Academic Presentations

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Now showing 1 - 20 of 29
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    3D electroanatomic mapping; clinical applications and role in life threatening arrhythmias
    (SCTIMST, 2024-02-03) Jyothi Vijay, MS
    3D electroanatomical mapping is an invasive procedure used in cardiac Electrophysiology for identifying the mechanisms, circuits and treat various cardiac arrhythmias. SCTIMST Electrophysiology has a pioneering role as well as one of the high volume centre in 3D mapping and ablation of Cardiac arrhythmias in the country. On a day to day practice, this constitutes about 20-25% of work in our Electrophysiology lab, yet this technology remains elusive. The principle and clinical applications of 3D electroanatomical mapping is reviewed. Few illustrative examples of potential role in life threatening cardiac conditions will be discussed. The potential for research and future directions will be discussed.
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    Assessment of diabetes-related distress among patients with Type 2 Diabetes mellitus attending cardiology units of a tertiary level hospital- A cross-sectional study.
    (SCTIMST, 2024-03-02) Suja Raj, L
    A person living with diabetes requires significant lifestyle changes to achieve their glycemic targets and avoid its complications. These demands can be frustrating and overwhelming, which affects the physical, psychological, and social aspects of everyday life, known as "Diabetes distress." A descriptive cross-sectional study was conducted among 200 Type 2 DM patients to estimate the prevalence of diabetes-related distress (DRD) and determine the associated socio-demographic and disease-related factors. Data was collected using the standardized tool- Diabetes Distress Scale (DDS-17). The details of the study and results will be presented
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    Autologous Blood Transfusion - The Chitra Experience
    (SCTIMST, 2024-06-15) Angel Mary Sam
    During the COVID-19 pandemic, there was a huge shortage of blood donations in our Blood Centre. To alleviate the crisis, we re-introduced the Autologous Transfusion programme. Autologous transfusion is one in which the donor and recipient of blood is the same individual. This avoids serious adverse effects caused by allogeneic blood transfusion, alleviate blood shortages and save blood resources. We could perform autologous transfusion in patients undergoing neurosurgeries as well as vascular surgeries. Methods such as Pre-deposit Autologous Donation, Acute Normovolemic Hemodilution and Intra-operative Cell Salvage were used according to the case specificity and patient conditions. We found that autologous transfusion is feasible in neurosurgical cases like Meningioma, Schwannoma, AV Malformations and spine surgeries and for vascular surgical cases like abdominal aortic aneurysms and thoracic mass lesions. The requirement of allogeneic blood and blood components intra-operatively can be significantly reduced by autologous blood transfusion. It can be practiced routinely and, is a safe alternative during any shortage or pandemic.
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    “Bombay Blood group” sharing the Chitra experience
    (SCTIMST, 2024-06-15) Punkesh Patel
    Blood transfusions are now part of the medical and surgical treatment in today’s patient care. It’s been more than a century back only ABO blood groups were discovered and blood banking started to give crossmatch compatible blood units to the patient in need. Patients with rare blood groups becomes a trouble for clinicians and Transfusion Medicine specialists in getting a compatible blood for them and Bombay blood group phenotype is such an example who can only be transfused with blood from another Bombay phenotype donor. Bombay blood group is a rare autosomal recessive phenotype within the ABO blood group. The estimated prevalence is 1 in 10,000 in India and 1 in 10,000,000 outside of India. First discovered by Dr. Y.M. Bhende, C. K. Deshpande and H.M Bhatia in 1952 at Bombay (now “Mumbai”). These patients can be mistaken with ‘O’ group if not typed with patient’s serum, and may lead to severe hemolytic transfusion reactions. At our Blood Centre we maintain rare donor registry for Bombay blood group donors. Interdepartmental communication between the clinicians and Blood Centre becomes crucial along with adopting the patient blood management and blood conservation techniques.
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    Case Report of a child with Transposition of Great Arteries(TGA) with regressed Left Ventricle (LV) who underwent Arterial Switch Operation(ASO)
    (SCTIMST, 2024-03-02) Anjusha, M
    TGA with regressed LV is a challenging situation for a congenital heart surgery ICU team. Expertise nursing care forms an integral part in the patient outcome. The child underwent Arterial Switch Operation under ECMO standby and had gone through several challenges in the postoperative period and was successfully discharged to home. Knowledge, skill, commitment and teamwork make the congenital heart surgery a success thereby saving small hearts.
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    Cryoablation
    (SCTIMST, 2023-12-30) Narayanan Namboodiri, KK
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    Data Science for Public Health: Journey of a PhD Scholar
    (SCTIMST, 2024-04-20) Arun Mitra, Peddireddy
    Overview: Data Science has opened new avenues for addressing complex public health problems and demonstrated that it can drive significant improvements in health services and policy-making. This presentation outlines my journey as a PhD scholar at the Achutha Menon Centre for Health Science Studies (AMCHSS) and my transition from public health to data science. The presentation will showcase some of the key projects including (a) AMCHSS COVID-19 Dashboard, (b) ICMR National COVID-19 Testing Database Project, (c) Trends in Caesarean Sections, (d) Disease Classification using Retinal Images, (e) Access to Stroke Facilities in India, and (f) Capacity Building in Public Health Data Science. The presentation will end with a brief overview of my PhD thesis on improving Maternal and Child Health services in tribal communities, illustrating both the challenges faced and learnings about the potential of data science to transform public health landscapes, particularly among Funderserved communities.
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    Determinants of technical success and mid-term patency rates of endovascular recanalization of thoracic central venous obstruction in patients on renal replacement therapy: A single-centre study
    (SCTIMST, 2024-05-18) Jayakrishnan, R
    Aim: To evaluate the factors affecting the technical success and patency rates of endovascular recanalization of thoracic central venous obstruction. To evaluate the differences in patency rates between various anatomical segments of stenosis of the thoracic central veins. A single centre Prospective study was conducted to include 72 patients of chronic kidney disease presenting with features of thoracic central venous obstruction and undergoing primary endovascular treatment from January 2018 to May 2023. Patient demographics, symptoms, existing co-morbid conditions, lesion location, history of previous jugular or subclavian catheter insertions were documented. Periodic follow-up was done as part of institutional protocol at 1, 3, 6, 12 months. Technical success was defined as residual stenosis <30%. Tapered beak morphology of venous obstruction p=0.05) and long segment occlusion (p=0.05) (defined as more than 5cm in the study) were associated with technical failure. Zones prone for extrinsic compression (from clavicle, first rib, and aorta in the retrosternal space) were a significant predictive factor of poor primary patency (p<0.01). In the two-year follow-up of venous stents, a higher number of stent restenosis was noted at the site of extrinsic compression in the costoclavicular space. Location of the stenosis/ occlusions in the areas of extrinsic compression was a significant negative predictor of patency. Majority of the stent restenosis occurred at the sites of extrinsic compression by the first rib.
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    Efficacy of infrapopliteal angioplasty on wound healing in patients with diabetic foot ulcer
    (SCTIMST, 2024-05-18) Venkata Subbaih, A
    Wound healing in patients with diabetic foot ulcer is influenced by the interplay of adequate glycemic control, infection, microangiopathy and vascular compromise. The WIFI (Wound Ischemia Foot Infection) score helps identify patients likely to benefit from endovascular revascularisation. It is therefore important to evaluate and identify the clinico-radiological factors affecting early wound healing. After taking approval from the institutional ethical committee, 107 patients with non-healing diabetic foot ulcer for more than 6 weeks and presenting to interventional radiology or vascular surgery out-patient clinic were prospectively enrolled. Patients with glycosylated hemoglobin levels more than 9 and WIFI score of more than or equal to 3 were excluded from the study. Patients with inline flow in a minimum of at least one infrapoliteal vessel were excluded from the study. Data on demographic, clinical, biochemical, imaging and angiographic data were collected and recorded in excel sheet. Technical success was defined as establishment of inline flow in atleast one of the infrapopliteal vessel. Clinical success was defined as healing of wound within 3 months of revascularisation. Data from the clinical follow-up and doppler assessments till 1 year at 3 monthly interval was recorded. Absence of recent history of smoking, adequate glycemic control and higher number of revascularized target vessels are associated with reduced incidence of major adverse limb events. However, poor glycemic control and wound infection are associated with delayed wound healing despite achieving technical success.
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    Epilepsy-associated lesions: Surgical Pathology
    (SCTIMST, 2024-04-06) Rajalakshmi, P
    Epilepsy is a complex disease and is caused by a variety of lesions that fall under various aetiologies such as malformative, genetic, infectious, metabolic, immune-mediated and neoplastic aetiologies. Patients’ evaluation and management require an interdisciplinary approach with the involvement of clinical assessment, electrophysiology, imaging and pathology. Definitive surgeries are offered to patients with poor response to anti-seizure medications and to those with a focal lesion. As Pathologists, we receive tissue samples from surgical resections of the epileptogenic focus. The most common lesions that are diagnosed histopathologically are hippocampal sclerosis, focal cortical dysplasias and neoplasms. This talk will give an overview of the various lesions that a neuropathologist encounters in the surgical samples of epilepsy-related disorders. How the samples are processed and assessed will be illustrated.
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    Evolution of Deep Brain Stimulation: Expanding Applications, Precision, and Cost-Effectiveness
    (SCTIMST, 2024-02-17) Asish, Vijayaraghavan
    Deep Brain Stimulation (DBS) is currently the standard of care for patients with advanced Parkinson’s disease with motor complications and selected forms of generalised dystonias and medically refractory essential tremors. The therapeutic power of neuromodulation comes from targeting and modulating a specific network. The majority of implanted neuromodulation devices currently operate in an “open-loop” mode of operation, providing a train of impulses to a particular anatomic target continuously or on a fixed duty cycle. DBS has continued to evolve with several advancements and ongoing research. Newer developments include “closed-loop systems” that adapt stimulation in real-time and “Directional stimulation” that allows for more precise targeting of specific brain regions while minimizing stimulation of surrounding areas. Implementing DBS encounters obstacles in developing nations. The Comprehensive Care Centre for Movement Disorders at Sree Chitra Tirunal Institute for Medical Sciences and Technology is at the forefront of exploring cutting-edge developments in DBS technology. Additionally, we are expanding our scope by offering DBS treatments for conditions beyond Parkinson's disease like generalised dystonia, and Tourette syndrome. We also collaborate closely with the Biomedical Technology Wing to develop indigenous hardware aimed at enhancing cost-effectiveness in DBS procedures.
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    Giant Intradural Vertebral Artery Aneurysms with Mass Effect
    (SCTIMST, 2024-03-30) Adarsh, Anil Kumar
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    Gross and histopathology of tissue - material interface in biocompatibility evaluation of biomaterials and medical devices- Part-I
    (SCTIMST, 2024-03-16) Sabareeswaran, A
    Safety evaluation is a critical component in medical device development. Biological evaluation should be carried out to identify the biological risk of biomaterials intended for medical devices after physicochemical characterization. Biocompatibility evaluation is a comprehensive terminology that broadly comprises in-vitro and in-vivo biological evaluations such as cytotoxicity tests, blood-material interactions, toxicological evaluation, etc. Testing for local effects after implantation is a major indicator for any candidate biomaterial safety, which is carried out in an appropriate animal model. The test sample is implanted into a site and animal species appropriate for the evaluation of the biological safety of the material. At the histopathology laboratory, we have tested metal, polymer, ceramic and composite biomaterials over the years as short and long-term implantation studies in rat and rabbit animal models. Gross and Histology images of compatible and non-biocompatible tissue response from intramuscular, subcutaneous and bone implantation in rabbit model and their relevance will be presented. The temporal variations of tissues responses and stages of foreign body reaction will be discussed. Specimen preparations, both soft and hard tissues starting from grossing, tissue processing, embedding, microtomy will be discussed. Gross and Histopathology evaluation of Chitra-TTK mechanical heart valve evaluated in-house in ovine(Sheep) and swine(Pig) model will be presented.
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    Long term outcomes of TEVAR for Thoracic Aneurysms - A single center study
    (SCTIMST, 2024-05-18) Apratim Roy Chaudhary
    Aims and objective: Thoracic Aortic Aneurysm (TAA) involves Ascending Aorta (40%) followed by DTA (35%), Aortic Arch (15%) and Thoraco-abdominal aneurysms(10%). TEVAR (Thoracic Endovascular Aneurysm Repair) is the standard of care for DTA and arch aneurysm, having mortality and morbidity advantages over surgical repair. Thoracic aortic diameter >5.5 cms, saccular aneurysm, growth of aneurysm >1 cm/year and symptomatic/ ruptured aneurysm were indications for repair. Existing literature shows excellent short term outcome of TEVAR for arch and DTA aneurysms, however literature regarding long term (>10 years) outcomes of TEVAR are scarce. Results: Technical success rate was 99%. Incidence of intra-procedural Type I endoleak was <10 % cases. On table aneurysm rupture/ dissection was seen in <2% cases. Neurological complications of embolic stroke and post-procedural para-plegia was seen in <5% cases. On long term CT follow-up, aneurysm sac regression was seen in about 70% cases, Type II endoleak and delayed Type I endoleak were observed in around 10% and 5% of cases respectively. Larger aneurysm size, Zone 0 proximal landing and increased aortic tortuosity were predictors of endoleak and re-intervention. Emergency TEVAR was associated with increased incidence of endoleak, neurological complications and mortality. Conclusions: TEVAR has a favourable outcome with respect to aneurysm sac regression. Our study is one of the first studies in the country, assessing the long term outcomes of TEVAR for arch and DTA aneurysms.
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    Long term surgical outcomes of Medulloblastoma – A single institution experience
    (SCTIMST, 2024-06-01) Lokesh, VD
    Medulloblastoma is the most common childhood malignant tumour of the brain and accounts for 20% of CNS tumours in children. These tumours are grouped into four morphological types viz 1. classical type, 2. desmoplastic nodular, 3. with extensive nodularity; 4. anaplastic/large cell variety. Based on molecular profile, Medulloblastoma has been reclassified into four subtypes: They are Wingless(WNT), Sonic hedgehog(SHH), Group 3 and Group 4 types. Medulloblastomas are risk stratified based on various factors into standard/average risk and high risk, according to clinical risk factors, histological features, molecular markers, age at diagnosis, extent of tumour resection and presence or absence of metastases. The main form of treatment for this condition is surgical resection followed by adjuvant therapies like chemotherapy and craniospinal radiotherapy. The main drawbacks of this treatment are significant side effects and long-term impairment due to adjuvant therapy and the morbidity related to surgery. Hence, we aimed to study this tumour in all aspects- clinico demographic profile, imaging characteristics, post operative complications, cerebellar mutism, recurrence, functional outcomes on follow up. In a small cohort of patients, we had a molecular data regarding the immunohistochemistry for small cohort of patients which was compared with Morphological type. This is one among the largest series of Medulloblastoma study in the world literature and maximum cases recorded from a single institute in India. Acknowledgement : Krishnakumar K1 , Easwer HV, George C.Vilanilam, Jayanand B Sudhir, Prakash Nair, Ganesh Divakar, Gowtham M, Deepthi N2, Rajaleksmy P2, Kesavadas C3, Bejoy Thomas3 ( 1=Department of Neurosurgery, 2= Department of Pathology, 3 = Department of IS & IR)
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    Management of Beneficiary Schemes – MRD Perspective
    (SCTIMST, 2024-01-20) Christudas, J
    The discussion will focus on various activities of Medical records department related to Management of patient Beneficiary Schemes for accurate and efficient revenue cycle while minimizing denied claims. It involves initial patient registration to denial Management each stage plays a vital role in ensuring the financial wheels keep turning smoothly. The following activities will be discussed in detail: • Beneficiary Identification • Transaction Management System • Claim submission, and • Denial Management.
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    Migration and Health: A public health priority
    (SCTIMST, 2024-04-20) Tijo, George
    Overview: Migration and health are now recognised as a global public health priority. The Sustainable Development Goals (SDGs) identify migration's pivotal role in achieving their promise of ‘to leave no one behind’. Internal migration is far more than international migration; in a country like India, sometimes the distance and cultures they transit may be more than international migration elsewhere. Thanks to COVID-19, we know how complex the migration nexus is in India. Additionally, India has a shortage of data addressing migration and health. So, during my PhD journey, I have been exploring the migration and health data in the Census and other large-scale surveys like the National Family Health Survey (NFHS) and the Longitudinal Ageing Survey in India (LASI). This presentation will take you through a few papers published and work in progress regarding migration, particularly migration and health.
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    Molecular Genetic testing and research activities
    (SCTIMST, 2024-01-06) Madhusoodanan, UK
    The discussion will focus on various current activities related to molecular genetics diagnostic tests and research publications. Specifically, we will address ongoing diagnostic tests, research publications, externally funded research initiatives, and future plans. The following activities will be discussed in detail: • Sanger sequencing tests • Streamlining DNA extraction protocol designed for DNA biobank and Sanger sequencing. • Modified lysosomal glucocerebrosidase assay for predicting lysosomal function in Parkinson’s disease (ICMR funded) • Exosomal miRNAs and proteins as markers for Parkinson’s disease (ICMR funded) • Collaborative research work and future directions
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