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Homma Y, Zhuang X, Watari T, Hayashi K, Baba T, Kamath A, Ishijima M. Differences in acoustic parameters of hammering sounds between successful and unsuccessful initial cementless cup press-fit fixation in total hip arthroplasty. Bone Jt Open 2024; 5:154-161. [PMID: 38423101 PMCID: PMC10904203 DOI: 10.1302/2633-1462.53.bjo-2023-0160.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
Aims It is important to analyze objectively the hammering sound in cup press-fit technique in total hip arthroplasty (THA) in order to better understand the change of the sound during impaction. We hypothesized that a specific characteristic would present in a hammering sound with successful fixation. We designed the study to quantitatively investigate the acoustic characteristics during cementless cup impaction in THA. Methods In 52 THAs performed between November 2018 and April 2022, the acoustic parameters of the hammering sound of 224 impacts of successful press-fit fixation, and 55 impacts of unsuccessful press-fit fixation, were analyzed. The successful fixation was defined if the following two criteria were met: 1) intraoperatively, the stability of the cup was retained after manual application of the torque test; and 2) at one month postoperatively, the cup showed no translation on radiograph. Each hammering sound was converted to sound pressures in 24 frequency bands by fast Fourier transform analysis. Basic patient characteristics were assessed as potential contributors to the hammering sound. Results The median sound pressure (SP) of successful fixation at 0.5 to 1.0 kHz was higher than that of unsuccessful fixation (0.0694 (interquartile range (IQR) 0.04721 to 0.09576) vs 0.05425 (IQR 0.03047 to 0.06803), p < 0.001). The median SP of successful fixation at 3.5 to 4.0 kHz and 4.0 to 4.5 kHz was lower than that of unsuccessful fixation (0.0812 (IQR 0.05631 to 0.01161) vs 0.1233 (IQR 0.0730 to 0.1449), p < 0.001; and 0.0891 (IQR 0.0526 to 0.0891) vs 0.0885 (IQR 0.0716 to 0.1048); p < 0.001, respectively). There was a statistically significant positive relationship between body weight and SP at 0.5 to 1.0 kHz (p < 0.001). Multivariate analyses indicated that the SP at 0.5 to 1.0 kHz and 3.5 to 4.0 kHz was independently associated with the successful fixation. Conclusion The frequency bands of 0.5 to 1.0 and 3.5 to 4.0 kHz were the key to distinguish the sound characteristics between successful and unsuccessful press-fit cup fixation.
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Affiliation(s)
- Yasuhiro Homma
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Orthopaedics, Faculty of Medicine, Juntendo University, Tokyo, Japan
- Department of Community Medicine and Research for Bone and Joint Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Xu Zhuang
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Taiji Watari
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Orthopaedics, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Koju Hayashi
- Department of Orthopaedics, Faculty of Medicine, Juntendo University, Tokyo, Japan
| | - Tomonori Baba
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Orthopaedics, Faculty of Medicine, Juntendo University, Tokyo, Japan
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Atul Kamath
- Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute, Cleveland Clinic Foundation, Cleveland, USA
| | - Muneaki Ishijima
- Department of Medicine for Orthopaedics and Motor Organ, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Orthopaedics, Faculty of Medicine, Juntendo University, Tokyo, Japan
- Department of Community Medicine and Research for Bone and Joint Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Department of Pathophysiology for Locomotive Diseases, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Pai A, Kamath A, Vasava I, Bhosale D, Nambiar G. Impact of ocular care training of nursing staff on the incidence of ocular surface disorder in medical intensive care unit patients. Indian J Ophthalmol 2023; 71:1446-1449. [PMID: 37026279 DOI: 10.4103/ijo.ijo_2644_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023] Open
Abstract
Purpose To assess the knowledge of nursing staff on ocular care in medical intensive care unit (ICU) and to compare the incidence of ocular surface disorders in patients of medical ICU pre- and post-training. Methods: Two hundred patients admitted in medical ICU for more than 24 h underwent a detailed ocular examination along with documentation of ICU stay, ventilation status, and Glasgow coma scale (GCS) scoring. An assessment on ocular care knowledge among the nursing staff of medical ICU was done. They were further given training in the form of audio-visuals and demonstration, and an eye care protocol was given to them. The second phase of the study was carried out in the same manner. A comparison was made between pre-training and post-training incidence of ocular surface disorders among ICU patients. Results Ventilated patients had more eye discharge. Incidence of eye discharge was more in patients with duration of stay of more than 7 days in ICU. Ocular surface disorders closely correlated with the degree of lagophthalmos. There was significant reduction in ocular morbidity following ocular care training of the nursing staff. Conclusion Eye care is a very important part of nursing care in sedated and ventilated patients in the ICU. Ophthalmic consultations are routinely needed in ICU subjects who are hospitalized for more than 1 week or if the ICU staff suspects any eye problems.
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Affiliation(s)
- Aditi Pai
- Fellow in Phaco-Refractive Surgery, Netradhama Superspeciality Eye Hospital, Jayanagar, Bengaluru, Karnataka, India
| | - Atul Kamath
- Department of Ophthalmology, Yenepoya Medical College Hospital, Yenepoya University Campus, Mangalore, Karnataka, India
| | - Indravadan Vasava
- Assistant Professor, Department of Ophthalmology, Medical College and SSG Hospital, Vadodara, Gujarat, India
| | - Dhananjay Bhosale
- Assistant Professor, Department of Ophthalmology, Government Medical College and District Hospital, Satara, India
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Kumar S, Shah U, Ravipati S, Rahulan V, Kamath A, Kumar P, Panda S, Kori S, John P, Nagaraju M, Arora S, Dutta P, Attawar S. Airway Complications After Lung Transplant for Post Coronaviral Disease (COVID-19) Acute Respiratory Distress Syndrome (ARDS) Related End Stage Lung Disease: Single Centre Experience. J Heart Lung Transplant 2022. [PMCID: PMC8988571 DOI: 10.1016/j.healun.2022.01.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Purpose Severe COVID-19 ARDS related end stage lung fibrosis with irreversible changes is a newer indication for lung transplantation with acceptable survival rate. Airway complication post lung transplant is a major source of morbidity and mortality with incidence as high as 25 to 49 percent. Patients with end stage COVID-19 fibrosis are likely to be clinically deconditioned with long duration of extracorporeal oxygenator (ECMO) support, high burden of sepsis and prolonged respiratory support which may affect the airways post lung transplantation. Methods This is a retrospective observational study after obtaining institutional ethical clearance. We reviewed electronic medical data of patients who underwent lung transplantation for post COVID-19 ARDS related fibrosis. We evaluated the incidence and type of airway complications and the various therapeutic interventions applied for its management. Results Between May 2020 and September 2021 our centre performed 23 bilateral lung transplants for end stage COVID-19 ARDS related fibrosis. 22 patients were on ECMO support with mean duration of 50.9 days before transplantation. All patients underwent lung transplantation with central Veno-Arterial ECMO support with mean organ ischaemia time of 360±154 minutes. The incidence of airway complication in our study group was 56%. We observed anastomotic narrowing in 3(13%), distal airway narrowing in 4(17%) and sloughing/coating of anastomotic site in 5(22%) patients. Nonspecific inflammatory polypi around the bronchial anastomotic site were noticed in 4(17%) and mild airway anastomotic dehiscence in 2 subjects. 8(34%) patients required serial bronchoscopy and balloon dilatation; 2 among them mandated additional cautery usage. 2 cases underwent polypectomy, further 4 subjects needed bronchial stent placement. 5 (21%) recipients were discharged with Tracheostomy while rest were successfully decannulated in the ward. Conclusion We observed a high incidence of airway complications in post lung transplant for COVID-19 ARDS related fibrosis. Early detection, timely management and serial follow up is of paramount importance in this subset of patients.
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Ho J, Savvidis P, Ismail MA, Zonza S, Kamath A, Needham A, Carmona Sánchez R, Liao H, Teo M. 192 An Early Innovation Report of an Epidermal Ventriculoperitoneal (VP) Shunt Pressure Sensor. Br J Surg 2022. [DOI: 10.1093/bjs/znac039.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Ventriculoperitoneal shunt insertion, a common procedure for hydrocephalus, has a revision rate of approximately 20–30% within the first year, and continues to increase with each consecutive year. In Leeds, the average work-up cost for suspected shunt malfunctions was £765/patient. Additionally, patients with malfunctioning shunts present with vague symptoms potentially contributing to delayed presentation, especially important in Low-Middle Income Countries (LMICs) where neurosurgical expertise is less accessible. To reduce investigative costs and delayed presentations, we sought to design an epidermal shunt reservoir sensor to detect shunt malfunction by measuring the reservoir pressure.
Method
Literature searches were conducted to identify a proof of concept and suitable materials to engineer a concept device based on a Failure Modes and Effects Analysis (FMEA) table with design specifications to assess relative clinical risks. Using the IDEAL-D Framework, we designed our low-fidelity prototype using Solidworks® software.
Results
Literature revealed several devices aimed to detect shunt malfunctions. For our concept device, our focus was an accurate sensor and reliable connectivity. Our prototype uses gold nanowires to achieve high sensitivity to pressure change, as small as 15mPa. Near-field communication (NFC) for connectivity has less power requirement and has rapid connectivity compared to Bluetooth. Estimated cost of the device is £500.
Conclusions
Our device, in Stage 0 of the IDEAL-D Framework, identified potential sensors and connectivity methods. We could utilise magnets to adhere to the reservoir with overlying hair. However, magnetic fields and atmospheric pressure could cause interference. Power source options still require exploring before benchtop testing for accuracy, interference, and feasibility.
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Affiliation(s)
- J.W. Ho
- Department of Neurosurgery, Bristol Institute of Clinical Neuroscience, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom, Bristol, United Kingdom
| | - P. Savvidis
- University of Leeds, School of Mechanical Engineering, Leeds, United Kingdom
| | - M. A Ismail
- York and Scarborough Teaching Hospitals NHS Foundation Trust, Leeds, United Kingdom
| | - S. Zonza
- University of Leeds, School of Medicine, Leeds, United Kingdom
| | - A. Kamath
- University of Leeds, School of Mechanical Engineering, Leeds, United Kingdom
| | - A. Needham
- University of Leeds, School of Mechanical Engineering, Leeds, United Kingdom
| | | | - H. Liao
- Biomedical Engineering, Department of Bioengineering, Imperial College London, London, United Kingdom
| | - Mario. Teo
- Department of Neurosurgery, Bristol Institute of Clinical Neuroscience, Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom, Bristol, United Kingdom
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Kamath A, Pai A, Reddy JK. Nocardia Endophthalmitis- Prophylactic Prevention with an Innovative Approach. Open Ophthalmol J 2021. [DOI: 10.2174/1874364102115010258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Nocardia is a common cause of endophthalmitis in southern India. It is an aggressive disease with a poor prognosis.
Objective:
This study was conducted using an amikacin antibiotic in the drip irrigation of balanced saline solution (BSS) during the surgery to prophylactically study the occurrence of Nocardia endophthalmitis and any subsequent toxic effects of the antibiotics used.
Methods:
Prospective study period was of 6 months, starting from July to December-2018. Preoperative and postoperative specular counts and macular thickness using Ocular Coherence Tomography (OCT) were compared with any incidence of Nocardia endophthalmitis. A total of 500 patients operated for manual SICS were randomly assigned into 2 groups. The first group of 250 patients received antibiotic amikacin added to the Balanced Saline Solution (BSS) irrigating solution throughout the course of the surgery. The second control group received no antibiotics. Manual SICS was performed on all 500 patients by a single surgeon and was found to be uneventful. Pre- and postoperative corneal endothelial cell density and mean macular thickness using OCT were taken and recorded of all the patients, respectively, and data obtained were statistically compared.
Results:
No incidence of Nocardia endophthalmitis among the cataract surgeries operated was found. There was no drug-related toxicity to the cornea or macula. Furthermore, no incidence of Nocardia endophthalmitis has been reported since 2018 after using antibiotics.
Conclusion:
A simple routine of adding amikacin in the drip prophylactically during the course of surgery helped us prevent Nocardia endophthalmitis with no side effects. Also, it will be an innovative technique that is economically feasible and effective in regions where Nocardia endophthalmitis is prevalent.
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Abstract
The utilization of dual mobility (DM) articulations in total hip arthroplasty (THA) is increasing. The principal appeal of DM implants is its ability to reduce postoperative instability by maximizing the effective ball head size for each reconstruction. However, while DM implants have been used worldwide for over 3 decades, the experience in North America is more limited. Moreover, there remains concerns with intraprosthetic dissociation, wear, metallosis, and soft tissue impingement. Therefore, the purpose of this article is to review the available evidence for these potential issues. First, intraprosthetic dissociation (IPD) is a unique complication of DM implants. Although the rate has decreased with improvements in materials and design, the reported prevalence is approximately 1%. Second, wear in DM implants can be unpredictable and increased wear has been reported in younger, active patients. Third, corrosion in modular DM implants has been described and elevations in serum cobalt and chromium levels have been reported. While the clinical significance of these elevations is unclear, it remains a source of concern with these implants. Finally, psoas impingement and entrapment can be a source of persistent groin pain after THA. DM articulations are a valuable addition to the armamentarium of total hip surgeons. However, these bearings are not free of complications. Consequently, current data only support selective use of DM bearings in patients at increased risk for postoperative instability after arthroplasty.
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Affiliation(s)
- Gwo-Chin Lee
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA
| | - Atul Kamath
- Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, OH
| | - P Maxwell Courtney
- Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Philadelphia, PA
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Kumar S, Rahulan V, John P, Nagaraj M, Shah U, Kumar P, Kamath A, Dutta P, Attawar S. Outcome of ECMO as a Bridge to Lung Transplantation: Largest Experience from India. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Shah U, Rahulan V, Kamath A, Kumar S, Kumar P, Dutta P, Attawar S. Panel Reactive Antibodies (PRA) and Donor-Specific Antibodies (DSA) in Lung Transplantation: An Indian Experience. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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John P, Nagaraj M, Shah U, Kumar S, Kamath A, Kumar P, Dutta P, Rahulan V, Attawar S. Titanicking the Clamshell. Anchoring the Bilateral Thoracosternotomy Incision with Titanium Plates, Screws and Sternal Band. Our Experience in Fifty Consecutive Patients of Double Lung Transplantation. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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10
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John P, Kumar S, Shah U, Nagaraj M, Kamath A, Kumar P, Dutta P, Rahulan V, Attawar S. Retailoring Donor-Recipient Size Mismatch in Double Lung Transplantation, Non-Anatomical Pulmonary Resections, Gratifying Early Surgical Outcomes. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Zarifkar P, Kamath A, Robinson C, Morgulchik N, Shah SFH, Cheng TKM, Dominic C, Fehintola AO, Bhalla G, Ahillan T, Mourgue d'Algue L, Lee J, Pareek A, Carey M, Hughes DJ, Miller M, Woodcock VK, Shrotri M. Clinical Characteristics and Outcomes in Patients with COVID-19 and Cancer: a Systematic Review and Meta-analysis. Clin Oncol (R Coll Radiol) 2021; 33:e180-e191. [PMID: 33261978 PMCID: PMC7674130 DOI: 10.1016/j.clon.2020.11.006] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/25/2020] [Accepted: 11/11/2020] [Indexed: 01/08/2023]
Abstract
Much of routine cancer care has been disrupted due to the perceived susceptibility to SARS-CoV-2 infection in cancer patients. Here, we systematically review the current evidence base pertaining to the prevalence, presentation and outcome of COVID-19 in cancer patients, in order to inform policy and practice going forwards. A keyword-structured systematic search was conducted on Pubmed, Cochrane, Embase and MedRxiv databases for studies reporting primary data on COVID-19 in cancer patients. Studies were critically appraised using the NIH National Heart, Lung and Blood Institute's quality assessment tool set. The pooled prevalence of cancer as a co-morbidity in patients with COVID-19 and pooled in-hospital mortality risk of COVID-19 in cancer patients were derived by random-effects meta-analyses. In total, 110 studies from 10 countries were included. The pooled prevalence of cancer as a co-morbidity in hospitalised patients with COVID-19 was 2.6% (95% confidence interval 1.8%, 3.5%, I2: 92.0%). Specifically, 1.7% (95% confidence interval 1.3%, 2.3%, I2: 57.6.%) in China and 5.6% (95% confidence interval 4.5%, 6.7%, I2: 82.3%) in Western countries. Patients most commonly presented with non-specific symptoms of fever, dyspnoea and chest tightness in addition to decreased arterial oxygen saturation, ground glass opacities on computer tomography and non-specific changes in inflammatory markers. The pooled in-hospital mortality risk among patients with COVID-19 and cancer was 14.1% (95% confidence interval 9.1%, 19.8%, I2: 52.3%). We identified impeding questions that need to be answered to provide the foundation for an iterative review of the developing evidence base, and inform policy and practice going forwards. Analyses of the available data corroborate an unfavourable outcome of hospitalised patients with COVID-19 and cancer. Our findings encourage future studies to report detailed social, demographic and clinical characteristics of cancer patients, including performance status, primary cancer type and stage, as well as a history of anti-cancer therapeutic interventions.
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Affiliation(s)
- P Zarifkar
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Aarhus, Denmark.
| | - A Kamath
- Faculty of Medicine, University of Oxford, Medical Sciences Divisional Office, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - C Robinson
- Faculty of Medicine, University of Oxford, Medical Sciences Divisional Office, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - N Morgulchik
- Imperial College London, Department of Chemistry, Molecular Sciences Research Hub, London, UK
| | - S F H Shah
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - T K M Cheng
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - C Dominic
- Barts and the London School of Medicine, Queen Mary University of London, London, UK
| | - A O Fehintola
- College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - G Bhalla
- Barts and the London School of Medicine, Queen Mary University of London, London, UK
| | - T Ahillan
- University College London Medical School, London, UK
| | | | - J Lee
- Nuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK
| | - A Pareek
- Department of Radiology Stanford University School of Medicine, Stanford, California, USA
| | - M Carey
- Department of Palliative Care Oxford University Hospitals NHS Foundation Trust, Sobell House Hospice, Churchill Hospital, Oxford, UK
| | - D J Hughes
- Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - M Miller
- Department of Palliative Care Oxford University Hospitals NHS Foundation Trust, Sobell House Hospice, Churchill Hospital, Oxford, UK
| | - V K Woodcock
- Department of Oncology, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - M Shrotri
- London School of Hygiene & Tropical Medicine, London, UK
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Mulder PA, van Balkom IDC, Landlust AM, Priolo M, Menke LA, Acero IH, Alkuraya FS, Arias P, Bernardini L, Bijlsma EK, Cole T, Coubes C, Dapia I, Davies S, Di Donato N, Elcioglu NH, Fahrner JA, Foster A, González NG, Huber I, Iascone M, Kaiser AS, Kamath A, Kooblall K, Lapunzina P, Liebelt J, Lynch SA, Maas SM, Mammì C, Mathijssen IB, McKee S, Mirzaa GM, Montgomery T, Neubauer D, Neumann TE, Pintomalli L, Pisanti MA, Plomp AS, Price S, Salter C, Santos-Simarro F, Sarda P, Schanze D, Segovia M, Shaw-Smith C, Smithson S, Suri M, Tatton-Brown K, Tenorio J, Thakker RV, Valdez RM, Van Haeringen A, Van Hagen JM, Zenker M, Zollino M, Dunn WW, Piening S, Hennekam RC. Development, behaviour and sensory processing in Marshall-Smith syndrome and Malan syndrome: phenotype comparison in two related syndromes. J Intellect Disabil Res 2020; 64:956-969. [PMID: 33034087 PMCID: PMC8957705 DOI: 10.1111/jir.12787] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 08/19/2020] [Accepted: 09/15/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Ultrarare Marshall-Smith and Malan syndromes, caused by changes of the gene nuclear factor I X (NFIX), are characterised by intellectual disability (ID) and behavioural problems, although questions remain. Here, development and behaviour are studied and compared in a cross-sectional study, and results are presented with genetic findings. METHODS Behavioural phenotypes are compared of eight individuals with Marshall-Smith syndrome (three male individuals) and seven with Malan syndrome (four male individuals). Long-term follow-up assessment of cognition and adaptive behaviour was possible in three individuals with Marshall-Smith syndrome. RESULTS Marshall-Smith syndrome individuals have more severe ID, less adaptive behaviour, more impaired speech and less reciprocal interaction compared with individuals with Malan syndrome. Sensory processing difficulties occur in both syndromes. Follow-up measurement of cognition and adaptive behaviour in Marshall-Smith syndrome shows different individual learning curves over time. CONCLUSIONS Results show significant between and within syndrome variability. Different NFIX variants underlie distinct clinical phenotypes leading to separate entities. Cognitive, adaptive and sensory impairments are common in both syndromes and increase the risk of challenging behaviour. This study highlights the value of considering behaviour within developmental and environmental context. To improve quality of life, adaptations to environment and treatment are suggested to create a better person-environment fit.
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Affiliation(s)
- P A Mulder
- Autism Team Northern-Netherlands, Jonx Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, Netherlands
| | - I D C van Balkom
- Autism Team Northern-Netherlands, Jonx Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, Netherlands
- Rob Giel Research Centre, Department of Psychiatry, University Medical Center Groningen, Groningen, Netherlands
| | - A M Landlust
- Autism Team Northern-Netherlands, Jonx Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, Netherlands
| | - M Priolo
- Unità Operativa di Genetica Medica, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy
| | - L A Menke
- Department of Paediatrics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - I H Acero
- Genetics Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - F S Alkuraya
- Saudi Human Genome Project, King Abdulaziz City for Science and Technology, and Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - P Arias
- Institute of Medical and Molecular Genetics (INGEMM), Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, and CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - L Bernardini
- Cytogenetics Unit, Casa Sollievo della Sofferenza Foundation, San Giovanni Rotondo, Italy
| | - E K Bijlsma
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, Netherlands
| | - T Cole
- Department of Clinical Genetics, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - C Coubes
- Département de Génétique Médicale, Hôpital Arnaud de Villeneuve, CHRU Montpellier, Montpellier, France
| | - I Dapia
- Institute of Medical and Molecular Genetics (INGEMM), Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, and CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - S Davies
- Institute of Medical Genetics, University Hospital of Wales, Cardiff, UK
| | - N Di Donato
- Institute for Clinical Genetics, TU Dresden, Dresden, Germany
| | - N H Elcioglu
- Department of Pediatric Genetics, Marmara University Medical School, Istanbul and Eastern Mediterranean University, Mersin, Turkey
| | - J A Fahrner
- McKusick-Nathans Institute of Genetic Medicine, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - A Foster
- Institute of Cancer and Genomic Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - N G González
- Unit Hospital Universitario Central de Asturias, Oviedo, Spain
| | - I Huber
- Sørland Hospital, Kristiansand, Norway
| | - M Iascone
- Medical Genetics Laboratory, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - A-S Kaiser
- Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
| | - A Kamath
- Institute of Medical Genetics, University Hospital of Wales, Cardiff, UK
| | - K Kooblall
- Academic Endocrine Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - P Lapunzina
- Institute of Medical and Molecular Genetics (INGEMM), Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, and CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - J Liebelt
- South Australian Clinical Genetics Services, Women's and Children's Hospital, North Adelaide, Australia
| | - S A Lynch
- UCD Academic Centre on Rare Diseases, School of Medicine and Medical Sciences, University College Dublin, and Clinical Genetics, Temple Street Children's University Hospital, Dublin, Ireland
| | - S M Maas
- Department of Clinical Genetics, Academic Medical Center, Amsterdam, Netherlands
| | - C Mammì
- Unità Operativa di Genetica Medica, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy
| | - I B Mathijssen
- Department of Clinical Genetics, Academic Medical Center, Amsterdam, Netherlands
| | - S McKee
- Northern Ireland Regional Genetics Service, Belfast Health and Social Care Trust, Belfast, UK
| | - G M Mirzaa
- Center for Integrative Brain Research, Seattle Children's Research Institute, and Division of Genetic Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - T Montgomery
- Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK
| | - D Neubauer
- Institute of Human Genetics, University Hospital Magdeburg, Magdeburg, Germany
| | - T E Neumann
- Mitteldeutscher Praxisverbund Humangenetik, Halle, Germany
| | - L Pintomalli
- Unità Operativa di Genetica Medica, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy
| | - M A Pisanti
- Medical Genetic and Laboratory Unit, "Antonio Cardarelli" Hospital, Naples, Italy
| | - A S Plomp
- Department of Clinical Genetics, Academic Medical Center, Amsterdam, Netherlands
| | - S Price
- Department of Clinical Genetics, Northampton General Hospital NHS Trust, Northampton, UK
| | - C Salter
- Wessex Clinical Genetics Service, Princess Ann Hospital, Southampton, UK
| | - F Santos-Simarro
- Institute of Medical and Molecular Genetics (INGEMM), Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, and CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - P Sarda
- Département de Génétique Médicale, Hôpital Arnaud de Villeneuve, CHRU Montpellier, Montpellier, France
| | - D Schanze
- Institute of Human Genetics, University Hospital Magdeburg, Magdeburg, Germany
| | - M Segovia
- CENAGEM, Centro Nacional de Genética, Buenos Aires, Argentina
| | - C Shaw-Smith
- Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - S Smithson
- University Hospitals Bristol NHS Trust, Bristol, UK
| | - M Suri
- Nottingham Clinical Genetics Service, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - K Tatton-Brown
- Division of Genetics and Epidemiology, Institute of Cancer Research, London and South West Thames Regional Genetics Service, St. George's University Hospitals NHS Foundation Trust, London, UK
| | - J Tenorio
- Institute of Medical and Molecular Genetics (INGEMM), Hospital Universitario La Paz, IdiPAZ, Universidad Autónoma de Madrid, and CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, ISCIII, Madrid, Spain
| | - R V Thakker
- Academic Endocrine Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - R M Valdez
- Genetics Unit, Hospital Militar Central "Cirujano Mayor Dr. Cosme Argerich", Buenos Aires, Argentina
| | - A Van Haeringen
- Department of Clinical Genetics, Leiden University Medical Centre, Leiden, Netherlands
| | - J M Van Hagen
- Department of Clinical Genetics, VU University Medical Centre, Amsterdam, Netherlands
| | - M Zenker
- Institute of Human Genetics, University Hospital Magdeburg, Magdeburg, Germany
| | - M Zollino
- Department of Laboratory Medicine, Institute of Medical Genetics, Catholic University, Rome, Italy
| | - W W Dunn
- Department of Occupational Therapy Education, School of Health Professions, University of Missouri, Columbia, MO, USA
| | - S Piening
- Autism Team Northern-Netherlands, Jonx Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, Netherlands
- Rob Giel Research Centre, Department of Psychiatry, University Medical Center Groningen, Groningen, Netherlands
| | - R C Hennekam
- Autism Team Northern-Netherlands, Jonx Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, Netherlands
- Department of Paediatrics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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Karjigi U, Kodishala C, Chandrashekara S, Kumar S, Haridas V, R S, Jois R, Daware M, Rao VKR, Dharmanand BG, Jain VRK, Singh YP, Singhai S, Chebbi P, Dharmapalaiah C, Kamath A, Prasad S, C S, Aithala R, Pinto B, Nazir B, Alur Shivakumar H, K M M, Shobha V. AB0785 REAL LIFE EXPERIENCE OF METHOTREXATE BASED DUAL COMBINATION DMARDS IN PSORIATIC ARTHRITIS- RESULTS FROM KARNATAKA PSORIATIC ARTHRITIS COHORT (KPsAC). Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Biologics have been the focus of recent treatment guidelines and ‘Treat to Target’ strategies for both psoriasis (PsO) & psoriatic Arthritis (PsA). However, in day-today practice, combination DMARDs anchored around methotrexate are mainstay in majority of patients.Objectives:To describe experience and effectiveness of Methotrexate in combination with conventional DMARDs in Karnataka Psoriatic Arthritis Cohort.Methods:Treatment information was extracted from KPsAC (n=549) which is a cross sectional, non-interventional study conducted across 17 rheumatology practicing centres in Karnataka, India using a structured proforma. This study was approved by respective Ethical committee. Information on efficacy was extracted for various csDMARDs in combination with methotrexate. Standard disease activity outcome measures were used for assessing the response to therapy (DAPSA, PASI, HAQ, MDA5). All participating rheumatologists underwent training to calculate PASI and other outcome scores.Results:Nearly half of the patients in our cohort were on methotrexate (44%) monotherapy. Proportion of patients who received combination csDMARD anchored on methotrexate were 29%. The choice of add on csDMARD was as per clinician discretion or subject preference. Patients were divided in to three groups based on treatments they were receiving at the time of study: Methotrexate (Mtx)+Leflunomide (Lef), Mtx+Sulfasalazine (SSz) and Mtx+Apremilast(Apr). Their characteristics along with outcome measures are depicted in table 1. In Mtx+Apr group: remission or low disease activity was present in 42%, HAQ score of <0.5 was seen in 82%, and only one patient had a PASI of > 10. PASI was significantly lower in the Mtx+Apr group compared to Mtx+Lef group (p<0.009) and Mtx +Ssz group (p < 0.020)Conclusion:Apremilast is an orally administered, small molecule inhibitor of phosphodiesterase 4 (PDE4)**. In this observational study, 3 groups of methotrexate plus csDMARD- leflunomide, sulphasalazine and apremilast fared similarly for articular domain of PsA. However, in cutaneous domain, PASI was significantly lower in apremilast + methotrexate group. To our knowledge, this is the first real life report of the use of combination DMARDs in unselected PsA patients demonstrating effectiveness of apremilast in cutaneous domain. Methotrexate remains anchor DMARD for treatment of PsA in 2/3rdof PsA patients. Addition of apremilast to methotrexate inadequate responders appears to be beneficial in PsA with persistent cutaneous disease. However, being an observational study, this needs to be confirmed in controlled clinical trials.References:**Apremilast: A Review in Psoriasis and Psoriatic Arthritis, Drugs March 2017, Volume 77, Issue 4.Table.Characteristics and comparison of combination csDMARDsMTX+SSZ(N=39)MTX+LEF (n=77)MTX+APR(N=45)Median Age (years)373935Median disease duration (months)96101112Enthesitis (Ever)6(15%)21(27%)4(8%)Dactylitis (Ever)9((23%)28(36%)12 (26%)DAPSA < 46(15%)9(11%)10(22%) 4-1414(36%)25(32%)13(29%) 14-287(18%)24(31%)11(24%)PASI >107(18%) #14(18%) *1(2%) *#HAQ < 0.530(77%)60(78%)37(82%)MDA 5 achieved16(41%)25(32%)19(42%)*P value < 0.009 #P value <0.02Disclosure of Interests:None declared
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Kodishala C, Chandrashekara S, Kumar S, Haridas V, R S, Jois R, Daware M, Rao VKR, B G D, Jain VRK, Singh YP, Singhai S, Chebbi P, Dharmapalaiah C, Kamath A, Karjigi U, Prasad S, C S, Aithala R, Pinto B, Nazir B, Alur Shivakumar H, K M M, Shobha V. AB0790 CLINICAL PROFILING OF PSORIATIC ARTHRITIS (PsA): AN OBSERVATIONAL STUDY FROM A SOUTH INDIAN PSORIATIC ARTHRITIS COHORT. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Clinical patterns and disease burden of PsA varies in different parts of the world. Demographic studies from Indian subcontinent are sparseObjectives:To study the cutaneous, articular profile of PsA and describe their disease activity, disability and co-morbidities (CMs)Methods:This is a multicenter, cross-sectional, non-interventional study from Karnataka, India. All consecutive PsA patients defined by CASPAR or expert diagnosis were evaluated over 8 months from 17 Rheumatology centers across Karnataka using standard parameters such as PASI, DAPSA, Indian version of HAQ-DI1, psoriatic co-morbidity index2(Cidx) and MDA 5. Patient consent and EC obtainedResults:549 PsA patients were evaluated and their disease characteristics are shown in Table 1 & 2. PsA preceded psoriasis in in 81 (14.7%).Table 1.Patient characteristics (n=549)DEMOGRAPHICSPsACommonest age group of PsA (yrs)31-40PsA SubclassificationM:F6:5Symmetric polyarthritis216(40.7%)Type 1 PsoriasisType 2 Psoriasis279(55.8%)221(44.2%)Mean duration (yrs)Asymmetric oligoarthritis202(38.1%)Psoriasis8.8(±7.8)DIP predominant88(16.6%)PsA5.2(±6.3)Arthritis mutilans16(4.2%)PsA preceded psoriasis81(14.7%)Dactylitis182(33.9%)Family h/oPsoriasis107(19.7%)Enthesitis109(20.3%)PsA33(6%)Mean TJC686.3(±8.9)AS11(2%)Mean SJC683.5(±5.2)Uveitis5(0.9%)Type of PsoriasisPlaque253(59.9%)IBD3(0.5%)Erythrodermic 31(7.3%)Type I & II psoriasis did not differ in PASI, DAPSA, HAQ-DI or having a family h/o psoriasis. Type II psoriasis had higher Cidx than type I (p=0.0001). Pt pain VAS, DAPSA, PhyGA, PtGA & SJC significantly correlated with higher HAQ-DI (p<0.0001). TJC, ESR, CRP & PASI had minor correlation with HAQ-DI. Females had higher HAQ-DI compared to males (p=0.02). Knee joint involvement caused disability most frequently. Cidx was higher in males (p=0.008). Minor correlation was found between Cidx with age, HAQ-DI & DAPSA. Mean BMI of our cohort was 26.8(±14.8) kg/m2. 56.5% were overweight. Higher BMI was not associated with age, duration of arthritis, DAPSA, PASI, HAQ-DI & Cidx.Infections (any time) were recorded in 10.8%, of which skin was the commonest site in 38.9%; 30.5% of these needed hospitalizations.Conclusion:Despite mild skin disease in majority, more than half of the patients have moderate to severe joint activity. Mild to moderate functional disability in nearly half of our cohort indicate high burden of damage. High incidence of co-morbidities in PsA compared with general population is in line with published literature. In addition to aggressive control of articular activity, detection and control of co-morbidities must be an integral part of PsA management.References:[1]https://doi.org/10.1093/rheumatology/41.12.1457[2]http://dx.doi.org/10.1136/annrheumdis-2016-eular.4598Table 2.Disease characteristicsDISEASE ACTIVITYDISABILITYCO-MORBIDITIESMean PASI: 3.8(7.4)Mean HAQ-DI: 0.3(0.45)Mean Cidx: 0.98(1.6)Mild (PASI 0-5)480(80%)Mild-mod disability260(48.2%)N with 1 or more CMs232(42.3%)Severe (>10)57(10.6%)ADL with most frequent disabilityClimbing a flight of stairs 189(35%)HTNT2DMSmokingPsA severity19.8%16.6%5.4%3.2%Mean DAPSA: 18.8(16.6)ADL with highest disability scoreSitting cross-legged/squattingAnxietyIHDDyslipidemiaOthers3.1%2.3%2%<2% eachRemission100(19.9%)Low DA145(28.8%)Moderate DA137(27.2%)High DA123(24.5%)Family h/o CV dis/stroke72(15.2%)Disclosure of Interests:None declared
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Knowlton ED, Kamath A. Ants Do Not Traverse the Silk of Adult Female Nephila clavipes (Linnaeus) Webs. Neotrop Entomol 2018; 47:780-785. [PMID: 30191403 DOI: 10.1007/s13744-018-0631-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 08/23/2018] [Indexed: 06/08/2023]
Abstract
Many organisms use chemicals to deter enemies. Some spiders can modify the composition of their silk to deter predators from climbing onto their webs. The Malaysian golden orb-weaver Nephila antipodiana (Walckenaer) produces silk containing an alkaloid (2-pyrrolidinone) that functions as a defense against ant invasion-ants avoid silk containing this chemical. In the present study, we test the generality of ants' silk avoidance behavior in the field. We introduced three ant species to the orb webs of Nephila clavipes (Linnaeus) in the tropical rainforest of La Selva, Costa Rica. We found that predatory army ants (Eciton burchellii Westwood) as well as non-predatory leaf-cutting ants (Atta cephalotes Linnaeus and Acromyrmex volcanus Wheeler) avoided adult N. clavipes silk, suggesting that an additional species within genus Nephila may possess ant-deterring silk. Our field assay also suggests that silk avoidance behavior is found in multiple ant species.
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Affiliation(s)
- E D Knowlton
- Entomology and Plant Pathology, Graduate Program in Environmental Science, Oklahoma State Univ, Stillwater, OK, USA.
| | - A Kamath
- Dept of Environmental Science, Policy, and Management, Univ of California, Berkeley, CA, USA
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Badagabettu S, Nayak DM, Kurien A, Kamath VG, Kamath A, George A. Effectiveness of a comprehensive educational programme for Accredited Social Health Activists (ASHAs) to identify individuals in the Udupi district with bleeding disorders: A community-based survey. Haemophilia 2018; 24:741-746. [PMID: 30102018 DOI: 10.1111/hae.13567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2018] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The awareness and knowledge on bleeding disorders is generally poor among the rural population. Accredited Social Health Activists (ASHAs) serve as the facilitators between the rural community and the health care system. Training of ASHAs in screening of rural population for early identification of bleeding disorders can enable prompt referral, timely detection and management of bleeding disorders. AIM The aim of the study was to evaluate the effectiveness of an ASHA training programme for identification of suspected bleeding disorder cases. METHODS A population-based, cross-sectional survey was implemented by 586 Accredited Social Health Activists (ASHAs) in rural Udupi district, who underwent a structured training programme on identification of bleeding disorders. A survey record book with a screening tool on assessment of bleeding symptoms was given to each ASHA. The screening tool consisted of symptoms related to bleeding disorders and family history of bleeding disorders. Using the screening tool, ASHAs carried out a door-to-door survey. After screening, those who reported with bleeding symptoms were referred by the ASHAs to the investigator, who conducted further assessment. A detailed bleeding history was documented and bleeding symptom assessment was carried out using bleeding assessment tool (BAT) at the haemophilia treatment centre. Further coagulation assessments were carried out as per the treatment centre protocol. This paper highlights the evaluation of an ASHA training programme on identification of individuals with bleeding symptoms in the rural population. RESULTS A total of 586 trained ASHAs surveyed a population of 318 214 in rural Udupi district. Out of the 124 cases reported by ASHAs, 29 bleeding disorder cases were identified; haemophilia (A and B) was the most commonly found bleeding disorder 22 (75.8%), followed by von Willebrand disease (vWD) 3 (10.3%) and 4 (13.8%) immune-mediated thrombocytopenic purpura (ITP), with an overall prevalence of 2.2/10 000 population. CONCLUSION Training ASHA health care workers, who are the most important link between the community and health services, resulted in increased awareness among the public for the early detection of bleeding disorders.
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Affiliation(s)
- S Badagabettu
- Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - D M Nayak
- Departments of Pediatrics, Dr. TMA Pai Hospital, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Manipal, India
| | - A Kurien
- Departments of Pathology, Melaka Manipal Medical College, Manipal Academy of Higher Education, Manipal, India
| | - V G Kamath
- Department of Community Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - A Kamath
- Department of Biostatistics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - A George
- Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
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Kiran S, Kamath A, Bellur R, Krishnan G. Probability proportional to size cluster sampling (PPS-CS) as an effective methodology to select survey sites for large-scale studies. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bagheri A, Kumar P, Kamath A, Rao P. Association of angiogenic cytokines (VEGF-A and VEGF-C) and clinical characteristic in women with unexplained recurrent miscarriage. ACTA ACUST UNITED AC 2017; 118:258-264. [PMID: 28516786 DOI: 10.4149/bll_2017_051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Recurrent miscarriage (RM) defined as 2 or more spontaneous miscarriage before 20 weeks of gestation, affects at least 1 % of couples trying to conceive. In over 50 % of cases, the cause of the loss of pregnancy remains unexplained. Reduced expression of Angiogenic factors such as: vascular endothelial growth factor (VEGF-A) and VEGF-C has been linked with spontaneous miscarriage, likely due to defective foetal and placental angiogenesis. AIMS AND OBJECTIVES To investigate the relationships between serum level of VEGF-A and VEGF-C with clinical characteristic in women with URM and compare to pregnant and healthy women. MATERIALS AND METHODS A case-control study, which was conducted between 90 non-pregnant women with history of RM, age-matched with 70 non-pregnant women without history of recurrent abortion with at least one child (controls) and 70 pregnant women without history of recurrent abortion with at least one child (controls). Those with unexplained RM were eligible. Demographic and Anthropometric data were retrieved by pre-test questionnaire and serum level of VEGF-A and VEGF-C measured by ELISA kit. RESULTS This study showeds that maternal levels of VEGF-A and VEGF-C were distinctly lower in RSA (189.87±88.1 vs 238.8±99.6) compared to healthy (239.1±99.7 vs 275.5±133.08) and pregnant (301.5±76.4 vs 402.5±128.6) women as control groups. Univariate analysis demonstrated that clinical characteristic factors were significantly associated with concentration of VEGF-A and VEGF-C in cases and controls. CONCLUSIONS Our findings suggest that these molecules could be used as potential predictive markers of miscarriage in these women presenting with URM (Tab. 4, Fig. 5, Ref. 40).
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Bapsy P, Maurya P, Dhande S, K L, Kamath A, Mudlapur C, Holla S, Patil C. What decides breast conservation versus mastectomy in the background of diverse sociocultural environment, an Indian study. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw364.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mathews CE, Kamath A, Unnikrishnan R. Comparison of Approaches to Spontaneous Breathing Trial for Extubation: Is PAV+ Better Than Other Methods? Respir Care 2016; 61:998. [DOI: 10.4187/respcare.04824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Gupta M, Lakhina K, Kamath A, Vandana KE, Mukhopadhyay C, Vidyasagar S, Varma M. Colistin-resistant Acinetobacter baumannii ventilator-associated pneumonia in a tertiary care hospital: an evolving threat. J Hosp Infect 2016; 94:72-3. [PMID: 27238611 DOI: 10.1016/j.jhin.2016.04.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 04/24/2016] [Indexed: 01/23/2023]
Affiliation(s)
- M Gupta
- Kasturba Medical College and Hospital, Manipal University, Manipal, Karnataka, India.
| | - K Lakhina
- Kasturba Medical College and Hospital, Manipal University, Manipal, Karnataka, India
| | - A Kamath
- Department of Community Medicine, Kasturba Medical College and Hospital, Manipal University, Manipal, Karnataka, India
| | - K E Vandana
- Department of Microbiology, Kasturba Medical College and Hospital, Manipal University, Manipal, Karnataka, India
| | - C Mukhopadhyay
- Department of Microbiology, Kasturba Medical College and Hospital, Manipal University, Manipal, Karnataka, India
| | - S Vidyasagar
- Department of General Medicine, Kasturba Medical College and Hospital, Manipal University, Manipal, Karnataka, India
| | - M Varma
- Department of General Medicine, Kasturba Medical College and Hospital, Manipal University, Manipal, Karnataka, India
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Tellapragada C, Kalwaje Eshwara V, Bhat P, Kamath A, Mukhopadhyay C. Vaginal colonization by microbes during early pregnancy and their association with adverse pregnancy outcomes. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Devi V, Ramnarayan K, Abraham RR, Pallath V, Kamath A, Kodidela S. Short-term outcomes of a program developed to inculcate research essentials in undergraduate medical students. J Postgrad Med 2016; 61:163-8. [PMID: 26119435 PMCID: PMC4943408 DOI: 10.4103/0022-3859.159315] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Participation in research during undergraduate studies may increase students' interest in research and inculcate research essentials in them. AIMS The purpose of this study was to evaluate the effectiveness of the mentored student project (MSP) program. SETTINGS AND DESIGN In the MSP program, students in groups (n = 3 to 5) undertook a research project, wrote a scholarly report, and presented the work as a poster presentation with the help of a faculty mentor. To begin with, the logic model of the program was developed to identify short-term outcomes of the program on students, mentors, and the institution. A quasi-experimental design was used to measure the outcomes. MATERIALS AND METHODS A mixed method evaluation was done using a newly-developed questionnaire to assess the impact of the MSP on students' attitude, a multiple-choice question (MCQs) test to find out the impact on students' knowledge and grading of students' project reports and posters along with a survey to check the impact on skills. Students' satisfaction regarding the program and mentors' perceptions were collected using questionnaires. Evidence for validity was collected for all the instruments used for the evaluation. STATISTICAL ANALYSIS Non-parametric tests were used to analyze data. Based on the scores, project reports and posters were graded into A (>70% marks), B (60-69% marks), and C (<59% marks) categories. The number of MSPs that resulted in publications, conference presentation and departmental collaborations were taken as impact on the institution. RESULTS Students' response rate was 91.5%. The students' attitudes regarding research changed positively (P = 0.036) and score in the MCQ test improved (P < 0.001) after undertaking MSP. Majority of project reports and posters were of grade A category. The majority of the items related to skills gained and satisfaction had a median score of 4. The MSPs resulted in inter-departmental and inter-institutional collaborations, 14 publications and 15 conference presentations. An area for improvement noted was to have the MSP implemented in the curriculum without increasing students' overall workload and stress. CONCLUSION The study identified strengths and weaknesses of the MSP program. Our model of undergraduate research project may be incorporated in undergraduate medical programs to foster positive attitude and knowledge base about scientific research and to instil research skills among students.
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Affiliation(s)
- V Devi
- Department of Pharmacology, Melaka Manipal Medical College, Manipal Camps, Manipal University, Manipal, Karnataka, India
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Pai KM, Kamath A, Goel V. Effect of Red Bull energy drink on muscle performance: an electromyographic overview. J Sports Med Phys Fitness 2015; 55:1459-1465. [PMID: 25331270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM The present study was aimed at investigating the effect of Red Bull Energy drink (RB) on muscle endurance and fatigue. METHODS Twenty students of second year MBBS (males N.=10, females N.=10) were involved in a cross over design separated by 7 days, where they received either RB (caffeine at 2 mg/kg body weight) or isoenergetic, isovolumetric, noncaffeinated control drink (CD). After one hour of intake of the drink, maximum isometric force (MVC) and electromyogram (EMG) (flexor carpi radialis) were recorded from the dominant hand using Biopac Systems. After MVC, all subjects performed a sustained isometric contraction at 75% of MVC to fatigue. The Root mean square amplitude (RMS) and mean frequency (MNF) were calculated from the EMG data. Statistical analysis was done using r within and across groups. RESULTS Following consumption of RB, the fatigue task showed a decreased tendency to fatigue based on the MNF value for both the drinks. However the EMG index with reference to RMS was inconclusive to interpret any delaying effect on fatigue. There was no significant difference between the two drinks in the parameters assessed during MVC and endurance time. CONCLUSION The Red Bull energy drink (caffeine at 2 mg/kg body weight) was no better than CD at significant delaying effect on fatigue during isometric contraction.
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Affiliation(s)
- K M Pai
- Department of Physiology, Kasturba Medical College, Manipal University, Manipal, India -
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Maurya P, Bapsy P, Chandrashekar M, Kamath A, Vaishnavi J, Patil C. 115P Surgical treatment of early breast cancer in a developing country. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv519.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Pandey D, Mohanty D, Potti C, Agrarwal A, Kamath A, Shetty J. Less-Invasive or Minimally-Invasive: Does it Really Matter? J Minim Invasive Gynecol 2015; 22:S225. [DOI: 10.1016/j.jmig.2015.08.793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Khurana S, Rao B, Lewis L, Kumaran D, Kamath A. Effect of structured neonatal physiotherapy intervention on neurobehavior of moderate to late preterm infants—a randomized controlled trial. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.3610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Shastry R, Adhikari P, Kamath A, Chowta MN, Ullal SD, Pai MR. Authors' reply. J Postgrad Med 2014; 60:94-95. [PMID: 24757753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
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Abstract
OBJECTIVE To evaluate the antidiabetic drug dosage differences between geriatric and nongeriatric diabetics with reference to duration of disease and creatinine clearance (Crcl). MATERIALS AND METHODS Prospective study conducted for 6 months in a tertiary care hospital. Patients with type 2 diabetes mellitus were grouped into geriatric (age ≥60 years) and nongeriatric (age <60 years). Patients' demographic data, duration of diabetes, medication, and serum creatinine were recorded. Crcl was calculated using Cockcroft-Gault formula. Doses of sulfonylureas (SU) were converted into equivalent doses, taking glibenclamide as standard. Univariate analysis was done for comparison of drug doses between groups. RESULT A total of 320 geriatric and 157 nongeriatric diabetics completed the study. The duration of diabetes and Crcl adjusted dose reduction of glibenclamide (mean dose: Geriatrics 7.2±0.4 mg, nongeriatrics 9.6±0.7 mg; P=0.01) and gliclazide (mean dose: Geriatrics 85.5±11.5 mg, nongeriatrics 115.3±32.7 mg; P=0.42) was 25%, glimepiride (mean dose: Geriatrics 1.62±0.13 mg, nongeriatrics 2.1±0.18 mg; P=0.06) was 22%. Glipizide did not require dose reduction. Mean converted equivalent dose of sulfonylurea monotherapy was significantly lower in geriatrics than nongeriatrics (3.2±0.5 vs 6.4±1.02 mg; P=0.01) and showed 50% dose reduction. Mean dose of metformin was lower in geriatrics (901±32.2 mg vs 946.7±45.8 mg; P=0.45) and showed 5% reduction in dosage. There was no difference in the mean drug doses of thiazolidinediones and insulin between the groups. CONCLUSION A substantial dose reduction of glibenclamide (25%), gliclazide (25%), glimepiride (22%), and metformin (5%) in geriatrics compared to nongeriatrics was observed. Smaller dosage formulations like 0.75 mg glibenclamide, 0.5 mg glimepiride, 20 mg gliclazide, and 250 mg metformin may be of value in geriatric diabetic practice.
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Affiliation(s)
- R Shastry
- Department of Pharmacology, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India
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Davis F, Vidyasagar S, Maiya A, Kamath A. Dose response relationship between exercise intensity and C Reactive Protein in sedentary individuals. J Sci Med Sport 2013. [DOI: 10.1016/j.jsams.2013.10.071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Nikolic M, Lok L, Mattishent K, Barth S, Yung B, Cummings N, Shulgina L, Wade D, Shittu M, Vali Y, Chong K, Wilkinson A, Mikolasch T, Brij S, Jenkins S, Kamath A, Pasteur M, Wason J, Marciniak SJ. S82 Multi-centre prospective comparison of the BTS and ACCP guidelines to determine size in primary spontaneous pneumothorax. Thorax 2013. [DOI: 10.1136/thoraxjnl-2013-204457.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abraham RR, Pallath V, Am C, Ramnarayan K, Kamath A. Avenues for professional development: faculty perspectives from an Indian medical school. Kathmandu Univ Med J (KUMJ) 2013; 10:60-5. [PMID: 23575055 DOI: 10.3126/kumj.v10i4.10997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Medical school faculty in India are challenged to balance teaching and professional development. Melaka Manipal Medical College (MMMC), Manipal Campus, Manipal University, India offers the Bachelor of Medicine and Bachelor of Surgery (MBBS) program. The institution incorporates certain effective practices based on adult learning principles which are aimed at fostering the professional development of faculty members. OBJECTIVES The present study was undertaken to explore the perceptions of faculty members regarding the scope for professional development at Melaka Manipal Medical College, Manipal Campus. METHODS In September 2009, a questionnaire comprising items (23) focusing on five adult learning principles (active participation, relevant learning, constructive feedback, safe, non-threatening environment and previous experiences) was designed and faculty members (n=23) were asked to respond to it on a 5-point Likert scale. Additionally, a force field analysis was conducted by asking the faculty to identify three factors which facilitated them to consciously get involved in professional development activities. They were also asked to identify three unfavorable factors that hindered their professional development. RESULTS Among the five characteristics, relevant learning was found to have a high mean score. Frequency analysis of responses revealed that at Melaka Manipal Medical College, there was ample scope for relevant self-learning that fosters professional development (91.3%). Force field response analysis revealed Melaka Manipal Medical College offered considerable flexibility and opportunities for continuing professional development along with faculty members' prevailing role as teachers. Nevertheless, the need for more research facilities and funds was highlighted. CONCLUSIONS Adherence to adult learning principles may provide avenues for professional development in medical schools. An organized attempt to make the medical school faculty aware of the scope of these practices appears to be necessary to nurture professional development in settings where there are resource constraints.
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Affiliation(s)
- R R Abraham
- Department of Physiology, Melaka Manipal Medical College (Manipal Campus) Manipal University, Manipal,Karnataka, India
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Patel A, Kamath A, Polykarpou M, Mascitelli J, Patel A, Moyle H. P-033 Aneurysm embolization treatment efficiency: comparing the penumbra coil 400TM system to conventional coils. J Neurointerv Surg 2012. [DOI: 10.1136/neurintsurg-2012-010455b.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Devi V, Abraham RR, Adiga A, Ramnarayan K, Kamath A. Fostering research skills in undergraduate medical students through Mentored Student Projects: Example from an Indian medical school. ACTA ACUST UNITED AC 2012; 8:294-8. [DOI: 10.3126/kumj.v8i3.6215] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Healthcare decision-making is largely reliant on evidence–based medicine; building skills in scientific reasoning and thinking among medical students becomes an important part of medical education. Medical students in India have no formal path to becoming physicians, scientists or academicians. Objectives This study examines students’ perceptions regarding research skills improvement after participating in the Mentored Student Project programme at Melaka Manipal Medical College, Manipal Campus, India. Additionally, this paper describes the initiatives taken for the continual improvement of the Mentored Student Project programme based on faculty and student perspectives. Methods At Melaka Manipal Medical College, Mentored Student Project was implemented in the curriculum during second year of Bachelor of Medicine and Bachelor of Surgery programme with the intention of developing research skills essential to the career development of medical students. The study design was cross-sectional. To inculcate the spirit of team work students were grouped (n=3 to 5) and each group was asked to select a research project. The students’ research projects were guided by their mentors. A questionnaire (Likert’s five point scale) on students’ perceptions regarding improvement in research skills after undertaking projects and guidance received from the mentor was administered to medical students after they had completed their Mentored Student Project . The responses of students were summarised using percentages. The median grade with inter-quartile range was reported for each item in the questionnaire. The median grade for all the items related to perceptions regarding improvement in research skills was 4 which reflected that the majority of the students felt that Mentored Student Project had improved their research skills. The problems encountered by the students during Mentored Student Project were related to time management for the Mentored Student Project and mentors. Results This study shows that students acknowledged that their research skills were improved after participating in the Mentored Student Project programme. Conclusions The Mentored Student Project programme was successful in fostering positive attitudes among medical students towards scientific research. The present study also provides scope for further improvement of the Mentored Student Project programme based on students’ and faculty perspectives.DOI: http://dx.doi.org/10.3126/kumj.v8i3.6215 Kathmandu Univ Med J 2010;8(3):294-8
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Basit A, Nair S, Chakraborthy K, Darshan B, Kamath A. Risk factors for under-nutrition among children aged one to five years in Udupi taluk of Karnataka, India: A case control study. Australas Med J 2012; 5:163-7. [PMID: 22952561 DOI: 10.4066/amj.20121022] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2022]
Abstract
BACKGROUND Despite her apparent economic success, India is plagued by a high burden of under-nutrition among children under five. This study was aimed at understanding some of the risk factors for under-nutrition in a region with favourable maternal and child health indicators. METHOD A case control study was carried out among children aged one to five years attending the paediatric outpatient department in six rural health care centres in Udupi taluk of Karnataka in Southern India. A total of 162 children were included in the study, of which 56 were cases. A semi-structured questionnaire was used to interview the caregivers of the children and the nutritional status was graded according to the Indian Academy of Paediatrics (IAP) grading of protein-energy malnutrition. RESULTS Under-nutrition was associated with illness in the last one month [OR- 4.78 (CI: 1.83 -12.45)], feeding diluted milk [OR-14.26 (CI: 4.65 - 43.68)] and having more than two children with a birth interval ≤2 years [OR- 4.93 (CI: 1.78 - 13.61)]. Lack of exclusive breast feeding, level of education of the caregiver and environmental factors like source of water did not have an association. CONCLUSION Childhood illness, short birth interval and consumption of diluted milk were some of the significant contributory factors noted among this population. Information, Education, Communication (IEC) campaigns alleviating food fads and promoting birth spacing is needed.
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Affiliation(s)
- A Basit
- Kasturba Medical College - Manipal, Manipal University
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Basit A, Nair S, Chakraborthy KB, Darshan BB, Kamath A. UNDER-NUTRITION AMONG CHILDREN IN UDUPI TALUK OF KARNATAKA, INDIA. Australas Med J 2012. [DOI: 10.21767/amj.2012.1022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Radhakrishnan RA, Reddy VM, Kamath A. p53 immunoprofiling of potentially malignant oral disorders: A case series analysis. Indian J Cancer 2012; 49:27-32. [DOI: 10.4103/0019-509x.98913] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Daniel AB, Shah H, Kamath A, Guddettu V, Joseph B. SP6-38 Tobacco smoke and the risk of Perthes' disease in south west India: a case-control study. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976q.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Kulothungan K, Kondagunta N, Shetty A, Kamath A. SP3-9 An epidemiological study on health provider practices and the factors influencing them in rural area of Udupi taluk, Karnataka, India. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976o.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
BACKGROUND Oral squamous cell carcinoma (OSCC) is a relatively common epithelial malignancy, and thus represents a significant public health problem. Early detection improves quality of life for affected patients. Identification of molecular markers (or biomarkers) which can predict disease progression is necessary for better management of these disorders. A correlation of cholinesterase with tumourigenesis, cell proliferation and cell differentiation has been observed. Butyrylcholinesterase (BChE; pseudocholinesterase) has been shown to be a biochemical marker for cervical cancer which is also an epithelial malignancy. In this study, we sought to estimate and compare serum BChE levels in healthy controls and patients with biopsy-proven oral squamous cell cancer (also an epithelial malignancy) before definitive therapy as radiotherapy or chemotherapy may alter the levels of BChE and may act as a confounding variable. METHOD After obtaining consent from biopsy proven oral cancer patients (n= 39) (before onset of any definitive treatment), and from age- and sex-matched healthy controls (n = 20), 2ml of blood was collected. After clot formation samples were centrifuged, serum was collected for estimation of BChE. RESULTS Pre-treatment serum BChE levels were significantly elevated (p < 0.0001) in oral cancer patients compared to that of controls. BChE levels showed a significant increase (p = 0.005) with advancing stage in oral cancer patients. CONCLUSION Our results show there could be a role for serum BChE in determining the prognosis of oral cancer.
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Affiliation(s)
- K Prabhu
- Department of Biochemistry Kasturba Medical College, Manipal, Manipal University, India
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Abstract
BACKGROUND Oral squamous cell carcinoma (OSCC) is one of the most common malignancies recognized nowadays. Its early detection is the better alternative to provide a good quality of life for the patients. During the last years, several studies have identified potential biomarkers of OSCC progression and prognosis. The phosphodiesterases (PDEs) are responsible for the hydrolysis of the second messengers with a fundamental role in the transduction of the intracellular signals. Variations in PDE activity have been correlated to different pathological mechanisms, such as cellular differentiation, apoptosis, and tumor invasivity. PDEs are also known to play a role in tumor growth by influencing angiogenesis. AIM To estimate and compare serum PDE levels in healthy controls and biopsy-proven oral cancer patients before definitive therapy. MATERIALS AND METHODS Institutional Ethics Committee gave us the permission to conduct this study. After obtaining consent from biopsy-proven oral cancer patients (n = 39) (before onset of any definitive treatment) and age- and sex-matched healthy controls (n = 20), 2 ml of blood was collected in plain vacutainers. After clot formation, samples were centrifuged and serum was collected for estimation of PDE. STATISTICAL ANALYSIS Kruskal-Wallis test; Mann-Whitney Test. RESULTS AND DISCUSSION Pretreatment PDE levels were significantly elevated in oral cancer patients (P<0.0001) as compared with the controls and also there was a significant increase in PDE levels (P<0.001) with advancing stage in oral cancer patients. This may implicate a role for serum PDE in pathophysiology of oral cancer.
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Affiliation(s)
- K Prabhu
- Department of Biochemistry, Kasturba Medical College, Manipal University, Manipal, India
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Lena A, Ashok K, Padma M, Kamath V, Kamath A. Health and social problems of the elderly: a cross-sectional study in udupi taluk, karnataka. Indian J Community Med 2011; 34:131-4. [PMID: 19966960 PMCID: PMC2781120 DOI: 10.4103/0970-0218.51236] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2008] [Accepted: 01/01/2009] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Change in socio-economic status and various health problems adversely affect an individual's way of life during old age. OBJECTIVES To study the health and social problems of the elderly and their attitude towards life. MATERIALS AND METHODS Descriptive study carried out in the Field practice area of the Department of Community Medicine in South India. A total of 213 elderly patients (60 years old and above) who attended the outreach clinics were interviewed using a pre-tested schedule. Findings were described in terms of proportions and percentages to study the socio-economic status of the samples and its correlation to social problems. RESULTS Around 73% of the patients belonged to the age group of 60-69 years old. Nearly half of the respondents were illiterate. Around 48% felt they were not happy in life. A majority of them had health problems such as hypertension followed by arthritis, diabetes, asthma, cataract, and anemia. About 68% of the patients said that the attitude of people towards the elderly was that of neglect. CONCLUSIONS The results of the study showed that there is a need for geriatric counseling centers that can take care of their physical and psychological needs. The stringent rules for eligibility to social security schemes should be made more flexible to cover a larger population.
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Affiliation(s)
- A Lena
- Department of Community Medicine, Kasturba Medical College, Manipal, India
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Kondamudi N, Kamath A, Jain P. 141: Anti-Tussive Medication Use Among Coughing Children Presenting to a Community Pediatric Emergency Department. Ann Emerg Med 2010. [DOI: 10.1016/j.annemergmed.2010.06.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Shetty J, Chawla R, Pandey D, Kamath A, Guddattu V. Sublingual misoprostol: a better choice for cervical priming before manual vacuum aspiration. ACTA ACUST UNITED AC 2010. [PMID: 22945779 DOI: 10.4103/0019-5359.100338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Misoprostol is effective for cervical priming before manual vacuum aspiration (MVA). Aim of study was to determine whether sublingual misoprostol with a shorter interval of 2 hours before MVA would be as effective as its standard vaginal administration. STUDY DESIGN This randomized control trial included 82 women randomly assigned to receive 400 mcg of misoprostol, either sublingually or vaginally. MVA was performed 2 hours and 3 hours after in sublingual and vaginal group, respectively. RESULTS Cervical dilatation of 8 mm was achieved within 2 hours in sublingual group. Mean time taken for procedure (14.4 ± 5.3: sublingual group and 16.2 ± 5.7: vaginal group), and blood loss was comparable (12.2 ± 9.7 ml in sublingual group and 13.7 ± 8.5 ml in vaginal group). CONCLUSION 2 hour of cervical priming with 400 mcg of sublingual misoprostol before MVA was as good as 3 hours with vaginal administration of the same dose.
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Affiliation(s)
- J Shetty
- Department of OBG, Kasturba Medical College, Manipal, India.
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Noronha JA, Bhaduri A, Bhat HV, Kamath A. Maternal risk factors and anaemia in pregnancy: A prospective retrospective cohort study. J OBSTET GYNAECOL 2010; 30:132-6. [DOI: 10.3109/01443610903267457] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Higgins M, Bochicchio G, Simpson P, Leach J, Kamath A, Deyette D. Performance of an automated blood glucose monitor in the OR/ICU. Crit Care 2010. [PMCID: PMC2933977 DOI: 10.1186/cc8811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Venkatanarasimha N, Kamath A, Mukherjee K, Kamath S. Potential pitfalls of a double PCL sign. Skeletal Radiol 2009; 38:735-9. [PMID: 19234702 DOI: 10.1007/s00256-009-0654-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2008] [Revised: 01/04/2009] [Accepted: 01/14/2009] [Indexed: 02/02/2023]
Abstract
The double posterior cruciate ligament (PCL) sign is seen on a midline sagittal MR image of the knee as a low-signal-intensity linear band paralleling the antero-inferior part of the PCL. Although the sign has a high specificity for a displaced bucket-handle tear of the medial meniscus, it can be mimicked by several normal and abnormal structures in the intercondylar region. Familiarity with these variants and identifying the other features supportive of meniscal injury will help to make a confident diagnosis of bucket-handle tear of the medial meniscus.
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Suvarna BS, Kamath A. Prevalence of attention deficit disorder among preschool age children. Nepal Med Coll J 2009; 11:1-4. [PMID: 19769227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood onset psychiatric disorders. Although the onset of ADHD is prior to the age of seven years, there is a paucity of data on the prevalence of the disorder in preschool age children. This study was performed to determine the prevalence rate of ADHD in preschool age children in kindergartens of south west, Mumbai. One thousand two hundred fifty (599 males and 651 females) children aged between 4-6 years, were selected from 40 kindergartens in 6 localities in south west Mumbai. The Conner's index questionnaire was completed for each child by teachers and parents. Parents of children whose scores were positive for ADHD (>15) were interviewed by a psychiatrist and the ADHD was diagnosed based on DSM-IV criteria Schedule for affective disorders. One hundred fifty two (12.2%) children were diagnosed to have ADHD. The prevalence of ADHD in preschool age school in south west of Mumbai is consistent with previous studies in other countries. This study recommends the need for diagnosis and treatment of ADHD in preschool age children.
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Affiliation(s)
- B S Suvarna
- Department of Pharmacology, Melaka Manipal Medical College, India
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