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Gupta S, Vasudeva A, Gupta G. Impaired Vibratory and Reciprocal Inhibition in Soleus H-Reflex Testing in Children With Spastic Cerebral Palsy. Cureus 2024; 16:e55541. [PMID: 38576699 PMCID: PMC10993142 DOI: 10.7759/cureus.55541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction Cerebral palsy (CP) is a neurodevelopmental condition that results from an injury to a developing brain. Children with CP fail to execute precise, well-coordinated movements, and excessive muscular co-contraction or co-activation is a prominent attribute of CP. The normal reciprocal relationship between agonists and antagonists during voluntary movements is altered in patients with CP. H-reflex, which is often regarded as the electrical equivalent of the spinal stretch reflex, can be used to examine the overall reflex arc, including the Ia sensory afferent strength and the spinal motoneuron excitability state. Furthermore, neuromodulatory influence of vibration on H-reflex has been found, which has been increasingly investigated to ascertain its potential use as an intervention in patients with increased spinal reflex excitability. Our goal was to identify the brain mechanism underlying the motor deficits by studying Soleus H-reflex changes during voluntary movement (dorsiflexion) and also to determine the role of vibration in H-reflex modulation in children with spastic CP. Methods Soleus H-reflex was recorded in 12 children with spastic CP (10-16 years) and 15 age-matched controls. Recordings were obtained at rest, during dorsiflexion, and during vibratory stimulation for each subject. H-responses (Hmax amplitudes and Hmax-to-Mmax ratio) were compared among the controls and the cases (CP), for the experiments performed, by the Wilcoxon signed-rank test. The recruitment curves depicting the distribution of mean H-response amplitudes with stimulus intensity increment, for dorsiflexion and vibration were compared among controls and cases by the two-sample Kolmogorov-Smirnov (KS) test. p-value <0.05 was considered as statistically significant. Results Hmax amplitudes and the Hmax-to-Mmax ratio increased (15 % and 12.2 % increment, respectively) from the resting values in the children with CP (p<0.05), while controls exhibited a decrease (reduction of 62% and 57 %, respectively) during dorsiflexion (p<0.05). Vibratory stimulation produced a decreasing trend in H-response measures in both the groups. There was about 15 % and 16 % reduction respectively among children with CP while that of 24 % and 21 % respectively among the controls. The differences in the recruitment curves (distribution of average H-response amplitudes with stimulation intensity) recorded during dorsiflexion and vibration experiments among controls compared with those with CP were found to be statistically significant by the two-sample KS test (p<0.0001). Conclusion The failure of H-reflex suppression during voluntary antagonist muscle activation suggests the presence of impaired reciprocal inhibition in spastic CP. The relatively modest H-response reduction caused by vibratory stimulation in children with CP provides limited evidence of vibratory regulation of the H-reflex in CP. More research into the mechanisms driving motor abnormalities in children with CP is needed, which could aid in therapy planning.
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Affiliation(s)
- Sangeeta Gupta
- Physiology, All India Institute of Medical Sciences, Gorakhpur, Gorakhpur, IND
| | - Abhimanyu Vasudeva
- Physical Medicine & Rehabilitation, All India Institute of Medical Sciences, Gorakhpur, Gorakhpur, IND
| | - Gaurav Gupta
- General Surgery, All India Institute of Medical Sciences, Gorakhpur, Gorakhpur, IND
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Vasudeva A, Sheikh NA. Exploring new avenues: Global health, democracy, and digital transformation. J Family Med Prim Care 2023; 12:3004. [PMID: 38186816 PMCID: PMC10771199 DOI: 10.4103/jfmpc.jfmpc_1155_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 09/08/2023] [Indexed: 01/09/2024] Open
Affiliation(s)
- Abhimanyu Vasudeva
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
| | - Nishat A. Sheikh
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
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Vasudeva A, Sheikh NA. Shared decision-making in health care. J Family Med Prim Care 2023; 12:1737. [PMID: 37767437 PMCID: PMC10521857 DOI: 10.4103/jfmpc.jfmpc_2304_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 06/07/2023] [Indexed: 09/29/2023] Open
Affiliation(s)
- Abhimanyu Vasudeva
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
| | - Nishat Ahmed Sheikh
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
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Vasudeva A, Tripathi R. Pregabalin Dependence and Management in a 55-Year-Old Female with Chronic Low Back Pain. Cureus 2023; 15:e44085. [PMID: 37750123 PMCID: PMC10518057 DOI: 10.7759/cureus.44085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/27/2023] Open
Abstract
This case report explores the complexities of managing chronic pain and the subsequent development of pregabalin dependence in a 55-year-old female patient with a prior history of vertebral fracture. Over a period of 10 years, the patient relied on a combination of Aceclofenac and pregabalin to alleviate her pain. An alternative treatment approach was implemented, involving adjustments to medication dosages and gradual tapering. Throughout the treatment process, interdisciplinary collaboration played a pivotal role in addressing unexpected symptoms such as facial movements and neck swelling. This case report highlights the significance of recognizing and addressing pregabalin dependence in patients with chronic pain.
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Affiliation(s)
- Abhimanyu Vasudeva
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Gorakhpur, Gorakhpur, IND
| | - Richa Tripathi
- Psychiatry, All India Institute of Medical Sciences, Gorakhpur, Gorakhpur, IND
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Vasudeva A, Sheikh NA. Making sense of complexity: Our era's most important challenge. J Family Med Prim Care 2023; 12:801-802. [PMID: 37312781 PMCID: PMC10259536 DOI: 10.4103/jfmpc.jfmpc_168_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 01/25/2023] [Indexed: 06/15/2023] Open
Affiliation(s)
- Abhimanyu Vasudeva
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
| | - Nishat A. Sheikh
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
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Kumar R, Sheikh NA, Bashar MA, Vasudeva A, Kumar A, Yadav A, Gupta SK. Epidemio-toxicological profile of fatal poisoning cases autopsied at a tertiary care centre of North India. J Family Med Prim Care 2023; 12:701-707. [PMID: 37312762 PMCID: PMC10259564 DOI: 10.4103/jfmpc.jfmpc_1974_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/14/2022] [Accepted: 01/13/2023] [Indexed: 06/15/2023] Open
Abstract
Background Poisoning is an important health hazard and one of the leading causes of morbidity and mortality worldwide including in India. The study was conducted to understand the magnitude, pattern, and gender differentials of all poisoning fatalities in relation to the manner of death autopsied at a tertiary care center. Methods A retrospective study of all fatal poisoning cases autopsied at the department of Forensic Medicine & Toxicology of a tertiary care institute in Northern India for the period 1st January 1998 to 31st December 2017 was conducted, and a profile of the victims of fatal poisoning was prepared. Data were analyzed with descriptive and inferential statistics. Results The study included a total of 1099 cases of fatal poisoning autopsied at the department of Forensic medicine & Toxicology. Suicidal poisoning was reported in 90.2% of cases and accidental poisoning was seen in 8.9% of cases. Males were predominantly affected (63.8%). The majority of the victims were in the 3rd decade (40.0%) of life. The age of the victims ranged from 2 to 82 years with a mean age of 38.4 years. Agrochemical compounds were implicated in 44.4% of the total fatalities. Conclusion Males in the 2nd to 4th decades of life were more prone to self-poisoning with Agrochemical compounds in the region of North India. Accidental poisoning deaths were uncommon and poisoning was not a preferred method of homicide in this region. Our approach to the study reveals that quantitative chemical (toxicological) analysis is required to further strengthen and improve the databases of the epidemiology of poisoning in this region.
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Affiliation(s)
- Rajesh Kumar
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
| | - Nishat Ahmed Sheikh
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
| | - Mohammad Abu Bashar
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
| | - Abhimanyu Vasudeva
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
| | - Adarsh Kumar
- All India Institute of Medical Sciences Delhi, India
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Sheikh N, Vasudeva A. Foot care in diabetes mellitus. J Family Med Prim Care 2023; 12:188. [PMID: 37025216 PMCID: PMC10071907 DOI: 10.4103/jfmpc.jfmpc_1584_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 10/04/2022] [Indexed: 02/18/2023] Open
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Sutay SS, Sheikh NA, Rath RS, Vasudeva A. Sleep Patterns, Issues, Reasons for Sleep Problems, and Their Impact on Academic Performance among First-Year Medical Students in Central India. Maedica (Bucur) 2022; 17:97-102. [PMID: 35733748 PMCID: PMC9168562 DOI: 10.26574/maedica.2022.17.1.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Introduction:Sleep is an essential part of the human daily routine. Studies have shown that sleep deprivation causes and worsens a wide range of psychological problems in people of all ages. Undergraduate students' sleep disorders are likely to persist and worsen over time. Medical students who work with sick patients on a daily basis and perform skilled activities find that sleep is very important for them. Aims and objectives: The main objective of the present study was to determine undergraduate medical students' sleeping habits as well as the numerous causes of sleep disorders. The secondary aim of our research was to determine the influence of sleep-related problems on students' academic performance. Methods:Following approval from the Ethics Committee, a cross-sectional study of 171 first-year medical students was conducted using a semi-structured self-administered questionnaire. Data was collected using Google Forms on the internet. Microsoft Excel 2019 was used to enter and analyze data. Prevalence was expressed as percentage with a 95% confidence interval. The mean and standard deviation of continuous variables was reported. Results:Of all included students, 39.2% reported they had six to seven hours of sleep each day. Study-related reasons were indicated by 32.6% of students, followed by those who utilized social media (21.7%). Laziness, exhaustion, annoyance, and restlessness were the top reasons for sleeping less (27.5%). Prior academic success was significantly connected to sleep length, while current sleep duration was not.
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Affiliation(s)
- Seema S Sutay
- Department of Forensic Medicine, Government Medical College, Khandwa, State Madhya Pradesh, India
| | - Nishat Ahmed Sheikh
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Gorakhpur, India
| | - Rama Shankar Rath
- Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Gorakhpur, India
| | - Abhimanyu Vasudeva
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Gorakhpur, India
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Sheikh N, Vasudeva A. Musculoskeletal ultrasonography-The way forward in India. J Family Med Prim Care 2022; 11:7501. [PMID: 36992997 PMCID: PMC10041203 DOI: 10.4103/jfmpc.jfmpc_1108_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/10/2022] [Accepted: 07/10/2022] [Indexed: 12/24/2022] Open
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Sahu S, Taraphdar P, Vasudeva A, Sheikh N, Bharti A, Chanu A, Yadav SL. Understanding health care seeking behavior in a tribal setting in West Bengal. J Family Med Prim Care 2022; 11:1443-1449. [PMID: 35516720 PMCID: PMC9067189 DOI: 10.4103/jfmpc.jfmpc_1363_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 12/08/2021] [Accepted: 12/11/2021] [Indexed: 11/04/2022] Open
Abstract
Background: The health-related problems of the tribal population depend on their ecology and culture. Often the tribal people do not utilize the medical and preventive health services available to them. Health problems in tribal groups need special attention because many tribal communities are backward. The current study was planned to determine the healthcare-seeking behavior of the tribal population in India. Method: A descriptive, cross-sectional study, conducted by interviewing key respondents of each participating family. Result: Two-thirds of the key respondents were literate and half (53.8%) of the total households in the three villages had a per capita monthly income between Rupees 500-1499. More than half (57%) of all respondents preferred government institutions for moderate illness, and the rest equally opted for private practitioners and quacks. However, for emergencies, dog bites, and snake bites, all key respondents in the three study villages unanimously preferred government institutions. A significant population (38.5%) got their children delivered at home. The majority of illiterate respondents (86.1%) preferred government institutions for health care of under-five children, while 60% of literates expressed a similar view. The choice of government institutions as a source of health care was increasingly favored with decreasing per capita monthly household income. Conclusion: Traditional healers are no longer preferred among the tribal population but they are reluctant to avail them because of the loss of valuable time. Home delivery is still prevalent. With improving socioeconomic status, people are going further away from government services as private practitioners, and quacks take less time.
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Tripathi R, Sheikh N, Vasudeva A. COVID-Related suicide during the second wave of COVID-19 pandemic in India: A tip of the iceberg of mental health problems. J Family Med Prim Care 2022; 11:4159-4167. [DOI: 10.4103/jfmpc.jfmpc_1517_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/05/2021] [Accepted: 01/24/2022] [Indexed: 11/04/2022] Open
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Sheikh N, Sahu S, Vasudeva A, Neyaz O, Yadav S. The need for physical medicine and rehabilitation as an integral component in the medical education curriculum in India. J Family Med Prim Care 2022; 11:434-438. [PMID: 35360817 PMCID: PMC8963593 DOI: 10.4103/jfmpc.jfmpc_1268_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 10/01/2021] [Accepted: 10/16/2021] [Indexed: 11/04/2022] Open
Abstract
Enhanced quality of health care and increased life expectancy come with issues about the quality of life. This challenge is especially relevant to physical medicine and rehabilitation (PM and R)—a specialty focused on enhancing the quality of life. With the increasing burden of chronic diseases and disabling conditions, requirement for PM and R specialists will increase. This narrative review discusses the changing demographics, the disability trends, and the unmet needs both at present and anticipated in future. We also discussed problems faced by the present training system in PM and R, identified the lacunae, and attempted to provide suggestions to fill those.
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Sheikh N, Vasudeva A. Patient satisfaction in carpal tunnel syndrome. J Family Med Prim Care 2022; 11:7508. [PMID: 36993122 PMCID: PMC10041194 DOI: 10.4103/jfmpc.jfmpc_1472_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 08/26/2022] [Indexed: 12/24/2022] Open
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Vasudeva A, Sheikh NA, Sahu S. International Classification of Functioning, Disability, and Health augmented by telemedicine and artificial intelligence for assessment of functional disability. J Family Med Prim Care 2021; 10:3535-3539. [PMID: 34934642 PMCID: PMC8653435 DOI: 10.4103/jfmpc.jfmpc_692_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 07/02/2021] [Accepted: 07/09/2021] [Indexed: 11/04/2022] Open
Abstract
The concept of functional disability is aligned with the biopsycho-social model of disability. However, there are reasons why the antiquated measurement of medical impairment continues to be in use. We propose solutions for a fairer process using the International Classification of Functioning, Disability, and Health (ICF) at the level of the medical boards augmented by telemedicine and artificial intelligence (AI). The proposed technologies (Level 1 and Level 2 AI) need to be tried in pilot projects. It will accomplish two goals, the first being the measurement of disability and not merely the impairment. Second, and perhaps more importantly, making the process more transparent in creating a "just" society.
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Affiliation(s)
- Abhimanyu Vasudeva
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
| | - Nishat A Sheikh
- Department of Forensic Medicine and Toxicology, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India
| | - Samantak Sahu
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Choudhary A, Sahu S, Vasudeva A, Sheikh NA, Venkataraman S, Handa G, Wadhwa S, Singh U, Gamanagati S, Yadav SL. Comparing Effectiveness of Combination of Collagen Peptide Type-1, Low Molecular Weight Chondroitin Sulphate, Sodium Hyaluronate, and Vitamin-C Versus Oral Diclofenac Sodium in Achilles Tendinopathy: A Prospective Randomized Control Trial. Cureus 2021; 13:e19737. [PMID: 34812335 PMCID: PMC8603329 DOI: 10.7759/cureus.19737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2021] [Indexed: 01/24/2023] Open
Abstract
Background Achilles tendinopathy, a common cause of heel pain, is primarily considered mechanical in origin, but its pathogenesis and treatment lack consensus. Molecules such as collagen peptide type-1, low molecular weight chondroitin sulphate, sodium hyaluronate and vitamin C have been shown to act as building blocks of tendon structure, and oral supplementation of these have promising results in Achilles tendinopathy. Methods This study was a prospective randomized control trial to compare the effectiveness of oral diclofenac sodium versus a nutraceutical combination of collagen peptide type-1, chondroitin sulphate, sodium hyaluronate, and vitamin C in the treatment of Achilles tendinopathy on pain and ultrasonographic structures. A total of 40 patients satisfying inclusion and exclusion criteria were randomly allocated into two groups and were given the nutraceutical combination in group A and diclofenac sodium in group B. The patient evaluation was done at baseline, six-week, and 12-week intervals in terms of VAS (Visual Analogue Scale) and tendo-Achilles thickness by ultrasound. Results Both nutraceutical combination and diclofenac reduced pain in persons with Achilles tendinopathy. The nutraceutical combination had a statistically significant better outcome in reducing pain at the end of 12 weeks. On ultrasound, both the interventions reduced Achilles tendon anteroposterior and mediolateral thickness by the end of 12 weeks. Although there was no absolute significant intergroup difference, the percentage change was more in the nutraceutical group in the case of anteroposterior thickness. Conclusion Combining collagen peptide type-1, low molecular weight chondroitin sulphate, sodium hyaluronate, and vitamin C is more effective than oral diclofenac in controlling pain in Achilles tendinopathy.
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Affiliation(s)
- Arun Choudhary
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Samantak Sahu
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Jodhpur, Jodhpur, IND
| | - Abhimanyu Vasudeva
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Gorakhpur, Gorakhpur, IND
| | - Nishat Ahmed Sheikh
- Forensic Medicine and Toxicology, All India Institute of Medical Sciences Gorakhpur, Gorakhpur, IND
| | - Srikumar Venkataraman
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Gita Handa
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Sanjay Wadhwa
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Upinderpal Singh
- Physical Medicine and Rehabilitation, Mahatma Gandhi Hospital, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, IND
| | | | - S L Yadav
- Physical Medicine and Rehabilitation, All India Institute of Medical Sciences New Delhi, New Delhi, IND
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Sheikh N, Vasudeva A, Sahu S. Digitization of disability certification using technology to curtail infringement of dignity. J Family Med Prim Care 2021; 10:3948-3950. [PMID: 35136750 PMCID: PMC8797068 DOI: 10.4103/jfmpc.jfmpc_961_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/12/2021] [Accepted: 07/16/2021] [Indexed: 12/01/2022] Open
Abstract
Privacy and dignity are the rights of every human being. The disability certificate issued has the medical diagnosis mentioned explicitly as well as the patients’ photograph. A person with disability needs to produce a certificate to avail the benefits, which the law of the land accords. This article discusses the dignity and privacy issues, which may be felt while producing such a certificate before competent authorities and proposes a blinded disability certificate. Besides, the proposed certificate uses advanced technologies to link a functioning profile to a cloud-based central database.
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Neyaz O, Vasudeva A, Parihar R, Bharti A, Handa G. Efficacy of a local corticosteroid injection on pain, disability and radial nerve thickness in patients with lateral epicondylitis. J Family Med Prim Care 2021; 10:4502-4508. [PMID: 35280608 PMCID: PMC8884310 DOI: 10.4103/jfmpc.jfmpc_1173_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/10/2021] [Accepted: 09/23/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction: The aim of this study was to compare the effect of a steroid injection with conservative therapy (CT) versus CT alone on pain, functional limitations and the cross-sectional area (CSA) of the radial nerve (RN) in patients with lateral epicondylitis (LE). Methods: In this clinical trial, seventy subjects in the age group of 30–60 years with a clinical diagnosis of LE were recruited. Patients received an ultrasound-guided steroid injection and CT (Group A, n = 35) or CT alone (Group B, n = 35). Pain intensity (numeric pain rating scale), functional limitations (Quick Disabilities of the Arm, Shoulder, and Hand questionnaire) and the CSA of RN (mm2) using ultrasound were assessed at baseline, 4 and 12 weeks. Results: There was a significant difference in pain intensity (P < 0.05) at 4 weeks in favour of Group A but not at 12 weeks. A statistically significant difference was not present favouring either group concerning disability at both the follow-ups. The difference in CSA of the RN at the affected side in both groups A and B was not statistically significant at either the spiral groove or the antecubital fossa at baseline or the subsequent follow-ups. Conclusions: The CT with a steroid injection proved to be more efficacious in the short term concerning pain intensity and functional limitations. The RN thickness is not increased in patients with LE, thereby refuting its role to some extent in the pathogenesis of LE.
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Affiliation(s)
- Abhimanyu Vasudeva
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, Gorakhpur Gorakhpur, Uttar Pradesh, India
| | - Tejas K Patel
- Department of Pharmacology, All India Institute of Medical Sciences, Gorakhpur, Gorakhpur, Uttar Pradesh, India
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Abstract
INTRODUCTION Tumor necrosis factor alpha (TNF-α) mediated inflammation has been implicated, in knee osteoarthritis, despite being a predominantly degenerative condition. PATIENT CONCERNS A 56-year old female, a case of left knee pain not responding to conventional conservative strategies. DIAGNOSIS A diagnosis of primary osteoarthritis of the left knee, grade 3 osteoarthritis as per the Kellgren-Lawrence Scale was established. INTERVENTIONS She was administered an intra-articular injection of 10 mg of Adalimumab, a commonly used anti-TNF agent. OUTCOMES The patient was evaluated at baseline, 1 month, 3 months, and at 6 months. There was a marked improvement in pain intensity (visual analog scale) and quality of life, despite no objective change on the parameters seen on ultrasound of the knee. CONCLUSION Injection of adalimumab via the intra-articular route into the knee joint in primary osteoarthritis yields promising results.
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Affiliation(s)
- Abhimanyu Vasudeva
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences (AIIMS), Gorakhpur
| | | | - Srishti Nanda
- Pain research and TMS Laboratory, Department of Physiology, All India Institute of Medical Sciences (AIIMS), New Delhi
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Vasudeva A, Sahu S, Chanu AR, Chandra P, Babbar A. Rehabilitation Challenge in Congenital Lower Limb Deficiency: A Case Report. J Clin Diagn Res 2019. [DOI: 10.7860/jcdr/2019/39744.12729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Vasudeva A, Laisram N, Chanu AR. Effect of Botulinum Toxin Type A on Functional Mobility in Cerebral Palsy with Lower Limb Spasticity. J Clin Diagn Res 2018. [DOI: 10.7860/jcdr/2018/34639.11554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Neyaz O, Vasudeva A, Yadav SL. Maintaining ‘V-Contour’ of the Neck after Surgery for Neglected Congenital Muscular Torticollis in an Adult (A New Technique). J Clin Diagn Res 2018. [DOI: 10.7860/jcdr/2018/38116.12337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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