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Keepanasseril A.,Jawaharlal Institute of Medical Education and Research JIPMER | Suri V.,Jawaharlal Institute of Postgraduate Medical Education & Research | Bagga R.,Jawaharlal Institute of Postgraduate Medical Education & Research | Aggarwal N.,Jawaharlal Institute of Postgraduate Medical Education & Research
Journal of Obstetrics and Gynaecology | Year: 2012

A prospective study was done in 311 women undergoing induction of labour for the formulation of a new score, which will be more objective than the conventional Bishop's score. Pre-induction cervical assessment was done by the transvaginal sonographic parameters followed by the digital examination. Labour induction was successful in 79.09%. A new score was formulated using the parameters having independent association and weighting of individual components was given according to its regression coefficients. A new score with a maximum value of 13 was proposed. The best cut-off point for the new score in receiver operating characteristics curve was six with a sensitivity of 95.5% and specificity of 84.6%. The new score was found to have a better area under the curve than the conventional score. © 2012 Informa UK, Ltd. Source


Gopalakrishnan M.,Jawaharlal Institute of Medical Education and Research JIPMER | Saurabh S.,Jawaharlal Institute of Medical Education and Research JIPMER
Medical Hypotheses | Year: 2014

Remote ischaemic preconditioning is emerging as a promising clinical technique which can afford immediate protection against coronary ischaemia. The mechanisms which mediate the signal transduction from remote organ to the heart are still unclear. The role of ATP sensitive potassium channels in ischaemic preconditioning has been established. It is known that the red blood cell (RBC) acts as a mediator of local autoregulation in adjusting oxygen supply to demand by sensing hypoxia and releasing ATP locally to achieve vasodilatation in the adjacent vascular beds. Our hypothesis links these two known mechanisms. Remote ischaemic preconditioning and local RBC autoregulation might share a common mechanism using the ATP sensitive potassium channels. Therefore, we hypothesize that the signal transduction by RBC might be partly responsible for this protection against ischaemia. © 2014 Elsevier Ltd. Source


Pal G.K.,Jawaharlal Institute of Medical Education and Research JIPMER | Shyma P.,Jawaharlal Institute of Medical Education and Research JIPMER | Habeebullah S.,Jawaharlal Institute of Medical Education and Research JIPMER | Shyjus P.,Jawaharlal Institute of Medical Education and Research JIPMER | And 2 more authors.
Indian Journal of Physiology and Pharmacology | Year: 2011

The early prediction of pregnancy-induced hypertension (PIH) is based on the demonstration of increased sympathetic activity in early part of pregnancy. However, the mechanisms that increase sympathetic activity in PIH have not yet been fully elucidated. Therefore, in the present study we have investigated the link of albumin-globulin ratio (AGR) to sympathovagal imbalance in PIH patients. Spectral analysis of HRV was performed in three groups of subjects (Group I: normal pregnant women; Group II: pregnant women with risk factors for PIH, but did not develop PIH; Group III: pregnant women with risk factors and developed PIH) and their biochemical parameters including AGR were recorded. It was observed that LF-HF ratio, the most sensitive indicator of sympathovagal balance was significantly high (P<0.01) since early pregnancy in group III compared to other groups, which was considerably correlated with AGR in group III (PIH subjects). It was suggested that alteration in AGR could have direct contribution to the sympathovagal imbalance that plays a critical role in the genesis of PIH. Source


Nugpok O.,Jawaharlal Institute of Medical Education and Research JIPMER | Menon J.,Jawaharlal Institute of Medical Education and Research JIPMER | Satyanarayana P.,Jawaharlal Institute of Medical Education and Research JIPMER
European Journal of Orthopaedic Surgery and Traumatology | Year: 2010

An injury involving fracture of the proximal humeral physis along with glenohumeral dislocation in preschool children is a very rare event. We report a 3-year-old girl child with fracture dislocation of the shoulder who was treated successfully with open reduction. © Springer-Verlag 2009. Source


Kodidela S.,Jawaharlal Institute of Medical Education and Research JIPMER | Suresh Chandra P.,Jawaharlal Institute of Medical Education and Research JIPMER | Dubashi B.,Jawaharlal Institute of Medical Education and Research JIPMER
European Journal of Clinical Pharmacology | Year: 2014

Purpose: The antifolate drug methotrexate (MTX) was introduced into clinical practice about 60 years ago and remains an important component of different acute lymphoblastic leukemia (ALL) treatment protocols. It acts by inhibiting several enzymes in the folate pathway, thereby resulting in the disruption of folate homeostasis. To date, treatment regimens have not been personalized despite there being experimental evidence that gene polymorphisms of folate metabolizing enzymes affect MTX response. The aim of this review was to evaluate the influence of genetic polymorphisms of the enzymes involved in the MTX pathway on ALL treatment outcomes and identify factors underlining the failure to personalize MTX therapy. Methods: We conducted a literature search in PUBMED and Goggle scholar using the following key words: methotrexate, polymorphism, acute lymphoblastic leukemia, pharmacogenetics, pharmacogenomics and personalized mediciner. Results: The reasons for the failure to personalize MTX therapy may be due to (1) most studies involving single-center, small-sized cohorts, (2) differences in MTX dose across different protocols, (3) failure to consider minimal residual disease as a risk factor for post-induction treatment, (4) differences in outcome criteria between studies and (5) failure to consider the folate levels of a patient before initiation of MTX therapy. Although high-throughput techniques allow the mapping of thousands of genetic polymorphisms in a single run, it remains a major challenge to dissect out folate-metabolizing enzymes which have a high impact on the efficacy and toxicity of MTX and which, therefore, could be the targets for intervention. Conclusions: Prospective pharmacogenetic studies which consider all of the above-mentioned factors should be undertaken to facilitate the design of personalized MTX treatment for ALL patients. © 2013 Springer-Verlag Berlin Heidelberg. Source

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