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Das A.T.,DM Wayanad Institute of Medical science | Prakash S.B.,DM Wayanad Institute of Medical science | Priyadarshini V.,DM Wayanad Institute of Medical science
Journal of Clinical and Diagnostic Research | Year: 2017

Introduction: Adenoidectomy is one of the most commonly performed surgical procedures in children. Conventional adenoidectomy is associated with incomplete adenoid tissue removal with persistence of symptoms. The advent of rigid nasal endoscopes, cold light source, fiber optics and powered instruments used in functional endoscopic sinus surgery helped in the development of endoscopic microdebrider-assisted adenoidectomy. Aim: To establish the safety and efficacy of combined conventional and endoscopic microdebrider-assisted adenoidectomy procedure. Materials and Methods: This is a prospective study of 60 child patients who underwent combined conventional and endoscopic microdebrider-assisted adenoidectomy. The study was conducted from September 2013 to September 2015. Only child patients with grade 3 and grade 4 Adenoid Hypertrophy (AH) was included in the study. At the end of conventional adenoidectomy and after combined procedure, the AH was graded again. Post-operative complications like neck pain, hypernasality and swallowing problems were noted. Their symptom score was reviewed before surgery and after one month and one year of surgery. The duration of surgery and amount of blood loss was recorded. Results: By this technique, complete clearance of adenoid tissue was obtained in all 60 (100%) cases. The mean pre-operative symptom score for AH was 3.7, which improved to 0 after one month of combined conventional and endoscopic microdebrider-assisted adenoidectomy. All child patients were symptom-free at the end of one month and one year. The duration of conventional adenoidectomy was 5 minutes 12 seconds while total duration of the combined conventional and endoscopic microdebrider-assisted adenoidectomy was 14 minutes 45 seconds. There was no significant blood loss (15 ± 3 ml approximately). There were no major complications in this study. Conclusion: The combined approach of conventional curette along with endoscopic microdebrider-assisted adenoidectomy is a safe and effective method for complete and accurate removal of large adenoids. © 2017, Journal of Clinical and Diagnostic Research. All rights reserved.


Shaikh S.B.,Institute of Medical science and Research | Haji I.M.,St Johns Medical College | Doddamani P.,DM Wayanad Institute of Medical Science | Rahman M.,Institute of Medical science and Research
Journal of Clinical and Diagnostic Research | Year: 2014

Background: Type1 diabetes mellitus (T1DM) results from autoimmune destruction of insulin-producing β cells and is characterized by the presence of insulitis and β-cell autoantibodies. Up to one third of patients develop an autoimmune polyglandular syndrome. Presence of other autoimmune disorders in patients with T1DM has been associated with increased morbidity and mortality. Hypoglycemia resulting from concurrent hypothyroidism or adrenal crisis can be dangerous; starting replacement therapy for hypothyroidism may result in adrenal crisis if background hypocortisolism is not recognized. Early detection of antibodies and latent organ-specific dysfunction is advocated to alert physicians to take appropriate action in order to prevent full-blown disease. Aims: The objectives of this study were to assess the concurrence of various autoimmune disorders in patients with T1DM, to review the concept and detect the overt forms of Autoimmune Thyroid Disease (AITD), Addison's disease, Vitamin B 12, vitiligo in T1DM and to find their correlation according to age and sex of the patients. Methods: It is a retrospective study where medical records between January 2007-June 2010 of all the patients diagnosed with T1DM, followed up at Department of Endocrinology were reviewed to find out the presence of Addison's disease, Autoimmune thyroidal disease (AITD), vitiligo, Vitamin B12 deficiency and Primary Gonadal Failure, which were diagnosed clinically with available investigational procedures. Results: A total of 100 cases of T1DM were evaluated during the present study. The age group of patients ranged from 8 to 40 years, with the average being 21.56 years. 64% of the patients were males and the rest were females. 29 % of T1DM subjects had Autoimmune Thyroid Disease (AITD) (Hashimoto's or Graves'disease), 5% were diagnosed with Vitamin B12 deficiency, 4% had Addison's disease (AD), and 6% showed Vitiligo. 28 % had family history of autoimmune endocrinopathy. Conclusion: The commonest autoimmune disorder associated with T1DM found in our study was AITD. Because genetic/ autoantibodies testing is not a feasible option, it is important to screen them with best available laboratory facilities and clinical assessment in view of high prevalence of associated autoimmune conditions.


PubMed | Sri Siddhartha Medical College, Wayanad Institute of Medical science and DM Wayanad Institute of Medical science
Type: Comparative Study | Journal: International journal of dermatology | Year: 2016

The diagnosis of superficial mycosis such as dermatophytosis is often done clinically. However, in difficult cases, a rapid test with high sensitivity and specificity helps in the immediate confirmation and administration of treatment.The efficacy, rapidity of detection, and cost-effectiveness of KOH preparation, calcofluor white (CW) stain, and Chicago sky blue (CSB) stain in the identification of fungal elements were assessed in patients with dermatophytoses attending the dermatology clinic of a tertiary care hospital. All three tests were performed on each sample collected from 73 patients according to standard procedure. The slides were examined after 5 and 30 minutes in 10 and 40 magnifications. The sensitivity and specificity of CW and CSB at 5 and 30 minutes were calculated using KOH preparation as the standard test.CSB stain showed highest positivity (94.5%) within 5 minutes when compared to KOH (75.3%) and CW (83.5%). After 30 minutes, positivity increased in KOH (84.9%) and CW stains (89%), but it remained the same in CSB stain. Both CW and CSB stains when compared to 10% KOH are equally sensitive (100%), but CW was more specific (72.7%), particularly at 30 minutes. When cost of performing tests on 100 specimens is considered, KOH, CW, and CSB stains cost Rs 5, 100, and 15, respectively.CSB stain is a better stain for rapid diagnosis of dermatophytoses because of ease of performance, rapidity of detection, better appreciation of morphology of fungal elements, and cost effectiveness.


Balasubrahmanya Prasad C.V.,DM Wayanad Institute of Medical science | Kodliwadmath M.V.,Navodaya Medical College | Kodliwadmath G.B.,Civil Hospital
Biomedicine (India) | Year: 2014

Introduction: Leprosy is a disease of great antiquity and it still continues to be a public health problem in few countries including India.Aim: Present study was set out to evaluate antioxidant vitamin levels in paucibacillary and multibacillary leprosy and in healthy control group for comparison.Materials and Methods: Plasma Vitamin A, E and C levels were estimated in leprosy groups and control group.Results: Plasma levels of antioxidant vitamins A, E and C were significantly reduced in PB leprosy and MB leprosy as compared to controls. The level was significantly low in MB leprosy as compared to PB leprosy.Conclusion: The low plasma antioxidant vitamin status may be in relation to over-consumption of these antioxidant nutrients as a consequence of increased exposure to oxidative attacks and lipid peroxidation. Antioxidant vitamin supplementation may be useful against the persisting oxidative stress in leprosy.


Gupta P.,All India Institute of Medical Sciences | Desai P.B.,DM Wayanad Institute of Medical science | Kulkarni S.,KLE University
Biomedicine (India) | Year: 2014

Introduction: Sudden ceased of women's menstural cycle for a year, is a post menopause period. In this period, ovaries stop synthesizing estrogen hormone and women undergo two distinct phases of bone loss: 1. Rapid, transient phase, begins at menopause, 2. slow, subsequent phase, continues indefinitely and indirectly leads to bone loss. Estrogen has dual effect - primary on bone metabolism and secondary on Lipid profile (body weight). Alteration in Lipid profile leads to various diseases.Aim: Therefore this study was conducted to assess the Lipid profile and bone markers in pre and post menopausal women.Materials and Methods: 30 post and 30 pre menopausal healthy women, as cases and control respectively, were enrolled in this study. Lipid profile and bone markers were analysed in both groups by standard biochemical methods.Results: As compared to pre menopausal, post menopausal women showed increased levels of serum Total Cholesterol, Triglycerides (TAG), Alkaline Phosphatase (ALP), Inorganic Phosphorus (IP) and decrease level of High Density Lipoproteins - Cholesterol (HDL-C) which were statistically significant.Conclusion: Increased levels of ALP and IP in post menopausal women shows susceptibility towards various bone diseases whereas increased levels of Total Cholesterol, TAG and decreased level of HDL- C represent dyslipidemia, key factor for various metabolic disease.


Maulingkar S.V.,DM Wayanad Institute of Medical science | Prakash R.,DM Wayanad Institute of Medical science | Harish P.,DM Wayanad Institute of Medical science | Salabha B.,DM Wayanad Institute of Medical science
Tropical Doctor | Year: 2015

The Widal test is still widely used in diagnosing typhoid fever in developing countries. Often, specific chemotherapy is administered based on a single Widal test. Interpretation of a single Widal test, in turn, depends on the baseline agglutinin titres among the local population in that area. Hence, we aimed to find out the baseline titres in our area. A single blood sample was collected from hospital outpatients with non-infectious diseases, the patients being aged above 18 years and residing in Wayanad district continuously for at least 5 years. The test was performed according to the Widal test kit manufacturer’s instructions and interpreted using standard guidelines. The baseline titre for Anti TO, TH, AH and BH agglutinins in our area was found to be 1:40, 1:80, 1:40 and 1:40, respectively. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.


Tauheed M.,DM Wayanad Institute of Medical science | Korula R.J.,DM Wayanad Institute of Medical science | Shankarnarayanan S.,DM Wayanad Institute of Medical science
Arthroscopy Techniques | Year: 2016

Osteoid osteoma of the foot is a rare condition particularly of the calcaneum. This condition is difficult to diagnose and is more difficult to treat particularly if it involves deeper part of the joints. We present an arthroscopic technique to deal with a case of juxta-articular osteoid osteoma of the calcaneum using two portals: the anterolateral portal for instrumentation and the anterior anterolateral portal for visualization of the subtalar joint. Because this approach is minimally invasive, it offers early recovery and reduced morbidity compared with the conventional techniques. © 2016 Arthroscopy Association of North America.


PubMed | DM Wayanad Institute of Medical science
Type: Journal Article | Journal: Arthroscopy techniques | Year: 2016

Osteoid osteoma of the foot is a rare condition particularly of the calcaneum. This condition is difficult to diagnose and is more difficult to treat particularly if it involves deeper part of the joints. We present an arthroscopic technique to deal with a case of juxta-articular osteoid osteoma of the calcaneum using two portals: the anterolateral portal for instrumentation and the anterior anterolateral portal for visualization of the subtalar joint. Because this approach is minimally invasive, it offers early recovery and reduced morbidity compared with the conventional techniques.


PubMed | DM Wayanad Institute of Medical science
Type: Journal Article | Journal: The Indian journal of surgery | Year: 2015

The rare situation of thyroid stone is discussed with literature review and case report. A case of isolated solitary stone of the thyroid is documented here. There are incidences of calcification in the thyroid gland commonly associated with carcinoma thyroid and multinodular goiter. But solitary stone of thyroid is reported rarely and one such case is reported from India. The possibility of malignancy is high, in case of calcification of thyroid swellings. Hence, isolated calcification should be surgically treated even if fine needle aspiration cytology is negative for malignancy.


PubMed | DM Wayanad Institute of Medical science
Type: Journal Article | Journal: Tropical doctor | Year: 2015

The Widal test is still widely used in diagnosing typhoid fever in developing countries. Often, specific chemotherapy is administered based on a single Widal test. Interpretation of a single Widal test, in turn, depends on the baseline agglutinin titres among the local population in that area. Hence, we aimed to find out the baseline titres in our area. A single blood sample was collected from hospital outpatients with non-infectious diseases, the patients being aged above 18 years and residing in Wayanad district continuously for at least 5 years. The test was performed according to the Widal test kit manufacturers instructions and interpreted using standard guidelines. The baseline titre for Anti TO, TH, AH and BH agglutinins in our area was found to be 1:40, 1:80, 1:40 and 1:40, respectively.

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