Browsing by Author "Kulkarni, R"
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Item Chloramphenicol resistant Salmonella typhi out break in a rural part of north-east Karnataka.(1994-12-01) Kulkarni, R; Bhandar, M; Srinivasa, SItem Comparative assessment of commercial enzyme-linked immunosorbent assay & rapid diagnostic tests used for dengue diagnosis in India(Indian Council of Medical Research, 2020-01) Kulkarni, R; Modak, M; Gosavi, M; Wani, D; Mishra, AC; Arankalle, VABackground & objectives: Dengue diagnosis is routinely carried out by detection of dengue virus (DENV) antigen NS1 and/or anti-DENV IgM antibodies using enzyme-linked immunosorbent assays (ELISAs) and rapid diagnostic tests (RDTs). This study was aimed at evaluation of quality of diagnostic assays currently in use in India for the identification of DENV infection. Methods: During 2016 dengue season (July-November) in Pune, India, comparative assessment of a few immunoassays was undertaken using (i) WHO-approved Panbio-Dengue-Early-(NS1)-ELISA and Panbio-Dengue-IgM-Capture-ELISA as reference tests, and (ii) Bayesian latent class analysis (BLCA) which assumes that no test is perfect. The assays included J.Mitra-Dengue-NS1-Ag-MICROLISA (JME-NS1), J.Mitra-Dengue-IgM-MICROLISA (JME-IgM), and two RDTs, namely, J.Mitra-Dengue-Day-1-Test (JM-RDT) and SD-BIOLINE-Dengue-Duo (SDB-RDT). Serum samples from patients seeking dengue diagnosis (n=809) were tested using the diagnostic kits. The presence of NS1 and/or IgM was taken as evidence for dengue-positive diagnosis. Results: Panbio-NS1/IgM-ELISAs identified 38.6 per cent patients as dengue positive. With Panbio-ELISA as reference, all the tests were less sensitive for IgM detection, while for NS1, JM-RDT was less sensitive. For combined diagnosis (both markers), sensitivity of all the tests was low (55.7-76.6%). According to BLCA, Panbio-ELISA was 84 per cent sensitive for NS1, 86 per cent specific for IgM and 87 per cent specific for combined diagnosis. Accordingly, performance of the other tests was substantially improved with BLCA; however, sensitivity of both the RDTs for IgM detection remained unacceptable. The NS1 ELISAs and RDTs detected all four DENV serotypes, JME being most efficient. All IgM tests exhibited higher sensitivity in secondary infections. Interpretation & conclusions: These results confirmed superiority of ELISAs, and testing for both NS1 and IgM markers for dengue diagnosis, and emphasized on improvement in sensitivity of RDTs.Item Delayed diagnosis for undescended testes.(2008-06-05) Sinha, C K; Vinay, S; Kulkarni, R; Nour, SDelayed diagnosis of undescended testes is a major problem. A retrospective review of 298 testes units was performed to assess the age at referral, age at operation, complications and final outcome. The mean age at referral was 57 months. Only 24% of cases were operated below 2 years. A similar pattern of delayed orchidopexy has been reported by many other centres. As orchidopexy is recommended soon after 6-7 months of age, there is an urgent need for increased awareness of undescended testes and its consequences at all levels of child health care.Item Effectiveness Of Yoga Versus Exercise on Lipid Profile, BMI, And Blood Pressure Among Patients with Type II Diabetes Mellitus - A Community Based Randomised Control Trial(Medsci Publications, 2022-10) Kulkarni, R; Walvekar, P.Context/Background: Lifestyle interventions have proven to reduce the incidence of type 2 diabetes mellitus and prevent the complications. Yoga is considered safe, simple to learn, and can be practiced even by ill, obese, elderly, or disabled persons at home. The present study was conducted to assess the effect of one year of yoga therapy on lipid profile, BMI, and blood pressure in subjects with type 2 diabe-tes mellitus. Methodology: This randomized controlled trial was conducted in an Urban Health center, Belagavi from July 2018 to December 2019. Around 120 participants diagnosed with type 2 diabetes mellitus were randomized into “Yoga” and “Exercise” groups. Fasting lipid profile, BMI, and blood pressure were exam-ined at baseline, six months, and after one year of intervention. Results: GEE model analysis showed that there were significant effects of Intervention × Time on Cho-lesterol (p=0.001), LDL (p=0.006) and VLDL (p=0.000). It was identified that the exercise intervention was found to decrease cholesterol and TG significantly more than the yoga group. Also, there was a sig-nificant reduction in BMI in both the exercise and yoga groups at the end of six months and one year (p=0.247). Conclusions: Yoga can be a complementary therapy for type 2 diabetes, along with medications and ex-ercise.Item Glycosaminoglycan content of normal human neonatal aorta.(1976-12-01) Madavan, M; Kulkarni, RItem Occurrence & detection of AmpC beta-lactamases at a referral hospital in Karnataka.(2003-07-30) Ratna, A K; Menon, I; Kapur, I; Kulkarni, RBACKGROUND & OBJECTIVES: AmpC beta-lactamases confer resistance to a wide variety of beta-lactam drugs except for cefepime, cefpirome and carbapenems. They are known to be responsible for nosocomial outbreaks, therapeutic failures and multidrug resistance. Although reported with increasing frequency the true rate of occurrence of these beta-lactamases in Enterobacteriaceae is not known. Hence the present study was undertaken to determine the occurrence of AmpC enzymes among clinical isolates. METHODS: A total of 520 consecutive, non-repeat clinical isolates were included in the present study. Twenty eight strains resistant to cefoxitin were tested for AmpC beta-lactamases by the modified 3-dimensional extract method. Isolates harbouring AmpC beta-lactamases were tested for inducible beta-lactamases by disc diffusion. RESULTS: Sixteen (3.3%) isolates were positive for AmpC beta-lactamases. Based on the species 9 (3.3%) Escherichia coli, 4 (2.2%) Klebsiella pneumoniae, 2 (5%) Citrobacter freundii and 1 (5.5%) isolate of Enterobacter aerogenes harboured AmpC enzymes. Nine (56.3%) of AmpC harbouring strains, were urinary isolates. All the isolates were sensitive to imipenem and variably sensitive to aminoglycosides and co-trimoxazole. INTERPRETATION & CONCLUSION: Our findings document the presence of AmpC enzymes in this region. Hence AmpC beta-lactamase detection should be undertaken in clinical isolates showing resistance to broad-spectrum cephalosporins.Item Pediatric transfusion therapy: practical considerations.(1999-05-08) Kulkarni, R; Gera, ROver the past decade, safety of blood has increased tremendously because of better donor screening as well as testing of the units for transmissible diseases. Component therapy has allowed more effective and economic use of blood. Whole blood is rarely used; instead, packed red cells, platelets, and fresh frozen plasma (FFP) are the most common components used. These products are further refined using irradiation and microaggregate filters and in the case of FFP, viral inactivation. Irradiation prevents transfusion-associated graft versus host disease, whereas microaggregate filters remove leukocytes, decreasing the rates of alloimmunization, febrile nonhemolytic (FNH) reactions, and cytomegalovirus (CMV) transmission. Autologous donation in older children probably provides the safest blood as far as transmissible diseases are concerned. More families request a directed donation and solicit physician help in deciding as well as making arrangements for autologous and/or directed donations. Transfusions of blood and blood components in children are often challenging and require a knowledge of physiologic changes in hemoglobin and blood volumes during different ages. The unique needs of neonates, immunocompromised patients, and patients with congenital hemolytic anemia (sickle cell, thalassemia) mandate that the pediatrician have an appropriate knowledge of transfusion volumes and choice of blood product as well as indications for transfusion.Item Preparation, Characterization and In-vitro Evaluation of Microcapsules for Controlled Release of Diltiazem Hydrochloride by Ionotropic Gelation Technique.(2013-04) Akifuddin, S K; Abbas, Z; Marihal, Sachin; Ranadev, A K; Kumar, I H Santosh; Kulkarni, RThe problems of frequent administration and variable low bioavailability after oral administration of conventional dosage forms of diltiazem can be attenuated by designing it in the form of microcapsules which would facilitate intimate contact with the absorption surface and thereby improve and enhance the bioavailability. Diltiazem-loaded microcapsules were successfully prepared by ionotropic gelation technique employing Sodium carboxy methylcellulose, Xanthan gum as rate controlling polymers and Aluminium chloride as cross linking agent. Microcapsules obtained were discrete, spherical, free flowing and showed a maximum encapsulation efficiency of 91.20 ± 0.08%. Particle size of the microcapsules was found to be in the range of 1009 – 1311 μm. Interaction studies performed using FTIR spectroscopy revealed that there were no drug and polymer interactions. The drug remained dispersed in the polymer matrix in amorphous state, which was confirmed by X-ray diffraction analysis. The in vitro drug release follows matrix-diffusion controlled release and the release mechanism was non-Fickian type controlled by swelling and relaxation of polymer. There was no significant change in drug content and cumulative drug release of drug-loaded microcapsules stored at different storage condition after 90 days. From the study, it was concluded that diltiazem loaded microcapsules could be successfully prepared by ionotropic gelation technique with high entrapment efficiency and prolonged release characteristics.Item The prevalence of occult hepatitis B infection among the blood donors in a tertiary care hospital, Puducherry(Indian Association of Medical Microbiologists, 2018-09) Athira, K, P; Vanathy, K; Kulkarni, R; Dhodapkar, ROccult hepatitis B infection (OBI) is a cause of concern while screening the blood donors to prevent transfusion-related transmission of infection. This study was conducted to assess the prevalence of OBI using total anti-HBc by ELISA and DNA detection by real time polymerase chain reaction (PCR). The samples included were negative for HBs Ag by ELISA. Out of 1102 samples tested, 156 were positive for total anti-hepatitis B core antigen and 52/156 by real-time PCR. Overall, the prevalence was found to be 4.71% (52/1102). The results indicate that nucleic acid-based testing should be an essential part of screening procedure to prevent missing of OBI.Item A study of leukemia.(1977-02-01) Kulkarni, R; Rao, V K; Bopardikar, K VItem Venous thromboembolism.(1999-03-08) Gera, R; Kulkarni, RIncidence of venous thromboembolism (VTE) in children is rapidly rising. Frequent use of central venous lines (CVLs) in children with a variety of disease processes has contributed to increased incidence of VTE. In addition, increased detection of VTE has been possible due to the availability of sensitive imaging studies such as Color Duplex/Doppler ultrasound, lineogram and venogram. Heightened awareness of congenital prethrombotic disorders may help identify children at higher risk of thrombosis. Anticoagulation with heparin, low molecular weight heparin (LMWH) and oral anticoagulant such as warfarin are used for the treatment of VTE. Thrombolytic therapy may be indicated in some cases. Clinical presentation, management and pathogenesis including role of congenital prethrombotic disorders in pediatric VTE are discussed.