Papers by N. Ananthakrishnan
The National medical journal of India
Although several studies have been published on lymphonodovenous shunt, there are no objective da... more Although several studies have been published on lymphonodovenous shunt, there are no objective data either on the outcome of lymphoedema or on various parameters likely to influence the results. A trial of lymphonodovenous shunt was carried out in 75 patients with unilateral filarial lymphoedema. The primary aim of the trial was to identify a cohort of responders as against non-responders and to correlate the outcome with various factors such as age, gender, duration and preoperative grade of lymphoedema, number of preoperative attacks of adenolymphangitis, operative impression of the lymph node, effect of venous reflex and type of nodovenous anastomoses. Change in oedema volume was measured objectively by water displacement method using the normal limb as a control. There was no operative mortality. Predominant postoperative complications included wound haematoma (8.5%), wound infection (13.6%) and transient lymphorrhoea (13.6%). In the immediate postoperative period, a reduction o...
Indian journal of hematology & blood transfusion : an official journal of Indian Society of Hematology and Blood Transfusion, 2014
Extranodal NK/Tcell lymphomas (ENKTL) are rare, aggressive lymphomas. The most common primary sit... more Extranodal NK/Tcell lymphomas (ENKTL) are rare, aggressive lymphomas. The most common primary site of involvement is the nasal cavity, nasopharynx and paranasal sinuses. The other sites of primary involvement are skin, gastrointestinal tract and testis. Advanced disease can show lymph node, bone marrow and peripheral blood involvement. We report a case of ENKTL of the jejunum, showing peripheral pancytopenia and haemophagocytosis in the bone marrow. The intestine showed multiple intestinal perforations, with evidence of infiltration by lymphoma with coexistent strongyloides infestation. The patient showed disseminated disease in the form of lymphadenopathy and had a rapidly downhill course and expired on 5th day of admission. We also discuss the problems encountered by the pathologist in diagnosing these uncommon lymphomas.
The National medical journal of India, 2016
SBV Journal of Basic, Clinical and Applied Health Science, 2019
Scholarship or scholarly activity is implied as part of the "job requirement" of faculty in healt... more Scholarship or scholarly activity is implied as part of the "job requirement" of faculty in health sciences. However, the concept of scholarship other than an emphasis on publications is hitherto lacking in India with no weightage being given to all four components of scholarship as described by Boyer, viz. the scholarship of discovery, application, integration or teaching leave alone a weightage for innovative activities. This paper describes the components of scholarly activities, the current requirement or lack of it of "mandatory" training right from the undergraduate student days in scholarly activities, poor scholarly requirements for postgraduates and a faculty appraisal which values only publications. Metrics have been suggested for all individual five components of scholarship and an emphasis has been laid on training right from the beginning of medical education for the activity to be internalized.
ISRN Vascular Medicine, 2012
Cancer is an important risk factor for venous thrombosis. Venous thromboembolism is one of the mo... more Cancer is an important risk factor for venous thrombosis. Venous thromboembolism is one of the most common complications of cancer and the second leading cause of death in these patients. Recent research has given insight into mechanism and various risk factors in cancer patients which predispose to thromboembolism. The purpose of this review is to summarize the current knowledge on the prophylaxis, diagnosis, and management of venous thromboembolism in these patients.
ANZ Journal of Surgery, 2004
Background: The present study investigates the effect of delay in appendicectomy on the outcome o... more Background: The present study investigates the effect of delay in appendicectomy on the outcome of surgery and also examines the contribution of patient and physician related delay to the stage of appendicitis. Methods: During a 12-month period, 114 consecutive adult patients undergoing appendicectomy for acute appendicitis were monitored prospectively. Time of onset of symptoms, presentation to the hospital, surgery consultation, decision to operate and starting of surgery were all noted. The stage of the appendicitis was identified based on operative findings and pathology reports. Postoperative events were recorded. The stage of appendicitis and outcome were related to the prehospital and in-hospital delay of each patient. Results: There were three (2.6%) normal, 62 (54.4%) early inflamed and 49 (43%) cases of advanced appendicitis. The total delay from onset of symptoms to performance of appendicectomy was 2.4 times longer in the advanced appendicitis group than in the early inflamed appendicitis group. There was no significant difference in the in-hospital delay between the two groups. Delay in the resumption of oral feed and total hospital stay were significantly higher in the advanced appendicitis group. Conclusions: The present prospective study concludes that morbidity caused by acute appendicitis correlates directly with delay in treatment. In the majority of cases the delay in treatment is predominantly caused by patient related factors. The negative appendicectomy rate can be reduced by close observation of cases with clinical uncertainty without increasing the morbidity.
Effective Medical Communication, 2020
SBV Journal of Basic, Clinical and Applied Health Science, 2018
The list of required competencies for the Indian Medical Graduate (IMG) along with suggested teac... more The list of required competencies for the Indian Medical Graduate (IMG) along with suggested teaching / learning methods and topics for integration have been notified by Medical Council of India. Also, the desired level of proficiency for various competencies has been defined with emphasis on the need to certify some of them. The corresponding Graduate Medical Education Regulations with details of curricular time assignment for various disciplines, scheduling and details of the evaluation process are still to be released and is expected shortly. With implementation fixed for the academic year 2019-20, it is necessary for all faculty to be apprised of the details of the changes being sought to be brought about. This paper will focus on details of the new curriculum, its merits compared to the previous version and some areas of concern which may require attention and rectification later on. One possible strategy for preparing and implementing the curriculum by August, 2019 will be suggested.
The National medical journal of India
Corrosive alimentary tract injuries are a source of considerable morbidity all over the world. De... more Corrosive alimentary tract injuries are a source of considerable morbidity all over the world. Despite this, actual data on the epidemiology of this problem are scarce mainly due to the lack of a well-established reporting system for poisoning in most countries. The burden of the disease is naturally more in countries such as India where the condition is common because of poor regulation of sale of corrosive substances. We analyse the available data on epidemiology of corrosive injuries, as well as patterns of involvement of the alimentary tract, with special reference to Indian data, and also provide an overview of the management options and long-term sequelae of this condition.
The Journal of the Association of Physicians of India, 2000
This study was carried out to determine the gross type and composition of gallstones from South I... more This study was carried out to determine the gross type and composition of gallstones from South India in order to compare it with published results from the North to see whether the sequential events in biliary lithogenesis are different in these two geographical areas. MATHODOLOGY: A total of 76 stones collected from various hospitals in South India including JIPMER were analysed using X-ray crystallography. Patient characteristics were recorded. Gross typing was done according to Bockus' morphological criteria. Patients with gallstones in South India were found to be older in age with near equal gender distribution. Pigment calcium stones accounted for 56.5%, pigment stones for 17.2% and mixed stones for 14.2% of gallstones. Bilirubin and its salts were the most frequently identified class of compounds by crystallography. Analysis of gallstones layer by layer revealed equal distribution of bilirubin compounds between the centre and outer layers except crystalline bilirubin whi...
Journal of clinical and diagnostic research : JCDR, 2014
Book Reviews, 2004
Page 1. NTTC BULLETIN Patron: KSVK Subba Rao Director, JIPMER. Project Director, NTTC, JIPMER. Ed... more Page 1. NTTC BULLETIN Patron: KSVK Subba Rao Director, JIPMER. Project Director, NTTC, JIPMER. Editor: KR Sethuraman, Project Officer, NTTC, JIPMER. Editorial Board CH Shashindran N. Ananthakrishnan Santosh Kumar ...
Tropical gastroenterology : official journal of the Digestive Diseases Foundation, 2009
AIM This study was carried out to assess whether the postprandial urinary alkaline tide, as a mar... more AIM This study was carried out to assess whether the postprandial urinary alkaline tide, as a marker for the completeness of vagotomy, is dependent on the nature of the test meal, whether it is affected by proton pump inhibitor therapy, and whether it is reliable. METHODS The postprandial urinary alkaline tide (PUAT) pattern was prospectively assessed in three different study groups and one control group of healthy volunteers. The three study groups were as follows; A (n = 20) i.e. the Proton Pump Inhibitor (PPI) Group; B (n = 25) i.e. the Truncal Vagotomy (TV) Group; and C (n = 5) i.e. the Recurrent Ulcer (RU) Group. Urinary pH was measured by a pocket digital pH meter. RESULTS Postprandial urinary alkaline tide in the control group was significantly higher compared to the fasting levels. Liquid diet did not elicit a significant urinary alkaline tide response. There was a statistically significant fall in both fasting urinary pH (5.34 +/- 0.70 vs. 4.80 +/- 0.61, p = 0.031) and the ...
Journal of Postgraduate Medicine
com objetivo de contribuir para maior integração institucional, em função da reestruturação organ... more com objetivo de contribuir para maior integração institucional, em função da reestruturação organizacional da Secretaria da Saúde do Estado da Bahia (SESAB), que unificou os Centros de Referência em DST e em AIDS. Constou de reuniões entre a equipe técnica da EESP e do CREAIDS e de três módulos de trabalho-o primeiro com coordenadores, o segundo com trabalhadores (seis turmas) e o terceiro de avaliação com representantes de todas as turmas. Utilizou-se da metodologia da Problematização e de abordagem teórico-vivencial, que possibilitou a análise e discussão do Sistema Único de Saúde (SUS), além da reflexão sobre aspectos éticos e relacionais da prática profissional. O trabalho proporcionou maior aproximação entre Diretoria, coordenadores e trabalhadores, e a reflexão sobre o momento atual da organização, contextualizando-a no SUS. Sugere-se a continuidade do
Indian journal of medical ethics
The "Ethical guidelines for biomedical research on human participants" prepared by the ... more The "Ethical guidelines for biomedical research on human participants" prepared by the Indian Council of Medical Research in 2006 came as a welcome step in the process of regulation of research on human subjects, since clear cut Indian guidelines were absent earlier. The guidelines have been accepted as the standard operating manual by Institutional Ethics Committees (IEC) in India. However, over a period of time, it has become obvious that the guidelines lack clarity in certain areas and require to be revised in the light of experiences of members in the IECs. Some of these problems with the ICMR guidelines have been highlighted in this paper to press for revision of the manual in the light of these experiences.
BMJ, 2003
Objectives To ascertain the prevalence of Helicobacter pylori in patients with gastro-oesophageal... more Objectives To ascertain the prevalence of Helicobacter pylori in patients with gastro-oesophageal reflux disease and its association with the disease. Design Systematic review of studies reporting the prevalence of H pylori in patients with and without gastro-oesophageal reflux disease. Data sources Four electronic databases, searched to November 2001, experts, pharmaceutical companies, and journals. Main outcome measure Odds ratio for prevalence of H pylori in patients with gastro-oesophageal reflux disease. Results 20 studies were included. The pooled estimate of the odds ratio for prevalence of H pylori was 0.60 (95% confidence interval 0.47 to 0.78), indicating a lower prevalence in patients with gastro-oesophageal reflux disease. Substantial heterogeneity was observed between studies. Location seemed to be an important factor, with a much lower prevalence of H pylori in patients with gastro-oesophageal reflux disease in studies from the Far East, despite a higher overall prevalence of infection than western Europe and North America. Year of study was not a source of heterogeneity. Conclusion The prevalence of H pylori infection was significantly lower in patients with than without gastro-oesophageal reflux, with geographical location being a strong contributor to the heterogeneity between studies. Patients from the Far East with reflux disease had a lower prevalence of H pylori infection than patients from western Europe and North America, despite a higher prevalence in the general population.
SBV Journal of Basic, Clinical and Applied Health Science, 2018
Journal of Scientific Dentistry
The undergraduate and postgraduate admission of dental seats in India has been facing a decline i... more The undergraduate and postgraduate admission of dental seats in India has been facing a decline in the recent past. The future of the dental profession is at stake in the country due to multifaceted issues. Without solving the actual underlying problem, there is no point in blaming the National Eligibility cum Entrance Test (NEET) or bringing down the scores to fill the seats. It's high time the policymakers, senior professionals, government, and the regulatory body take an action to improve the scenario and save the profession from the crisis.
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Papers by N. Ananthakrishnan