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Krupp K.,Public Health Research Institute | Marlow L.A.V.,University College London | Kielmann K.,London School of Hygiene and Tropical Medicine | Doddaiah N.,JSS Medical College and Hospital | And 2 more authors.
Journal of Adolescent Health | Year: 2010

Purpose: This qualitative study investigated physician intention-to-recommend the human papillomavirus (HPV) vaccine to parents of adolescent girls in India. There are currently no data on attitudes to HPV vaccination among healthcare providers in India. Methods: Between June and August 2008, 20 semistructured qualitative in-depth interviews were conducted among physicians from a range of specialties and practice settings in Mysore District, India. Physicians were interviewed about their specialty and the types of patients they saw in their practice, attitudes toward recommending HPV vaccination to parents of adolescent girls, perceived subjective norms surrounding the promotion of vaccines in their work settings, and their perceptions regarding self-efficacy in recommending the HPV vaccine. Results: The study found that knowledge about HPV infection and its relationship to cervical cancer was low among physicians across specialties. While most physicians expressed positive attitudes toward vaccination in general, and HPV vaccination in particular, the overwhelming majority believed that few of their patients would react positively to a vaccine recommendation. Physicians were concerned about talking to parents about their adolescent daughters' reproductive lives. Certain specialties, particularly obstetrician/gynecologists, suggested that recommending immunization was not appropriate in their work setting. Conclusion: With the HPV vaccine recently being approved in India, there is a strong need to provide more education for physicians about the relationship of HPV infection and cervical cancer and the benefits of vaccinating adolescent girls to prevent cervical cancer in the future. © 2010 Society for Adolescent Medicine. Source


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. Source


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. Source


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. Source


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. Source

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