14 research outputs found
A study on sarcoidosis with clinical profile, diagnosis and treatment: A clinic’s perspective
No full textBackground: Sarcoidosis is a multisystem granulomatous disease of unknown etiology and a close mimic of Tuberculosis in TB endemic are as which poses a diagnostic challenge. Objective: The main objective of the study is to determine the prevalence of Sarcoidosis with respect to its clinical profile, diagnosis and treatment. Methodology: The present study is a descriptive study with20 documented cases of Sarcoidosis from South India; the study span was from 2011 to 2021with Particular reference to cardiac and other organ involvement. Results: The results showed pulmonary involvement in 100% of patients followed by peripheral Lymph nodal involvement in 70% of patients which offered easy and cost effective diagnosis .Cardiac involvement was noted in 15% of patients as against scarce case reports from India. Ocular and Cutaneous involvement was seen in 15% of patients each. Kidneys and Parotids were involved in 5% of Patients. It should be suspected in any patient with appropriate clinical/radiological findings and the diagnosis of non-caseating granuloma should be made from an easily accessible peripheral site, followed by bronchoscopic and other methods. It should be differentiated from Tuberculosis and other granulomatous lesions. It is a steroid responsive condition and carries good prognosis
Optimized Public Auditing and Data Dynamics for Data Storage Security in Cloud Computing
No full textAbstractCloud Computing is a promising service platform to access computing resources on demand over the Internet. It moves the data and applications to the large data centres where data and services can be managed in a much better manner than locally. However, its use puts forth a lot of challenging issues related to security, privacy and reliability of the overall system. In this paper, we focus on the problem of data-integrity verification(by a third party auditor) for the client's data residing on a cloud storage server(CSS). Here, we optimize an existing third party auditing protocol and make it resistant to replace, replay and forge attacks launched by malicious insiders at cloud storage server. We also propose a protocol to perform efficient block-level and fine-grained dynamic-data update operations on data stored on cloud using a modified Chameleon Authentication Tree. Extensive security and performance analysis shows that our protocols are efficient and can resist aforementioned attacks
A comparative study on efficacy of chlorthalidone and azilsartan in confirmed cases of hypertension associated with ace gene polymorphism
No full textThe angiotensin-converting enzyme (ACE) gene consists of 26 exons, it is located on chromosome 17 and its polymorphism is a major contributing factor to hypertension. The aim is to compare the efficacy of Chlorthalidone and Azilsartan in newly diagnosed hypertension patients in association with ACE gene polymorphism. The study was conducted in the department of pharmacology, Rama medical college, Kanpur. After doing genetic test and basic investigation, 90 newly diagnosed patients with hypertension associated with ACE gene polymorphism were recruited, followed by grouping into two A&B. Group-A(n=45) patients were given Azilsartan 45mg/day and group-B(n=45) patients were given Chlorthalidone 25mg/day for 3 months. Systolic and diastolic blood pressure (SBP& DBP) was measured before and after 3 months of treatment in both groups and they were compared. Three genotypes were found in ACE gene polymorphism-associated hypertension cases such as I/I, I/D and D/D, the severity of hypertension is more in the D/D genotype followed by I/D and I/I genotypes. All three genotypes of both group-A & B had shown a significant mean reduction in SBP& DBP after 3 months of treatment (p<0.05) but the mean reduction was high in the I/I genotype followed by the I/D and then D/D genotype. 
Comparative evaluation of antimicrobial activity of newer herbal disinfectant formulations on hospital microbial flora
No full textBackground: The world is now focusing on use of herbals because they are eco-friendly and less toxic on human health and environment Objectives:To evaluate antimicrobial activity of newer herbal disinfectant formulations on hospital microbial flora Methods: Herbal disinfectants were prepared with medicinal plant leaf extracts of Tridax procumbens, Withania somnifera, Tinospora cordifolia, Costus igneus and Nepata cataria. Hospital microbial flora was isolated by rubbing and rotating sterile swabs from targeted spots. Extract formulations were tested for the antimicrobial activity against five isolatedbacterial strains i.e., Escherichia coli, Pseudomonas aeruginosa, Enterobacter sp., Enterococcus faecalis and Staphylococcus aureus using Kirby-bauer disc diffusion method. Results: Extracts exhibited antimicrobial activity against all tested microorganisms. Among the five different herbal disinfectants, Tinospora cordifolia showed good antimicrobial activity against Escherichia coli, Enterobacter and Enterococcus faecalis with 27mm, 20mm and 14mm of zone of inhibition respectively. Costus igneus showed high antimicrobial activity to Pseudomonas aeruginosa with 22mm of zone of inhibition. The herbal disinfectant formulations in the present study were reported effective results against hospital microbial flora which cause nosocomial infections Conclusions: Herbal disinfectants Tinospora cordifolia, Costus igneus, Withania somnifera exhibits antimicrobial activities against MDR bacterial pathogens isolated from hospital wards
Prospective analysis of CNS tumor spectrum: A single centre experience in South India Corresponding Author
No full textPrimary total knee replacement using dished polyethylene with resected posterior cruciate ligament
No full textBackground: The choice between preserving, sacrificing or substituting the posterior cruciate ligament (PCL) is always a controversial topic in total knee replacement (TKR). Dished polyethylene insert with PCL resection enables correction of the commonly present fixed flexion and varus deformities. Additionally, the risk of premature wear of polyethylene is less because of the confirming articular geometry between the femoral and tibial component.Methods: This is a retrospective study in which we studied 120 knees in 95 consecutive patients undergoing primary TKR by the senior author at our institute. We used TKR system with dished metal backed polyethylene tibial component. PCL resection was performed in all cases. Pre-operative and post-operative functional assessment were done using knee society clinical scores and Western Ontario and McMaster universities osteoarthritis index (WOMAC). All radiographs were assessed using the knee society Roentgenographic scoring system (KSRES). Statistical analysis was performed using paired student t tests. Survivorship was determined using Kaplan-Meier survivorship curves. Results: Mean follow-up was 8 years. Range of motion increased from 75 degrees to 110 degrees. The knee society pain score increased from 30 to 94. The knee society function score increased from 35 to 75. WOMAC score increased in terms of pain, stiffness and physical function.Conclusions: We conclude that deep dish bearing is a viable option in presence of deficient PCL and provides adequate stability and functional outcome. We need a larger sample size, multicentre trial and longer follow-up to see for complication rate, revision rate and survival
Demographic and Clinical Profiles of Parkinson's Disease in India:Observations from a Nation-Wide Multicenter Study
No full textBACKGROUND: Parkinson's disease (PD) phenotype may vary with genetic, ethno-geographic, cultural, and environmental factors.OBJECTIVES: The aim was to develop a clinical database of PD in India and assess the influence of age-at-onset (AAO), gender, and motor subtype on the clinical profile of PD.METHODS: A cross-sectional study of PD was conducted across 18 Indian hospitals. Standardized assessments were performed by movement disorder specialists. Data were collected using uniform questionnaires during the recruitment visit. A total of 3300 age- and gender-matched case-control pairs were analyzed for environmental exposures, habits, and co-morbidities.RESULTS: We recruited 7918 PD cases with a mean AAO of 54.2 ± 11.8 years and a median disease duration of 5 years (interquartile range: 2-9). Subgroup analyses based on AAO, gender, and motor phenotype revealed significant differences in motor and non-motor symptoms, exposures, habits, and co-morbidities. Except coffee consumption, previously known associations were observed for exposure to insecticides/pesticides/fungicides (odds ratio [OR]: 1.67), head injury (OR: 3.11), coffee consumption (OR: 1.73), diabetes (OR: 1.48), hypertension (OR: 1.73), and smoking (OR: 0.74) in the Indian population.CONCLUSIONS: This large pan-Indian study highlights the clinical characteristics, environmental exposures, habits, and comorbid diseases associated with PD, which were broadly similar to those observed in European populations. The earlier AAO in Indian PD patients suggests a potentially higher genetic risk, warranting further investigation. A nationwide, community-based, epidemiological study is needed to achieve a comprehensive understanding of all risk factors for PD in India and to validate the risk factors identified in this hospital-based study. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.</p
Characterising acute and chronic care needs: insights from the Global Burden of Disease Study 2019
No full textChronic care manages long-term, progressive conditions, while acute care addresses short-term conditions. Chronic conditions increasingly strain health systems, which are often unprepared for these demands. This study examines the burden of conditions requiring acute versus chronic care, including sequelae. Conditions and sequelae from the Global Burden of Diseases Study 2019 were classified into acute or chronic care categories. Data were analysed by age, sex, and socio-demographic index, presenting total numbers and contributions to burden metrics such as Disability-Adjusted Life Years (DALYs), Years Lived with Disability (YLD), and Years of Life Lost (YLL). Approximately 68% of DALYs were attributed to chronic care, while 27% were due to acute care. Chronic care needs increased with age, representing 86% of YLDs and 71% of YLLs, and accounting for 93% of YLDs from sequelae. These findings highlight that chronic care needs far exceed acute care needs globally, necessitating health systems to adapt accordingly.
© 2025. The Author(s)
Classical fever of unknown origin in 21 countries with different economic development: an international ID-IRI study
No full text© 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.Fever of unknown origin (FUO) is a serious challenge for physicians. The aim of the present study was to consider epidemiology and dynamics of FUO in countries with different economic development. The data of FUO patients hospitalized/followed between 1st July 2016 and 1st July 2021 were collected retrospectively and submitted from referral centers in 21 countries through ID-IRI clinical research platform. The countries were categorized into developing (low-income (LI) and lower middle-income (LMI) economies) and developed countries (upper middle-income (UMI) and high-income (HI) economies). This research included 788 patients. FUO diagnoses were as follows: infections (51.6%; n = 407), neoplasms (11.4%, n = 90), collagen vascular disorders (9.3%, n = 73), undiagnosed (20.1%, n = 158), miscellaneous diseases (7.7%, n = 60). The most common infections were tuberculosis (n = 45, 5.7%), brucellosis (n = 39, 4.9%), rickettsiosis (n = 23, 2.9%), HIV infection (n = 20, 2.5%), and typhoid fever (n = 13, 1.6%). Cardiovascular infections (n = 56, 7.1%) were the most common infectious syndromes. Only collagen vascular disorders were reported significantly more from developed countries (RR = 2.00, 95% CI: 1.19–3.38). FUO had similar characteristics in LI/LMI and UMI/HI countries including the portion of undiagnosed cases (OR, 95% CI; 0.87 (0.65–1.15)), death attributed to FUO (RR = 0.87, 95% CI: 0.65–1.15, p-value = 0.3355), and the mean duration until diagnosis (p = 0.9663). Various aspects of FUO cannot be determined by the economic development solely. Other development indices can be considered in future analyses. Physicians in different countries should be equally prepared for FUO patients
[S] Mortality and disability-adjusted life years in North Africa and Middle East attributed to kidney dysfunction: a systematic analysis for the Global Burden of Disease Study 2019
No full textBackground. The study aimed to estimate the attributable burden to kidney dysfunction as a metabolic risk factor in the North Africa and Middle East (NAME) region and its 21 countries in 1990-2019. Methods. The data used in this study were obtained from the Global Burden of Diseases (GBD) 2019 study, which provided estimated measures of deaths, disability-adjusted life years (DALYs), and other epidemiological indicators of burden. To provide a better insight into the differences in the level of social, cultural, and economic factors, the Socio-Demographic Index (SDI) was used. Results. In the NAME region in 2019, the number of deaths attributed to kidney dysfunction was 296 632 (95% uncertainty interval: 249 965-343 962), which was about 2.5 times higher than in the year 1990. Afghanistan, Egypt, and Saudi Arabia had the highest, and Kuwait, Turkey, and Iran (Islamic Republic of) had the lowest age-standardized rate of DALYs attributed to kidney dysfunction in the region in 2019. Kidney dysfunction was accounted as a risk factor for ischemic heart disease, chronic kidney disease, stroke, and peripheral artery disease with 150 471, 111 812, 34 068, and 281 attributable deaths, respectively, in 2019 in the region. In 2019, both low-SDI and high-SDI countries in the region experienced higher burdens associated with kidney dysfunction compared to other countries. Conclusions. Kidney dysfunction increases the risk of cardiovascular diseases burden and accounted for more deaths attributable to cardiovascular diseases than chronic kidney disease in the region in 2019. Hence, policymakers in the NAME region should prioritize kidney disease prevention and control, recognizing that neglecting its impact on other diseases is a key limitation in its management. © The Author(s) 2023. Published by Oxford University Press on behalf of the ERA. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.kz
