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Kalaiselvi V.S.,Sree Balaji Medical College and Hospital | Saikumar P.,Sree Balaji Medical College and Hospital | Prabhu K.,Sree Balaji Medical College and Hospital | Prashanth Krishna G.,Sri Ramachandra Medical College
Journal of Clinical and Diagnostic Research | Year: 2012

Background: Ovarian Reserve (OR) is a term which describes the functional potential of the ovary, which constitutes the size of the ovarian follicle pool and reflects the number and quality of the oocytes which are within it. Assessment of the OR helps in reflecting the reproductive potential of women. Various markers are available for assessing the OR and the best marker is the Anti Mullerian Hormone (AMH) which reflects the ovarian follicular pool in the ovary. In this study, the serum level of AMH/MIS(Mullerian Inhibiting Substance)was estimated to assess the ovarian reserve in both fertile and infertile women. Objective: To assess the ovarian reserve in women of the fertile and subfertile groups with regular cycles, who were in the age range of 26 -33yrs, by estimating the level of AMH and those of other hormones like FSH and E2 and also to calculate the ovarian volume and the Antral follicular count by an ultrasonographic method. Materials and Methods: Thirty fertile and thirty sub fertile women whose ages ranged from 26-33yrs were included as group 1 and group 2 respectively. The hormones like AMH, FSH and oestradiol were assayed. Measurement of the ovarian volume and the antral follicular count by doing a transvaginal ultrasonogram, was done in all the subjects who were involved in both the groups. The correlation test was studied between the variables and the test of significance of the variables between the 2 groups was also analyzed by the Statistical Package Of Social Sciences (SPSS). Results: The Antral Follicular Count (AFC) and the ovarian volume were negatively correlated with the age. The ovarian volume was positively correlated with the AFC. The FSH negatively correlated with the AFC. The Anti Mullerian Hormone negatively correlated with the age, and it positively correlated with the AFC. The mean values of AFC, FSH, and AMH were also statistically significant between the two groups. Conclusion: AMH can be considered as a marker for assessing the ovarian reserve, as it is cycle independent as compared to the other hormones. The women in the subfertile group with low levels of AMH should be insisted to proceed for ART as early as possible.

Mohan P.,Stanley Medical College | Ramu B.,Stanley Medical College | Bhaskar E.,Sri Ramachandra Medical College | Venkataraman J.,Stanley Medical College
Annals of Hepatology | Year: 2011

Background. Bacterial infections are often associated with significant morbidity and mortality in cirrhosis. The common practice of outdoor barefoot walking in the developing world may predispose cirrhotic individuals to skin infection. Aims. To determine the prevalence, risk factors, spectrum of infective organism and outcome of bacterial skin infection in cirrhosis. Methods. Consecutive newly diagnosed patients with cirrhosis (n = 200) between September 2007 and September 2008 were studied. Patients with congestive heart failure (n = 50) and chronic kidney disease (n = 50) on follow up at the same institution served as controls. Baseline demographic details, history of outdoor barefoot walking, details of skin infection along with cultures from skin and blood were obtained. The association between patient factors and risk of skin infection was evaluated using logistic regression. Results. Alcoholism was the predominant etiology for cirrhosis. (50%) Most of them were of Child B cirrhosis. Walking on barefoot was found to be similar in cases and controls. 21(10.5%) patients with cirrhosis had skin infection, three fourth of them had a history of barefoot walking. None of the controls had skin infection. Cellulitis with hemorrhagic bullae, leg ulcers, infected callosity and abscess were observed. The infective organism could be isolated in 17 patients. Escherichia coli was the most frequent organism identified. Logistic regression showed outdoor barefoot walking and serum albumin < 2.5 gm/dL as risk factors for skin infection. Four patients died. Conclusion. The prevalence of skin infection in cirrhosis was 10.5% with a mortality of 19%. Escherichia coli was the commonly implicated organism. Outdoor barefoot walking was a strong risk factor for skin infection in cirrhosis.

Anandarani V.S.,Sri Ramachandra Medical College
Biomedicine | Year: 2011

Anomalous pancreatico biliary junction is an unusual variant of pancreatico biliary anatomy of clinical importance. It is a congenital anomaly where the common duct formed by the union of main pancreatic duct and bile duct is more than 15 mm in length. According to the mode of termination two different types are described .Each type is associated with specific clinical conditions.

Saminatha P.,Karpagam University | Rajendran P.,Sri Ramachandra Medical College
International Journal of Pharma and Bio Sciences | Year: 2014

Biosurfactant are surface active compounds produced by microorganisms. These molecules reduce surface tension between aqueous solutions and hydrocarbon mixtures. Hundred hydrocarbon saturated soil samples were collected from thirty different areas in Chennai, TamilNadu, India. Seventy two bacterial strains were isolated and cultured by enriching carbon (Glycerol) source. Each culture medium was screening to confirm the ability of biosurfactant production. These were conducted using surface tension and emulsification activity methods. The result reveals that fifty four strains of bacteria showed surface tension in the range between 0.026Nm-1 to 0.072Nm-1. The emulsifying capacity evaluated by the E24 emulsification index range from 36-85% EA. Among 54 isolates, 9 isolates displayed highest activity after detection with emulsification index method. They were identified for potent biosurfactant production. These were conducted using series of screening methods.

Bharatam K.K.,Consultant General | Maran M.,Mehta Hospital | Siva Raja P.K.,Sri Ramachandra Medical College
International Journal of Surgery Case Reports | Year: 2014

INTRODUCTION Laparoscopic Nissen fundoplication and Nissen Rossetti fundoplication represent two different surgical approaches for treating hiatus hernia. We report a Laparoscopic Nissen Rossetti fundoplication (LNRF) for gastro esophageal reflux disease (GERD) in a patient with situs inversus totalis (SIT).PRESENTATION OF CASE: A 38-year-old man with SIT was diagnosed with sliding hiatus hernia. We performed Laparoscopic Nissen Rossetti procedure for this patient. The patient was discharged on first postoperative day after he tolerated oral liquids.DISCUSSION SIT is a rare anomaly presenting in 1-2 per 10,000 individuals. As this rare anomaly (SIT) led preoperative anticipation of respiratory and blood loss complications the above procedure was chosen. Less operating time, less calculated blood loss and improvement of symptoms with no associated gas bloating syndrome was noted especially with SIT.CONCLUSION We recommend relook into the Laparoscopic Nissen Rossetti fundoplication as an effective procedure in GERD especially with rare anomalies like SIT. © 2014 The Authors. Published by Elsevier Ltd.

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