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Palakkad, India

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. Source

Thomas M.,Tropical Institute of Ecological science | Kumaran R.,Karuna Medical College | Samuel K.A.,Cms College | Kurian P.,St. Marys 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. Source

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. Source

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. Source

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. Source

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