Kasturba Medical College, Manipal

About: Kasturba Medical College, Manipal is a education organization based out in Manipal, Karnataka, India. It is known for research contribution in the topics: Population & Diabetes mellitus. The organization has 7034 authors who have published 8488 publications receiving 103415 citations.

Anatomical organization of aortic arch variations in the India: embryological basis and review

Abstract: OBJECTIVES: To determine the percentage and type of aortic arch variations in Indian subjects and their clinical and surgical importance and embryological basis. PATIENTS AND METHOD: In our investigation, branching patterns of the aortic arch were studied in 62 formalin-fixed cadavers of both sexes of Indian origin, aged 45-79. The dissections were carried out in formalin-preserved cadavers and the aortic arch variations were observed after exposing the thoracic and cervical region during routine dissection of undergraduate students of Indian origin in Kasturba Medical College, Mangalore. RESULTS: The usual three-branched aortic arch was found in 56 cadavers (91.4%); variations were found in six cadavers (9.6%); 4.8% presented common origin of the carotid arteries; 1.6% had bi-innominate sequence, and the same specimen had left coronary artery arising from arch of aorta directly; 1.6% presented right subclavian artery arising directly from the aorta; 1.6% had left vertebral artery a branch of aortic arch. Five out of six cadavers with anomalous aortic arch branching pattern were females. One male cadaver presented anomalous origin of left vertebral artery directly from the arch. CONCLUSION: The wide spectrum of variations in the anatomical arrangements of the aortic arch branches in the Indian population was at par with other populations of the world. Although anomalous origins of the aortic arch branches are merely anatomic variants, accurate information about them is vital for vascular surgery in the thorax, head and neck region.

A comprehensive predictive scoring method for difficult laparoscopic cholecystectomy.

Abstract: Context: Laparoscopic cholecystectomy (LC) is the gold standard cholecystectomy. LC is the most common difficult laparoscopic surgery performed by surgeons today. The factors leading to difficult laparoscopic cholecystectomy can be predicted. Aims: To develop a scoring method that predicts difficult laparoscopic cholecystectomy. Settings and Design: Bidirectional prospective study in a medical college setup. Materials and Methods: Following approval from the institutional ethical committee, cases from the three associated hospitals in a medical college setup, were collected using a detailed proforma stating the parameters of difficulty in laparoscopic cholecystectomy. Study period was between May 10 and June 12. Preoperative, sonographic and intraoperative criteria were considered. Statistical Analysis Used: Chi Square test and Receiver Operater Curve (ROC) analysis. Results: Total 323 patients were included. On analysis, elderly patients, males, recurrent cholecystitis, obese patients, previous surgery, patients who needed preoperative Endoscopic retrograde cholangiopancreatography (ERCP), abnormal serum hepatic and pancreatic enzyme profiles, distended or contracted gall bladder, intra-peritoneal adhesions, structural anomalies or distortions and the presence of a cirrhotic liver on ultrasonography (USG) were identified as predictors of difficult LC. A scoring system tested against the same sample proved to be effective. A ROC analysis was done with area under receiver operator curve of 0.956. A score above 9 was considered difficult with sensitivity of 85% and specificity of 97.8%. Conclusions: This study demonstrates that a scoring system predicting the difficulty in LC is feasible. There is scope for further refinement to make the same less cumbersome and easier to handle. Further studies are warranted in this direction.

Psychological effects of the Coronavirus disease-2019 pandemic

Abstract: Going by the current physical reach of the COVID-19 pandemic in the population there are bound to be long-term socio-economic and psychological implications. The swift rise of fear and anxiety among people due to uncertainty of the disease are coupled with essential yet socially disruptive measures like lockdowns and quarantines. These can lead to significant psychological and psychiatric disturbances such as post-traumatic stress disorder, depression, anxiety, panic disorders, and behavioural disorders. Predisposing factors include staying away from family, loneliness, misinformation on social media, financial insecurity and stigmatization. Healthcare workers, too, have a high risk of developing post-traumatic stress disorder and burnout; therefore, it is paramount to understand and research the psychological impact and key determinants to prevent, identify, and manage such problems. Suggested actions include support lines for anxious people, tele-counselling, virtual connecting & help groups, encouraging meditation, conducting research on psychological consequences, and developing and utilising suitable interventions.