Dr.M.L.Patel Patel - Academia.edu (original) (raw)

Papers by Dr.M.L.Patel Patel

Journal of Human Ecology, 2006

The study was carried out to determine the health and morbidity status of Bharia tribe. A total o... more The study was carried out to determine the health and morbidity status of Bharia tribe. A total of ten villages were surveyed, and total of 172 households and nine hundred ten individuals were covered. The major occupation of the head in the households surveyed is agriculture and agriculture labor. 66.4 percent of the population was illiterate. Acute respiratory infection and fever were the commonest morbidity found more in preschool and school going children than adult population. According to weight for age, 52.5 percent of the Preschool children were underweight (<-2SD). Stunting was 48.1 and wasting was 33.9 percent. Prevalence of chronic energy deficiency (BMI<18.5) was about 35.6 percent in adult population. Bharia Children are suffering with more morbidity like fever, respiratory infection and malnutrition than adult population.

Indian Journal of Nephrology, 2016

Aminoglycoside nephrotoxicity may manifest as nonoliguric renal failure or tubular dysfunction, s... more Aminoglycoside nephrotoxicity may manifest as nonoliguric renal failure or tubular dysfunction, such as Fanconi-like syndrome, Bartter-like syndrome (BS), or distal renal tubular acidosis. We report a case who developed severe renal tubular dysfunction on the the 7th day of gentamicin therapy, resulting in metabolic alkalosis, refractory hypokalemia, hypocalcemia, hypomagnesemia, and polyuria. The patient was diagnosed as a case of transient BS associated with gentamicin exposure. The patient recovered with conservative management.

Indian journal of nephrology

Chronic kidney disease (CKD) is associated with early mortality, decreased quality of life and in... more Chronic kidney disease (CKD) is associated with early mortality, decreased quality of life and increased health care expenditures. The aim of this study was to determine whether or not urinary NGAL (uNGAL) level is associated with renal damage and kidney disease progression in patients with CKD and to evaluate the predictive value of uNGAL in progression of CKD. Totally, 91 cases of CKD stage II, III, IV, and 50 age-matched healthy controls were enrolled. The follow-up end-point was 18 months; end-point of the study was progression to an estimated glomerular filtration rate (eGFR) of <15 ml/min and/or CKD stage V. Forty-five cases (49.4%) were progressors and 46 were nonprogressors. uNGAL levels were significantly higher in CKD subjects as compared to healthy controls (log 1.09 ± 0.22 μg/ml in controls versus log 1.22 ± 2.08 μg/ml in stage II, log 3.34 ± 2.74 μg/ml in stage III and log 3.70 ± 0.18 μg/ml in stage IV). Univariate Cox proportional hazards model showed that only eGFR...

The Indian journal of tuberculosis, 2013

Tuberculosis is still frequently observed in third world countries like Africa and Asia. Here we ... more Tuberculosis is still frequently observed in third world countries like Africa and Asia. Here we report three cases of genital tuberculosis with variable presentations. First case was a lady of reproductive age group who presented with polymenorrhea and post-coital bleeding with unhealthy cervix. Histopathology of cervical tissue revealed tubercular cervicitis. Second and third cases presented with different complaints like discharge per vaginum, post-coital bleeding and pain in lower abdomen with growth over the cervix. Cervical biopsy was inconclusive of tuberculosis but endometrial tissue sampling for TB PCR was positive. This shows that newer diagnostic marker test can help us to detect secondary genital tuberculosis.

International Journal of Gynecology & Obstetrics, 2012

Objectives: To determine the rate of vaginal births, operative delivery of first twin and the rat... more Objectives: To determine the rate of vaginal births, operative delivery of first twin and the rate and indications of operative delivery of second twin after vaginal delivery of the first twin. Materials: A total of 1871 multiple were identified from Hospital Maternity Electronic Database from 2000-2010. Of these, 1778 (892 twin 1 and 866 twin 2) were twin deliveries and 93 were triplet deliveries. Individual Delivery Records were analysed. Methods: Triplets were excluded from the analysis. The mode of delivery of the first and second twins as well as the indications for emergency caesarean sections for first and second twins in labour were analysed. Stillbirths were excluded fronm the study. Results: Total number of live twin 1 and twin 2 births were 873 and 866, respectively. 428 twins (48%) had an elective caesarean section (323 and 105 twins were delivered by elective, and semi-elective caesarean sections, respectively). Out of 52% who attempted a vaginal birth, 159 (18%) had an emergency caesarean section during labour. Of these, 87% caesarean sections were performed during first stage of labour for failure to progress or for suspected fetal compromise and 13% of emergency caesarean sections were performed for the delivery of the second twin, after the successful vaginal delivery of the first twin. Abnormal lie (32%) and suspected fetal compromise (42%) were the commonest indications. 6% of second twins had an emergency caesarean section for failed instrumental vaginal delivery. In cases where the second twin was delivered by an emergency caesarean section in the second stage of labour, 78% of first twin had spontaneous vaginal delivery and 19% had an operative vaginal birth whereas 3% had an assisted vaginal breech delivery of the first twin. Conclusions: Our 10-year experience has shown that successful vaginal birth could be achieved in 82% women with twin pregnancies who attempt a vaginal delivery. Abnormal lie, suspected fetal compromise and failed instrumental vaginal delivery are the commonest indication for caesarean section of the second twin after vaginal delivery of the first twin (13%). Hence, skills and drills training on internal podalic version and assisted vaginal breech delivery and improved CTG interpretation may help reduce the incidence of emergency caesarean sections of the second twin, after the successful vaginal delivery of the first twin

Background and aims: Body fluids such as saliva, tears and urine from patients with hepatitis B v... more Background and aims: Body fluids such as saliva, tears and urine from patients with hepatitis B virus (HBV) infection are well known to be infectious. However, the infectivity of internal body fluids like ascitic fluid from patients with HBV infection has not been established. So, we conducted this study to know the infectivity of ascitic fluid for hepatitis B in decompensated cirrhosis by detecting HBV DNA in it.Methods: Patients with HBV related cirrhosis with ascites were enrolled. The levels of HBV DNA in the ascitic fluid from these patients were quantified by real-time PCR, and compared with HBV DNA levels in serum. Clinical and laboratory parameters to predict HBV DNA positivity in ascitic fluid were also assessed.Results : Twenty one patients (mean age 45.43±13 years) with HBV related cirrhosis with ascites were enrolled. HBV DNA in ascitic fluid was detected in 4/21 (19 %) patients. The ascitic fluid HBV DNA levels ranged from 4.8 to 6.4 log copies/mL (mean ± SD = 5.27 ± 0....

Background- The aim of this study was to evaluate the lipid abnormalities associated with differe... more Background- The aim of this study was to evaluate the lipid abnormalities associated with different stages of albuminuria and also examine role of ApoB lipoprotein as a predictor of early diabetic nephropathy in type 2 diabetic patients. Methods and Results- A total 100 diabetic patients (58 men and 42 women) with mean age group 59.15±10.4 years were studied. Normoalbuminurea (n=36), microalbuminurea (n=42) and macroalbuminurea (n=22) were defined as 300 mg/day respectively. Lipid parameters included, total cholesterol, triglyceride (TG), high and low density lipoprotein cholesterol, apolipoproteins A1, and Apo B. Result showed that Apo B differed significantly (P<0.05) between normoalbuminurea and micro and macroalbuminurea. Triglyceride increases progressively with increasing albuminurea. In multivariate logistic regression analysis, with 24 hours urinary albumin levels was dependent on triglyceride, total cholesterol, HDL, LDL, VLDL, Apo-B, Apo-A1 , Apo-B/Apo-A1 and for trigly...

A 55 year old male patient, known case of hypothyroidism since last four years was admitted to ou... more A 55 year old male patient, known case of hypothyroidism since last four years was admitted to our nephrology unit in a state of drowsiness and confusion. He had paralytic ileus and impaired renal functions at the time of admission. On routine investigations hypokalemia was present, which likely contributed to the paralytic ileus and together with dehydration had lead to renal injury. Nonetheless, hypothyroidism would have been the principal precipitant of both these complications. Both paralytic ileus and acute kidney injury improved with thyroxine replacement. Hypothyroidism may induce de novo acute kidney injury or it may exacerbate ongoing chronic kidney disease. This rare complication is assumed to be due to the hypodynamic circulatory state as a consequence of thyroid hormone deficiency. Paralytic ileus is even a rarer fatal manifestation of hypothyroidism and is thought to be due to autonomic neuropathy affecting the intestines that can be reversed by the thyroxine replacement.

Aim: The objective of this study was to determine the prevalence and to evaluate factors associat... more Aim: The objective of this study was to determine the prevalence and to evaluate factors associated with excessive daytime sleepiness as a symptom of sleep apnea syndrome (SAS) in type 2 diabetic patients. Material and Methods: The Berlin Sleep Apnea (BSA) questionnaire was administered to 242 consecutive patients with type 2 diabetes and a body mass index (BMI) ≥30kg/m 2 . High or low risk was considered pathologic. Results: Twenty-two percent of diabetic obese patients had excessive daytime sleepiness. Compared with patients without daytime sleepiness, the median HbA1c was increased with 1.3% (p<0.001) in sleepy patients. Waist circumference (odds ratio:1.04, 95% CI (1.01-1.07), BMI (odds ratio: 1.1, 95%CI (1.04-1.18) and HbA1c (odds ratio 1.29, 95%CI (1.07-1.56) were significantly related to the presence of excessive daytime sleepiness. Conclusion: Excessive daytime sleepiness as a symptoms of suspected SAS is highly prevalent in patients with type 2 diabetes and should be sys...

Journal of family medicine and primary care

Pulmonary arterial hypertension (PAH) is a complication of chronic obstructive pulmonary disease ... more Pulmonary arterial hypertension (PAH) is a complication of chronic obstructive pulmonary disease (COPD) in advance stages, and its presence indicates poor prognosis. The present study was design to know the prevalence of PAH in patients with COPD and its correlation with stages of COPD, exercising capacity, and quality of life. It is a cross-sectional prevalence study over a period of 1 year from August 2015 to July 2016. The study included 109 COPD patients, diagnosed by spirometry, and severity was determined according Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification criteria. Screening two-dimensional echocardiography was done to determine pulmonary arterial hypertension and exercising capacity assessed by 6 min walk test (6MWT) while the quality of life was assessed by St George respiratory Questionnaire for COPD (SGRQ-C) Questionnaires. Out of 109 patients, PAH was present in 68 (62.4%) cases consisting of mild grade 41 (37.6%), moderate grade 11 (10...

Journal of clinical and diagnostic research : JCDR, 2017

Chronic Obstructive Pulmonary Disease (COPD) is known to cause various systemic problems includin... more Chronic Obstructive Pulmonary Disease (COPD) is known to cause various systemic problems including Metabolic Syndrome (MetS). MetS is a group of cardiovascular risk factors. By assessing MetS, one can assess the cardiovascular disease risk. There is increasing evidence of MetS in COPD patients. However, the frequency of MetS and its individual components are not still been clearly shown which is likely to vary in different population. To know the extent of association of metabolic syndrome and its components in patients with COPD. This study was designed as an analytical case control study. Ninety cases of COPD satisfying the inclusion criteria and 45 healthy volunteer subjects as controls were recruited over 18 months duration. Simple random sampling method was used to select all cases attending outdoor and indoor medicine department. All subjects (cases and controls) were matched for age, sex, occupation and socioeconomic status. Prior to participation in the study, written inform...

Advanced Biomedical Research, 2016

Symmetrical peripheral gangrene (SPG) is a rare clinical entity, infective, and noninfective both... more Symmetrical peripheral gangrene (SPG) is a rare clinical entity, infective, and noninfective both types of etiologies are responsible. The basic underlying pathology in SPG is being disseminated intravascular coagulation and carries a high mortality. Here, we describe a 52-year-old male with dengue fever, who developed bilateral symmetrical dry gangrene of both hand and feet. His dengue IgM antibody was positive. All the peripheral pulses of the affected limbs were palpable. Color Doppler study of upper and lower limb vessels showed normal flow. The patient was managed with intravenous fluids, low molecular weight heparin, and fresh frozen plasma. His general condition was improved within 72 h with no further progression of gangrene. Clinician should suspect the possibility of SPG while dealing a case of dengue fever presenting as peripheral gangrene.

BMJ case reports, Jan 27, 2012

Tuberculosis (TB) is still frequently observed in third-world countries like Africa and Asia. Her... more Tuberculosis (TB) is still frequently observed in third-world countries like Africa and Asia. Here we report three cases of genital TB with variable presentation. First case was a lady of reproductive age group who presented with polymenorrhagia and postcoital bleeding with unhealthy cervix. Histopathology of cervical tissue revealed tubercular cervicitis. Second and third cases presented with different complaints like discharge per vaginum, postcoital bleeding and pain in lower abdomen with growth over the cervix. Cervical biopsy was inconclusive of TB but endometrial tissue sampling for TB PCR was positive. This shows that newer diagnostic marker test can help us to detect secondary genital TB.

Case Reports, 2011

BACKGROUND Renal derangement in a patient is of high concern for physician as well as relatives o... more BACKGROUND Renal derangement in a patient is of high concern for physician as well as relatives of patient.This is mostly because of fear that it may progress to chronic renal failure. In these two cases, renal impairment was attributed to hypothyroidism which fully recovered after giving hormone replacement therapy. CASE PRESENTATION Case 1 A 40-year-old female patient presented with chief complain of facial puffi ness. There was no signifi cant medical history. On examination, her blood pressure was 150/100 mm Hg, pulse rate 56/min and there was facial puffi ness. Rest of the examination was within normal limit. Case 2 A 45-year-old male patient presented with complaints of indigestion, weight gain and lethargy for last 6 months. There was no signifi cant medical history. On examination, his blood pressure was 160/100 mm Hg, pulse rate 70/min, there were facial puffi ness and mild pedal oedema. Rest of the examination was within normal limit. INVESTIGATIONS Case 1 Routine investigation includes haemoglobin 10.5 g/l, white cell counts 6500/dl, S. Sodium 137 mEq/l serum potassium 3.7 mmol/l. Serum creatinine 1.86 mg/dl, estimated glomerular fi lteration rate (GFR) by Cockcroft-Gault equation 40 ml/min. Urea 21 mg/dl, Cholesterol 390 mg/dl, SGOT 95 IU/l, SGPT 42 IU/l, alkaline phosphatase 85 IU/l, albumin 4.5 g/dl, calcium 9.7 mg/dl and glucose 90 mg/dl. Twenty-four hours urinary protein was 400 mg. Ultrasonography revealed both kidneys were normal in size and echotexture. Renal biopsy was undertaken, 15-18 ▶ Enjoy fast sympathetic peer review and rapid publication of accepted articles ▶ Access all the published articles ▶ Re-use any of the published material for personal use and teaching without further permission ▶

International Journal of …, 2012

Background: One of the best characterized apoptosis triggering systems is the CD95/Fas/APO-1 path... more Background: One of the best characterized apoptosis triggering systems is the CD95/Fas/APO-1 pathway. Aim of the study was to evaluate the serum sFas levels in cervical neoplasia and localized cervical cancer patients and examines its role as a discriminator between precancerous and cancerous cervical lesion.

Clinical Reviews in Allergy & Immunology, 2000

Based on a high genetic homology in the Finnish population, it was possible to localize the APS-1... more Based on a high genetic homology in the Finnish population, it was possible to localize the APS-1 gene locus and to determine the gene defects that cause APS1 (6-8,11,12). The gene was named autoimmune regulator (AIRE) or autoimmune polyendocrinopathycandiadiasis-ectodermal-dystropy (APECED); it is approx 13 kb in length and has 14 exons (7,8). The major gene product was named autoimmune regulator 1 (AIRE-1) (8). The AIRE-1 open reading frame is 1635 bp in length and encodes for a predicted protein of 545 amino acids (13), a theoretical molecular weight of 57.7 kDa and a calculated isoelectric point of 7.32 (7,8). The AIRE-1 protein is characterized by two PHD-finger motifs (aa 299-340 and aa 434-475), a proline-rich region (aa 350-407), and three LXXLL motifs (aa 7-11, 63-67, and 516-520) (Fig. 1B) (7,8). The AIRE-1 PHD fingers are cystein-rich structures (aa 299-340 and aa 434-475) that share strong homology with the PHD finger motifs in nuclear proteins such as Mi-2 (14,15), TIF1 (16,17), and hKRIP-1 (18) (Fig. 1C). AIRE-1 and Mi-2 have two PHD motifs without additional zinc fingers. In contrast KRIP-1 and TIF1 contain only one PHD finger in addition to other 168 Obermayer-Straub et al.

Despite the existence of a safe and effective vaccine, Nigeria has remained a hyper-endemic area ... more Despite the existence of a safe and effective vaccine, Nigeria has remained a hyper-endemic area for hepatitis B virus infection, with estimated 12% of the total population being chronic carriers. Vertical transmission is an important route of transmission for hepatitis B virus infection. Neonates who contact hepatitis B virus infection will have an almost 90% risk of developing chronic hepatitis B surface antigen (HBsAg) carrier state and chronic liver disease. The objectives of this study was to determine the sero-prevalence of hepatitis B Virus among pregnant women, rate of vertical transmission and identifying potential risk factors associated with the infection. This study was an observational crosssectional study of 250 pregnant women who presented to the labour ward of the University of Port-Harcourt Teaching Hospital (UPTH). Blood samples from all consenting pregnant women and corresponding umbilical cord blood were collected at delivery. A structured proforma designed for this purpose was used to obtain socio-demographic information and the presence of risk factors. Data collated was analysed using Statistical Package for Social Sciences (SPSS) 17.0 for windows ® statistical software with P<0.05 at 95% confidence interval. The mean age of the pregnant women studied was 33.5±0.8 years, while the mean parity was 1.58 ± 0.5. HBsAg was detected in 15 women, giving a seroprevalence rate of 6% and a neonatal seroprevalence rate of 3.2%. All HBsAgpositive babies were born to HBsAg-positive mothers with a vertical transmission rate of 53.3%. Hepatitis B virus infection amongst parturients was more in patients with history of termination of pregnancy and multiple sexual partners (P<0.05). An intermediate prevalence of hepatitis B virus infection was identified which justifies the need for routine screening in pregnancy in order to identify and treat the infection, thus reducing the risk of vertical transmission of the virus. Contraceptive options aimed at prevention of pregnancy and sexually transmitted infection (STI) should be encouraged.