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Devaru J.S.,Dr Br Ambedkar Medical College | Sakranaik S.,Bangalore Medical College and Research Institute | Divakar S.V.,Dr Br Ambedkar Medical College
Indian Journal of Community Health | Year: 2012

Setting: TU/DMCs of Bangalore city. India. All new sputum positive patients registered to the selected TU/DMCs were interviewed. A total of 468 patients aged above 20 years were enrolled. The study period was from January to June 2009. Objectives: To track the delay in diagnosis and treatment of patients reporting to tuberculosis units and microscopy centers. Design: A cross sectional study. TU/DMCs were randomly selected. A pretested questionnaire was administered to collect data. Results: The study population had 326 (69.7%) males. The mean age of study population was 38.5 years. 74.4% were married, 20.7% were illiterates, 27.8% were daily wagers, 10.5% were unemployed. The median and mean total delays from development of cough to diagnosis were 41 days and 36.04 days; the median and mean patient delay was 24 days and 20.7 days, and health system delay was 18 and 15.31 days respectively. There was a significant difference among the different age group of patients with older people having longer patient delay (p<0.0001). Lower income, illiteracy, unemployment, showed significant association with patients delay (p<0.0001). Alcohol intake and smoking habit among the male patients had significant association for longer patient delay (p=0.00004). Health seeking behavior like self medication, also had longer patient delay. Other socio demographic factors had no significant influence on the patient delay. Longer health system delay was found among patients who visited general practitioners and Ayurvedic medicine. Conclusion: More specific and effective health education of the general public on tuberculosis and seeking of appropriate medical consultation are likely to improve case detection.


Ali S.S.,Dr Br Ambedkar Medical College | Dhaded S.M.,Jawaharlal Nehru University | Goudar S.S.,Jawaharlal Nehru University
International Journal of Preventive Medicine | Year: 2014

Background: In India, child malnutrition is mostly the result of high levels of exposure to infection and inappropriate infant and young child feeding and caring practices and has its origins almost entirely during the first 2 to 3 years of life. This study aims in assessing the impact of breast feeding on child development of children at 3 years. Methods: About 530 children at 3 years were assessed for developmental delay by Ages and Stages Questionnaire (ASQ). Growth measurements and hemoglobin estimation were carried out at the time of developmental evaluation. Physical growth was assessed by using World Health Organization growth charts. Children were assessed for their duration of breast feeding and weaning period. They were analyzed for the feeding practices versus developmental outcome. Chi-square test was used to compare the categorical variables. Differences were considered significant at P < 0.05 level. Results: Children who were exclusively breastfed for at least 6 or more months had significantly higher ASQ scores with P value for communication (0.003), gross motor (0.004), fine motor (0.007) and problem solving (0.013) except personal social (0.059) compared with children who had exclusively breastfed for less than 6 months. Children, who were weaned beyond 12th month, had significantly higher ASQ scores with P value for communication (0.004), gross motor (0.091), fine motor (0.044), problem solving (0.001) and personal social (0.012) as against those who were weaned at 6th month or earlier in all domains. Conclusion: Breast feeding has a positive effect on the overall development of the child and should be promoted in the present generation. In India, child malnutrition is responsible for a higher percentage of the country's burden of disease. Undernutrition also affects cognitive and motor development and undermines educational attainment; and ultimately impacts on productivity at work and at home, with adverse implications for income and economic growth.


PubMed | Dr Br Ambedkar Medical College and Apollo Hospital
Type: Journal Article | Journal: Journal of cytology | Year: 2016

Mediastinal lymphadenopathy (ML) presents a diagnostic challenge. The technique to sample the lymph nodes has evolved from conventional blind transbronchial needle aspiration (TBNA) to the present day endobronchial ultrasound (EBUS)-guided procedure that improves the accuracy of sampling.This study was undertaken to evaluate the utility of rapid on-site evaluation (ROSE) in EBUS-guided TBNA (EBUS-TBNA) for the diagnosis of ML.This prospective study included 80 patients who underwent EBUS-TBNA for computed tomography/positron emission tomography (CT/PET) diagnosed ML over a 4-month period at a single tertiary care center. All 80 of these patients underwent histopathological evaluation (HPE) in addition to cytology. Three out of these 80 (3.7%) patients were excluded in view of inadequate material on EBUS-TBNA. After the sampling of nodes was done, the slides were stained with rapid hematoxylin and eosin (H&E) and then on-site evaluation was done. The tissue derived was also processed for HPE in all cases.ROSE revealed granuloma in 27 patients and malignancy in 14 patients, and the remaining patients showed nonspecific inflammation. Concomitant histopathology revealed granuloma in 34 patients and malignancy in 14 patients. Considering HPE as gold standard, the overall sensitivity and specificity of EBUS-TBNA for diagnosis were 85.4% and 89.6%, respectively. For malignancy alone, the sensitivity and specificity were 100% and 98.4%, respectively.This novel approach is safe, has good diagnostic yield, and has an excellent potential in assisting safe and accurate diagnostic interventional bronchoscope.


Cherian S.M.,Dr Br Ambedkar Medical College
Indian Journal of Public Health Research and Development | Year: 2015

Objectives: 1. To study the prevalence of anaemia in women of reproductive age group. 2. To determine change in haemoglobin levels after health education and supplementation of iron and folic acid tablets among women who are anaemic during the study period. 3. To suggest recommendations for improvement of health status in women of reproductive age. Method: A c ross-sectional study with intervention was done among women of reproductive age group 15-44 years from November 2005 to October 2006. Sample size of 203 was calculated and systematic random sampling done to select the study women. The women were interviewed using pretested proformas and Sahli's method used to estimate haemoglobin. Health education and iron and folic acid tablets were given to women who were anaemic. Repeat haemoglobin was done for those on therapy after 100 days. Statistical analysis was done using percentages, mean and standard deviation, chi-square, paired and unpaired t tests. Results: Prevalence of anaemia was 59.61% and decreased to 46.80% after intervention. There was a significant association between occupation and BMI with anaemia. Association between parity and anaemia was highly significant. The mean increase in haemoglobin levels was 1.10 gm/dl in mild anaemia and 1.15 gm/dl in moderate anaemia after intervention. © 2015, Indian Journal of Public Health Research and Development. All rights reserved.


Padma L.,Dr Br Ambedkar Medical College
Journal of Association of Physicians of India | Year: 2013

Cough is one of the commonest symptoms of respiratory tract infections and is a frequent problem encountered in general practice as well as in hospital practice. A wide range of disease processes may present with cough and definitive treatment depends on identifying the cause and diagnosis. Specific treatment of the cause should control the cough, but this may not occur in all cases and in a sizeable proportion of patients, no associated cause can be found. An increased sensitivity of the cough reflex can be observed in patients with dry cough. Symptomatic relief must be considered when the cough interferes with the patient's daily activities and this is effectively treated with antitussive preparations which are available as combinations of codeine or dextromethorphan with antihistamines, decongestants and expectorants Antitussives are used for effective symptomatic relief of dry or non-productive cough. First generation antihistamines like chlorpheniramine and centrally acting opioid derivatives like codeine are often used alone or in combination in the management of nonspecific cough. Sedation caused by these is valuable, particularly if the cough is disturbing the sleep. Although there is extensive experimental data on single agent antitussives and antitussive combinations, there is a major paucity of published literature on these combination s in nonspecific cough. Treatment of dry cough remains a challenge in some patients and this article reviews the scope of the current drugs and combination of Codeine and Chlorpheniramine in the effective management of dry cough.


Udupa S.,Deparment of Pathology | Usha M.,Deparment of Pathology | Visweswara R.N.,Deparment of Pathology | Desai M.G.,Dr Br Ambedkar Medical College
Indian Journal of Pathology and Microbiology | Year: 2012

Adrenal myelolipoma (AML) is a rare benign tumor composed of mature adipose and hematopoietic tissue. Most of these patients are asymptomatic and the tumors are non-secreting. We present a case with a large functional adrenal myelolipoma, wherein the patient was hypertensive and biochemistry revealed increase in 24 hours urinary Vanillylmandelic Acid (VMA), a metabolite of catecholamine. The mass was removed surgically and diagnosed as adrenal myelolipoma on histopathological examination. Both his blood pressure and urinary VMA returned to normal following surgery, which suggested that the mass was functioning and was secreting catecholamine. To the best of our knowledge, a catecholamine secreting adrenal myelolipoma has been reported in the literature only once previously. The association of hypertension and adrenal myelolipoma may not be entirely coincidental, as it may be associated with secreting catecholamine, as seen in our case. We also review the literature on functioning adrenal myelolipoma.


Manjunath B.G.,Dr Br Ambedkar Medical College | Shenoy V.G.,Dr Br Ambedkar Medical College | Raj P.,Dr Br Ambedkar Medical College
Indian Journal of Surgery | Year: 2010

Persistent müllerian duct syndrome (PMDS) is usually a surprise finding either during orchidopexy or during routine inguinal hernia repair in male patients. Often, the surgeon would face a dilemma about what is to be done with the remnants of müllerian duct, i. e. the fallopian tubes, uterus and proximal vagina. Till recently, it was advised to retain these structures whenever it was felt that the complete excision of these structures may jeopardise the blood supply and integrity of the vas deferens. Recent reports of malignancy in these retained structures would justify more aggressive approach. In our patients with PMDS, we have removed the mucosa of the retained müllerian structures, without compromising the integrity and vascularity of the vas deferens, thus reducing the chances of malignancy. © 2009 Association of Surgeons of India.


Tiwari D.K.,Dr Br Ambedkar Medical College | Golia S.,Dr Br Ambedkar Medical College | Sangeetha K.T.,Dr Br Ambedkar Medical College | Vasudha C.L.,Dr Br Ambedkar Medical College
Journal of Clinical and Diagnostic Research | Year: 2013

Introduction: Blood stream infections are very common in the pediatric age group. Patients with bacteremia may have either a transient bacteremia that may be rapidly and permanently cleared by a patient's host defenses with no major consequences, or persistent bacteremia which can be self-limited without development of focal infection or sequelae, or may progress to a more serious fatal infection or toxic symptoms. Objectives: The aim of our study is to analyze the hospital data on bacteremia in children less than 10 years with special reference to male and female cases, the pathogens involved, and the antibiotic susceptibility patterns. Methods: Over a one year period samples were collected from 128 children who included all newborn babies and children admitted with fever and suspected of having sepsis. Blood was collected depending upon age groups with aseptic precaution and incubated at 37oC for 10 days. Subcultures were made on blood agar and MacConkey agar plates. Organisms were identified and antibiotic sensitivity test of the isolates were performed. Results: Out of 128 suspected cases, 32 (25%) was culture positive. Male to female ratio is 1.28:1.0. Klebsiella species (43.75%) was the most common organism isolated followed by Staphylococcus aureus (18.75%). Prevalence of gram negative organism was 71.87%. Most of the gram negative organisms showed maximum resistance to ampicillin and the gram positive organisms to penicillin. In this study three gram negative organisms were extended-spectrum beta lactamases (ESBLs) producers and one Pseudomonas aeruginosa was metallo-beta lactamase (MBL) producer. 33.33% of staphylococcus aureus was Methicillin resistant Staphylococcus aureus (MRSA) strains. Interpretation and Conclusion: This study showed a 25% prevalence rate of bacteremia among children with an increasing prevalence in the age group of 5-10 years and also an observed decline in susceptibility of the pathogens to common antibiotics which ultimately stresses on the need for continuous screening and surveillance for antibiotic resistance in the pediatric care unit and calls for increased efforts to ensure more rational use of these drugs.


PubMed | Dr Br Ambedkar Medical College
Type: Journal Article | Journal: Indian dermatology online journal | Year: 2016

Granuloma faciale (GF) is a benign, chronic inflammatory disorder, characterized by reddish brown plaques with prominent follicular orificesand telangeictasia, usually occurring over the face. The condition often presents a problem in differential diagnosis. Herein we describe a case of GF with an unusual diascopic finding of an apple jelly appearance on diascopy.


Golia S.,Dr Br Ambedkar Medical College | Sangeetha K.T.,Dr Br Ambedkar Medical College | Vasudha C.L.,Dr Br Ambedkar Medical College
Journal of Clinical and Diagnostic Research | Year: 2013

Introduction: Ventilator-associated pneumonia (VAP), an important form of hospital-acquired pneumonia (HAP), specifically refers to pneumonia developing in a patient on mechanical ventilator for more than 48 h after intubation or tracheostomy. Despite the advancements in antimicrobial regimes, VAP continues to be an important cause of morbidity and mortality. VAP requires a rapid diagnosis and initiation of appropriate antibiotic treatment, as there is adverse effect of inadequate antibiotic treatment on patients' prognosis and the emergence of multidrug-resistant (MDR) pathogens. Aims: The present study was undertaken to assess the etiological agents of early-onset and late-onset VAP and to know their sensitivity pattern. Material and Methods: VAP data over a period of 12 months (February 2012 -February 2013) in a tertiary care ICU was retrospectively analysed. The patients were stratified by age, sex, duration of VAP (Early/Late onset) and the identified pathogens with their sensitivity pattern. Results: Incidence of VAP was found to be 35.14%, out of which 44.23% had early-onset (<4 days MV) VAP and 55.77% had late-onset (>4 days MV) VAP. The most common organisms isolated in early onset and late onset VAP was Pseudomonas aeruginosa, E.coli and Acinetobacter baumanii. All enterobacteriaceal isolates were extended spectrum beta lactamase (ESBL) producing organisms and all Staphylococcus aureus isolates except one were methicillin resistant. The incidence of Multidrug resistant (MDR) Pseudomonas aeruginosa and Acinetobacter were 40% and 37.5% respectively. Conclusion: Due to the increasing incidence of multidrug-resistant organisms in our ICU, early and correct diagnosis of VAP is an urgent challenge for an optimal antibiotic treatment and cure. Hence, knowing the local microbial flora causing VAP and effective infection control practices are essential to improve clinical outcomes.

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