Biomedical subjects

Jayaprakash Muliyil

Publications and source records attributed to Jayaprakash Muliyil.

16 recordsLinked to original sources

PubMed2006

Carrying angle in children: a normative study.

Information about the carrying angle and its variations are important in the management of paediatric elbow injuries. We measured the carrying angle using bony landmarks for 300 rural South Indian children aged 5-18 years. The study confirms that the clinical carrying angle correlates best with age up to 15 years, following which there was a slight decrease in the angles. The rate of increase of the carrying angle for boys and girls is 0.42 and 0.60 degrees per year respectively. Sex differences seem to gradually increase with a maximum being around puberty. The carrying angle is greater in girls than in boys by a mean of 1.31 degrees. The carrying angle did not correlate well with height, weight, humeral length or ulnar length. The reproducibility of measuring the carrying angle by the simple technique used in our study leads us to propose that this may be used in actual clinical practice.

Adolescent↗

PubMed2006

Mortality rate and years of life lost from unintentional injury and suicide in South India.

We calculated mortality rates and years of life lost because of unintentional injuries and suicides using community based information obtained prospectively over a 7-year period, from 1998 to 2004, among a rural and peri-urban population of 108,000 in South India. Per 100,000 population the total mortality rate for unintentional injuries and suicides combined was 137.1, with 54.9 for unintentional injuries and 82.2 for suicides respectively. Hanging and self-poisoning with pesticides were the preferred means of suicide. Unintentional injuries and suicides resulted in 26.9% of total life years lost over the study period while 18.9% of all deaths in the population were attributable to unintentional injuries and suicides in the same period. The high burden is particularly notable in the 15-29 age group, where up to 70% of years of life lost are due to injury. The burden of injuries reported in this study is significantly higher than the figures reflected in available reports for India and is likely due to the under reporting in routine mortality statistics, particularly of suicides.

Adolescent↗

PubMed2006

Multilocus genotyping of Cryptosporidium sp. isolates from human immunodeficiency virus-infected individuals in South India.

This study characterized cryptosporidial infections in 48 human immunodeficiency virus-infected individuals in India by multilocus genotyping. Cryptosporidium hominis, C. parvum, C. felis, C. muris, and C. meleagridis were identified. Cpgp40/15 PCR-restriction fragment length polymorphism identified six subgenotypes. Cryptosporidial diarrhea was associated with decreased CD4 counts, below 200 (P = 0.009), but not high viral loads.

AIDS-Related Opportunistic Infections↗

PubMed2006

Prevalence of proteinuria in rural adult population in Tamil Nadu.

BACKGROUND & OBJECTIVES: Presence of proteinuria is considered as an early marker of an increased risk of progressive kidney disease. Angiotensin converting enzyme (ACE) inhibitors (ACEi) and angiotensin II receptor blockers (ARB) treatment to persons with proteinuria and chronic kidney disease has been shown to decrease the progression to endstage renal disease. As the exact prevalence of proteinuria is not known in the general population, we undertook this study to estimate the same in a rural adult population in Vellore district, Tamil Nadu. METHODS: A convenient sample of 5,043 adults was included. All individuals were tested for albuminuria by albumin dipstick examination in an untimed urine sample. Individuals who tested positive for albuminuria underwent a second dipstick examination after a gap of one week. Individuals with persistent albuminuria on the second dipstick examination underwent further evaluation which included medical history, physical examination, 24 h urine protein estimation, total serum protein and albumin estimation. Ultrasound of the abdomen was done in patients with renal failure and renal biopsy was performed in selected patients. RESULTS: Of the total 5,043 individuals screened, 63.1 per cent were females. Mean age of the study population was 50.94 +/- 11.2 yr. First dipstick test identified 594 individuals positive for albuminuria. Repeat dipstick could be done in only 576, of whom 212 showed persistent albuminuria. Significant proteinuria was detected in 24 individuals of the 208 who had 24 h urine protein measured. Of these 24 patients, 3 were found to have chronic renal failure, 12 were presumed to have diabetic nephropathy clinically, one each had focal segmental glomerulosclerosis and biopsy proven diabetic nephropathy, and 7 patients had proteinuria of unknown aetiology. INTERPRETATION & CONCLUSION: The prevalence of proteinuria in this adult rural population was 0.47 per cent (0.30-0.67%). The detection and treatment of chronic kidney disease in 24 individuals is bound to reduce the rate of decline of renal functions. Screening programme for proteinuria in different parts of country may be an effective measure to bring a decline in rate of progression of chronic kidney disease in general population.

Adult↗

PubMed2005

Amplitude of accommodation and its relation to refractive errors.

AIMS: To evaluate the relationship between amplitude of accommodation and refractive errors in the peri-presbyopic age group. MATERIALS AND METHODS: Three hundred and sixteen right eyes of 316 consecutive patients in the age group 35-50 years who attended our outpatient clinic were studied. Emmetropes, hypermetropes and myopes with best-corrected visual acuity of 6/6 J1 in both eyes were included. The amplitude of accommodation (AA) was calculated by measuring the near point of accommodation (NPA). In patients with more than +/- 2 diopter sphere correction for distance, the NPA was also measured using appropriate soft contact lenses. RESULTS: There was a statistically significant difference in AA between myopes and hypermetropes (P < 0.005) and between myopes and emmetropes (P < 0.005) in the 35-39 year age group. In the 40-44 year age group, there was a significant difference in AA between emmetropes and hypermetropes (P < 0.0001), emmetropes and myopes (P < 0.01) and hypermetropes and myopes (P < 0.0001). In patients above 45 years of age there was no significant difference (P > 0.5). CONCLUSION: Our study showed higher amplitude of accommodation among myopes between 35 and 44 years compared to emmetropes and hypermetropes.

Accommodation, Ocular↗

PubMed2004

Suicides in young people in rural southern India.

Different rates of suicide have been reported in India. In Vellore, southern India, we have noted that the rates of suicides are several fold higher than those reported anywhere in the world, especially in young women. The department of community health at the Christian Medical College, Vellore, has obtained data prospectively on births, deaths, and morbidity in a population of 108?000. We used the verbal autopsy method to assign cause of death. The mortality rates were analysed for 10 years, from 1992 to 2001, for the age-group 10-19 years. Suicides accounted for about a quarter of all deaths in young men and between 50% and 75% of all deaths in young women. The average suicide rate for young women was 148 per 100?000, and for young men 58 per 100?000. We believe that our findings are reliable. The system of surveillance is well established and the verbal autopsy method has been validated. These very high rates of suicide need urgent intervention.

Adolescent↗

PubMed2004

Validation of test duration as a screening criterion for frequency doubling perimetry.

PURPOSE: To validate the test duration in frequency doubling perimetry as an independent criterion to screen for glaucomatous field defects. DESIGN: Prospective cross-sectional study METHODS: Group I included 85 eyes (85 patients) with established field defects on automated perimetry. Group II comprised 41 normal eyes (41 subjects). Both groups underwent Swedish interactive testing algorithm standard tests as well as frequency doubling perimetry (C20-1). A cutoff level of 90 seconds was used to calculate test duration sensitivity and specificity. We also categorized patients into those who took <=90 seconds or less and those who took >90 seconds to complete the test and compared frequency doubling perimetry (any two abnormal points) with Swedish interactive testing algorithm in these groups. RESULTS: Duration of the test >90 seconds had 97.5% specificity with 62.3% sensitivity. Eleven subjects with glaucoma completed test in <91 seconds). CONCLUSION: Test duration alone has a limited value in screening for glaucoma.

Algorithms↗

PubMed2004

Water contamination in urban south India: household storage practices and their implications for water safety and enteric infections.

Water contamination, at source and during household storage, is a major cause of enterically transmitted infections in developing countries. This study assessed contamination of the municipal water in a south Indian town, which obtains its water intermittently from a surface lake and by pumping subsurface water from a dry river bed, and monitored microbial contamination during household storage. All samples of the 'treated' municipal water were contaminated when freshly pumped, and on household storage, 25/37 (67%) showed increased contamination during storage periods from 1 to 9 days. Household storage in brass, but not in containers of other materials significantly decreased contamination of water (p = 0.04). This was confirmed in the laboratory by testing water seeded with 10(3) to 10(5) Escherichia coli per 100 ml stored in containers of different materials (p < 0.01). Despite the requirements for provision of safe drinking water in municipal areas, in practice the water supplied in Vellore is contaminated and current household storage practices increase the level of contamination in at least two-thirds of households. The implementation of locally appropriate point-of-use disinfection and safe household storage practices in developing countries is an urgent need to ensure a safe, reliable year-round supply in areas where clean water is not available.

Adult↗

PubMed2003

Five-year risk of progression of primary angle closure to primary angle closure glaucoma: a population-based study.

OBJECTIVE: To report the 5-year progression to primary angle closure glaucoma (PACG) in a population-based cohort of primary angle closure (PAC) subjects. METHODS: A total of 37 patients diagnosed as PAC during a population-based study in 1995 were invited for re-examination in 2000. Patients underwent a complete ophthalmic examination including ocular biometry. Progression to PACG was based on optic disc damage and field defects on automated perimetry. RESULTS: In all, 28 of 32 PAC subjects who could be contacted presented for examination. Eight (28.5%; 95% CI 12-45%) had progressed to PACG; two of seven with appositional and six of 21 with synechial closure. All were advised laser peripheral iridotomy (LPI) in 1995; one of the nine who underwent LPI progressed compared to seven of 19 who refused LPI. Four of those originally diagnosed with appositional closure developed peripheral anterior synechiae. One eye of a person previously diagnosed with appositional PAC was reclassified as a primary angle closure suspect (PACS). There was no significant difference in biometric parameters between those who progressed and those who did not. None developed acute PACG or blindness due to glaucoma. CONCLUSION: In this population-based study of primary angle closure, the 5-year incidence of PACG was eight patients (28.5%; 95% CI 12-45%). We were unable to identify any features that predicted progression.

Biometry↗

PubMed2003

Prevalence of glaucoma in treated multibacillary Hansen disease.

PURPOSE: To determine the prevalence of glaucoma in a population of patients with multibacillary Hansen disease who had completed treatment. PATIENTS AND METHODS: The authors examined 386 of 446 patients with treated multibacillary Hansen disease residing in a geographically limited area. A complete ophthalmic examination including slit-lamp, applanation tonometry, gonioscopy, ophthalmoscopy, and stereobiomicroscopic examination of the optic disc was performed in all subjects. Glaucoma suspects were invited to the base hospital for further examination including automated perimetry. RESULTS: The overall prevalence of glaucoma was 3.6% (CI 1.9-5.3); 1.3% had primary open-angle glaucoma, 7% were primary angle-closure suspects (occludable angles), 1.8% had primary angle-closure glaucoma, and 0.5% had secondary glaucoma. CONCLUSION: The prevalence of primary glaucoma in patients with treated multibacillary Hansen disease was similar to that in the general population, and secondary glaucoma was rare.

Adolescent↗

PubMed2003

Glaucoma in India.

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Antihypertensive Agents↗

PubMed2003

Comparison between latanoprost and brimonidine efficacy and safety in Indian eyes.

PURPOSE: To compare the short-term efficacy and safety of topical latanoprost and brimonidine in Indian eyes. MATERIALS AND METHODS: Twenty-eight patients with ocular hypertension, primary open-angle, pseudoexfoliation or pigmentary glaucoma were enrolled. Following baseline measurements, latanoprost was applied topically once daily in the evening for 12-weeks. After a washout period, brimonidine was applied twice daily in all patients for 6 weeks; 16 patients continued for 12 weeks. Patients were examined at 2, 6 and 12 weeks. The primary outcome measure was the difference in mean intra ocular pressure (IOP) reduction at 6 and 12 weeks. The mean diurnal variation of IOP at baseline and at 12 weeks was also compared. RESULTS: Twenty-six of 28 enrolled patients completed the study. One randomly selected eye of each patient was used for analysis. At 6 weeks, the mean IOP reduction was 11.2 mm Hg (+/- 2.9 mmHg) with latanoprost and 6 mmHg (+/- 3.3 mmHg) with brimonidine. At 12 weeks this was 10.8 mmHg (+/- 2.8 mmHg) and 6.9 mmHg (+/- 3.1 mmHg) respectively. At 6 weeks 85.7% (24) eyes obtained more than 25% reduction in IOP with latanoprost compared to 13 (46.4%) with brimonidine. IOP reduction was maintained with both drugs throughout the study period. Two eyes did not show any response to brimonidine. Latanoprost reduced the diurnal variation of IOP from 5.10 to 2.90 mmHg; brimonidine reduced it from 4.70 to 3.90 mmHg. Conjunctival hyperaemia was present in one patient on latanoprost and three patients on brimonidine. Two patients experienced drowsiness with brimonidine. Neither drug produced side effects necessitating withdrawal from the study. CONCLUSION: In this short-term study, both latanoprost and brimonidine effectively reduced IOP and stabilised the diurnal curve in Indian eyes. Latanoprost was more effective than brimonidine.

Adrenergic alpha-Agonists↗

PubMed2003

Five-year risk of progression of ocular hypertension to primary open angle glaucoma. A population-based study.

PURPOSE: To report the progression of ocular hypertension (OHT) to primary open angle glaucoma (POAG) during a 5-year follow up of a population-based sample. METHODS: Twenty-nine patients diagnosed to have OHT and 110 randomly selected normals from a population-based study in 1995 were invited for ocular examination in 2000. All patients underwent a complete ophthalmic examination; including the daytime diurnal variation of intraocular pressure (IOP) and measurement of central corneal thickness (CCT). The "corrected" IOP was used for analysis. Progression to POAG was based on typical optic disc changes with corresponding field defects on automated perimetry. RESULTS: Twenty-five of the 29 persons with OHT who could be contacted were examined. After correcting for CCT, two persons were reclassified as normal. Four of 23 (17.4%; 95% CI: 1.95-32.75) had progressed to POAG. One person amongst the 110 normals progressed to normal tension glaucoma (NTG). The relative risk of progression amongst OHT was 19.1 (95% CI: 2.2-163.4). All those who progressed had bilateral OHT. The mean and peak IOP in those who progressed was 25.4 mm Hg and 29.3 mm Hg compared to 23.9 mm Hg and 25.7 mm Hg in those who did not. Those who progressed had more than 8 mm Hg diurnal variation. The diurnal variation was less than 6 mm Hg in those who did not progress. No patient developed blindness due to glaucoma. CONCLUSION: The 5-year incidence of POAG amongst OHT in this population was 17.4% (3.5% per year). Bilateral OHT, higher peak IOP and large diurnal variation may be the risk factors for progression.

Disease Progression↗

PubMed2002

Post-partum depression in a cohort of women from a rural area of Tamil Nadu, India. Incidence and risk factors.

BACKGROUND: Community-based epidemiological data on post-partum depression from developing countries are scarce. AIMS: To determine the incidence of and risk factors for developing post-partum depression in a cohort of women living in rural south India. METHOD: We assessed 359 women in the last trimester of pregnancy and 6-12 weeks after delivery for depression and for putative risk factors. RESULTS: The incidence of post-partum depression was 11% (95% CI 7.1-14.9). Low income, birth of a daughter when a son was desired, relationship difficulties with mother-in-law and parents, adverse life events during pregnancy and lack of physical help were risk factors for the onset of post-partum depression. CONCLUSIONS: Depression occurred as frequently during late pregnancy and after delivery as in developed countries, but there were cultural differences in risk factors. These findings have implications for policies regarding maternal and childcare programmes.

Adolescent↗

PubMed2002

Visual field defects in non-functioning pituitary adenomas.

PURPOSE: To report the prevalence and pattern of visual field loss in non-functioning pituitary adenomas and to study the relationship between the tumour size and severity of field defects. METHODS: Ninety-three patients with histologically confirmed pituitary adenomas, non-functional on hormonal assessment, underwent a complete ophthalmic assessment and automated perimetry using the HFA 30-2 programme. Defects with quadrantanopic or hemianopic characteristics, defined using criteria on the threshold/pattern deviation plots were considered typical. Typical defects were graded as mild, moderate and severe. All other defects were considered atypical. A neuroradiologist measured tumour size on a CT or MRI Scan. The Chi-square test for trend was used to test association of tumour volume with severity of typical defects. RESULTS: Eighty-eight (94.6%) of the 93 patients had a field defect. Typical field defects were seen in 69 (74.2%) patients and atypical in 19 (20.4%). A severe typical defect involving at least 3 quadrants in one or both eyes was the most common (24 patients or 25.80%). All 31 patients (33.3%) with a tumour size greater than 20 cc had field defects. Severity of field defect increased with tumour volume (Chi-square test for trends significant p = 0.0096). CONCLUSIONS: Field defects occurred in 95% of patients with non-functioning pituitary macroadenoma. A severe visual field loss involving at least 3 quadrants in one or both eyes was the most common. 20% of patients had atypical field defects. Severity of field defects increased with tumour volume.

Adenoma↗

PubMedDate not supplied

Medico-social dimensions of menopause: a cross-sectional study from rural south India.

BACKGROUND: The quality of life of the increasing ageing population is becoming an important issue in India. There are very little data on the effect of menopause on women, especially from rural India. METHOD: A population-based cross-sectional study was conducted on perceptions regarding menopause, prevalence of menopausal symptoms and association of family environmental factors with menopausal symptoms among 100 postmenopausal and 100 premenopausal rural women in south India. RESULTS: Fifty-seven per cent of postmenopausal women perceived menopause as convenient. Sixty-nine per cent of them complained of diminishing abilities after menopause. Twenty-three per cent felt that sexual life ends with the onset of menopause. Sixteen per cent reported that their husbands had become disinterested in them after menopause and I1% were apprehensive about the loss of femininity. A higher proportion of postmenopausal women reported hot flushes, night sweats, urge incontinence and other somatic symptoms as compared to premenopausal women. Fifty-four per cent of postmenopausal and 32% of premenopausal women were currently not sexually active. Fifty-nine per cent of postmenopausal and 38% of premenopausal women expressed loss of sexual desire and this difference was statistically significant. There was no significant association between menopause and depression. A poor perceived relationship within the family was shown to have a significant association with depression. There was a significant association between multiple somatic symptoms and menopause. CONCLUSION: A significantly higher proportion of postmenopausal women suffer from vasomotor symptoms, urge incontinence, loss of sexual desire and multiple somatic symptoms. They do not link these symptoms with menopause. Poor family environmental factors have a stronger association with depression than menopause. In view of these findings, it is important to determine the feasibility and impact of hormone replacement therapy in preventive health care in rural India.

Adult↗