Father Muller Medical College Hospital

Mangalore, India

Father Muller Medical College Hospital

Mangalore, India

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PubMed | Father Muller Medical College Hospital and Concetta Hospital
Type: Journal Article | Journal: Journal of orthopaedic case reports | Year: 2016

Intra-articular glenoid fractures are extremely rare and may be associated with other injuries. Traditionally open reduction and internal fixation has been recommended in displaced intra-articular glenoid fractures. However open reduction is difficult and it may not be possible to address the associated intra-articular soft tissue injuries. A few reports of arthroscopic assisted fixation of these fractures have been recently published. We are reporting a case of Ideberg type 3 glenoid fracture and its treatment.We are presenting our case where a 52 year old man presented with Type 3 intra-articular glenoid fracture. The fracture was fixed percutaneously under simultaneous arthroscopic and fluoroscopic guidance.Intra-articular glenoid fractures are uncommon and difficult to treat. Arthroscopy assisted percutaneous fixation technique can be a valuable adjunct for the surgeon in dealing with not only the fracture but also the associated soft-tissue injuries.


PubMed | Tata Memorial Center and Father Muller Medical College Hospital
Type: Journal Article | Journal: Indian journal of cancer | Year: 2017

Unlike the developed countries, there is a lack of good epidemiologic data for testicular germ cell tumors (GCTs) in India with majority presenting in advanced stage. This study aims to elaborate on the epidemiology of testicular GCTs and response to standard first-line chemotherapy (CT).GCTs treated at our center from January 2013 to June 2014 were retrospectively analyzed. Patients underwent orchidectomy either outside or at our hospital. Based on stage and risk group, standard CT (bleomycin, etoposide, and cisplatin/etoposide and cisplatin/carboplatin AUC7) and radiotherapy were given as appropriate. Response was calculated based on the Response Evaluation Criteria in Solid Tumors. Statistical analysis was performed using SPSS 18 software.Fifty nonseminomatous germ cell tumor (NSGCT) and 36 of SGCT cases were studied. 30%, 46%, and 64% of NSGCT and 11%, 28%, and 22% of SGCT had N2, N3, and M1 diseases, respectively. The mean nodal size was 7 cm (1.5-19) in NSGCT and 5.5 cm (1.3-11) in SGCT. As per the International Germ Cell Cancer Collaborative Group classification, in patients with metastatic disease, 9% of NSGCT were good, 53% were intermediate, and 38% were poor risk whereas 75% of SGCT were good and 25% were intermediate risk. Following CT among NSGCT, 5% and 71% had radiologic complete response (CR) and partial response (PR), respectively. Among SGCT, 46% and 38% had radiologic CR and PR, respectively. 22%, 53%, and 13% of NSGCT and 12%, 24%, and 20% of SGCT developed febrile neutropenia, Grade 3 or 4 hematological and nonhematological toxicities, respectively, after standard chemotherapy.GCTs in India present with high nodal and high-risk diseases wherein the standard first-line CT may not be adequate as curative therapy; however, significant chemotoxicity is also a hindrance.


Mathanda T.R.,Father Muller Medical College Hospital | M. Bhat R.,Father Muller Medical College Hospital | Hegde P.,Father Muller Medical College Hospital | Anand S.,Father Muller Medical College Hospital
Pediatric Dermatology | Year: 2016

Background Transepidermal water loss (TEWL) is the normal, constitutive loss of water vapor from the skin in the absence of sweat gland activity. It is regarded as one of the most important parameters for characterizing skin barrier function, and the values are dependent on multiple variables. The objective of this study was to evaluate TEWL in neonates using a closed- chamber system, and determine if there is a variation of TEWL with the mode of delivery, pre-term birth, low birthweight or phototherapy. Methods This prospective study was conducted in 104 healthy neonates, 30 neonates in the Neonatal Intensive Care Unit (NICU) and 40 adults using a noninvasive, closed- chamber system (VapoMeter™). Results A statistically significant difference in TEWL was noted between newborns and adults. No remarkable difference in TEWL was seen between boys or men and girls or women or those born via normal vaginal birth and caesarean section, but TEWL was significantly higher in preterm and low birthweight neonates. Significantly higher TEWL was noted from the antecubital fossa of the neonates who received phototherapy when compared with six other sites. Conclusions The closed- chamber system is an acceptable alternative to the more widely used open-chamber system. The higher mean TEWL in neonates suggests that the epidermal barrier is still adapting to extrauterine life, making newborn skin more sensitive and requiring appropriate, age adapted care. © 2015 Wiley Periodicals, Inc.


Nayak M.T.,Father Muller Medical College Hospital | Raghavendra B.S.,Father Muller Medical College Hospital
Journal of Clinical and Diagnostic Research | Year: 2015

Introduction: Lumbar Spondylolisthesis as a cause of low back pain and lower limb radiculopathy has been treated using varied surgical options. The role of laminectomy for decompression of neural elements and stabilization using instrumentation in the form of pedicle screws and rod construct has been a well-established and time tested treatment modality. Aim and Objectives: This study analyses the role of laminectomy and instrumentation in obtaining clinical and radiologically favourable outcome. Materials and Methods: Data was analysed from the case records for the duration from January 2010 to March 2014. The study analyses the influence of lumbar decompression (laminectomy) and transpedicular instrumentation using titanium pedicle screws and intertransverse process iliac crest graft on patients with degenerative lumbar spondylolisthesis and spinal stenosis. Conclusion: Decompression primarily relieves radicular symptoms and neurogenic claudication whereas fusion primarily relieves back pain by elimination of instability. The addition of posterolateral instrumentation (pedicle screws) enhances the ability to obtain a solid arthrodesis. Posterolateral instrumentation enables improved functional outcome, better patient satisfaction and less back and lower limb symptomatology. This is irrespective of bony arthrodesis or pseudoarthrosis, at least in the short term follow-up. © 2015, Journal of Clinical and Diagnostic Research. All Rights Reserved.


Dsouza D.C.,Father Muller Medical College Hospital | Ali N.M.,Father Muller Medical College Hospital
Asian Journal of Pharmaceutical and Clinical Research | Year: 2015

Objective: Warts are a common skin disease seen by dermatologists. It is an infection caused by different strains of human papilloma virus. The presence of various topical and systemic treatments for warts is a testament to the lack of a rapid, simple, uniformly effective, inexpensive, nonscarring, and painless treatment. The purpose of this study was to compare the safety and efficacy of 85% formic acid with 30% formic acid on palmoplantar warts. Methods: A non-randomized, open trial was performed in 30 patients with common warts attending Father Muller’s Medical College Hospital, Mangalore. 15 patients received 85% formic acid application, and 15 patients received 30% formic acid using a to puncture technique every day. Results: About 73.3% in Group I and 73.3% in Group II showed disappearance of warts at the end of 3 months. No major side-effects were seen at the end of therapy in either group. Conclusions: The results show that both 30% and 85% formic acid application are a safe, economical, and effective alternative in the treatment of common warts with few side-effects and 30% formic acid may be an effective replacement of 85% formic acid. A study with more number of patients is needed to see the efficacy of this treatment. © 2015, Asian Journal of Pharmaceutical and Clinical Research. All rights reserved.


John S.K.,Father Muller Medical College Hospital | Joseph J.,Father Muller Medical College Hospital | Shetty S.R.,Father Muller Medical College Hospital
National Medical Journal of India | Year: 2011

Background. Appendectomy is one of the most frequently performed abdominal operations in rural surgical practice. In spite of various preoperative investigations to aid in the diagnosis, the rate of negative appendectomies is 15%-30%. Qualitative C-reactive protein (CRP) estimation is an inexpensive diagnostic test which can be done in small laboratories using a simple kit. We studied the value of estimating the CRP level in diagnosing acute appendicitis and reducing negative appendectomies. Methods. Patients who had been clinically diagnosed with acute appendicitis and planned for appendectomy, were selected by purposive sampling. Leucocyte counts, CRP level estimation and ultrasonography of the abdomen were done preoperatively. The sensitivity, specificity, predictive value, diagnostic accuracy, false-positive and false-negative rates, and likelihood ratios were calculated for various components of the diagnosis. Results. Of the 238 patients, 193 had histological evidence of acute appendicitis. When the diagnosis was based on the consultant's decision, the overall negative appendectomy rate was 18.9%. CRP level estimation yielded a sensitivity of 98% (95% CI 95%-100%) and specificity of 87% (95% CI 73%-94%). A positive CRP value was associated with acute appendicitis (p<0.0001). Adding CRP to the diagnostic work-up increased the sensitivity to 100% (95% CI 98%- 100%) and diagnostic accuracy to 92% (95% CI 87%- 95%), and would have reduced negative explorations to 3%. Conclusion. CRP estimation complements the clinical diagnosis by a consultant surgeon, and should be included in the diagnostic work-up of appendicitis. CRP estimation is inexpensive and does not add an undue burden to the cost of management. © The National Medical Journal of India 2011.


Nayak M.T.,Father Muller Medical College Hospital | Raghavendra B.S.,Father Muller Medical College Hospital
Journal of Clinical and Diagnostic Research | Year: 2015

Introduction: The Craniovertebral junction (CVJ) refers to a bony enclosure where the occipital bone surrounds the foramen magnum, the atlas and the axis vertebrae. Because of the complexity of structures, CVJ instability is associated with diagnostic and therapeutic problems. Posterior CV fusion procedures have evolved a lot over the last couple of decades. There has been a lookout for one such surgical procedure which is inherently safe, simple, easily reproducible and biomechanically sound. In our study, we present the initial experience the cases of CV junction instrumentation using O-C1-C2 screw & rod construct operated by the author. Aims and Objectives: The current study is a descriptive analysis of the cases of CVJ instability treated by us with instrumentation using O-C1-C2 screw and rod construct fusion technique. Materials and Methods: It is a retrospective, analytical study in which cases of CV junction instability operated by the author between January 2010 to March 2014 were analysed using various clinical, radiological and outcome parameters. Conclusion: CV junction instrumentation using O-C1-C2 screw and rod construct fusion technique proved to be safe, effective, easily reproducible and biomechanically sound technique which can be adopted by all surgeons who may be at any stage of their learning curve. © 2015, Journal of Clinical and Diagnostic Research. All rights reserved.


PubMed | Father Muller Medical College Hospital and Manipal University India
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2016

Surgical procedures in abdominal area lead to changes in pulmonary function, respiratory mechanics and impaired physical capacity leading to postoperative pulmonary complications, which can affect up to 80% of upper abdominal surgery.To evaluate the effects of flow and volume incentive spirometry on pulmonary function and exercise tolerance in patients undergoing open abdominal surgery.A randomized clinical trial was conducted in a hospital of Mangalore city in Southern India. Thirty-seven males and thirteen females who were undergoing abdominal surgeries were included and allocated into flow and volume incentive spirometry groups by block randomization. All subjects underwent evaluations of pulmonary function with measurement of Forced Vital Capacity (FVC), Forced Expiratory Volume in the first second (FEV1), Peak Expiratory Flow (PEF). Preoperative and postoperative measurements were taken up to day 5 for both groups. Exercise tolerance measured by Six- Minute Walk Test during preoperative period and measured again at the time of discharge for both groups. Pulmonary function was analysed by post-hoc analysis and carried out using Bonferronis t-test. Exercise tolerance was analysed by Paired T-test.Pulmonary function (FVC, FEV1, and PEFR) was found to be significantly decreased in 1(st), 2(nd) and 3(rd) postoperative day when compared with preoperative day. On 4(th) and 5(th) postoperative day the pulmonary function (FVC, FEV1, and PEFR) was found to be better preserved in both flow and volume incentive spirometry groups. The Six-Minute Walk Test showed a statistically significant improvement in pulmonary function on the day of discharge than in the preoperative period. In terms of distance covered, the volume- incentive spirometry group showed a greater statistically significant improvement from the preoperative period to the time of discharge than was exhibited by the flow incentive spirometry group.Flow and volume incentive spirometry can be safely recommended to patients undergoing open abdominal surgery as there have been no adverse events recorded. Also, these led to a demonstrable improvement in pulmonary function and exercise tolerance.


PubMed | Father Muller Medical College Hospital
Type: Journal Article | Journal: Pediatric dermatology | Year: 2016

Transepidermal water loss (TEWL) is the normal, constitutive loss of water vapor from the skin in the absence of sweat gland activity. It is regarded as one of the most important parameters for characterizing skin barrier function, and the values are dependent on multiple variables. The objective of this study was to evaluate TEWL in neonates using a closed- chamber system, and determine if there is a variation of TEWL with the mode of delivery, pre-term birth, low birthweight or phototherapy.This prospective study was conducted in 104 healthy neonates, 30 neonates in the Neonatal Intensive Care Unit (NICU) and 40 adults using a noninvasive, closed- chamber system (VapoMeter).A statistically significant difference in TEWL was noted between newborns and adults. No remarkable difference in TEWL was seen between boys or men and girls or women or those born via normal vaginal birth and caesarean section, but TEWL was significantly higher in preterm and low birthweight neonates. Significantly higher TEWL was noted from the antecubital fossa of the neonates who received phototherapy when compared with six other sites.The closed- chamber system is an acceptable alternative to the more widely used open-chamber system. The higher mean TEWL in neonates suggests that the epidermal barrier is still adapting to extrauterine life, making newborn skin more sensitive and requiring appropriate, age adapted care.


PubMed | Father Muller Medical College Hospital
Type: Journal Article | Journal: Indian journal of dermatology | Year: 2016

Seborrheic keratosis (SK) is the most common benign epidermal tumor of the skin. Even though SK has been well characterized clinically, dermoscopically, and histopathologically, data regarding clinical dermoscopic and histopathological correlation of different types of SK are inadequate.We carried out this study to establish any correlation between the clinical, dermoscopic, and histopathological appearance of SK and its variants.This was a descriptive study. Patients with SK were evaluated with respect to age, sex, family history of similar lesions, site of lesions, and symptoms associated with the lesions. Dermoscopy was performed in all cases. Biopsies were taken from the lesions and assessed for histopathology.The most common age group affected by SK was 31-50 years (42%). A female preponderance of 76% was seen. Majority of our patients had a positive family history (62%), though Sun exposure was not seen to be a major factor. The most common clinical variant was common SK (CSK) (46%). The most common dermoscopic findings seen in CSK were comedo-like (CL) openings, fissures and ridges (FR), and milia-like (ML) cysts. Dermatosis papulosa nigra and pedunculated SK had characteristic FR and CL openings on dermoscopy. Stucco keratoses showed network-like (NL) structures and sharp demarcation. CL opening on dermoscopy corresponded to papillomatosis and pigmentation, ML cysts corresponded to horn cysts, FR corresponded to papillomatosis, and NL structures corresponded to an increase in basal layer pigmentation.This study emphasizes the use of dermoscopy in improving the diagnostic accuracy of SK. The correlation between the various histological and dermoscopic features is described.

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