis and human health. Diabetes and hypertension are the leading causes of chronic kidney disease (CKD), and the significance of magnesium in CKD has been astonishing in medical practice. In this study, we investigated the serum levels of magnesium and its prevalence at different stages of CKD. This cross-sectional descriptive study was conducted over a period of 2 months. Serum magnesium levels were analysed in 224 patients with CKD and were grouped into five stages of CKD according to the guidelines of the Kidney Disease: Improving Global Outcomes (KDIGO) based on glomerular filtration rate. Laboratory data of patients was analysed using the IBM SPSS V23 software (Chicago, USA) for statistical relationship between serum magnesium levels and stages of CKD in patients with CKD. Mean serum magnesium level of the study population was 2.21 ± 0.75 mg/dL; 50.9% of the patients were normomagnesemic (normal level of magnesium ions in the blood), followed by 30.4% hypomagnesemic and 20.5%, hypermagnesemic. CKD was more common in males (63.4%), compared to females (36.6%). Mean age of patients in G5 stage was significantly higher than in G3a, G3b, and G4 stages (P = 0.001). A progressive decline in renal function and retention of uraemic solutes was observed with progression of CKD. Multiple factors, both inherited or acquired, such as diuretics and alcohol, are implicated in controlling serum magnesium levels. Magnesium deficiency leads to 2.12-fold higher risk of progression to end-stage renal disease (ESRD).

10.15586/jrenhep.v8i1.173

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An Appraisal of Epidemiologic, Clinical, Bacteriologic, Histopathologic, and Immunologic Parameters in Cutaneous Tuberculosis

International Journal of Dermatology (1987)

V N Sehgal Govind Srivastava Vatsala Khurana Vinod Sharma Preena Bhalla

Cutaneous tuberculosis incidence was recorded as 0.15%. Of the 42 patients, 23 had scrofuloderma, 17 lupus vulgaris, and 2 tuberculosis verrucosa cutis. Both men and women were affected by the disease in the second and third decades. Its duration was variable. An affirmative family history was elicited in five scrofuloderma patients. The clinical expression largely conformed to the ritual text. Variation in Mantoux test positivity was unremarkable. The disparity in the demonstration of bacilli in the smear and tissue sections was, however, quite apparent in scrofuloderma. The correlation of different parameters indicates a continuous spectrum, formed at one end by lupus vulgaris, and at another by scrofuloderma. A moderate to strongly positive Mantoux text, enormous lymphocytes in the granuloma, absence of tubercle bacilli, negative culture, and an apparently normal immunoprofile were features of lupus vulgaris; whereas scrofuloderma had a moderately positive Mantoux test, lesser number of lymphocytes in the granuloma, large number of bacilli in tissue smear and/or tissue section, raised levels of immunoglobulins, and a grossly lowered C3 levels. The other variants probably occupy a position in between.

10.1111/j.1365-4362.1987.tb02294.x

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Citations (125)

Implications of Inflammatory markers for disease management in patients with chronic kidney disease and COVID-19 infection: A cross-sectional study from North India

Current Medicine Research and Practice (2023)

Vatsala Khurana Binita Goswami Sunita Aggarwal Smita Kaushik

ABSTRACT Background: The world witnessed the emergence of a global pandemic. Individuals with chronic illnesses like chronic kidney disease (CKD), already known to be immunologically compromised, have the potential to develop a scenario of an acute-on-chronic condition on coronavirus disease 2019 (COVID-19) contraction. Measurement of serum inflammatory biomarkers like interleukin (IL-6), high-sensitivity C-reactive protein (hsCRP) and ferritin may foresee the prognosis despite the pre-existing low-grade inflammation in these patients. Aims: To determine the utility of serum IL-6, hsCRP and Ferritin levels to determine COVID-19 severity and probable prognosis in CKD patients with COVID-19. Materials and Methods: A cross-sectional study was performed on 100 adult known cases of stage 5 of CKD, recently diagnosed as COVID-19 positive by real-time reverse transcription-polymerase chain reaction. The study population was divided into two groups according to COVID-19 severity: A non-severe and a severe group based on guidelines given in the Clinical Management Protocol: COVID-19. Their clinical and laboratory data obtained on the day of admission were analysed. Results: The severe group ( n = 17) had 65% of males and 35% of females. A significant difference was found with respect to the age, body mass index and serum IL-6, hsCRP and ferritin levels between the two groups ( P < 0.05). Among the three inflammatory biomarkers, hsCRP was found to have the maximum potential to categorise COVID-19 as severe or non-severe disease. Conclusion: Similar to patients with uncomplicated COVID-19 disease, higher serum levels of inflammatory biomarkers – IL-6, hsCRP and ferritin are seen in patients of CKD with severe COVID-19 illness in comparison to those with non-severe COVID-19, despite having a pre-existing background of low-grade chronic inflammation. The serum levels of IL-6, hsCRP and ferritin can be utilised to determine COVID-19 severity and probable prognosis in CKD patients with COVID-19.

Cross-sectional study

Pandemic

10.4103/cmrp.cmrp_113_22

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Angiotensin converting enzyme (ACE)

Clinica Chimica Acta (2021)

Vatsala Khurana Binita Goswami

Pathogenesis

Peptidyl-Dipeptidase A

Angiotensin-converting enzyme 2

10.1016/j.cca.2021.10.029

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Single monoclonal spike characterized as double monoclonal gammopathy in a patient with multiple myeloma: A rare finding

Indian Journal of Pathology and Microbiology (2023)

Rajni Saijpaul Vatsala Khurana Rashmi Verma Smita Kaushik

ABSTRACT Multiple myeloma (MM) is associated with the secretion of a unique monoclonal protein (M-protein) due to overproduction of immunoglobulin (Ig) by a clone of abnormally proliferating plasma cells. However, in 4% of the cases more than one M-protein can be found. This category of gammopathies is called “double monoclonal gammopathies.” Here, we present a rare case of MM with double monoclonal gammopathy, where the presence of both M-proteins was observed in the single sharp peak on capillary zone electrophoresis (CZE). Further the interference of Hook effect is also discussed. Double monoclonal gammopathies need to be identified to increase diagnostic accuracy and reliability, and to get a better understanding of the disease pathogenesis and progression.

clone (Java method)

Serum protein electrophoresis

Paraproteinemias

Monoclonal gammopathy

Myeloma protein

10.4103/ijpm.ijpm_904_21

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T041 Multiple myeloma with unique presenting symptoms: A case report

Clinica Chimica Acta (2022)

Vatsala Khurana R. Verma R. Saijpaul S. Kaushik

10.1016/j.cca.2022.04.278

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Interplay between coagulopathy and inflammation in patients with COVID-19

MGM Journal of Medical Sciences (2023)

Vatsala Khurana Shailata Prisi Binita Goswami

Abstract Background: Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a systemic disease. Most patients have mild-to-moderate symptoms; however, severe respiratory symptoms develop in some. Although increased inflammatory markers and abnormal coagulation profile are related to the severity and mortality of COVID-19, no definitive relation has been established. Materials and Methods: The laboratory data of 199 patients with COVID-19 admitted to our dedicated COVID-19 care facility, categorized into mild (36), moderate (76), and severe (87) cases, were analyzed for a statistical association between the inflammatory markers and coagulation profile. IBM SPSS V23 software, Chicago, was used for data analysis. Results: A gradual increase in serum IL-6, ferritin, and D -dimer levels were observed from mild, moderate, and severe categories with statistically significant differences among all three groups. A positive correlation was observed between serum IL-6 and D -dimer ( r 2 = 0.36, P < 0.01) only in the severe group. Among the three parameters, D -dimer had the best discriminating ability between severe and nonsevere disease with a serum cutoff level of 451 ng/mL. Conclusion: Thrombin has pro-inflammatory action. Similarly, IL-6 induces the release of acute-phase reactants like fibrinogen. Because of this interplay, patients with severe COVID-19 are at a dual risk of inflammatory and thromboembolic complications and must be monitored stringently.

2019-20 coronavirus outbreak

10.4103/mgmj.mgmj_54_23

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Student Perception Regarding the Utility of Information Technology as a Facilitator of Learning in Medical Education

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH (2021)

Vatsala Khurana Rashmi Verma Binita Goswami Vikas Malhotra

Introduction: Information Technology (IT) has influenced all fields including healthcare and Medical Education (ME). The present generation of students have grown up in an IT enriched atmosphere and are comfortable with most IT tools and gadgets. Aim: To understand the perception of first year MBBS students regarding role of IT in ME. Materials and Methods: A cross-sectional, questionnaire based study was carried out on 250 first year MBBS students from August 1st, 2019 to August 31st, 2019 over a period of one month. A questionnaire containing three sections was administered to the students before the starting of IT module in foundation year. The responses to the items of the questionnaire were assessed on the basis of the student responses on the likert scale. Results: The study revealed that students acknowledged the utility of IT for academic purposes and were primed for its inclusion as an essential component of the medical curriculum. The students conceded to browsing internet on their computers and smartphones for social media handles. However, when it came to teaching methods, students were not comfortable with the idea of replacing traditional teaching methods with e-learning. Also, students were more comfortable in reading hard copies instead of e-books. Conclusion: It was concluded that there is a need to amalgamate the traditional teaching methods with the innovative e-learning platforms in such a way that they become mutually inclusive and facilitate the learning process. Also, ME practices need to be continuously re-evaluated to make the educational process more effective for learners, teachers and for the society in general.

Facilitator

10.7860/jcdr/2021/47276.14935

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Differences in hepatitis B markers between clinical and preclinical health care personnel.

PubMed (1997)

Vatsala Khurana P Kar Naresh Mansharamani Vipin Jain Anup K. Kanodia

Hepatitis B virus (HBV) infection is an occupational risk for health care personnel (HCP). Vaccination is an important preventive measure but high cost of vaccination limits the feasibility of giving vaccine to all HCP. To find an optimum approach for vaccination we conducted a study on HCP in Maulana Azad Medical College and associated LNJPN hospital. A total of 162 subjects were screened. Eight were excluded because of prior vaccination against HBV. Two groups of subjects were selected namely preclinical and clinical. The preclinical group comprised first year medical students and the clinical group comprised of HCP who have been exposed to clinical departments. The subjects were screened for HBsAg, anti HBs and anti HBc viral markers. 86 subjects were screened in the preclinical group. Two (2.3%) were positive for HBsAG; 16 (18%) and 9 (10.4%) were positive for anti HBs and anti HBc respectively. In the clinical group a total of 68 subjects were screened. Amongst them 1.4% were positive for HBsAg; 47 (69%) and 38 (55%) were positive for anti HBs and anti HBc respectively. The study revealed that there was a significant difference in the titre of the viral markers in the preclinical group as compared to the clinical group. Seventy (82%) of preclinical subjects were at high risk for the infection as they moved into clinical departments. Few subjects will be excluded from the vaccination schedule based on anti HBs screening and hence screening prior to vaccination is not cost effective. However in the clinical group 69% will be excluded from the vaccination schedule based on anti HBs positivity and screening will save up to 60% of cost involved in vaccination.

Hepatitis B

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W182 Association between nutritional and inflammatory biomarkers in COVID-19 patients with chronic kidney disease

Clinica Chimica Acta (2022)

Vatsala Khurana B. Goswami S. Kaushik

2019-20 coronavirus outbreak

10.1016/j.cca.2022.04.940

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