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Sreedharan Geetha Sajith,Yen-Li Goh,Joshua Marcus Wee 대한가정의학회 2017 Korean Journal of Family Medicine Vol.38 No.6
Background: Studies worldwide indicate that people with intellectual disability have high risks of physical andmental morbidities, and poor quality of health care. This study was aimed at determining general practitioners’perceptions on barriers in clinical assessment and training needs with regard to the healthcare of communitydwellingpeople with intellectual disability. Methods: A survey questionnaire was developed specifically for the study through focus group discussions and aliterature review. The study was conducted as a cross-sectional anonymous survey of private general practitionerspracticing in Singapore. The survey contained questions on their experience and training needs in assessing andtreating patients with intellectual disability. Results: Forty-nine of the 272 questionnaires sent out were returned. The respondents were predominantly malegeneral practitioners working in “solo” practices. For most general practitioners, the proportion of patients with intellectualdisability ranged from 1% to 5%. Nearly 90% of general practitioners identified problems in communicatingwith such patients as an important barrier that affected the quality of assessment of their health conditions. Other barriers identified were behavioral issues and sensory impairments. Only one-third of the general practitionerswere confident that they had sufficient knowledge of physical and mental health conditions related to patientswith intellectual disability. Three-fourths of the general practitioners believed that further training in this areawould be beneficial. Conclusion: Appropriate interventions to address barriers in assessment and management of patients with intellectualdisability with further training for general practitioners may improve the standard of healthcare provided tothis population group.
Incidence of Type 2 Diabetes Mellitus among Emirati Residents in Ajman, United Arab Emirates
Jayadevan Sreedharan,Jayakumary Muttappallymyalil,Shatha al Sharbatti,Sana Hassoun,Rawda Safadi,Iehab Abderahman,Wathib Abdulsamad Hameed,Abdul Mohsen Ibrahim,Mohamed Tahir Takana,Ahmad Mohammad Fouda 대한가정의학회 2015 Korean Journal of Family Medicine Vol.36 No.5
Background: Diabetes mellitus (DM), particularly type-2 is a major public health concern worldwide. Not much information is available with regard to the incidence of DM in United Arab Emirates (UAE). This study aimed at determining the incidence rate of diabetes mellitus among Emirati population in Ajman, UAE. This is a retrospective cohort study. Methods: This study was conducted in all primary health care centers and Shaikh Khalifa and GMC Hospitals, Ajman, UAE where the Emirati population primarily go for diagnosis and treatment. The incident cases of diabetes mellitus were collected during the period 2010 January to December. Results: A total of 158 cases newly detected in 2010, 54 were among non-Emiratis and one was type-1 diabetes. Eliminating these, the remaining 101 were included in the analysis. The age of the patients ranged from 23 years to 78 years; 35 (34.7%) males and 66 (65.3%) were females. The overall incidence observed was 4.8/1,000 person-years (PY) with a female predominance of 6.3/1,000 PY against incidence among males of 3.3/1,000 PY. With regard to age specific incidence rate among males, it increases with age till 60 years and then showed a decreasing trend. Among females also the same trend was observed but not as similar to males. Conclusion: The highest incidence rate was observed in the 55–59 age group among males, 23.4/1,000 PY and females, 32.4/1,000 PY. Among males the incidence rate was much less compared to females in—the age groups older than 59 years.
Sarojam, Santhi,Raveendran, Sureshkumar,Vijay, Sangeetha,Sreedharan, Jayadevan,Narayanan, Geetha,Sreedharan, Hariharan Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.9
The CCAAT/enhancer-binding protein-alpha (CEBPA) is a transcriptional factor that plays a crucial role in the control of proliferation and differentiation of myeloid precursors. This gene was recognized as the target of genetic alterations and were associated with clinical complexity among AML. We here analyze the frequency and types of CEBPA mutations and polymorphisms in a de novo AML patients from South India and tried to find out associations of these variations with different clinical parameters and the prognostic significance in AML. Study was carried out in 248 de novo AML patients, cytogenetic analysis was performed from the bone marrow samples and was karyotyped. PCR-SSCP analysis and sequencing was performed for the detection of CEBPA gene variations. All the statistical analysis was performed using SPSS 17 (statistical package for social sciences) software. Pearson Chi-square test, Mann-Whitney U test, Kaplan-Meier survival analysis and log rank tests were performed. CEBPA mutations were detected in 18% and CEBPA polymorphisms were detected in 18.9% of AML cases studied. Most of the mutations occured at the C terminal region. Polymorphisms were detected in both N and C terminal region. with most common being, c.584_589dup ACCCGC and c.690G>T. A significant association was not observed for the mutation and polymorphism with respect to clinical and laboratory parameters. Survival advantage was observed for the mutated cases compared to non mutated cases, especially for the normal karyotype groups. Polymorphisms has no effect on the survival pattern of AML patients. CEBPA mutation and polymorphisms were observed with similar frequency and was identified in all the FAB subtypes as well as in cytogenetic risk groups in our study population, but CEBPA mutations alone confer a prognostic value for NK AML patients.
Raveendran, Sureshkumar,Sarojam, Santhi,Vijay, Sangeetha,Geetha, Aswathy Chandran,Sreedharan, Jayadevan,Narayanan, Geetha,Sreedharan, Hariharan Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.9
IDH1/2 mutations which result in alternation in DNA methylation pattern are one of the most common methylation associated mutations in Acute myeloid leukaemia. IDH1/2 mutations frequently associated with higher platelet level, normal cytogentics and NPM1 mutations. Here we analyzed IDH1/2 mutations in 200 newly diagnosed unselected Indian adult AML patients and investigated their correlation with clinical, cytogenetic parameters along with cooperating NPM1 mutation. We detected 5.5% and 4% mutations in IDH1/2 genes, respectively. Except IDH2 c.515_516GG>AA mutation, all the other identified mutations were reported mutations. Similar to reported c.515G>A mutation, the novel c.515_516GG>AA mutation replaces $172^{nd}$ arginine to lysine in the active site of the enzyme. Even though there was a preponderance of IDH1/2 mutations in NK-AML, cytogenetically abnormal patients also harboured IDH1/2 mutations. IDH1 mutations showed significant higher platelet count and NPM1 mutations. IDH2 mutated patients displayed infrequent NPM1 mutations and lower WBC count. All the NPM1 mutations in the IDH1/2 mutated cases showed type A mutation. The present data suggest that IDH1/2 mutations are associated with normal cytogenetics and type A NPM1 mutations in adult Indian AML patients.
Vaidyanathan Gowri,Sreedharan V Koliyadan,Aisha Al Hamdani,Nayil Al Kindy 대한부인종양학회 2012 Journal of Gynecologic Oncology Vol.23 No.3
Ovarian Sertoli-Leydig cell tumors are rare sex cord-stromal tumors, accounting for less than 1% of ovarian tumors. Majority of these tumors are benign and unilateral, only 3-5% are bilateral. These patients present with clinical features of virilization due to excessive secretion of testosterone from the tumor, however 50% may have no endocrine symptoms. We report a case of poorly differentiated Sertoli-Leydig cell tumour in a woman diagnosed during routine investigation of infertility. She had two spontaneous successful pregnancies after tumor excision laparoscopically.
A hands-on microsurgery course for nurses
Satkunanantham, Mala,Sechachalam, Sreedharan Korean Society of Plastic and Reconstructive Surge 2021 Archives of Plastic Surgery Vol.48 No.3
Microsurgical procedures are time-consuming and sometimes fatigue-inducing. However, a skilled assistant and scrub nurse can help surgery be performed more smoothly and rapidly. Three microsurgical simulation courses were held for perioperative nurses at our institution. Each course consisted of two lectures and two practice microsurgical sessions, and was evaluated with a post-course survey. The respondents all felt that their knowledge of microsurgical instruments, sutures, microscope set-up, and microsurgical skills had improved following the course. Many felt that their ability to predict what the surgeon would request during a microsurgical case improved, and that they were able to handle instruments and sutures better. The nurses also reported improved confidence in assisting with microsurgical procedures and tolerance of the long operative time in some microsurgical cases. Based on our experience, a basic microsurgery course for nurses can play a significant role in training effective and competent microsurgical scrub nurses.
Sathian, Brijesh,Fazil, Abul,Sreedharan, Jayadevan,Pant, Sadip,Kakria, Anjali,Sharan, Krishna,Rajesh, E.,Vishrutha, K.V.,Shetty, Soumya B.,Shahnavaz, Shameema,Rao, Jyothi H.,Marakala, Vijaya Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.3
Background: To estimate the numbers and trends in cervix cancer cases visiting the Radiotherapy Department at Manipal Teaching Hospital, Pokhara, Nepal, statistical modelling from retrospective data was applied. Materials and Methods: A retrospective study was carried out on data for a total of 159 patients treated for cervix cancer at Manipal Teaching Hospital, Pokhara, Nepal, between $28^{th}$ September 2000 and $31^{st}$ December 2008. Theoretical statistics were used for statistical modelling and forecasting. Results: Using curve fitting method, Linear, Logarithmic, Inverse, Quadratic, Cubic, Compound, Power and Exponential growth models were validated. Including the constant term, none of the models fit the data well. Excluding the constant term, the cubic model demonstrated the best fit, with $R^2$=0.871 (p=0.004). In 2008, the observed and estimated numbers of cases were same (12). According to our model, 273 patients with cervical cancer are expected to visit the hospital in 2015. Conclusions: Our data predict a significant increase in cervical cancer cases in this region in the near future. This observation suggests the need for more focus and resource allocation on cervical cancer screening and treatment.
Exploration of the fetus with gross anomaly: a case of pseudo prune belly syndrome
Bhagyam Valappil,Lalu Krishna,Ranjith Sreedharan,Ashwija Shetty 대한해부학회 2018 Anatomy & Cell Biology Vol.51 No.3
Prune belly syndrome is a rare congenital anomaly usually presented with triad characteristic feature of deficient abdominal muscles, cryptorchidism, and urinary tract anomalies. Here, we present a case with all the characteristic features of prune belly and the associated secondary features which were observed on detailed dissection and exploration of the fetus.
Prevalence of Tobacco Use Among Adolescents in North Kerala, India
Muttappallymyalil, Jayakumary,Divakaran, Binoo,Thomas, Teena,Sreedharan, Jayadevan,Haran, Jeesha C.,Thanzeel, Mohammed Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.11
The present study was conducted to assess the prevalence and type of tobacco use among adolescents and also the reasons for the initiation of tobacco use amongst them. It was conducted in ten randomly selected schools in the Kannur district of Kerala state, India. A total of 3,000 school children participated. The study observed an overall prevalence of 5.5%. The prevalence observed among boys was 12% and none of the girls were tobacco users. Association between father's and friend's tobacco habits were observed.
Cigarette Alternatives: Are they Safe?
Shantakumari, Nisha,Muttappallymyalil, Jayakumary,John, Lisha Jenny,Sreedharan, Jayadevan Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.8
In spite of limited data regarding the safety or effectiveness of electronic cigarette introduced into the market as a healthier alternative to tobacco smoking, its popularity has increased enormously. E-cigarettes have penetrated the market rapidly owing to the elaborate marketing network and attractive marketing strategies. Stated advantages include the claim that they help quit smoking and produce less exposure than conventional smoking. The list of disadvantages is even more elaborate. While the majority of the studies supporting health claims and efficacy for quitting smoking are not scientifically sound, they are also challenged by studies providing contradictory results. Owing to the limited evidence on the potential advantages and disadvantages of e-cigarettes, the debate on their safety continues.