Publications by authors named "Baldeep Singh"

22 Publications

  • Page 1 of 1

Identification and validation of potent Mycobacterial proteasome inhibitor from Enamine library.

J Biomol Struct Dyn 2021 May 6:1-11. Epub 2021 May 6.

Centre for Drug Design Discovery and Development (C4D), SRM University, Delhi NCR, Sonepat, India.

As a consequence of present status of tuberculosis (TB) it is the obligation to develop novel targets and potential drugs so that rate of drug resistant TB can be declined. Mycobacterium proteasome is considered to be significant target for the purpose of drug designing as it is responsible for resisting the effect of NO (nitric oxide) immune system defence mechanism against the bacterial cells. Small compounds library from Enamine database has already been tested using virtual screening and molecular docking studies. Further a reanalysis with two picked out significant compounds Z1020863610, Z106766984 was carried out using molecular dynamic simulation studies and in vitro validations ( susceptibility assay, enzyme inhibition assay and MTT assay). outcome that two inhibiters were interacting at the active site pocket of receptor with high stability, was found to be very consistent with results. So it was conferred that compounds (Z1020863610, Z106766984) are potential lead for future process of drug development ( testing and clinical trials).Communicated by Ramaswamy H. Sarma.
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http://dx.doi.org/10.1080/07391102.2021.1914173DOI Listing
May 2021

Building Bridges Between Community Health Centers and Academic Medical Centers in a COVID-19 Pandemic.

J Am Board Fam Med 2021 Feb;34(Suppl):S229-S232

From the Division of Primary Care & Population Health, Stanford University School of Medicine, Stanford, California (NKT, MM, BS, SC, SMA, JGS); Roots Community Health Center, Oakland, California (NKT, NA); Stanford Health Care, Stanford, California (TS-M); Center for Innovation to Implementation, VA Palo Alto Health Care System, Palo Alto, California (SMA); Ravenswood Family Health Center, East Palo Alto, California (JGS).

The threat to the public health of the United States from the COVID-19 pandemic is causing rapid, unprecedented shifts in the health care landscape. Community health centers serve the patient populations most vulnerable to the disease yet often have inadequate resources to combat it. Academic medical centers do not always have the community connections needed for the most effective population health approaches. We describe how a bridge between a community health center partner (Roots Community Health Center) and a large academic medical center (Stanford Medicine) brought complementary strengths together to address the regional public health crisis. The 2 institutions began the crisis with an overlapping clinical and research faculty member (NKT). Building on that foundation, we worked in 3 areas. First, we partnered to reach underserved populations with the academic center's newly developed COVID test. Second, we developed and distributed evidence-based resources to these same communities via a large community health navigator team. Third, as telemedicine became the norm for medical consultation, the 2 institutions began to research how reducing the digital divide could help improve access to care. We continue to think about how best to create enduring partnerships forged through ongoing deeper relationships beyond the pandemic.
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http://dx.doi.org/10.3122/jabfm.2021.S1.200182DOI Listing
February 2021

The COVID-19 Pandemic as an Opportunity for Operational Innovation at 2 Student-Run Free Clinics.

J Prim Care Community Health 2021 Jan-Dec;12:2150132721993631

Stanford University School of Medicine, Stanford, CA, USA.

The onset of the COVID-19 pandemic and subsequent county shelter-in-place order forced the Cardinal Free Clinics (CFCs), Stanford University's 2 student-run free clinics, to close in March 2020. As student-run free clinics adhering to university-guided COVID policies, we have not been able to see patients in person since March of 2020. However, the closure of our in-person operations provided our student management team with an opportunity to innovate. In consultation with Stanford's Telehealth team and educators, we rapidly developed a telehealth clinic model for our patients. We adapted available telehealth guidelines to meet our patient care needs and educational objectives, which manifested in 3 key innovations: reconfigured clinic operations, an evidence-based social needs screen to more effectively assess and address social needs alongside medical needs, and a new telehealth training module for student volunteers. After 6 months of piloting our telehealth services, we believe that these changes have made our services and operations more robust and provided benefit to both our patients and volunteers. Despite an uncertain and evolving public health landscape, we are confident that these developments will strengthen the future operations of the CFCs.
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http://dx.doi.org/10.1177/2150132721993631DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7900784PMC
February 2021

Methemoglobinemia - The Cryptic Cause of Dyspnoea.

J Assoc Physicians India 2018 Sep;66(9):95-96

Resident, Dept. of Medicine, Bharati Vidyapeeth Deemed University Medical College, Pune, Maharashtra, India.

Methemoglobinemia is a life threatening condition that can be difficult to diagnose. It can be congenital or, more often an adverse drug effect. A good, detailed history taking and thorough knowledge of drugs and toxins is the secret to early diagnosis. We present two interesting cases of methemoglobinemia. First was phenol poisoning with G6PD deficiency leading to hemolysis and methemoglobinemia and second was phenol induced methemoglobinemia. Here we discuss the diagnosis and management of a patient with acquired methemoglobinemia.
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September 2018

An Analysis of Lung Cancer Screening Beliefs and Practice Patterns for Community Providers Compared to Academic Providers.

Cancer Control 2018 Jan-Dec;25(1):1073274818806900

11 Division of Pulmonary & Critical Care Medicine, USF Health Morsani College of Medicine, Tampa, FL, USA.

Despite guidelines recommending annual low-dose computed tomography (LDCT) screening for lung cancer, uptake remains low due to the perceived complexity of initiating and maintaining a clinical program-problems that likely magnify in underserved populations. We conducted a survey of community providers at Federally Qualified Health Centers (FQHCs) in Santa Clara County, California, to evaluate provider-related factors that affect adherence. We then compared these findings to academic providers' (APs) LDCT screening knowledge, behaviors, and attitudes at an academic referral center in the same county. The 4 FQHCs enrolled care for 80 000 patients largely of minority descent and insured by Medi-Cal. Of the 75 FQHC providers (FQHCPs), 36 (48%) completed the survey. Of the 36 providers, 8 (22%) knew screening criteria. Fifteen (42%) FQHCPs discussed LDCT screening with patients. Compared to 36 APs, FQHCPs were more concerned about harms, false positives, discussion time, patient apathy, insurance coverage, and a lack of expertise for screening and follow-up. Yet, more FQHCPs thought screening was effective (27 [75%] of 36) compared to APs ( P = .0003). In conclusion, provider knowledge gaps are greater and barriers are different for community clinics caring for underserved populations compared to their academic counterparts, but practical and scalable solutions exist to enhance adoption.
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http://dx.doi.org/10.1177/1073274818806900DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6210633PMC
April 2019

Identifying Opportunities to Improve Intimate Partner Violence Screening in a Primary Care System.

Fam Med 2018 10;50(9):702-705

Division of Primary Care and Population Health, Department of Medicine, Stanford University School of Medicine.

Background And Objectives: Intimate partner violence (IPV) is a silent epidemic affecting one in three women. The US Preventive Services Task Force recommends routine IPV screening for women of childbearing age, but actual rates of screening in primary care settings are low. Our objectives were to determine how often IPV screening was being done in our system and whether screening initiated by medical assistants or physicians resulted in more screens.

Methods: We conducted a retrospective chart review to investigate IPV screening practices in five primary care clinics within a university-based network in Northern California. We reviewed 100 charts from each clinic for a total of 500 charts. Each chart was reviewed to determine if an IPV screen was documented, and if so, whether it was done by the medical assistant or the physician.

Results: The overall frequency of IPV screening was 22% (111/500). We found a wide variation in screening practices among the clinics. Screening initiated by medical assistants resulted in significantly more documented screens than screening delivered by physicians (74% vs 9%, P<0.001).

Conclusions: IPV screening is an important, but underdelivered service. Using medical assistants to deliver IPV screening may be more effective than relying on physicians alone.
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http://dx.doi.org/10.22454/FamMed.2018.311843DOI Listing
October 2018

An Academic Achievement Calculator for Clinician-Educators in Primary Care.

Fam Med 2017 Sep;49(8):640-643

Stanford University Department of Medicine, Division of Primary Care and Population Health.

Background And Objectives: Academic medical centers need better ways to quantify the diverse academic contributions of primary care clinician-educators. We examined the feasibility and acceptability of an "academic achievement calculator" that quantifies academic activities using a point system.

Methods: A cohort of 16 clinician-educators at a single academic medical center volunteered to assess the calculator using a questionnaire. Key measures included time needed to complete the calculator, how well it reflected participants' academic activities, whether it increased their awareness of academic opportunities, whether they intend to pursue more academic work, and their overall satisfaction with the calculator.

Results: Most participants (69%) completed the calculator in less than 20 minutes. Three-quarters (75%) reported that the calculator reflected the breadth of their academic work either "very well" or "extremely well". The majority (81%) stated that it increased their awareness of opportunities for academic engagement, and that they intend to pursue more academic activities. Overall, three-quarters (75%) were "very satisfied" or "extremely satisfied" with the calculator.

Conclusions: To our knowledge, this is the first report of a tool designed to quantify the diverse academic activities of primary care clinician-educators. In this pilot study, we found that the use of an academic achievement calculator may be feasible and acceptable. This tool, if paired with an annual bonus plan, could help incentivize and reward academic contributions among primary care clinician-educators, and assist department leaders with the promotion process.
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September 2017

Immersion medicine programme for secondary students.

Clin Teach 2018 10 14;15(5):370-376. Epub 2017 Aug 14.

General Medicine Disciplines, Stanford University School of Medicine, Stanford, California, USA.

Background: Although the proportion of ethnicities representing under-represented minorities in medicine (URM) in the general population has significantly increased, URM enrolment in medical schools within the USA has remained stagnant in recent years.

Methods: This study sought to examine the effect of an immersion in community medicine (ICM) programme on secondary school students' desire to enter the field of medicine and serve their communities. The authors asked all 69 ICM alumni to complete a 14-question survey consisting of six demographic, four programme and four career questions, rated on a Likert scale of 1 (completely disagree) to 5 (completely agree), coupled with optional free-text questions. Data were analysed using GraphPad prism and nvivo software.

Results: A total of 61 students responded, representing a response rate of 88.4 per cent, with a majority of respondents (73.7%) from URM backgrounds. An overwhelming majority of students agreed (with a Likert rating of 4 or 5) that the ICM programme increased their interest in becoming a physician (n = 56, 91.8%). Students reported shadowing patient-student-physician interactions to be the most useful (n = 60, 98.4%), and indicated that they felt that they would be more likely to lead to serving the local community as part of their future careers (n = 52, 85.3%). Of the students that were eligible to apply to medical school (n = 13), a majority (n = 11, 84.6%) have applied to medical school. URM enrolment in medical schools within the USA has remained stagnant in recent years DISCUSSION: Use of a community medicine immersion programme may help encourage secondary students from URM backgrounds to gain the confidence to pursue a career in medicine and serve their communities. Further examination of these programmes may yield novel insights into recruiting URM students to medicine.
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http://dx.doi.org/10.1111/tct.12694DOI Listing
October 2018

Child maltreatment: Cross-sectional survey of general dentists.

J Forensic Dent Sci 2017 Jan-Apr;9(1):24-30

Department of orthodontics, Rama Dental College, Kanpur, Uttar Pradesh, India.

Background: Child abuse continues to be a social menace causing both physical and emotional trauma to benevolent children. Census has shown that nearly 50-75% of child abuse include trauma to mouth, face, and head. Thus, dental professionals are in a strategic position to identify physical and emotional manifestations of abuse.

Aim: A cross-sectional survey was conducted to assess knowledge and attitude of dental professionals on the exigent issue of child abuse.

Methodology: With prior consent, a 20-question survey including both multiple choice and dichotomous (yes/no) questions was mailed to 120 state-registered general dentists and the data collected were subjected to statistical analysis.

Statistical Analysis: The overall response rate to the questionnaires was 97%. Lack of knowledge about dentist role in reporting child abuse accounted to 55% in the reasons for hesitancy to report. Pearson's Chi-square test did not show any significant difference between male and female regarding the reason for hesitancy to report and legal obligation of dentists.

Results: Although respondent dentists were aware of the diagnosis of child abuse, they were hesitant and unaware of the appropriate authority to report.

Conclusion: Increased instruction in the areas of recognition and reporting of child abuse and neglect should be emphasized.
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http://dx.doi.org/10.4103/jfo.jfds_6_15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5450479PMC
June 2017

Patient and primary care provider attitudes and adherence towards lung cancer screening at an academic medical center.

Prev Med Rep 2017 Jun 26;6:17-22. Epub 2017 Jan 26.

Stanford University School of Medicine, Department of Radiology, Stanford, CA, United States; Stanford University School of Medicine, Division of Pulmonary & Critical Care Medicine, Stanford, CA, United States.

Low dose CT (LDCT) for lung cancer screening is an evidence-based, guideline recommended, and Medicare approved test but uptake requires further study. We therefore conducted patient and provider surveys to elucidate factors associated with utilization. Patients referred for LDCT at an academic medical center were questioned about their attitudes, knowledge, and beliefs on lung cancer screening. Adherent patients were defined as those who met screening eligibility criteria and completed a LDCT. Referring primary care providers within this same medical system were surveyed in parallel about their practice patterns, attitudes, knowledge and beliefs about screening. Eighty patients responded (36%), 48 of whom were adherent. Among responders, non-Hispanic patients ( = 0.04) were more adherent. Adherent respondents believed that CT technology is accurate and early detection is useful, and they trusted their providers. A majority of non-adherent patients (79%) self-reported an intention to obtain a LDCT in the future. Of 36 of 87 (41%) responding providers, only 31% knew the correct lung cancer screening eligibility criteria, which led to a 37% inappropriate referral rate from 2013 to 2015. Yet, 75% had initiated lung cancer screening discussions, 64% thought screening was at least moderately effective, and 82% were interested in learning more of the 33 providers responding to these questions. Overall, patients were motivated and providers engaged to screen for lung cancer by LDCT. Non-adherent patient "procrastinators" were motivated to undergo screening in the future. Additional follow through on non-adherence may enhance screening uptake, and raising awareness for screening eligibility through provider education may reduce inappropriate referrals.
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http://dx.doi.org/10.1016/j.pmedr.2017.01.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5304233PMC
June 2017

Assessment of objective and subjective measures as indicators for facial esthetics.

J Forensic Dent Sci 2016 Sep-Dec;8(3):139-144

Department of Orthodontics, Mahatama Gandhi Missions Dental College and Hospital, Kamothe, Navi Mumbai, Maharashtra, India.

Background: The study mentioned was aimed to examine the contribution of the objective measures representing anterior-posterior (AP) and vertical characteristics, dental esthetics, or their combination that are used in daily orthodontic practice in the assessment of the facial esthetics.

Materials And Methods: A panel of 64 laypersons evaluated the facial esthetics of 32 boys and 32 girls, stratified over four different angle classes, on a visual analog scale. The relationship between the objective parameters and facial esthetics was evaluated by the backward multiple regression analysis.

Results: Dental esthetics, expressed by the esthetic component of the index of orthodontic treatment need (AC/IOTN), appeared to be the most vital indicator for facial esthetics. The horizontal sum, a variable for AP characteristics of the patient, could be a better variable when compared with the overjet.

Conclusion: Addition of this newly defined parameter to the AC/IOTN improved the prognostic value from 25% to 35%.
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http://dx.doi.org/10.4103/0975-1475.195107DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5210100PMC
January 2017

Influence of Smile Arc and Buccal Corridors on Facial Attractiveness: A Cross-sectional Study.

J Clin Diagn Res 2016 Sep 1;10(9):ZC20-ZC23. Epub 2016 Sep 1.

Consultant in Orthodontics (MDS), Rastogi Dental Hospital , Allahabad, Uttar Pradesh, India .

Introduction: Two aspects of the smile: the Smile Arc (SA) and Buccal Corridors (BC) have been the interest of the orthodontist in recent years.

Aim: The present study was undertaken to evaluate the influence of the smile arc and buccal corridors on facial attractiveness as evaluated by orthodontists, general dentists and laymen.

Materials And Methods: Two subjects (one male & one female) were selected from the regional population fulfilling the criteria of an ideal smile arc and ideal buccal corridors. Frontal smile view photographs of these subjects were taken and modified by using adobe photoshop 7.0 to create combination of three smile arc variance and three buccal corridors variations respectively which were shown to 25 orthodontists, 25 general dentists & 25 laymen, to rate the facial attractiveness of each image on a rating scale.

Results: All the three groups (laypersons, dentists and orthodontists) showed significant difference in ratings, indicating that they had different perceptions on the facial attractiveness.

Conclusion: Orthodontists were more precise in discerning the smile arc and buccal corridors compared to dentists and laypersons.
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http://dx.doi.org/10.7860/JCDR/2016/19013.8436DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5072073PMC
September 2016

Fulfilling outpatient medicine responsibilities during internal medicine residency: a quantitative study of housestaff participation with between visit tasks.

BMC Med Educ 2016 May 10;16:139. Epub 2016 May 10.

Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, HC007, Stanford, CA, 94305-5133, USA.

Background: Internal Medicine residents experience conflict between inpatient and outpatient medicine responsibilities. Outpatient "between visit" responsibilities such as reviewing lab and imaging data, responding to medication refill requests and replying to patient inquiries compete for time and attention with inpatient duties. By examining Electronic Health Record (EHR) audits, our study quantitatively describes this balance between competing responsibilities, focusing on housestaff participation with "between visit" outpatient responsibilities.

Methods: We examined EHR log-in data from 2012-2013 for 41 residents (R1 to R3) assigned to a large academic center's continuity clinic. From the EHR log-in data, we examined housestaff compliance with "between visit" tasks, based on official clinic standards. We used generalized estimating equations to evaluate housestaff compliance with between visit tasks and amount of time spent on tasks. We examined the relationship between compliance with between visit tasks and resident year of training, rotation type (elective or required) and interest in primary care.

Results: Housestaff compliance with logging in to complete "between visit" tasks varied significantly depending on rotation, with overall compliance of 45% during core inpatient rotations compared to 68% during electives (p = 0.01). Compliance did not significantly vary by interest in primary care or training level. Once logged in, housestaff spent a mean 53 min per week logged in while on electives, compared to 55 min on required rotations (p = 0.90).

Conclusions: Our study quantitatively highlights the difficulty of attending to outpatient responsibilities during busy core inpatient rotations, which comprise the bulk of residency at our institution and at others. Our results reinforce the need to continue development and study of innovative systems for coverage of "between visit" responsibilities, including shared coverage models among multiple residents and shared coverage models between residents and clinic attendings, both of which require a balance between clinic efficiency and resident ownership, autonomy and learning.
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http://dx.doi.org/10.1186/s12909-016-0665-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4862079PMC
May 2016

Shear punch strength evaluation of nanocomposite and compomer, post-conditioning in dietary solvents - An in-vitro study.

J Oral Biol Craniofac Res 2014 Jan-Apr;4(1):30-4. Epub 2014 Mar 27.

Senior Lecturer, Awadh Dental College, Jamshedpur, Jharkhand, India.

Background: Perpetual research in esthetic dentistry has stupendously contributed in improving the mechanical and esthetic properties of restorative materials. Recently introduced nanocomposite claim to possess higher optimized esthetic and mechanical properties superior to other esthetic restorative materials in clinical use. It has been highlighted in many studies that intraoral degradation of composites is a consequence of both mechanical factors and chemical degradation. Thus, this in-vitro study was conducted to determine the strength of commonly used esthetic restorative materials after conditioning them in dietary solvents, thereby, simulating the intraoral environment.

Aim: Evaluation of shear punch strength of nanocomposite and compomer, post-conditioning in dietary solvents.

Materials And Methods: Two test groups mentioned above, each containing sixty preconditioned samples, divided into four subgroups of fifteen samples each and conditioned in different dietary solvents, were subjected to shear punch test in custom designed shear punch apparatus in Universal Testing Machine.

Results: Among the dietary solvents, citric acid caused maximum decrease in the strength while conditioning in heptane showed increase in strength of the test restorative materials.

Conclusion: Nanocomposite revealed to have higher strength, thereby indicating its better application universally.
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http://dx.doi.org/10.1016/j.jobcr.2014.02.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4252630PMC
March 2015

Complex dislocation of the first metatarsophalangeal joint.

Chin J Traumatol 2009 Oct;12(5):318-20

Department of Orthopaedics, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi 110029, India.

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October 2009

Tuberculosis of the shoulder joint with impingement syndrome as initial presentation.

J Microbiol Immunol Infect 2008 Jun;41(3):275-8

Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

Tuberculosis of the shoulder can be difficult to diagnose in the early stages. If not diagnosed early, bony tuberculosis may reduce quality of life. Therefore, tuberculosis should be suspected in cases of long-standing pain in the shoulder. It is necessary to keep tuberculosis in the differential diagnosis of impingement syndrome of the shoulder. We report a young patient presenting with features suggestive of impingement syndrome. After failure to improve with adequate therapy, the patient was further investigated and diagnosed as having early tuberculosis of the shoulder joint. The patient had good clinical recovery with conservative management. The importance of considering early tuberculosis as a differential diagnosis in impingement syndrome is highlighted.
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June 2008

Comments on Addolorata Corrado et al. review "Extra skeletal effects of bisphosphonates".

Joint Bone Spine 2007 Oct 7;74(5):518; author reply 518-9. Epub 2007 Aug 7.

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http://dx.doi.org/10.1016/j.jbspin.2007.06.002DOI Listing
October 2007

The uninsured patient.

Am J Med 2006 Feb;119(2):166.e1-5

UCLA Department of General Internal Medicine, Los Angeles, Calif 90095, USA.

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http://dx.doi.org/10.1016/j.amjmed.2005.08.024DOI Listing
February 2006