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PubMed | Meenakshi Medical College Hospital and Research institute and Professor
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2014

Pre-hypertension refers to blood pressure in the range of 120 to 139 mm of Hg / 80 to 89 mm of Hg and its prevalence is increasing in India. Previous studies have documented the increase in homocysteine, C-reactive protein and insulin resistance and their role in the development of hypertension. In recent years much attention has been focused on subjects with prehypertension, as the risk for development of cardiovascular disease is higher in these subjects compared to those with normal blood pressure.To evaluate the serum homocysteine, hs-CRP level and insulin resistance in subjects with prehypertension.Sixty prehypertensives and 32 normotensives were recruited according to Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of blood pressure (JNC 7) guidelines. Serum homocysteine, vitamin B12, folate, insulin, hs-CRP and lipid profile were analysed. Independent t-test was carried out to compare two groups and pearson correlation analyses were carried out between various parameters with systolic blood pressure (SBP) and diastolic blood pressure (DBP).Cardiovascular risk factors like serum homocysteine, insulin resistance and inflammatory marker hs-CRP were significantly increased in prehypertensives. Total cholesterol, TG, LDL-C and VLDL-C were significantly increased when compared to normotensives. Serum homocysteine correlated positively and vitamin B12 and folate negatively with Systolic Blood Pressure.The present study concludes that the established cardiovascular risk factors, homocysteine, insulin resistance, and hs-CRP which have roles in the etiopathogenesis of hypertension, were elevated in subjects with prehypertension. Thus, early detection and life style modification may reduce the risk or delay the onset of hypertension and other cardiovascular complications.


Parkhad Suchitra B.,Meenakshi Medical College Hospital and Research Institute | Palve Sachin B.,Meenakshi Medical College Hospital and Research Institute | Dayoub M.A.L.,King Abdullah Hospital
Biomedicine (India) | Year: 2014

Introduction: Obstructive sleep apnoea (OSA) is suggested to be associated with peripheralnerve damage. Aim: In this study, it was examined whether treatment for OSA has a possible beneficial effect on peripheral nerve function. Material and Methods: Participants were 50 patients with OSA and 50 controls matched for age and body mass index (BMI), all without any known cause of peripheral nerve damage. The sensory nerve action potential (SNAP) amplitudes of both peroneal nerves were determined. After 6 months of treatment for OSA, treatment compliance was evaluated and nerve conduction studies were repeated. Results: Patients with OSA had significantly lower mean (standard deviation) peroneal SNAP amplitudes than controls (6.3 (3.5) v 11.2 (5.0), p<0.001). Multivariate regression analysis including the variables age, BMI and Apnoea-Hypopnea Index (AHI) showed that both age (p<0.01) and AHI (p<0.05) were inversely related to the SNAP amplitude. On follow-up, the peroneal SNAP showed an increase of 2.6 mV on average (p<0.001). Multivariate regression analysis including the variables age, BMI, AHI, pretreatment SNAP and treatment compliance identified only treatment compliance as being significantly related to the SNAP increase (p≤0.005). Conclusion: OSA is an independent risk factor for axonal dysfunction of peripheral sensory nerves. Impaired neural function is at least partly reversible with treatment for sleep apnoea.


Talikoti P.,Meenakshi Medical College Hospital and Research institute | Bobby Z.,Jipmer | Hamide A.,Jipmer
Journal of Clinical and Diagnostic Research | Year: 2014

Background: Pre-hypertension refers to blood pressure in the range of 120 to 139 mm of Hg/80 to 89 mm of Hg and its prevalence is increasing in India. Previous studies have documented the increase in homocysteine, C-reactive protein and insulin resistance and their role in the development of hypertension. In recent years much attention has been focused on subjects with prehypertension, as the risk for development of cardiovascular disease is higher in these subjects compared to those with normal blood pressure.Objectives: To evaluate the serum homocysteine, hs-CRP level and insulin resistance in subjects with prehypertension. Materials and Methods: Sixty prehypertensives and 32 normotensives were recruited according to Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of blood pressure (JNC 7) guidelines. Serum homocysteine, vitamin B12, folate, insulin, hs-CRP and lipid profile were analysed. Independent t-test was carried out to compare two groups and pearson correlation analyses were carried out between various parameters with systolic blood pressure (SBP) and diastolic blood pressure (DBP). Results: Cardiovascular risk factors like serum homocysteine, insulin resistance and inflammatory marker hs-CRP were significantly increased in prehypertensives. Total cholesterol, TG, LDL-C and VLDL-C were significantly increased when compared to normotensives. Serum homocysteine correlated positively and vitamin B12 and folate negatively with Systolic Blood Pressure. Conclusion: The present study concludes that the established cardiovascular risk factors, homocysteine, insulin resistance, and hs-CRP which have roles in the etiopathogenesis of hypertension, were elevated in subjects with prehypertension. Thus, early detection and life style modification may reduce the risk or delay the onset of hypertension and other cardiovascular complications.


Sivalingam J.,Meenakshi Medical College Hospital and Research Institute | Kumar A.,Vidya Health Imaging
Journal of Clinical and Diagnostic Research | Year: 2015

Background: Tuberculous spondylitis is one of the commonest forms of skeletal tuberculosis in developing countries like India causing significant morbidity due to compression of spinal cord and adjacent nerve roots. Diagnosis and intervention at early stage can prevent permanent damage such as spinal deformity and neurological deficits. Aim: The purpose of this study was to demonstrate atypical MRI features in cases of tubercular spondylitis resembling neoplastic lesions and to stress that tuberculous spondylitis should be one of the differential diagnoses in any spinal pathology especially in developing countries. Materials and Methods: This was a prospective study done in the patients diagnosed as tuberculous spondylitis on 0.2 T Siemens MRI between June 2011 and December 2014 in a tertiary care hospital in India. Total 529 cases of tubercular spinal lesions were diagnosed. Out of which only 59 patients showed atypical features on MR imaging which resembled neoplastic lesions were included in the study. The diagnosis was confirmed by cytology, histopathology, serology and corroborative findings. Results: Lumbo-sacral region involvement (30.5%) is the commonest in our study followed by dorsal and cervical region. Multiple level lesions are seen in 14 cases (23.7%). All the 59 (100%) cases show no involvement of intervetebral disc. Posterior appendage involvement seen in 32 cases (54.2%). Soft tissue component seen in Intraspinal (37.2%) and paraspinal (45.7%) compartments. Cord compression seen in 19 cases (32.2%), out which only 7 cases (11.8%) shows cord oedema. Conclusion: On MRI, tubercular spondylitis may have variable pictures on imaging. For any spinal and paraspinal lesions, we should also consider the possibility of tubercular aetiology along with other. Since early diagnosis avoids unnecessary delay in the treatment thereby reducing morbidity and possible complications. © 2015, Journal of Clinical and Diagnostic Research. All rights reserved.


Ravish D.K.,Anna University | Shenbaga Devi S.,Anna University | Krishnamoorthy S.G.,Meenakshi Medical College Hospital and Research Institute
Biomedical Research (India) | Year: 2015

This paper deals with the wavelet analysis method for seizure detection in EEG time series and coherence estimation. The main part of the paper presents the basic principles of signal decomposition in connection with the EEG frequency bands. Wavelet analysis method has been used for detection of seizure onset. The wavelet filtered signal is used for the computation of spectral power ratio. The results show that our method can identify pre seizure, seizure, post seizure and non seizure phases. When dealing with seizure detection and prediction problems it is important to identify seizure precursor dynamics and necessary to identify information about onset and spread of seizures. Therefore in the second part the coherence and phase synchrony during pre seizure, seizure, post seizure and non seizure are computed. We expect this method to provide more insight into dynamic aspects of the seizure generating process. © 2015, Scientific Publishers of India. All rights reserved.


PubMed | Meenakshi Medical College Hospital and Research Institute, Christian Medical College and Hospital and Saveetha Medical College
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2016

Chronic Obstructive Pulmonary Disease (COPD) is a disease of wasting with airflow limitation, associated with a variety of systemic manifestations such as reduced Bone Mineral Density (BMD). There is a paucity of Indian studies on the effects of COPD on BMD.This study was conducted to estimate the prevalence of osteopenia and osteoporosis in COPD patients and the correlation between bone density and severity of COPD classified according to GOLD Global initiative for chronic Obstructive Lung Disease guidelines (GOLD).A prospective study of 60 patients diagnosed to have COPD, was conducted in the outpatient department of Respiratory Medicine, at a tertiary care hospital in Southern India, between September 2012 and September 2013. BMD was measured using ultrasound bone densitometer (ACHILLES GE HEALTH CARE). Patients with a T-score between -1 and -2.5 were considered to be osteopenic while patients with a T score less than -2.5 were considered to be osteoporotic (WHO criteria).Overall, 40 (67%) patients had an abnormal bone mineral density. A total of 21 (35%) patients were osteoporotic while 19 (33%) were osteopenic. BMD levels correlated with severity of obstruction (p<0.001), smoking status (p=0.02), age (p=0.05) and number of pack years (p=0.001).Patients with COPD are at an increased risk for lower BMD and osteoporotic fractures and the risk appears to increase with disease severity. Further studies are required to assess whether routine BMD measurements in COPD patients is beneficial to diagnose osteoporosis and reduce morbidity.


PubMed | Meenakshi Medical College Hospital and Research Institute and Christian Medical College and Hospital
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2017

Lung cancer is associated with a poor prognosis, if detected late in the disease course. Delay in seeking health care, wrong diagnosis and delay in specialist referral can contribute to delay in diagnosis.This study was done to assess physician related delays in the diagnosis of lung cancer and the treatments given before presenting to our center.A total of 96 consecutive patients diagnosed with lung cancer were enrolled in this study. Details of previous physician consultations, their specialization, diagnoses made and treatments given were obtained from records available with the patients.Patients, on an average consulted two physicians before presenting to our center. Less than half of the physicians (45%) suspected lung cancer during their evaluation. Around 18% of physicians made an incorrect diagnosis of tuberculosis, out of whom, 88.6% had prescribed anti-tuberculous therapy. Only 27% of physicians referred the patients to higher medical centres for evaluation. Pulmonology Specialists (PS) were the most likely to diagnose lung cancer (p<0.0001). General Medicine Specialists (GMS) were the most likely to misdiagnose cancer as tuberculosis, followed by General Practioners (GP) when compared to PS (p-value =0.0422).Our study demonstrates that, many physicians have a low index of suspicion to diagnose lung malignancy and most commonly misdiagnose it as tuberculosis. It is likely that most patients failed to seek the services of PS directly or through referral either due to a shortage of PS or due to other reasons.


Revathi M.,Meenakshi Medical College Hospital and Research Institute | Chandrasekar M.,Meenakshi Medical College Hospital and Research Institute
Biomedicine (India) | Year: 2014

Introduction: 80% of rural household in India still rely on unprocessed solid biomass like wood and animal dung for cooking and heating source. These materials when burnt inside the dwellings, due to its incomplete burning, releases pollutants which produces indoor air pollution. Prolonged exposure to biomass smoke pollutants during household work is a risk factor for respiratory disease among women.Aim: The aim of this study was to compare the haematological and cardio respiratory parameters of biomass fuel exposed women to that of non biomass fuel users.Materials and Methods: About 100 women participated in this study. They were randomly selected from rural Kanchipuram. 50 subjects comprised of women using biomass fuel and the remaining 50 subjects were as controls who used cleaner fuels (LPG, electricity). The subjects were nonsmokers in the age group of 20-40 yrs who used to cook regularly for 2-3 hours/day. Women with respiratory and cardiovascular disorder were excluded from the study after clinical examination. Each individual's demographic details and anthropometry was recorded (age, height, weight, cooking duration and no. of cooking years). Resting Blood pressure, Pulse was recorded by Digital Sphygmomanometer in sitting position. Pulmonary function test was measured by RMS Medspiror according to American Thoracic Society recommendation. Blood samples were collected from each of the subjects for analysing haematological parameters using automated analyser.Results: Blood pressure was significantly increased in biomass users when compared to the controls. The WBC count was increased in the biomass users against the controls which was significant. The lung function parameters were decreased in the biomass users than the controls but did not have any statistical significance.Conclusion: Biomass smoke exposure can have an adverse effect on cardiovascular system.


Teli Chandrika G.,Meenakshi Medical College Hospital and Research Institute | Kate Nilesh N.,Meenakshi Medical College Hospital and Research Institute
Biomedicine (India) | Year: 2012

Objectives and Aims: The present study is undertaken to assess use orbital dimensions as a parameter to predict gestational age of fetus. Methods: 62 human fetuses, 12 to 39 weeks were obtained from medical termination of pregnancy, spontaneous abortions or vaginal still birth. For measuring orbital dimensions, soft tissues were cleaned off to expose the bony land-marks. Height, Width of orbit, Outer orbital distance, Inner orbital distance, Distance between infra-orbital foraminae was recorded with the help of craniometer. 't' test was used for testing significance. Results: All parameters correlated with gestational age, highly significant (p<0.001). GA = 5.5689 x width of orbit - 26.6779, GA = 3.9999 xheight of orbit - 35.9999, GA =0.5593 x outer orbital diameter + 0.5997, GA = 2.8235 x inner orbital diameter - 1.4117, GA = 0.9759 xdist. between infraorbital foramina - 7.566 Conclusion: The development of orbit is dependent on development of eye ball, blood vessels and nerves of orbit, nasal cavity, paranasal sinuses, temporal fossa and cranial cavity. So assessing the orbital dimensions we are indirectly assessing above parameters also. We strongly suggest orbital dimensions should be used as routine to opine about gestational age in addition to conventionally used other parameters.


Parkhad S.B.,Meenakshi Medical College Hospital and Research Institute | Palve S.B.,Meenakshi Medical College Hospital and Research Institute
National Journal of Physiology, Pharmacy and Pharmacology | Year: 2014

Background: Diabetic poly neuropathy, a common complication of diabetes, is diagnosed by symptoms, signs, physical examination, nerve conduction studies, and other neuro-physiological methods. Although nerve conduction studies are useful in the diagnosis and evaluation of diabetic neuropathy, there are difficulties in using them for the differential diagnosis of peripheral neuropathy because the pathological changes of diabetic neuropathy are varied.Aims & Objective: To investigate the usefulness of a new parameter, the ratio of motor nerve conduction velocity to F-wave conduction velocity (M/F ratio), for the differential diagnosis of diabetic neuropathy.Materials and Methods: Nerve conduction studies were conducted in 100 patients with diabetic neuropathy during the period of December 2012 to February 2013, 45 non diabetic patients with peripheral neuropathy, and 25 normal control participants. Non diabetic patients with neuropathy were grouped by clinical diagnosis as follows: segmental demyelination (n = 15), axonal neuropathy (n = 11), alcoholic poly neuropathy (n = 5), and other poly neuropathy (n = 14). Motor nerve conduction velocity (MCV) of post-tibial nerves, sensory nerve conduction velocity (SCV) of sural nerves, and F-wave conduction velocity (FWCV) of post-tibial nerves were measured by standardized techniques. The M/F ratio was calculated from these measurements.Results: The motor conduction velocity (MCV) and sensory conduction velocity (SCV) of diabetic patients were significantly slower and the M/F ratio was significantly lower than those of normal participants: MCV, 43.7 ± 5.4 vs. 47.1 ± 2.9 m/s, P < 0.001; SCV, 44.7 ±11.1 vs. 48.3 ± 5.7 m/s, P < 0.05; M/F ratio, 0.84 ± 0.09 vs. 0.90 ± 0.06, P < 0.001. The FWCV of non-diabetic patients with neuropathy was significantly slower (40.0 ± 6.3 vs. 48.3 ± 4.0 m/s, P < 0.001) and the M/F ratio was significantly higher (1.04 ± 0.12, P < 0.001) than that of normal participants, respectively. Although MCV, SCV, and FWCV were correlated with age in normal control participants, the M/F ratio was independent of age in the diabetic as well as the non-diabetic patients with neuropathy.Conclusion: Results suggest that the M/F ratio, which is influenced by the neuronal damages in the distal segment of peripheral nerves, is useful in the differential diagnosis of diabetic neuropathy. © 2014, Mrs Deepika Charan. All rights reserved.

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