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Sahai S.,Gr Medical College | Kiran R.,Ms Ramaiah Medical College And Hospitals
Saudi Journal of Gastroenterology | Year: 2015

Background/Aims: Acute liver failure (ALF) in pregnancy is often associated with a poor prognosis. In this single-center observational study we aim to study the incidence, causes, and factors affecting mortality in pregnant women with ALF. Patients and Methods: Sixty-eight pregnant women reporting with clinical features of liver dysfunction were enrolled as "cases." Their clinical course was followed and laboratory studies were performed. The presence of ALF was defined as the appearance of encephalopathy. The results were compared with a "control" group of 16 nonpregnant women presenting with similar complaints. The cases were further subdivided into two groups of "survivors" and "nonsurvivors" and were compared to find out the factors that contribute to mortality. Results: ALF was seen in significantly more number of pregnant women than the controls (P = 0.0019). The mortality rate was also significantly higher (P = 0.0287). Hepatitis E virus (HEV) caused jaundice in a higher number of pregnant women (P < 0.001). It also caused ALF in majority (70.3%) of pregnant women, but HEV infection was comparable between the survivors and nonsurvivors (P = 0.0668), hence could not be correlated with mortality. Conclusions: Pregnant women appear to be more susceptible for HEV infection and development of ALF. The mortality of jaundiced pregnant women increased significantly with appearance of ALF, higher bilirubin, lower platelet count, higher international normalized ratio, and spontaneous delivery. Source


Belagavi A.C.,Ms Ramaiah Medical College And Hospitals | Shalini M.,Sri Siddhartha Medical College
Journal of Association of Physicians of India | Year: 2011

Objectives: to assess the utility of C-reactive protein (CrP) levels and adenosine deaminase (ADA) activity in the cerebrospinal fluid (CsF) as rapid screening tests to differentiate various types of meningitis in adults and to establish a cut off level for ADA. Methods: CsF samples were obtained from 50 patients who presented to the emergency room and out-patient of sri siddhartha medical Hospital, tumkur during the period between August 2006 and september 2008. Diagnosis of meningitis was based on the clinical presentation and CsF analysis. Results: Out of a total of 50 patients who were enrolled in the study, 24 were diagnosed as tubercular meningitis (tbm) based on the clinical features and CsF analysis. the mean Adenosine deaminase (ADA) activity was 14.14±7.44 U/l in the tbm group. the sensitivity and specificity was 73.9% and 92.6% respectively when a cut-off value of ADA of 10U/l was used, with an accuracy of 84%. CsF-C reactive protein (CrP) was significantly higher in pyogenic meningitis compared to non-pyogenic meningitis. the sensitivity and specificity of the test was 83.3% and 100% respectively with an accuracy of 98%. Conclusions: 2 rapid screening tests- CrP and ADA activity in the CsF can help in the differential diagnosis of pyogenic from non-pyogenic meningitis and tubercular from viral meningitis respectively. CrP being elevated in pyogenic meningitis and ADA activity noted to be higher in tbm. the levels of ADA and CrP were found to be low in viral meningitis. © JAPI. Source


Patil S.S.,BGS Global Institute of Medical science | Rajaram D.,Ms Ramaiah Medical College And Hospitals | Seeri J.S.,BGS Global Institute of Medical science
Indian Journal of Public Health Research and Development | Year: 2016

Background: There is growing evidence that older people are at risk for manifold co morbidities.A thorough examination of the geriatric morbidity and related risk factors are required to improve of health of the elderly. Materials and methods: Community based cross sectional study conducted for one year using a interview schedule by census methodology in elderly ≥ 60 years of age. Data analyzed using SPSS 17.Chi-square test, unadjusted odds ratio with 95%CI were estimated, multiple logistic regression analysis was employed. Results: Total 416 elderly studied, females 268(64.4%) and males 148(35.6%). On univariate analysis,risk of diabetes mellitus was significantly higher among elderly with non-BPL 59(21.5%), sedentary lifestyle 61(21.4%), literates 28(24.6%). Hypertension risk was significantly higher among females 90(33.5%),sedentary lifestyle 97(34.0%), alcohol users 111(30.5%), tobacco addicts 99(31.6%), non exercising group 105(26.7%). The risk of visual impairment was significantly higher in ≥80 years of age group 19(82.6%),below poverty line 71(50.4%),tobacco users 54(52.4%).Arthritis was significantly higher in ≥80years 19(82.6%), females 156(58.2%),sedentary lifestyle165(57.9%).On multiple logistic regression analysis, illiteracy, sedentary lifestyle, inadequate sleep and lack of Exercise were significantly associated with diabetes mellitus. Female gender, BPL family and sedentary lifestyle were significantly associated with hypertension. Inadequate sleep, illiteracy were significantly associated with visual impairment. For arthritis, increasing age, sedentary lifestyle, were significant. Conclusion: the study highlights the importance of lifestyle factors in contributing the majority of the chronic non-communicable diseases. © 2016, Indian Journal of Public Health Research and Development. All rights reserved. Source


Vinay M.,Bangalore Medical College and Research Institute | Tejesh C.A.,Ms Ramaiah Medical College And Hospitals
Saudi Journal of Anaesthesia | Year: 2016

Background: Central venous catheters (CVCs) are inserted in many critically ill patients, but there is no gold standard in estimating their approximate depth of insertion. Many techniques have been described in literature. In this study, we compare the topographic method with the standard formula technique. Materials and Methods: 260 patients, in whom central venous catheterization was warranted, were randomly assigned to either topographic method or formula method (130 in each group). The position of the CVC tip in relation to carina was measured on a postprocedure chest X-ray. The primary endpoint was the need for catheter repositioning. Results: The majority of the CVCs tips positioned by the formula method were situated below the carina, and 68% of these catheters required repositioning after obtaining postprocedure chest X-ray (P < 0.001). Conclusion: The topographic method is superior to formula approach in estimating the depth of insertion of right internal jugular CVCs. © 2016 Saudi Journal of Anesthesia | Published by Wolters Kluwer - Medknow. Source


Deviseti P.,Ms Ramaiah Medical College And Hospitals | Pujari V.S.,Ms Ramaiah Medical College And Hospitals
Journal of Clinical and Diagnostic Research | Year: 2016

Wolff-Parkinson-White (WPW) syndrome is an uncommon cardiac condition where there is an abnormal band of atrial tissue connecting atria and ventricles which can electrically bypass atrioventricular node. The anaesthetic management in these patients is challenging as life threatening complications can occur perioperatively like paroxysmal supraventricular tachycardia and atrial fibrillation. Also, regional anaesthetic technique like subarachnoid block is a safe and cost effective alternative to general anaesthesia as it avoids polypharmacy. We report the successful anaesthetic management of Wolff Parkinson White syndrome in a primi with hydatiform mole posted for suction and evacuation. © 2016, Journal of Clinical and Diagnostic Research. All rights reserved. Source

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