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Lupus ◽  
2021 ◽  
pp. 096120332110345
Sujata Sawhney ◽  
Manjari Agarwal

Introduction: Children with systemic lupus erythematosus have a more challenging and difficult course as compared to their adult counterparts. Today, the aim of therapy for any child with lupus is to keep the child in a state of sustained remission with minimal or no use of steroids. This laudable goal is often difficult to achieve for the child with lupus. In addition to the use of disease modifying agents, sometimes in combination, Rituximab (RTX) is also used as an off-label indication to manage such patients. Objectives: To study the use, efficacy and safety of RTX in a cohort of patients with pediatric lupus followed at a single tertiary level center in Northern India. Methods: This paper is a retrospective review looking at the use of RTX in children with systemic lupus at a tertiary level pediatric rheumatology center in North India over a period of seventeen years. This paper describes the indications, use, efficacy and safety of RTX in childhood systemic lupus erythematosus. Results: RTX was used in 17 of 225 pediatric lupus patients (7.5%), with the most common indication being resistant renal disease (53%). Significant improvement was seen in all domains studied: The mean SLEDAI was 16.25 prior to RTX and reduced to 1.43 six months after the RTX (p value 0.001), steroid use dropped from 100% pre- RTX to 33% at 2 years, there was a sustained reduction in proteinuria in the patients with nephritis from a mean urine spot protein creatinine ratio of 3.1 pre RTX to 0.4 at one year post RTX (p= .006). Finally, 82% of the children had no flare during the follow up (median 24 months). No patient had any adverse event. Conclusions: This study confirms that RTX is very effective in childhood lupus and can be safely used even in a country with a very high burden of infectious diseases. This data adds to the scarce literature in this area from the developing world.

Sandeep N. Lal ◽  
Arti Maria ◽  
Tapas Bandyopadhyay

AbstractThis study aimed to determine antimicrobial resistance pattern and predictors of adverse outcome in neonatal meningitis. A retrospective study by analyzing case files of 134 cases of neonatal meningitis. We noted an alarming degree of multidrug resistance (MDR) among both gram-negative (Klebsiella spp., 50%; Escherichia coli, 100%; and and Acinetobacter spp., 50%), as well as positive (Enterococcus, 100%) isolates in cerebrospinal fluid (CSF) culture. The incidence rate of adverse outcome (i.e., mortality and abnormal neurological examination at discharge) was 8.2 and 17.2%, respectively. On univariate analysis, delayed seeking of medical care, bulging anterior fontanelle, vomiting, positive sepsis screen, shock during hospital course, ventriculitis, diversion procedures for raised intracranial pressure, central line placement, low CSF sugar, and failed hearing screening test at discharge were associated with increased risk of adverse outcome. Further, delayed seeking of medical care, shock during hospital course, positive sepsis screen, thrombocytopenia, and MDR infections were independently found to be associated with adverse outcomes. An alarming degree of antimicrobial resistance among the CSF isolates necessitates the need to understand the pathogenesis of resistance and curtail the irrational prescription of antibiotics in neonatal meningitis. Further, delayed seeking of medical care, shock during hospital course, positive sepsis screen, thrombocytopenia, and MRD infection may have prognostic value in neonatal meningitis

Sanjay Kumar ◽  
M.C. Keerthi ◽  
Tejveer Singh ◽  
Veeresh Kumar ◽  
V.K. Yadav

Background: Egyptian clover (Trifolium alexandrinum L.) is one of the most important annual, winter, multi-cut fodder legumes grown in northern India. Many a times, poor activity of pollinators cited for lower seed production in berseem. Therefore, an appropriate local food-based bee attractants need to be identified and their effectiveness in enhancing berseem seed yield needs to be assessed. Methods: The experiment was conducted to evaluate the significance of bee visit on yield parameters of berseem. In addition, the effect of attractant (jaggery and sugar at 10%) in enticing honey bees towards the berseem flower was evaluated at ICAR- IGFRI, Jhansi during 2017 and 2018. Result: Both the attractants (jaggery and sugar at 10%) are equally effective in drawing the Apis dorsata towards berseem and higher bee visits (8.75 and 8.54/m2/5 min) were recorded one hour after application. Maximum seed setting percentage was recorded in plots sprayed with jaggery (83.53) followed by sugar solution (82.58), which is significantly superior over farmers practice i.e. crop left for open pollination (74.86). Maximum seed yield was obtained from plots sprayed with jaggery solution (8.15 q/ ha). The bee visit had significant positive effect on seed yield (0.685*) and 1000 seed weight (0.671*).

2021 ◽  
Akash Anand ◽  
Divya Khanna ◽  
Payal Singh ◽  
Anuj Singh ◽  
Abhishek Pandey ◽  

Abstract BackgroundMedical Certification of Cause of Death (MCCD) can provide valuable health status data regarding disease incidence, prevalence and mortality in a community. It can guide local health policy and help in setting priorities. On the contrary, incomplete and inaccurate MCCD data can significantly impair the precision of a national health information database. In the current study, the accuracy of death certificates at two tertiary cancer care hospitals in Northern India, has been evaluated.MethodsThis retrospective study has been conducted at Tata Memorial Centres namely, Mahamana Pandit Madan Mohan Malaviya Cancer Centre and Homi Bhabha Cancer Hospital, Varanasi, India on MCCD over a period of two and a half years. Medical records and death certificates of all the deceased were examined. The demographic characteristics, administrative details, co-morbidities and cause of death from death certificates were collected using an approved standardized form. The accuracy of this information was validated using the medical records. Errors in the death certificates were classified according to Haque’s grading scale.1Results778 deaths occurred during the study period between May 2018 to December 2020, and all certificates were accessed for analysis. Only 30 (4%) certificates were error-free. 591(75.9%) death certificates had an inappropriate immediate cause of death. 231(29.7%) death certificates had incorrectly labelled mode of death, such as cardiopulmonary arrest as the immediate cause of death. 585 (75.2%) death certificates had an incorrect underlying cause of death. Majority of the death certificates were prepared by the post MBBS junior residents and this was significantly associated with higher certification errors.ConclusionA high rate of errors was identified in the death certificates completed at our hospitals. Inaccurate death certificates related to cancers can potentially influence the cancer statistics of the defined region and thereby affect policymaking for cancer prevention and control. There is a pressing need for appropriate intervention/s to resolve this important issue. In an attempt to improve the quality of certification, it is envisaged to conduct training for all consultants and residents in proper death certification.

2021 ◽  
Vol 11 (8) ◽  
C. Prakasam ◽  
R. Saravanan ◽  
M. K. Sharma ◽  
Varinder S. Kanwar

AbstractAs the surface water in northern India is the main water resource for regional economic and also supply for drinking and irrigation purposes. However, deficiency of water quality leads to serious water pollution in the Pandoh river basin (PRB). Therefore, the main objective of the present study is to evaluate the quality of surface water. With this objective, surface water samples were collected from the PRB of northern India, and analyzed for pH, EC, turbidity, alkalinity, total dissolved solids, and total hardness. Moreover, geographical information system (GIS) tools were used to prepare the geology, drainage pattern, and location maps of the study region. Surface water quality observed from the PRB has an alkaline nature with a moderately hard type. Further studies are encouraged to better understand the water quality in northern India.

Priti meena ◽  
Vinant bhargava ◽  
Sumit Sehrawat ◽  
Devinder Singh Rana ◽  
Anil Kumar Bhalla ◽  

2021 ◽  
Vol 11 (1) ◽  
Brijesh K. Bansal ◽  
Kapil Mohan ◽  
Mithila Verma ◽  
Anup K. Sutar

AbstractDelhi region in northern India experiences frequent shaking due to both far-field and near-field earthquakes from the Himalayan and local sources, respectively. The recent M3.5 and M3.4 earthquakes of 12th April 2020 and 10th May 2020 respectively in northeast Delhi and M4.4 earthquake of 29th May 2020 near Rohtak (~ 50 km west of Delhi), followed by more than a dozen aftershocks, created panic in this densely populated habitat. The past seismic history and the current activity emphasize the need to revisit the subsurface structural setting and its association with the seismicity of the region. Fault plane solutions are determined using data collected from a dense network in Delhi region. The strain energy released in the last two decades is also estimated to understand the subsurface structural environment. Based on fault plane solutions, together with information obtained from strain energy estimates and the available geophysical and geological studies, it is inferred that the Delhi region is sitting on two contrasting structural environments: reverse faulting in the west and normal faulting in the east, separated by the NE-SW trending Delhi Hardwar Ridge/Mahendragarh-Dehradun Fault (DHR-MDF). The WNW-ESE trending Delhi Sargoda Ridge (DSR), which intersects DHR-MDF in the west, is inferred as a thrust fault. The transfer of stress from the interaction zone of DHR-MDF and DSR to nearby smaller faults could further contribute to the scattered shallow seismicity in Delhi region.

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Vikrant Kaushal ◽  
Deepak Jaiswal ◽  
Rishi Kant ◽  
Nurmahmud Ali

PurposeThe study aims to explore and test the integrated relationships between university reputation and its key antecedents. In doing so, theoretically derived antecedents of university reputation were examined. The study reports the complex interplay among image, quality, value, satisfaction and attachment and their subsequent effect on reputation.Design/methodology/approachA quantitative method was used to achieve research objectives. Data collected from students enrolled in major private university in Northern India were analysed to test the proposed model directly and indirectly using structural equation modelling (SEM).FindingsThe findings confirmed most of the hypothesised relationships. Prominently, image construct was found to be significantly affecting students' quality perceptions along with satisfaction, attachment, value and importantly reputation. The study found evidence for the impact of students' attachment on university reputation. Findings also indicated the presence of several indirect relationships among the considered dimensions.Research limitations/implicationsCurrent research offers implications for universities that are met with the perpetual challenge of survival in the competitive higher education (HE) marketplace. Findings from the study not only help build theory on university reputation but make essential contribution towards guiding managers in developing effective strategies by building reputation via concentrating on the most crucial determinants.Originality/valueAlthough research in HE marketing is growing, effects of student attachment towards building reputation has not garnered attention, which is theoretically a vital construct. The paper presents new framework to realise university reputation with the help of integrated relationships among select dimensions in the setting of an emerging HE market.

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