Browsing by Author "Vishal Khurana"

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A clinico-epidemiological study of cognitive function status of community-dwelling elderly
(Wolters Kluwer Medknow Publications, 2014) Indarjeet Singh Gambhir; Vishal Khurana; Dhiraj Kishore; Ashutosh K. Sinha; S.C. Mohapatra
Background: Cognitive decline and dementia are an important problem affecting quality-of-life in elderly and their caregivers. There is regional variation in prevalence of cognitive decline as well as risk factors from region to region. Aim: The aim was to determine the prevalence of dementia and cognitive decline and its various risk factors in the elderly population of more than 60 years in Eastern Uttar Pradesh (India). Materials and Methods: A camp-based study was conducted on rural population of Chiraigaon block of Varanasi district from February 2007 to May 2007. Block has 80 villages, of which 11 villages were randomly selected. Eleven camps were organized for elderly people in 11 randomly selected villages on predetermined dates. A total of 728 elderly persons of age >60 years were examined, interviewed and data thus collected was analyzed. Elderly who got Hindi-mini-mental state examination (HMSE) score developed by Ganguli based on the Indo-US Cross-National Dementia Epidemiology Study) score ≤23 were evaluated further and in those with confirmed cognitive and functional impairment, diagnosis of dementia was assigned according to Diagnostic and Statistical Manual for Mental Disorder fourth edition criteria after ruling out any psychiatric illness or delirium. Based on International Classification of Diseases-10 diagnostic criteria sub-categorization of dementia was done. Results: Mean, median and 10 th percentile of HMSE of the study population were 23.4, 24 and 17, respectively. About 14.6% elderly had scored <17. 42.9% of rural elderly population had HMSE score <23, 70.6% <27 and 27.7% between 23 and 27. Literate people had statistically significant higher mean HMSE score (26.1 ± 3.9) than illiterate people (22.9 ± 4.9). Other risk factors were female gender, malnutrition, and obesity. Prevalence of dementia was 2.74%; in male 2.70% and in female 2.80%. Most common type of dementia was Alzheimer (male 1.5%, female 1.5%) followed by vascular (male 1.2%, female 0.6%) and others 0.6% (male 0%, female 0.6%). Conclusions: Study showed that a very high percentage of rural elderly attending health camps had poor cognitive function score; though the prevalence of dementia was relatively low. Alzheimer dementia was most common, followed by vascular dementia, which was predominant in males. Illiteracy, age, and under-nutrition were the most important risk factors for poor cognitive function. Our study suggest that cut-off of HMSE score should be 17 (10 th percentile) for illiterate population.
Acute polyradiculoneuropathy following wasp sting
(2009) Dhiraj Kishore; Vishal Khurana; Indarjeet Singh Gambhir; Surender Misra
[No abstract available]
Cefpodoxime-induced hyperprolactinemic galactorrhea
(American College of Physicians, 2010) Vishal Khurana; Indrajeet Singh Gambhir
[No abstract available]
Dizziness and collapse? It's a steal!
(Elsevier B.V., 2009) Vishal Khurana; Inderjeet Singh Gambhir; Arvind Srivastava; Dhiraj Kishore
[No abstract available]
Erratum in study of impact of delirium on short-term mortality in elderly inpatients, by Matías González, Ph.D., et al.
(Elsevier Inc., 2009) Vishal Khurana
[No abstract available]
Evaluation of delirium in elderly: A hospital-based study
(2011) Vishal Khurana; Indrajeet Singh Gambhir; Dhiraj Kishore
Aim: The study aimed to study the prevalence, etiologies, clinical profile and outcome of delirium in hospitalized elderly in medicine wards. Methods: Four hundred elderly patients of more than 60years of age admitted with delirium in the emergency and medicine wards of Sir Sunderlal Hospital Varanasi, India, were evaluated and managed. The Hindi version of the Mini-Mental Status Examinations, a vernacular (Hindi) version of the Mini-Mental State Examination, was used for evaluation of cognitive function status of patients and Confusion Assessment Method (CAM), a screening instrument based on the third edition of the Diagnostic and Statistical Manual of Mental Disorders was used for diagnosis of delirium. Results: A total of 400 hospitalized elderly delirious patients were included in the study aged 61-105years. The mean age of the subjects was 70.87±9.26years and 70.81±8.4years amongst males and females, respectively. The mortality rate was 14.75%. Out of nine CAM features, all the cases had all three essential features, 78.75% had four features, 58.5% had five features, 44.5% had six features and 9.25% had all nine features. There was a high prevalence of hypoactive delirium (65%) as compared to hyperactive (25%) or mixed (10%). Most common etiologies were sepsis followed by metabolic abnormalities. 70% had 2 or more etiologies. Conclusion: Sepsis and metabolic abnormalities were the most common etiologies of delirium in this study. The maximum patients had more than one etiology and this emphasizes the multifactorial nature of delirium and need for thorough evaluation to unravel them. Most of the causes were treatable and have favorable outcome (83% recovered). © 2011 Japan Geriatrics Society.
Hepatocellular carcinoma presenting as polymyositis: A paraneoplastic syndrome
(2011) Dhiraj Kishore; Vishal Khurana; Amit Raj; Indarajeet Singh Gambhir; Amita Diwaker
Polymyositis as a paraneoplastic syndrome associated with hepatocellular carcinoma is quite rare; only a few cases have been reported. We report a case of a 50-year-old female who presented with subacute quadriparesis, neck muscle weakness, elevated creatinine phosphokinase, a myogenic pattern on the EMG and was diagnosed as having polymyositis, a paraneoplastic syndrome associated with hepatocellular carcinoma with negative hepatic viral markers and a positive ANA. Improvement in patient symptoms and areduction in creatinine phosphokinase, which occurred after lobectomy, supports this rare association.
High cervical intradural lipoma
(BMJ Publishing Group, 2010) Vishal Khurana; Dhiraj Kishore; Indarjeet Singh Gambhir
[No abstract available]
Microangiopathic hemolytic anemia following disseminated intravascular coagulation in aluminum phosphide poisoning
(2009) Vishal Khurana; I. Gambhir; Dhiraj Kishore
[No abstract available]