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Deka P.K.,Melaka Manipal Medical College
Bangladesh Journal of Medical Science | Year: 2011

After the concept of evidence based medicine it became important all over the world to have more structured, clinical oriented curriculum. According to the United Nations, Asia is divided into five sub regions. Brunei, Cambodia, East Timor, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam belong to South-eastern Asia. To cope with the rapid changes in medical education curriculum most of the medical school in Asia particularly south East Asian countries adopted took up curriculum to fit to the current need. Medical education in Malaysia and Singapore developed similarly as the two countries together formed a federation in the British Empire until independence in 1957. Currently, in medical education, a trend has emerged to utilize "trustable research findings" in place of "personal opinions" as a basis for educational management and decision-making. Several of Malaysia's medical schools partner with other European, American and Asian schools, and students sometimes earn the certification or accreditation to practice in those countries as well. In the context of changing medical education system, South East Asia is also adopting up to date medical curriculum for the medical students in these countries. As a result rapid changes in curriculum with special focus on research these schools likely to become a hub of 'educational tourist'. Source

Karanth L.,Melaka Manipal Medical College
The Cochrane database of systematic reviews | Year: 2013

Congenital bleeding disorders can cause obstetric haemorrhage during pregnancy, labour and following delivery. Desmopressin acetate is found to be an effective drug which can reduce the risk of haemorrhage and can also stop bleeding in certain congenital bleeding disorders. Its use in pregnancy has been controversial. Hence beneficial and adverse effects of desmopressin acetate in these groups of pregnant women should be evaluated. To determine the efficacy of desmopressin acetate in preventing and treating acute bleeds during pregnancy in women with congenital bleeding disorders. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Coaguopathies Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant and abstract books of conferences proceedings. We also searched for any randomised controlled trials in a registry of ongoing trials and the reference lists of relevant articles and reviews.Date of most recent search: 28 February 2013. Randomised and quasi-randomised controlled trials investigating the efficacy of desmopressin acetate versus tranexamic acid or factor VIII or rFactor VII or fresh frozen plasma in preventing and treating congenital bleeding disorders during pregnancy were eligible. No trials matching the selection criteria were eligible for inclusion. No trials matching the selection criteria were eligible for inclusion. The review did not identify any randomised controlled trials investigating the relative effectiveness of desmopressin acetate for bleeding during pregnancy in women with congenital bleeding disorders. In the absence of high quality evidence, clinicians need to use their clinical judgement and lower level evidence (e.g. from observational trials) to decide whether or not to treat women with congenital bleeding disorders with desmopressin acetate.Given the ethical considerations, future randomised controlled trials are unlikely. However, other high quality controlled studies (such as risk allocation designs, sequential design, parallel cohort design) to investigate the risks and benefits of using desmopressin acetate in this population are needed. Source

Suvarna B.S.,Melaka Manipal Medical College
Kathmandu University Medical Journal | Year: 2012

Sirtuins are evolutionary conserved NAD+ dependent acetyl-lysine deacetylases and ADP ribosyltransferases dual-function enzymes involved in the regulation of metabolism and lifespan. Sirtuins represent a promising new class of III NAD dependent histone deacetylases that regulate a number of physiological processes, originally identified in yeast. Sirtuins regulate various normal and abnormal cellular and metabolic processes, including tumorgenesis, neurodegeneration and processes associated with type 2 diabetes and obesity. Several age-related diseases such as Alzheimer's disease and longevity have also been linked to the functions of sirtuins. Because of these associations, the identification of small molecules sirtuin modulators has been of significant interest. Source

Suvarna B.,Melaka Manipal Medical College
Kathmandu University Medical Journal | Year: 2013

Adenosine receptors are major targets of caffeine, the most commonly consumed drug in the world. There is growing evidence that they could also be promising therapeutic targets in a wide range of conditions, including cerebral and cardiac ischaemic diseases, sleep disorders, immune and inflammatory disorders and cancer. After more than three decades of medicinal chemistry research, a considerable number of selective agonists and antagonists of adenosine receptors have been discovered, and some have been clinically evaluated, although none has yet received regulatory approval. However, recent advances in the understanding of the roles of the various adenosine receptor subtypes, and in the development of selective and potent ligands, as discussed in this review, have brought the goal of therapeutic application of adenosine receptor modulators considerably closer. Source

Subramaniam B.S.,Melaka Manipal Medical College
Italian Journal of Public Health | Year: 2011

Background: Heart Rate Variability (HRV) analysis is easy to perform, has good reproducibility and provides prognostic information about Coronary Heart Disease. Objective: This work was devised to correlate exercise induced HRV with BMI and compare gender variability among healthy Indian children aged 13-20 years. Methods: The Heart Rate Variability of sixty-five students in the 13-20 years age group was assessed by time-domain methods during resting and after exercise. On the basis of BMI, the subjects were grouped into T1 group (BMI<18) and T2 group (≥18). The HRV of these groups were analyzed. In addition, based on gender, male students were divided on the basis of BMI as follows: M1 group <18 and M2 group ≥ 18. Likewise females were grouped into F1 and F2 groups. The HRV of 3 male groups and 3 female groups were also separately analysed. A paired t- test was used for the dependent variables and an unpaired t-test was carried out for normally distributed variables using Statistical Package for Social Sciences (SPSS) 11.0 for windows. Results: Females showed higher HRV than males during resting condition. But immediately after exercise, the HRV increased in all groups and there was no difference in HRV based on gender and BMI. When recorded 5 minutes after exercise, the HRV decreased further regardless of gender and BMI. However, the HRV taken 30 minutes after exercise behaved more like the resting condition. The HRV recorded 30 minutes after exercise increased from the "5 minutes after exercise" value but still remained lower in all groups regardless of gender and BMI. Conclusions: The results demonstrate that, in healthy adolescents, the parasympathetic activity is higher in females than in males during the rest period. Exercise induced sympathetic activity lasts longer in females with higher BMI and lower age, resulting in decreased HRV. Source

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