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Krishnan A.,Stanley Medical College and Hospital
Annals of Coloproctology | Year: 2013

Liposarcomas are common tumors arising in the retroperitoneum. However, a primary mesenteric liposarcoma is a rare entity and less than 50 cases have been reported so far. Further, a liposarcoma arising in the transverse mesocolon is very unusual, and cases of multiple primary tumors arising from the transverse mesocolon are extremely rare. We want to report a case of a multiple primary mesenteric liposarcoma arising from the transverse mesocolon in a 63-year-old female who was successfully treated by surgery. Because a primary mesenteric liposarcoma is a rare entity, it should be considered with the differential diagnosis of an abdominal mesenchymal tumor. It can be diagnosed preoperatively by using contrast enhanced computed tomography and magnetic resonance imaging. The treatment for such a liposarcoma is surgical resection with sufficient surgical margin; the role of adjuvant therapy has yet to be defined. © 2013 The Korean Society of Coloproctology.


Premalatha S.,Stanley Medical College and Hospital | Sarveswari K.,Dr Rangarajan Memorial Hospital | Lahiri K.,Apollo Gleneagles Hospitals
Indian Journal of Dermatology | Year: 2010

Ehlers-Danlos Syndrome (EDS) is a rare group of inheritable connective tissue disorder of defective collagen. Skin, joints and blood vessels are most commonly affected. Clinical signs such as Gorlin sign and Metenier sign have been described in this syndrome. We report another new clinical sign called ′Reverse-Namaskar′ sign as an important clinical finding in EDS, based on the family pedigree study of the proband.


Nalini D.,University of Madras | Karthick R.,University of Madras | Shirin V.,University of Madras | Manohar G.,Stanley Medical College and Hospital | Malathi R.,University of Madras
Thrombosis Journal | Year: 2015

Background: Obesity is currently regarded as a pro-inflammatory condition during which leptin (Ob gene product) might act as a risk factor for Cardiovascular Diseases (CVD) including Acute Myocardial Infarction (AMI). There is a marked increase in circulating leptin concentrations and inflammatory markers such as Tumor Necrosis Factor-α (TNF-α) in AMI patients but still the association of leptin with inflammation during AMI is not known. The present study suggest that elevated levels of leptin might elicit the risk for CVD by signaling for the secretion of inflammatory cytokines especially, TNF-α. Methods: Blood samples were collected from 100 CVD subjects diagnosed for AMI immediately after their admission to the hospital and serum leptin, insulin, glucose, lipids and inflammatory marker such as TNF-α were measured. 5ml random (non-fasting) blood was collected from 100 non-CVD (control) subjects and the results obtained in case of AMI subjects were compared with that of the control subjects. The subjects under study included both men and women belonging to the age group of 35-75 and they were classified based on their BMI as normal weight, overweight and obese. Results: Circulating levels of leptin are found to be elevated in obese control subjects and in patients with AMI irrespective of their Body Mass Index (BMI). In addition, leptin is also found to be positively correlated to serum triglycerides, insulin and TNF-α in AMI subjects. MANOVA analysis suggests that leptin might influence the synthesis of insulin and TNF-α. This is the first report relating leptin to TNF-α in Chennai based population, India. Conclusions: Hyperleptinemia might act as a risk marker for AMI. The present study suggests that at elevated levels, leptin may favor atherosclerosis by promoting the synthesis of TNF-α and insulin. However, our report warrants further investigation both in vitro and in vivo to determine the exact mechanism behind the pro-atherogenic role of leptin. The observed positive correlation between leptin and BMI in both AMI and control subjects suggests that obese subjects manifest leptin resistance and hence, they possess a greater risk for the incidence of CVD. © Nalini et al.


Rajasekaran R.,Anna University | Aruna P.R.,Anna University | Koteeswaran D.,Meenakshi Ammal Dental College and Hospital | Padmanabhan L.,Billroth Hospitals | And 5 more authors.
Photochemistry and Photobiology | Year: 2013

Urine is one of the diagnostically important bio fluids, as it has different metabolites in it, where many of them are native fluorophores. Native fluorescence characteristics of human urine samples were studied using excitation-emission matrices (EEMs) over a range of excitation and emission wavelengths, and emission spectra at 405 nm excitation, to discriminate patients with cancer from the normal subjects. The fluorescence spectra of urine samples of cancer patients exhibit considerable spectral differences in both EEMs and emission spectra with respect to normal subjects. Different ratios were calculated using the fluorescence intensity values of the emission spectra and they were used as input variables for a multiple linear discriminant analysis across different groups. The discriminant analysis classifies 94.7% of the original grouped cases and 94.1% of the cross-validated grouped cases correctly. Based on the fluorescence emission characteristics of urine and statistical analysis, it may be concluded that the fluorophores nicotinamide adenine dinucleotide (NADH) and flavins may be considered as metabolomic markers of cancer. Characterisation of urine of normal subjects and cancer patients and discriminating them were carried out by native fluorescence spectroscopic techniques viz., Excitation emission matrix and Fluorescence emission spectroscopy (FES) at 405 nm excitation. The EEM and FES reveals that there is a considerable variation in the emission indicating that the emission characteristics of urine metabolites, flavin and its derivatives have altered photophysical characteristics. © 2012 The American Society of Photobiology.


Somasundaram A.,Stanley Medical College and Hospital | Venkataraman J.,Stanley Medical College and Hospital
Singapore Medical Journal | Year: 2012

Chronic hepatitis C infection is an important cause of cirrhosis and hepatocellular carcinoma (HCC). Antiviral therapy (AVT) for patients with cirrhosis due to hepatitis C may retard the progression of cirrhosis and prevent both the development of HCC as well as the recurrence of hepatitis C following liver transplantation. This review highlights the issues associated with AVT for patients with compensated and decompensated cirrhosis due to hepatitis C virus.


Cherian J.V.,Stanley Medical College and Hospital
Tropical gastroenterology : official journal of the Digestive Diseases Foundation | Year: 2010

The incidence of peptic ulcer disease has steadily declined throughout the world. The influence of seasonal changes on the incidence of peptic ulcer disease is not well established. The aim of the study was to identify the changing trends in the occurrence of peptic ulcer disease from a tertiary referral center in south India and to study the seasonal Correspondence: variation in the occurrence of peptic ulcer. Retrospective analysis of the endoscopic records between the years 1989 to 2004. There was a significant decrease in the endoscopic diagnosis of duodenal and gastric ulcers (DU and GU) over the years. Both duodenal and gastric ulcers were more common in men than women. Over the years, there was a steady increase in the proportion of women affected with both DU and GU. A steady increase in the meanage of endoscopic diagnosis of GU and DU was seen over the years. The adjusted seasonal index revealed an increase in the endoscopic diagnosis of GU and DU in the months October-March. The endoscopic diagnosis of DU and GU has shown a decreasing trend over the past 16 years. The adjusted seasonal index has shown an increasing trend between the months of October-March.


Nattusamy L.,PSG Institute of Medical science and Research | Singh S.,Stanley Medical College and Hospital
Annals of Tropical Medicine and Public Health | Year: 2012

Quadriplegia may be of acute, subacute, or chronic onset and may have varied etiologies. Leptospirosis can produce quadriplegia, secondary to hypokalemia, which occurs due to kaliuresis. Leptospirosis is under diagnosed and under reported in India. The clinical features of leptospirosis are non-specific. Combining clinical expertise and awareness with rapid tests for diagnosis will increase the recognition of patients with leptospirosis and hypokalemia. Renal involvement is common in leptospirosis. In our country, hypokalemic manifestations of leptospirosis are under reported. We report a case of quadriplegia due to hypokalemia, secondary to leptospirosis.


Cherian J.V.,Stanley Medical College and Hospital | Deepak N.,Stanley Medical College Hospital | Ponnusamy R.P.,Stanley Medical College and Hospital | Somasundaram A.,Stanley Medical College and Hospital | Jayanthi V.,Stanley Medical College and Hospital
Saudi Journal of Gastroenterology | Year: 2011

Background/Aim: Current guidelines recommend screening cirrhotic patients with an endoscopy to detect esophageal varices and to institute prophylactic measures in patients with large esophageal varices. In this study, we aimed at identifying non-endoscopic parameters that could predict the presence and grades of esophageal varices. Patients and Methods: In a prospective study, 229 newly diagnosed patients with liver cirrhosis, without a history of variceal bleeding, were included. Demographic, clinical, biochemical and ultrasonographic parameters were recorded. Esophageal varices were classified as small and large, at endoscopy. Univariate analysis and multivariate logistic regression analysis were done to identify independent predictors for the presence and grades of varices. Results: Of the 229 patients (141 males; median age 42 years; range 17-73 years) with liver cirrhosis, 97 (42.3%) had small and 81 (35.4%) had large varices. On multivariate analysis, low platelet count (Odd's Ratio [OR], 4.3; 95% confidence interval [CI], 1.2-14.9), Child Pugh class B/C (OR, 3.3; 95% CI, 1.8-6.3), spleen diameter (OR, 4.3; 95% CI, 1.6-11.9) and portal vein diameter (OR, 2.4; 95% CI, 1.1-5.3) were independent predictors for the presence of varices. Likewise, for the presence of large esophageal varices, low platelet count (OR, 2.7; 95% CI, 1.4-5.2), Child Pugh class B/C (OR, 3.8; 95% CI, 2.3-6.5) and spleen diameter (OR, 3.1; 95% CI, 1.6-6.0) were the independent risk factors. Conclusion: The presence and higher grades of varices can be predicted by a low platelet count, Child-Pugh class B/C and spleen diameter. These may be considered as non-endoscopic predictors for the diagnosis and management of large grade varices.


Kalaivani J.,Dr. M.G.R. Educational and Research Institute | Selvi R.,Stanley Medical College and Hospital | Raj S.P.,Dr. M.G.R. Educational and Research Institute
International Journal of Pharma and Bio Sciences | Year: 2016

Bacterial infections are the most common pathogenic infections, during the first month of post kidney transplantation. In this study, about 164 kidney transplanted patients were assessed for the presence of the pathogenic bacteria such as Escherichia coli, Klebsiella spp. etc. Urine samples collected from the patients were cultured for the isolation of bacteria and were identified using regular biochemical tests and antibiotic resistances assays. The incidence of infection was positive for 96 (58.54%) out of 164 patients. E. coli was mostly isolated bacteria with a frequency rate of 32.5%, followed by Klebsiella spp. (20%), Pseudomonas spp. (11.3%), Proteus spp. (8.4%), Acinetobacter spp. (7.5%), Citrobacter spp. (4.3%) and Streptococcus aureus (12.8%). All the Gram-negative bacteria were found to be sensitive to amikacin (92.4-100%) and other isolates showed sensitive to Cefotaxime, Imepenem and Gentamicin. Thus, the present study aims to implement a new prophylaxis regimen for the treatment of post-operative infection.


PubMed | Stanley Medical College and Hospital
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2016

Trophic ulcers secondary to leprosy pose a great stigma to the patients and remain a challenge to the treating dermatologists. The discovery of Platelet Rich Plasma (PRP) with its favourable role in wound healing is a boon for the patients. PRP introduces the growth factors directly into the wound and aids in rapid healing.To study the efficacy and safety of PRP in the healing of trophic ulcers secondary to Hansens disease in a tertiary care centre in Southern India.Based on inclusion and exclusion criteria, 50 patients were enrolled in the study. PRP was prepared by manual double spin method. After wound bed preparation, activated PRP was sprayed over the ulcer and occlusive dressings were applied. Same procedure was repeated every week until complete re-epithelisation or up to six sittings whichever occurred earlier.In our study, 46 patients (92%) showed complete healing. In 4 patients (8%), there was marked reduction in wound size with partial re-epithelization. In 88%, complete healing was seen after the fourth sitting. Mean time for ulcer healing was around 4.38 weeks.PRP therapy leads to faster rate of induction of granulation tissue with rapid healing. Healing had no direct statistical correlation with the size, site and duration of ulcer, the leprosy spectrum and associated motor deformities. It is a simple, safe and cost effective in-office procedure, albeit requiring an optimal set-up and expertise.

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