institute of medical science and research Center

Mangalore, India

institute of medical science and research Center

Mangalore, India
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Bharati S.M.,Institute of Medical science and Research Center | Singh N.,Armed Forces Medical College
Journal of Pharmacology and Pharmacotherapeutics | Year: 2016

Objective: To study the effects of losartan and atenolol on glucometabolic parameters in nondiabetic hypertensive patients. Materials and Methods: In a prospective, open-label, parallel group study, nondiabetic patients with mild to moderate hypertension were randomized to either losartan (titrated from 50 to 100 mg/day, n = 20) or atenolol (titrated from 25 mg to 100 mg/day, n = 20) for period of 24 weeks. At baseline, 12 and 24 weeks fasting plasma glucose (FPG), fasting plasma insulin (FPI), homeostasis model assessment for insulin resistance (HOMA-IR) apart from lipid parameters, mean systolic, and diastolic blood pressures levels were determined. Results: At the end of study, losartan significantly (P < 0.05) reduced FPG, FPI, and HOMA-IR compared to atenolol and baseline. While atenolol increased the HOMA-IR levels significantly compared to the baseline. Conclusions: Losartan improved the insulin sensitivity while atenolol worsened it. Losartan is better than atenolol for its effects on the glucose-insulin metabolism. © 2016 Journal of Pharmacology and Pharmacotherapeutics | Published by Wolters Kluwer - Medknow.


PubMed | Institute of Medical science and Research Center and Pravara Institute of Medical Sciences
Type: | Journal: Anatomy research international | Year: 2016

The right hepatic artery is an end artery and contributes sole arterial supply to right lobe of the liver. Misinterpretation of normal anatomy and anatomical variations of the right hepatic artery contribute to the major intraoperative mishaps and complications in hepatobiliary surgery. The frequency of inadvertent or iatrogenic hepatobiliary vascular injury rises with the event of an aberrant anatomy. This descriptive study was carried out to document the normal anatomy and different variations of right hepatic artery to contribute to existing knowledge of right hepatic artery to improve surgical safety. This study conducted on 60 cadavers revealed aberrant replaced right hepatic artery in 18.3% and aberrant accessory right hepatic artery in 3.4%. Considering the course, the right hepatic artery ran outside Calots triangle in 5% of cases and caterpillar hump right hepatic artery was seen in 13.3% of cases. The right hepatic artery (normal and aberrant) crossed anteriorly to the common hepatic duct in 8.3% and posteriorly to it in 71.6%. It has posterior relations with the common bile duct in 16.7% while in 3.4% it did not cross the common hepatic duct or common bile duct. The knowledge of such anomalies is important since their awareness will decrease morbidity and help to keep away from a number of surgical complications.


Bahekar S.E.,Institute of Medical science and Research Center | Kale R.S.,Mahatma Gandhi Institute
Journal of Pharmacy and Bioallied Sciences | Year: 2016

Aims: The study aimed to explore the antioxidant activity of ethanolic leaf extract of Manihot esculenta Crantz leaves (MEC) in wistar rats. Materials and Methods: Ethanolic extract of MEC leaves in the doses of 50 mg/kg, 100 mg/kg, and 200 mg/kg were used in wistar rats of either sex. The oxidative stress was produced by overdose of acetaminophen and estimation of serum concentration of various enzymes such as malonaldehyde (MDA), superoxide dismutase (SOD), reduced glutathione (GSH), and catalase (CAT) were measured by standard biochemical methods. Silymarin (100 mg/kg) was used as a standard drug for assessment of antioxidant status. Statistical Analysis Used: Results were analyzed by one-way analysis of variance followed by Student's unpaired t-test. Results: When compared with the standard antioxidant silymarin, MEC extract did not exhibit antioxidant activity in terms of MDA level reduction. However, it significantly increased serum levels of the antioxidant enzymes (SOD, GSH, and CAT) exerting a potent antioxidant effect in a graded manner. Conclusions: The observed results suggest that MEC could be a potential source of antioxidants. However, further studies are required to explore this therapeutic property of plant. © 2016 Journal of Pharmacy And Bioallied Sciences | Published by Wolters Kluwer - Medknow 83.


Bahekar S.E.,Institute of Medical science and Research Center | Kale R.S.,MGIMS
Journal of Ayurveda and Integrative Medicine | Year: 2015

Background: Use of Manihot esculenta Crantz (MEC) plant has been mentioned in literature of Food and Agriculture Organization of United Nations, Central Tuber Crops Research Institute and many others. It is also known commonly as tapioca, continues to be a crop of food security for the millions of people, especially in the developing countries of the globe including India. Medicinal uses of this plant including diarrhea have been mentioned in literature, but scientific evidence is lacking. Objective: The objective was to study antidiarrheal activity of ethanolic leaf extract of MEC in Wistar rats. Materials and Methods: Ethanolic extract of MEC leaves in the doses of 50 mg/kg, 100 mg/kg and 200 mg/kg were used in Wistar rats of either sex. Experimental models used were castor oil-induced intestinal fluid accumulation and charcoal passage test. Loperamide and atropine sulfate were the standard drugs used in these models respectively. Results: MEC extracts decreased intestinal fluid volume in dose dependent manner no extract group was comparable with standard drug loperamide (5 mg/kg). MEC extracts also significantly inhibited gastrointestinal motility in dose dependent manner. MEC (100 mg/kg) and MEC (200 mg/kg) were comparable with standard drug atropine sulfate (5 mg/kg) in this aspect. <0.05 were considered to be significant. Conclusions: Ethanolic extract of MEC leaves exhibited significant antidiarrheal activity by decreasing intestinal fluid accumulation and the gastrointestinal motility in Wistar rats.


Shetty A.,Sapthagiri Institute of Medical science and Research Center | Geethamani V.,Institute of Medical science and Research Center
Journal of Oral and Maxillofacial Pathology | Year: 2016

Introduction: Neoplastic lesions of salivary glands present an interesting subject because of their histologic diversification. Complex features exhibited by them have aroused considerable speculations concerning their histogenesis and continues to hold the interest of clinicians and pathologists. Major salivary glands are superficial and have easy accessibility for fine-needle aspiration cytology (FNAC). These glands are generally not subjected to incisional or core needle biopsy, because of the possible risks of fistula formation and tumor seedling. FNAC diagnosis of major salivary gland neoplasms aids in proper planning of required surgery and avoidance of the same in cases of non-neoplastic lesions. Materials and Methods: Cytological features of major salivary gland tumors diagnosed on FNAC were studied over a period of one and a half years. Cytological and architectural patterns in smears were compared with histopathological features in cases where the specimens were available with a note on the age, sex and presenting complaints. Statistical Analysis: Analysis of variance (ANOVA) was used to find the significance of study parameters.Chi-square/Fisher Exact was used to find the significance of study parameters on categorical scale between two or more groups. P value of <0.05 was considered to be significant. Results: A total of 114 salivary gland FNACs were done, 75 patients were clinically suspected to be neoplasms. The peak incidence was in the third to fourth decade of life with a female preponderance. Parotid was the most commonly affected gland (80%) with pleomorphic adenoma and mucoepidermoid carcinoma (10.7%) being the most common benign and malignant tumors respectively. The diagnostic accuracy of FNAC was 97.6%. Warthins tumor was misdiagnosed and was associated with a strong smoking history. Conclusion: Salivary gland neoplasms constitute a small but significant percentage of head and neck tumors. FNAC is inexpensive, quick, and aids in the preoperative diagnosis and planning of surgery. © 2016 Journal of Oral and Maxillofacial Pathology | Published by Wolters Kluwer - Medknow.


Bommanahalli B.,Institute of Medical science and Research Center | Bhat R.,Indira Gandhi Medical College | Rupanarayan R.,Sri Devaraj Urs Medical College
Journal of Cytology | Year: 2010

Aim: Our study aimed at a cell pattern approach to interpret thyroid cytology and to demonstrate diagnostic accuracy of fine needle aspiration cytology (FNAC) with an emphasis on diagnostic pitfalls. Materials and Methods: A total number of 218 goitre cases, from the year 2000 to 2004, were reviewed retrospectively from the cytology files, without considering the previous cytological diagnosis. Four cases with inadequate aspirate were excluded. The predominant cell pattern, such as macro/normofollicular, microfollicular, papillary, syncytial, dispersed and cystic pattern, was noted in each case. The final diagnosis was arrived by observing the cellular details and background elements. Cytological diagnosis was correlated with histopathology in 75 cases. The sensitivity and specificity were computed. Results: Normo/macrofollicular pattern was seen in 71.96% of nodular goitre and 6.9% of follicular neoplasms. Around 86.2% of follicular neoplasms and 17.6% of papillary carcinoma had microfollicular pattern. The papillary pattern was seen in 47% of papillary carcinoma. Syncytial pattern was noticed in 72.3% of chronic lymphocytic thyroiditis and 29.4% of papillary carcinoma. Cytological diagnosis was concordant with histopathological diagnosis in 65 cases. Overall sensitivity and specificity of FNAC in diagnosing neoplastic lesions of thyroid were 83.33 and 95.55%, respectively. Conclusion: FNAC is more sensitive and specific in triaging neoplastic from non-neoplastic thyroid lesions. Identification of the predominant cell pattern would be complementary to analysis of cell morphology and background details in cytological diagnosis of thyroid lesions. This approach helps to diagnose follicular neoplasm and follicular variant of papillary thyroid carcinoma.


Babu K.V.Y.,Institute of Medical science and Research Center | Visweswaraiah D.S.,KMCT Medical College | Kumar A.,Institute of Medical science and Research Center
Journal of Natural Science, Biology and Medicine | Year: 2014

Metallo-beta-lactamase (MBL) mediated resistance to carbapenems is an emerging threat in Pseudomonas aeruginosa (PA) nosocomial infections. Limited data on role of Imipenem resistant MBL positive PA (IR-MBLP-PA) and IR-MBL negative-PA (IR-MBLN-PA) infections on mortality and morbidity initiated the present study. Objectives: The aim of this study is to determine the role of IR-MBLP-PA and IR-MBLN-PA infections on mortality and morbidity. Materials and Methods: Prospective observational study of 1 year with 110 PA nosocomial infections was conducted with Imipenem + ethylene-diamine-tetra-acetic acid combined disc test for MBL detection. Role of IR-MBLP-PA and IR-MBLNPA infections on the outcome and morbidity were assessed in terms of crude mortality rate, Charlson's comorbidity score and mean duration of stay in intensive care unit (ICU) until cure and until death, number of episodes of complications and underlying disease. Results were analyzed by z test for proportions and Student t-test. Results: Relatively high crude mortality was observed among IR-MBLP-PA infections than IR-MBLN-PA (42.86% [6/14] vs. 20% [2/10], Z = 0.69, P = 0.49 NS). Ventilator-associated pneumonia was the underlying disease and a confounding factor in all deaths due to IR-MBLP-PA infections. IR-MBLP-PA infections resulted in rapid downhill course to death with short mean duration of stay in ICU until death than IR-MBLN-PA infections (3.167 ± 0.98 days vs. 16 ± 2.82, P < 0.001 highly significant [HS]) with more number of complications (5.85 ± 1.65 vs. 3.7 ± 1.31, P < 0.001 HS). With the exception of previous Imipenem therapy, association of higher Charlson's comorbidity score, severe underlying diseases, multidrug and pandrug resistance and pre-disposing risk factors with IR-MBLP-PA infections was not statistically significant. Conclusions: Higher mortality in IR-MBLP-PA than in IR-MBLN-PA was not significant indicating IR as an important predictor of mortality than MBL production. Higher morbidity and increased virulence was observed with certainty in IR-MBLP-PA infections. © Journal of Natural Science, Biology and Medicine.


Muthusamy D.,Institute of Medical science and Research Center | Boppe A.,Institute of Medical science and Research Center
Journal of Clinical and Diagnostic Research | Year: 2012

Purpose of the Study: The purpose of this study was to evaluate the production of various beta lactamases among multi-drug resistant Acinetobacter baumanii isolates from clinical specimens. Methods Used: A total of 100 Acinetobacter baumannii meropenem resistant isolates were used for the detection of carbapenemases (Modified Hodge test), AmpC beta lactamase (the AmpC disc test) and metallo beta lactamase (the Disc potentiation test). Results and Conclusion: Among 100 meropenem resistant isolates, 20% were carbapenemase producers, 73% were AmpC producers, and 10% were metallo beta lactamase producers. MBL production, AmpC beta lactamase production and carbapenemase production is becoming common in the multi drug resistant isolates of A. baumannii. Our study suggests that the disc potentiation test, the Amp C disc test, and the Modified Hodge test are simple tests that can be done routinely in the lab for all the multi drug resistant isolates of A. baumannii.


Ravikumar S.,Institute of Medical science and Research Center
World Journal of Laparoscopic Surgery | Year: 2011

Surgical treatment of incompetent perforating veins of the lower leg performed by open method carries considerable morbidity and also associated with poor wound healing. Subfascial endoscopic perforator surgery (SEPS) is a new, minimally invasive endoscopic technique performed in patients with advanced chronic venous insufficiency. This technique offers an effective treatment alternative which avoids the lengthy incisions of the classical open Linton subfascial ligation techniques. The favorable ulcer healing rate and improvement in clinical symptoms suggest that SEPS is a feasible, safe and effective treatment of the incompetent perforator veins in patients with advanced chronic venous insufficiency. © Jaypee Brothers Medical Publishers (P) Ltd.


Patil U.N.,Institute of Medical science and Research Center | Jambulingappa K.L.,Institute of Medical science and Research Center
Journal of Clinical and Diagnostic Research | Year: 2015

Introduction: Previous studies have suggested the use of rational combination therapy for the treatment of multi-drug resistant (MDR) infections. An antibiotic adjuvant entity (AAE) of ceftriaxone, sulbactam and disodium edetate (Elores) was approved for multi-drug resistant infections in India. Aim: This study was designed to investigate the efficacy and safety of this AAE in patients with sepsis due to extended spectrum beta lactamse (ESBL) and metallo-beta lactamase (MBL) producing pathogens. Materials and Methods: A retrospective observational study was conducted in patients admitted in intensive care unit (ICU) at tertiary health care site in India, with enrollment from 24 March, 2012 to 7 Aug, 2012. Patients eligible for enrollment had clear infection of bacterial septicaemia, were aged 12-65 years, and were considered for treatment with Cephalosporins categories of antibiotics. Results: Total 18 patients were included in the study and all assigned to combination of ceftriaxone, sulbactam and disodium edetate. Complete clinical cure in terms of relief and no-disease symptoms had observed in 15 (83.3%) subjects, however 3 (16.6%) showed treatment failure (TF). Similarly for bacteriological eradication response, 15 (83.3%) patients displayed complete bacteriological eradication response and 03 (16.6%) subjects showed TF. No serious side effect was observed during the study. Conclusion: This study recommends the use of combination of ceftriaxone, sulbactam and disodium edetate (EDTA) for the treatment of MDR septicaemia associated with ESBL and MBL producing microbes. © 2015, Journal of Clinical and Diagnostic Research. All right reserved.

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