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Karnataka, India

Fernandes S.C.,Manipal University India
The Indian journal of medical research | Year: 2013

Enterococci are the leading cause of nosocomial infections, and are thus a persisting clinical problem globally. We undertook this study to determine the virulence factors and the antibiotic resistance in Enterococcus clinical isolates. One hundred and fifty Enterococcus isolates obtained from various clinical specimens were speciated biochemically and subjected to antibiotic susceptibility testing using Kirby-Bauer disk diffusion method. Resistance to vancomycin was determined by using agar screen method. Haemolysin and gelatinase productions were detected using 5 per cent sheep blood agar and 12 per cent gelatin agar, respectively. Among the 150 Enterococcus isolates, 84 (56%) were E. faecalis. 51(34%) E. faecium, and 15 (10%) were other Enterococcus spp. Haemolysin production was seen among 123 (82%) isolates while 61 (40.6%) isolates produced gelatinase. Nearly 50 per cent of the isolates showed high level aminoglycoside resistance (HLAR). A total of 13 (8.6%) isolates showed vancomycin resistance, of which 11(7.3%) had an MIC >8 μg/ml. Presence of VRE was found to be low among the isolates studied. However, occurrence of VRE along with HLAR calls for regular detection of vancomycin resistance promptly and accurately to recognize VRE colonization and infection. Early detection of VRE and HLAR along with their virulence trait will help in preventing the establishment and spread of multidrug resistant Enterococcus species. Source


Mahabala C.,Manipal University India
Vascular health and risk management | Year: 2013

Hypertension is a major independent risk factor for cardiovascular diseases. Management of hypertension is generally based on office blood pressure since it is easy to determine. Since casual blood pressure readings in the office are influenced by various factors, they do not represent basal blood pressure. Dipping of the blood pressure in the night is a normal physiological change that can be blunted by cardiovascular risk factors and the severity of hypertension. Nondipping pattern is associated with disease severity, left ventricular hypertrophy, increased proteinuria, secondary forms of hypertension, increased insulin resistance, and increased fibrinogen level. Long-term observational studies have documented increased cardiovascular events in patients with nondipping patterns. Nocturnal dipping can be improved by administering the antihypertensive medications in the night. Long-term clinical trials have shown that cardiovascular events can be reduced by achieving better dipping patterns by administering medications during the night. Identifying the dipping pattern is useful for decisions to investigate for secondary causes, initiating treatment, necessity of chronotherapy, withdrawal or reduction of unnecessary medications, and monitoring after treatment initiation. Use of this concept at the primary care level has been limited because 24-hour ambulatory blood pressure monitoring has been the only method for documenting dipping/nondipping status so far. This monitoring technique is expensive and inconvenient for routine usage. Simpler methods using home blood pressure monitoring systems are evolving to document basal blood pressure in the night, which would help in greater acceptance and use of the concept of dipper/nondipper in managing hypertension at the primary care level. Source


Paitya N.,Manipal University India
Journal of Bionanoscience | Year: 2013

Osteoblast cells are the most abundant and fundamental elements in bone, and their concentration in serum is closely linked to bone metabolism and serves as a biological marker for the clinical assessment of bone disease. In this paper, the theoretical analysis of the induced membrane potential for a single and dense osteoblast cell with different microelectrodes in which the response of a cell model at various frequencies and the effect of cell parameters, such as cell membrane resistance and capacitance, are studied using the numerical simulation. The results of the paper determines that the induced Trans Membrane Potential (TMP) of osteoblast cell depends not only on its radius and geometry of the microelectrode but also the resistances and capacitances of suspending medium, which effects the dielectric property of osteoblast cell. All the information of our study gives the new aid to the osteo clinical diagnosis and bone cancer treatment. This study reveals that in osteoblast cell trans membrane potential, density and radius of pore in membrane, can be controlled by changing the microstructure of electrode. Copyright © 2013 American Scientific Publishers. All rights reserved. Source


Kamath C.,Manipal University India
IET Signal Processing | Year: 2011

It is hypothesised that a key characteristic of ECG signal is its non-linear dynamic behaviour and that the non-linear component changes more significantly between normal and arrhythmia conditions than the linear component. This study makes an attempt to analyse ECG beats from an energy point of view by accounting for the features derived from non-linear component in time and frequency domains using Teager energy operator (TEO). The key feature of TEO is that it models the energy of the source that generated the signal rather than the energy of the signal itself. Hence any deviations in the regular rhythmic activity of the heart get reflected in the Teager energy function. To show the validity of appropriate choice of features, t-tests and scatter plot are used. The t-tests show significant statistical differences and scatter plot of mean of Teager energy in time domain against mean of Teager energy in frequency domain for the ECG beats evaluated on selected Manipal Institute of Technology-Beth Israel Hospital (MIT-BIH) database, which reveals an excellent separation of the features into five different classes: normal, left bundle branch block, right bundle branch block, premature ventricular contraction and paced beats. The neural network results achieved through only two non-linear features exhibit an average accuracy that exceeds 95%, average sensitivity of about 80% and average specificity of almost 100%. © 2011 The Institution of Engineering and Technology. Source


Background: Lumbar segmental stability is an important biomechanical component that influences symptoms amongst patients with Mechanical low back pain. Aims: To compare the efficacy of segmental stabilization exercises utilizing multifidus and transversus abdominis muscles versus a placebo treatment in patients with lumbar segmental instability. Materials and methods: The study was an observer-blinded randomized placebo-controlled cross-over study of 18 adults (12 men, 6 women), of mean age 22.5 ± 1.09 yrs who scored 7/13 in subjective aspects and 8/14 in objective aspects of Delphi criteria for lumbar segmental instability. The selected subjects were then randomized to receive either placebo-control (prone lying) or experimental (lumbar segmental stabilization) as a first treatment. Each treatment was followed by a wash-out period of 24 hours. Outcomes were measured four times- pre- and post- first intervention, pre- and post- second intervention. The outcome measures used were pain on Visual analogue scale, Pressure pain threshold and Joint play grading scale (0-6 scale) on that level. Results: Two-way analysis of variance and post-hoc analysis using Bonferonni test were used with level of significance set at p<.05 using Statistical package for social sciences version 12.0.1 for Windows. Visual analogue scale changed significantly in both the periods of intervention- in control (P =.016) and experimental (P =.000) periods. However this improvement was more significant in the experimental period. The Joint play grading scale scores improved only in the experimental condition compared to the control condition significantly. The Pressure pain threshold also improved significantly in the experimental condition (P =.000) while the changes in control condition was not statistically significant (P=.816). Conclusion: Segmental stabilization exercise was more effective than placebo intervention in symptomatic lumbar segmental instability. Source

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