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1.  Consensus & Evidence-based INOSA Guidelines 2014 (First edition) 
Obstructive sleep apnoea (OSA) and obstructive sleep apnoea syndrome (OSAS) are subsets of sleep-disordered breathing. Awareness about OSA and its consequences amongst the general public as well as the majority of primary care physcians across India is poor. This necessiated the development of the INdian initiative on Obstructive sleep apnoea (INOSA) guidelines under the auspices of Department of Health Research, Ministry of Health & Family Welfare, Government of India. OSA is the occurrence of an average five or more episodes of obstructive respiratory events per hour of sleep with either sleep related symptoms or co-morbidities or ≥ 15 such episodes without any sleep related symptoms or co-morbidities. OSAS is defined as OSA associated with daytime symptoms, most often excessive sleepiness. Patients undergoing routine health check-up with snoring, daytime sleepiness, obesity, hypertension, motor vehicular accidents and high risk cases should undergo a comprehensive sleep evaluation. Medical examiners evaluating drivers, air pilots, railway drivers and heavy machinery workers should be educated about OSA and should comprehensively evaluate applicants for OSA. Those suspected to have OSA on comprehensive sleep evaluation should be referred for a sleep study. Supervised overnight polysomnography (PSG) is the “gold standard” for evaluation of OSA. Positive airway pressure (PAP) therapy is the mainstay of treatment of OSA. Oral appliances are indicated for use in patients with mild to moderate OSA who prefer oral appliances to PAP, or who do not respond to PAP or who fail treatment attempts with PAP or behavioural measures. Surgical treatment is recommended in patients who have failed or are intolerant to PAP therapy.
PMCID: PMC4248396  PMID: 25366217
Bariatric surgery; CPAP; Indian guidelines; OSA; OSAS; polysomnography; sleep apnoea; sleep study; Syndrome Z
2.  Standardization of Sulaharan Yoga: An Ayurvedic Tablet Formulation 
Quality assurance of herbal products may be ensured by proper quality control of the herbal ingredients and by means of good manufacturing practice. We have developed a simple scheme for the standardization and authentication of Sulaharan Yoga a poly herbal formulation. Sulaharan Yoga was prepared as per Ayurvedic Formulary of India. In-house and marketed preparation has been standardized on the basis of organoleptic characters, physical characteristics and physico-chemical properties. The set parameters were found to be sufficient to standardize the Sulaharan Yoga and can be used as reference standards for the quality control/ quality assurance study.
doi:10.4103/0250-474X.89758
PMCID: PMC3224411  PMID: 22131623
Organoleptic characters; physicochemical parameters; standardization; traditional medicine
3.  Ethnomedicinal plants used by the Paroja tribe of Koraput 
Ancient Science of Life  2010;30(2):42-46.
This paper reports the ethno-medicinal uses of 30 plants by the Paroja tribes of Koraput, Odisha. All the plants were enumerated with botanical name, family name, local name, short description of the plant and information on ethnic use.
PMCID: PMC3336276  PMID: 22557424
4.  Pleural fluid MDA and serum-effusion albumin gradient in pleural effusion 
Pleural fluid malondialdehyde (PMDA) and serum effusion albumin gradient(SEAG) were estimated in 60 patients of pleural effusion of diverse etiologies. The results were compared with Light’s criteria to distinguish between transudates and exudates. The mean PMDA level was 0.68±0.24nmol/ml and 1.17±0.25nmol/ml in transudates and exudates respectively showing a statistically significant (p<0.05) rise in exudates in comparison to transudates. SEAG registered a significant fall in exudates (P<0.001) when compared with transudates. PMDA revealed a positive correlation with pleural protein(r=+0.30) and a significant negative association with SEAG (r= −0.33).Sensitivity and specificity of PMDA were better than the parameters of Light’s criteria. Whereas SEAG documented approximately equal sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) with Light’s criteria. Therefore PMDA and SEAG can be taken together in addition to Light’s criteria to strengthen the discrimination between transudates and exudates in borderline cases of pleural effusion.
doi:10.1007/s12291-008-0019-1
PMCID: PMC3453668  PMID: 23105727
Pleural Fluid; Exudates; Transudates
5.  Evaluation of oxidative stress in pregnancy induced hypertension 
This work was undertaken to investigate correlation between oxidative stress and initiation of pathogenesis of pregnancy induced hypertension (PIH). Fifty primigravidae in age group of 20–35 years and gestational age 28–42 weeks with PIH were taken as cases. Twenty healthy primigravidae with no medical and surgical complications of pregnancy and with blood pressure ≤140/90 mm Hg served as controls. The cases were again subgrouped as severe preeclampsia (12 in number) and mild pre-eclampsia (38 in number). All of them were evaluated for serum malondialdehyde (MDA), Serum vitamin E and plasma vitamin C levels. The serum MDA levels were raised significantly in women with mild preeclampsia (P<0.01) and in women with severe preeclampsia (P<0.01) in comparison to normal primi gravida. The serum vitamin E levels were decreased in primi gravida with mild preeclampsia (p<0.1) and in primi with severe pre eclampsia (P<0.1) in comparison to normal primi gravida but the fall was not statistically significant. There was a significant fall (P<0.05) in the vitamin C levels in primi with mild preeclampsia than in the normal primi. The vitamin C levels in severe preeclamptic patients were lower than the normal primi but the fall was not statistically significant (P=0.10). The serum MDA and vitamin E showed a negative correlation in all the cases. The serum MDA and plasma vitamin C also showed a negative correlation in the control and study group. This observation suggests that in hypertensive disorders of pregnancy there is an imbalance between lipid peroxidation and antioxidant vitamin status because of oxidative stress. The decreased serum concentrations of the antioxidant vitamins supports the hypothesis that lipid peroxidation is an important causative factor in the pathogenesis of preeclampsia. The rise in antioxidants is probably to compensate the increased peroxide load in severe preeclampsia.
doi:10.1007/BF02913074
PMCID: PMC3453780  PMID: 23105577
Lipid peroxides; vitamin E; ascorbic acid
6.  Evaluating role of oxidative stress in determining the pathogenesis of falciparum malaria induced acute renal failure 
Serum malondialdehyde was measured in sixty-one falciparum malaria cases, which include thirty uncomplicated, and thirty-one complicated with acute renal failure. Twenty-six healthy individuals were also studied as controls. Serum malondialdehyde level was found to be significantly elevated in falciparum malaria induced acute renal failure cases when compared with uncomplicated falciparum malaria (p<0.001) and healthy controls (p<0.001). A positive correlation with the raised urea, creatinine and bilirubin levels were significant (r=0.62, p<0.025; r=0.65, p<0.05 and r=0.72, p<0.001 respectively) indicating the severity of complication with rise of lipid peroxides in falciparum malaria induced acute renal failure cases.
doi:10.1007/BF02872399
PMCID: PMC3453903  PMID: 23105436
Acute renal failure; Falciparum malaria; Reactive oxygen species; Malondialdehyde
7.  STEVENS JOHNSON SYNDROME DURING TREATMENT WITH LITHIUM AND VALPROATE IN MOOD DISORDER: A REPORT OF TWO CASES 
Indian Journal of Psychiatry  2002;44(3):301-302.
Very rarely Stevens Johnson Syndrome develops following drug therapy particularly Lithium and Valproate. Worldwide, the reports regarding Lithium and Valproate induced Stevens Johnson Syndrome are very few. Here, we present two cases of Stevens Johnson Syndrome following treatment with Lithium and Valproate for Mood Disorder.
PMCID: PMC2954405  PMID: 21206589
Stevens Johnson Syndrome; Lithium; Valproate
8.  Concurrent preputial calculi and penile carcinoma--a rare association. 
Postgraduate Medical Journal  1989;65(762):256-257.
A case of concurrent preputial calculi and carcinoma of the penis is reported. The causal relationship of both the lesions is still controversial and the possible common aetiopathogenesis of the entity is discussed.
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PMCID: PMC2429261  PMID: 2594604

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