Browsing by Author "Gyan P. Singh"

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A Multicentric, Randomized, Controlled Phase III Study of Centhaquine (Lyfaquin®) as a Resuscitative Agent in Hypovolemic Shock Patients
(Adis, 2021) Anil Gulati; Rajat Choudhuri; Ajay Gupta; Saurabh Singh; S. K. Noushad Ali; Gursaran Kaur Sidhu; Parvez David Haque; Prashant Rahate; Aditya R. Bothra; Gyan P. Singh; Sanjiv Maheshwari; Deepak Jeswani; Sameer Haveri; Apurva Agarwal; Nilesh Radheshyam Agrawal
Introduction: Centhaquine (Lyfaquin®) showed significant safety and efficacy in preclinical and clinical phase I and II studies. Methods: A prospective, multicentric, randomized phase III study was conducted in patients with hypovolemic shock, systolic blood pressure (SBP) ≤ 90 mmHg, and blood lactate levels ≥ 2 mmol/L. Patients were randomized in a 2:1 ratio to the centhaquine group (n = 71) or the control (saline) group (n = 34). Every patient received standard of care (SOC) and was followed for 28 days. The study drug (normal saline or centhaquine 0.01 mg/kg) was administered in 100 mL of normal saline infusion over 1 h. The primary objectives were to determine changes (mean through 48 h) in SBP, diastolic blood pressure (DBP), blood lactate levels, and base deficit. The secondary objectives included the amount of fluids, blood products, and vasopressors administered in the first 48 h, duration of hospital stay, time in intensive care units, time on ventilator support, change in acute respiratory distress syndrome (ARDS), multiple organ dysfunction syndrome (MODS), and the proportion of patients with 28-day all-cause mortality. Results: The demographics of patients and baseline vitals in both groups were comparable. The cause of hypovolemic shock was trauma in 29.4 and 47.1% of control group and centhaquine group patients, respectively, and gastroenteritis in 44.1 and 29.4%, respectively. Shock index (SI) and quick sequential organ failure assessment at baseline were similar in the two groups. An equal amount of fluids and blood products were administered in both groups during the first 48 h of resuscitation. A lesser amount of vasopressors was needed in the first 48 h of resuscitation in the centhaquine group. An increase in SBP from baseline was consistently higher up to 48 h (12.9% increase in area under the curve from 0 to 48 h [AUC0–48]) in the centhaquine group than in the control group. A significant increase in pulse pressure (48.1% increase in AUC0–48) in the centhaquine group compared with the control group suggests improved stroke volume due to centhaquine. The SI was significantly lower in the centhaquine group from 1 h (p = 0.032) to 4 h (p = 0.049) of resuscitation. Resuscitation with centhaquine resulted in a significantly greater number of patients with improved blood lactate (control 46.9%; centhaquine 69.3%; p = 0.03) and the base deficit (control 43.7%; centhaquine 69.8%; p = 0.01) than in the control group. ARDS and MODS improved with centhaquine, and an 8.8% absolute reduction in 28-day all-cause mortality was observed in the centhaquine group. Conclusion: Centhaquine is an efficacious resuscitative agent for treating hypovolemic shock. The efficacy of centhaquine in distributive shock is being explored. Trial Registration: Clinical Trials Registry, India; ctri.icmr.org.in, CTRI/2019/01/017196; clinicaltrials.gov, NCT04045327. © 2021, The Author(s).
Management of impacted all canines with surgical exposure and alignment by orthodontic treatment
(Wolters Kluwer Medknow Publications, 2013) Radha Katiyar; Pradeep Tandon; Gyan P. Singh; Akhil Agrawal; T.P. Chaturvedi
Canine impaction is a dental problem very often encountered in orthodontic practice. After the third molar, the canine is the most frequently impacted tooth. Bringing the impacted canine into a normal position is important for functional occlusion and the final esthetics of the orthodontic treatment. This article illustrates a peculiar case, in which all four permanent canines maintained their unerupted status at age of 16 years. All four impacted canines were surgically exposed, attachment bonded, traction given with K-9 spring and ideally positioned with fixed orthodontic mechanotherapy. © 2013 Wolters Kluwer Medknow Publications. All rights reserved.
Methodological application of quantile mapping to generate precipitation data over Northwest Himalaya
(John Wiley and Sons Ltd, 2019) Usha Devi; Manorama S. Shekhar; Gyan P. Singh; Nalamasu N. Rao; Uma S. Bhatt
Continuous high quality data are critical for weather and climate investigations. Numerous data gaps exist particularly over mountainous regions which limits the ability to construct climatologies and perform trend analysis. This study addresses the issue of sparse precipitation data over Northwest Himalaya (NWH) and fills data voids by applying the quantile mapping (QM) method. QM is applied to observed winter precipitation for a period of 25 years (1991–1992 to 2015–2016) to construct a continuous reliable data set. The first 20 years (1991–1992 to 2010–2011) are used for training and the remaining 5 years (2011–2012 to 2015–2016) are used for validation. In total, 10 stations are available for this study and each one is considered serially as a reference to generate daily precipitation values at the other stations. The mean precipitation of NWH region is constructed by considering the mean of all the stations. Standard statistical measures like root mean square errors, standard deviation, skill score and its decompositions are applied to evaluate the generated datasets. Based on statistical analysis, the Kanzalwan station, located in Great Himalaya range, is one of the best performing reference stations for generating precipitation values over NWH. The statistical measures of this station show the highest skill scores, lowest root mean square error and lowest standard mean errors for all winter months except January. This study provides a successful application of QM to generate precipitation data for climate analysis over the complex terrain of the Himalaya region. © 2019 Royal Meteorological Society