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Prasad M.S.R.,Indian Institute of Technology Madras | Manivannan M.,Indian Institute of Technology Madras | Manivannan M.,Christian Medical College | Manoharan G.,Government Stanley Medical College and Hospital | Chandramohan S.M.,Institute of Surgical Gastroenterology
Journal of Surgical Education | Year: 2016

Background: Most of the commercially available virtual reality-based laparoscopic simulators do not effectively evaluate combined psychomotor and force-based laparoscopic skills. Consequently, the lack of training on these critical skills leads to intraoperative errors. Objectives: To assess the effectiveness of the novel virtual reality-based simulator, this study analyzed the combined psychomotor (i.e., motion or movement) and force skills of residents and expert surgeons. The study also examined the effectiveness of real-time visual force feedback and tool motion during training. Design: Bimanual fundamental (i.e., probing, pulling, sweeping, grasping, and twisting) and complex tasks (i.e., tissue dissection) were evaluated. In both tasks, visual feedback on applied force and tool motion were provided. The skills of the participants while performing the early tasks were assessed with and without visual feedback. Participants performed 5 repetitions of fundamental and complex tasks. Reaction force and instrument acceleration were used as metrics. Setting: Surgical Gastroenterology, Government Stanley Medical College and Hospital; Institute of Surgical Gastroenterology, Madras Medical College and Rajiv Gandhi Government General Hospital. Participants: Residents (N = 25; postgraduates and surgeons with <2 years of laparoscopic surgery) and expert surgeons (N = 25; surgeons with >4 and ≤10 years of laparoscopic surgery). Results: Residents applied large forces compared with expert surgeons and performed abrupt tool movements (p < 0.001). However, visual + haptic feedback improved the performance of residents (p < 0.001). In complex tasks, visual + haptic feedback did not influence the applied force of expert surgeons, but influenced their tool motion (p < 0.001). Furthermore, in complex tissue sweeping task, expert surgeons applied more force, but were within the tissue damage limits. In both groups, exertion of large forces and abrupt tool motion were observed during grasping, probing or pulling, and tissue sweeping maneuvers (p < 0.001). Conclusions: Modern day curriculum-based training should evaluate the skills of residents with robust force and psychomotor-based exercises for proficient laparoscopy. Visual feedback on force and motion during training has the potential to enhance the learning curve of residents. © 2016 Association of Program Directors in Surgery.

Vijayabhaskar C.,Government Stanley Medical College and Hospital
Indian Journal of Practical Pediatrics | Year: 2010

Pityriasis rosea is a common self limiting condition seen in children and adolescents characterized by appearance of herald patch followed by skin lesions along the Langer 's line. Exact etiology is not known. Viral etiology has been proposed and may present without any symptoms to mild itching and rarely severe itching and lasts up to 8 weeks. The disease has to be differentiated from other conditions such as secondary syphilis, drug eruption, tinea corporis, erythema multiforme, etc. It is usually a clinical diagnosis in which reassurance of the patient and parents are important. Topical steroids and oral antihistamines are used. Erythromycin orally and acyclovir have been tried to shorten the course of the disease.

Benjamin J.B.E.,University of Madras | Jayanthi V.,Government Stanley Medical College and Hospital | Devaraj H.,University of Madras
Clinica Chimica Acta | Year: 2010

Background: The molecular events that underlie the conversion of normal human gastric epithelium into adenocarcinoma are poorly understood. MUC1 overexpression and localization in mitochondria might confer cancer cells with attenuation of stress induced apoptosis. We studied MUC1 expression pattern, interaction with HSP70 and localization in mitochondria in preneoplastic and neoplastic human gastric tissues. Methods: Immunohistochemistry and Western blot were used to study MUC1 expression pattern and localization in mitochondria. Coimmunoprecipitation was used to study MUC1 interaction with HSP70. MUC1 expression was correlated with other causative features including erbB2 expression. Results: MUC1 was expressed in 75.8% (147/194). MUC1 overexpression was detected in 50.0% (19/38 cases) dysplasia and 58.2% (32/55 cases) adenocarcinoma tissues. MUC1-CT-HSP70 interaction was seen in 71.66% (43/60 cases) and MUC1 localized to mitochondria in 33.33% (5/15) dysplasia samples and in 47.05% (8/17) adenocarcinoma samples. MUC1 expression showed significant association with smoking (Χ 2=5.945; p<0.015), alcohol consumption (Χ 2=4.055; p<0.044) and erbB2 positivity (Χ 2=10.75; p<0.001). MUC1 expression did not show appreciable association with age (Χ 2=0.15; p<0.698), sex (Χ 2=0.22; p<0.640) or Helicobacter pylori infection (Χ 2=3.06; p<0.080). Conclusions: Significant correlation was found between MUC1 expression and smoking, alcohol and erbB2 expression. MUC1 showed aberrant expression in dysplasia and adenocarcinoma stages. MUC1 cytosolic tail was bound by HSP70 in all the stages but MUC1-CT was found to localize in mitochondria only in dysplasia and adenocarcinoma. MUC1-CT localization to mitochondria in dysplasia and adenocarcinoma might aid in the attenuation of epithelial stress response induced loss of polarity. © 2010 Elsevier B.V.

Bhaskar E.,Sri Ramachandra University | Mohan P.,Government Stanley Medical College and Hospital
Journal of Infection in Developing Countries | Year: 2010

Numerous resources relevant to the 2009 pandemic influenza are available online. A casual search in Google using the phrase "swine flu resources" yields 9,180,000 items, making a time-bound search less fruitful for an average health care professional. This review summarizes the contents useful to practicing clinician available in 12 web sites that were selected based on their relevance to clinical care. © 2010 Bhaskar and Mohan.

Krishnaiah B.,Penn State Hershey Medical Center | Alwar S.P.,Government Stanley Medical College and Hospital | Ranganathan L.N.,Madras Medical College
Journal of Neurosciences in Rural Practice | Year: 2016

Introduction: People living with epilepsy continue to suffer from enacted or perceived stigma that is based on myths, misconceptions, and misunderstandings that have persisted for many years. In the last decade, there has been an increase in individual literacy rate and increased access to technology in rural population. However, it is unclear if this has any effect on knowledge, attitude, and practice (KAP) attitude toward epilepsy. Objective: Our primary aim is to evaluate KAP toward epilepsy. In addition, we also estimated the prevalence of stroke and epilepsy in rural South India. Materials and Methods: Using a 14-item questionnaire, we assessed KAP toward epilepsy and identified determinants of inappropriate attitudes toward people with epilepsy and 10-item questionnaires to assess the prevalence of epilepsy and stroke among 500 randomly selected populations in a Pattaravakkam village (Tamil Nadu, India). Results: About 87.7% of the people had heard or read about epilepsy. Negative attitudes appeared to be reinforced by beliefs that epilepsy is hereditary (23.1%), kind of insanity (22.6%), or as contagious (12.0%). The knowledge about the clinical characteristics and first aid to a person during a seizure was 25.8%. About 36.5% of people think that society discriminates people with epilepsy. Moreover, our prevalence study showed that 8.7% people are suffering from epilepsy and 3.7% had stroke previously and at the day of survey, the stroke prevalence is 3.3%. Conclusion: Even with increased literacy, technology, and communication devices, the KAP of people toward epilepsy is relatively low. General public education campaigns and specific school education campaigns children should be encouraged to increase the KAP toward epilepsy. The prevalence and pattern of epilepsy and stroke is on the higher side in the village of Pattaravakkam. Future research regarding the value of targeted education in improving KAP will be worthwhile.

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