Christian Medical College Vellore

Vellore, India

Christian Medical College Vellore

Vellore, India
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Peedicayil J.,Christian Medical College Vellore
International Journal of Social Psychiatry | Year: 2017

Background: Epigenetics refers to the study of heritable changes in gene expression not involving changes in DNA sequence and is presently an active area of research in biology and medicine. There is increasing evidence that epigenetics is involved in the pathogenesis of psychiatric disorders. Aims and Methods: Several studies conducted to date have suggested that psychosocial factors act by modifying epigenetic mechanisms of gene expression in the brain in the pathogenesis of psychiatric disorders. Such studies have been conducted both on brain tissues and also using peripheral tissues as substitutes for brain tissues. This article reviews such studies. Results and Conclusion: Epigenetic mechanisms of gene expression in the brain appear to link one individual with another in the context of social psychiatry. Epigenetics appears to be of major importance to the field of social psychiatry. © The Author(s) 2016.

Objective: Tenecteplase-based pharmacoinvasive percutaneous coronary intervention (PCI) has been shown to yield outcomes comparable to primary PCI in the setting of acute ST elevation myocardial infarction (STEMI). This study was designed to compare the efficacy of pharmacoinvasive PCI following successful thrombolysis with Streptokinase versus primary PCI in patients with STEMI. Methodology: We conducted a prospective single center observational study in 120 patients with STEMI who underwent primary PCI (n = 60) and Streptokinase-based pharmacoinvasive PCI (n = 60). Patients with Killips class 3 or 4 at presentation, and those with evidence of failed fibrinolysis were excluded. The primary outcome was LV systolic function after angioplasty, as assessed by 2D global longitudinal strain (GLS) using speckle tracking echocardiography (STE), as well as 2D LVEF using Simpson's biplane method. Results: LV systolic function after PCI was significantly lower in the pharmacoinvasive arm as compared to the primary PCI arm, both by 2D STE (GLS: -9% vs -11%; p = 0.03) and 2D Simpson's biplane method (LVEF: 40.7% vs 45.1%; p = 0.02). TIMI flow in the culprit vessel prior to angioplasty was better in the pharmacoinvasive arm indicating successful thrombolysis, whereas post angioplasty flow was not different. There was no in-hospital mortality in either group. There was a trend toward increased incidence of acute kidney injury in the pharmacoinvasive arm. Conclusion: LV systolic function is significantly better after primary angioplasty as compared to pharmacoinvasive PCI following successful thrombolysis with Streptokinase. © 2017.

Philip George A.J.,Christian Medical College Vellore | Banerji J.S.,Christian Medical College Vellore
Urology | Year: 2013

A case of primary hyperparathyroidism with bilateral renal staghorn calculi and brown tumor right thumb is reported in these images, along with the appropriate sequential management. Percutaneous nephrolithotomy (PCNL)was done after management of hypercalcemia and after parathyroidectomy. This case highlights the need for urologists and general practitioners to have a holistic approach in patient management. © 2013 Elsevier Inc. All Rights Reserved.

Rabi S.,Christian Medical College Vellore | Jacob T.M.,Christian Medical College Vellore | Lionel J.,Christian Medical College Vellore | Indrasingh I.,Christian Medical College Vellore
Journal of Obstetrics and Gynaecology Research | Year: 2014

Aim Langerhans cells (LC) are antigen-presenting cells present in tissues with high antigenic exposure. Their role in the upper female reproductive tract is not fully understood. This study aims to determine the distribution and morphology of LC in the normal and post-partum human uterine tubes and uterus by staining with the specific LC markers, CD1a and zinc iodide-osmium (ZIO), and to determine their association with helper and cytotoxic T cells. Material and Methods Normal and post-partum uterine tube and uterine specimens were stained with CD1a and ZIO and their morphology and distribution noted. Double immune staining with CD1a-CD4 and CD1a-CD8 in post-partum uterine tube were also done. Results It was noted that CD1a-positive cells were significantly fewer and smaller in diameter than ZIO-positive cells in the uterine tube and both types of cells were significantly more prevalent in post-partum tubes. Perivascular clusters of ZIO-positive cells were seen in the post-partum tubes. Close association of CD1a-positive cells with CD4- and CD8-positive T cells was noted in the post-partum uterine tube. In the uterus, scanty CD1a-positive cells were present in the surface and glandular epithelium and endometrial stroma. ZIO-positive cells were absent. Conclusion This study suggests that CD1a-positive and ZIO-positive cells may be different subsets of LC that are needed for presentation of antigen to immunocompetent cells. Their respective functions are yet to be determined. © 2014 Japan Society of Obstetrics and Gynecology.

Das S.,Christian Medical College Vellore | Subhashini J.,Christian Medical College Vellore | Rami Reddy J.K.,Christian Medical College Vellore | Kantipal S.,Christian Medical College Vellore | And 2 more authors.
Gynecologic Oncology | Year: 2015

Background We investigated the feasibility of neoadjuvant low-dose radiation and chemotherapy with paclitaxel and carboplatin (LDCRT) before radical chemoradiation (CRT) and assessed the feasibility, efficacy, and response rate to such a regimen. Methods This is a single-arm phase II trial of 24 patients, with locally advanced squamous cell carcinoma of the cervix (stage IIB-IIIB). Patients received low-dose fractionated radiotherapy, carboplatin (AUC × 5) and paclitaxel (175 mg/m2), three weekly for two cycles followed by CRT. The primary end point was overall and disease-free survival. Results Mean age of the patients at diagnosis was 50 years; Radiological complete or partial response rate was 40% and 60%, respectively, post-LDCRT. The median follow-up was 30 months (24-36 months). Both overall and progression-free survivals at 2.5 years were 84%. Grade 3/4 toxicities were 24% hematological toxicity during LDCRT and 46% during CRT (hematological: 42%, non-hematological: 4%). Conclusion A good response rate is achieved by low-dose radiation and chemotherapy with carboplatin and paclitaxel followed by radical CRT. This treatment regimen is feasible and effective as evidenced by the acceptable toxicity and 84% local control at 2.5 years. © 2015 Elsevier Inc. All rights reserved.

Young G.P.,University of South Australia | Mortimer E.K.,University of South Australia | Gopalsamy G.L.,University of South Australia | Alpers D.H.,University of Washington | And 5 more authors.
American Journal of Clinical Nutrition | Year: 2014

Zinc deficiency is a major cause of childhood morbidity and mortality. The WHO/UNICEF strategy for zinc supplementation as adjunctive therapy for diarrhea is poorly implemented. A conference of experts in zinc nutrition and gastrointestinal disorders was convened to consider approaches that might complement the current recommendation and what research was needed to develop these approaches. Several key points were identified. The design of novel zinc interventions would be facilitated by a better understanding of how disturbed gut function, such as environmental (or tropical) enteropathy, affects zinc absorption, losses, and homeostasis. Because only 10% of zinc stores are able to be rapidly turned over, and appear to be rapidly depleted by acute intestinal illness, they are probably best maintained by complementary regular supplementation in a primary prevention strategy rather than secondary prevention triggered by acute diarrhea. The assessment of zinc status is challenging and complex without simple, validated measures to facilitate field testing of novel interventions. Zinc bioavailability may be a crucial factor in the success of primary prevention strategies, and a range of options, all still inadequately explored, might be valuable in improving zinc nutrition. Some therapeutic actions of zinc on diarrhea seem attributable to pharmacologic effects, whereas others are related to the reversal of deficiency (ie, nutritional). The distinction between these 2 mechanisms cannot be clarified given the insensitivity of serum zinc to identify subclinical deficiency states. Why zinc seems to be less effective than expected at all ages, and ineffective for secondary prevention of diarrhea in children ,12 mo of age, remains unclear. It was concluded that a reframing of the current recommendation is warranted with consideration of how to better optimize and deliver zinc and whether to provide a complementary public health primary prevention zinc strategy. This requires careful consideration of the zinc product to be used as well as strategies for its delivery. © 2014 American Society for Nutrition.

Rempel G.R.,University of Alberta | Blythe C.,University of Alberta | Blythe C.,Lloydminster Hospital | Rogers L.G.,University of Alberta | And 2 more authors.
Journal of Family Nursing | Year: 2012

The Family Management Style Framework (FMSF) was used as a conceptual basis for secondary data analysis of 55 previously conducted interviews with mothers and fathers of children with a lethal congenital condition from two surgical treatment eras. The directed content analysis was guided by a coding structure developed from family management dimensions identified in prior research of family response to childhood chronic conditions. Results indicated that application of the FMSF was helpful in differentiating families and their processes of family management at the onset of their infant's illness through to surviving the first surgery and going home. The dimensions of Illness View and Child Identity were central to the parents' capacity to manage their baby's illness demands within their family context. Applying a robust family framework to a complex neonatal condition at illness onset provides compelling direction for clinical interventions and their rigorous evaluation. © SAGE Publications 2012.

Moses V.,Christian Medical College Vellore | Korah I.,Christian Medical College Vellore
American Journal of Roentgenology | Year: 2015

OBJECTIVE. There arc few articles in the literature describing the security and safety aspects of networked medical equipment in radiology departments. Most radiologists are unaware of the security issues. We review the security of the networked medical equipment of a typical radiology department. MATERIALS AND METHODS. All networked medical equipment in a radiology department was scanned for vulnerabilities with a port scanner and a network vulnerability scanner, ami the vulnerabilities were classified using the Common Vulnerability Scoring System. A network sniffer was used to capture and analyze traffic on the radiology network for exposure of confidential patient data. We reviewed the use of antivirus software and firewalls on the networked medical equipment. USB ports and CD and DVD drives in the networked medical equipment were tested to see whether they allowed unauthorized access. Implementation of the virtual private network (VPN) thai vendors use to access the radiology network was reviewed. RESULTS. Most of the networked medical equipment in our radiology department used vulnerable software witli open ports and services. Of the 144 hems scanned, 64 (44%) had at least one critical vulnerability, and 119 (83%) had at least one high-risk vulnerability. Most equipment did not encrypt traffic and allowed capture of confidential patient data. Of the 144 items scanned, two (1%) used antivirus software and three (2%) had a firewall enabled. The I ISls ports were not secure on 49 of the 58 (84%) ileitis with USB ports, and the CD or DVD drive was not secure on 17 of the 31 (55%) items with a CD or DVD drive. One of three vendors had an insecure implementation of Vl'N access. CONCLUSION. Radiologists and the medical industry need lo urgently review and rectify the security issues in existing networked medical equipment. We hope that the results of our study and this article also raise awareness among radiologists about the security issues of networked medical equipment. © American Roentgen Ray Society.

Agency: European Commission | Branch: FP7 | Program: CP-FP | Phase: HEALTH-2007-1.4-1 | Award Amount: 5.56M | Year: 2008

Enteric infections remain a major cause of morbidity and mortality globally, accounting for an estimated 2 millions deaths each year. Effective preventive and therapeutic interventions are not yet available for many etiological agents of diarrheal diseases. Furthermore, even where vaccines are available, the lag time needed to induce an immune response can be critical in epidemic situations. We have developed a model system in which Lactobacillus, a GRAS microorganism, can be transformed with antibody fragment encoding vectors. This allows the production of functional single-chain antibodies against mucosal pathogens in situ. These antibody fragments retain their biological properties in vivo and may mitigate or prevent disease. The aim of this project is to develop an effective treatment against rotavirus and Clostridium difficile based on lactobacilli producing VHH and scFv antibody fragments. As a proof of principle, a lead VHH fragment against rotavirus will be tested in a human clinical trial in India. In parallel, we will generate, select and express scFv and VHH fragments against the gastrointestinal pathogens rotavirus and C. difficile in lactobacilli. The modified bacteria will be tested for their protective capacity in animal models. The genes encoding the antibody fragments will further be cloned using food grade and biologically contained expression systems and these lactobacilli will be tested for safety in a human clinical trial. Our approach, which falls into the priority Innovative approaches and interventions and the work program Development and production of new generation antibodies represents a novel system for the induction of passive immunity that can be rapidly applied to populations at risk (for example through the drinking water, rehydrating solution or as a food supplement). If successful, this project could be applied to therapy against a vast number of human/animal pathogens in the gastrointestinal tract.

PubMed | University of Kansas Medical Center and Christian Medical College Vellore
Type: | Journal: Frontiers in microbiology | Year: 2017

Colistin has long been a reserve drug used for the treatment of carbapenem resistant

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