Nitin Gupta
@mmimsr.mmumullana.org
Associate Professor, Department of General Medicine
Maharishi Markandeshwar Institute of Medical Sciences & Research - [MMIMSR], Mullana,Ambala.Haryana(India)
EDUCATION
M.B.B.S, M.D(General Medicine)
RESEARCH INTERESTS
Neurology, Infectious disease, Drug resistance
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Nitin Gupta, Preethy Kathiresan, and Jitender Aneja
SAGE Publications
Prabha Chandra and Nitin Gupta
Medknow
Henal Shah and Nitin Gupta
SAGE Publications
Nitin Gupta and Hitesh Khurana
Medknow
Sumeet Gupta, Ogba Onwuchekwa, Lakshmi Ramana Alla, Richard K Morriss, Rachel Steele, and Nitin Gupta
Wiley
Savita Malhotra and Nitin Gupta
SAGE Publications
Nitin Gupta, Nishant Goyal, and Eesha Sharma
SAGE Publications
Learning disorder (LD), one of the most common neurodevelopmental disorders, affects 3% to 10% of children. It is characterized by poor academic skills that are quantifiably below those expected for an individual’s chronological age (at least 1.5 standard deviation below the age-wise population mean). Significant interference with academic and/or occupational performance or with activities of daily living is observed. LD is confirmed with standardized achievement measures and comprehensive clinical assessments. Learning difficulties are usually noticed during school years; however, they may not manifest till later, whenever demands in academics exceed an individual’s capacity.
RSrinivasa Murthy and Nitin Gupta
Medknow
Kashish Dutta, Varinder Saini, Nitin Gupta, and Kranti Garg
Medknow
Nitin Gupta, Nidhi Chauhan, and Prerna Sharma
SAGE Publications
The motivation to avoid pain and injury is a fundamental instinct, crucial to the survival of human beings and other living species. However, for the last 1 to 2 decades, there is an increasing number of individuals presenting to clinicians with self-injurious behavior but “without an intent to die.” This phenomenon of harming oneself without the intent to die is referred to as Non-suicidal Self Injury (NSSI). NSSI is defined as “the direct and deliberate destruction of one’s own bodily tissue in the absence of lethal intent and for reasons not socially sanctioned.”1 Accidental and indirect self-injurious behaviors such as disordered eating, drug abuse, suicidal behaviors, and socially accepted behaviors (tattooing, piercing, or religious rituals) do not form part of NSSI. The recognition of this behavior led researchers to include NSSI in section III of DSM 5 as a “condition in need of further study.” ICD-10 included NSSI either as a symptom of borderline personality disorder or as “intentional selfinjury with a sharp object (X78),” whereas, ICD-11 does not include it as a diagnostic entity. While some researchers criticize the defined dichotomy between NSSI and suicidal behaviors, others are of the view that NSSI and suicide should be understood as lying on a continuum of self-harming behaviors.
Subhash Das, Nitin Gupta, and Tanupreet Kaur
Medknow
Background: There are very few specialised hospital with quality assurance services catering to the needs of the elderly with mental illness. The concept of 'Appointment adherence' has received little attention in the field of geriatric mental health from India. There is a need to study the pattern of 'drop-out' amongst geriatric patients. Method: An initial cohort of first 105 cases presenting to the clinic were followed up to explore their socio-demographic and clinical variables, overall functioning and satisfaction with the services. Adopting a 'naturalistic approach,' and using the 'service evaluation framework', at the assessment period of about 36 months, tools like socio-clinical profile, Hindi Mental State Examination (HMSE), Everyday Abilities Scale for India (EASI), Global Assessment of Function (GAF) scale, WHOQOL-BREF-Hindi version, Patient Satisfaction Scale (PAT-SAT) and 'Service Evaluation (SSS-16 and SSS-10 Practitioner Versions)' were administered. Result: 68 cases were available for assessment of functional outcome and satisfaction parameters were assessed for 78 of the cases. 75% had functional disorders and medical morbidity was present in more than 50% of cases. The mean score for WHOQOL-BREF and GAF were 44.4 (poor quality of life) and 72.91 (slight impairment in socio-occupational functioning) respectively. PAT-SAT score in all the sub-categories were above average. 'Organic' diagnosis patients had lower QoL on certain domains compared to 'functional' patients. Only 30.47% patients were coming for follow-up with 25.71% having died. Of the 32/68 (34.29%) cases who had dropped out, 50% were adherent to treatment in different ways. Additionally, GAF scores were lower in 'drop-out' group. Conclusions: There is a relatively high rate of 'drop-out' over a 3-year period. However, if patients keep coming for follow-up (i.e. do not 'drop-out'), they are more likely to show improvement in their level of social and occupational functioning.
Nitin Gupta, Jitender Aneja, and Preethy Kathiresan
SAGE Publications
Richa Saroa, Divya Mehta, Sanjeev Palta, and Nitin Gupta
Medknow
Background and Aims: Studies comparing the effect of propofol and etomidate on hemodynamic parameters during electroconvulsive therapy (ECT) have shown ambiguous results. Although some studies observed a larger increase in blood pressure and heart rate during the use of etomidate than propofol in ECT, whereas some studies have shown no difference in hemodynamic parameters with the use of etomidate or propofol. Most of the studies done to compare the hemodynamic effects of etomidate and propofol were limited by small sample size or retrospective in nature. Therefore, we conducted a prospective randomized trial to compare the effects of etomidate and propofol on hemodynamics during ECT. Material and Methods: A prospective randomized crossover study was conducted on 30 patients with American Society of Anesthesiologist physical status I and II, between age 18 and 65 years, suffering from a mental disorder as per International Classification of Diseases-10 and requiring bilateral ECT as per clinical decision of consultant psychiatrist. They were randomized to receive both the drugs for their successive ECT sessions and were subjected to evaluation after clubbing together the ECT sessions of propofol or etomidate as anesthetic agent. Results: Duration of motor seizures was significantly more in patients receiving etomidate, whereas patients receiving propofol had more stable hemodynamics. Conclusion: Though propofol maintains stable hemodynamics during MECT, yet clinical applicability of etomidate outstrips it by a reasonable margin due to its better effect on seizure parameters.
Rosy Bala, Narinder Kaur, Nitin Gupta, Jyoti Chauhan, Ritu Garg, Harit Kumar, and Adesh K Saini
Journal of Pure and Applied Microbiology
The resistance to MLSB antibiotics, i.e. Macrolide-Lincosamide-Streptogramin B (MLSB), is an increasing problem among Methicillin-resistant Staphylococci. The resistance to macrolides can be by efflux mechanism or via inducible or constitutive resistance. Unfortunately, routine clindamycin susceptibility testing fails to detect the inducible resistance, which commonly results in treatment failure and necessitates incorporating a simple D-test to detect such resistance. A retrospective observational study was performed on S. aureus isolates from patients. The strains were subjected to antibiotic susceptibility testing followed by detection of mecA gene by a polymerase chain reaction and, the ‘D-test’ was performed to know the inducible resistance to clindamycin. A total of 235 isolates were identified as S. aureus. Antibiotic susceptibility test indicated 190 MRSA and 45 are sensitive to MLSB (MS). Inducible clindamycin resistance was found among 48 (20.4%) isolates and constitutive resistance in 104 (44.2%). MRSA strains had higher inducible and constitutive resistance than MSSA strains (22.1%, 51.6% and 13.3%, 13.3%, respectively). Clindamycin is a commonly used antibiotic in patients with MRSA infections to spare higher-end anti-MRSA antibiotics like linezolid and vancomycin. To detect inducible clindamycin to avoid treatment failures; the study showed the importance of incorporating the D-test in routine testing.
RSrinivasa Murthy and Nitin Gupta
Medknow
Shikha Tyagi, Akshit Katoch, Subhash Das, and Nitin Gupta
Medknow
Treatment gap in mental health is vast and continues to remain a grim reality. Amongst community mental health care, one approach available is home based care (HBC). However, HBC services are almost lacking in India. Nevertheless, the limited evidence points towards a successful utility of HBC till date. In this article, the Chandigarh experience of HBC is presented and discussed in detail in order to demonstrate its utility and effectiveness. Lastly, recommendations are provided for the future of HBC.
Rosy Bala, Narinder Kaur, Nitin Gupta, and Udit Narang
Journal of Pure and Applied Microbiology
Kocuria sp. may cause bacteremia, peritonitis, brain abscesses, meningitis, endocarditis, and acute cholecystitis in immunocompromised individuals. Recent reports identified Kocuria rosea in bacteremia associated with in dwelling intravenous lines, continuous dialysis fluids etc. We report on the case of bacteremia caused by K.rosea, a gram-positive microorganism in a 65-year-old female with a known case of end-stage renal disease on hemodialysis. After Piperacillin and Tazobactam antibiotic treatment, the patient got cured of fever and infection. This report presents a rare case of K.rosea bacteremia successfully treated with common antibiotics. Proper identification systems should be there to know the cause of bacteremia. The bacteremia cases with rare organisms should not be ignored.
Nitin Gupta
Medknow
Nitin Gupta, Parmod Kumar, Shubham Kamal, and Shubhangi Tuli
Medknow
The COVID-19 pandemic in India has been reported to be associated with numerous major mental health issues globally; the most common is – stress, anxiety, depressive symptoms, insomnia, denial, anger, and fear. This case series presents three different cases, wherein the COVID-19 pandemic resulted not only in deterioration of previous symptoms experienced by patients (obsessive–compulsive disorder and depression) but also led to the development of new symptoms specifically related to coronavirus (Psychosis). Authors highlight the need to develop preventive strategies for vulnerable groups and try to understand the etiopathogenesis of illnesses so developing, in order to identify support systems and management strategies during the pandemicrelated crisis.
Ajoy Tiwari, Dinesh Kumar, Mohammad S. Ansari, Santosh Kumar Chaubey, Nitin R. Gupta, Vivek Agarwal, Kumar Prafull Chandra, Arunkumar r Pande, Rajiv Awasthi, Mukulesh Gupta,et al.
Elsevier BV
Nitin Gupta, Mitthat Miglani, and BirSingh Chavan
Medknow
Background: Recently, the assessment of pain has been used as a parameter to differentiate adolescents who indulge in deliberate self-harm from healthy individuals. Aims and objectives: The present study was conducted to compare pain sensitivity between three groups, i.e., nonsuicidal self-injury/nonsuicidal self-harm (NSSI), suicide attempters (SA), and matched healthy control (NSSI, SA, and healthy controls). Materials and Methods: Ninety participants (30-NSSI, 30-SA, and 30 matched control) between the age of 10 and 25 years were inducted from the individuals who came for help at the outdoor and emergency services for recent self-harm. Pain sensitivity was assessed by cold pain stimulation test through a cold pressor task. Results: Pain threshold, pain tolerance, total pain index as well as pain experience intensity were significantly different in the three groups. Conclusion: Participants who indulge in NSSI and SA have significantly higher pain threshold, pain tolerance, total pain index, and pain experience intensity as compared to healthy control. Although all the pain parameters were higher in the NSSI group as compared to SA group, the difference did not reach to significant level.