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).
Koteswara C.M.,AJ Institute of Medical science |
Sheetal D.,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.
Bhandary R.,AJ Institute of Medical science |
Boloor R.,Father Muller Medical College
Journal of Clinical and Diagnostic Research | Year: 2016
Introduction: Severe Respiratory Syncytial Virus (RSV) pulmonary disease manifesting as bronchiolitis and pneumonia continues to play a major role in the childhood mortality and morbidity. Hence the present study was undertaken to evaluate the prevalence of RSV among hospitalized children presenting with Acute Respiratory Tract Infection (ARTI) and its correlation with risk factors. Aim: To determine the occurrence of RSV related respiratory tract infection in paediatric patients and to access the risk factors and clinical features associated. Materials and Methods: RSV antigen detection was performed by Direct Fluorescent Antibody (DFA) staining on 100 nasopharyngeal aspirate collected from hospitalized children below 5 years of age with a diagnosis of ARTI. Results: Out of the 100 samples tested for RSV with DFA, 22 (22%) were found RSV positive with a mean age of 12 months and a male to female ratio of (1.75:1). Clinical features significantly associated with RSV were wheezing and breathlessness. Congenital heart disease (CHD) and prematurity were the risk factors significantly associated with RSV infection. Conclusion: RSV infection is a significant cause of morbidity among children presenting with ARTI. In resource limited countries DFA can be used as an important tool for rapid detection of RSV and can potentially eliminate prolonged hospitalization and unnecessary use of antibiotics. © 2016, Journal of Clinical and Diagnostic Research. All Rights Reserved.
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.
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.
Shiju M.P.,Aj Institute Of Medical Science |
Yashavanth R.,Aj Institute Of Medical Science |
Narendra N.,Aj Institute Of Medical Science
Journal of Clinical and Diagnostic Research | Year: 2010
Purpose The incidence of Extended Spectrum F -Lactamase (ESBL) producing strains among clinical Klebsiella species and Escherichia coli isolates has been steadily increasing over the past years. ESBL producing organisms pose a major problem for clinical therapeutics. Identifying organisms that are ESBL producers are a major challenge for the clinical microbiology laboratory. An attempt was therefore made to study ESBL production and multidrug resistance in clinical isolates of K.pneumoniae and E.coli at a hospital in Mangalore. Method ESBL production and multidrug resistance was studied in a total of 228 isolates of K.pneumoniae and E.coli which were obtained from various clinical samples during one year period from January to December 2008. Identification of the isolates was done based on cultural characteristics and reactions in standard biochemical tests. All the isolates were tested for antimicrobial susceptibility by the disk diffusion technique according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. The screening for ESBL production was done by the phenotypic confirmatory test using ceftazidime discs in the presence and absence of clavulanic acid. Result All the isolates showed resistance or decreased susceptibility to at least one of the third generation cephalosporins (ceftazidime, cefotaxime, ceftriaxone) which were used for the study. ESBL production was noted in 59.65% of the isolates tested. ESBL production was detected in 51.47% strains of E.coli and 48.53% strains of K.pneumoniae (70% of E.coli isolated from urine samples and 75% of K.pneumoniae isolated from exudates samples were ESBL producers). All the isolates were found to be sensitive to the antibiotic, imipenem. Sensitivity of E.coli to piperacillin-tazobactum (Pt) and cefaperazone-sulbactum (Cfs) was 100%, whereas K.pneumoniae showed 98% sensitive to Pt and 88% sensitive to Cfs. Conclusion The study has shown an increase in the incidence of ESBL producing E.coli and K.pneumoniae strains in Mangalore. The prevalence of ESBL and multidrug resistant strains constitute a serious threat to the current β-lactam therapy. Tests for the detection of ESBL producing bacteria should be carried out at all diagnostic centers routinely and the use of third generation cephalosporins should be restricted. This can reduce the prevalence of ESBL producing organisms.
Venkatappa K.G.,AJ Institute of Medical Science |
Vinutha Shankar M.S.,Sri Devaraj Urs University
Biomedical Research | Year: 2012
The IT capital of India, Bengaluru in 21st century has seen an unprecedented increase in vehicular noise caused by exponential increase in the number of vehicles. With the steady rise of vehicular traffic in the city, policemen manning the traffic are being exposed to all kinds of health hazards. Noise not only affects hearing but also trigger the body's stress response. The objectives were to measure noise levels at major traffic junctions in Bengaluru city and the association between noise levels and stress in traffic policemen. The study included 60 traffic policemen deputed at different junctions of Bengaluru. Informed consent was taken and ethical clearance was obtained. Road traffic noise was measured using sound level meter. Stress questionnaire which consisted of questions like sleep deprivation, tension, headache etc was administered to which the subjects responded on five- point likert scale. The stress levels thus obtained was correlated with noise levels using Pearson Correlation coefficient. Road traffic noise ranged from 71.2 to 91dB. There was a significant positive correlation between stress and noise level (r = +0.578, p =0.00). Present study showed there is a significant positive correlation between noise levels & stress. Higher the noise level more is the stress in traffic policemen. Hence some preventive modalities should be undertaken to prevent psycophysiological problems in long run because of job related stress in traffic policemen.
Monteiro F.N.P.,AJ Institute of Medical science |
Kanchan T.,Kasturba Medical College |
Bhagavath P.,Kasturba Medical College |
Kumar G.P.,Kasturba Medical College |
And 2 more authors.
Singapore Medical Journal | Year: 2012
Introduction Snakebite is an important and preventable health hazard. Viper bites are more common than other poisonous snakebites in human beings. The present study aimed to collate the victim profile of viper bite cases in the region and to determine the pattern, manifestations, complications and the associated risk factors of these bites. Methods This was a prospective study of viper bite cases admitted to Kasturba Hospital, Manipal, India between August 2003 and November 2005. The demographic and clinical details of each case were obtained from the patients, their relatives and the patients' hospital records, and analysed. Results A total of 31 viper bite cases were reported during the study period. The victims were predominantly male and aged 25-55 years. The highest number of cases occurred during daytime in the months of September and October, which coincided with the harvesting season, and involved the lower limbs. 94% of the snakebite victims were farmers, suggesting that this was an occupational hazard. Envenomation was observed in patients with scratch marks, suggesting the importance of keeping the victim under observation in all alleged snakebite cases, even in the absence of clear fang marks. The mortality rate in our study was 6.5%. Conclusion Immobilising and transporting snakebite victims to the hospital and prompt administration of anti-snake venom remain the best way to reduce morbidity and mortality. It is also important to practise correct first aid measures, as otherwise they may cause more harm than good.
Naik B.S.,Aj Institute Of Medical Science |
Shetty N.,Aj Institute Of Medical Science |
Maben E.V.S.,Aj Institute Of Medical Science
European Journal of Internal Medicine | Year: 2010
Taste and smell are critical components to a person's overall sense of well-being and quality of life. Taste related problems can cause pain and discomfort and can hinder the maintenance of a satisfying and nutritious diet. Loss of taste interferes with pleasure derived from food and food-related activities. Many drugs can affect this special sense and contribute significantly to the morbidity of the associated illness. This article gives a brief account of this problem and emphasizes the need for more awareness of the clinicians about this problem. © 2010 European Federation of Internal Medicine.