Shankar Narayan - Academia.edu (original) (raw)

Papers by Shankar Narayan

Research paper thumbnail of Hypomelanosis of Ito

Medical journal, Armed Forces India, 2006

Research paper thumbnail of Hiv : Scenario in Andaman and Nicobar Islands

Medical journal, Armed Forces India, 1999

Research paper thumbnail of Profile of Live-born Infants of In-vitro Fertilisation

Medical journal, Armed Forces India, 2010

Research paper thumbnail of Breast Feeding and Antenatal Preparation: REPLY

Medical journal, Armed Forces India, 2006

Dear Editor, We thank the author(s) for their appreciation of our work reported in the article “M... more Dear Editor, We thank the author(s) for their appreciation of our work reported in the article “Maternal and neonatal factors adversely affecting breast feeding in the perinatal period “[1]. We fully agree with the author[s] contention that antenatal preparation of the prospective mother including counselling, examination and management of any anatomical problems with her breasts forms a very important part of effort at ensuring successful breastfeeding. Our colleagues in the Department of Obstetrics at the tertiary care hospital have been rendering commendable service in this field and as mentioned in the article, regular antenatal counseling for breastfeeding is an integral part of the obstetric services. Examination of the mother's breast is also being done in all prospective mothers antenatally though this was not specifically mentioned in our article. We thank the author[s] of the above letter for their comments and once again express our full agreement with their observati...

Research paper thumbnail of Steroids in perinatology

Indian pediatrics, 2002

1. Indian Pediatr. 2002 Apr;39(4):347-61. Steroids in perinatology. Narayan S, Deorari AK. Neonat... more 1. Indian Pediatr. 2002 Apr;39(4):347-61. Steroids in perinatology. Narayan S, Deorari AK. Neonatal Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110 029, India. Comment in Indian Pediatr. 2002 Nov;39(11):1075-7; author reply 1078-80. ...

Research paper thumbnail of Exploring attributes influencing patient satisfaction in a group of hospitals

Journal of Marine Medical Society, 2022

Introduction: The main purpose of hospitals is to provide quality care to their clientele. Many s... more Introduction: The main purpose of hospitals is to provide quality care to their clientele. Many studies have been conducted to assess patient satisfaction and suggest measures to improve patient satisfaction in government and private hospitals. This study was conducted in a different setting with the aim to assess patient satisfaction in a group of hospitals exclusively for their entitled clientele. Materials and Methods: The study was a questionnaire-based observational study conducted in nine hospitals belonging to one central administration. The questions pertained to five domains. The data were collected on a numerical scale and the weighted average was calculated for each question. Results: A total of 2850 patients were administered with questionnaire. About 95% of patients were satisfied with services provided by the hospitals. The strengths of the hospitals were the general cleanliness and the way the medical and paramedical staff treat their patients. The weaknesses were the waiting period at reception and to see the doctor as well as the quality of food provided to the inpatients. Conclusion: This study has brought out that a large percentage of patients were satisfied with the services provided by the hospitals. The analysis has facilitated the administrator to know the strengths of the hospitals as well as to identify the weaknesses. It is essential that the administration of the hospitals addresses the weaknesses to further improve the patient satisfaction. In conclusion, it is recommended that patient satisfaction surveys should be part of the Standard Operating Procedure of all health-care facilities and the same should be an ongoing process rather than a one-time measure.

Research paper thumbnail of Can umbilical cord blood counts substitute venous blood counts done in the first six hours of life in term neonates?

Journal of Marine Medical Society, 2014

Background: A large number of neonatal conditions can be anticipated before or identified at birt... more Background: A large number of neonatal conditions can be anticipated before or identified at birth. Many of these conditions need venous sampling of neonates to determine hematologicalparameters. There are no studies to show whether the easily available umbilical cord sample can be used to obtain these test parmeters in full-term neonates. Materials & Methods: This retrospective, one-year study included full-term neonates with conditions that can be predicted before birth (infection in the infant of a mother with prolonged rupture of membranes, Rh negative mothers′ infant, Intra-uterine growth retardation, transient tachypnoea ofnewborn following caesarean section) or at birth (birth asphyxia). Umbilical cord blood hemoglobin, total and differential leukocyte counts and platelet counts were compared with the same parameters obtainedfrom venous blood drawn from neonates within six hours of birth. Results: A total of 49 neonates were eligible and included. The mean (s.d.) values of pa...

Research paper thumbnail of Estimating neonatal nursing staff requirement by activity analysis

Background: Nursing staff requirements for Neonatal Intensive Care Unit (NICU) are often determin... more Background: Nursing staff requirements for Neonatal Intensive Care Unit (NICU) are often determined by number of admitted patients even though activity analysis provides a more objective estimation. This study estimates nursing staff requirements by activity analysis in an Armed Forces facility. Materials & Methodology: A prospective observational study between 2 7 January 2014 and 26 February 2014 (31 days) in the NICU of tertiary care teaching hospital of Armed Forces where timing of all nursing activities performed during study period by NICU staff was recorded to the nearest minute by self-reporting. Nursing activities were classified as Direct (40 activities) and Indirect (23 activities) α-priori. Data was entered on an electronic spreadsheet (Microsoft Excel) and relevant analysis performed. Results: During study period, there were 32 neonates (total 238 patient-days) in NICU and 18 (57patient-days) in step-down nursery. There was no patient on invasive ventilation nor was any...

Research paper thumbnail of Comparison of Neonatal Outcome After Induction of Labour with 25 and 50 meg of Misoprostol

Journal of Marine Medical Society, 2016

Background: There are only very few studies which compared 25 and 50 microgram of misoprostol in ... more Background: There are only very few studies which compared 25 and 50 microgram of misoprostol in relation to neonatal outcome and Indian data in this context are lacking. Methods: This study was carried out as a single centre, prospective, observational study which consisted of 100 term pregnant women divided in two groups. Neonatal outcome was compared in relation to frequency of abnormalfetal heart rate tracings, meconium passage, 1- or 5-minute Apgar scores < 7, neonatal resuscitations, or admissions to the neonatal intensive care unit Result: Meconium stained liquor was observed in 6% of cases in both groups. Apgar score at 1 min was <7 in 10% of cases in 25 meg group against 6% in 50 meg group. Requirement of neonatal resuscitation was observed in 10% of cases in each group. Fetal heart rate abnormality was observed in 22% of cases in 50 meg group against 12% in 25 meg group. Neonatal problems were detected in 14% and 12% of cases in 25 meg and 50 meg group respectively. Statistically these difference were not significant Conclusion: There is no significant difference in neonatal outcome with 25 and 50 microgram of misoprostol used for induction of delivery in term pregnancy.

Research paper thumbnail of Effectiveness of teaching of neonatal resuscitation programme at a workshop for a mixed population of medical personnel

Medical Journal Armed Forces India, 2004

We evaluated the effectiveness of teaching at a neonatal resuscitation programme (NRP) workshop h... more We evaluated the effectiveness of teaching at a neonatal resuscitation programme (NRP) workshop held for 35 medical personnel (including postgraduate trainee doctors, general duty medical officers, nursing officers and probationer nurses) using a onegroup pretest-posttest design. None of the participants had any formal exposure to the NRP guidelines. A pre-workshop test of 20 multiple-choice questions was administered to all the participants. At the end of the workshop, the same 20 questions were administered and the two scores compared using t-test for paired data on SPSS statistical software. The mean pre-workshop score was 9.03 (SD 2.66) which improved to a mean of 15.53 (SD 1.93) post-workshop. This improvement was highly significant with p < 0.0001 (two-tailed) and the 95% confidence interval being-7.41 to-5.59. Subgroup analysis revealed that nursing officers and probationer nurses showed highly significant improvement in the post-workshop scores while trainee doctors doing Medicine, Pediatrics and the general duty medical officers showed statistically significant improvement in the post-workshop scores. This study shows that a medical workshop is an effective means of imparting knowledge to a mixed group of medical personnel.

Research paper thumbnail of Association of asymptomatic structural cardiac defects in neonates with transient tachypnea at birth: A case-control study

Journal of the Pediatrics Association of India, 2020

Background: Transient tachypnea of the newborn (TTNB) has been documented as the most common caus... more Background: Transient tachypnea of the newborn (TTNB) has been documented as the most common cause of neonatal respiratory distress, accounting for more than 40 percent of cases. Materials and Methods: This study was a prospective study on 75 patients (neonates who were born with TTNB) who underwent two-dimensional (2D) echocardiography (Echo) after tachypnea subsided. The controls (neonates who did not manifest tachypnea) were matched for birth weight, period of gestation, mode of delivery, and sex. Appropriate Chi-square tests were done for categorical variables, while Student's t-test was done for continuous variables. Results: Incidence of asymptomatic structural cardiac lesions detected by 2D Echo was significantly higher in neonates in the study group (n = 38; 50.66%) as compared to the control group (n = 7; 9.33%). This difference was statistically significant P < 0.0000002 (odds ratio 9.4586; 95% confidence interval 3.84–23.27). The most common cardiac lesion in both groups was atrial septal defect. Conclusion: The incidence of asymptomatic structural cardiac defects was found to be approximately five times higher in neonates manifesting TTNB (50.66% vs. 9.33%). Based on the findings of this study, screening for structural cardiac lesions by 2D echo is recommended in all neonates who manifest with TTNB.

Research paper thumbnail of Planning a modular intensive care unit for patients of the COVID-19 pandemic

Journal of Marine Medical Society, 2020

Introduction: The COVID-19 pandemic has provided opportunity to the Armed Forces Medical Services... more Introduction: The COVID-19 pandemic has provided opportunity to the Armed Forces Medical Services (AFMS) healthcare institutions to plan and execute their surge capacity facilities and identify areas for improvements in planning in the future. Material and Methods: Available medical literature on the experiences of other countries in activating surge capacities in healthcare for the pandemic were examined in detail as were existing guidelines for establishing Intensive Care Units (ICU). Personal communications with peers to understand difficulties faced in activating surge capacities were also factored in. Results: Based on the findings from these sources, a plan to establish ten-bedded ICU units specifically for COVID-19 is evolved. The best practices and latest guidelines and experiences have been collated and modified suitably to suit the AFMS in this aspect. Conclusion: Planning ICUs in ten-bedded modular units will enable the AFMS to cater to surge capacities in the future for all situations where sudden increase in number of patients is anticipated.

Research paper thumbnail of A study to assess the Knowledge, Aptitude and Practices towards Voluntary Blood Donation in a Peripheral Hospital in North India

Donated blood is a lifeline in an emergency and for people who need long term treatment.Adequate ... more Donated blood is a lifeline in an emergency and for people who need long term treatment.Adequate and safe blood transfusion is still a challenge in a developing countries like ours.There is a precarious need to put efforts to recruit donors in groups less willing to donate and simultaneously reinforce the positive behaviour of willing groups converting previous donors into regular practice.

Research paper thumbnail of Relationship between oxygen saturation and clinical symptoms or signs in infants from 2 months to 12 months age with acute respiratory distress due to hyper reactive airway disease

Journal of Marine Medical Society, 2016

Background: Facilities to measure SP02 are not available at all centers especially in the resourc... more Background: Facilities to measure SP02 are not available at all centers especially in the resource poor developing countries. This study is therefore important to identify a minimum set ofclinical signs that can reliably predict presence of hypoxemia in children with hyperreactive airway disease that can be used by health care provider to institute oxygen therapy. Methods: study was carried out as a single centre, prospective, observational study fromyear 2005 to 2007. A total of 51 children were studied equally divided in three groups depending upon oxygen saturation. A clinical scoring system was used which was generated after reviewing many studies and taking more practical aspect in relation to its use in peripheral set up. Result: The average age of the infants with oxygen saturation > 95% (Group A), 90–95% (Group B) and <90% ( Group C) was 7.82, 8.02 and 8.17 months respectively. It was observed that clinical score for group A (Sp02 >95%) was ranging between 1 to 6, for group . (90–95%) was between 6 to 11 andfor group C ( <90%) was between 8 to 13. Median score for patients with Sp02 > 95% was 3, with Sp02 90–95% was 8 and with Sp02 <90% was 11 ( Table 2). Correlation coefficient was −0.906, as oxygen saturation was inversely related to clinical scoring of respiratory distress. Confidence interval at 95% for group A was 3.235±0.815,for group . was 8±0.672 andfor group C was 10.882 ± ft 917. The difference of clinical score between group A, group . and group C were statistically significant (p< 0.001). Conclusion: Oxygen can be started for all babies with hyperreactive airway disease who are having clinical score of 7 or more and amount of oxygen to be increased as score increases from 7 to 14.

Research paper thumbnail of Association of personality traits with performance in military training

Medical Journal Armed Forces India, 2021

Background In today's era of asymmetric and unconventional warfare, psychological fitness is ... more Background In today's era of asymmetric and unconventional warfare, psychological fitness is equally important as physical fitness. Personality assessment of soldiers, and more so officers who are leaders of men is essential in deciding what makes a good "War asset" The present study was conducted to explore the correlation between personality traits of cadets undergoing training in an Armed Forces Training Academy and their performance in terms of their military and academic pursuits. Methods Personality traits of 607 cadets determined using Revised Neuroticism-Extraversion-Openness Personality Inventory (NEO PI-R) were compared and correlated with their performance in terms of Officer Like Qualities (OLQ), Outdoor activities (ODT), Academics, and Extracurricular Activities (ECA). Results Cadets with high personality traits scores in Neuroticism and low scores in Conscientiousness (Work ethics) had performed poorly in all the domains/criteria for evaluation of performance viz Officer like qualities, Outdoor activities, Academics, and Extracurricular Activities. Further, a significant negative correlation was observed between facets of Neuroticism and Academics, ODT, and OLQ. In contrast, personality facets of Conscientiousness (Work ethic) were found to be positively correlated with performance in Academics, ODT, and OLQ. Extracurricular activities were found to be positively correlated with Modesty and Intellectual Curiosity. Conclusion The present study represents the first-ever attempt in Indian Armed Forces to correlate and identify personality traits most suited for military training. The findings of the study indicate that cadets with low scores of neuroticism and high scores of conscientiousness perform well in the military academy. However, more such studies are required to reaffirm the findings of the present study and to conclusively recommend personality traits most conducive for military training.

Research paper thumbnail of Waveform blending technique for text-to-speech system

Research paper thumbnail of Skin follicle types, ratios, and population densities in Rajasthan sheep breeds

Australian Journal of Agricultural Research, 1960

Observations are reported of skin follicle types, ratios, population densities, and percentages o... more Observations are reported of skin follicle types, ratios, population densities, and percentages of medullated fibres in four Rajasthan sheep breeds – Chokla, Marware, Jaisalmere, and Malpura. Data from three body regions – shoulder, side, and breech – were available for a total of 21 sheep, and for 12 more there were observations for at least one of the three regions. The Chokla breed had the highest total and highest primary follicle population density (9.4 and 3.1 per mm2 respectively), as well as the highest ratio of secondary to primary follicles (2.1) and the lowest percentage medullation (24 per cent. of all fibres, 2 per cent. of secondary fibres). The Malpura breed had the lowest total and lowest primary follicle population density (5.6 and 2.5 per mm2), and was equal with the Marware breed for the lowest ratio (1.3). The Malpura breed had the highest percentage medullation (77 per cent. of all fibres, 60 per cent. of secondary fibres). Of the three body regions studied, the...

Research paper thumbnail of Mathematical modeling, interpretation, and simulation of tumor dynamics in the presence of CD4 + cells with chemotherapeutic drug intervention

ESSENCE OF MATHEMATICS IN ENGINEERING APPLICATIONS: EMEA-2020

A tumor is a condition of uncontrolled cell division in solid tissues such as an organ, bone, or ... more A tumor is a condition of uncontrolled cell division in solid tissues such as an organ, bone, or muscle. After a sequence of mutations (changes in the genetic sequence), tumor cells normally develop and become progressively abnormal. These mutations in our environment are either hereditary or, more commonly, caused by carcinogens (cancer-causing substances). This abnormal condition of tumor growth evolves a series of mechanisms that can caricature the peripheral immune forbearance and hence escaping the tumoricidal attack by the immune cells. In the present research, we contemplate mocking the roles of various immune cells in tumor attack using the mathematical model formulated. Also, we study the constitution of these various cell densities, involved under our study, by employing drug interventions through diverse therapy techniques. The mathematical model formulated for our study prevails to be unique due to the exemplary composition: tumor cells, natural killers, dendritic cells, CD8+ cells, CD4+ cells, interleukin 2 cytokines (IL-2 cytokines), and drug interference term. The model established is analyzed mathematically for its stability using standard methods. The system of differential equations is solved using an ordinary differential equation solver, with the values of the parameters taken from pathologically tested sources. The cases of with and without drug interference have been analyzed using the graphical results obtained. Also, we intend to study the tumor cell density by changing the frequency of therapy employed. The results followed a hysteresis loop, adding uniqueness to our present work.

Research paper thumbnail of Study of correlation between maternal and cord blood vitamin D3 levels

International Journal of Contemporary Pediatrics

Background: Vitamin D deficiency during pregnancy and in newborn period is common in this country... more Background: Vitamin D deficiency during pregnancy and in newborn period is common in this country. Vitamin D status of the mother is known to influence the vitamin D levels in the neonate, however how closely the maternal vitamin D level correlates with the cord blood Vitamin D is not clearly understood. To study the correlation between maternal and neonatal serum Vitamin D3 levels by as indicated by cord blood 25(OH)D levels and find out if there is a significant variation of cord blood 25(OH)D levels in Vitamin D sufficient and insufficient mothers.Methods: Healthy pregnant women between 18-45 years of age with no known history of chronic disease or long-term medication, consenting for the study were enrolled. Maternal blood sample was collected in peripartum period, cord blood sample was obtained after delivery from the umbilical cord after clamping. Vitamin D3 levels were measured by RIA and paired maternal and cord blood levels were statistically analyzed.Results: 569 paired sa...

Research paper thumbnail of Epidemiological assessment of road traffic accidents among the naval population

Journal of Marine Medical Society

Research paper thumbnail of Hypomelanosis of Ito

Medical journal, Armed Forces India, 2006

Research paper thumbnail of Hiv : Scenario in Andaman and Nicobar Islands

Medical journal, Armed Forces India, 1999

Research paper thumbnail of Profile of Live-born Infants of In-vitro Fertilisation

Medical journal, Armed Forces India, 2010

Research paper thumbnail of Breast Feeding and Antenatal Preparation: REPLY

Medical journal, Armed Forces India, 2006

Dear Editor, We thank the author(s) for their appreciation of our work reported in the article “M... more Dear Editor, We thank the author(s) for their appreciation of our work reported in the article “Maternal and neonatal factors adversely affecting breast feeding in the perinatal period “[1]. We fully agree with the author[s] contention that antenatal preparation of the prospective mother including counselling, examination and management of any anatomical problems with her breasts forms a very important part of effort at ensuring successful breastfeeding. Our colleagues in the Department of Obstetrics at the tertiary care hospital have been rendering commendable service in this field and as mentioned in the article, regular antenatal counseling for breastfeeding is an integral part of the obstetric services. Examination of the mother's breast is also being done in all prospective mothers antenatally though this was not specifically mentioned in our article. We thank the author[s] of the above letter for their comments and once again express our full agreement with their observati...

Research paper thumbnail of Steroids in perinatology

Indian pediatrics, 2002

1. Indian Pediatr. 2002 Apr;39(4):347-61. Steroids in perinatology. Narayan S, Deorari AK. Neonat... more 1. Indian Pediatr. 2002 Apr;39(4):347-61. Steroids in perinatology. Narayan S, Deorari AK. Neonatal Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi 110 029, India. Comment in Indian Pediatr. 2002 Nov;39(11):1075-7; author reply 1078-80. ...

Research paper thumbnail of Exploring attributes influencing patient satisfaction in a group of hospitals

Journal of Marine Medical Society, 2022

Introduction: The main purpose of hospitals is to provide quality care to their clientele. Many s... more Introduction: The main purpose of hospitals is to provide quality care to their clientele. Many studies have been conducted to assess patient satisfaction and suggest measures to improve patient satisfaction in government and private hospitals. This study was conducted in a different setting with the aim to assess patient satisfaction in a group of hospitals exclusively for their entitled clientele. Materials and Methods: The study was a questionnaire-based observational study conducted in nine hospitals belonging to one central administration. The questions pertained to five domains. The data were collected on a numerical scale and the weighted average was calculated for each question. Results: A total of 2850 patients were administered with questionnaire. About 95% of patients were satisfied with services provided by the hospitals. The strengths of the hospitals were the general cleanliness and the way the medical and paramedical staff treat their patients. The weaknesses were the waiting period at reception and to see the doctor as well as the quality of food provided to the inpatients. Conclusion: This study has brought out that a large percentage of patients were satisfied with the services provided by the hospitals. The analysis has facilitated the administrator to know the strengths of the hospitals as well as to identify the weaknesses. It is essential that the administration of the hospitals addresses the weaknesses to further improve the patient satisfaction. In conclusion, it is recommended that patient satisfaction surveys should be part of the Standard Operating Procedure of all health-care facilities and the same should be an ongoing process rather than a one-time measure.

Research paper thumbnail of Can umbilical cord blood counts substitute venous blood counts done in the first six hours of life in term neonates?

Journal of Marine Medical Society, 2014

Background: A large number of neonatal conditions can be anticipated before or identified at birt... more Background: A large number of neonatal conditions can be anticipated before or identified at birth. Many of these conditions need venous sampling of neonates to determine hematologicalparameters. There are no studies to show whether the easily available umbilical cord sample can be used to obtain these test parmeters in full-term neonates. Materials & Methods: This retrospective, one-year study included full-term neonates with conditions that can be predicted before birth (infection in the infant of a mother with prolonged rupture of membranes, Rh negative mothers′ infant, Intra-uterine growth retardation, transient tachypnoea ofnewborn following caesarean section) or at birth (birth asphyxia). Umbilical cord blood hemoglobin, total and differential leukocyte counts and platelet counts were compared with the same parameters obtainedfrom venous blood drawn from neonates within six hours of birth. Results: A total of 49 neonates were eligible and included. The mean (s.d.) values of pa...

Research paper thumbnail of Estimating neonatal nursing staff requirement by activity analysis

Background: Nursing staff requirements for Neonatal Intensive Care Unit (NICU) are often determin... more Background: Nursing staff requirements for Neonatal Intensive Care Unit (NICU) are often determined by number of admitted patients even though activity analysis provides a more objective estimation. This study estimates nursing staff requirements by activity analysis in an Armed Forces facility. Materials & Methodology: A prospective observational study between 2 7 January 2014 and 26 February 2014 (31 days) in the NICU of tertiary care teaching hospital of Armed Forces where timing of all nursing activities performed during study period by NICU staff was recorded to the nearest minute by self-reporting. Nursing activities were classified as Direct (40 activities) and Indirect (23 activities) α-priori. Data was entered on an electronic spreadsheet (Microsoft Excel) and relevant analysis performed. Results: During study period, there were 32 neonates (total 238 patient-days) in NICU and 18 (57patient-days) in step-down nursery. There was no patient on invasive ventilation nor was any...

Research paper thumbnail of Comparison of Neonatal Outcome After Induction of Labour with 25 and 50 meg of Misoprostol

Journal of Marine Medical Society, 2016

Background: There are only very few studies which compared 25 and 50 microgram of misoprostol in ... more Background: There are only very few studies which compared 25 and 50 microgram of misoprostol in relation to neonatal outcome and Indian data in this context are lacking. Methods: This study was carried out as a single centre, prospective, observational study which consisted of 100 term pregnant women divided in two groups. Neonatal outcome was compared in relation to frequency of abnormalfetal heart rate tracings, meconium passage, 1- or 5-minute Apgar scores < 7, neonatal resuscitations, or admissions to the neonatal intensive care unit Result: Meconium stained liquor was observed in 6% of cases in both groups. Apgar score at 1 min was <7 in 10% of cases in 25 meg group against 6% in 50 meg group. Requirement of neonatal resuscitation was observed in 10% of cases in each group. Fetal heart rate abnormality was observed in 22% of cases in 50 meg group against 12% in 25 meg group. Neonatal problems were detected in 14% and 12% of cases in 25 meg and 50 meg group respectively. Statistically these difference were not significant Conclusion: There is no significant difference in neonatal outcome with 25 and 50 microgram of misoprostol used for induction of delivery in term pregnancy.

Research paper thumbnail of Effectiveness of teaching of neonatal resuscitation programme at a workshop for a mixed population of medical personnel

Medical Journal Armed Forces India, 2004

We evaluated the effectiveness of teaching at a neonatal resuscitation programme (NRP) workshop h... more We evaluated the effectiveness of teaching at a neonatal resuscitation programme (NRP) workshop held for 35 medical personnel (including postgraduate trainee doctors, general duty medical officers, nursing officers and probationer nurses) using a onegroup pretest-posttest design. None of the participants had any formal exposure to the NRP guidelines. A pre-workshop test of 20 multiple-choice questions was administered to all the participants. At the end of the workshop, the same 20 questions were administered and the two scores compared using t-test for paired data on SPSS statistical software. The mean pre-workshop score was 9.03 (SD 2.66) which improved to a mean of 15.53 (SD 1.93) post-workshop. This improvement was highly significant with p < 0.0001 (two-tailed) and the 95% confidence interval being-7.41 to-5.59. Subgroup analysis revealed that nursing officers and probationer nurses showed highly significant improvement in the post-workshop scores while trainee doctors doing Medicine, Pediatrics and the general duty medical officers showed statistically significant improvement in the post-workshop scores. This study shows that a medical workshop is an effective means of imparting knowledge to a mixed group of medical personnel.

Research paper thumbnail of Association of asymptomatic structural cardiac defects in neonates with transient tachypnea at birth: A case-control study

Journal of the Pediatrics Association of India, 2020

Background: Transient tachypnea of the newborn (TTNB) has been documented as the most common caus... more Background: Transient tachypnea of the newborn (TTNB) has been documented as the most common cause of neonatal respiratory distress, accounting for more than 40 percent of cases. Materials and Methods: This study was a prospective study on 75 patients (neonates who were born with TTNB) who underwent two-dimensional (2D) echocardiography (Echo) after tachypnea subsided. The controls (neonates who did not manifest tachypnea) were matched for birth weight, period of gestation, mode of delivery, and sex. Appropriate Chi-square tests were done for categorical variables, while Student's t-test was done for continuous variables. Results: Incidence of asymptomatic structural cardiac lesions detected by 2D Echo was significantly higher in neonates in the study group (n = 38; 50.66%) as compared to the control group (n = 7; 9.33%). This difference was statistically significant P < 0.0000002 (odds ratio 9.4586; 95% confidence interval 3.84–23.27). The most common cardiac lesion in both groups was atrial septal defect. Conclusion: The incidence of asymptomatic structural cardiac defects was found to be approximately five times higher in neonates manifesting TTNB (50.66% vs. 9.33%). Based on the findings of this study, screening for structural cardiac lesions by 2D echo is recommended in all neonates who manifest with TTNB.

Research paper thumbnail of Planning a modular intensive care unit for patients of the COVID-19 pandemic

Journal of Marine Medical Society, 2020

Introduction: The COVID-19 pandemic has provided opportunity to the Armed Forces Medical Services... more Introduction: The COVID-19 pandemic has provided opportunity to the Armed Forces Medical Services (AFMS) healthcare institutions to plan and execute their surge capacity facilities and identify areas for improvements in planning in the future. Material and Methods: Available medical literature on the experiences of other countries in activating surge capacities in healthcare for the pandemic were examined in detail as were existing guidelines for establishing Intensive Care Units (ICU). Personal communications with peers to understand difficulties faced in activating surge capacities were also factored in. Results: Based on the findings from these sources, a plan to establish ten-bedded ICU units specifically for COVID-19 is evolved. The best practices and latest guidelines and experiences have been collated and modified suitably to suit the AFMS in this aspect. Conclusion: Planning ICUs in ten-bedded modular units will enable the AFMS to cater to surge capacities in the future for all situations where sudden increase in number of patients is anticipated.

Research paper thumbnail of A study to assess the Knowledge, Aptitude and Practices towards Voluntary Blood Donation in a Peripheral Hospital in North India

Donated blood is a lifeline in an emergency and for people who need long term treatment.Adequate ... more Donated blood is a lifeline in an emergency and for people who need long term treatment.Adequate and safe blood transfusion is still a challenge in a developing countries like ours.There is a precarious need to put efforts to recruit donors in groups less willing to donate and simultaneously reinforce the positive behaviour of willing groups converting previous donors into regular practice.

Research paper thumbnail of Relationship between oxygen saturation and clinical symptoms or signs in infants from 2 months to 12 months age with acute respiratory distress due to hyper reactive airway disease

Journal of Marine Medical Society, 2016

Background: Facilities to measure SP02 are not available at all centers especially in the resourc... more Background: Facilities to measure SP02 are not available at all centers especially in the resource poor developing countries. This study is therefore important to identify a minimum set ofclinical signs that can reliably predict presence of hypoxemia in children with hyperreactive airway disease that can be used by health care provider to institute oxygen therapy. Methods: study was carried out as a single centre, prospective, observational study fromyear 2005 to 2007. A total of 51 children were studied equally divided in three groups depending upon oxygen saturation. A clinical scoring system was used which was generated after reviewing many studies and taking more practical aspect in relation to its use in peripheral set up. Result: The average age of the infants with oxygen saturation > 95% (Group A), 90–95% (Group B) and <90% ( Group C) was 7.82, 8.02 and 8.17 months respectively. It was observed that clinical score for group A (Sp02 >95%) was ranging between 1 to 6, for group . (90–95%) was between 6 to 11 andfor group C ( <90%) was between 8 to 13. Median score for patients with Sp02 > 95% was 3, with Sp02 90–95% was 8 and with Sp02 <90% was 11 ( Table 2). Correlation coefficient was −0.906, as oxygen saturation was inversely related to clinical scoring of respiratory distress. Confidence interval at 95% for group A was 3.235±0.815,for group . was 8±0.672 andfor group C was 10.882 ± ft 917. The difference of clinical score between group A, group . and group C were statistically significant (p< 0.001). Conclusion: Oxygen can be started for all babies with hyperreactive airway disease who are having clinical score of 7 or more and amount of oxygen to be increased as score increases from 7 to 14.

Research paper thumbnail of Association of personality traits with performance in military training

Medical Journal Armed Forces India, 2021

Background In today's era of asymmetric and unconventional warfare, psychological fitness is ... more Background In today's era of asymmetric and unconventional warfare, psychological fitness is equally important as physical fitness. Personality assessment of soldiers, and more so officers who are leaders of men is essential in deciding what makes a good "War asset" The present study was conducted to explore the correlation between personality traits of cadets undergoing training in an Armed Forces Training Academy and their performance in terms of their military and academic pursuits. Methods Personality traits of 607 cadets determined using Revised Neuroticism-Extraversion-Openness Personality Inventory (NEO PI-R) were compared and correlated with their performance in terms of Officer Like Qualities (OLQ), Outdoor activities (ODT), Academics, and Extracurricular Activities (ECA). Results Cadets with high personality traits scores in Neuroticism and low scores in Conscientiousness (Work ethics) had performed poorly in all the domains/criteria for evaluation of performance viz Officer like qualities, Outdoor activities, Academics, and Extracurricular Activities. Further, a significant negative correlation was observed between facets of Neuroticism and Academics, ODT, and OLQ. In contrast, personality facets of Conscientiousness (Work ethic) were found to be positively correlated with performance in Academics, ODT, and OLQ. Extracurricular activities were found to be positively correlated with Modesty and Intellectual Curiosity. Conclusion The present study represents the first-ever attempt in Indian Armed Forces to correlate and identify personality traits most suited for military training. The findings of the study indicate that cadets with low scores of neuroticism and high scores of conscientiousness perform well in the military academy. However, more such studies are required to reaffirm the findings of the present study and to conclusively recommend personality traits most conducive for military training.

Research paper thumbnail of Waveform blending technique for text-to-speech system

Research paper thumbnail of Skin follicle types, ratios, and population densities in Rajasthan sheep breeds

Australian Journal of Agricultural Research, 1960

Observations are reported of skin follicle types, ratios, population densities, and percentages o... more Observations are reported of skin follicle types, ratios, population densities, and percentages of medullated fibres in four Rajasthan sheep breeds – Chokla, Marware, Jaisalmere, and Malpura. Data from three body regions – shoulder, side, and breech – were available for a total of 21 sheep, and for 12 more there were observations for at least one of the three regions. The Chokla breed had the highest total and highest primary follicle population density (9.4 and 3.1 per mm2 respectively), as well as the highest ratio of secondary to primary follicles (2.1) and the lowest percentage medullation (24 per cent. of all fibres, 2 per cent. of secondary fibres). The Malpura breed had the lowest total and lowest primary follicle population density (5.6 and 2.5 per mm2), and was equal with the Marware breed for the lowest ratio (1.3). The Malpura breed had the highest percentage medullation (77 per cent. of all fibres, 60 per cent. of secondary fibres). Of the three body regions studied, the...

Research paper thumbnail of Mathematical modeling, interpretation, and simulation of tumor dynamics in the presence of CD4 + cells with chemotherapeutic drug intervention

ESSENCE OF MATHEMATICS IN ENGINEERING APPLICATIONS: EMEA-2020

A tumor is a condition of uncontrolled cell division in solid tissues such as an organ, bone, or ... more A tumor is a condition of uncontrolled cell division in solid tissues such as an organ, bone, or muscle. After a sequence of mutations (changes in the genetic sequence), tumor cells normally develop and become progressively abnormal. These mutations in our environment are either hereditary or, more commonly, caused by carcinogens (cancer-causing substances). This abnormal condition of tumor growth evolves a series of mechanisms that can caricature the peripheral immune forbearance and hence escaping the tumoricidal attack by the immune cells. In the present research, we contemplate mocking the roles of various immune cells in tumor attack using the mathematical model formulated. Also, we study the constitution of these various cell densities, involved under our study, by employing drug interventions through diverse therapy techniques. The mathematical model formulated for our study prevails to be unique due to the exemplary composition: tumor cells, natural killers, dendritic cells, CD8+ cells, CD4+ cells, interleukin 2 cytokines (IL-2 cytokines), and drug interference term. The model established is analyzed mathematically for its stability using standard methods. The system of differential equations is solved using an ordinary differential equation solver, with the values of the parameters taken from pathologically tested sources. The cases of with and without drug interference have been analyzed using the graphical results obtained. Also, we intend to study the tumor cell density by changing the frequency of therapy employed. The results followed a hysteresis loop, adding uniqueness to our present work.

Research paper thumbnail of Study of correlation between maternal and cord blood vitamin D3 levels

International Journal of Contemporary Pediatrics

Background: Vitamin D deficiency during pregnancy and in newborn period is common in this country... more Background: Vitamin D deficiency during pregnancy and in newborn period is common in this country. Vitamin D status of the mother is known to influence the vitamin D levels in the neonate, however how closely the maternal vitamin D level correlates with the cord blood Vitamin D is not clearly understood. To study the correlation between maternal and neonatal serum Vitamin D3 levels by as indicated by cord blood 25(OH)D levels and find out if there is a significant variation of cord blood 25(OH)D levels in Vitamin D sufficient and insufficient mothers.Methods: Healthy pregnant women between 18-45 years of age with no known history of chronic disease or long-term medication, consenting for the study were enrolled. Maternal blood sample was collected in peripartum period, cord blood sample was obtained after delivery from the umbilical cord after clamping. Vitamin D3 levels were measured by RIA and paired maternal and cord blood levels were statistically analyzed.Results: 569 paired sa...

Research paper thumbnail of Epidemiological assessment of road traffic accidents among the naval population

Journal of Marine Medical Society