Karnataka, India
Karnataka, India

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Ibrahim S.,Louisiana Tech University | Chowriappa P.,Louisiana Tech University | Dua S.,Louisiana Tech University | Acharya U.R.,Ngee Ann Polytechnic | And 3 more authors.
Medical and Biological Engineering and Computing | Year: 2015

Prolonged diabetes retinopathy leads to diabetes maculopathy, which causes gradual and irreversible loss of vision. It is important for physicians to have a decision system that detects the early symptoms of the disease. This can be achieved by building a classification model using machine learning algorithms. Fuzzy logic classifiers group data elements with a degree of membership in multiple classes by defining membership functions for each attribute. Various methods have been proposed to determine the partitioning of membership functions in a fuzzy logic inference system. A clustering method partitions the membership functions by grouping data that have high similarity into clusters, while an equalized universe method partitions data into predefined equal clusters. The distribution of each attribute determines its partitioning as fine or coarse. A simple grid partitioning partitions each attribute equally and is therefore not effective in handling varying distribution amongst the attributes. A data-adaptive method uses a data frequency-driven approach to partition each attribute based on the distribution of data in that attribute. A data-adaptive neuro-fuzzy inference system creates corresponding rules for both finely distributed and coarsely distributed attributes. This method produced more useful rules and a more effective classification system. We obtained an overall accuracy of 98.55 %. © 2015, International Federation for Medical and Biological Engineering.


PubMed | KMC Manipal, MIT Manipal, Louisiana Tech University and Ngee Ann Polytechnic
Type: Journal Article | Journal: Medical & biological engineering & computing | Year: 2015

Prolonged diabetes retinopathy leads to diabetes maculopathy, which causes gradual and irreversible loss of vision. It is important for physicians to have a decision system that detects the early symptoms of the disease. This can be achieved by building a classification model using machine learning algorithms. Fuzzy logic classifiers group data elements with a degree of membership in multiple classes by defining membership functions for each attribute. Various methods have been proposed to determine the partitioning of membership functions in a fuzzy logic inference system. A clustering method partitions the membership functions by grouping data that have high similarity into clusters, while an equalized universe method partitions data into predefined equal clusters. The distribution of each attribute determines its partitioning as fine or coarse. A simple grid partitioning partitions each attribute equally and is therefore not effective in handling varying distribution amongst the attributes. A data-adaptive method uses a data frequency-driven approach to partition each attribute based on the distribution of data in that attribute. A data-adaptive neuro-fuzzy inference system creates corresponding rules for both finely distributed and coarsely distributed attributes. This method produced more useful rules and a more effective classification system. We obtained an overall accuracy of 98.55%.


George B.M.,Manipal University India | Kumar A.,K S Hegde Medical Academy | Rao M.S.,KMC Manipal | Rao M.S.,Kuwait University
Journal of Clinical and Diagnostic Research | Year: 2013

Introduction: Few studies regarding foot changes and health of professional coconut tree climbers of south India are report-ed. Medical emergencies are very common, especially due to accidental fall from coconut trees, while on job. Objective of the present study is to analyze the altered biomechanics of lower limb joints used by the coconut tree climbers. Method: Videographs of tree climbing each from a total of 30 male volunteers, all between 30-55 years, engaged in coconut tree climbing profession were collected. Results: The data revealed the coconut tree climbers are us-ing abnormal rages of foot and lower limb joint motions. Conclusion: This study establishes an occupationally induced form of altered biomechanics, which leads to professional health hazards.


Kulkarni C.,KMC Manipal | Vivekanand U.,ASRAM Medical CollegeAndhra Pradesh
Journal of Clinical and Diagnostic Research | Year: 2014

Purpose: To determine the outcomes of extra large temporal sclero-corneal tunnel incision Cataract Surgery.Materials and Methods: This consecutive case series of eyes undergoing temporal tunnel cataract extraction with tunnel length of 8 to 10 mm was identified retrospectively. Surgical procedure details, follow up, complications, visual and astigmatic outcomes at 6wks were recorded and analysed.Results: Ninety six eyes with extra large tunnel incision were identified for analysis from a dataset of 670 manual small incision cataract surgery cases. 58% eyes had NO5 or denser cataracts. Intraoperative complications included, tunnel related problems (1 eye, 1.04%), bleeding into Anterior Chamber (10 eyes, 10.4%), Posterior Capsular Rent (2 eyes, 2.1%). Early postoperative complications included striate keratopathy (7 eyes, 7.3%). The mean Best Corrected Visual Acuity was 6/7.5 (0.1 logMAR) and 98% cases had Best Corrected Visual Acuity of 6/12 (0.3 logMAR) or better at 6wk. The aggregate Surgically Induced Astigmatism was 0.32D at 850.Conclusion: Extra Large Tunnel of length 8 to 10 mm can be self sealing with low SIA. The complication rates and visual outcomes of ETCE are comparable to those of conventional MSICS. This method can be valuable in complicated cases and during learning period. © 2014, Journal of Clinical and Diagnostic Research. All rights reserved.


Thanusubramanian H.,Manipal University India | Patil N.,Manipal University India | Shenoy S.,Manipal University India | Bairy K.L.,Manipal University India | Sharma Y.,KMC Manipal
Journal of Clinical and Diagnostic Research | Year: 2014

The author reports a 55-year-old female diagnosed of chronic kidney disease grade-5 with associated co-morbidities like type 2 diabetes mellitus, diabetic retinopathy and hypothyroidism was admitted for arteriovenous fistula construction. She was started on ferric carboxymaltose for the treatment of anaemia. She was given a test dose before administering the drug intravenously and she did not develop any reaction. The drug ferric carboxymaltose was then administered over a period of one hour. About half an hour after drug administration, the patient developed breathlessness and myalgia. After half hour of the above episode of breathlessness and myalgia. She also developed vomiting (one episode). Patient was managed with oxygen therapy, IV fluids and other drugs like corticosteroids, phenaramine maleate and nalbuphine which controlled the above symptoms. © 2014, Journal of Clinical and Diagnostic Research. All rights reserved.


Karanth S.S.,KMC Manipal | Gupta A.,KMC Manipal | Prabhu M.,KMC Manipal
Asian Pacific Journal of Tropical Medicine | Year: 2012

Dengue hemorrhagic fever is a more serious form of disease characterised by plasma leakage syndrome, thrombocytopenia and disseminated intravascular coagulation. We present a 51 year old male who presented with fever, petechiae and acute onset of breathlessness. Emergency chest rhoentogram showed a massive right sided pleural effusion. On insertion of intercostal drain, there was a sudden gush of blood tinged fluid suggestive of hemothorax. There was no history of trauma or bleeding tendencies. Laboratory investigations revealed a raised hematocrit and severe thrombocytopenia. Dengue IgM was surprisingly positive. After aggressive supportive management the patient gradually improved and was discharged. While bilateral pleural effusion is a known occurrence in dengue hemorrhagic fever, massive hemothorax is unheard of. We report the first case in literature of dengue hemorrhagic fever presenting as unilateral massive hemothorax. A suspicion of dengue must also be borne in mind in cases of non-traumatic hemothorax especially in endemic areas. © 2012 Hainan Medical College.


Kumar M.,KMC Manipal | Aroor S.,KMC Manipal | Mundkur S.,KMC Manipal | Kumar S.,KMC Manipal
Journal of Clinical and Diagnostic Research | Year: 2015

Background: Guillain-Barre Syndrome (GBS) is an acute monophasic demyelinating neuropathy characterized by progressive motor weakness of limbs with areflexia.Aim: To study the clinical pattern and outcome of children with Guillain-Barre syndrome.Materials and Methods: It was a cross-sectional study conducted in a pediatric unit of tertiary care hospital over a period of 18 months. We assessed the clinical manifestations, results of electro-diagnostic tests, functional status, treatment instituted and outcome of 20 children diagnosed with GBS.Results: Of the 20 (male to female ratio = 2.3:1) children studied, all had motor weakness, 5 (25%) had sensory loss, 4 (20%) had cranial nerve palsies and 4 (20%) had autonomic disturbances. Respiratory paralysis was found in 7 (35%) children requiring assisted ventilation. Antecedent illness preceding GBS was recorded in 50% children. The GBS subtype distribution as per electrodiagnostic studies was as follows: acute motor axonal neuropathy (AMAN) in 7 (38.9%), acute motor sensory axonal neuropathy (AMSAN) in 4 (22.2%), acute inflammatory demyelinating polyradiculoneuropathy (AIDP) in 4 (22.2%) and both axonal and demyelinating neuropathy in 3 (16.7%). Intravenous immunoglobulins (IVIG) constituted the treatment given in majority of the patients. Plasmapharesis was performed in one child in view of poor response to IVIG. Complete recovery was observed in 14 children and the remaining 3 children experienced only incomplete recovery.Conclusion: Male preponderance and presence of antecedent illness in a majority of subjects was observed in our study. Regardless of the severity of illness at admission and electrophysiological subtypes, a majority achieved full recovery. Intravenous Immunoglobulin and supportive care form the cornerstone of management in childhood GBS. © 2015, Journal of Clinical and Diagnostic Research. All rights reserved.


Poovathingal M.A.,KMC Manipal | Nagiri S.K.,KMC Manipal | Nagaraja,KMC Manipal
Asian Pacific Journal of Tropical Biomedicine | Year: 2014

Objective: To document the various clinical manifestations, lab parameters, complications and outcomes of Falciparum Malaria. The above data would be correlated with the parasitic index to deduce whether it would be an effective measure of the same. Methods: This was a prospective study among 183 inpatients aged above 18 from Kasturba Hospital, Manipal from May 2009 to January 2011. Ethical clearance was taken. Statistical analysis was done with the independent paired t test, linear correlation and Chi square test using SPSS 16. Results: In this study 78% cases were males. Most cases occurred during the monsoons. Fever was the major presentation with others being jaundice, vomiting and head ache. 50.8 % had complications, including hepatic dysfunction (40.9%), renal failure (19.13%), shock (7%), altered sensorium (9%), ARDS (3.27%) and severe anemia (1.63%). Hypoglycemia and gram negative sepsis were rare. Parasitic index, renal parameters and death were correlating positively. ESR was significantly related (P < 0.003) to complications and not to cerebral malaria. There were 12 mortalities out of which 9 were due to MODS and 3 due to ARDS. Conclusions: 50.8% cases conformed to the WHO definition of severe malaria indicating most present with complications. High parasite index and abnormal renal function are predictors of mortality and complications. Early diagnosis, anticipation of complications, close monitoring and combination therapy to over come drug resistance helps to contain the extent of mortality. © 2014 by the Asian Pacific Journal of Tropical Biomedicine.


PubMed | KMC Manipal
Type: Journal Article | Journal: Asian Pacific journal of tropical biomedicine | Year: 2014

To document the various clinical manifestations, lab parameters, complications and outcomes of Falciparum Malaria. The above data would be correlated with the parasitic index to deduce whether it would be an effective measure of the same.This was a prospective study among 183 inpatients aged above 18 from Kasturba Hospital, Manipal from May 2009 to January 2011. Ethical clearance was taken. Statistical analysis was done with the independent paired t test, linear correlation and Chi square test using SPSS 16.In this study 78% cases were males. Most cases occurred during the monsoons. Fever was the major presentation with others being jaundice, vomiting and head ache. 50.8 % had complications, including hepatic dysfunction (40.9%), renal failure (19.13%), shock (7%), altered sensorium (9%), ARDS (3.27%) and severe anemia (1.63%). Hypoglycemia and gram negative sepsis were rare. Parasitic index, renal parameters and death were correlating positively. ESR was significantly related (P<0.003) to complications and not to cerebral malaria. There were 12 mortalities out of which 9 were due to MODS and 3 due to ARDS.50.8% cases conformed to the WHO definition of severe malaria indicating most present with complications. High parasite index and abnormal renal function are predictors of mortality and complications. Early diagnosis, anticipation of complications, close monitoring and combination therapy to over come drug resistance helps to contain the extent of mortality.


PubMed | KMC Manipal
Type: Case Reports | Journal: Asian Pacific journal of tropical medicine | Year: 2012

Dengue hemorrhagic fever is a more serious form of disease characterised by plasma leakage syndrome, thrombocytopenia and disseminated intravascular coagulation. We present a 51 year old male who presented with fever, petechiae and acute onset of breathlessness. Emergency chest rhoentogram showed a massive right sided pleural effusion. On insertion of intercostal drain, there was a sudden gush of blood tinged fluid suggestive of hemothorax. There was no history of trauma or bleeding tendencies. Laboratory investigations revealed a raised hematocrit and severe thrombocytopenia. Dengue IgM was surprisingly positive. After aggressive supportive management the patient gradually improved and was discharged. While bilateral pleural effusion is a known occurrence in dengue hemorrhagic fever, massive hemothorax is unheard of. We report the first case in literature of dengue hemorrhagic fever presenting as unilateral massive hemothorax. A suspicion of dengue must also be borne in mind in cases of non-traumatic hemothorax especially in endemic areas.

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