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Aswathy R.,AJ Institute of Medical science
Indian Journal of Practical Pediatrics | Year: 2014

The perioperative period is laden with rapid and dynamic changes in physiologic condition. Anticipation of hemodynamic events and good care are the key to success. Postoperative mortality continues to be high in high-risk population when they undergo surgical procedures. Additionally,patients who undergo high risk corrective procedures or complex palliative surgeries may experience considerable morbidity that further challenges the intensive care physician to improve care and outcome.

Pandit L.,NITTE University | Ramagopalan S.V.,University of Oxford | Malli C.,NITTE University | D'Cunha A.,NITTE University | And 2 more authors.
Multiple Sclerosis Journal | Year: 2013

Background: Vitamin D deficiency is widely prevalent in India. The association between vitamin D status and multiple sclerosis (MS) has not been previously studied in Indians. Objective: The objective of this paper is to determine whether vitamin D status is associated with MS in India. Methods: In this study 110 MS patients and 108 matched controls were included. Serum 25-hydroxyvitamin D (25(OH) D) was measured in 63 patients in relapse, 77 patients in remission and all controls. Quantity of sun exposure in childhood and body mass index (BMI) were calculated. Patients and controls were genotyped for HLA-DRB11501. Results: Patients had significantly lower 25(OH)D levels than matched controls (p = 0.003), and patients in relapse had a significantly lower vitamin D level as compared to those in remission (p = 0.001). Vitamin D deficiency (< 50 nmol/l) was seen in a higher proportion of cases (71.8%) than controls (53.7%) (p = 0.01). Higher quartiles of vitamin D (> 58 nmol/l) showed an inverse relationship with MS (OR = 0.28, CI = 0.11-0.68, p= 0.005). This effect persisted after adjusting for sun exposure. Conclusion: The results of our study indicated that serum 25(OH)D shows an inverse relationship with MS in the Indian population. Reverse causality cannot be excluded. © 2013 The Author(s).

Joseph N.,Manipal University India | Kumar G.,JIPMER | Nelliyanil M.,AJ Institute of Medical science
Annals of Indian Academy of Neurology | Year: 2013

Background: The prevalence and incidence of epilepsy is higher in developing countries than in developed countries. Understanding pattern and risk factors of seizure cases will help in suggesting appropriate preventive measures. Objectives: This study was carried out to assess the pattern of seizure, its management and compliance with treatment. Materials and Methods: Data from medical records of seizure cases in three tertiary care hospitals of Mangalore city in south India admitted from January 2006 to December 2011 were collected and analyzed. Results: Nearly half (44.4%) of the 196 cases belonged to productive age group (15-45 years) and 2/3 rd (60.7%) were males. Majority (>80% cases) were unskilled workers and of low socio-economic status groups. Family history of seizures was present in 8.4% cases. Mean age of onset of seizure was found to be 19.9 years. Proportion of generalized tonic clonic seizure cases was 78.1%. Secondary seizures were seen in 66 (33.7%) cases with the most common cause being trauma to the head (24.2%). Refractory seizures were present in 2.7% cases. Monotherapy was the most commonly followed treatment regimen and phenytoin was the most popular anti-epileptic drug (AED) used. Non-compliance with AEDs was seen in 18.1% cases and was more among patients on polytherapy (P = 0.032). Conclusion: Seizure manifestations and treatment compliance vary widely in the studied population. In depth analysis of each seizure type will give more information about the factors associated with it.

Bakkannavar S.M.,Manipal University India | Monteiro F.N.P.,AJ Institute of Medical science | Arun M.,JSS University | Kumar G.P.,Manipal University India
Medicine, Science and the Law | Year: 2012

Teeth, in the living as well as the dead, are the most useful objects in the field of forensic investigation. Their ability to survive in situations like mass disasters makes them important tools in victim identification. Though the morphology and structure is similar in both men and women, there are subtle differences. Variation in dental size can give a clue about differences between the sexes. Many authors have measured the crowns of teeth in both men and women and found certain variations. Canines, reported to survive air crash and hurricane disasters, are perhaps the most stable teeth in the oral cavity because of the labiolingual thickness of the crown and the root anchorage in the alveolar process of the jaws. Measurement of mesiodistal width of the mandibular and maxillary canines provides good evidence of sex identification due to dimorphism.

Koteswara C.M.,AJ Institute of Medical science
Journal of Clinical and Diagnostic Research | Year: 2014

Background: Functional Endoscopic Sinus Surgery (FESS) is associated with significant post-operative pain. Intravenous (iv) paracetamol provides pain relief in most patients who have undergone FESS. In some studies, it was found to be inadequate. It has been observed from previous studies conducted on patients undergoing other surgeries like abdominal surgeries that the analgesic efficacy of iv paracetamol improves when used Pre-emptively. There are no studies done previously on use of iv paracetamol Pre-emptively in FESS. Objective: The purpose of the study was to determine the post-operative analgesic effects of Pre-emptive intravenous (iv) paracetamol in Functional Endoscopic Sinus Surgeries (FESS). Materials and Methods: Following institutional ethics committee approval, thirty nine American Society of Anesthesiology (ASA) physical status I-II patients were assigned in a randomized manner into two groups: Group I received iv paracetamol 1g, in 100mL, 15 minutes before induction and Group II received iv paracetamol 1g, in 100 mL, at the end of the surgery. The time to first analgesic use and the total analgesic consumed in 24 hours was recorded. Visual Analog Scale (VAS) pain scores were obtained from all patients at 0, 30 min, 1, 2, 6, 12 and 24 hours after the end of the Surgery. Results: Time to first analgesic requirement was significantly longer in Group I compared to Group II (p = 0.0329). Rescue analgesic consumption and post-operative VAS pain scores recorded were significantly lower in Group I compared to Group II (p < 0.05) until 24 after surgery. Conclusion: Pre-emptive iv paracetamol in comparison to intra-operative paracetamol, provided effective and reliable post-operative analgesia after FESS.

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