Manipal UniversityKarnataka

Manipala, India

Manipal UniversityKarnataka

Manipala, India
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Patel P.N.,Manipal UniversityKarnataka | Sah P.,Manipal UniversityKarnataka | Chandrashekar C.,Manipal UniversityKarnataka | Vidyasagar S.,Manipal UniversityKarnataka | And 3 more authors.
Diabetes Research and Clinical Practice | Year: 2017

Objectives To determine the oral candidal carriage (OCC), activity of virulent factors and fluconazole susceptibility in subjects with type 2 diabetes mellitus (T2DM) and investigate their association with HbA1c measurements. Materials and methods A cross sectional study was conducted on 100 diabetics and 100 healthy volunteers. The virulence was assessed by measuring the phospholipase activity and proteolysis index. Fluconazole susceptibility was performed using the gradient diffusion method. The OCC, virulence factors and antifungal susceptibility were correlated with patients’ HbA1c measurements. Results The OCC and candidal density carriage was significantly higher in diabetics. Candida albicans (C. albicans) was the most frequently isolated species followed by Candida tropicalis (C. tropicalis). Relatively uncommon species, Candida lusitaniae (C. lusitaniae) and Candida lipolytica (C. lipolytica) were isolated from the diabetics. Prevalence of virulence factor, proteinase, was greater in diabetic group (p < 0.05). Reduced fluconazole susceptibility was noted among the isolates from diabetics; however it was not statistically significant (p = 0.593). Except one, all the susceptible-dose dependent and resistant isolates were Candida no-albicans (C. non-albicans). Conclusion C. albicans remains the predominant pathogen in diabetics, although other species are on the rise. Compared to control group, the isolated species from T2DM group had higher proteinase activity. Resistance to fluconazole was considerably greater among the C. non-albicans isolates from T2DM group. These findings warrant effective treatment modalities to reduce the occurrence of oropharyngeal candidiasis. © 2017 Elsevier B.V.


Kuberan P.,Manipal UniversityKarnataka | Vijaya K.K.,Manipal UniversityKarnataka | Joshua A.M.,Manipal UniversityKarnataka | Misri Z.K.,Manipal UniversityKarnataka | Chakrapani M.,Manipal UniversityKarnataka
Bangladesh Journal of Medical Science | Year: 2017

Background: Stroke subjects presented with greater postural instability which lead to challenge their balance control in sensory conflict conditions. Studies have shown that deficits of sensorimotor integration and an inability to select the appropriate sensory input are associated with balance measures following stroke.However, limited studies have been focused to sensorimotor integration in balance rehabilitation. Objective: Our study aimed to evaluate the Task Oriented Training (TOT) with sensory manipulation to enhance balance and functional mobility in chronic stroke subjects. Design: Randomized controlled pilot study. Setting: Department of Physiotherapy in a Tertiary care Hospital. Subjects: A convenience sample consisting of 26 hemi paretic subjects at least 6 months post stroke duration with Brunnstrom’s recovery stage ≥5 for the lower limb and Berg Balance Score of 40 or above were randomly assigned control group (n=13) and in experimental group (n=13). Interventions: Control group received the conventional physical therapy and in the Experimental group received TOT with manipulations of sensory inputs and provision of sensory conflict for the trunk and lower limb focusing on balance and mobility were implemented for 15 sessions, 5 days a week for 3 weeks with each session of 45-60 mints duration. Outcome measures: Dynamic Gait Index (DGI), Timed Up and Go Test (TUGT) and Fall Efficacy Scale (FES) were analyzed before and after the training. Results: Post training there was a significant improvement in all the outcome measurements for both the groups. However components 3, 4 and 5 of DGI, TUGT and FES of experimental group had a highly significant statistical difference between-group analysis with p<.05. Conclusion:Task oriented exercises with altered sensory input was found to be effective in improving functional mobility in terms of dynamic balance and reduction in their fear of fall levels after a 3 week training program. © 2017, Ibn Sina Trust. All rights reserved.


Nayak Y.,Manipal UniversityKarnataka | Avadhani K.,Manipal UniversityKarnataka | Mutalik S.,Manipal UniversityKarnataka | Nayak U.Y.,Manipal UniversityKarnataka
Recent Patents on Nanotechnology | Year: 2016

Background: HIV infection persists for a longer time in AIDS patient compared to many other viral diseases. This is mainly because the HIV resides maximally in lymphatic system mainly the lymph nodes. Most of the present anti-HIV drugs have very poor bioavailability at lymphatic tissue. Hence, pharmaceutical scientists have made many efforts to formulate anti-HIV drugs for targeting lymphatic system. The exploration of nanoparticulate drug delivery systems have been popularly investigated for lymphatic targeting and for improving therapeutic efficacy. Methods: An electronic search was undertaken to review the recent publications and patents from the available resources on nanoformulations of anti-HIV drugs for lymphatic delivery. Results: Various carrier systems such as liposomes, polymeric nanoparticles, solid-lipid nanoparticles, nanostructured lipid carriers, polymeric micelles, dendrimers, and nanocrystals have been tried for lymphatic targeting. These nanoparticles are widely studied as passive targeting carriers for lymphatic systems. There is dearth of active targeting for anti-HIV drugs. The studies on surface modified nanoparticles have shown promising results for lymphatic targeting. Conclusion: One of the reasons for low success rate in targeting the lymphatic tissue is poor-understanding of pharmacokinetic interactions of novel delivery systems in disease pathology. Apart from this, there are several hurdles in biological screening models and clinical trials. These issues should never be neglected in developing newer targeted delivery systems for treatment of AIDS. © 2016 Bentham Science Publishers.


Mudiganty S.,Manipal UniversityKarnataka | Sipani A.K.,Silchar Medical College and Hospital | Das S.K.,Tezpur Medical College and Hospital
JMS - Journal of Medical Society | Year: 2015

A 13-year-old female presented with chronic instability of her left hip due to late sequela of infantile hip infection. Instability of hip causes significant problems due to pain, limp, and shortening. Such a case is rare and difficult to treat. We performed a subtrochanteric valgus extension pelvic support osteotomy, along with distal varization and lengthening osteotomy utilizing a monolateral fixator. The patient was clinically and radiologically followed up for 24 months after her operation. The fixator was removed after 12 months once radiological union and adequate lengthening was achieved. Pre- and postoperative assessments were done using the Harris Hip Score, which showed a significant improvement. Long duration of usage of the fixator, knee stiffness, and pin tract infections are a few of the limitations observed. © 2015 Journal of Medical Society.


Madireddi J.,Manipal UniversityKarnataka | Reddy G.,Manipal UniversityKarnataka | Stanley W.,Manipal UniversityKarnataka | Prabu M.,Manipal UniversityKarnataka
Journal of Clinical and Diagnostic Research | Year: 2016

Historically, temporal lobe encephalitis is considered as a pathognomonic feature of Herpes simplex encephalitis. This rule may not always be true and we believe that clinicians should keep their differential open. We here report once such. Case of a 36-year-old Indian male who developed altered sensorium following a prodrome of headache and fever. Examination and imaging suggested Temporal Lobe Encephalitis (TLE). Herpes encephalitis was considered and he was started on anti-virals awaiting lumbar puncture reports. Cerebrospinal fluid (CSF) analysis for Herpes Polymerase Chain Reaction (PCR) turned out to be negative. Later, to our surprise PCR for tuberculosis (TB) was positive. CSF was 100% lymphocytic and Adenosine deaminase was 12. He was started on 5 drug anti-tuberculosis regimen following which he showed a significant clinical improvement. Given the prevalence of tuberculosis in the sub-continent, clinicians must be aware of this diagnostic possibility when a patient with TLE does not respond to anti-virals. Apart from disease specific therapy, multi-disciplinary approach involving speech therapy is warranted. An early aetiological characterization of TLE has both diagnostic and prognostic implications, failing which patient may succumb. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved.


Valsaraj B.P.,Manipal UniversityKarnataka | Bhat S.M.,Manipal University India | Latha K.S.,Manipal University India
Journal of Clinical and Diagnostic Research | Year: 2016

Introduction: Chronic Kidney Disease (CKD) is becoming a major public health problem worldwide. The very diagnosis of CKD brings a plethora of psychological problems that adds the agony of the debilitating illness. Financial difficulties apart from the excruciating physical burden of the disease, owing to series of psychosocial issues. Anxiety and depression are two major concerns that to be managed effectively to sustain the life of people undergoing Haemodialysis. Aim: The study aimed at finding the effect of Cognitive Behaviour Therapy (CBT) on anxiety and depression among people undergoing haemodialysis. Materials and Methods: An experimental approach with Randomized controlled trial design was adopted for the study. The instruments used for data collection were Background Proforma and Hospital Anxiety and Depression Scale (HADS). A total of 150 subjects undergoing haemodialysis in a tertiary care hospital of South Karnataka were screened for inclusion and exclusion criteria and 80 participants were recruited for the study. Through computerized block randomization 40 each were allotted to experimental and control groups whereas 33 and 34 respectively in both the groups completed the study. CBT, a structured individual therapy of cognitive, behavioural and didactic techniques, with 10 weekly sessions each was administered to the experimental group. Non-directed counseling, a psychological intervention with ten weekly sessions of individual counseling was given to the control group. Results: The findings of the study revealed that there was a significant reduction of mean anxiety (F=76.739, p=0.001) and depression (F=57.326, p= 0.001) in the experimental group when compared with the control group. Conclusion: Researchers concluded that CBT can be effectively utilized for people undergoing haemodialysis in order to obtain control over their negative thoughts thereby reducing anxiety and depression. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved.


Shetty J.K.,United Arab Emirates University | Maradi R.,Manipal UniversityKarnataka | Prabhu K.,Manipal UniversityKarnataka | Bhat G.,Manipal UniversityKarnataka
Journal of Clinical and Diagnostic Research | Year: 2015

Bisalbuminemia is a rarely encountered anomaly characterized by presence of bifid albumin bands or a single widened albumin band in electrophoretogram. Inherited bisalbuminemia is quite rare and inherited as an autosomal dominant form. The acquired form of bisalbuminemia is usually transient and may be observed during long term beta lactam antibiotic therapy, acute pancreatitis, myeloma and nephrotic syndrome. This is a case of bisalbuminemia in 61-year-old diabetic female with hypothyroidism came with acute exacerbation of bronchial asthma. © 2015,Journal of Clinical and Diagnostic Research. All rights reserved.


Saravu K.,Manipal UniversityKarnataka | Prasad M.,Manipal UniversityKarnataka | Eshwara V.K.,Manipal UniversityKarnataka | Mukhopadhyay C.,Manipal UniversityKarnataka
Pathogens and Global Health | Year: 2015

Background: Nosocomial infections are linked to rising morbidity and mortality worldwide. We sought to investigate the pattern of nosocomial sepsis, device usage, risk factors for mortality and the antimicrobial resistance pattern of the causative organisms in medical intensive care units (ICUs) in an Indian tertiary care hospital. Methods: We conducted a single-centre based prospective cohort study in four medical ICUs and patients who developed features of sepsis 48 hours after admission to the ICUs were included. Patients’ demographics, indwelling device usage, microbiological culture reports, drug resistance patterns and the outcomes were recorded. The Acute Physiology and Chronic Health Evaluation (APACHE) III score and the relative risk of variables contributing towards non recovery were calculated. Results: Pneumonia (49%) was the commonest nosocomial infection resulting in sepsis, followed by urosepsis (21.8%), bloodstream infection (BSI) (10.3%) and catheter-related bloodstream infection (CRBSI) (5%). Sixty three percent of the Acinetobacter baumannii and 64.4% of the Pseudomonas aeruginosa were multidrug-resistant (MDR). Seventy percent of the Klebsiella pneumoniae were extended spectrum beta-lactamase producers and 7.4% were resistant to carbapenems. Forty three percent of the Staphylococcus aureus were methicillin-resistant S. aureus. Resistance to carbapenems was 35.2% in this study. High APACHE III scores (P=0.006 by unpaired t-test) and chronic kidney disease (P=0.023) were significantly associated with non-recovery. Conclusions: A high degree of multidrug resistance was observed among both Gram-positive and -negative organisms in nosocomial sepsis patients. Carbapenem resistance was a common occurrence. Chronic kidney disease and high APACHE III scores were significantly associated with non-recovery. Male gender and sepsis leading to cardiovascular failure were the independent predictors of mortality. © W. S. Maney & Son Ltd 2015.


Kaur H.,Regional Center for Biotechnology | Kaur H.,Manipal UniversityKarnataka | Salunke D.M.,Regional Center for Biotechnology | Salunke D.M.,National Institute of Immunology
IUBMB Life | Year: 2015

Affinity maturation is associated with reduced malleability of the paratope that optimizes an antibody to bind to the bonafide antigen with high specificity and affinity. However, it has been illustrated that mature antibodies tend to exhibit promiscuity despite acquisition of a relatively rigid binding pocket. Such an attribute is contrary to the established paradigm of specificity in antigen recognition. In this review, an explicit dissection of the underlying mechanisms fostering such versatility in mature antibodies has been done. Polyspecificity is essentially achieved by undergoing minimal structural rearrangement at the paratope complemented with plasticity in interaction with antigen. Besides, the structural invariance of the antigen across species could modulate mature antibody specificity. Polyreactivity has been well documented for germline antibodies as broad spectrum antibody repertoire amplification is primarily governed by recombination event of the genetic machinery, which is further expanded at the structural and functional level of interaction. Degenerate specificity in antigen recognition obviates the need to produce distinct antibody for every incoming epitope © 2015 IUBMB Life, 67(7):498-505, 2015 © 2015 International Union of Biochemistry and Molecular Biology.


Su H.,Chang Gung University | Pandey D.,Manipal UniversityKarnataka | Liu L.-Y.,Chang Gung University | Yen C.-F.,Chang Gung University | And 3 more authors.
Gynecology and Minimally Invasive Therapy | Year: 2016

Objective To establish a specific hysteroscopic pattern–the “glomerular pattern”–to diagnose high-grade endometrial cancer and evaluate the accuracy rate of the pattern, based on final histology. Materials and methods From 2008 to 2011, 30 patients for whom pathology indicated endometrial cancer, based on the office hysteroscopy study, were included in the study. We reviewed the hysteroscopic pictures to determine the specific hysteroscopic pattern in high-grade endometrial cancer. Results Thirty patients who had endometrial cancer under hysteroscopy were included to the study. The study population had a mean age of 49.9 years. All patients had abnormal uterine bleeding. Office hysteroscopy was completed in all patients without anesthesia. The findings of the office hysteroscopy suggested endometrial cancer in 30 patients. Fifteen patients had the specific hysteroscopic pattern, called the “glomerular pattern.” All 15 patients had grade 2 or grade 3 disease. Among patients who had a glomerular pattern, 53.3% (8/15) of patients had grade 2 endometrioid adenocarcinoma and 46.7% (7/15) patients had grade 3 endometrioid adenocarcinoma. Among the nonglomerular pattern group patients, 66.7% (10/15) patients had grade 1 endometrioid adenocarcinoma, 26.7% (4/15) patients had grade 2 endometrioid adenocarcinoma and 6.7% (1/15) patients had grade 3 endometrioid adenocarcinoma. Conclusion Our conclusion is that patients with the glomerular pattern have a high percentage of moderate or high-grade endometrioid adenocarcinoma. The glomerular sign may provide information on preoperative pathohistology and decrease the possibility of histology upgrade after hysterectomy. However, large series, prospective, and comparison studies are still needed. © 2015

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