Mangalore, India
Mangalore, India

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PubMed | JSS Medical College and Professor and Unit Head
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2015

Despite advances in diagnosis, management and critical care of patients with peritonitis due to hollow viscus perforation, prognosis remains poor. Early assessment by scoring systems will influence the management and prognosis.Evaluation of Mannheim Peritonitis Index (MPI) score for predicting the outcome in patients with peritonitis.Prospective study of 50 patients admitted and operated for peritonitis in JSS Medical College Hospital. The structured scoring system i.e. MPI was applied along with other clinical and biochemical parameters recorded in pre-structured proforma. Data was analysed for predicting mortality and morbidity using EPI info and SPSS software.The overall mortality and morbidity was 14% and 38% respectively. MPI scores of 20, 21-29, and 30 had a mortality of 5%, 14%, and 50% respectively. MPI score of 25 had highest sensitivity of 72.09% and specificity of 71.43% in predicting mortality, 80.65% sensitivity and 57.89% specificity for morbidity. MPI score of > 25 were associated with 6.45 times higher risk of mortality (p=0.03), 5.72 times higher risk of morbidity (p=0.005) compared to patients with MPI score 25.MPI is disease specific, easy scoring system for predicting the mortality in patients with secondary peritonitis. Increasing scores are associated with poorer prognosis, needs intensive management and hence it should be used routinely in clinical practice.

PubMed | Senior Registrar, Dr Sn Medical College and Professor and Unit Head
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2016

Adolescence is the formative period of life. Poor adolescent health translates into poor maternal health leading to increased maternal morbidity with inter-generational consequences.To compare anthropometric, socio-demographic, menstrual and nutritional status of rural and urban adolescent school going girls of Western Rajasthan, India.A cross-sectional comparative study was conducted in two rural schools and one urban school of Jodhpur region. Anthropometric, socio-economic (family history, menstrual history, maternal education) and dietary habit data of 327 (137 urban and 190 rural) school going adolescent girls aged 11-16 years were collected using structured questionnaires by a school based survey after consent from parents and school officials. Height and weight were taken using the standard procedure. Stunting (height for age) and thinness [Body Mass index (BMI) for age] were calculated as per the National Center for Health and Statistics (NCHS) standards. Statistical analysis was done using student t-test, fisher-exact test and Chi-square test.Mean height was significantly higher in urban girls while mean BMI of adolescents was significantly higher in rural areas as compared to their urban counterparts. Growth spurt was between 12-13 years showing maximum increase in mean height, coinciding with or immediately post-menarche. Menarche was one year earlier in urban girls as compared to rural girls (p<0.001). Thinness was more prevalent among females in urban areas and stunting was more common amongst girls residing in rural areas.Life style habits (poor dietary habits, sedentary life style) of the urban girls may contribute to an early menarche but rural girls despite having a later onset of menarche; have a lower final height which may be attributed to their poor nutritional status. Improving nutrition of rural girls and modifying the life style of urban girls and educating their mothers will reduce the disparity and lead to better health and development of adolescent girls in this region and this could be expected to improve maternal health in future.

PubMed | Assistant Professor, JSS Medical College and Professor and Unit Head
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2014

Adult intussusception is relatively rare in patients with bowel obstructions. Adult invagination is mostly caused by benign tumours. Intussusceptions caused by inflammatory fibroid polyps (IFPs) are uncommon. IFPs are rare, localized, non-neoplastic lesions originating in the submucosa of the gastrointestinal tract. We are reporting a rare case of intestinal obstruction caused by an ileo-ileal intussusception, caused by an IFP, a rare but peculiar and always benign tumour.

PubMed | Rnt Medical College and Professor and Unit Head
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2016

Acute hypocalcaemia is a medical emergency that can have catastrophic implications like tetany, seizures, cardiac arrythmias or laryngospasm if left untreated. We are presenting a case of a 30-year-old female patient undergoing total abdominal hysterectomy with bilateral salpingoopherectomy under spinal anaesthesia. She developed unexpected bilateral carpal spasm intraoperatively which was promptly diagnosed and successfully managed with intravenous calcium administration. We conclude that the anaesthetist should be aware of the clinical presentation of acute hypocalcaemia, its causes and emergency management in the perioperative period to prevent any adverse outcomes.

PubMed | Junior Resident and Professor and Unit Head
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2017

Iron deficiency is the most common cause of Post-partum anaemia, reported as 50-60% in India. It is primarily due to inadequate iron intake and due to peripartum blood loss. It has been associated with significant post-partum complications. Therefore, Post-partum iron deficiency warrants greater attention and higher quality care. Oral iron treatment has been considered the standard of care. However, parenteral iron treatment is expected to be advantageous in cases where oral iron therapy is not possible. As a result, there is increased interest in parenteral iron therapy. Recently, a new parenteral iron preparation, Ferric Carboxy Maltose (FCM), was developed to facilitate effective treatment of Iron Deficiency Anaemia (IDA). This study was carried out in women with Post-partum IDA who were expected to benefit from the short treatment period permitted by the larger doses given parenterally.To evaluate the efficacy, safety and tolerability of intra venous FCM compared to oral iron in treating Post-partum IDA patients.This was a hospital based prospective comparative study. Women with Haemoglobin (Hb) between 7-10 g/dl and peripheral smear showing microcytic hypochromic anaemia on the first Post-partum day were included in the study. These women were randomised to receive either IV FCM (single dose 1000 mg) or oral ferrous ascorbate (100 mg twice daily for 6 weeks). Statistical analysis was done by students paired and unpaired t-test and by chi- square test and fischer-exact t-test.Ninety patients (45 in each group) were followed at one week and six weeks from the start of treatment and their Hb were estimated. Significant rise in Hb was observed in subjects treated with FCM compared to oral iron. FCM treated subjects were more likely to achieve an Hb rise greater than or equal to 3.0 g/dL. FCM was better tolerated with complete adherence to treatment as compared to oral ferrous ascorbate.FCM showed robust evidence of efficacy, tolerability and safety in comparison to oral iron. Collectively, these data support the clinical utility of FCM in treating Post-partum IDA patients.

PubMed | Junior Resident. and Professor and Unit Head
Type: Case Reports | Journal: The Journal of the Association of Physicians of India | Year: 2016

Cysticercosis, a parasitic disease caused by larval form of Taenia solium, is a major health concern in the developing world. The encysted larval stage can affect any part of the body, but are most frequently detected in brain, eye, skeletal muscle and subcutaneous tissue. Most muscular cysticercosis are almost always associated with central nervous system involvement or with multiple intramuscular cysts or both. Here we report an unusual case of cysticercosis in right rectus muscle which was an isolated muscle involvement without any other systemic manifestation.

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