Browsing by Author "L.P. Meena"

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Assessment of left ventricular diastolic dysfunction in sub-clinical hypothyroidism
(Avicena Publishing, 2012) C.L. Meena; R.D. Meena; R. Nawal; V.K. Meena; A. Bharti; L.P. Meena
Background: Adverse cardiovascular effect of hypothyroidism has been identified in many studies. Early identification of patients with sub-clinical hypothyroidism may lead to early treatment and thereby favourable effect on cardiovascular morbidity and mortality. Objectives: To find out the association of sub clinical hypothyroidism and left ventricular dysfunction and also to find out relationship between systolic and diastolic dysfunction in these patients. Material and Methods: A total 30 cases of sub clinical hypothyroidism along with 15 age sex matched healthy control subjects were included in study. Serum TSH, T4, T3 hormone level was measured and those who were found to have sub-clinical hypothyroidism underwent for 2DEcho. Results: Significant reduction in peak early filling velocity (PE) (p<0.001) and early filling time velocity integral (Ei) (p<0.001). Ratio of early and late peak velocities (PE/PA) (p<0.001), ratio of time velocity integral of early and atrial filling (Ei/Ai) (p<0.001) and ratio of the early peak to average velocity (PE/M) (p<0.001) were also reduced. Mean EF was 54.9± 5.55 as compared to 55.7 ± 3.46 of control subjects with a T. value of 0.48, however there was significant diastolic dysfunction in case of hypothyroid patients (mean Ei/Ai = 1.35 ± 0.53) as compared to control group subjects (mean Ei/AI = 2.11 ± 0.26) with a T value of 5.22. Conclusion: Sub-clinical hypothyroidism showed significant diastolic dysfunction in the absence of significant impairment of systolic function. © AVICENA 2012.
Association of serum uric acid and microalbuminuria in prehypertension: A cross sectional study
(Mrs Deepika Charan, 2013) C.L. Meena; R. Harsa; V.K. Meena; Anju Bharti; Rajani Nawal; L.P. Meena; Nilesh Kumar; R.N. Meena
Background: The relationship between uric acid and microalbuminuriain healthyadultswithoutother cardiovascular risk factors may help to clarify the role of uric acid in cardiovascular disease. Objective: To study and compare the association of serum uric acid levels with microalbuminuria in normotensive and pre-hypertensive subjects without a history of cardiovascular disease or renal dysfunction. Materials and Methods: 350 subjects were included in study. All the routine investigations along with serum uric acid and urinary albumin were conducted. Microalbuminuria was detected by immunoprecipitation in a random urine sample. Serum uric acid level was estimated by Spectrophotometry. Results: The overall prevalence of prehypertension was 38.06% (Males, 39.10% and females, 35.56%). The total prevalence of microalbuminuria was 11.61% (9.9% of normotensivesand14.4%ofpre-hypertensives). Hyperuricemia was seen in 10.32% of the total study population. Among normotensives, 9% of males and 8.6% of females and in pre-hypertensive subjects, 14% of males & 9.4% of females had hyperuricemia. Among the pre- hypertensives,thosewith microalbuminuriahada significantly higher (p<0.001) serum uric acid level (7.024 ± 1.023 mg/dl) as compared to those without microalbuminuria (5.089 ± 0.965 mg/dl). Conclusion: This study demonstrates a strong independent association between uric acid level and microalbuminuria in pre-hypertensive subjects without a history of cardiovascular disease, diabetes decreased renal function.
Clinical profile and response to first-line ARV in HIV patients from eastern UP and Bihar: A retrospective study
(2013) Rohit Goel; M. Rai; J. Chakravarty; L.P. Meena; Narendra K. Tiwary; Shyam Sundar; Anju Bharti
Background and objectives: Spectrum of infections in Human Immunodeficiency Virus (HIV) infected patient from Eastern UP and Bihar has not been systemically evaluated. This study was conducted with the following objectives; a) explore the spectrum of clinical conditions associated with HIV disease, b)the difference between clinical and investigatory parameters in those patients who presented with infection from those who present without infection and c) to evaluate the effect of anti-retroviral (ARV) therapy. Methods: 1248 subjects who fulfilled the inclusion criteria were enrolled for the study from May 2007 to November 2008. Patients were evaluated for their baseline characteristics along with CD4 count and followed up for at least for 6 months after initiation of ARV (6-24 months). Result and interpretation: In this retrospective study, tuberculosis (58.96%) was the commonest infection followed by chronic diarrhoea (26.56%) and various skin infections. Males had significantly higher incidence (p value<.001) of infection as compared to females. There was a significant difference between the patients who presented with infection from those who presented without infection for their baseline weight (42.3 vs 45.42), haemoglobin (9.06 vs 9.91), mean CD4 count at baseline (107.38 vs 128.38/μL) and CD4 count after 6 month of therapy (298.09 vs 322.98 /μL). Mortality was also significantly high (p value<0.05) in those who presented with infection (19.95% vs 15.1%), although there was no difference between these two groups on their improvement in CD4 count from baseline after 6 months of therapy. Conclusion: Among the spectrum of infection in HIV patient from North East part of India, tuberculosis was commonest, followed by skin infections and chronic diarrhoea. Patients who presented with infection at the time of initial presentation had a low haemoglobin, body weight and CD4 count and had high initial mortality but if they survived they show similar response to ARV therapy as patients who presented without infection. © JAPI.
Diabetic striatopathy in an adult with ketotic hyperglycaemia
(2023) Eram Nahid; Saumya Gupta; Kshitij Prasad; Anish Kumar Saha; Mukti Prakash Meher; L.P. Meena
Diabetic striatopathy (DS) is a rare and life-threatening mani- festation of diabetes. The disease commonly affects individuals of Asian descent, women and the elderly. DS is characterized by dyskinesias with basal ganglia hyperintensities on imaging. Despite being rare, prompt recognition of a hyperglycaemia- induced hemichorea-hemiballismus is essential because the symptoms are reversible with correction of hyperglycaemia. Diagnosis is based on blood analysis and neuroimaging findings. Laboratory tests reveal raised glycosylated haemoglobin (HbA1c) levels, which indicate poorly controlled diabetes. Neuroimaging provides suggestive findings of DS. It is usually associated with non-ketotic hyperglycaemia. We report a 50-year-old woman who presented with ketotic hyperglycaemia and left-sided hemichorea and partial seizures with secondary generalization.
Endocrine changes in male HIV patients
(2011) L.P. Meena; M. Rai; S.K. Singh; J. Chakravarty; A. Singh; R. Goel; A. Pathak; Shyam Sundar
Aims and objectives: To determine the frequency of adrenal, thyroid and gonadal dysfunction in HIV positive male patients and to evaluate the endocrine function at different level of CD4 cell counts. Material and Methods: A total of 150 male HIV positive subjects were included in study. The patients were divided in three groups on the basis of CD4 cell counts. "Group A": HIV positive with CD4 count < 200/mm, "Group B": HIV positive with CD4 count 200-350/mm3 and "Group C": HIV positive with CD4 count > 350/ mm3. Results: In "group A" (n=50) 2 patients had basal cortisol < 5μg/dl while 23 patients had basal cortisol > 25 \xg/ dl. 15 patients had subclinical hypothyroidism while 11 patients had overt hypothyroidism.25 patients in this group had gonadal dysfunction: majority of them(24) had primary gonadal dysfunction (elevated LH). None of the patients in "group B" (n=50) had hypocortisolism while 11 patients had elevated cortisol; 18 had subclinical hypothyroidism while 4 had overt hypothyroidism while 17patinets were hypogonad, all having elevated LH. In"group C" (n=50) 2 patients had hypocortisolism and 5 had elevated cortisol; 12 patients had subclinical and one had overt hypothyroidism; 7 patients had primary hypogonadism and one had secondary hypogonadism. Overall 4(2.66%) had hypocortisolism while 39 (26%) had elevated cortisol; 45 (30%) had subclinical hypothyroidism while 16(10.66%) had overt hypothyroidism. Gonadal dysfunction was observed in 50 patients (33%) majority of them(48) had primary hypogonadism. On analysis of Pearson's correlation coefficient CD4 count has strong inverse correlation with basal cortisol (r=-0.301, p <0.0001), TSH (r=-0.257,p=0.002)and LH (r=-0.228, p=0.006), while there was a direct correlation with serum testosterone (r=0.175, p=0.037), Conclusion: This pilot study has demonstrated a high incidence of endocrine dysfunction in HIV infected patient in this part of country. High incidence of thyroid and gonadal dysfunction may contribute to morbidity of the patients and have a bearing on quality of life of the HIV infected patients. Hypocortisolism was not that common but high level of cortisol may be a marker of stress due to HIV per se or due to associated infection. Many of these dysfunctions might be transient and a large longitudinal study should be undertaken to substantiate the finding of the present study. © JAPI.
Knowledge and health seeking behavior related to Kala-Azar in rural communities of East Champaran District, Bihar
(Innovare Academics Sciences Pvt. Ltd, 2017) Navin Kumar; T.B. Singh; L.P. Meena
Objective: To find out the sociodemographic characteristics, knowledge and health seeking behavior related to KA in the East Champaran district, Bihar among study subject. Methods: A case-control study was conducted to understand the knowledge and health seeking behavior related to KA in the East Champaran district. A total of 100 KA cases and 100 healthy controls selected from the neighborhoods of cases. Results: The knowledge of the population showed that the male constituted 58% of the total population in which 56% were case and 60% were control. Majority of the respondent 76.5% were aware from the KA. Maximum of the respondent 72.5% believed that biting time of sand flies were in the night. Moreover, 71% respondent cannot know how to protect the KA transmission. Conclusion: These results will be useful for further improvement in the KA control programs for intervention strategies. The knowledge of the study subject about KA, the vectors, the transmission of KA, and control measures was poor which needs some effort of the public health system by the Ministry working in the field of health. © 2017 The Authors.
Neurological manifestation of HIV infection in North-Eastern part of India
(Mrs Deepika Charan, 2014) S.K. Sharma; N.C. Dwivedi; Nilesh Kumar; Anju Bharti; L.P. Meena
Background: The nervous system is among the most frequent and serious target of HIV infection, occurring in patients with profound immunosuppression even some time neurological disease is the first manifestation of symptomatic HIV infection in 10-20% of patients. Aims & Objective: (1) To study the clinical, investigation profile and various neurological disorders in HIV positive patients; (2) To correlate neurological manifestations in HIV patients with CD4 Counts. Materials and Methods: 40 HIV positive patients with neurological manifestations were enrolled. Apart from routine investigations, CD4 cell count, MRI brain, CSF, electromyography and nerve conduction study were done whereas required. Results: Meningitis was the commonest diagnosis (52.5%) followed Peripheral neuropathy (20%). Cerebrovascular accident was present in 3 cases. Intracranial space occupying lesion was found in 3 cases. Headache was the commonest neurological symptom seen in 25(62.5%) patients. Altered sensorium was found in 55%. Cranial nerve involvement was seen in 7 (17.5%) patients. Convulsion was reported in 10 (25%) of the patients. Choreoathetoid movement was present in one patient. CD4 Count was done in 37 patients. In 13 patients it was between 200-500/μl & <200/μl in 24 Patients. CD4 count was <200/ μl in most of the patients having TBM (73%), < 200/μl in 75% of cryptococcal meningitis. Conclusion: Most of the neurological sign symptoms are due to secondary causes which vary according to the geographical areas. So the knowledge of epidemiology of neurological presentation may help in early diagnosis and treatment of patients.
Stroke incidence, mortality, subtypes in rural and urban populations in five geographic areas of India (2018–2019): results from the National Stroke Registry Programme
(Elsevier Ltd, 2024) Sukanya Rangamani; Deepadarshan Huliyappa; Vaitheeswaran Kulothungan; Sankaralingam Saravanan; P.K. Murugan; Radha Mahadevan; Chelladurai Rachel Packiaseeli; Esakki Bobby; Kandasamy Sunitha; Ashok Kumar Mallick; Soumya Darshan Nayak; Santosh Kumar Swain; Manoranjan Behera; Bhaskar Kanti Nath; Abhijit Swami; Amit Kumar Kalwar; Bijush Difoesa; Vijay Sardana; Dilip Maheshwari; Bharat Bhushan; Deepika Mittal; Rameshwar Nath Chaurasia; L.P. Meena; K.S. Vinay Urs; Rahul Rajendra Koli; Natesan Suresh Kumar; Prashant Mathur
Background: Increasing stroke burden in India demands a long-term stroke surveillance framework. Earlier studies in India were urban-based, short term and provided limited data on stroke incidence and its outcomes. This gap is addressed by the establishment of five population-based stroke registries (PBSRs) of the National Stroke Registry Programme, India. This paper describes stroke incidence, mortality and age, sex, and subtypes distribution in the five PBSRs with urban and rural populations. Methods: First-ever incident stroke patients in age group ≥18 years, resident for at least one year in the defined geographic area, identified from health facilities were registered. Death records with stroke as the cause of death from the Civil Registration System (CRS) were included. Transient ischemic attack (TIA) was excluded. Three PBSRs (Cuttack, Tirunelveli, Cachar) included urban and rural populations. PBSRs in Kota and Varanasi were urban areas. The crude and age-standardized incidence rate (ASR) by age, sex, and residence (urban and rural), rate ratios of ASR, case fatality proportions and rates at day 28 after onset of stroke were calculated for years 2018–2019. Findings: A total of 13,820 registered first-ever stroke cases that included 985 death certificate-only cases (DCOs) were analysed. The pooled crude incidence rate was 138.1 per 100,000 population with an age-standardized incidence rate (ASR) of 103.4 (both sexes), 125.7 (males) and 80.8 (females). The risk of stroke among rural residents was one in seven (Cuttack), one in nine (Tirunelveli), and one in 15 (Cachar). Ischemic stroke was the most common type in all PBSRs. Age-standardized case fatality rates (ASCFR) per 100,000 population for pooled PBSRs was 30.0 (males) and 18.8 (females), and the rate ratio (M/F) ranged from 1.2 (Cuttack) to 2.0 (Cachar). Interpretation: Population-based registries have provided a comprehensive stroke surveillance platform to measure stroke burden and outcomes by age, sex, residence and subtype across India. The rural–urban pattern of stroke incidence and mortality shall guide health policy and programme planning to strengthen stroke prevention and treatment measures in India. Funding: The National Stroke Registry Programme is funded through the intramural funding of the Indian Council of Medical Research, Department of Health Research, Ministry of Health and Family Welfare, India. © 2023 The Author(s)
Study of mutations in β-Thalassemia trait among blood donors in eastern Uttar Pradesh
(2013) L.P. Meena; K. Kumar; V.K. Singh; Anju Bharti; S.K.H. Rahman; K. Tripathi
Background: Knowledge on distribution of different mutations of thalassaemia, which are prevalent in a particular area, is a prerequisite for prenatal diagnosis. Objectives: Studying mutations in β - thalassaemia trait among blood donors in eastern Uttar Pradesh, India. Material and Methods: One thousand non - remunerated voluntary blood donors who were between 18 - 40 years of age, were included in the study. Both replacement and voluntary healthy blood donors were included. 4ml of venous blood was collected and it was stored at 4oC. Complete Blood Count (CBC), Haemoglobinopathy Screening and Molecular Analysis by ARMS - PCR (Amplification Refractory Mutation System - PCR) were done. Screening for β thalassaemia was done in a blood bank by using D - 10, Bio Rad, which was based on High Performance Liquid Chromatography (HPLC). Results: Twenty Eight subjects with β - thalassaemia trait were found among 1000 voluntary blood donors. IVS 1-5 (G-C) mutation was most common type (50%), followed by FS 8/9 (+G) 25% which was the second most common type. In our study, a rare mutation of CD 16 (-C) was also found. Out of 14 subjects who had IVS 1-5 (G-C) mutation (most common), six were from Varanasi (6/261) and five of them were Sindhis. It was seen that FS 41/42 (TCTT) mutation was distributed among all groups of populations which had higher prevalences of β-thalassaemia trait. Conclusion: A comprehensive knowledge on beta thalassaemia mutations is necessary for determining a prenatal diagnosis. The occurrence of mutations may vary according to geographic region. Therefore, this study dealt with current problem of unknown mutations, in order to avoid complications.