Chennai Medical College Hospital and Research Center

Tiruchirappalli, India

Chennai Medical College Hospital and Research Center

Tiruchirappalli, India

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Sweni S.,Sri Gokulam Hospitals and Research Institute | Senthilkumaran S.,Sri Gokulam Hospitals and Research Institute | Balamurugan N.,Sri Gokulam Hospitals and Research Institute | Thirumalaikolundusubramanian P.,Chennai Medical College Hospital and Research Center
Emergency Radiology | Year: 2013

Tension Pneumocephalus (PC) was described 50 years ago. A case of pneumocephalus (PC) following cervical epidural injection in a 50-year-old male worsened by air travel and manifested as tension pneumocephalus, confirmed by advanced neuroimaging, is reported for the first time along with literature review. The patient underwent emergent frontal burr hole evacuation and air gushed under pressure. The patient recovered well and is stable during a follow-up of 12 months. Presenting features and clinical course along with Mount Fuji sign, Peaking sign, and air bubble sign observed in this case are described. Also, the importance of considering neurosurgical and spinal procedures leading to PC have to be considered by practitioners before issuing fitness certificate before air travel, as PC is likely to get transformed to tension PC and can cause an in-flight emergency. © 2013 Am Soc Emergency Radiol.

Sweni S.,Chennai Medical College Hospital and Research Center | Meenakshisundaram R.,Chennai Medical College Hospital and Research Center | Senthilkumaran S.,Sri Gokulam Hospitals and Research Institute | Thirumalaikolundusubramanian P.,Chennai Medical College Hospital and Research Center
Medical Hypotheses | Year: 2011

Propofol, an intravenous anesthetic agent induces priapism in humans. We hypothesize the probable central nervous system and local mechanisms through which a similar molecule can be used as a therapy in erectile dysfunction. Previous literatures published over a period of 35. years (1976-2010) were searched using the key words, mechanisms were identified and discussed. In the central nervous system, propofol has an inhibitory effect on serotonin receptors and on gamma-aminobutyric acid A (GABA-A) receptors as well as a facilitatory action on N-methyl-d-aspartate (NMDA) mediated calcium response and agonistic action on dopaminergic D2 receptors, which might contribute towards maintaining erections. While in the penile tissue, propofol's action may be due to increased synthesis of nitric oxide (NO), the principal mediator of penile erection. In addition, it may also have inhibitory effect on thromboxane A2, a potent vasoconstrictor and stimulatory action on penile adenosine triphosphate (ATP) dependent potassium (K-ATP) channels, a potent vasodilator. In view of the above mechanisms, use of propofol or similar molecule in erectile dysfunction needs to be ascertained and evaluated. © 2011 Elsevier Ltd.

Gugapriya T.S.,Chennai Medical College Hospital and Research Center | Karthick S.,Melmaruvathur Adiparasakthi Institute of Medical science and Research | Nagarjuna B.,Melmaruvathur Adiparasakthi Institute of Medical science and Research
Journal of Clinical and Diagnostic Research | Year: 2014

Introduction: Diabetes mellitus (DM) is one of the metabolic syndromes prevalent worldwide, with more concentration in the Asian region. Many studies have been conducted in order to understand the complex pathogenesis of this disease. Yet, there exists a lacuna in our knowledge about DM. This study aims at establishing the reason for glycemic variation in menstruating Type-2 diabetic women by estimation of C-reactive protein, an inflammatory marker that exhibits significant association with changes in blood glucose levels. Methodology: A prospective study was undertaken in Type-2 diabetic women of reproductive age group to assess the variability of glycemic control during different phases of menstrual cycle using high sensitivity C reactive protein (hs-CRP) as the biomarker. Fifty women were enrolled after satisfying a set of inclusion and exclusion criteria. The fasting blood glucose, hs-CRP concentration and endogenous female hormones were assayed in follicular and luteal phases of the cycle. The observed parameters were analyzed statistically for significant correlation.Observation and Result: The result showed that hs-CRP level significantly correlates with increasing levels of fasting blood glucose level in both the phases of menstrual cycle in Type-2 diabetic women. The significance is statistically stronger during luteal phase of the cycle (r = 0.807; p<0.05). The correlation observed between hs-CRP and Estrodiol in follicular phase (r = -0.311; p < 0.05) was not statistically significant. The hs-CRP level increased significantly with progesterone level during luteal phase (r = 0.826; p <0.05). Conclusion: This study concludes that Type-2 diabetic women of reproductive age group encounter a period of poor glycemic control during luteal phase, as shown by statistically high hs-CRP level mediated by endogenous progesterone hormone. Therefore, this study advocates careful monitoring, life style adjustments and drug regime to reduce the fluctuation in glycemic level experienced by Type-2 diabetic premenopausal women in the luteal phase.

Meenakshisundaram R.,Madras Medical College | Rajendiran C.,Madras Medical College | Thirumalaikolundusubramanian P.,Chennai Medical College Hospital and Research Center
Tobacco Induced Diseases | Year: 2010

Objectives. The objectives were to investigate into the relationship between lipid profile including Apolipoprotein-A1 (Apo-A1) and Apolipoprotein-B (Apo-B) and smokers and to relate them with smoking pack years. Materials and Methods. A total of 274 active male smokers without any other illnesses and age matched male healthy control subjects (78) with similar socio-cultural background were assessed for clinical details, dietary habits, physical activities, smoking and alcohol consumption. Standard methods were adopted to check the lipid levels. The data were analyzed statistically. Results. Their ages ranged from 40 to 59 years, systolic BP from 110 to 130 mmHg, and diastolic BP from 76 to 88 mmHg. All of them had similar pattern of diet (vegetarianism with occasional meat). None was on any medication influences lipid level. Their physical activity was moderate. Number of pack years varied from 10 to 14 (mild), 15 to 19 (moderate) and 20 and above (heavy) among 69, 90 and 115 cases, whose mean ages were 43, 44 and 49 respectively. The mean (+SD) values in mg/dl of total cholesterol (TC), Triglyceride (TGL), Apo-B, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol and Apo-A1 in mg/dl among mild/ moderate/ heavy smokers and control subjects were 198 (30.6)/ 224 (27.2)/ 240 (24.3) and 160 (20.4); 164(42.6)/ 199 (39.5)/ 223(41.7) and 124 (31.6); 119 (24.9)/ 121 (27)/ 127 (28.3) and 116 (21.4); 94 (19.7)/ 104 (21.8)/ 120 (20.5) and 82 (17.6); 42 (5.9)/ 39 (3.1)/ 35(4.4) and 48 (5.3); and 120 (17)/ 119 (21)/ 115 (25) and 126 (19), respectively. In smokers, there was a rise in TC, TGL, LDL, Apo-B and fall in HDL and Apo-A; these changes were significant (P < 0.05). Conclusion. Number of pack years was directly proportional to abnormal lipid profile. It is also concluded that changes in Apo-A1 and Apo-B were more significant when compared to HDL and LDL cholesterol among smokers. In the view of double risk for smokers (smoking and altered lipid profile) efforts may be made to introduce smoking cessation program. © 2010 Meenakshisundaram et al; licensee BioMed Central Ltd.

Anbarasi M.,Chennai Medical College Hospital and Research Center | Vishwanatha Rao B.,Madras Medical College
Biomedicine (India) | Year: 2012

Background & Objectives: Human brain is capable of adaptive plastic changes from one sensory modality to another. This study is done to test the concept of cross-modal plasticity by doing two different hearing tests - Pure tone Audiometry (PTA) and Brainstem Evoked Response Audiometry (BERA) on blind subjects and comparing the results with that of normal sighted subjects. Methods: This is a comparative, cross-sectional study done in Madras Medical College, Chennai. The study group comprised of 30 blind subjects (15 male and 15 female) and the control group included 30 age and sex matched normal sighted subjects. Both the groups were subjected to PTA and BERA and their hearing was assessed. Results: The pure tone audiometry results showed no significant difference between the two groups. In BERA, the absolute latency for wave V of BERA was significantly shorter in male blind subjects compared to the control group (right ear - 5.47 Vs 5.66; p - 0.004 & left ear - 5.43 Vs 5.62; p value -0.02). Conclusion: The shorter absolute latency of wave V indicates the evidence of enhanced hearing ability and hence cross-modal plasticity in blind people.

Aarthi R.,Chennai Medical College Hospital and Research Center | Prakash V.R.,Government Medical College
Asian Journal of Pharmaceutical and Clinical Research | Year: 2016

Objectives: The aim of our study is to measure the urine albumin excretion in apparently healthy adults, to find out the prevalence of elevated urine albumin excretion, and to correlate urine albumin excretion with anthropometric parameters. Methods: For this, cross-sectional study was conducted where healthy adults of age group 35-50 years were taken. Systolic, diastolic blood pressures, fasting plasma glucose, 2 hrs postprandial glucose, serum urea, serum creatinine, serum cholesterol, serum high-density lipoprotein cholesterol, serum low-density lipoprotein cholesterol, estimated creatinine clearance, body mass index, body surface area, mid arm circumference, waist circumference, hip circumference, wasit: hip ratio, mid-thigh circumference, mid-calf circumference, urine albumin, urine creatinine, and urine albumin creatinine ratio were measured. The relationship between urine albumin creatinine ratio and the individual anthropometric measures was studied using spearman rank correlation analysis. Results: 2 out of 54 participants had a urine albumin creatinine ratio in excess of 30 μg/mg which signifies microalbuminuria. This corresponds to a prevalence of 3.7%. Conclusion: Urine albumin creatinine ratio correlated positively with the waist circumference and waist hip ratio. The relationship with other anthropometric measures was negative. None of them found to be significant. © 2016, Innovare Academics Sciences Pvt. Ltd. All rights reserved.

Reddy N.B.,Chennai Medical College Hospital and Research Center
Indian journal of public health | Year: 2012

The sub-centers (SCs) are under constant criticism for their inability to deliver quality services due to the nonavailability of adequate infrastructure, manpower and supply of drugs.A cross-sectional study was conducted in Chittoor District of Andhra Pradesh to assess the availability of physical infrastructure and manpower in the SCs. A total of 34 SCs were selected by multistage and stratified random sampling technique. The data was statistically analyzed by using Microsoft Excel. The deficiency in the availability of health workers male and female were found to be 67.7% and 27.5%, respectively. The residential facility for health workers was available only in 26.4% SCs. Only 20.6% of SCs had stethoscope and B.P apparatus. The physical infrastructure and manpower availability at the SCs needs considerable improvement as per the Indian Public Health Standard (IPHS). Facilities to conduct the normal delivery and 24-hours emergency referral services need to be addressed at the earliest.

Singh R.K.,Chennai Medical College Hospital and Research Center
Indian journal of public health | Year: 2012

A cross-sectional study was conducted on Lucknow highway in Bareilly district of Uttar Pradesh to study the knowledge of truck drivers about HIV transmission and prevention and to study the sexual behaviour of these drivers with reference to HIV/AIDS. Age, marital status, education, income, drinking alcohol, length of stay away from home, knowledge about transmission and prevention of HIV, and HIV-prone behavior of truck drivers were studied. Chi-square, mean, and SD were calculated. In all, 289 (97.6%) drivers had heard about HIV/AIDS. Only 242 (81.8%) were aware of HIV transmission by heterosexual route. Misconceptions such as HIV transmission by mosquito bites, living in same room, shaking hands, and sharing food were found. Out of 174 (58.8%) who visited Commercial Sex Workers (CSW), 146 (83.9%) used a condom. 38 (12.8%) visited more than 5 CSW in the last 3 months. Time away from home on the road, marital status, alcohol use, and income class were associated with visiting CSW. High-risk behavior was established in the study population. Safe sex and use of condoms need to be promoted among the truck drivers and better condom availability needs to be assured on highways.

Neelakandan R.,Chennai Medical College Hospital and Research Center | Shankar Sethu P.,Chennai Medical College Hospital and Research Center
Journal of Clinical and Diagnostic Research | Year: 2014

Objective: To study the prevalence of Gestational diabetes mellitus and to assess the impact of early universal screening to detect Gestational diabetes mellitus. Materials and Methods: Consecutive 1106 pregnant women were screened for Gestational diabetes mellitus at their first prenatal visit during the study period of February 2012 to January 2013. All the women were screened with a initial 50 gram one hour glucose challenge test (GCT) and those women who tested positive were subjected to a standardized 75 gram oral glucose tolerance test(OGTT).The prevalence of Gestational diabetes mellitus and its association with age, infertility, obesity, hypertension, family history of diabetes was studied. The impact of early universal screening for GDM was assessed. American diabetic association (ADA) and International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria for diagnosis of Gestational diabetes mellitus was used in our study. Results: Of the total 1106 pregnant women who were screened with the initial 50 gram one hour glucose challenge test (GCT), 458 (41.4%) had their one hour plasma glucose value >130 gm/dl. Of the 440 women who responded to and underwent the subsequent 75gram OGTT, 158 (61.2%) had one abnormal value, 73(28.2%) had two abnormal values and 27 (10.5%) had three abnormal values. 64(24.8%) of them had fasting plasma glucose ≥ 92/dl. 36(13.9%) women were found to have GDM in the first trimester (12 weeks), 43 (16.7%) in the 13-18 weeks, 114 (44.1%) in the 19-28 weeks and 65 (25.2%) in the third trimester(28 weeks). The overall prevalence of GDM was 23.3%.There was increased association of GDM with increasing age, parity, family predisposition and infertility. Conclusion: It is evident that there is increased prevalence of GDM in Indian population. Universal screening for GDM is better to routine risk factor based screening and it should be done at the first prenatal visit for early diagnosis of glucose intolerance in pregnancy especially in countries like India. There is increased association of GDM with infertility, advanced age, obesity, family predisposition and parity.

Nivethitha T.,Chennai Medical College Hospital and Research Center | Vijayalakshmi S.,Institute of Pharmacology
International Journal of Pharma and Bio Sciences | Year: 2015

Polycystic ovarian syndrome and hypothyroidism are closely associated. Metformin is routinely prescribed for the treatment and has proven clinical and biological benefits. Hence this study was conducted to assess the effect of Metformin on thyroid profile in patients with polycystic ovarian syndrome and subclinical hypothyroidism, who were diagnosed according to Rotterdam's criteria. 64 patients were taken for the final analysis. Apart from and significant reductions in body weight, body mass index, Metformin caused a significant reduction in serum Thyroid stimulating hormone (TSH) from 8.24 ± 0.63 μ IU/ml to 2.67 ± 0.29 μ IU/ml (P < 0.001). Thus, from this study we conclude that Metformin can be used either as a sole therapy or as an adjuvant in women with Polycystic ovarian syndrome and subclinical hypothyroidism and clinical hypothyroidism, respectively.

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