Kempegowda Institute of Medical science Hospital and Research Center

Bangalore, India

Kempegowda Institute of Medical science Hospital and Research Center

Bangalore, India
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Manjunatha R.,Kempegowda Institute of Medical science | Pundarikaksha H.P.,Kempegowda Institute of Medical science | Madhusudhana H.R.,Kempegowda Institute of Medical science Hospital and Research Center | Amarkumar J.,Kempegowda Institute of Medical science | Hanumantharaju B.K.,Kempegowda Institute of Medical science Hospital and Research Center
Indian Journal of Pharmacology | Year: 2016

Objectives: Benign prostatic hyperplasia (BPH) is a common and progressive disease affecting elderly males, often associated with lower urinary tract symptoms (LUTS). α1-blockers are the mainstay in symptomatic therapy of BPH. Because of their greater uroselectivity and minimal hemodynamic effects, alfuzosin, tamsulosin, and silodosin are generally preferred. The aim of this study was to compare the efficacy and tolerability of alfuzosin, tamsulosin, and silodosin in patients with BPH and LUTS. Methods: Ninety subjects with BPH and LUTS were randomized into three groups of thirty in each, to receive alfuzosin sustained release (SR) 10 mg, tamsulosin 0.4 mg, or silodosin 8 mg for 12 weeks. The primary outcome measure was a change in the International Prostate Symptom Score (IPSS), and the secondary outcome measures were changes in individual subjective symptom scores, quality of life score (QLS), and peak flow rate (Qmax) from baseline. The treatment response was monitored at 2, 4, 8, and 12 weeks. Results: IPSS improved by 88.18%, 72.12%, and 82.23% in alfuzosin SR, tamsulosin and silodosin groups (P < 0.001) at 12 weeks. Improvement in QLS was >75% in all the three groups (P < 0.001). A significant improvement in Qmax was seen with alfuzosin and tamsulosin (P = 0.025 andP < 0.001) but not with silodosin (P = 0.153). However, the intergroup differences in IPSS, QLS, and Qmax were not significant. Ejaculatory dysfunction was more common with silodosin and corrected QT (QTc) prolongation occurred only with alfuzosin (two subjects) and tamsulosin (three subjects). Conclusion: Alfuzosin, tamsulosin, and silodosin showed similar efficacy in improvement of LUTS secondary to BPH, with good tolerability, acceptability, and minimum hemodynamic adverse effects. Alfuzosin, tamsulosin, and silodosin are comparable in efficacy in symptomatic management of BPH. The occurrence of QTc prolongation in three subjects with tamsulosin in the present study is an unexpected adverse event as there are no reports of QTc prolongation with tamsulosin in any of the previous studies. © 2016 Indian Journal of Pharmacology Published by Wolters Kluwer - Medknow.


PubMed | Kempegowda Institute of Medical science and Kempegowda Institute of Medical science Hospital and Research Center
Type: Journal Article | Journal: Indian journal of pharmacology | Year: 2016

Benign prostatic hyperplasia (BPH) is a common and progressive disease affecting elderly males, often associated with lower urinary tract symptoms (LUTS). 1-blockers are the mainstay in symptomatic therapy of BPH. Because of their greater uroselectivity and minimal hemodynamic effects, alfuzosin, tamsulosin, and silodosin are generally preferred. The aim of this study was to compare the efficacy and tolerability of alfuzosin, tamsulosin, and silodosin in patients with BPH and LUTS.Ninety subjects with BPH and LUTS were randomized into three groups of thirty in each, to receive alfuzosin sustained release (SR) 10 mg, tamsulosin 0.4 mg, or silodosin 8 mg for 12 weeks. The primary outcome measure was a change in the International Prostate Symptom Score (IPSS), and the secondary outcome measures were changes in individual subjective symptom scores, quality of life score (QLS), and peak flow rate (Qmax) from baseline. The treatment response was monitored at 2, 4, 8, and 12 weeks.IPSS improved by 88.18%, 72.12%, and 82.23% in alfuzosin SR, tamsulosin and silodosin groups (P < 0.001) at 12 weeks. Improvement in QLS was >75% in all the three groups (P < 0.001). A significant improvement in Qmax was seen with alfuzosin and tamsulosin (P = 0.025 and P < 0.001) but not with silodosin (P = 0.153). However, the intergroup differences in IPSS, QLS, and Qmax were not significant. Ejaculatory dysfunction was more common with silodosin and corrected QT (QTc) prolongation occurred only with alfuzosin (two subjects) and tamsulosin (three subjects).Alfuzosin, tamsulosin, and silodosin showed similar efficacy in improvement of LUTS secondary to BPH, with good tolerability, acceptability, and minimum hemodynamic adverse effects. Alfuzosin, tamsulosin, and silodosin are comparable in efficacy in symptomatic management of BPH. The occurrence of QTc prolongation in three subjects with tamsulosin in the present study is an unexpected adverse event as there are no reports of QTc prolongation with tamsulosin in any of the previous studies.


Ravi Kumar K.L.,Kempegowda Institute of Medical science Hospital and Research Center | Ashok V.,Kempegowda Institute of Medical science Hospital and Research Center | Ganaie F.,Kempegowda Institute of Medical science Hospital and Research Center | Ramesh A.C.,Kempegowda Institute of Medical science Hospital and Research Center
Indian Journal of Medical Research | Year: 2014

Methods: A total of 109 male and 81 female children in the age group of three months to five years belonging to different socio-economic classes were enrolled. They were recruited across all age groups from those attending paediatric OPD of a tertiary care and research centre for immunization program. Fifty three isolates identified as pneumococci were tested for their antimicrobial susceptibility pattern by Kirby-Bauer’s disc diffusion and E-Test methods. Serotyping was performed by detection of the quelling reaction with specific antiserum.Background & objectives: Information related to nasopharyngeal carriage of Streptococcus pneumoniae among healthy children is scanty in India. This prospective study was undertaken to determine the presence of asymptomatic nasopharyngeal colonization, assess serogroups/types (SGT) and drug resistance of S. pneumoniae in children below five years of age.Interpretation & conclusions: High level of antibiotic resistance was present in S. pneumoniae isolated from healthy children below age five. A pneumococcal conjugate vaccine with the prevailing SGTs would help to reduce the pool of antibiotic resistant pneumococci. Continued surveillance of serotypes and tracking susceptibility pattern of S. pneumoniae will help to introduce appropriate vaccination protocols.Result: The pneumococcal carriage rate in the study population was 27.9 per cent. The isolation rate was associated with age being higher (49.2%) in smaller children (3-12 months) and among male (62.2%). The most prevalent SGTs were 19 followed by 10, 14 and 7; 21 per cent of isolates belonging to serotype 10 (n=7) were 11 (n=4) were not covered in any of the conjugate vaccines currently available in Indian market. Resistance to co-trimoxazole, tetracycline, penicillin and erythromycin was observed in 91 per cent (n=48), 36 per cent (n=19), 17 per cent (n=9) and 9 per cent (n=5) isolates, respectively. All the penicillin resistant isolates were found to be intermediately resistant by E-Test. Multidrug resistance was observed in 19 per cent (n=10) isolates. © 2014, Indian J Med Res. All Rights Reserved.


Ravi Kumar K.L.,Kempegowda Institute of Medical science Hospital and Research Center | Ganaie F.,Kempegowda Institute of Medical science Hospital and Research Center | Ashok V.,Kempegowda Institute of Medical science Hospital and Research Center
Journal of Clinical and Diagnostic Research | Year: 2013

Background: Globally, Streptococcus pneumoniae is estimated to be responsible for 1 to 2 million deaths annually, in extremes of age. Serotypic distribution of pneumococci varies with age, time, and geographical area. Limited data is available on serotypic prevalence and antimicrobial susceptibility patterns of pneumococci in India. Aim: To assess resistance trends to different groups of antimicrobials and serotypic prevalences of invasive pneumococci. Settings and Design: A prospective, hospital based study was conducted for two years, at a tertiary care medical college hospital in south Bangalore. Forty invasive pneumococcal isolates from children who were ≤5 years, with a clinical and radiological diagnosis of invasive pneumococcal disease, (IPD) were evaluated. Methods: Qualitative typing/grouping was performed by doing the capsular reaction test (Neufeld test). Antimicrobial susceptibility was tested by Minimum Inhibitory Concentration method using automated microdilution procedure. Results: The predominant invasive pneumococcal serotypes were serogroups/types (SGTs) 6 (25%) and 14 (17.5%). 35%, 77.5% and 15% of isolates were resistant to Penicillin, Trimethoprim/Sulfamethoxazole (TMP-SMX) and Ceftriaxone respectively. Intermediate and high level resistances to penicillin were seen in 22.5% and 12.5% of S. pneumoniae isolates correspondingly. Multidrug resistance was observed in 20% of strains. Conclusion: This study reported presence of high level drug resistance in invasive pneumococcal isolates which were obtained from children. The serogroup/type distribution in our study and those in other Indian studies were not even. This calls for monitoring of resistance and mapping of serotype distribution.


Sudarshan M.K.,Kempegowda Institute of Medical science Hospital and Research Center | Ashwath Narayana D.H.,Kempegowda Institute of Medical science Hospital and Research Center | Ravish H.S.,Kempegowda Institute of Medical science Hospital and Research Center
National Medical Journal of India | Year: 2011

Background. Rabies immunoglobulins are life-saving in patients with severe exposure to rabies. Despite the high degree of purification of equine rabies immunoglobulin (ERIG), the product inserts still recommend a skin sensitivity test before administration of this heterologous serum. A recent WHO recommendation states that there are no scientific grounds for performing a skin test before administering ERIG because testing does not predict reactions and it should be given irrespective of the result of the test. In this conflicting situation, we assessed the use of the skin sensitivity test in predicting adverse events to ERIG. Methods. The data analysed were from the Antirabies Clinic of the Kempegowda Institute of Medical Sciences Hospital, Bengaluru, India. The period of study was 26 months (June 2008-July 2010). The skin sensitivity test was validated by evaluating its sensitivity, specificity, predictability, false-positive and false-negative results. Results. A total of 51 (2.6%) adverse events were reported in 31 (1.5%) subjects. Most of these were mild to moderate in nature and subsided without medication. There was no serious adverse event. The sensitivity and specificity of the skin sensitivity test to predict an adverse event was 41.9% and 73.9%, respectively. Conclusion. Our experience with the skin sensitivity test suggests that it may not be required before administering ERIGs, as recommended by WHO. © The National Medical Journal of India 2011.


Ramya H.S.,Kempegowda Institute of Medical science Hospital and Research Center | Sushanth,Kempegowda Institute of Medical science Hospital and Research Center | Manjunath M.N.,Kempegowda Institute of Medical science Hospital and Research Center
British Journal of Medical Practitioners | Year: 2013

Jeune syndrome or asphyxiating thoracic dystrophy is a rare autosomal recessive skeletal dysplasia characterised by a small chest and short ribs which restrict the growth and expansion of the lungs often causing life threatening complications. The inheritance is autosomal recessive. A locus has been identified on chromosome 15q13, while recently, mutations were found in the IFT80 gene, encoding an intraflagellar protein. Other symptoms may include shortened bones in the arms and legs, unusually shaped pelvic bones, and extra fingers and/or toes (polydactyly). It is estimated to occur in 1 per 100, 000 - 130, 000 live births. Children that survive the breathing and lung challenges of infancy, can later develop life-threatening kidney problems. Heart defects and a narrowing of the airway (subglottic stenosis) are also possible. Other, very less common features of Jeune syndrome include liver disease, pancreatic cysts, dental abnormalities, and an eye disease called retinal dystrophy that can lead to the loss of vision. We report a preterm neonate with Jeune syndrome.


Parasuramalu B.G.,Kempegowda Institute of Medical science Hospital and Research Center | Sathish Chandra M.R.,BGS Global Institute of Medical science | Huliraj N.,Kempegowda Institute of Medical science Hospital and Research Center | Gowda G.,Kempegowda Institute of Medical science Hospital and Research Center | Gangaboraiah,Kempegowda Institute of Medical science Hospital and Research Center
Asian Journal of Pharmaceutical and Clinical Research | Year: 2015

Objectives: The present study was under taken to assess and compare the improvement in HRQoL among mild to moderate persistent asthma between Mometasone & Formoterol versus Fluticasone & Formoterol using dry powder inhaler using Asthma HRQoL questionnaire which is disease-specific 32-item instrument including 4 domains: symptoms, emotions, exposure to environmental stimuli and activity limitations where impairments experienced during the previous 14 days and respond on 7-point scale. Methods: The present study was conducted in Preventive Medicine Unit and Chest & TB diseases OPD, KIMS & RC, Bangalore during March 2011 to February 2012. 60 patients were recruited in each group based on inclusion and exclusion criteria. PFT was done pre and post bronchodilator with Salbutamol nebulization with Spirometry. Study medications were randomized and were given for 12weeks. HRQoL questionnaire was administered before and after the medications and outcome was compared between them. Statistical test used were descriptive statistics, t- test. Results: There was a significant improvement in HRQoL from baseline to the end of 12 weeks in all domains (symptoms, emotional, exposure to environmental stimuli and activity limitations) in both the groups. The overall improvement in the HRQoL was better in Mometasone & Formoterol group compared to Fluticasone & Formoterol group but this difference was not statistically significant, which revealed both combinations were equally effective in improving HRQoL in mild to moderate persistent asthma. Conclusion: Both Mometasone & Formoterol and Fluticasone & Formoterol combinations are equally effective in improving HRQoL in mild to moderate persistent asthma patients. © 2015, Asian Journal of Pharmaceutical and Clinical Research. All rights reserved.


Girish N.,Kempegowda Institute of Medical science Hospital and Research Center | Santosh S.,MVJ Medical College | Keshavamurthy S.R.,Kempegowda Institute of Medical science Hospital and Research Center
Journal of Clinical and Diagnostic Research | Year: 2013

Introduction: Neonatal jaundice is the commonest abnormal physical finding in the new born nursery and hemolytic disease of the newborn (HDN) among babies born to Rh negative mothers is the most formidable etiology. During last few decades considerable evolution has been observed in this entity secondary to development of several novel preventive, diagnostic and therapeutic modalities. Objective: To study the current trends in presentation, management and outcome of hyperbilirubinemia among newborns delivered to Rh negative mothers. Methodology: This observational descriptive study with prospective data collection included one hundred live born term babies born to Rh negative mothers in our hospital. A predesigned proforma was used to record antenatal and postnatal data.Cord blood collected during delivery for assessment of bilirubin,hematocrit and direct coombs test.Serum bilirubin levels were estimated in babies with clinical jaundice and treated for the same if required.All babies were regularly followed up weekly for one month. Chi square test/Fisher Exact test and Student "t" test has been used to find the significant association of jaundice(incidence,treatment) and study characteristics. Results: Out of 100 babies enrolled, 57 babies developed jaundice. Jaundice is 2.7 times more likely associated with babies born to multiparous Rh-ve mothers with p=0.017*. Jaundice is 3 times more likely associated with Rh+ve babies born to multiparous mothers with p=0.020*. Jaundice is 3.97 times more likely associated with Rh+ve babies born to multiparous mothers who have not received Anti-D with p=0.154. Treatment of jaundice is 2.75 times more likely in Rh+ve babies born to multiparous mothers who have not received Anti-D with p=0.162. Duration of phototherapy is significantly more in Rh+ve babies born to multiparous mothers who had not received Anti-D with p=0.0097*.Exchange transfusion was required in two babies. Conclusion: Although the incidence of Rh isoimmunization has declined dramatically over the years,it is still an important cause of neonatal morbidity and mortality emphasizing the need for more vigorous preventive efforts and up-to-date management skills.

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