ICMR STS Projects

Ami Mehta - ICMR STS 2018

Electrophoretic pattern analysis of serum and urinary proteins in nephrotic syndrome

The prevalence of nephrotic syndrome diagnosis is 50 to 60 per year according to the pediatrician in this hospital. Accordingly, 25 samples will be considered which include all newly diagnosed patients as well as those under treatment as our subjects. 25 serum and urine samples of patients, will be collected from clinical biochemistry laboratory, sent for investigations and stored in -80°C till we proceed with the experiments. The total protein concentration will be determined using Biuret method. Even though polyacrylamide gel preparation for PAGE is a time-consuming and tedious process and requires an initiator and polymerizing catalyst, the pore size of polyacrylamide gels can be altered in a more controlled manner than that of agarose gels. Polyacrylamide gels have high resolving power while agarose gels have low resolving power. The obtained electrophoretogram will be compared for urinary and serum proteins patterns of the same patient, at the time of diagnosis, monitoring during treatment or as the disease progresses. 

Akhil Ashok - ICMR STS 2018

Development of an improved lymph node prediction score model in early stage squamous cell carcinoma of oral cavity based on histopathological parameters

Oral cancer continues to remain the leading cancer prevalent in India. Many parameters are known to affect the overall prognosis in patients afflicted with this neoplasm. Lymph node metastasis, however, is the most significant parameter affecting overall survival in patients of oral squamous cell carcinoma (OSCC). Cases of OSCC with cervical lymph node metastasis show a 50% decrease in survival and a higher incidence of distant metastasis. The histologic parameters which constitute the existent scoring system (The Aditi-Nuzhat Lymph-node Prediction Score (ANLPS) System) included such parameters as the T stage, grading of tumor, tumor budding, tumor thickness, depth of invasion, shape of tumor nest, lymphoid response at tumor-host interface and pattern of invasion, eosinophilic reaction, foreign-body giant cell reaction, lymphovascular invasion and perineural invasion. We come across hundreds of cases of OSCC at our centre. This score could potentially be of benefit in guiding therapy and prognosis. In this proposed project, we intend to add few more parameters which could possibly increase the sensitivity and the specificity of the score. These components include type of tumour invasion (expansile or infiltrating margins), satellite tumour nodules at advancing edge and presence or absence of a desmoplastic stromal response.

Anukriti Jain - ICMR STS 2018

Screening for hearing impairment among Type 2 diabetes mellitus patients and its bearing on Quality of Life at a tertiary care hospital in Coastal Karnataka

Diabetes mellitus is a recognized risk factor for hearing impairment in patients. The typical hearing impairment seen in diabetics is a bilateral sensorineural hearing loss. The study was aimed to assess hearing impairment among patients with T2DM and the association of hearing impairment on quality of life. A cross-sectional study was conducted among 196 patients, at a tertiary care referral hospital. Sociodemographic details, tuning fork tests, hearing handicap inventory and WHO-QOL BREF questionnaire was administered to the participants. It was noted that 17% of the subjects showed lateralization in Weber’s test for auditory function. In Rinne’s test, 15% of the subjects had Bone Conduction > Air Conduction bilaterally. Based on the responses to the hearing handicap inventory, 177 (90.3%) participants did not have any hearing handicap, 13 had mild to moderate handicap while only six (3%) participants reported severe handicap. With respect to WHO QoL domain wise mean scores, the highest average score was seen in the environmental domain (104.4 ±14.5), while the least score was in the social domain (40.2±5.4). The WHO QoL domain wise mean scores were comparable across the normal and abnormal categories for Rinnes’ and Weber’s test. Over 70% of the diabetic subjects with an abnormal Rinne’s test were aged >60 years. Across all the screening instruments, the higher proportion of abnormal tests belonged to BPL category. The only significant variable identified was age for Rinne’s test (chi-square value – 11.72, p value – 0.001) and hearing handicap inventory (chi-square value – 9.85, p value – 0.002).

Himanshu YN -ICMR STS 2018

Impact of preeclampsia drugs labetalol and nifedipine treatment on neural stem cell proliferation and their neuronal differentiation

Preeclampsia or pregnancy induced hypertension (PIH) is seen in up to 8% of the pregnancies, mostly after 20 weeks of pregnancy. It is well known to cause severe maternal and fetal morbidity and mortality worldwide. Although the use of antihypertensive drug is debatable for PIH due to its unknown impacts on the growing fetus, treatments are selected for individual patients with PIH by comparing risk versus benefits. Labetalol and nifedipine are most commonly used antihypertensive drugs during pregnancy apart from methyldopa. Among them, methyldopa is a α2-adrenergic receptor agonist and labetalol is a non-selective β adrenergic blocking agent while nifedipine is a calcium channel blocker. According to FDA, methyldopa is a class B drug with no known adverse reactions while labetalol and nifedipine are class C drugs having unknown potential adverse effects on human fetal growth. During second and third trimester, active growth of brain occurs with rapid proliferation of neural stem cells. Neural stem cells are building blocks of brain, their proliferation plays a central role during this critical period of brain development for generating large number of neural progenitors and multiple types of functional neurons and glia . Thus, it is critical to assess the impact of class C drugs labetalol and nifedipine on the proliferation and differentiation of neural stem cells to assess their impact on normal brain development. Since neural stem cells generated from human induced pluripotent stem cells (hiPSCs) are very well mimicking the in vivo brain developmental path , we planned a brief study to find the effect of labetalol and nifedipine on the proliferation and neuronal differentiation of human neural stem cells.

Pritam A Shetty - ICMR STS 2018

Patient Outlook on Bedside Teaching in Medical Schools

Medical Education involves a multitude of diverse aspects, imparting both knowledge and skills to the students. Bedside teaching is considered to be one of the most important part of medical education. It provides students with the experiences of understanding patients and their problems, taking medical history, clinical reasoning, professionalism, performing procedures or even witness the doctors performing. It’s the mutual connection between the doctor, students and the patients that make this system work well. Since the transition, patient’s rights and informed consent have gained greater visibility, and patients now have the right to choose whether to have medical students involved in their care or not. These facts have prompted us to conduct this study to assess patients’ attitude towards bedside teaching in our hospital and to identify factors that may potentially influence their decision to allow or refuse medical students’ participation in their care, so that academic institutions would be adequately prepared to address different scenarios in order to guarantee high quality medical education. A detailed study of the results can make us think over certain debatable aspects and come to conclusions regarding methods to improve the patient-student relationship, taking care of aspects on both sides. Possible ideas for changes in the medical system could be thorough prior explanation to the patient about medical students by the doctor. Decreased involvement of students in certain issues and any other suggestions from the patients.

Shivani Shenoy K - ICMR STS 2018

Knowledge, attitude and practices about transmission and prevention of Hepatitis B infection among healthcare workers

Hepatitis B virus is a major cause of morbidity and mortality among health care professionals (HCPs) . Among HCPs there is a four-fold higher risk of infection due to exposure to blood, blood products, other body fluids and needle-stick injuries. Having enough knowledge and proper attitude toward the infection is crucial in preventing its occupational exposure. To assess the level of knowledge, attitude and practices regarding transmission and prevention and vaccination coverage of Hepatitis B infection among HCPs. Consenting subjects comprising of consultants, junior residents, nursing staffs, laboratory technicians and house-keeping staff working in the hospital were given a pre-tested, semi-structured questionnaire containing questions pertaining to knowledge, attitude and practices about Hepatitis B infection transmission and prevention. A total of 361 HCPs participated in the study with 78.9% having a satisfactory knowledge about Hepatitis B infection. More than three fourth of, 306 (84.7%) the respondents believed that their job puts them at risk of HBV infection and 357 (98.9%) believed vaccination is necessary for the preventing Hepatitis B infection. However, only 66% of the subjects had satisfactory practice. Spearman rank correlation revealed significant positive correlations between knowledge-attitude (r = 0.589, p < 0.01), knowledge-practice (r = 0.689, p < 0.01) and attitude-practice (r = 0.599, p < 0.01). It was reported that about 7% of the subjects didn’t complete the course of vaccination and only 112 (37%) of the subjects had their immunity status evaluated post vaccination. Although knowledge and attitude towards hepatitis B were good but the gaps in the practice can be minimized by implementing policy guidelines on preventive measures, compulsory vaccination and evaluation of immunity status at regular intervals.

Shreya Sinha - ICMR STS 2018

Stress in Parents of Low Birth Weight Preterm babies and Outcome of Family Integrated Care

Preterm birth is a stressful event for parents. Preterm birth has two consequences: the medical and neurophysiological condition that puts the child in danger and it also affects the parent-child relationship. Preterm birth hampers the physical and neurological development of the child. Infants are physically, psychologically, and emotionally separated from their parents. Studies have shown that 13% of the mothers remain depressed till 27 months after birth and worry about child health among Neonatal intensive care unit (NICU) parents. Parent stress, anxiety, depression, and fatigue alter parenting behaviour and perception of parental competence, parent-infant interaction, and ultimately infant outcomes such as cognitive development, emotional regulation, and health. Many programs, such as kangaroo mother care, skin-to-skin care, and family-centred care have been developed to encourage greater parent involvement. However, most programs still adhere to the common premise that only NICU professionals with special skills can provide care for the infant, and parents are generally delegated to a supportive role. Studies have shown that Family Integrated Care( FIC) is feasible and safe and results in improved weight gain among preterm infants. This innovation has the potential to improve not only weight gain and breast feeding, but also other short and long-term infant and family outcomes. Based on current knowledge, evaluation of parents during infant NICU hospitalization is needed to assess current responses to stress associated with the NICU experience and to identify parents at risk for extended physical and emotional consequences. Parent stressor scale (PSS: NICU) 1 can be used to quantify the stress level in NICU parents using a Likert scale (1 = not at all stressful, 5 = extremely stressful). 

Snehal Nayak - ICMR STS 2018

Usefulness Of Estimation Of C Reactive Protein Levels In Predicting The Severity Of Dengue Fever

Dengue is one of the rapid spreading pandemic diseases in the world. Global incidence and its geographical distribution has rapidly increased in the last 5 decades as per the current statistics. India alone has witnessed a huge outbreak and doubling of cases in the recent past.  Dengue has a wide spectrum of clinical presentation and unpredictable outcomes. Early case classification of dengue is essential for triage, appropriate treatment and also for making decision regarding the requirements of admission for the management of patients. These aspects are significant in case of sudden outbreak of the disease and in resource limited health care setups. However, there is no specific laboratory test for the early prediction of the severity of dengue. At present warning signs laid down by WHO is being used as a key in assessing the severity, despite its low sensitivity in the early phase. Therefore a reliable, simple biomarker is essential for the clinicians for effective management of the patient at early phase.C-reactive protein is an acute phase protein synthesized in all inflammatory conditions. It also distinguishes between the viral and bacterial infections. CRP levels are altered in severe dengue. Hence, to improve the case classification of dengue by severity, Serum CRP levels are measured.