Palakkad, India
Palakkad, India

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Shinto A.S.,KMCH | Shibu D.,KMCH | Kamaleshwaran K.K.,KMCH | Das T.,Bhabha Atomic Research Center | And 5 more authors.
Journal of Nuclear Medicine Technology | Year: 2014

177Lu-labeled ethylenediaminetetramethylene phosphonic acid (177Lu-EDTMP) is an agent that concentrates in areas of enhanced osteoblastic activity. The potential of 177Lu-EDTMP for palliation of metastatic bone pain has been documented in the recent literature. The objective of the present work was to study the efficacy and safety of the agent after administration to a limited number of patients. Methods: Ten patients (median age, 68.5 y) with disseminated skeletal metastases received a single bolus infusion of 177Lu-EDTMP (3.7 GBq). All patients had painful bone metastases in more than one anatomic region that were not relieved by narcotic analgesics. The efficacy of the agent was studied by following pain scores assessed at baseline and at 4, 8, and 12 wk after therapy, by using Karnofsky indices and mobility scores, and by determining the requirement for analgesics at baseline and 4 wk after therapy. The toxicity of the agent was assessed by analyzing complete blood counts. Results: A significant reduction in the mean pain score was noted in all patients. The initial mean pain score of 8.44 dropped to 5.73 within 1 mo of treatment. Six patients who required analgesics for pain management had either reduced or completely withdrawn from their use by 4 wk. Compared with initial scans, scans obtained 1 mo after therapy also showed a decreased uptake of the radiotracer. The mobility scores of all patients were higher at 4 wk. The mean Karnofsky performance score of all patients was initially 45 and increased markedly to 69 at 4 wk. None of the patients experienced blood-related toxicity. Conclusion: 177Lu-EDTMP, with only low bone marrow toxicity, provided significant pain relief to patients and considerably increased their mobility, resulting in an overall improvement in the quality of life. The results of the preliminary clinical studies indicate that 177Lu-EDTMP can be considered an effective and safe therapeutic radiopharmaceutical for pain palliation of patients with disseminated skeletal disease. © 2014 by the Society of Nuclear Medicine and Molecular Imaging, Inc.


Kuppast N.,Karuna Medical College | Dileep Kumar R.,Sri Siddhartha Medical College | Rajashekar S.,SSIMS and RC | Iddalgave S.,Karuna Medical College | Siddaramanna T.C.,Sri Siddhartha Medical College
Journal of Indian Academy of Forensic Medicine | Year: 2015

The study of Medical Professional Liabilities was carried out in Bellary region of Karnataka state. Details of the cases were collected from the district consumer forum Bellary between January 2000-December 2009 (10 years). In each case, complaint of the complainant and response to a complaint by the opponent was studied and analyzed. Date of filing and date of judgment was noted in each case. In our study out of ten cases, general practitioners were more prone for professional liabilities. Six cases were compensated monetarily. In our study the most common cause for litigation was found to be breach of practice guidelines, which can be prevented by attending continuous medical education (CME) programs and workshops, followed by misguided allegation which can be prevented by proper communication to the patient at first consultation. The lawsuits not only have heavy emotional toll on doctors and patients but on the society as a whole. Medical professionals should opt for medical indemnity insurance, which defends his or her case in all aspects and may even pay compensation on his behalf in case of professional liabilities.


Thomas M.,Tropical Institute of Ecological science | Kumaran R.,Karuna Medical College | Samuel K.A.,CMS College | Kurian P.,St. Mary's College
Journal of Pure and Applied Microbiology | Year: 2012

Wetland ecosystems are unique ecologically and incessant human dependence is noted from time immemorial. Water rats (Rattus norvegicus) play a vital role in disease transmission and a study was conducted to assess the pathogenic diversity among water rats (Rattus norvegicus) inhabiting Vembanadu-Kol wetland agroecosystem. A total of twelve bacterial pathogens were isolated from the trapped six water rats including Salmonella enterica, Klebsiella pneumoniae and Staphylococcus aureus. Fifteen fungal pathogens were isolated including two dermatophytes (Microsporum audouinii and Trichophyton rubrum). Genus Aspergillus was more predominant representing four species. The presence of Trichosoporon biegelii was observed in both blood and lungs. Six parasites were also identified with more prevalence of Ancylostoma duodenalae (100%) followed by Hymenolepis diminuta (66.67%). As human-water-rat contact is inevitable in wetland ecosystem, the presence of pathogens in rats inhabiting in it are a matter of serious concern.


PubMed | Karuna Medical College, Banaras Hindu University, West Bengal State University, CSIR - Central Electrochemical Research Institute and Oscar Medicare Pvt. Ltd
Type: | Journal: Experimental parasitology | Year: 2016

Rab proteins form the largest branch of the Ras superfamily. Rab proteins are key regulators of intracellular vesicular transport and membrane trafficking. Although RabGTPases are well-recognized targets in human diseases but are under-explored therapeutically in the Leishmania parasite. Using a quantitative cytofluorimetric assay, we analyzed the composition and organization of Rab6GTPase protein which was found to be primarily localized on the parasite subpellicular membrane and flagellum due to its association with kinesin motor proteins in the cytoskeletal microtubules. Our aim was to also assess the diagnostic role of recombinant Rab6 protein from Leishmania donovani (rLdRab6) using sera/plasma of Indian visceral leishmaniasis (VL) patients. Receiver-operating characteristic (ROC) curve analysis indicated 100% sensitivity and 100% specificity for rLdRab6-based ELISA which was almost similar in comparison to recombinant K39-based ELISA (95.83% sensitivity and 100% specificity). Sera of patients from another intracellular pathogenic infection, Mycobacterium tuberculosis, did not contain any significant levels of anti-rLdRab6 antibody. Thus rLdRab6 accuracy in visceral leishmaniasis diagnosis makes it a promising antigen for clinical use.


Srinivasan U.S.,MIOT Hospitals | Kumar G.S.,Karuna Medical College | Mahesha K.B.,Yenepoya Medical College
Asian Spine Journal | Year: 2011

Study Design: A retrospective study was undertaken to delineate the characteristics of non-traumatic sequestrated epidurally migrated cervical disc prolapse. Purpose: To present first case series of eight such cases diagnosed preoperatively and to discuss their magnetic resonance imaging (MRI) characteristics and their management. Overview of Literature: Non-traumatic spontaneous migration of the sequestrated disc fragment epidurally behind cervical vertebral body is rare. Only ten cases have been reported in literature. Methods: Detailed clinico-radiological profiles of these 8 cases are presented. In six cases their clinical picture was suggestive of cervical myelopathy. MRI scan showed single level epidural migrated disc behind body of C4, C6, and C7 in six patients and two cases with multiple levels (C5-C6). In six cases, anterior corpectomy with excision of the disc was performed and the seventh patient underwent dorsal laminectomy. The eighth patient chose not to undergo surgery. Results: T1 images of the MRI scan showed an isointense signal in all the 8 cases. T2 images revealed a varying intensity. In six cases who underwent anterior corpectomy, there was a rent in the posterior longitudinal ligament. Among those in two cases multiple disc fragments were seen. In the rest four cases, a single large fragment was observed. These patients improved after anterior corpectomy and disc excision. There was no improvement in the patient who had undergone dorsal laminectomy. The eighth patient who refused surgery progressively deteriorated. Conclusions: We opine that MRI scan especially T1 images are useful in these cases. We prefer to treat these cases through anterior corpectomy with excision of the sequestrated disc which proved to result in excellent outcome.


Ali A.,Karuna Medical College | Mohan P.,Karuna Medical College | Kareem H.,Karuna Medical College | Muhammed M.K.,Karuna Medical College
Journal of Clinical and Diagnostic Research | Year: 2016

Introduction: Thrombotic disorders have been found to be associated with recurrent abortions. Several risk factors have been identified. APTT reflects the common pathway and intrinsic pathway of coagulation cascade and hence is a good marker for thrombotic work. Elevated factor VIII: C has also been identified as risk factor for recurrent miscarriage. This study aims at identifying association of elevated factor VIII levels, shortened APTT and recurrent abortions in Indian population as little has been studied about this and the literature available is also based on studies done in European population. This study also aims to find whether shortened APTT can be an independent risk as well. Materials and Methods: Women referred to the obstetrics department with a history of early recurrent early pregnancy loss (at least three pregnancy losses before 13 weeks of gestation) were included in this study. Exclusion criteria were elevated CRP levels, positive antiphospholipid antibodies, endocrine, immunological or anatomical cause of embryo demise. A total of 68 cases of recurrent abortion were included in this study, 68 normal pregnant females (<15 weeks of gestation) were also included as controls with no history of abortion. The age group of the cases as well as control was 20-45 years. Activated partial thromboplastin time and factor VIII assay (one stage APTT based) were done on the blood samples. Results: Increased factor VIII levels were seen in 25 cases (36.4%); 19 cases showed shortened APTT (27.3%); 12 cases showed both increased factor VIII levels as well as shortened APTT (18%). All risk factors were negative in 36 cases (52.9%). None of the controls showed elevated factor VIII levels or shortened APTT. The mean APTT values of the control subjects was 31.01 and cases were 27.01 (p=0.001). The mean factor VIII levels of case were 152.85% and control 144.953% (p=0.012). Conclusion: There was significant association between recurrent abortions and elevated factor VIII :c levels and shortened APTT.Shortened APTT was also identified as an independent risk factor. © 2015, Journal of Clinical and Diagnostic Research. All rights Reserved.


Mathew M.M.,Karuna Medical College | Rudramurthy K.G.,Karuna Medical College | Geetha R.K.,Karuna Medical College | Sabitha B.,Karuna Medical College | Ramya K.,Karuna Medical College
Indian Journal of Public Health Research and Development | Year: 2015

Introduction: Acinetobacter spp are ubiquitous aerobic gram negative coccobacilli that are increasingly responsible for a large number of nosocomial infections. It represents severe problems for choosing effective antimicrobials because of the resistance to many available drugs. Materials and method: Specimens collected from IP patients were cultured and identified as Acinetobacter spp using standard methods. Antibiotic sensitivity pattern was done using modified Kirby Bauer disc diffusion method. Result: A total of 60 isolates of Acinetobacter spp were isolated from 312 mid stream urine samples. Among these, 80% were female and highest prevalence was seen in age group of more than 60 years (40%). 66.6% isolates were sensitive to Amikacin, 60% sensitive to Norfloxacin and all were sensitive to Netilmycin and Imipenem. Conclusion: Emergence of multidrug resistance in Acinetobacter spp is a formidable challenge. Continued efforts are needed to develop better antimicrobial policies against this pathogen. © 2015, Indian Journal of Public Health Research & Development. All rights reserved.


Nagarajan S.,Karuna Medical College
National Journal of Physiology, Pharmacy and Pharmacology | Year: 2014

Background: Slow and deep breathing leads to an immediate decrease in blood pressure and increase in heart rate variability (HRV). Maximum HRV is reported during breathing at 0.1 Hz frequency (6 breaths/minute). In hypertensive patients, slow breathing at 0.1 Hz frequency has been shown to improve the arterial baroreflex sensitivity (BRS) and decrease the blood pressure.Aims & Objective: This study was designed to see whether regular practice of slow breathing exercises will bring about changes in the HRV and blood pressure even during natural breathing in healthy participants.Materials and Methods: Eight healthy participants performed slow breathing exercises at 6 breaths per minute, for 30 minutes daily for 4 weeks. Their respiratory rates, mean heart rate, standard deviation of the normal-to-normal RR intervals (SDNN) and mean arterial pressure (MAP) were compared before and after the 4 weeks of breathing exercise.Results: The resting MAP decreased significantly from 82.33 ± 3.40 to 79.17 ± 3.64 mm Hg (P < 0.05), after the 4 weeks of respiratory training. The respiratory rates of the participants also showed a significant decrease (P < 0.01). Although there was an increase in the SDNN during supine rest, it was not statistically significant. Nevertheless, the SDNN during quiet standing increased significantly from 36.63 ± 4.44 to 46.25 ± 4.20 msec (P < 0.05). Training did not significantly change the mean heart rate.Conclusion: This study shows that deep slow breathing training reduces the spontaneous respiratory rate and MAP while increasing the HRV during quiet standing in healthy participants. © 2014, Mrs Deepika Charan. All rights reserved.


PubMed | Karuna Medical College
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2016

Thrombotic disorders have been found to be associated with recurrent abortions. Several risk factors have been identified. APTT reflects the common pathway and intrinsic pathway of coagulation cascade and hence is a good marker for thrombotic work. Elevated factor VIII: C has also been identified as risk factor for recurrent miscarriage. This study aims at identifying association of elevated factor VIII levels, shortened APTT and recurrent abortions in Indian population as little has been studied about this and the literature available is also based on studies done in European population. This study also aims to find whether shortened APTT can be an independent risk as well.Women referred to the obstetrics department with a history of early recurrent early pregnancy loss (at least three pregnancy losses before 13 weeks of gestation) were included in this study. Exclusion criteria were elevated CRP levels, positive antiphospholipid antibodies, endocrine, immunological or anatomical cause of embryo demise. A total of 68 cases of recurrent abortion were included in this study, 68 normal pregnant females (<15 weeks of gestation) were also included as controls with no history of abortion. The age group of the cases as well as control was 20-45 years. Activated partial thromboplastin time and factor VIII assay (one stage APTT based) were done on the blood samples.Increased factor VIII levels were seen in 25 cases (36.4%); 19 cases showed shortened APTT (27.3%); 12 cases showed both increased factor VIII levels as well as shortened APTT (18%). All risk factors were negative in 36 cases (52.9%). None of the controls showed elevated factor VIII levels or shortened APTT. The mean APTT values of the control subjects was 31.01 and cases were 27.01 (p=0.001). The mean factor VIII levels of case were 152.85% and control 144.953% (p=0.012).There was significant association between recurrent abortions and elevated factor VIII :c levels and shortened APTT. Shortened APTT was also identified as an independent risk factor.


PubMed | Karuna Medical College
Type: Journal Article | Journal: Dermatology reports | Year: 2015

We report a rare case of onychomycosis caused by Syncephalastrum racemosum in a 50-year-old diabetic patient. The patients nail was surgically excised and thorough debridement was done. The patient was successfully treated with topical nystatin.

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