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Jagadish Kumar K.,JSS Medical College and Hospital
Archives of Clinical Infectious Diseases | Year: 2013

Typhoid fever is a common infection in children in developing countries. Typhoid fever is a systemic illness which affects many organs. Isolated hepatitis, thrombocytopenia and acute renal failure complicating typhoid fever are well known. The potential of multiorgan involvement in typhoid fever - on rare occasions - may occur simultaneously in the same patient. © 2013, Shahid Beheshti University of Medical Sciencces.


Ravikumar B.R.,JSS Medical college and hospital | Tejus C.,JSS Medical college and hospital | Madappa K.M.,JSS Medical college and hospital | Prashant D.,JSS Medical college and hospital | Dhayanand G.S.,JSS Medical college and hospital
International Braz J Urol | Year: 2015

To compare the efficacy of sono-urethrogram and ascending urethrogram in the evaluation of stricture urethra. Materials and Methods: In this prospective study 40 patients with obstructive lower urinary tract symptoms and suspected to be having stricture urethra were subjected to ascending urethrogram and sonourethrogram. The radiologist was blinded to the findings of ascending urethrogram. All the sonourethrograms were done by the same radiologist. The findings of sonourethrogram & ascending urethrogram were compared with the findings of cystoscopy and intra-operative findings. The specificity, sensitivity, positive predictive value and negative predictive value of each modality in the diagnosis of various urethral anomalies were estimated. Results: The sonourethrogram identified stricture disease in all the patients who had abnormal ascending urethrogram. In addition, other abnormalities like spongiofibrosis, diverticula and stones which were not picked up in ascending urethrogram were diagnosed by sonourethrogram. The cystoscopic and intra-operative findings with respect to stricture length, diameter and spongiofibrosis correlated well with sono-urethrogram findings. 5 patients who had stricture in the ascending urethrogram were found to be having the normal urethra in sonourethrogram and confirmed by cystoscopy. Conclusion: sonourethrogram is an effective alternative to ascending urethrogram in the evaluation of stricture urethra. It is more sensitive in the diagnosis of anterior urethral strictures than posterior urethral strictures. It is superior to ascending urethrogram in the identification of spongiofibrosis, diameter and length of the stricture. The complications were lower in sonourethrogram group compared to ascending urethrogram.


Singh J.,JSS Medical College and Hospital | Jain K.,JSS Medical College and Hospital | Mruthyunjaya,JSS Medical College and Hospital | Ravishankar R.,JSS Medical College and Hospital
Indian Journal of Orthopaedics | Year: 2011

Background: The proximal phalanx (PP) of the fingers is fractured more frequently than the middle or even distal phalanges. The problems of malunion, stiffness and sometimes loss of skin or other soft tissues associated with PP fracture increases the disability. The optimum treatment depends on fracture location, fracture geometry and fracture stability. The objective of the study was to analyse the treatment outcome in a series of closed proximal phalangeal fractures of the hand. Materials and Methods: Eighty-four proximal phalangeal fractures in 68 patients were enrolled from 2007 to 2009. The treatment modalities were broadly categorised into two groups, Group A consisted of conservative treatment, and Group B consisted of surgical treatment. Group A included 47 digits treated with closed reduction (CR) with immobilization (n=43), extension block cast and dynamic traction (n=4), while 37 digits were treated in Group B, which included closed or open reduction (OR) and internal fixation (IF) with K-wires (n=31), OR and IF with stainless-steel wiring (n=2), and mini external-fixator (n=4). Belsky's criteria and Gingrass' criteria were used for assessment of finger injuries and to assess the efficacy of conservative and surgical modalities for closed proximal phalangeal fractures of the hand. Results: Average period of follow-up was 1 year (range 10-14 months). The excellent to good results seen in Groups A and B were 89% and 92%, respectively. Six complications were seen in Group A, which included four cases with malunion and two cases with digital stiffness. Three complications were seen in Group B, which included one each of malunion, digital stiffness and extensor lag. Overall, maximum poor results (n=4) were seen with CR and buddy strapping. Conclusion: Conservative treatment is an inexpensive method, particularly suitable for stable fractures, and in patients who are poor candidates for surgery, Surgical modalities have distinct advantage of stable fixation, but with added risk of digital stiffness. Percutaneous pinning is a reliable, most commonly used surgical modality and technically easier. Both conservative and surgical modalities have good efficacy when used judiciously.


Ram D.,JSS Medical College and Hospital | Gowdappa B.,JSS Medical College and Hospital
Revista de Psiquiatria Clinica | Year: 2015

Background: Trust and expectation are important aspect of doctor patient relationship and its role in patient’s satisfaction and medication adherence is unclear. Objective: To study the levels of trust and expectation on psychiatrist and its relationship with patient’s satisfaction and treatment adherence. Methods: One hundred and twenty three consecutive outpatients were recruited on follow-up if they satisfied the selection criteria. They were assessed with socio-demographic and clinical proforma designed for this study, Patient Trust Scale, Patient Satisfaction Survey, Patient Expectations Questionnaire and Medication Adherence Rating Scale. Results: There was a high mean score on trust scale (Mean 38.9, SD 8.5) and expectation questionnaire (Mean 13.5, SD 3.3). On Kruskal-Wallis H test significant group differences were observed in nuclear vs joint family type (χ2 = 18.496, η2 =.151, df = 1, Sig. =.000) and knowledge of treatment option (medication only vs medication + psychotherapy) treatment option (χ2 = 18.100, η2 =.148, df = 2, Sig. =.000) and occupational status (employed vs unemployed) (χ2 = 3.165, η2 =.029, df = 1, Sig. =.056) on the score of PTS. Similar differences were also observed in method of treatment sought before (no treatment vs allopathic) (χ2 =.065, η2 =.065, df = 3, Sig. =.005), knowledge about treatment option (medication only vs medication + psychotherapy) (χ2 =.026, η2 =.161, df = 2, Sig. =.000) and occupation (employed vs unemployed) (χ2 =.061, η2 =.061, df = 1, Sig. =.006) on the score of PEQ. On regression analysis (R2 =.723, F = 156.46, p =.000) value of the score on patient satisfaction was statistically significant as predicted by score on measure of expectation (beta = -0.095, t = -1.966, p = 0.052) and trust (beta =.842, t = 17.504, p =.000). Discussion: Levels of patients trust and expectation on physician varies with knowledge about treatment option & occupational status, and significantly associated with levels of satisfaction. © 2015, Lemos Editorial e Graficos Ltda. All rights reserved.


Kiran H.S.,JSS Medical College and Hospital
Journal of the Indian Medical Association | Year: 2012

Thyroid storm is a severe variety of thyrotoxicosis. It is an uncommon condition but can be fatal. Mildly raised serum bilirubin levels can be seen in up to 5% of patients with thyrotoxicosis, butmarked elevations are rare. The association of severe thyrotoxicosis with severe hepatic dysfunction hasbeen rarely reported. Here an interesting case of thyrotoxicosis induced liver disease which improved following aggressive treatment is reported.


Kumar K.J.,JSS Medical College and Hospital | Manjunath V.G.,JSS Medical College and Hospital | Shailashree M.,JSS Medical College and Hospital | Girish G.N.,JSS Medical College and Hospital
Journal of the Indian Medical Association | Year: 2012

Dengue fever outbreaks are reported from India since last 10 years. Since 2005, chikungunya is also causing massive outbreaks in India and other parts of Asia. Both viruses are transmitted by aedes genus and both viruses can re-emerge in many regions due to climatic changes. The clinical presentation of both arthropod borne diseases are similar. Here a concomitant infection of chikungunya and dengue is reported in an 8-year-old child.


Prabhakar S.K.,Jss Medical College And Hospital
Saudi Journal of Ophthalmology | Year: 2014

Purpose: Primary pterygium is a fibrovascular proliferation over the nasal cornea, probably resulting from the limbal stem cell deficiency. Intraoperative mitomycin-C application seems to associate with reduced recurrences, however produced ocular surface problems and vision threatening complications. The present clinical study investigated the safety profile of autologous limbal conjunctival transplantation in terms of recurrence rate, as the main outcome measure and complications as the secondary outcome. Methods: The present study was randomised, interventional and prospective clinical study conducted from a tertiary Hospital. Pterygium excision was performed with limbal conjunctival autograft availed from the affected eye. Secondary pterygia resulting from inflammation, trauma and other diseases were excluded. Patients were followed up for 18. months for recurrence and other complications. Microsoft Office Excel 2007 was used for statistical analysis. Results: A total of 71 eyes of sixty-eight patients with primary pterygia included between November 2007 and October 2010. The study recruited 35 (51%) males and 33 (49%) females with mean age of 36.9 with ±12.82. years standard deviation (mean, SD) ranging from 19 to 75. years. Age grouped by range intervals categorised into six groups. Pterygium was diagnosed in 32 (45%) right eyes and 39 (55%) left eyes. There were 65 (91.55%) nasal and 4 (5.63%) temporal pterygium and no case of double head pterygia found. Average horizontal extension of the pterygium measured was 1.67. mm (±4.23) from the apex to the corneal limbus. Graft oedema in 1 (0.71%) patient, graft bleed in 2 (1.42%) cases and 1 (0.72%) case of granuloma observed. No recurrences encountered during 18. months follow up. Conclusions: Pterygium occurred predominantly in the younger population group 36.9. mm (±12.82) probably due to the increased outdoor activity with high exposure to sunlight and dusty atmosphere. Absence of recurrences was probably attributable to the smaller pterygium size of 1.67. mm (±4.23), use of the autologous limbal conjunctival graft and treatable intra and post operative complications successfully. © 2014.


Nanjappa V.,JSS Medical College and Hospital
The Journal of the Association of Physicians of India | Year: 2012

Extrapulmonary involvement can occur in isolation or along with a pulmonary focus as in the case of patients with disseminated tuberculosis. Vulval TB is very rare and the presentation can be quite variable, and may be misdiagnosed as sexually transmitted disease. We herein report a young lady with disseminated TB presenting as Vulval TB.


Koteshwar S.,Jss Medical College And Hospital | Siddesh A.,Jss Medical College And Hospital
Journal of Clinical and Diagnostic Research | Year: 2016

Introduction: Tubectomy remains one of the most popular methods of permanent contraception in developing countries. But about 10% of them regret their decision and 1% want to restore their fertility. Out of many options open method of tubal recanalisation is one of the method of restoring fertility. Aim: Primary objective was to analyse whether open tubal recanalization is a feasible option for those planning to conceive after tubectomy. Secondary objective was to evaluate the pregnancy rate and analyse the various factors affecting pregnancy rate after tubal recanalization. materials and methods: A prospective study, follow-up of 2 year in patients treated with tubal recanalization during 20122013 at tertiary teaching hospital. 10 women underwent tubal recanalization procedure. Open surgery was done and the principles of microsurgery were followed meticulously throughout the procedure. statistical Analysis: All statistical analyses were performed using SPSS for Windows version 17.0 (SPSS Inc., Chicago, IL, USA). Data were expressed as means, medians, standard deviations, and percentages. We used Student's t-test to compare group means and Fisher-exact test to compare proportions. A p-value of <0.05 was considered significant. results: Out of 10 women who went recanalization an overall 50% pregnancy rate was achieved. All pregnancies occurred within 1 year of procedure. When previous sterilisation was done by laparoscopic route, after reversal all of them (100%) conceived while in those sterilised by Pomeroys method the pregnancy rate after reversal was only 16.6%. Following reversal pregnancy was stastically more significant in those with final tubal length of >5cm (p=0.04) and in those with Isthmo-Isthmic type of anastomosis. conclusion: Open tubal recanalisation remains a feasible option for those planning pregnancy after tubectomy. The important factors for determining the success of operation were age of the patient, time interval between sterilization and reversal, site of ligation, method used for previous ligation and the remaining length of the tube after recanalisation. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved.


Mahesh P.A.,Jss Medical College And Hospital
The Indian journal of chest diseases & allied sciences | Year: 2010

BACKGROUND: Non-adherence to specific allergen immunotherapy is a major hurdle faced by the allergist, contributing to poor clinical outcomes. OBJECTIVES: To assess the independent association of various factors with non-adherence to specific allergen immunotherapy. METHODS: Fifty consecutive (non-adherent) and control (adherent) subjects receiving specific allergen immunotherapy were included in the study and various factors related to non-adherence including socio-demographic, clinical and immunotherapy related variables were compared between the two groups by univariate and multivariate analysis. RESULTS: On univariate analysis, gender, allergic conjunctivitis, family history, progression of disease, perception of immunotherapy, medicine requirement, and the pattern of missed doses greater than two in the last 10, 20 and 30 doses were found to be significantly associated with non-adherence. On multivariate analysis, independent association was observed with allergic conjunctivitis, family history, perception of immunotherapy, missed doses greater than two in the last 10 doses of immunotherapy and medicine requirement. CONCLUSIONS: The independent factors associated with non-adherence may vary between different settings and countries. There is a need for developing individual case holding programmes to improve clinical outcomes in patients receiving specific allergen immunotherapy.

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