Dhanalakshmi Srinivasan Medical College

Perambalur, India

Dhanalakshmi Srinivasan Medical College

Perambalur, India

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Prasad Nayak N.,AJ Institute of Medical science | Nayak R.P.,Dhanalakshmi Srinivasan Medical College | Soans S.T.,AJ Institute of Medical science | Alva S.,AJ Institute of Medical science | And 2 more authors.
Asian Pacific Journal of Tropical Disease | Year: 2014

Objective: To study the clinical profile and management of malaria in the paediatric age group. Methods: This retrospective study was done at AJ Institute of Medical Sciences, Mangalore in Karnataka, India. The prescriptions case records of patients diagnosed with malaria, treated as inpatients in the Department of Paediatrics, AJ Institute of Medical Sciences from January 2010 to July 2012 were collected. The data (demographic profile, clinical features, investigation, treatment and complications) from all the case records were filled up in predesigned proforma and analysed statistically. Results: A total of 74 patients were diagnosed and treated for malaria. Males (58.1%) were more affected than females (41.9%). The patients in the age group of 0-5 years (42%) were more affected. The incidence of malaria increased from the month of June onwards coinciding with the monsoon season. Plasmodium vivax was the major parasite type (56.8%), followed by mixed malarial infection(37.9%) and Plasmodium falciparum (5.4%). Main presenting symptoms were fever (100%), chills & rigors (90.5%), vomiting (52.7%) and headache (40.5%). Vomiting was the main drug adverse effect seen. Conclusion: Malaria is a major health concern in this region, particularly more in rainy season. It is found that compared to the older children, the 0-5 years age group was more affected. Plasmodium vivax was the major parasite type causing malaria. Implementation of national drug policy on malaria has certainly decreased the morbidity and mortality in this region. © 2014 Asian Pacific Tropical Medicine Press.


Sageerabanoo S.,Dhanalakshmi Srinivasan Medical College | Malini A.,Government of Puducherry | Mangaiyarkarasi T.,Sri Manakula Vinayagar Medical College | Hemalatha G.,Aarupadai Veedu Medical College
Journal of Natural Science, Biology and Medicine | Year: 2015

Background: Production of β-lactamase enzymes by Gram-negative bacteria is the most common mechanism to acquire drug resistance to β-lactam antibiotics. Limitations in detecting extended spectrum β-lactamases (ESBL) and Amp-C β-lactamases have contributed to the uncontrolled spread of bacterial resistance and are of significant clinical concern. Materials and Methods: A total of 148 samples was selected on the basis of resistance against third-generation cephalosporin for screening ESBLs and Amp-C β-lactamases production. These multidrug-resistant strains were phenotypically screened for ESBL production by phenotypic confirmatory disc diffusion test and double disc synergy test. Modified three-dimensional method was used for Amp-C β-lactamases detection. Result: Among the 148 isolates, 82 (55.40%) were ESBL producers, and 115 (77.70%) were Amp-C β-lactamases producers. Co-existence of ESBL and Amp-C was observed in 70 (47.29%) isolates. Escherichia coli was the most common ESBL and Amp-C β-lactamase producer. All ESBL producers were highly resistant to ciprofloxacin (83.10%), cotrimoxazole (95.27%), and gentamicin (89.18%). However, these bacterial strains were sensitive to imipenem 146 (98.64%) and piperacillin/tazobactam 143 (96.62%). Conclusion: Our study showed that ESBL producing organisms were not only resistant to cephalosporins but also to other group of drugs and also that multiple mechanisms play a role in drug resistance among Gram-negative bacteria.


Sathiavageesan S.,Dhanalakshmi Srinivasan Medical College | Sathiavageesan S.,Sundaram Hospital
Indian Journal of Nephrology | Year: 2016

Melioidosis, an infectious disease caused by Burkholderia pseudomallei, is endemic in the Northern Australia and South-East Asia. It is an emerging disease in the Indian subcontinent. Melioidosis tends to run a potentially lethal course in immunocompromised individuals and data in renal transplantation are scarce. The clinical presentation of melioidosis is diverse, mimicking several other infectious diseases. Diagnosis could be delayed in transplant recipients. Choice and duration of antimicrobial therapy, management of immunosuppression, and patient and graft outcomes are other issues to be addressed. We report septicemic melioidosis with pulmonary involvement in a 32-year old renal transplant recipient that caused acute allograft dysfunction. © 2016 Indian Journal of Nephrology l Published by Wolters Kluwer - Medknow.


PubMed | Sri Manakula Vinayagar Medical College, Aarupadai Veedu Medical College, Government of Puducherry and Dhanalakshmi Srinivasan Medical College
Type: Journal Article | Journal: Journal of natural science, biology, and medicine | Year: 2015

Production of -lactamase enzymes by Gram-negative bacteria is the most common mechanism to acquire drug resistance to -lactam antibiotics. Limitations in detecting extended spectrum -lactamases (ESBL) and Amp-C -lactamases have contributed to the uncontrolled spread of bacterial resistance and are of significant clinical concern.A total of 148 samples was selected on the basis of resistance against third-generation cephalosporin for screening ESBLs and Amp-C -lactamases production. These multidrug-resistant strains were phenotypically screened for ESBL production by phenotypic confirmatory disc diffusion test and double disc synergy test. Modified three-dimensional method was used for Amp-C -lactamases detection.Among the 148 isolates, 82 (55.40%) were ESBL producers, and 115 (77.70%) were Amp-C -lactamases producers. Co-existence of ESBL and Amp-C was observed in 70 (47.29%) isolates. Escherichia coli was the most common ESBL and Amp-C -lactamase producer. All ESBL producers were highly resistant to ciprofloxacin (83.10%), cotrimoxazole (95.27%), and gentamicin (89.18%). However, these bacterial strains were sensitive to imipenem 146 (98.64%) and piperacillin/tazobactam 143 (96.62%).Our study showed that ESBL producing organisms were not only resistant to cephalosporins but also to other group of drugs and also that multiple mechanisms play a role in drug resistance among Gram-negative bacteria.


Katta A.V.,Dhanalakshmi Srinivasan Medical College | Katkam R.V.,Dr V M Government Medical College | Geetha H.,Dhanalakshmi Srinivasan Medical College
Journal of Clinical and Diagnostic Research | Year: 2013

Background: Cataract is one of the major causes of a visual impairment, which eventually leads to blindness. An oxidative damage to the lens proteins is a major factor which leads to cataract formation. Therefore, we intended to study the relationship between the biochemical markers of oxidative stress and various forms of cataracts. Methods: We examined the lenses and the sera of 120 subjects who were aged 50 to 80 years, who were distributed in two groups, viz. the study group (90 patients) and the control group (30 subjects). The oxidative stress was assessed by estimating the lipid peroxidation product in the form of thiobarbituric acid reactive substances (TBARS), the antioxidant status by measuring the levels of vitamin E and the total antioxidant capacity (TAC). The study group patients were further divided into those with nuclear cataracts (30 patients), cortical cataracts (30 patients), and diabetic cataracts (30 patients). Results: In this study, it was found that the levels of TBARS in the study group were significantly high (p<0.001), whereas the TAC (p<0.001) and the vitamin E (p<0.001) levels were significantly low, both in the lenses and the blood of the study group as compared to those of the control group. Conclusion: Thus, the present study suggests that an imbalance between the oxygen free radicals and the antioxidants may lead to lipid peroxidation in the lens. Also, the elevated levels of glucose in the diabetic cataracts lead to the auto-oxidation of glucose and a non-enzymatic glycation of the lens protein. Thereby, the high molecular weight proteins aggregate in the cataract.


Rao S.,All India Institute of Medical Sciences | Masilamani S.,Dhanalakshmi Srinivasan Medical College | Sundaram S.,Sri Ramachandra University | Duvuru P.,Sri Ramachandra University | Swaminathan R.,Sri Ramachandra University
Journal of Clinical and Diagnostic Research | Year: 2016

Introduction: Quality monitoring in histopathology unit is categorized into three phases, pre-analytical, analytical and post-analytical, to cover various steps in the entire test cycle. Review of literature on quality evaluation studies pertaining to histopathology revealed that earlier reports were mainly focused on analytical aspects with limited studies on assessment of pre-analytical phase. Pre-analytical phase encompasses several processing steps and handling of specimen/sample by multiple individuals, thus allowing enough scope for errors. Due to its critical nature and limited studies in the past to assess quality in pre-analytical phase, it deserves more attention. Aim: This study was undertaken to analyse and assess the quality parameters in pre-analytical phase in a histopathology laboratory. Materials and Methods: This was a retrospective study done on pre-analytical parameters in histopathology laboratory of a tertiary care centre on 18,626 tissue specimens received in 34 months. Registers and records were checked for efficiency and errors for pre-analytical quality variables: specimen identification, specimen in appropriate fixatives, lost specimens, daily internal quality control performance on staining, performance in inter-laboratory quality assessment program {External quality assurance program (EQAS)} and evaluation of internal non-conformities (NC) for other errors. Results: The study revealed incorrect specimen labelling in 0.04%, 0.01% and 0.01% in 2007, 2008 and 2009 respectively. About 0.04%, 0.07% and 0.18% specimens were not sent in fixatives in 2007, 2008 and 2009 respectively. There was no incidence of specimen loss. A total of 113 non-conformities were identified out of which 92.9% belonged to the pre-analytical phase. The predominant NC (any deviation from normal standard which may generate an error and result in compromising with quality standards) identified was wrong labelling of slides. Performance in EQAS for pre-analytical phase was satisfactory in 6 of 9 cycles. Conclusion: A low incidence of errors in pre-analytical phase implies that a satisfactory level of quality standards was being practiced with still scope for improvement. © 2015, Journal of Clinical and Diagnostic Research. All rights Reserved.


Swarnlatha N.,Dhanalakshmi Srinivasan Medical College
Indian Journal of Public Health Research and Development | Year: 2013

Background: The growing menace created by the HIV/AIDS has alarmed not only the public health officials but also the general community. The Voluntary Counseling and Testing centre remodeled as Integrated Counseling and testing Centres are reversing the epidemic. Objectives: To identify the socio-demographic profiles, HIV sero-status and risk behavior pattern of the attendees in the VCTC attached to a Medical College Hospital in Tirupati, A.P., Study Design: Cross-sectional observational study Setting: Voluntary Counseling and Testing Centre attached to Microbiology Department of the Medical College, Tirupati. Participants: All the VCTC attendees between January 2011 and March 2011 were included in the study Study variables: Age, sex, marital status, level of education, occupation, place of residence, HIV sero-status, pattern of risk behavior in relation to HIV/AIDS and the person referring. Statistical Analysis: Proportions and chi-square test. Results: It was found that out of 2863 individuals, 11.4% were sero-positives. Sero-positivity was high in 20-49 years age group (79.4%), illiterates (45.8%), unskilled workers (39.1%), rural areas (60.3%) and married (71.7%) individuals.


Swarnalatha N.,Dhanalakshmi Srinivasan Medical College
Journal of Clinical and Diagnostic Research | Year: 2013

It has been documented that the elderly are more prone to psychological problems and depression is the commonest of the geriatric psychiatric disorders. In fact, the elderly in India face a multitude of psychological, social, and physical health problems. There is a dearth of community studies in India, which have investigated geriatric depression and its associated risk factors. Hence, the present study was undertaken with the following objectives. Study Objectives: 1. To assess the prevalence of depression among the elderly. 2. To determine the epidemiological factors which are associated with depression. Design: A cross-sectional, observational, community based study. Period: April 2009 to September 2009. Setting: A Rural Health Centre which was a rural field practice area which was attached to the Community Medicine Department, SV Medical College, Tirupati, India. Subjects: The individuals who were aged 60 years and above were interviewed and examined. Method: By random sampling, the villages were selected. This study was conducted through house-to-house visits in the selected villages. Clinical examinations, observations and interviews were carried out by using a pre-designed, pre-tested proforma in the local language. Size: Four hundred subjects. The data was analysed by using SPSS (Statistical Package for Social Sciences), version17. Results: The prevalence of depression was 47%. The depression was high among the elderly who were aged 80 years and above (54.3%), females (56.5%), illiterates (59.0%), those who were below the poverty line (86.1%), those who were living alone (87.3%), those who were economically partially dependent (63.3%) and those depended totally for the activities of daily living (100.0%). These factors were significantly associated with depression. Conclusion: The prevalence of depression was found to be positively associated with increasing age, the female sex, illiteracy, a low socio-economic status, those who were living alone, those who were economically partially dependent and those who were totally dependent for the activities of daily living.


PubMed | Sri Ramachandra University, Dhanalakshmi Srinivasan Medical College and All India Institute of Medical Sciences
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2016

Quality monitoring in histopathology unit is categorized into three phases, pre-analytical, analytical and post-analytical, to cover various steps in the entire test cycle. Review of literature on quality evaluation studies pertaining to histopathology revealed that earlier reports were mainly focused on analytical aspects with limited studies on assessment of pre-analytical phase. Pre-analytical phase encompasses several processing steps and handling of specimen/sample by multiple individuals, thus allowing enough scope for errors. Due to its critical nature and limited studies in the past to assess quality in pre-analytical phase, it deserves more attention.This study was undertaken to analyse and assess the quality parameters in pre-analytical phase in a histopathology laboratory.This was a retrospective study done on pre-analytical parameters in histopathology laboratory of a tertiary care centre on 18,626 tissue specimens received in 34 months. Registers and records were checked for efficiency and errors for pre-analytical quality variables: specimen identification, specimen in appropriate fixatives, lost specimens, daily internal quality control performance on staining, performance in inter-laboratory quality assessment program {External quality assurance program (EQAS)} and evaluation of internal non-conformities (NC) for other errors.The study revealed incorrect specimen labelling in 0.04%, 0.01% and 0.01% in 2007, 2008 and 2009 respectively. About 0.04%, 0.07% and 0.18% specimens were not sent in fixatives in 2007, 2008 and 2009 respectively. There was no incidence of specimen lost. A total of 113 non-conformities were identified out of which 92.9% belonged to the pre-analytical phase. The predominant NC (any deviation from normal standard which may generate an error and result in compromising with quality standards) identified was wrong labelling of slides. Performance in EQAS for pre-analytical phase was satisfactory in 6 of 9 cycles.A low incidence of errors in pre-analytical phase implies that a satisfactory level of quality standards was being practiced with still scope for improvement.


PubMed | Dhanalakshmi Srinivasan Medical College
Type: Journal Article | Journal: Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine | Year: 2016

The Tamil Nadu model of public health is renowned for its success in providing quality health services at an affordable cost especially to the rural people. Tamil Nadu is the only state with a distinctive public health cadre in the district level and also the first state to enact a Public Health Act in 1939. Tamil Nadu has gained significant ground in the various aspects of health in the last few decades largely because of the significant reforms in its health sector which dates back to 1980s which saw rigorous expansion of rural health infrastructure in the state besides deployment of thousands of multipurpose health workers as village health nurses in rural areas. Effective implementation of Universal Immunization Programme, formation of Tamil Nadu Medical Services Corporation for regulating the drug procurement and promoting generic drugs, early incorporation of indigenous system of medicine into health care service, formulation of a health policy in 2003 by the state with special emphasis on low-income, disadvantaged communities alongside efficient implementation of The Tamil Nadu Health Systems Project (TNHSP) are the major factors which contributed for the success of the state. The importance of good political commitment and leadership in the health gains of the state warrants special mention. Moreover, the economic growth of the state, improved literacy rate, gender equality, and lowered fertility rate in the last few decades and contributions from the private sector have their share in the public health success of the state. In spite of some flaws and challenges, the Tamil Nadu Model remains the prototype health care delivery system in resource-limited settings which can be emulated by other states also toward a better health care delivery system.

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