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Thathapudi S.,Vasavi Medical and Research Center | Kodati V.,Vasavi Medical and Research Center | Erukkambattu J.,Kamineni Academy of Medical science and Research Center | Katragadda A.,Anu Fertility Center | And 3 more authors.
Genetic Testing and Molecular Biomarkers | Year: 2014

Background: Tumor necrosis factor-alpha (TNF-α) appears to be linked with hyperandrogenism (HA), increased insulin resistance (IR), and obesity (Ob), which were common features noted with polycystic ovarian syndrome (PCOS). Our aim was to study the role of TNF-α in the pathogenesis of IR and Ob in PCOS, as well as a C850T (rs1799724) polymorphism in the promoter region of the TNF-α gene, in a group of 204 PCOS patients and 204 age-matched healthy controls. Results: Significant differences were observed between PCOS patients and controls. All the PCOS had elevated body mass index, waist circumference, waist-to-hip ratio, fasting insulin, homeostatic model assessment (HOMA) score, and serum TNF-α when compared with controls (p<0.05). Genotype distribution for the C-850T polymorphism was observed with the frequency of the variant T allele being 0% in the PCOS group and 9% in the control group (p=0.0032). Conclusions: In conclusion, our present results suggest that the TNF-α system might contribute to the pathogenesis of HA, Ob, and IR in PCOS independent of a polymorphism of the TNF-α C850T (rs1799724) in our population. © 2014 Mary Ann Liebert, Inc.


Beedimani R.S.,Kamineni Academy of Medical science and Research Center | Kalmath B.,Al Badar Rural Dental College and Hospital
International Journal of Pharma and Bio Sciences | Year: 2014

Phosphodiesterase 5 (PDE5) is a key enzyme involved in the regulation of cGMPspecific signaling pathways in normal physiological processes such as smooth muscle contraction and relaxation. Initially, PDE5 inhibitors were developed as potential antianginal agents, but early clinical results were disappointing and the focus of these drugs moved to the treatment of Erectile Dysfunction (ED) based on the findings that nitric oxide and cyclic guanosine monophosphate were important mediators of penile erection. The overall goal of this review is to provide a comprehensive understanding of the current and potential therapeutic roles of the PDE5 enzyme inhibitors. Novel PDE5 inhibitors are highly selective for the PDE5 isoenzyme, and this may translate into potential novel indications and fewer adverse systemic effects. Larger scale, well designed clinical trials are needed to ascertain the safety, efficacy and costeffectiveness of PDE5 inhibitors in the future treatment of urological, cardiovascular, gastrointestinal, and central nervous system disorders.


Vuppala R.,Apollo Institute of Medical science and Research | Burugula K.,Kamineni Academy of Medical science and Research Center | Balakrishnan R.,Kasturba Medical College
Asian Journal of Pharmaceutical and Clinical Research | Year: 2016

Objective: Identifying the role of nasopharyngeal bacteria in recurrent middle ear (ME) infection helps in developing an effective treatment strategy. We aimed to compare bacterial flora of ME with nasopharynx (NP) and their sensitivity patterns in active stage of mucosal disease - otitis media (CSOM). Methods: Ear and nasopharyngeal swabs from patients with active ear discharge for >3 months were processed for culture and sensitivity, the organisms were identified using Gram-stain. Results: Twenty patients between 10 and 65 years and male:female ratio of 13:7 were enrolled. 9 had symptoms since childhood. 10 patients complained unilateral ear discharge; five each had discharge from the left and right ear. 11 patients had nasal symptoms; nose block due to obstruction (9), nasal discharge (8), and both symptoms were seen in eight patients. 14 patients (70.0%) had deviated nasal septum and 8 (40.0%) had discharge in the NP. Of 20 ear swabs, 19 grew bacteria; 1 was sterile (5.0%). 13 (65%) nasopharyngeal swabs grew bacteria, 7 were sterile. Culture yielded aerobic bacteria. Staphylococcus aureus was the most common bacterium (9/20, 45.0%) followed by Pseudomonas (7/20, 35.0%) isolated from the ear. The most common nasopharyngeal isolate was S. aureus (9=45%). 10 patients had common ME and nasopharyngeal flora. Organisms were sensitive to amoxicillin+clavulanic acid, fluoroquinolones. Sensitivity was observed to polymyxin, trimethoprim, and sulfamethoxazole also. Conclusion: Common ME and nasopharyngeal flora with same antibiotic sensitivity pattern suggest nasopharyngeal etiology. Nasopharyngeal flora may have a role in recurrent ME infections in mucosal disease - otitis media. © 2016, Innovare Academics Sciences Pvt. Ltd. All rights reserved.


PubMed | Kamineni Academy of Medical science and Research Center, Gandhi Medical College, Kamineni Institute of Medical science, Kamineni Hospitals and Dr Pinnamaneni Sidhartha Institute of Medical science and Research Foundation
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2015

Ischemic heart disease (IHD) remains a major public health problem nationally and internationally. Smoking is a major risk factor for IHD.The deletion (D) allele of the angiotensin converting enzyme (ACE) gene polymorphism has been associated with hypertension, ischemic stroke and myocardial infarction. The present study was carried out to determine the association of the ACE gene insertion/deletion (I/D) polymorphism in IHD patients with and without smoking.One hundred seven male IHD patients admitted consecutively in the Cardiology unit of a Government Hospital and 100 age and sex matched healthy controls were enrolled in this study.The patients were further divided into smokers and nonsmokers. All the subjects were checked for I/D polymorphism of ACE gene, which is mapped to 17q23.3 with OMIM no 106180, by polymerase chain reaction (PCR). The subjects were also investigated for lipid profile and ejection fraction (EF).We found significant difference in the distribution of D allele between patients and controls (p=0.009, OR 1.69, 95% CI 1.139 to 2.517).The significantly lower EF (p<0.001) was suggestive of greater cardiovascular compromise in smokers. The frequency of ID genotype was significantly associated with cases compared to controls (p=0.012, OR 2.054, 95% CI 1.1694-3.624) but was not significantly associated with smokers as compared to nonsmokers.We infer significant association of D allele with IHD. The smokers with ID genotype should be put on prophylactic ACE inhibitor therapy to prevent the morbidity and mortality associated with IHD.


Thathapudi S.,Vasavi Medical and Research Center | Kodati V.,Geneticist and Research Coordinator | Erukkambattu J.,Kamineni Academy of Medical science and Research Center | Katragadda A.,Anus Fertility Center | And 2 more authors.
International Journal of Endocrinology and Metabolism | Year: 2014

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine conditions affecting women of reproductive age with a prevalence of approximately 5-10% worldwide. PCOS can be viewed as a heterogeneous androgen excess disorder with varying degrees of reproductive and metabolic abnormalities, whose diagnosis is based on anthropometric, biochemical and radiological abnormalities. To our knowledge, this is the first study investigating the anthropometric, biochemical and ultrasonographic characteristics of PCOS in Asian Indians of South India, using the Androgen Excess Society (AES-2006) diagnostic criteria. Objectives: To assess anthropometric, biochemical and ultrasonographic features of PCOS subgroups and controls among South Indian women using the AES-2006 criteria. Materials and Methods: Two hundred and four women clinically diagnosed with PCOS, and 204 healthy women controls aged 17 to 35 years were evaluated. PCOS was diagnosed by clinical hyperandrogenism (HA), irregular menstruation (IM), and polycystic ovary (PCO). PCOS was further categorized into phenotypic subgroups including the IM+HA+PCO (n = 181, 89%), HA+PCO (n = 23, 11%), IM+HA (n = 0), and also into obese PCOS (n = 142, 70%) and lean PCOS (n = 62, 30%) using body mass index (BMI). Anthropometric measurements and biochemical characteristics were compared among the PCOS subgroups. Results: The PCOS subgroups with regular menstrual cycles (HA+PCO), had more luteinizing hormone (LH), follicle stimulating hormone (FSH), fasting glucose, fasting insulin, and high insulin resistance (IR) expressed as the Homeostasis Model Assessment (HOMA) score, compared with the IM+HA+PCO subgroups and controls. Similarly, the obese PCOS had high BMI, waist to hip ratio (WHR), fasting glucose, LH, LH/FSH, fasting insulin, HOMA score (IR), and dyslipidemia, compared with lean PCOS and controls. Unilateral polycystic ovary was seen in 32 (15.7%) patients, and bilateral involvement in 172 (84.3%) patients. All the controls showed normal ovaries. Conclusions: Anthropometric, biochemical, and ultrasonographic findings showed significant differences among PCOS subgroups. The PCOS subgroups with regular menstrual cycles (HA+PCO), had high insulin resistance (IR) and gonadotropic hormonal abnormalities, compared with the IM+HA+PCO subgroups and controls. © 2014, Research Institute For Endocrine Sciences and Iran Endocrine Society; Published by Kowsar Corp. © 2014, Research Institute For Endocrine Sciences and Iran Endocrine Society.


Akkenapally P.L.,Kamineni Academy of Medical science and Research Center
Journal of Obstetrics and Gynecology of India | Year: 2016

Objective: To compare the effectiveness, success rate and induction to abortion interval between administration of misoprostol only and mifepristone with misoprostol in second trimester abortions (14–20 weeks). Materials and methods: The study was conducted by dividing women approaching for second trimester termination, into two groups each consisting of 100 women. Group-I received only misoprostol; 600 mcg initial vaginal insertion followed by 400 mcg sublingually every 3 h until termination. Women in Group-II received mifepristone 200 mg and after 24 h started with 600 mcg misoprostol, per vaginal followed by 400 mcg sublingually till abortion was completed, up to a maximum of five doses in both groups. Results: The success rate in Group-I was 89 %, whereas in Group-II it was 96 %. The mean induction abortion interval in Group-I was 10.67 ± 3.96 h compared to Group-II which was significantly less 6.19 ± 2.70 h (p value < 0.01). The mean dose of misoprostol in Group-I was 1610 ± 511.18 mcg and in Group-II, it was lesser 1046 ± 392.71 mcg (p value < 0.01). There was significant difference in the mean blood loss also, 97.20 ± 36.35 ml in Group-I and 52.55 ± 27.96 ml in Group-II. Also among the individual groups multigravidae and lower gestational age (<17 weeks), women had lesser IAI as well as lesser misoprostol dose was required. Conclusion: Pretreatment with mifepristone significantly reduces the induction abortion interval and the misoprostol dose along with minimal blood loss. © 2016 Federation of Obstetric & Gynecological Societies of India


Thathapudi S.,Vasavi Medical and Research Center | Kodati V.,Vasavi Medical and Research Center | Erukkambattu J.,Kamineni Academy of Medical science and Research Center | Addepally U.,Jawaharlal Nehru Technological University | And 2 more authors.
Genetic Testing and Molecular Biomarkers | Year: 2015

Background: Polycystic ovaries and irregular menstruation/anovulation are important diagnostic criteria along with hyperandrogenism as per the Androgen Excess Society-2006 criteria for polycystic ovarian syndrome (PCOS). In the etiopathogenesis of PCOS, one of the candidate genes causing ovarian failure is the luteinizing hormone (LH) chorionic gonadotropin hormone receptor (LHCGR). Our aim was to study the association of LHCGR polymorphism (rs2293275) with PCOS in our study population. Materials and Methods: Genetic case-control study from multiple gynecological centers from Hyderabad, a cosmopolitan city in South India. The study involved 204 women with PCOS and 204 healthy, sex-, and age-matched controls. Anthropometric and biochemical profiles were taken in a well-designed pro forma. Isolation of deoxyribonucleic acid (DNA) and genotype analysis were done for the entire study population using the polymerase chain reaction-restriction fragment length polymorphism method followed by 12% polyacrylamide gel electrophoresis. Results: In this study, we have demonstrated an association between LHCGR (rs2293275) polymorphism and PCOS. The frequency of the G allele was 0.60 in PCOS and 0.49 in controls (odds ratio [OR] 1.531, confidence interval [CI] 1.16-2.01, and p-value=0.0026), which indicates that the G allele is associated with PCOS in our population. The GG genotype conferred a significant risk of developing PCOS (OR 3.36, CI 1.96-5.75, and p-value<0.0001). We found a significant association of the GG allele with body-mass index, waist to hip ratio, insulin resistance, LH, and LH/follicle-stimulating hormone (FSH) ratio in PCOS when compared with controls. The AA allele showed high basal FSH levels. Conclusions: This study suggests that LHCGR (rs2293275) polymorphism is associated with PCOS and could be used as a relevant molecular marker to identify women with the risk of developing PCOS in our population and may provide an understanding about the etiology of PCOS. © Mary Ann Liebert, Inc. 2015.


Ravishankar Reddy A.,Kamineni Academy of Medical science and Research Center | Chand K.,Kamineni Academy of Medical science and Research Center
International Journal of Pharma and Bio Sciences | Year: 2014

Studies Associate with APS and SLE are very scanty from our part of country. So the present study was conducted to find out the relation of APS with special reference to SLE in this region. Prospective study was carried out in 103 patients after approval by the Institute Ethical Committee and informed consent was taken from the patients who are attending Kamineni Hospitals. Estimation of different auto-antibodies was done by using standard immunological tests. 103 patients having SLE in the age group 21 to 30 years with female predominance. 22 patients had APS 13 male patients having SLE with APS. The most common clinical manifestation in SLE patients was musculoskeletal involvement (85.18%) followed by fever (74.07%), the patients having SLE with APS musculoskeletal involvement was the most common manifestation (77.27%) followed by fever and mucocutaneous involvement (72.72% and 59.09% respectively). The results are tabulated. APS syndrome is a major cause of morbidity and mortality in patients of SLE. The prevalence of secondary APS syndrome in SLE varies in different geographical regions. The associated complications and its incidence are also variable in different parts of the world because of genetic susceptibility related to aPL and APS. Screening for the presence of aPL antibody and timely initiation of prophylactic treatment can prevent many of complications.


PubMed | Kamineni Academy of Medical science and Research Center
Type: Journal Article | Journal: Journal of mid-life health | Year: 2017

This study was conducted with the objective of assessing serum 25-hydroxyvitamin D (25(OH)D) in postmenopausal women (PMW), to detect osteopenia or osteoporosis in PMW and to establish a correlation between serum 25(OH)D levels and bone mineral density (BMD).A total of 100 healthy PMW were selected, and a prospective observational study was conducted to correlate the BMD with serum 25(OH)D levels. Their laboratory investigations along with serum 25(OH)D levels were done. Their BMD was assessed with dual-energy X-ray absorptiometry at lumbar spine and neck of femur; T-scores were derived. Correlation analysis was done to investigate the relationship between serum 25(OH)D levels and BMD.The proportion of osteoporosis at the hip was 31.9% in deficient group, 16.1% in insufficient, and 18.2% in sufficient group and at lumbar spine, it was 27.7%, 16.1%, and 22.7%, respectively. Forty-seven percent of PMW had deficient (<20 ng/ml) serum 25(OH)D levels and 31% had insufficiency. T-score at hip in deficient group was -2.05 0.25, and in an insufficient group, it was -1.79 0.13; T-score at lumbar spine was -1.92 0.12 and -1.79 0.12, respectively, but both were not statistically significant. Osteoporosis was seen in 24%, osteopenia in 55% at hip level and 23% and 59% respectively at lumbar spine. There was no association between serum 25(OH)D levels and BMD neither at hip nor at lumbar spine (In this study, among our cohort of patients there was no correlation between serum 25(OH)D levels and BMD. However, Vitamin D deficiency coexists with low BMD. Vitamin D insufficiency is a common risk factor for osteoporosis associated with increased bone remodeling and low bone mass.


PubMed | Kamineni Academy of Medical science and Research Center
Type: Journal Article | Journal: Journal of obstetrics and gynaecology of India | Year: 2016

To compare the effectiveness, success rate and induction to abortion interval between administration of misoprostol only and mifepristone with misoprostol in second trimester abortions (14-20weeks) .The study was conducted by dividing women approaching for second trimester termination, into two groups each consisting of 100 women. Group-I received only misoprostol; 600mcg initial vaginal insertion followed by 400mcg sublingually every 3h until termination. Women in Group-II received mifepristone 200mg and after 24h started with 600mcg misoprostol, per vaginal followed by 400mcg sublingually till abortion was completed, up to a maximum of five doses in both groups.The success rate in Group-I was 89%, whereas in Group-II it was 96%. The mean induction abortion interval in Group-I was 10.673.96h compared to Group-II which was significantly less 6.192.70h (p value<0.01). The mean dose of misoprostol in Group-I was 1610511.18mcg and in Group-II, it was lesser 1046392.71mcg (p value<0.01). There was significant difference in the mean blood loss also, 97.2036.35ml in Group-I and 52.5527.96ml in Group-II. Also among the individual groups multigravidae and lower gestational age (<17weeks), women had lesser IAI as well as lesser misoprostol dose was required.Pretreatment with mifepristone significantly reduces the induction abortion interval and the misoprostol dose along with minimal blood loss.

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