Choudhury I.,Padmashree Dr D Y Patil Medical College |
Indian Journal of Clinical Biochemistry | Year: 2012
Hypertension, a well known risk factor for various cardiovascular, peripheral vascular and renal events is an important public health challenge. Renin angiotensin system (RAS) being the most vital pathogenic mechanism of hypertension is mediated by a key component; the angiotensin converting enzyme (ACE). The present study was aimed to know the relationship of ACE gene polymorphism and the possible risk of development of hypertension in south Indian population. The study included 101 clinically diagnosed hypertensive patients without any associated disease condition and 81 age and sex matched apparently healthy controls. Genotyping was performed using a polymerase chain reaction, (PCR) amplification of the intron 16 fragment harboring the 287 bp Alu repeat sequence. Three possible genotypes D/D, I/I homozygous and I/D heterozygous were analyzed where the D/D genotypes corresponds to higher ACE levels (D-Deletion, I-Insertion). The PCR products were separated on 2 % agarose gel. Statistical analysis was performed using SPSS.15 software program. We found a significance in frequency of D/D genotype in the hypertensive patients compared to the control group (p = 0.0005, odd's ratio = 4.157). This suggested that ACE (D/D) genotypes are more prone for the development of hypertension. This is relatively a pilot study; but nevertheless may assist in identifying the pathophysiological cause of hypertension. © Association of Clinical Biochemists of India 2012.
PubMed | Kothari Medical and Research Institute, Dr S N Medical College, Padmashree Dr D Y Patil Medical College, B Y L Nair Charitable Hospital & T N Medical College and 5 more.
Type: | Journal: Malaria research and treatment | Year: 2015
Background. Primaquine is used to eradicate latent Plasmodium vivax parasite from liver, with administration of standard dose daily up to 14 days. We studied efficacy, safety, and tolerability of sustained release (SR) formulation of primaquine in comparison with conventional primaquine in preventing relapse of P. vivax malaria. Methods. Microscopically confirmed cases of P. vivax malaria received chloroquine therapy for three days. Aparasitemic and asymptomatic patients were then randomized to receive either conventional primaquine 15mg for 14 days or primaquine SR 15mg for 14 days, or primaquine SR 30mg for seven days. Results. Of the 360 patients, who received chloroquine therapy, 358 patients were randomized. Two-hundred eighty-eight patients completed six-month follow-up and four patients (three: conventional primaquine 15mg (2.86%), one: primaquine SR 30mg (0.93%)) showed relapse confirmed by PCR genotyping. Drug compliance was significantly better in primaquine SR 30mg group (95.57%, p = 0.039) without any serious adverse events. Conclusion. Primaquine SR 15mg and primaquine SR 30mg could be an effective alternative to conventional primaquine 15mg due to their comparable cure rates and safety profile. Shorter treatment duration with primaquine SR 30mg may increase patient compliance and may further reduce relapse rates. Clinical Trial Registration. This trial is registered with CTRI/2010/091/000245.
A study of psycho-behavioral patterns in patients emerging from general anesthesia using sevoflurane, propofol and their combination in early, intermediate and late post-operative period: A randomized controlled trial
PubMed | Padmashree Dr D Y Patil Medical College and Public Hospitals Authoritys Rand Memorial Hospital
Type: Journal Article | Journal: Anesthesia, essays and researches | Year: 2015
It has been contended the general anesthetic agents also may affect the psycho-social behavior of the patients, especially during the emergence from GA. This assumes much significance in day cases where, patients have to be roadworthy and mentally stable before discharge.We compared the psycho-behavioral effects of propofol, sevoflurane and their combination, while emerging from anesthesia.The patients coming for short duration day care anesthesia were studied in a prospective randomized controlled comparison.The psycho-behavioral changes in early, intermediate and late recovery period were studied in 60 consenting patients undergoing Total Intra Venous Anesthesia (TIVA) using Propofol, Volatile Induction and Maintenance Anesthesia (VIMA) using Sevoflurane and the combination of these two agents.Statistical Analysis of the data and application of various statistical tests was carried out with help of Statistical Package for Social Services (SPSS version 18). Data were compiled, analyzed and presented as frequency, proportions, mean and standard deviation. The tests of significance, like Chi-square test, percentages, independent sample t test, paired t test, and P value were used in the study.Both the modalities of GA, viz; TIVA and VIMA, do produce significant psycho-behavioral changes in the patients after GA, though transiently. So it is imperative for the Clinicians to anticipate the entire aspect of Psycho-behavioral patterns before discharging the day cases from the Post anesthesia Care Unit (PACU).
Sahasrabudhe T.,Padmashree Dr D Y Patil Medical College
Research Journal of Pharmaceutical, Biological and Chemical Sciences | Year: 2012
Prophylactic pyridoxine is routinely prescribed to patients on TB chemotherapy to prevent Isoniazid induced neuropathy. The study aimed to determine the incidence of peripheral neuropathy in Indian patients on daily TB chemotherapy without prophylactic pyridoxine and whether they really needed therapeutic doses of pyridoxine, if it occurred. 559 patients on TB chemotherapy as per WHO categorization without prophylactic pyridoxine were followed throughout the course of treatment. Patients with proven or suspected drug resistance, those with existing peripheral neuropathy or those suffering from a condition predisposing to neuropathy such as diabetes were excluded. Patients reporting with symptoms of peripheral neuropathy were followed. Other causes of neuropathy were ruled out. They were given daily vitamin B-complex for one week. 100 mg daily pyridoxine was given only if there was no adequate response. A total of 26/559 patients (4.65%) developed neuropathy symptoms. 19/26 (73.07%) patients responded to one week course of B-complex and never had recurrence of symptoms. 7/559 (1.25%) patients needed 100 mg of pyridoxine to relieve their symptoms. This study indicates very low incidence of peripheral neuropathy in patients on daily TB chemotherapy without use of prophylactic pyridoxine, in Indian scenario. Not all patients developing neuropathy need high dose pyridoxine.
Pinto V.,Padmashree Dr D Y Patil Medical College
Journal of Natural Science, Biology and Medicine | Year: 2013
The global events of the last two decades indicate that the threat of biological warfare is not a myth, but a harsh reality. The successive outbreaks caused by newly recognized and resurgent pathogens and the risk that high-consequence pathogens might be used as bioterrorism agents amply demonstrate the need to enhance capacity in clinical and public health management of highly infectious diseases. This review article provides a concise overview of bioterrorism, the agents used, and measures to counteract it, with a relevant note on India′s current scenario of surveillance systems, laboratory response network, and the need for preparedness.
Dubhashi S.P.,Padmashree Dr D Y Patil Medical College |
Kumar H.,Padmashree Dr D Y Patil Medical College |
Nath S.R.,Padmashree Dr D Y Patil Medical College
American Journal of Case Reports | Year: 2012
Prostate cancer is the most common cancer in men in many Western countries and is the second-leading cause of cancer in men. More than 30% of men over the age of 50 will develop a malignant change in the prostate. Common sites of metastasis include bone and regional lymph nodes. This is a case report of prostate cancer in an elderly man presenting with cough and cervical lymph-adenopathy. The lymph node cytology reported moderately differentiated adenocarcinoma, and immunohistochemistry of the biopsy specimen with PSA staining demonstrated the malignancy to be of prostatic origin. The patient responded dramatically to androgen blockade therapy. Clearing of chest infltrates and regression in size of cervical lymph nodes were evident within 6 months. Prostate cancer should be considered as one of the differential diagnoses of generalized lymph-adenopathy in males with adenocarcinoma of undetermined origin, even in the absence of lower urinary tract symptoms. Immunohistochemistry with PSA staining can confrm the diagnosis. Hormonal therapy is an effective treatment modality, even in patients with an advanced stage of disease. © Am J Case Rep, 2012.
Rao M.,Padmashree Dr D Y Patil Medical College |
Swamy V.,Padmashree Dr D Y Patil Medical College |
Arole V.,Padmashree Dr D Y Patil Medical College |
Mishra P.,Padmashree Dr D Y Patil Medical College
Journal of Minimal Access Surgery | Year: 2013
Introduction: Laparoscopy has been in vogue for more than 2 decades. Making portals in the anterior abdominal wall for introducing laparoscopic instruments is done with trocar and cannula which is a blind procedure. Stab incision and trocar insertion, though safe, at times can lead to injury of blood vessels of anterior abdominal wall more so the inferior epigastric artery (IEA). Trauma to abdominal wall vessels is 0.2%-2% of laparoscopic procedures and said to be 3 per 1000 cases. Injury to IEA is one of the commonest complications seen. Purpose of the present study was to observe the course of IEA in 50 formalin preserved cadavers, by dissection. Materials and Methods: In 50 formalin fixed cadavers, IEA was exposed by opening the rectus sheath. Rectus was divided and IEA was exposed. Five reference points A, B, C, D, and E were defined. A was at pubic symphysis, while E at umbilicus. B, C, and D were marked at the distance of 3.5, 7, and 10.5 cm, respectively from pubic symphysis. Distances of the IEA from these midline points were measured with the help of sliding vernier calipers. Results: Significant observation was variations in the length of IEA. It was seen to end at a lower level than normal (three cases on right and four on left side) by piercing rectus. In 14, cadavers artery did not reach up to umbilicus on both sides. Nearest point of entry of IEA in to rectus sheath at the level of pubic symphysis was 1.2 cm on left and 3.2 cm on right side. Farthest point from point A was 6.8 cm on right and 6.9 cm on left side. Width of strip of abdominal wall which was likely to have IEA beneath was up to 4 cm till level C and beyond which it widened up to 5cm on left side and 6 cm on right at umbilicus. Discussion: Present study did reveal notable variations in length and termination of IEA. No uniformity in entry of IEA in to the rectus sheath was observed. Findings did concur with earlier observations but the strip of skin of arterial zone was not equidistant from midline but had moved more medially on left side. Medial limit of this safety zone found to be lesser than 2 cm on left side. However, the lateral limit of the zone was within 7.5 cm. Additional variation was strip of abdominal wall likely to have IEA beneath was up to 4 cm till level C and had diverging limits beyond C. IEA was more notorious in its course. These variations prompt for a preoperative mapping of IEA and thus a useful step in preoperative protocol.
Kakrani A.L.,Padmashree Dr D Y Patil Medical College |
Gokhale V.S.,Padmashree Dr D Y Patil Medical College |
Vohra K.V.,Padmashree Dr D Y Patil Medical College |
Chaudhary N.,Padmashree Dr D Y Patil Medical College
Journal of Association of Physicians of India | Year: 2014
Aims and Objectives: 1) To study types of neuropathy in Type 2 diabetes. 2) To correlate clinical features of peripheral neuropathy with nerve conduction study in Type 2 diabetes. Material: A total of 50 diabetics, whose onset of diabetes after the age of 30 years were studied from Dr. D. Y. Patil hospital and research centre. Type 2 Diabetes mellitus with symptom suggestive of peripheral neuropathy were studied and included. Chronic alcoholic, peripheral neuropathy due to any other known cause were excluded. Method of Collection of Data: History of symptoms like paraesthesia like tingling sensation, burning feet, hyperaesthesia, foot ulcer, history of weakness and gait abnormality was noted. Complete central nervous system examination was performed to look for signs such as diminished ankle jerk, diminished power. Sensory examination for loss of light touch, superficial pain, temperature sense, vibration and joint position was done. Nerve conduction studies were performed using Clarity Octopus NCV/EMG machine. Written and informed consent from patient were taken. Results: 1) 46 patients i.e. 92% presented with complaints of tingling sensation and 32 patients i.e. 64% had burning feet. 2) 29 patients i.e. 58% have diminished ankle jerk, 29 patients i.e. 58% have diminished or loss of vibration sense, in 21 patients i.e. 42% patients have diminished light touch and 20 patients i.e. 40% patients have loss of joint position senses. 3) NCV performed on 50 patients of diabetic neuropathy out of which all patients i.e. 100% had involvement of lower limb and only 24 patients i.e. 48% had involvement of upper limb also. 4) Involvement of tibial and sural nerve is more common i.e. 86% and 82% respectively. 5) 42 patients i.e. 84% found to have distal symmetrical polyneuropathy, 2 patients i.e. 4% had isolated tibial nerve involvement, 4 patients i.e. 8% had pure sensory sural nerve involvement, and only 1 patient each of isolated medial and plantar nerve involvement. Conclusion: Distal symmetrical polyneuropathy is most common form of diabetic neuropathy. Involvement of tibial and sural nerve is more common in diabetic neuropathy. © JAPI.
PubMed | Padmashree Dr D Y Patil Medical College
Type: Journal Article | Journal: Journal of orthopaedic case reports | Year: 2016
Aneurysmal bone cyst is an expansile, lytic, multiloculated, fluid filled cavities which usually occurs in the metaphysis of the long bones. ABC of the pubic ramus is a rare entity..We present a case of a 21 year old male who presented with a swelling of the right inguinal region which was gradually progressive. Radiologically, there was a lytic expansile lesion of the superior pubic ramus. A contrast computed tomography revealed multiloculated cystic cavities and histopathology confirmed the diagnosis of ABC. Surgical excision of the complete tumor by anterior approach was done. Till date (2 years since surgery) patient has no recurrence.ABC of pubic ramus is a rare entity and other differentials should always be kept in mind with confirmation of diagnosis by histopathology. Treatment with surgical curettage and bone grafting the defect is curative in selective cases but in this case due to size and location excision is the choice of treatment.
PubMed | Padmashree Dr D Y Patil Medical College
Type: Journal Article | Journal: Urology annals | Year: 2015
Percutaneous nephrolithotomy (PCNL) is the treatment of choice for staghorn and large renal stones. The success of PCNL is highly related to optimal renal access. Upper calyceal puncture being more difficult and more demanding have relatively few studies presented.This prospective study was carried out to evaluate the effectiveness and safety of upper calyceal versus lower calyceal puncture for the removal of complex renal stones through PCNL.A total of 94 patients underwent PCNL for complex renal stone in our institute. Fifty-one of them underwent lower calyceal, while 43 underwent upper calyceal puncture. The two approaches are compared as per total duration of surgery, intraoperative blood loss, infundibular/pelvic tear, rate of complete clearance and rate of postoperative complications (pulmonary, bleeding, fever and sepsis, etc.).In our study, the success rate was 76.47% for those in the lower, 90.70% for those in the upper calyceal access group. Thoracic complications (hydrothorax) occurred to 1 patient in upper calyceal supracostal access group. Bleeding requiring blood transfusion happened to 5 patients in lower calyceal access and 1 in upper calyceal group.In our study for the management of complex renal calculi, we conclude that in a previously unoperated kidney, upper calyceal puncture through subcostal or supra 12(th) rib is a feasible option minimizing lung/pleural rupture and gives a better clearance rate. We suggest that with due precautions, there should not be any hesitation for upper calyceal puncture in indicated patients.