Hemraj Pal

Publications (12)15.81 Total impact

• Article: Assessment of social support in HIV-positive individuals attending a tertiary care center.

  Debashis Nath, Naveet Wig, Nitin Mishra, Sajan Jiv Singh Nagpal, Madhu Vajpayee, Hemraj Pal, C S Pandav
  Indian Journal of Sexually Transmitted Diseases and AIDS 01/2010; 31(1):56-7.
• Article: Endoscopic or percutaneous biliary drainage for gallbladder cancer: a randomized trial and quality of life assessment.

  Sundeep Singh Saluja, Manpreet Gulati, Pramod Kumar Garg, Hemraj Pal, Sujoy Pal, Peush Sahni, Tushar K Chattopadhyay
  [show abstract] [hide abstract]
  ABSTRACT: Background & Patients with carcinoma of the gallbladder (GBC) and obstructive jaundice are usually not amenable to curative resection. Effective palliation by biliary decompression is the goal of treatment. Endoscopic stenting (ES) and percutaneous transhepatic biliary drainage (PTBD) can provide biliary decompression. We compared unilateral PTBD and ES in patients with a hilar block caused by GBC and assessed their quality of life (QOL). Consecutive patients with GBC not suitable for curative resection with Bismuth type 2 or 3 block were randomized to either PTBD or ES with a 10F plastic stent. Technical success, successful drainage, early cholangitis, complications, procedure-related mortality, 30-day mortality, survival, and QOL before and 1 and 3 months after stenting were compared between the 2 groups. All patients were followed up until death. Fifty-four patients were randomized to PTBD or ES (27 each). Successful drainage was better in the PTBD group (89% vs 41%; P < .001). Early cholangitis was significantly higher in the ES group (48% vs 11%; P = .002). Procedure-related (4% vs 8%) and 30-day mortality (4% vs 8%) and median survival were similar (60 days in both; P = .71). Although the World Health Organization-Quality of Life 1- and 3-month physical and psychological scores were better after PTBD, the difference was not significant. The European Organization for Research and Treatment of Cancer (EORTC)-Quality of Life Questionnaire 30 global health status at 3 months was significantly better after PTBD (75 vs 30.5, P = .02). The EORTC symptom scores improved in both groups, but only fatigue was significantly better after PTBD. PTBD provides better biliary drainage and has lower complication rates in patients with GBC and hilar block.
  Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association 06/2008; 6(8):944-950.e3. · 5.64 Impact Factor
• Article: Tetralogy of Fallot in teenagers and adults: surgical experience and follow-up.

  Akshay Kumar Bisoi, John Santosh Kumar Murala, Balram Airan, Ujjwal Kumar Chowdhury, Shyam Sunder Kothari, Hemraj Pal, Chetan D Patel, Cheemalapati Sai Krishna, Sai Krishna Cheemalapati, Sandeep Chauhan, Venugopal Panangipalli
  [show abstract] [hide abstract]
  ABSTRACT: The aim of this study was to review short- and long-term outcomes following total correction in patients with tetralogy of Fallot that presented during adulthood. It was a retrospective analysis of 284 patients (aged 14-50 years, mean 19.4 +/- 2.5 years) with tetralogy of Fallot who underwent total correction at our institution between January 1991 and December 2001. Thirty patients were subjected to postoperative first-pass radionuclide angiocardiography scans. A Hindi version of the standard World Health Organization quality of life proforma was mailed to 120 patients operated on during the first half of the study period. Altogether, 45 (15.8%) patients had palliative shunts, and 32 (11%) had preoperative coil embolization. The transatrial/transpulmonary artery approach was used in 62 (22%) patients, the transventricular approach in 86 (30%) patients, and a combined approach in 136 (48%) patients. A transannular pericardial patch was used in 200 (70%) patients. A total of 61 (21%) patients had nonfatal complications. There were 28 hospital deaths. Follow-up ranged from 1 month to 10 years (mean 4.6 +/- 2.3 years). There were 7 (2.5%) late deaths and 6 (2.1%) reoperations. Altogether, 94% of patients were in New Yk Heart Association (NYHA) class I. Radionuclide angiocardiography showed normal right ventricular and left ventricular function in 18 (60%) and 22 (73%) patients, respectively. All of the 66 respondents perceived an improved quality of life. The actuarial survival and freedom from reoperation at 10 years were 82.88% +/- 3.80% and 92.82% +/- 3.40%, respectively. Total correction in this subset of patients offers the best option for long-term symptom-free survival.
  General Thoracic and Cardiovascular Surgery 04/2007; 55(3):105-12.
• Article: The impact of HIV/AIDS on the quality of life: a cross sectional study in north India.

  Naveet Wig, Raja Lekshmi, Hemraj Pal, Vivek Ahuja, Chander Mohan Mittal, Sunil Kumar Agarwal
  [show abstract] [hide abstract]
  ABSTRACT: To determine the impact of Human Deficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) on the quality of life (QOL) on such patients in North India. A cross sectional study. Outpatient setting and wards, Department of Medicine at a premier tertiary health care center, North India. Sixty-eight consecutive HIV/AIDS patients attending Medicine out patient department and/or admitted to the wards of All India Institute of Medical Sciences were administered a structured questionnaire by the HIV nurse coordinator. QOL was evaluated using the WHOQOL-Bref (Hindi) instrument. One way Analysis of Variance (ANOVA) was performed to find out significant difference between the clinical categories and socio-demographic variables on QOL domains. The overall QOL mean score on a scale of 0-100 was found to be 25.8. Similarly, on the scale of 0-100 the mean scores in the four domains of QOL in descending order were social (80.9); psychological (27.5); physical (17.7) and environmental domain (11.65). There was a significant difference of quality of life in the physical domain between asymptomatic patients (14.6) and patients with AIDS (10.43) defining illnesses (p< 0.001) and asymptomatic and early symptomatic (12) patients (p=0.014). QOL in the psychological domain was significantly poorer in early symptomatic (12.1) (p< 0.05) and AIDS patients (12.4) (p< 0.006) as compared to asymptomatic individuals (14.2). A significant difference in QOL scores in the psychological domain was observed with respect to the educational status (p< 0.037) and income of patients (p< 0.048). Significantly better QOL scores in the physical (p< 0.040) and environmental domain (p< 0.017) were present with respect to the occupation of the patients. Patients with family support had better QOL scores in environmental domain. In our study, QOL is associated with education, income, occupation, family support and clinical categories of the patients.
  Indian Journal of Medical Sciences 01/2006; 60(1):3-12.
• Article: The impact of HIV/AIDS on the quality of life: A cross sectional study in north India

  Naveet Wig, Raja Lekshmi, Hemraj Pal, Vivek Ahuja, Chander Mittal, Sunil Agarwal
  [show abstract] [hide abstract]
  ABSTRACT: objective: To determine the impact of Human Deficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS) on the quality of life (QOL) on such patients in North India. Design: A cross sectional study. Setting: Outpatient setting and wards, Department of Medicine at a premier tertiary health care center, North India. Participants: Sixty-eight consecutive HIV/AIDS patients attending Medicine out patient department and/or admitted to the wards of All India Institute of Medical Sciences were administered a structured questionnaire by the HIV nurse coordinator. QOL was evaluated using the WHOQOL-Bref (Hindi) instrument. Analysis: One way Analysis of Variance (ANOVA) was performed to find out significant difference between the clinical categories and socio-demographic variables on QOL domains. Results: The overall QOL mean score on a scale of 0-100 was found to be 25.8. Similarly, on the scale of 0-100 the mean scores in the four domains of QOL in descending order were social (80.9); psychological (27.5); physical (17.7) and environmental domain (11.65). There was a significant difference of quality of life in the physical domain between asymptomatic patients (14.6) and patients with AIDS (10.43) defining illnesses (p<0.001) and asymptomatic and early symptomatic (12) patients (p=0.014). QOL in the psychological domain was significantly poorer in early symptomatic (12.1) (p<0.05) and AIDS patients (12.4) (p<0.006) as compared to asymptomatic individuals (14.2). A significant difference in QOL scores in the psychological domain was observed with respect to the educational status (p<0.037) and income of patients (p<0.048). Significantly better QOL scores in the physical (p<0.040) and environmental domain (p<0.017) were present with respect to the occupation of the patients. Patients with family support had better QOL scores in environmental domain. Conclusions: 0 In our study, QOL is associated with education, income, occupation, family support and clinical categories of the patients.
  Indian Journal of Medical Sciences. 01/2006;
• Article: Quality of life in Indian patients with rheumatoid arthritis.

  Gurdesh S Bedi, Nikhil Gupta, Rohini Handa, Hemraj Pal, R M Pandey
  [show abstract] [hide abstract]
  ABSTRACT: Rheumatoid arthritis (RA) is a multisystem disease with various extra-articular manifestations (EAMs). Health-related quality of life (HRQOL) issues are assuming increasing importance in chronic rheumatic diseases like RA. No data on QOL in RA is available from the Indian subcontinent. There is also a paucity of literature on the impact of EAMs on HRQOL in RA. The objective of this study was to address these lacunae. The study group comprised 81 patients with RA from a rheumatology clinic in India. Quality of life was estimated by the generic HRQOL measure: World Health Organization quality of life instrument (WHOQOL-Bref). Disease activity in RA was measured by calculating Disease Activity Score-28 (DAS28). The mean HRQOL scores of the patients were 12.0+/-2.8, 13.2+/-2.7, 14.4+/-2.9 and 13.3+/-2.6 in the physical, psychological, social, and environmental domains of the WHOQOL-Bref respectively. Age, gender, disease duration, educational status, constitutional symptoms, rheumatoid factor positivity, erosions and deformities did not influence HRQOL. Disease activity had a negative influence on the physical and psychological domains. Patients with EAMs had significantly higher DAS28 scores compared to patients without EAMs. Even after adjustment for disease activity, patients with EAMs had lower HRQOL scores than patients without these features (statistically significant for physical domain). The physical domain of HRQOL is most affected in Indian patients with RA. Increasing disease activity and presence of EAMs worsens the quality of life.
  Quality of Life Research 11/2005; 14(8):1953-8. · 2.30 Impact Factor
• Article: Quality of life measures in lung cancer

  Mohan Anant, Randeep Guleria, Ashutosh Pathak, Manisha Bhutani, Hemraj Pal, Mohan Charu, V Kochupillai
  [show abstract] [hide abstract]
  ABSTRACT: Lung cancer is one of the leading causes of cancer death worldwide. Survival has not improved significantly in spite of newer therapies. In view of the high-symptom burden and severe morbidity, evaluation of quality of life (QOL) becomes important in these patients. Several instruments are now available for this purpose, and have demonstrated good correlation with performance status, symptoms, and survival. Quality of life assessments also help in comparing different therapeutic regimes, thus allowing selection of the appropriate modality. Problems of inconsistent interpretability and high-patient dropout rate poses a challenging problem that needs to be tackled. In spite of these drawbacks, QOL is now considered to be an essential component of lung cancer management and should be performed routinely. Such a practice will help the physician plan appropriate treatment strategies and set practical therapeutic goals.
  Indian Journal of Cancer. 01/2005;
• Article: Psychiatric Co-morbidty Associated With Pheniramine Abuse And Dependence

  Hemraj Pal, Rajesh Kumar, Shashi Bhushan, Neeraj Berry
  Indian Journal of Psychiatry. 01/2005;
• Source

  Available from: gacguidelines.ca

  Article: Post-marketing surveillance of buprenorphine.

  Rajat Ray, Hemraj Pal, Rajesh Kumar, Pallab Maulick, R Mangla
  [show abstract] [hide abstract]
  ABSTRACT: This study was undertaken to evaluate the adverse consequences of recently introduced higher strength (0.4 and 2.0 mg per tablet) buprenorphine in Indian market. Buprenorphine, a partial opiate agonist and antagonist, is an emerging alternative to methadone as an agent for long-term treatment of opiate dependence. The current investigation was conducted through a multi-centric post-marketing surveillance (PMS) study using a structured performa from patients receiving buprenorphine as routine therapy from de-addiction centres. Evaluation included subjective and objective assessments and recording of adverse events. Of the 5551 observations from ten centres, common subjective symptoms were generalised weakness (48.9%), sense of high (euphoria) (44.5%), muscle aches (39.5%) and relief from pain (37.2%). About 5% observations recorded systolic hypertension. Among 55 subjects where laboratory tests were conducted, 12 showed raised levels of AST ad 9 had elevated ALT. Twelve adverse events reported included seizure, epistaxis, panic attacks, constipation and dyspnoea. Significant relation was seen between duration of use and time since last dose, and total number of subjective symptoms reported. Majority of the adverse effects could be understood as either effects related to intoxication or withdrawal from agonists.
  Pharmacoepidemiology and Drug Safety 10/2004; 13(9):615-9. · 2.53 Impact Factor
• Article: Molecular genetics of schizophrenia: a critical review.

  Neeraj Berry, Vaidehi Jobanputra, Hemraj Pal
  [show abstract] [hide abstract]
  ABSTRACT: We present an overview of current progress and future directions in the molecular genetics of schizophrenia. We review linkage studies, involving the genome-wide scan of chromosomes with closely spaced polymorphic markers, and association studies of candidate genes, identified on the basis of receptors, neurotransmitters and response to certain drugs. The limitations of the research methodology involved in analyzing such a complex disorder are discussed, as are methods to strengthen this methodology with newer statistical and technological advances to give results that are replicable, statistically significant and applicable to a wider population. A greater understanding of the genetic mechanisms and the application of pharmacogenetics would lead to improvements in therapeutic interventions.
  Journal of psychiatry & neuroscience: JPN 12/2003; 28(6):415-29. · 5.34 Impact Factor
• Source

  Available from: Anant Mohan

  Article: Quality of life measures in lung cancer.

  Mohan Anant, Randeep Guleria, Ashutosh K Pathak, Manisha Bhutani, Hemraj Pal, Mohan Charu, V Kochupillai
  [show abstract] [hide abstract]
  ABSTRACT: Lung cancer is one of the leading causes of cancer death worldwide. Survival has not improved significantly in spite of newer therapies. In view of the high-symptom burden and severe morbidity, evaluation of quality of life (QOL) becomes important in these patients. Several instruments are now available for this purpose, and have demonstrated good correlation with performance status, symptoms, and survival. Quality of life assessments also help in comparing different therapeutic regimes, thus allowing selection of the appropriate modality. Problems of inconsistent interpretability and high-patient dropout rate poses a challenging problem that needs to be tackled. In spite of these drawbacks, QOL is now considered to be an essential component of lung cancer management and should be performed routinely. Such a practice will help the physician plan appropriate treatment strategies and set practical therapeutic goals.
  Indian Journal of Cancer 42(3):125-32.
• Article: Psychiatric co-morbidity associated with pheniramine abuse and dependence

  Hemraj Pal, Rajesh Kumar, Shashi Bhushan, Neeraj Berry
  [show abstract] [hide abstract]
  ABSTRACT: The abuse of cough syrups containing antihistamines and codeine is being increasingly noted. The abuse of antihistamines alone has also been reported. The use of antihistamines alone or in combination with other substances of abuse may predispose individuals to develop psychiatric symptoms or syndromes as a part of intoxication, withdrawal or as co-morbid conditions. We present two case reports to highlight the occurrence of co-morbid psychopathology in association with antihistamine abuse and dependence.