Aatif Sanaie | Government Medical College Srinagar Kashmir India (original) (raw)

Papers by Aatif Sanaie

International Journal of Medical Science and Innovative Research (IJMSIR), 2022

Background: The relationship between vitamin D status and Parkinson's disease (PD) remains unclea... more Background: The relationship between vitamin D status and Parkinson's disease (PD) remains unclear, and whether or not supplementation is beneficial beyond bone health in PD has yet to be determined. The most consistent finding in the literature is a higher prevalence of vitamin D deficiency and insufficiency in PD compared to controls. The main objective of the study was to find out if any association, at all, exists between serum 25-OH-vitamin D levels & severity of Parkinson's disease.
Methods: It was a cross-sectional observational study consisting of 200 patients meeting inclusion criteria. Vitamin D levels were estimated & severity of Parkinson's disease was measured using Modified Hoehn & Yahr (HY) staging scale. Data was collected and analysed.
Results: In our study, the mean age (years) was 65.64 ± 10.30 with 34.5 % participants belonging to 61-70 years age group. Hypertension and Diabetes constituted two main comorbidities. Mean BMI in our study was 28.89 ± 4.28 kg/m 2. The mean duration Of Illness (years) was 4.51 ± 3.16. In our study, the mean (SD) of S. Vitamin D (ng/mL) was 22.26 (8.65). The S. Vitamin D (ng/mL) ranged from 6.6-45.91. Our study showed significant correlation between Vitamin D levels & severity of Parkinson's Disease (χ2 = 331.348, p = <0.001).
Conclusion: Majority of the Parkinson's Disease patients are Vitamin D deficient. There is significant correlation between Vitamin D levels & Severity of Parkinson's Disease. Further investigations are warranted to understand the mechanism of underlying association.

International Journal of Medical Science and Innovative Research (IJMSIR), 2021

Diabetes has become one of the largest global healthcare problems of the 21 century. According to... more Diabetes has become one of the largest global healthcare problems of the 21 century. According to the Centers for Disease Control and Prevention, the population prevalence of diabetes in the US is approaching 10% and is increasing by 5% each year. Diabetic neuropathy is the most common complication associated with diabetes mellitus. There has been an evolution in our understanding of the pathophysiology and the management of diabetic polyneuropathy over the past decade. The purpose of the current study is to evaluate the degree of correlation of clinical examination with electrophysiology in diabetics with peripheral neuropathy for better management of neuropathy in terms of its early and timely detection.
Results ;Most common age group in our study was 70-79 years 26 (27.1%) followed by 25 (26.0%) who belonged to age groups 50-59 and 60-69 years while as 20 (20.8%) belonged to age group < 50 years. The mean age in our study was 59.4 + 11.83.The minimum age was 37 years and maximum age was 79 years. We assessed the sensitivity and specificity of two major scores NSS and NDS . Sensitivity, specificity, NPV, PPV and accuracy of clinical examination of NSS was 83.33, 66.64, 70.58, 80.64, 66.66;and NDS was 93.93, 52.77, 86.36, 77.02, 69.29 respectively.
Conclusion; neurological examination is important for screening neuropathy in diabetics .using different scores like NDS and NSS neuropathy can be predicted with high reliability which can help in early detection and timely management.
Keywords: Centers for Disease Control and Prevention, Diabetes, Peripheral nerve,
pathophysiology, polyneuropathy.

International Journal of Medical Science and Innovative Research (IJMSIR), 2021

Introduction: Among all the neurologic disease stroke ranks first in frequency and importance. St... more Introduction: Among all the neurologic disease stroke ranks first in frequency and importance. Stroke is one of the leading causes of mortality and morbidity worldwide.
Materials and methods: An observational study of 173 stroke patients presenting within 24 hours of onset, was undertaken. Patients were divided into three groups, non-diabetic (Hba1c <5.7%), prediabetic (5.7-6.4%) and diabetic (≥6.5%). Neurological status was assessed by NIHSS (National institute of health stroke scale) score on admission and on day 7/discharge. Functional outcome was assessed by Modified Rankin Scale (MRS) on day 7/discharge.
Results-The average age of the patients was 61.3+ _ 10.74 years. The male female ratio was 1.7:1. 52.6% had ischemic stroke while as 82% had haemorrhagic stroke. Neurological improvement was noted in nondiabetic group as there was decrease in mean NIHSS score from admission to day 7. Neurological deterioration was noted in pre-diabetic and diabetic groups as there was increase in mean NIHSS score from admission to day 7. Poor functional outcomes as defined by higher MRS score on discharge, were noted in prediabetic and diabetic patients.
Conclusion: HbA1c level is an important tool to know the prognosis in acute stroke patients. Both diabetes and pre-diabetes are associated with poor neurological and functional outcome as compare to non-diabetes in acute stroke patients.
Keywords: ICH- Intracerebral Haemorraghe, MRSModified Rankinson scale, NIHSS-National Institute of Health Stroke Scale, Hba1c-Glycated Hemoglobin

International Journal of Medical Science and Innovative Research (IJMSIR), 2021

Background: Intracerebral hemorrhage (ICH) and Ischemic stroke (ISCHS) can occur along with many ... more Background: Intracerebral hemorrhage (ICH) and Ischemic stroke (ISCHS) can occur along with many metabolic abnormalities in acute stage. Electrolyte disturbances can occur in acute stage of stroke due to many causes.The aim of this study was to find out the initial electrolyte abnormalities in acute stroke, to compare serum sodium, potassium, calcium and magnesium levels between patients of ischemic and haemorrhagic stroke, to compare outcome with normal and abnormal initial electrolyte levels.
Methods: It was a prospective observational study consisted of 186 stroke patients meeting inclusion criteria. . Serum sodium, potassium, calcium and magnesium levels were estimated at the time of admission. Data was collected and analysed. Severity of stroke on admission and on day 7/discharge was assessed by NIHSS score. MRS was used to assess outcome on day 7/discharge whichever was earlier.
Results: The mean age in our study patients was 63.2+12.9 years. ISCHS was seen in 62.4% patients and ICH in 37.6% patients. Hyponatremia was seen in 11 (9.5%) ISCHS and 27 (38.6%) ICH patients. Hypernatremia was seen in 6 (5.2%) ISCHS. (P < 0.001). Hypokalaemia was seen in 16 (22.9%) ICH and 19 (16.4%) ISCHS patients. Hyperkalaemia was present in 1(1.4%) ICH and 2 (1.7%) patients with ISCHS. (p<0.024). Hypocalcaemia was seen in 5 (7.1%) ICH and 35 (30.2%) ISCHS patients. Hypercalcemia in 1 (1.4%) ICH group. Hypomagnesaemia was seen in 3 (4.3%) ICH and 40 (34.5%) ISCHS patients. Severity of stroke as assessed by NIHSS increased from admission to day7/discharge in patients with dyselectrolytemia. However in patients with normal electrolytes, neurological improvement was noted as there was decrease in NIHSS score from admission to day 7/discharge. It was statistically significant with p
value <0.001. Poor functional outcome was more among dyselectrolytemic patients compared to patients with normal electrolytes. The difference was statistically significant with p value <o.oo1.
Conclusion: Hyponatremia and hypokalemia were common in ICH and hypocalcaemia and hypomagnesaemia were more common in ISCHS in our study. Higher rates of morbidity and mortality were associated with dyselectrolytemia.
Keywords: Electrolyte abnormalities, stroke, NIHSS, MRS.

International Journal of Medical Science and Innovative Research (IJMSIR), 2019

Background: This study was done in SMHS hospital of Government Medical College Srinagar over a pe... more Background: This study was done in SMHS hospital of Government Medical College Srinagar over a period of 2 years.Different clinical presentation of GBS were noted and correlation between clinical features and outcome at discharge was analysed.Various poor prognostic factors were noted in these patients. Conclusion: Varied presentation of GBS was noted in the study and newer variants like Ataxic and CCPD were observed. Patients with bulbar dysfunction, axonal variant of GBS and Autonomic dysfunction had poor outcome. Indication for mechanical ventilation had adverse effect on outcome.
Methods: 50 patients admitted in medical wards were included in the study based on diagnostic criteria modified by ASBURY. Detailed history and examination was done and necessary lab investigations including CSF and electrophysiological study were done.
Results: Out of 50 patients,20 patients had classical AIDP presentation.10 patients had paraparetic variant of GBS.7 patients needed ventilator support in view of bulbar dysfunction.4 patients were Miller fischer variant.4 patients had polyneuritis cranalis and 2 pts had Ataxic variant.3 had Combined central and peripheral demylination syndrome (CCPD) The factors responsible for poor outcome at discharge were
a. Need for mechanical ventilation.
b. Axonal variant GBS on EPS
c. Markedly reduced CMAP
d. Bulbar involvement
e. Autonomic dysfunction
Conclusion: Varied presentation of GBS was noted in the study and newer variants like Ataxic and CCPD were observed. Patients with bulbar dysfunction, axonal variant of GBS and Autonomic dysfunction had poor outcome.Indication for mechanical ventilation had adverse effect
on outcome.
Keywords: GBS = Guillain Barre Syndrome, EPS= Electrophysiological Studies, AV = Ataxic Varient, CCPD = Combined Central & Peripheral Demyelination

International Journal of Contemporary Medical Research [IJCMR], May 1, 2019

Introduction: Worldwide, cancer has become a public health problem and one of the leading causes ... more Introduction: Worldwide, cancer has become a public health problem and one of the leading causes of death. Gastric cancer develops in stomach and may spread to other parts of the body, particularly the liver, lungs, bones, lining of the abdomen and lymph nodes. Kashmir is a high prevalence zone of stomach cancer. Incidence of gastric cancer in Kashmir has been reported to exceed 40% of all cancers and the incidence is 3 to 6 times higher than that at various metropolis cancer registries in India. Hence, the aim of the present study was to assess the serum lipid levels of the gastric cancer patients in Kashmir.
Material and Methods: This study was conducted in Department of Biochemistry Govt. Medical College, Srinagar on sixty patients diagnosed with gastric carcinoma and admitted in Shri. Maharaja Hari Singh Hospital. Venous blood samples were collected in green top tubes and were transported to the laboratory and the samples were centrifuged at 3000 rpm for 10 minutes and serum was separated for the estimation of Lipid profile. Each sample was processed on the same day of its collection and was analyzed for total cholesterol, triglycerides, HDL-Cholesterol and LDL-Cholesterol.
Results: The mean total cholesterol, triglyceride, HDLCholesterol and LDL-Cholesterol levels were found to be 157.14 mg/dl, 136.85 mg/dl, 38.96 mg/dl and 91.52 mg/dl respectively. The level of total cholesterol ranged from 90 to 212 mg/dl while the level of triglyceride ranges between 77 to 291 mg/dl and that of HDL-Cholesterol from 28 to 70mg/dl and LDL-Cholesterol from 35-140 mg/dl.
Conclusion: The serum triglycerides, total cholesterol and LDL-cholesterol levels fall in the normal reference range in gastric cancer patients while the mean HDL-cholesterol level is slightly lower than the normal reference range.
Key words: Gastric cancer, Lipid profile, Hypocholesterolemia

International Journal of Medical Science and Innovative Research (IJMSIR), 2022

Background: The relationship between vitamin D status and Parkinson's disease (PD) remains unclea... more Background: The relationship between vitamin D status and Parkinson's disease (PD) remains unclear, and whether or not supplementation is beneficial beyond bone health in PD has yet to be determined. The most consistent finding in the literature is a higher prevalence of vitamin D deficiency and insufficiency in PD compared to controls. The main objective of the study was to find out if any association, at all, exists between serum 25-OH-vitamin D levels & severity of Parkinson's disease.
Methods: It was a cross-sectional observational study consisting of 200 patients meeting inclusion criteria. Vitamin D levels were estimated & severity of Parkinson's disease was measured using Modified Hoehn & Yahr (HY) staging scale. Data was collected and analysed.
Results: In our study, the mean age (years) was 65.64 ± 10.30 with 34.5 % participants belonging to 61-70 years age group. Hypertension and Diabetes constituted two main comorbidities. Mean BMI in our study was 28.89 ± 4.28 kg/m 2. The mean duration Of Illness (years) was 4.51 ± 3.16. In our study, the mean (SD) of S. Vitamin D (ng/mL) was 22.26 (8.65). The S. Vitamin D (ng/mL) ranged from 6.6-45.91. Our study showed significant correlation between Vitamin D levels & severity of Parkinson's Disease (χ2 = 331.348, p = <0.001).
Conclusion: Majority of the Parkinson's Disease patients are Vitamin D deficient. There is significant correlation between Vitamin D levels & Severity of Parkinson's Disease. Further investigations are warranted to understand the mechanism of underlying association.

International Journal of Medical Science and Innovative Research (IJMSIR), 2021

Diabetes has become one of the largest global healthcare problems of the 21 century. According to... more Diabetes has become one of the largest global healthcare problems of the 21 century. According to the Centers for Disease Control and Prevention, the population prevalence of diabetes in the US is approaching 10% and is increasing by 5% each year. Diabetic neuropathy is the most common complication associated with diabetes mellitus. There has been an evolution in our understanding of the pathophysiology and the management of diabetic polyneuropathy over the past decade. The purpose of the current study is to evaluate the degree of correlation of clinical examination with electrophysiology in diabetics with peripheral neuropathy for better management of neuropathy in terms of its early and timely detection.
Results ;Most common age group in our study was 70-79 years 26 (27.1%) followed by 25 (26.0%) who belonged to age groups 50-59 and 60-69 years while as 20 (20.8%) belonged to age group < 50 years. The mean age in our study was 59.4 + 11.83.The minimum age was 37 years and maximum age was 79 years. We assessed the sensitivity and specificity of two major scores NSS and NDS . Sensitivity, specificity, NPV, PPV and accuracy of clinical examination of NSS was 83.33, 66.64, 70.58, 80.64, 66.66;and NDS was 93.93, 52.77, 86.36, 77.02, 69.29 respectively.
Conclusion; neurological examination is important for screening neuropathy in diabetics .using different scores like NDS and NSS neuropathy can be predicted with high reliability which can help in early detection and timely management.
Keywords: Centers for Disease Control and Prevention, Diabetes, Peripheral nerve,
pathophysiology, polyneuropathy.

International Journal of Medical Science and Innovative Research (IJMSIR), 2021

Introduction: Among all the neurologic disease stroke ranks first in frequency and importance. St... more Introduction: Among all the neurologic disease stroke ranks first in frequency and importance. Stroke is one of the leading causes of mortality and morbidity worldwide.
Materials and methods: An observational study of 173 stroke patients presenting within 24 hours of onset, was undertaken. Patients were divided into three groups, non-diabetic (Hba1c <5.7%), prediabetic (5.7-6.4%) and diabetic (≥6.5%). Neurological status was assessed by NIHSS (National institute of health stroke scale) score on admission and on day 7/discharge. Functional outcome was assessed by Modified Rankin Scale (MRS) on day 7/discharge.
Results-The average age of the patients was 61.3+ _ 10.74 years. The male female ratio was 1.7:1. 52.6% had ischemic stroke while as 82% had haemorrhagic stroke. Neurological improvement was noted in nondiabetic group as there was decrease in mean NIHSS score from admission to day 7. Neurological deterioration was noted in pre-diabetic and diabetic groups as there was increase in mean NIHSS score from admission to day 7. Poor functional outcomes as defined by higher MRS score on discharge, were noted in prediabetic and diabetic patients.
Conclusion: HbA1c level is an important tool to know the prognosis in acute stroke patients. Both diabetes and pre-diabetes are associated with poor neurological and functional outcome as compare to non-diabetes in acute stroke patients.
Keywords: ICH- Intracerebral Haemorraghe, MRSModified Rankinson scale, NIHSS-National Institute of Health Stroke Scale, Hba1c-Glycated Hemoglobin

International Journal of Medical Science and Innovative Research (IJMSIR), 2021

Background: Intracerebral hemorrhage (ICH) and Ischemic stroke (ISCHS) can occur along with many ... more Background: Intracerebral hemorrhage (ICH) and Ischemic stroke (ISCHS) can occur along with many metabolic abnormalities in acute stage. Electrolyte disturbances can occur in acute stage of stroke due to many causes.The aim of this study was to find out the initial electrolyte abnormalities in acute stroke, to compare serum sodium, potassium, calcium and magnesium levels between patients of ischemic and haemorrhagic stroke, to compare outcome with normal and abnormal initial electrolyte levels.
Methods: It was a prospective observational study consisted of 186 stroke patients meeting inclusion criteria. . Serum sodium, potassium, calcium and magnesium levels were estimated at the time of admission. Data was collected and analysed. Severity of stroke on admission and on day 7/discharge was assessed by NIHSS score. MRS was used to assess outcome on day 7/discharge whichever was earlier.
Results: The mean age in our study patients was 63.2+12.9 years. ISCHS was seen in 62.4% patients and ICH in 37.6% patients. Hyponatremia was seen in 11 (9.5%) ISCHS and 27 (38.6%) ICH patients. Hypernatremia was seen in 6 (5.2%) ISCHS. (P < 0.001). Hypokalaemia was seen in 16 (22.9%) ICH and 19 (16.4%) ISCHS patients. Hyperkalaemia was present in 1(1.4%) ICH and 2 (1.7%) patients with ISCHS. (p<0.024). Hypocalcaemia was seen in 5 (7.1%) ICH and 35 (30.2%) ISCHS patients. Hypercalcemia in 1 (1.4%) ICH group. Hypomagnesaemia was seen in 3 (4.3%) ICH and 40 (34.5%) ISCHS patients. Severity of stroke as assessed by NIHSS increased from admission to day7/discharge in patients with dyselectrolytemia. However in patients with normal electrolytes, neurological improvement was noted as there was decrease in NIHSS score from admission to day 7/discharge. It was statistically significant with p
value <0.001. Poor functional outcome was more among dyselectrolytemic patients compared to patients with normal electrolytes. The difference was statistically significant with p value <o.oo1.
Conclusion: Hyponatremia and hypokalemia were common in ICH and hypocalcaemia and hypomagnesaemia were more common in ISCHS in our study. Higher rates of morbidity and mortality were associated with dyselectrolytemia.
Keywords: Electrolyte abnormalities, stroke, NIHSS, MRS.

International Journal of Medical Science and Innovative Research (IJMSIR), 2019

Background: This study was done in SMHS hospital of Government Medical College Srinagar over a pe... more Background: This study was done in SMHS hospital of Government Medical College Srinagar over a period of 2 years.Different clinical presentation of GBS were noted and correlation between clinical features and outcome at discharge was analysed.Various poor prognostic factors were noted in these patients. Conclusion: Varied presentation of GBS was noted in the study and newer variants like Ataxic and CCPD were observed. Patients with bulbar dysfunction, axonal variant of GBS and Autonomic dysfunction had poor outcome. Indication for mechanical ventilation had adverse effect on outcome.
Methods: 50 patients admitted in medical wards were included in the study based on diagnostic criteria modified by ASBURY. Detailed history and examination was done and necessary lab investigations including CSF and electrophysiological study were done.
Results: Out of 50 patients,20 patients had classical AIDP presentation.10 patients had paraparetic variant of GBS.7 patients needed ventilator support in view of bulbar dysfunction.4 patients were Miller fischer variant.4 patients had polyneuritis cranalis and 2 pts had Ataxic variant.3 had Combined central and peripheral demylination syndrome (CCPD) The factors responsible for poor outcome at discharge were
a. Need for mechanical ventilation.
b. Axonal variant GBS on EPS
c. Markedly reduced CMAP
d. Bulbar involvement
e. Autonomic dysfunction
Conclusion: Varied presentation of GBS was noted in the study and newer variants like Ataxic and CCPD were observed. Patients with bulbar dysfunction, axonal variant of GBS and Autonomic dysfunction had poor outcome.Indication for mechanical ventilation had adverse effect
on outcome.
Keywords: GBS = Guillain Barre Syndrome, EPS= Electrophysiological Studies, AV = Ataxic Varient, CCPD = Combined Central & Peripheral Demyelination

International Journal of Contemporary Medical Research [IJCMR], May 1, 2019

Introduction: Worldwide, cancer has become a public health problem and one of the leading causes ... more Introduction: Worldwide, cancer has become a public health problem and one of the leading causes of death. Gastric cancer develops in stomach and may spread to other parts of the body, particularly the liver, lungs, bones, lining of the abdomen and lymph nodes. Kashmir is a high prevalence zone of stomach cancer. Incidence of gastric cancer in Kashmir has been reported to exceed 40% of all cancers and the incidence is 3 to 6 times higher than that at various metropolis cancer registries in India. Hence, the aim of the present study was to assess the serum lipid levels of the gastric cancer patients in Kashmir.
Material and Methods: This study was conducted in Department of Biochemistry Govt. Medical College, Srinagar on sixty patients diagnosed with gastric carcinoma and admitted in Shri. Maharaja Hari Singh Hospital. Venous blood samples were collected in green top tubes and were transported to the laboratory and the samples were centrifuged at 3000 rpm for 10 minutes and serum was separated for the estimation of Lipid profile. Each sample was processed on the same day of its collection and was analyzed for total cholesterol, triglycerides, HDL-Cholesterol and LDL-Cholesterol.
Results: The mean total cholesterol, triglyceride, HDLCholesterol and LDL-Cholesterol levels were found to be 157.14 mg/dl, 136.85 mg/dl, 38.96 mg/dl and 91.52 mg/dl respectively. The level of total cholesterol ranged from 90 to 212 mg/dl while the level of triglyceride ranges between 77 to 291 mg/dl and that of HDL-Cholesterol from 28 to 70mg/dl and LDL-Cholesterol from 35-140 mg/dl.
Conclusion: The serum triglycerides, total cholesterol and LDL-cholesterol levels fall in the normal reference range in gastric cancer patients while the mean HDL-cholesterol level is slightly lower than the normal reference range.
Key words: Gastric cancer, Lipid profile, Hypocholesterolemia