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Sulthana B.,Indira Gandhi Medical College and Research Institute IGMCRI | Shewade H.D.,IGMCRI | Sunderamurthy B.,IGMCRI | Manoharan K.,Indira Gandhi Medical College and Research Institute IGMCRI | Subramanian M.,Primary Health Center Muthialpet
Indian Journal of Medical Research, Supplement | Year: 2015

Background and objectives: Unmet need for contraception remains a national problem. The study was conducted in an urban area of Puducherry, India, among the eligible couples to assess the unmet need for contraception and to determine the awareness and pattern of use of contraceptives along with the socio-demographic factors associated with the unmet needs for contraception.  Methods: This cross-sectional study included eligible couples with married women in age group of 15-45 yr as the study population (n=267). Probability proportional to size sampling followed by systematic random sampling was used. A pre-tested questionnaire was administered to collect data from the respondents. Double data entry and validation of data was done.  Results: Unmet need for contraception was 27.3 per cent (95% CI: 22.3-33); unmet need for spacing and limiting was 4.9 and 22.5 per cent, respectively. Among those with unmet need (n=73), 50 per cent reported client related factors (lack of knowledge, shyness, etc.); and 37 per cent reported contraception related factors (availability, accessibility, affordability, side effects) as a cause for unmet need.  Interpretation and conclusions: Our study showed a high unmet need for contraception in the study area indicating towards a necessity to address user perspective to meet the contraception needs. © 2015, Indian Council of Medical Research. All rights reserved.


Adiga U.S.,IGMCRI | Adiga S.,IGMCRI
International Journal of Pharma and Bio Sciences | Year: 2013

Thyroid hormone, secreted by thyroid gland have a profound effects on the lipid metabolism. It exerts its action mainly by its genomic action. It diffuses from the extracellular fluid across the plasma membrane and go directly into the nucleus. The cognate receptor binds to the thyroid hormone response element [TRE].It regulates the gene expression of key enzymes involved in lipid metabolism by modulating their transcription. Thyroid hormone induces acetyl CoA carboxylase, fatty acid synthase, malic enzyme and thereby favours fatty acid synthesis. Paradoxically it also favours oxidation of fatty acids by enhancing the expression of carnitine palmitoyl transferase. Thyroid hormone is closely associated with lipoprotein metabolism, known to decrease triglycerides by enhanced activity of lipoprotein lipase and hepatic lipase activities. It is universally accepted that this hormone lowers cholesterol content of low density lipoprotein by affecting the expression of LDL receptors and clearance of LDL. It also has important role in stabilizing the mRNA coding for the rate limiting enzyme of cholesterol biosynthesis, HMG CoA reductase. Cholesterol clearance is affected as this hormone influences the enzymes of bile acid synthesis. This review discusses the effect of thyroid hormone in lipid metabolism in detail and lipid variations that occur in hypo and hyperthyroid conditions. The effects of thyroid hormone on the lipid metabolism makes it a potential molecule to develop a class of drugs which can modify the lipid levels. Clinical trials are going on to test the use of thyroid hormone analogues in the treatment of hyperlipidemias.


Adiga U.S.,IGMCRI | Vickneshwaran V.,JRF | Sen S.K.,Pondicherry Institute of Medical science
Research Journal of Pharmaceutical, Biological and Chemical Sciences | Year: 2013

Acute pancreatitis is a pancreatic inflammatory disease. The pathologic spectrum of acute pancreatitis varies from interstitial pancreatitis, which is usually a mild and self-limited disorder, to necrotizing pancreatitis, in which the degree of pancreatic necrosis correlates with the severity of the attack. Pancreatitis results when proteolytic enzymes are activated in the pancreas rather than in the intestinal lumen. Endotoxins, exotoxins, viral infections, ischemia, anoxia, and direct trauma are believed to activate these proenzymes. Activated proteolytic enzymes, digest pancreatic and peripancreatic tissues and bring about a severe damage. Elevated levels of serum amylase and lipase establish the diagnosis of acute pancreatitis. Aim of the study was to, i.determine the ratio of serum lipase to serum amylase(L/A) in alcoholic and nonalcoholic pancreatitis patients as compared to age and sex matched normal healthy persons and also to find out whether this index will be useful in differentiating pancreatitis of alcoholic etiology from that of nonalcoholic. Serum amylase and lipase levels were estimated in fifty acute pancreatitis patients (in which 50% were alcoholic and 50% were nonalcoholic) and fifty age and sex matched normal controls. Assay was done automated clinical chemistry analyzer. Lipase/Amylase was calculated. Both the enzymes were elevated in all acute pancreatitis patients, but the rise in amylase was double in nonalcoholic pancreatitis as compared to alcoholics. The extent of elevation of lipase was the same in both the groups of pancreatitis patients. L/A ratio was more than 4 in alcoholics and more than 2 in nonalcoholic pancreatitis patients. L/A ratio might help to differentiate the alcoholic and nonalcoholic pancreatitis, and thus it might have a significant role in establishing the etiology of the disease. Further studies need to be done in larger population of pancreatitis patients.


PubMed | IGMCRI and JIPMER
Type: Journal Article | Journal: Anesthesia, essays and researches | Year: 2015

We present an unusual case of life-threatening hemothorax in a 15-year-old boy following subclavian vein tear during internal jugular vein (IJV) cannulation prior to initiation of surgery (mitral valve replacement). Successful IJV cannulation was done in the third attempt. However, we missed the subclavian tear which occurred during the first two initial attempts as there was no clinical evidence suggestive of it at that point of time. This undiagnosed hemothorax led to hemodynamic decompensation requiring high volume and inotropic support to wean the patient off cardiopulmonary bypass. This unusually high requirement of fluid and inotropes required the surgeon to look for noncardiac causes for the hemodynamic disturbance and he noticed a bulge in the right pleura, which on exploration had approximately 1.5 L of collected blood. It was then retrospectively analyzed that the cause of this hemothorax could have been the undue lateral orientation of the needle during IJV cannulation and the advancement of the dilator to its entire length could have injured the subclavian vein. Here, we also would like to discuss the safety precautions to be taken during the cannulation, like the needle orientation and the length to which the dilator must be advanced for safe central venous cannulation.


PubMed | IGMCRI
Type: Journal Article | Journal: The Indian journal of medical research | Year: 2015

Unmet need for contraception remains a national problem. The study was conducted in an urban area of Puducherry, India, among the eligible couples to assess the unmet need for contraception and to determine the awareness and pattern of use of contraceptives along with the socio-demographic factors associated with the unmet needs for contraception.This cross-sectional study included eligible couples with married women in age group of 15-45 yr as the study population (n=267). Probability proportional to size sampling followed by systematic random sampling was used. A pre-tested questionnaire was administered to collect data from the respondents. Double data entry and validation of data was done.Unmet need for contraception was 27.3 per cent (95% CI: 22.3-33); unmet need for spacing and limiting was 4.9 and 22.5 per cent, respectively. Among those with unmet need (n=73), 50 per cent reported client related factors (lack of knowledge, shyness, etc.); and 37 per cent reported contraception related factors (availability, accessibility, affordability, side effects) as a cause for unmet need.Our study showed a high unmet need for contraception in the study area indicating towards a necessity to address user perspective to meet the contraception needs.


PubMed | IGMCRI and Mahatma Gandhi Institute
Type: Journal Article | Journal: Anesthesia, essays and researches | Year: 2015

We present a case of a 40-year-old male patient who presented to us with radicular pain in arm for anterior cervical discectomy with fusion. The preanesthetic checkup including indirect laryngoscopy was normal with routine investigations within normal limits. The patient was induced and intubated with the established routine technique without any obvious airway problems. Prophylactic dexamethasone was administered, and the intraoperative course was uneventful. Immediately after extubation, it was noticed that the patient had inspiratory stridor and whispered voice on the operation theater table itself. Assessment by Bonfils retromolar fiberscope under fentanyl sedation revealed bilateral vocal cord edema. The patient was re intubated and put on T piece with humidified O2. After 72-h, patient was extubated after confirming normal vocal cord movement under flexible fiberscope guidance. This case is presented to alert anesthesiologist about the possibility of vocal cord edema even though other potential airway complications are possible. We would also highlight the importance of Bonfils retromolar fiberscope in awake vocal cord examination and flexible fiberscope use in managing patients presenting with airway problems during extubation.

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