Max Healthcare

About: Max Healthcare is a healthcare organization based out in New Delhi, India. It is known for research contribution in the topics: Population & Medicine. The organization has 391 authors who have published 410 publications receiving 14404 citations.

CoViD-19 Epidemic in India and Projections: Is Relief in Sight?

Abstract: Background Projection of cases and deaths in an epidemic such as CoViD-19 is hazardous and the early projections were way-off the actual pattern. However, we now have actual data for more than 50 consecutive days in India that can be effectively used for projection. Methods We closely track the trend and use the same pattern for projection. We call this Empirical Model. We also fit a Theoretical Model based on a Gamma function on the pattern of some of the previous epidemics. Results The Empirical Model predicts the peak around the fourth week of May and the near end of the epidemic by the end of June 2020. The maximum number of active cases is likely to be nearly 75,000 during the second week of June. This would mean a peak demand of nearly 15,000 beds and nearly 4000 ventilators. The case-fatality based on those who have reached an outcome was nearly 10% in the first week of May and is likely to remain at this level for some time. Theoretical Model projected a peak of nearly 2500 new cases per day in the second week of May that seems to have been already breached. This model predicts the near end of the epidemic by the middle of July 2020. Conclusion With the current trend, the end of the epidemic is in sight with relatively mild consequences in India compared with most other countries.

Assessment of Correlation between Craniofacial Proportions and Genetic Indicators.

Abstract: Aim and objective To assess correlation among craniofacial proportions and genetic indicators using estrogen receptors (ESR1 and ESR2). Materials and methods A total of 128 patients undergoing orthodontic treatment with age range 12-18 years of both genders were included. Lateral cephalogram of all subjects were taken. Vertical and sagittal parameters were studied on these cephalogram. Saliva was used for DNA extraction. Real-time polymerase chain reaction was performed for assessment of genetic indicators in ESR1 (rs9340799 and rs2234693) and in ESR2 (rs4986938 and rs1256049). Results The mean SN cranial base was 68.4 mm, ANB (sagittal jaw relationship) was 2.8°, Ptm-A maxillary length was 46.2 mm, Go-Pg (mandibular body length) was 68.2 mm, Co-Gn (total mandibular length) was 112.8 mm, lower anterior facial height (ANS-Me) was 58.4 mm, N-Me (total anterior facial height) was 108.4 mm, lower posterior facial height (Co-Go) was 58.7 mm, and S-Go (total posterior facial height) was 72.4 mm. It was found that rs4986938 in ESR2 was linked with S-N dimension, with patients having CC genotype possessing negative correlation values (p value 0.05). Similarly, CC genotype possessed minimum mandibular body dimension, and it was found that rs4986938 in ESR2 was also linked with Go-Pg dimension (p value = 0.02). We found reduction in the ANS-Me values in patients with CC genotype in ESR1 rs2234693 (p value = 0.02), whereas there was no correlation of rest genotype with other craniofacial measurements (p value > 0.05). Conclusion Evaluation of ESR1 and ESR2 may show role of genetic markers in disparity of craniofacial dimensions in individuals. Clinical significance This study provides an outlay and supports the concept of possible correlation between genetic markers and craniofacial measurements.

Comparison of single dose versus multiple doses of antibiotic prophylaxis in elective caesarean section

Abstract: Background: Infectious complications after caesarean delivery (CD) are a substantial cause of maternal morbidity, increase in hospital stay and treatment cost. The spectrum of these complications’ spreads from fever, wound infection, endometritis, urinary tract infection, and some serious complications like pelvic abscess, septic shock and septic pelvic vein thrombophlebitis. To prevent these prophylactic antibiotics have been used however the use of antibiotics should be judicious. Aim was to compare the efficacy of single dose versus multiple doses of antibiotics in elective caesarean section.Methods: This study was conducted in a tertiary care hospital from December 2017 to May 2020. It was a prospective case control study. Sample size was 600, patients were randomly allocated in two groups A and B by card method. Pregnancy category B drug “cefuroxime” was given.Results: Incidence of SSI was 2.7% (n=8) in single dose group and 3% (n=9) in multi-dose group, this difference was not statistically significant. Incidence of fever for more than 48 hours was 1.3% (n=4) in the single dose group and 0.6% (n=2) in multi-dose group, this difference was not statistically significant. Urine R/M for all patients on 3rd post-operative day, in single dose group 2.3% (n=7) patients and in multi-dose group 2.0 % (n=6) patients had more than 5 pus cells. Patients, who had more than 5 pus cells in urine R/M, were subjected to urine culture and sensitivity. Four (1.40%) patients in single dose group had positive cultures (E. coli was detected in three patients and Klebsiella pneumoniae in one) and three (1.0%) patients, in multi dose group, (all the three patients had E. coli in growth). These results were statistically not significant.Conclusions: Single dose antibiotic prophylaxis was found to be comparable to multi-dose antibiotics in our study. Hence it is advocated that single dose antibiotic can be given in elective caesarean section as it is cost effective and as efficient as multi-dose regimen, ensures complete compliance and minimizes side effects and cut-down nursing work-load.

Prevalence of nafld among healthy liver donors

Abstract: NAFLD is hepatic pandemic of the twenty rst century, being leading cause of chronic hepatic disease in western world. We did a cross sectional study to nd out prevalence of NAFLD among prospective healthy liver donors at a tertiary care hospital at New Delhi, India over a period from June 2014 to March 2016. 124 apparently healthy prospective liver donors were selected. Exclusion criteria were set to exclude all those who had signicant history of alcohol intake (dened as greater than 30g/day for men and greater than 20g/day for women over last two years), Hepatitis B or C infection, severe surgical weight loss or emaciation, Obstructive Sleep Apnea, Celiac disease, history of drug intake known to cause hepatic steatosis. Out of 124 prospective liver donors included in this study, 29 (23%) donors were found to have fatty liver on USG abdomen; 38 (31%) donors had fatty liver on unenhanced CTof the abdomen (LAI of ≤ 5 HU); 61 (49%) donors had fatty liver on magnetic resonance.