Ravinder Pal

Post Graduate Institute of Medical Education and Research

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SurinderSingh Rana

Post Graduate Institute of Medical Education and Research

Tarun

Indira Gandhi Mirpur University

Kim Vaiphei

Post Graduate Institute of Medical Education and Research

Kartar Singh

Leipzig University

Manoj Biswas

All India Institute of Medical Sciences Bhopal

Rajeev Sarpal

Swami Rama Himalayan University

Ankur Mittal

All India Institute of Medical Sciences

N. T. Singh

Government Medical College

Karamveer Singh Rathore

Swami Rama Himalayan University

Ankit Chamoli

Government Medical College

Cooperative Institutions

Post Graduate Institute of Medical Education and Research

Institute of Medical Sciences

Swami Rama Himalayan University

University of Toronto

Government Medical College

University Health Network

Himalayan Institute of Yoga Science and Philosophy

Institute of Post Graduate Medical Education and Research

Health Sciences Centre

Sri Aurobindo Institute of Medical Sciences

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Co-morbidity pattern among type-II diabetes mellitus patients attending outpatient department of a rural tertiary care institute of North India

Asian Journal of Medical Sciences (2021)

Ravinder Pal Ramesh Kumar Verma N. T. Singh Tarun Dr

Background: Diabetes mellitus (DM) describes a group of metabolic disorders characterized by high blood glucose levels. People with diabetes have an increased risk of developing a number of serious life-threatening health problems resulting in higher medical care costs, reduced quality of life and increased mortality. Knowledge of the prevalence about coexisting medical conditions in specific population groups helps healthcare providers and policymakers to allocate health resources efficiently and tailor diabetic care management to effectively utilize healthcare programs while decreasing healthcare expenditure. Aims and Objectives: To find out the pattern of comorbidity burden among Type-II diabetes mellitus patients attending outpatient department of a rural tertiary care institute of North India. Materials and Methods: Study setting: Outpatient department (OPD) of General Medicine of Rural Tertiary Care Institute in North India. Study design: Descriptive, cross-sectional. Study population: Patients who had already been diagnosed by a physician of having Type 2 diabetes mellitus (T2DM) and attended OPD for follow-up during study period i.e. 1st November 2019 to 31st January 2020. Results: Among 82 study participants, 36 were males and 46 females. A total of sixty-six study participants had co-morbidities along with diabetes mellitus. Most common co-morbidity recorded was related to cardiovascular system and neuropathies. Adherence to treatment was followed by 46 (56%) and dietary advice by 42 (51%) study participants. Conclusion: In light of the chronicity of the disease and increasing prevalence of diabetes with associated comorbid conditions, there is a need for clearcut guidelines to address health risks of diabetes with other comorbid conditions. There should be provision for regular formal health education sessions to address co-morbidities, complications due to diabetes.

Outpatient clinic

Tertiary care

10.3126/ajms.v12i7.36148

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Role of N-acetylcysteine in rifampicin-induced hepatic injury of young rats

World Journal of Gastroenterology (2006)

SV Rana Savita Verma Attri Kim Vaiphei Ravinder Pal Arun K. Attri

AIM:To study the role of N-acetylcysteine (NAC) as a protective agent in rifampicin (RMP)-induced oxidative hepatic injury of young rats. METHODS:Hepatic injury was produced by giving 50mg/kg body weight/day of RMP for 3 wk.A dose of NAC (100mg/kg body weight/day) was given in combination with RMP intraperitoneally.Analysis of lipid peroxidation, thiol levels, cytochrome P 450 , superoxide dismutase (SOD), catalase, glutathione peroxidase, reductase and transferase were estimated in liver along with the body weight, liver weight and histological observations.RESULTS: RMP exposure resulted in no change in body and liver weight while antioxidative enzymes were altered but the non protein thiol (GSH) status was well preserved.Cytochrome P 450 system and peroxidation of lipids were induced by RMP exposure.Partial protection was observed with NAC against RMP-induced changes in liver, which was evidenced from the prevention of increase in lipid peroxidation and the reduction in SOD and catalase enzyme levels.CONCLUSION: NAC protects young rats against RMPinduced oxidative hepatic injury.

Glutathione reductase

10.3748/wjg.v12.i2.287

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Citations (40)

To Study The Causes of Hospital Admission of Chronic Kidney Disease Patients In A Tertiary Care Centre

Indian Journal of Scientific Research (2020)

Jasminder Singh Himanshu Aggarwal Shaveta Dahiya Taruna Pahuja Varun Kulkarni

Tertiary care

10.32606/ijsr.v11.i1.00007

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Hepatoprotection by carotenoids in isoniazid–rifampicin induced hepatic injury in rats

Biochemistry and Cell Biology (2010)

SurinderSingh Rana Ravinder Pal Kim Vaiphei R. P. Ola Kartar Singh

This study evaluates the hepatoprotective effect of carotenoids against isoniazid (INH) and rifampicin (RIF). Thirty-six adult rats were divided into the following 4 groups: (1) control group treated with normal saline; (2) INH + RIF group treated with 50 mg·(kg body mass) –1 ·day –1 of INH and RIF each; (3) INH + RIF+ carotenoids group treated with 50 mg·(kg body mass) –1 ·day –1 of INH and RIF each and 10 mg·(kg body mass) –1 ·day –1 of carotenoids; and (4) carotenoids group treated with 10 mg·(kg body mass) –1 ·day –1 of carotenoids for 28 days intragastrically. Oxidative stress and antioxidant levels in liver and blood, liver histology and change in transaminases were measured in all the above-mentioned groups. There was an increase in lipid peroxidation with a reduction in thiols, catalase, and superoxide dismutase (SOD) in the liver and blood of rats accompanied by an increase in transaminases, bilirubin, and alkaline phosphatase. Treatment with carotenoids along with INH + RIF partially reversed lipid peroxidation, thiols, catalase, and SOD in the liver and blood of rats. Elevated levels of the enzymes in serum were also reversed partially by this treatment. The degree of necrosis, portal triaditis, and inflammation were also lowered in the carotenoids group. In conclusion, carotenoids supplementation in INH + RIF treated rats showed partial protection.

Hepatoprotection

10.1139/o10-023

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Prevalence and risk factors associated with prehypertension and hypertension among attendants of patients at a rural tertiary care institute of Haryana

International Journal of Community Medicine and Public Health (2019)

Babita Rani Ravinder Pal Sanjay Kumar Jha Anita Punia Sanjeet Singh

Background: Hypertension (HTN) is the leading risk factor for death and disability globally and disproportionately impacts low-and middle-income countries. HTN is present in 25% of urban and 10% of rural subjects in India. Our objective was to estimate the prevalence of pre-HTN and HTN among the attendants of patients at a rural tertiary care institute of Haryana.Methods: This was a hospital-based cross-sectional study. A total of 309 attendants of patients were enrolled for this study. Diagnosis of pre-HTN and HTN was done on the basis of seventh joined national committee guidelines. Data were collected on a semi-structured proforma and were analysed by using R software.Results: The prevalence of pre-HTN and HTN was 18.4% and 21.4% respectively. Both the pre-HTN and HTN were significantly higher in males (p=0.002) and in the age group of 45 to 55 years (p<0.001). The multinomial logistic regression analysis revealed that sex, age >55 years and BMI >23 kg/m2 were significantly associated with pre-HTN and HTN.Conclusions: The prevalence of both prehypertension and hypertension is high in rural Haryana. This makes the people of this area vulnerable to several chronic diseases. The ﬁndings warrant urgent measures to lower the risk factors in rural communities. So, programs are needed to improve the surveillance systems and implementation of community based screening programs for early detection of hypertension.

Prehypertension

Cross-sectional study

Tertiary care

10.18203/2394-6040.ijcmph20191401

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Comparing the effect of Alpha blocker (Silodosin) and Phosphodiesterase type 5 inhibitor (Tadalafil) in benign prostate hyperplasia patients with lower urinary tract symptoms: a single centre study

International Surgery Journal (2018)

Sanket Narayan Singh Manoj Biswas Ankur Mittal Yogesh Kalra Rajeev Sarpal

Background: Benign prostatic hyperplasia (BPH) is a histologic diagnosis that refers to the proliferation of smooth muscle and epithelial cells within the prostatic transition zone. The aim of this systematic review is to determine the comparative effectiveness and safety of phosphodiesterase 5 inhibitors (PDE5-Is) and alpha blockers used alone or in combination for the treatment of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH).Methods: We analyzed 54 patients of BPH with LUTS with baseline IPSS, Qmax and PVR over one-year period. They were randomized equally in three groups i.e. group receiving alpha blocker, group receiving phosphodiesterase 5 inhibitors and group receiving combination of the two drugs. These patients were followed up at the end of 1st month and 3rd month and IPSS, Qmax and PVR was compared.Results: Out of 54, 45 patients completed the study. At the end of the study all the three groups showed significant improvement in IPSS, PVR and Qmax, all p <0.05, but the combination group showed much better improvement in terms of percentage. Two patients on alpha blockers had episode of hypotension.Conclusions:Thus, we summarize that phosphodiesterase 5 inhibitors should be preferred over alpha blockers in patients with LUTS/BPH as it has, firstly, outcome similar to alpha blockers. Secondly, have no documented side effect. Third, can be given in any patient, irrespective of the fact that whether the patient is suffering from erectile dysfunction or not.

Silodosin

Alpha (finance)

10.18203/2349-2902.isj20181599

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Citations (5)

Association of hospital and physician case volumes with cardiac monitoring and cardiotoxicity during adjuvant trastuzumab treatment for breast cancer: a retrospective cohort study

CMAJ Open (2016)

Nicolas Chin‐Yee Andrew T. Yan Alexander Kumachev Dennis T. Ko Craig C. Earle

Background:

Adjuvant trastuzumab is the standard of care for patients with HER2 overexpressing breast cancer, but use of trastuzumab may lead to cardiotoxicity. Our goal was to evaluate the relationship between hospital and physician case volume and cardiac outcomes in this population.

Methods:

In this retrospective cohort study, we identified all female patients in Ontario with a breast cancer diagnosis in 2003-2009 who underwent treatment with trastuzumab through a provincial drug-funding program and linked these patients to administrative databases to ascertain patient demographics, treating hospital and physician characteristics, admissions to hospital, cardiac risk factors, cardiac imaging and comorbidities. Insufficient cardiac monitoring was defined as per the Canadian Trastuzumab Working Group guideline. Cardiotoxicity was defined as receiving fewer than 16 of 18 doses of trastuzumab because of heart failure admission, heart failure diagnosis or discontinuation of the drug after cardiac imaging. We constructed hierarchical multivariable logistic regression models to evaluate the effect of annual hospital volume, cumulative physician volume and treatment period on cardiac monitoring and cardiotoxicity.

Results:

Of 3777 women treated by 214 oncologists at 68 hospitals, 918 (24.3%) had insufficient cardiac monitoring and cardiotoxicity developed in 640 (16.9%). Cardiotoxicity occurred in 389 (42.4%) and 251 (8.8%) patients in the insufficient- and sufficient-monitoring groups, respectively. Higher annual hospital and cumulative physician volumes, and more recent calendar period, were all independent predictors for decreased cardiotoxicity. Adjustment for rates of cardiac monitoring annulled the relationships between case volume and cardiotoxicity.

Interpretation:

Greater hospital and physician case volumes are associated with reduced rates of trastuzumab-related cardiotoxicity, most likely because of better cardiac monitoring at higher volume centres.

Cardiotoxicity

10.9778/cmajo.20150033

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Citations (12)

Clinical profile of patients with hypertensive crisis in a tertiary care hospital in Haryana, India – A retrospective cross-sectional study

Asian Journal of Medical Sciences (2022)

N. T. Singh Tarun Ravinder Pal Ankit Chamoli

Background: A hypertensive crisis may manifest as hypertensive emergency or urgency. Hypertensive emergency is characterized by target organ damage and poses immediate threat to life, a situation not seen in urgency. Aims and Objectives: The aims of the study were as follows: (1) To determine the prevalence of hypertensive crisis classified as emergency, urgency, and pseudocrisis. (2) To assess the various systems (neurological, cardiovascular, and renal) affected in relation to a particular type of hypertensive crisis. Materials and Methods: The retrospective study comprised analysis of medical records of 100 patients of hypertensive crisis admitted to emergency unit of BPS Government Medical College and Hospital for Women, Sonepat, Haryana, India, in the 2 years period from January 2018 to December 2019 and study their prevalence among hospital emergencies and clinical presentation. Results: Total number of clinical emergencies analyzed during this time interval was 6666. The prevalence of hypertensive crisis accounted to 1.5% of all the clinical emergencies received. About 66% presented as hypertensive emergencies, 32% as hypertensive urgency, and 2% presented as hypertensive pseudocrisis. Males of the fifth decade of life while females of the sixth decade of life were most affected by hypertensive crisis. Headache (58%) followed by giddiness (44%) was the most common clinical presentation in the emergency. About 34% of patients had associated neurological deficit. Only 16% of patients had cardiovascular system involvement. Conclusion: Symptoms provided by patients in the emergency department are of paramount importance for the outcome of hypertensive crisis. Severe complication of hypertensive crisis can be prevented if hypertension is timely diagnosed and appropriately managed.

Hypertensive emergency

Hypertensive crisis

Cross-sectional study

Presentation (obstetrics)

10.3126/ajms.v13i1.39591

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Citations (3)

Clinical profile of patients with hypertensive crisis in a tertiary care hospital in Haryana, India – A retrospective cross-sectional study

Asian Journal of Medical Sciences (2022)

N. T. Singh Tarun Ravinder Pal Ankit Chamoli

Tertiary care

Cross-sectional study