Kempegowda Institute of Medical science

Bangalore, India

Kempegowda Institute of Medical science

Bangalore, India
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Background: Chronic obstructive pulmonary disease (COPD) is a major cause of mortality and morbidity. It is the fourth leading cause of death worldwide. Acute exacerbations of COPD are common and are associated with worsening lung function and mortality. Objectives: To evaluate the prevalence of elevation of cTnI in patients admitted with acute exacerbation of COPD and to study its association with the need for ventilator support, duration of hospital stay, and in-hospital mortality. Methods: In a prospective design, 50 patients admitted to our hospital with acute exacerbation of COPD were included. cTnI was assayed in a blood sample obtained at admission and 24 h later. Levels above 0.017 μg/L were taken as positive. The following data were also recorded-demographic data, pattern of tobacco use, clinical symptoms and signs, comorbidities, Glasgow Coma Scale, arterial blood gas, electrocardiogram/two-dimensional echocardiography, chest X-ray, and peak expiratory flow rate. Results: Among the 50 patients, 4 were females, and 46 were males. cTnI was positive in 32% of patients with a mean value of 0.272. Patients with cTnI positive were taken as Group I and those with negative were included in Group II. Prevalence of comorbidities was higher in cTnI positive group, so was the duration of COPD. cTnI elevation correlated significantly with the need for ICU admission and ventilator support. No significant difference was found in the duration of ventilator support, hospital stay, and in-hospital mortality. Conclusion: cTnI is elevated in a significant subset of patients with acute exacerbation of COPD. Duration of their illness was longer, higher incidence of ischemic heart disease was also found in these patients. Patients with cTnI elevation are more likely to require ICU care and ventilator support. However, it did not predict in-hospital mortality. Thus, it can be used as a marker to identify high-risk patients during acute exacerbation of COPD. © 2016 Indian Chest Society.

Rao D.,University of Washington | Horton R.,Seattle University | Raguram R.,Kempegowda Institute of Medical science
Social Psychiatry and Psychiatric Epidemiology | Year: 2012

Purpose: While exploring experiences of psychological distress among psychiatric outpatients in Southern India, we set out to further understand interpersonal and socio-cultural factors that are associated with depressive symptoms. Methods: Using a grounded theory framework, we thematically coded narrative accounts of the women who sought treatment at the psychiatric clinic. In addition, we included author notes from participant observation and field work experiences in the South Indian psychiatric clinic. Results: Of the 32 women who participated in the study, 75 % qualified for a diagnosis of a current major depressive episode. Depressive symptoms were associated with experiences of domestic violence and, in Farmer's terms, structural violence. Although only a partial response to gender-based suffering, allopathic psychiatric treatment seemed the best available means of coping with their circumstances. Conclusion: The paper moves beyond a medicalized model of disease and behavior to explore social and contextual factors that enabled these women to brave additional stigmas surrounding psychiatric treatment and seek a better outcome for themselves. It concludes by discussing the need for a multi-layered approach to addressing the suffering that women in South India experience. © Springer-Verlag 2012.

Sudarshan M.K.,Kempegowda Institute of Medical science
Indian journal of public health | Year: 2010

A survey of 23 infectious diseases (ID) hospitals/ID wards of general hospitals was done during 2008-09 to assess the facilities for and management of rabies patients. All were Government hospitals and 0.5% of total beds was earmarked for rabies cases. The hospitals were mostly run by medical colleges (47.8%) and ID hospitals (30.4%) and located outside city limits (52.2%). The patients were admitted to 'rooms (39.1%)' and 'wards (43.5%)'. The general conditions of rabies sections i.e. sanitation and linen (65%), space and toilet (52% and 56%) and bed (47.8%) require improvements. There is a need to improve staff availability, use of personal protective wears, preventive vaccination of care providers and medicinal supplies. It is recommended to encourage hospitalization of human rabies cases to ensure a 'painless and dignified death' and this must be considered as a 'human rights' issue.

Ramesh Masthi N.R.,Kempegowda Institute of Medical science
Indian journal of public health | Year: 2012

Domestic accidents are worldwide health problems. A cross-sectional study was conducted in the rural field practice area of Kempegowda Institute of Medical Sciences, Bangalore. A total of 5419 individuals were selected from 30 clusters (villages) using cluster sampling technique. Of the 5419 study population, 50.9% (2748) were males and the rest were females. The prevalence of domestic accidents in the rural community was found to be 9.6% (522 individuals who had sustained domestic accidents), was found to be more in females compared with males, which was statistically significant with P-value =0.0077 (Z value =9.09). Falls 43% (225) was the most common type of domestic accidents. The most common place of occurrence of domestic accidents was 46% (243) kitchen, most frequent site of injures in domestic accidents was upper limbs.

Kulesza M.,University of Washington | Raguram R.,Kempegowda Institute of Medical science | Rao D.,University of Washington
Asian Journal of Psychiatry | Year: 2014

Background: Few studies exist on the topic of gender associated with depression and mental health-related stigma coming out of non-Western countries such as India. We aimed to add to the literature by assessing these relationships among adults seeking psychiatric services in India. Methods: Participants were 60 individuals seeking care at a psychiatric clinic in Bangalore, India. The majority of participants were female with a mean age of 36 years (SD= 9.75). Results: Contrary to our prediction, there were no significant differences between men (M= 28.96; SD= 9.85) and women (M= 33.03; SD= 12.08) on depression severity, t(58). = 1.42, p= .16. Yet, women (M= 10.09, SD= 8.23) reported significantly more perceived stigma than men (M= 5.79, SD= 5.86), t(58). = 2.30, p= .02. Conclusion: While men and women seeking psychiatric services at the psychiatric clinic in India report similar levels of depression severity, women reported more perceived mental illness stigma. Having experienced regular forms of discrimination associated with female status in India, it may be the case that women are more attuned to other forms of stigma, such as mental health stigma investigated in the present study. Given the detrimental impact of stigma on treatment adherence and engagement in care, additional research is needed support this work, including research on interventions to reduce stigma and improve engagement in care. © 2014 Elsevier B.V.

Upadhyaya G.P.M.,Kempegowda Institute of Medical science | Lingadevaru U.B.,ESI PGIMSR | Lingegowda R.K.,Kempegowda Institute of Medical science
Journal of Infection in Developing Countries | Year: 2011

Introduction: Because of increasing difficulty in treating enterococcal infections, effort is being devoted to understanding factors that are responsible for causing nosocomial infection, with a focus toward targeting these factors with new therapeutics. Evidence has emerged that the esp gene mediates biofilm formation in vitro, which helps the organism colonize and cause infection. Methodology: This study was conducted over a four-year period in a tertiary-care hospital. There were 200 clinical pathogenic strains isolated from nosocomial infections and 100 commensals from stool specimens of healthy individuals. The study compared the production of biofilm and detection of the esp gene among clinical and commensal isolates. Results: Among 200 clinical isolates of Enterococcus faecalis 65 (32.5%) isolates were positive for biofilm production and 60 (30%) for the esp gene by PCR. Among 100 commensal isolates, 16 (8%) and 14 (7%) were positive for biofilm formation and the esp gene, respectively. Five clinical and two commensal isolates produced biofilm without any amplification of the esp gene. Conclusion: The study shows a significant difference in production of biofilm and presence of the esp gene between clinical and commensal isolates (P < 0.002). Therefore, it can be concluded that biofilm production has an important role in causing nosocomial infection. Although detection of the esp gene correlates with biofilm production, it may not be the only factor determining the formation of biofilm since few isolates produced biofilm without the esp gene. Strains isolated from indwelling medical devices showed high production of biofilm and esp gene. © 2011 Upadhyaya et al.

Shruthi P.,Kempegowda Institute of Medical science
Journal of Indian Academy of Forensic Medicine | Year: 2013

Road traffic accident (RTA), a cause of unnatural death is the third major preventable one amongst all deaths. Road deaths in India are publicly glaring, while road safety is professionally lacking and politically missing. A retrospective observational study was conducted in the Department of Forensic Medicine and Toxicology, Kempegowda Institute of Medical Sciences, Bangalore between January 2010 to December 2012, with an objective to study the demographic, injury profile and mortality pattern in autopsy cases with an alleged history of RTA and to draw public attention and awareness in order to prevent/control RTA. Out of 225 autopsied RTA victims, 55.11% victims were between 21-30 years of age, males constituted 78.22% of the total victims, and four wheeler vehicles were involved in 68.44% RTAs. Maximum RTAs occurred during the daytime, between 6 AM to 12 PM. Head injures constituted 30.22% of the total injuries, followed by injuries involving abdomen, thorax and limb. Haemorrhagic shock caused 63.11% of deaths, while head injury caused death in 30.22% of cases. This study emphasizes that interventions in RTA should include combined efforts from the community, public and private sector, governmental and non- governmental organizations.

Ramanan M.,Childrens Hospital Westmead | Shankar A.,Kempegowda Institute of Medical science
Journal of Clinical Neuroscience | Year: 2013

The use of minimally invasive surgery (MIS) in the treatment of primary supratentorial intracerebral haemorrhage (ICH) is controversial. This review was undertaken to combine all available evidence on this topic and to assess the efficacy of MIS compared to medical treatment or haematoma evacuation via craniotomy for patients with primary supratentorial ICH. The Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE databases were searched for randomised controlled trials which compared MIS to any control treatment for intracerebral haemorrhage. Conference proceedings, reference lists and internet-based clinical trial registries were searched for additional studies. Quality was assessed using the Cochrane "risk of bias" analysis tool. The methodological quality of studies was not high, with only two studies conforming to all quality standards assessed. There were 11 studies with 1717 patients. There was a significant reduction in relative risk (RR) for death at end of follow-up when MIS was compared to both medical management (RR = 0.67, 95% confidence interval 0.53-0.84) and craniotomy (RR = 0.57, 95% confidence interval 0.39-0.84) with no significant heterogeneity. Non-significant benefits were observed for the outcomes death or dependent survival (RR = 0.95, 95% confidence interval 0.91-1.00) and independent survival (RR = 1.24, 95% confidence interval 0.99-1.55). There was significant heterogeneity for both these outcomes. MIS for primary supratentorial ICH is associated with a significant reduction in the RR of death when compared to medical management and craniotomy. Other important outcomes need further evaluation. © 2013 Elsevier Ltd. All rights reserved.

Parasuramalu B.G.,Kempegowda Institute of Medical science
Indian journal of public health | Year: 2010

A cross-sectional study was conducted in the rural field practice area of Kempegowda Institute of Medical Sciences, Bangalore. A total of 3194 adult individuals (18-70 years) were selected from 30 villages (clusters) using a cluster-sampling technique. Individuals with symptoms suggestive of asthma were subjected for clinical examination for the diagnosis of asthma. Among the 3194 respondents, 1518 (47.5%) were males and 1676 (52.5%) were females. The prevalence of bronchial asthma was 2.88%. The prevalence of asthma was higher among those reporting a history of current smoking. Among current smokers, the number of cigarettes/bidis/hookah smoked daily did not differ (P > 0.05) between individuals without asthma and with asthma, whereas the mean number of years of smoking did differ (P < 0.001). There was significant association between tobacco smoking and bronchial asthma.

Prasad S.,Kempegowda Institute of Medical science
The journal of obstetrics and gynaecology research | Year: 2011

Ovarian squamous cell carcinoma is a rare malignancy and its occurrence is commonly attributed to malignant transformation of a pre-existing mature cystic teratoma. The de novo occurrence of primary squamous cell carcinoma is extremely rare. Malignant transformation in a mature cystic teratoma is almost always unilateral; however, there have been isolated reports of an uncomplicated mature cystic teratoma in the contralateral ovary. We report here a case of a 40-year-old woman presenting with squamous cell carcinoma of both ovaries with antecedent dermoid cyst in the left ovary, along with involvement of the fallopian tubes, cervix and omentum. © 2011 The Authors. Journal of Obstetrics and Gynaecology Research © 2011 Japan Society of Obstetrics and Gynecology.

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