Dr. Mukul Singhal | Rajasthan University of Health Sciences, Jaipur (original) (raw)

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Papers by Dr. Mukul Singhal

Endocrine Practice, 2021

Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. centers and rehabilitation facilities should develop processes to ensure care coordination from the inpatient to outpatient setting.

International Journal of Research in Medical Sciences, 2022

Background: The COVID-19 pandemic, in its omnipresence, descended an unprecedented blow on the re... more Background: The COVID-19 pandemic, in its omnipresence, descended an unprecedented blow on the reeling facilities nationwide, which at its stabilising junction posed another threat – mucormycosis. Potentially immunodeficient cases, diabetes and excessive rampancy of steroids propagated this neo-epidemic, currently challenging the fretting mortality rate. Aim of the study was to analyse the clinical profile elaborating the recent illnesses and progression in patients admitted with mucormycosis in a dedicated ‘mucor-care’ centre.Methods: Total 195 admitted patients were evaluated based on their COVID protocol management and oxygen therapy administered with special emphasis on hygiene maintenance in view of mask support, oral care and hospitalisation course with duration and medications provided. Type and duration of glucocorticoids, injectable or oral, dispensed to the patients were duly logged and analysed.Results: Half cases (50%) were found COVID reverse transcriptase-polymerase ch...

International Journal of Research in Medical Sciences , 2022

The pandemic of COVID-19 descended to every possible damage onto the grieving healthcare infrastr... more The pandemic of COVID-19 descended to every possible damage onto the grieving healthcare infrastructure of the nation and beyond, which on its reeling end has now propagated a dark nightmare. In recent times, as the second wave of COVID gained momentum, influx of cases of 'COVID-induced black fungus' has taken the world by storm. An angio-invasive disease characterized by tissue infarction and necrosis, 'mucormycosis' is an invasive calamity caused by mold fungi belonging to genus Mucor, Rhizopus, Rhizomucor and Absidia, cross reacting in immune-compromised hosts. 1 As per Indian Council of Medical Research (ICMR) census, 24872 cases were reported as of 28 December 2021 with Gujarat leading the cascade with 8276 cases. 2 The first episode in Rajasthan was a 18 month old post COVID baby in Bikaner, diagnosed with the brutal ailment on 29 April 2021 post which the state has encountered an epidemic which stands at 4202 cases till date.

International Journal Dental and Medical Sciences Research, 2021

Background: The Covid-19 pandemic with unprecedented increased influx of patients proved strenuou... more Background: The Covid-19 pandemic with unprecedented increased influx of patients proved strenuous for the already overburdened healthcare infrastructure. It was important that the existing centres, especially in developing countries, take up the challenge. Aim: To study the differential functioning and transformed triage management protocol in an Indian multispecialty hospital during the covid-19"lockdown"frame from March 29-June 01, 2021. Materials and methods: Multiple departments in the hospital were integrated to identify clinical characteristics and comorbidities for triage. Separate corona outdoor in addition to routine OPD and emergency services was created for influx of suspected patients according to symptomatic severity. Further inter-ward transfer of patients was planned based on patient"s clinical severity and covid status. This was executed inclusively with least compromise to renal, haemophilic or chemotherapy day-care interventions. Results: Out of 2791 patients studied, 690 were admitted through dedicated corona outdoor and 2101 through emergency. Respiratory distress (966) was the highlight in majority followed by multisystem involvement (795). Hypertension (675) and diabetes (406) were common comorbidities. Hospital stay was longer in patients with comorbidities averaging 4.3 days for both covid and non-covid cases altogether. Maximal covid positives(46.05%) were detected in earmarked observation wardscreated to reduceexposure. The condition worsened in 104suspects from ARI thus shifted accordingly. Out of 1201 patients transferred, maximum were from ARI (63.4%) with total 1301 dischargesoverall post cure and637 mortalities. Conclusion: This system enhanced interdepartmental cooperation and performance to deal the pandemic, achieved through triage and treatment by training personnel into different roles.

Endocrine Practice (AACE), 2021

Objective: The Covid-19 pandemic proved provocative to the already grieving Indian healthcare inf... more Objective: The Covid-19 pandemic proved provocative to the
already grieving Indian healthcare infrastructure confronting the
ever-growing metabolic epidemic, thereby accentuating the
morbidity and mortality statistics in overtly obese, diabetics and
hormonally compromised. Imminent for the existing centres, they
evolved to consummate the task.
Aim: How does the distinctive functioning and triage-protocol of
systemically variable co-morbid patients affects within an Indian
multispecialty hospital during the covid-19 pandemic era? To
determine prevalence of SARS-CoV-2 infection influence the
outcomes?
Methods: The projected study is an observational retrospective
mono-centric analysis, derived from the medical case records
and interviews of patients/relatives investigating the clinical
outcomes of endocrine patients. The employed protocol segregated
those archiving variable clinico-pathologic expositions
and endocrinal comorbidities triaging into 3 separate wards.
These involved the endocrine patients without respiratory illness
(A), with respiratory difficulty (B) and with confirmed covid
infection (C). A separate corona outdoor managed the influx of
suspected patients with other ailments as per symptomatic
severity. Individuals with co-ailments viz. diabetes, hypertension
was ascertained clinically and marshalled from non-comorbid
cases in view of critical care obligation. Each super-speciality
worked separately providing noteworthy attention towards
realms embracing renal, pituitary or immune-compromised
patients.
Results: Out of 2790 patients admitted, 890 endocrinal patients,
through dedicated outdoor or emergency were reallocated
emphasizing 144(Ward A), 411(B) and 335(C) separately. Ward (B)
cases highlight-able with hormonal affliction, once recovered (293)
or found covid positive (118) on repeat testing were transferred to
ward A & C respectively. 95% cases (136) with predominant
dysfunction (A) and 77% ward (B) cases (316) were discharged with
mandatory ‘supplemental’ steroids. Hospital stay was the
maximum in ward C cases averaging 6.3 days owing covid status,
with < 4% mortality. 104 suspects (B) and 143 cases (C), majorly
diabetics were proficiently shifted to critical-care units, as condition
downgraded.
Discussion/Conclusion: This protocol portrayed effective specialtycentred
furcation and salient role played by endocrinologists that
aided us to achieve positive results.

International Journal of Atherogenic Diabetic Dyslipidemia (IJADD), 2020

Background: Acute myocardial infarction (AMI) is one of the most common causes of morbidity and m... more Background: Acute myocardial infarction (AMI) is one of the most common causes of morbidity and mortality globally. It occurs when myocardial ischemia, the diminished blood supply to the heart, exceeds a particular threshold and saturates the myocardial repair mechanisms capacity to maintain normal function and homeostasis. Furthermore, the presence of hyperglycaemia substantiates electrophysiological alteration, impairs left ventricular (LV) function and causes perfusion defects promoting multiple cardiac complications viz. arrhythmias, cardiogenic shock, heart failure and death. Raised admission random blood sugar (RBS) signifies hyperglycaemia and HbA1c serves a prognostic purpose in patients of myocardial infarction (MI) to be watchful regarding complications. Aim: The present study was carried out to study the association between admission blood glucose levels and the development of complications in patients having acute MI. We also studied the association of HbA1c levels with prognosis in MI patients.

Drafts by Dr. Mukul Singhal

In this era of modernised diseases, 'the new captain of the men of death' takes a toll, where onl... more In this era of modernised diseases, 'the new captain of the men of death' takes a toll, where only a planned approach by 'the last internist' can curb its outfall" Known as the disease of the better-offs, diabetes mellitus has emerged as a new age non-communicable pandemic, which has troubled the entire world. As per International Diabetes Federation (IDF 2019), the current pool is of 285 million affected people and expected to encompass 435 million worldwide by 2039, so controlling this conglomerate of metabolic abnormalities is the need of the hour. Why is it important to diagnose the diabetes early? Despite being a preventable and salvageable modality, diabetes becomes a menace owing to its late diagnosis. In such scenario, maintaining a good glycaemic control by timely monitoring and evaluation, using variable available resources to guide therapeutic interventions can achieve best outcomes and can prevent complications. Why is it important to control blood glucose levels? Persistent high blood glucose damages the major vitality of essential organs of the body which cause grave complications both at macro and micro levels and early viable control can prevent that scenario.

Endocrine Practice, 2021

Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on ... more Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. centers and rehabilitation facilities should develop processes to ensure care coordination from the inpatient to outpatient setting.

International Journal of Research in Medical Sciences, 2022

Background: The COVID-19 pandemic, in its omnipresence, descended an unprecedented blow on the re... more Background: The COVID-19 pandemic, in its omnipresence, descended an unprecedented blow on the reeling facilities nationwide, which at its stabilising junction posed another threat – mucormycosis. Potentially immunodeficient cases, diabetes and excessive rampancy of steroids propagated this neo-epidemic, currently challenging the fretting mortality rate. Aim of the study was to analyse the clinical profile elaborating the recent illnesses and progression in patients admitted with mucormycosis in a dedicated ‘mucor-care’ centre.Methods: Total 195 admitted patients were evaluated based on their COVID protocol management and oxygen therapy administered with special emphasis on hygiene maintenance in view of mask support, oral care and hospitalisation course with duration and medications provided. Type and duration of glucocorticoids, injectable or oral, dispensed to the patients were duly logged and analysed.Results: Half cases (50%) were found COVID reverse transcriptase-polymerase ch...

International Journal of Research in Medical Sciences , 2022

The pandemic of COVID-19 descended to every possible damage onto the grieving healthcare infrastr... more The pandemic of COVID-19 descended to every possible damage onto the grieving healthcare infrastructure of the nation and beyond, which on its reeling end has now propagated a dark nightmare. In recent times, as the second wave of COVID gained momentum, influx of cases of 'COVID-induced black fungus' has taken the world by storm. An angio-invasive disease characterized by tissue infarction and necrosis, 'mucormycosis' is an invasive calamity caused by mold fungi belonging to genus Mucor, Rhizopus, Rhizomucor and Absidia, cross reacting in immune-compromised hosts. 1 As per Indian Council of Medical Research (ICMR) census, 24872 cases were reported as of 28 December 2021 with Gujarat leading the cascade with 8276 cases. 2 The first episode in Rajasthan was a 18 month old post COVID baby in Bikaner, diagnosed with the brutal ailment on 29 April 2021 post which the state has encountered an epidemic which stands at 4202 cases till date.

International Journal Dental and Medical Sciences Research, 2021

Background: The Covid-19 pandemic with unprecedented increased influx of patients proved strenuou... more Background: The Covid-19 pandemic with unprecedented increased influx of patients proved strenuous for the already overburdened healthcare infrastructure. It was important that the existing centres, especially in developing countries, take up the challenge. Aim: To study the differential functioning and transformed triage management protocol in an Indian multispecialty hospital during the covid-19"lockdown"frame from March 29-June 01, 2021. Materials and methods: Multiple departments in the hospital were integrated to identify clinical characteristics and comorbidities for triage. Separate corona outdoor in addition to routine OPD and emergency services was created for influx of suspected patients according to symptomatic severity. Further inter-ward transfer of patients was planned based on patient"s clinical severity and covid status. This was executed inclusively with least compromise to renal, haemophilic or chemotherapy day-care interventions. Results: Out of 2791 patients studied, 690 were admitted through dedicated corona outdoor and 2101 through emergency. Respiratory distress (966) was the highlight in majority followed by multisystem involvement (795). Hypertension (675) and diabetes (406) were common comorbidities. Hospital stay was longer in patients with comorbidities averaging 4.3 days for both covid and non-covid cases altogether. Maximal covid positives(46.05%) were detected in earmarked observation wardscreated to reduceexposure. The condition worsened in 104suspects from ARI thus shifted accordingly. Out of 1201 patients transferred, maximum were from ARI (63.4%) with total 1301 dischargesoverall post cure and637 mortalities. Conclusion: This system enhanced interdepartmental cooperation and performance to deal the pandemic, achieved through triage and treatment by training personnel into different roles.

Endocrine Practice (AACE), 2021

Objective: The Covid-19 pandemic proved provocative to the already grieving Indian healthcare inf... more Objective: The Covid-19 pandemic proved provocative to the
already grieving Indian healthcare infrastructure confronting the
ever-growing metabolic epidemic, thereby accentuating the
morbidity and mortality statistics in overtly obese, diabetics and
hormonally compromised. Imminent for the existing centres, they
evolved to consummate the task.
Aim: How does the distinctive functioning and triage-protocol of
systemically variable co-morbid patients affects within an Indian
multispecialty hospital during the covid-19 pandemic era? To
determine prevalence of SARS-CoV-2 infection influence the
outcomes?
Methods: The projected study is an observational retrospective
mono-centric analysis, derived from the medical case records
and interviews of patients/relatives investigating the clinical
outcomes of endocrine patients. The employed protocol segregated
those archiving variable clinico-pathologic expositions
and endocrinal comorbidities triaging into 3 separate wards.
These involved the endocrine patients without respiratory illness
(A), with respiratory difficulty (B) and with confirmed covid
infection (C). A separate corona outdoor managed the influx of
suspected patients with other ailments as per symptomatic
severity. Individuals with co-ailments viz. diabetes, hypertension
was ascertained clinically and marshalled from non-comorbid
cases in view of critical care obligation. Each super-speciality
worked separately providing noteworthy attention towards
realms embracing renal, pituitary or immune-compromised
patients.
Results: Out of 2790 patients admitted, 890 endocrinal patients,
through dedicated outdoor or emergency were reallocated
emphasizing 144(Ward A), 411(B) and 335(C) separately. Ward (B)
cases highlight-able with hormonal affliction, once recovered (293)
or found covid positive (118) on repeat testing were transferred to
ward A & C respectively. 95% cases (136) with predominant
dysfunction (A) and 77% ward (B) cases (316) were discharged with
mandatory ‘supplemental’ steroids. Hospital stay was the
maximum in ward C cases averaging 6.3 days owing covid status,
with < 4% mortality. 104 suspects (B) and 143 cases (C), majorly
diabetics were proficiently shifted to critical-care units, as condition
downgraded.
Discussion/Conclusion: This protocol portrayed effective specialtycentred
furcation and salient role played by endocrinologists that
aided us to achieve positive results.

International Journal of Atherogenic Diabetic Dyslipidemia (IJADD), 2020

Background: Acute myocardial infarction (AMI) is one of the most common causes of morbidity and m... more Background: Acute myocardial infarction (AMI) is one of the most common causes of morbidity and mortality globally. It occurs when myocardial ischemia, the diminished blood supply to the heart, exceeds a particular threshold and saturates the myocardial repair mechanisms capacity to maintain normal function and homeostasis. Furthermore, the presence of hyperglycaemia substantiates electrophysiological alteration, impairs left ventricular (LV) function and causes perfusion defects promoting multiple cardiac complications viz. arrhythmias, cardiogenic shock, heart failure and death. Raised admission random blood sugar (RBS) signifies hyperglycaemia and HbA1c serves a prognostic purpose in patients of myocardial infarction (MI) to be watchful regarding complications. Aim: The present study was carried out to study the association between admission blood glucose levels and the development of complications in patients having acute MI. We also studied the association of HbA1c levels with prognosis in MI patients.

In this era of modernised diseases, 'the new captain of the men of death' takes a toll, where onl... more In this era of modernised diseases, 'the new captain of the men of death' takes a toll, where only a planned approach by 'the last internist' can curb its outfall" Known as the disease of the better-offs, diabetes mellitus has emerged as a new age non-communicable pandemic, which has troubled the entire world. As per International Diabetes Federation (IDF 2019), the current pool is of 285 million affected people and expected to encompass 435 million worldwide by 2039, so controlling this conglomerate of metabolic abnormalities is the need of the hour. Why is it important to diagnose the diabetes early? Despite being a preventable and salvageable modality, diabetes becomes a menace owing to its late diagnosis. In such scenario, maintaining a good glycaemic control by timely monitoring and evaluation, using variable available resources to guide therapeutic interventions can achieve best outcomes and can prevent complications. Why is it important to control blood glucose levels? Persistent high blood glucose damages the major vitality of essential organs of the body which cause grave complications both at macro and micro levels and early viable control can prevent that scenario.