Abstracts of Annual Research Day 2013 The 4th Annual Research Day th 15 November 2013 SCUDDER AUDITORIUM CHRISTIAN MEDICAL COLLEGE VELLORE 1 Abstracts of Annual Research Day 2013 Schedule for 4th Annual Research Day Poster Installation 11.00 am Categories: Basic Sciences Medicine Specialties Surgery Specialties Field Work and Epidemiology Nursing Poster Session and 01.00 - 03.30 pm Judging: Lunch 12.30 pm Oral Presentation 2.55 pm – 6.12 pm Special Addresses Vice Principal - Prof. Nihal Thomas Director - Prof. Sunil Chandy Principal - Prof. Alfred Job Daniel Special Oration by Chief Guest - Prof. V.I Mathan (Retired Distinguished Scientist) Prize Distribution and Valediction 6.50 pm 2 Abstracts of Annual Research Day 2013 ANNUAL RESEARCH DAY – 2013 MEDAL AND ORATION FOR DISTINGUISHED RETIRED FACULTY Prof. V.I. Mathan graduated MBBS from the then Madras University in 1960 and obtained his MD in General Medicine (1965) and PhD (1973) in Epidemiology from the same University through the Christian Medical College, Vellore. He joined the faculty of the Christian Medical College, Vellore in 1965 in the Department of Medicine and was appointed as Professor of Medicine and Gastroenterology in 1973. He started the Department of Gastroenterology at Vellore in 1972 and by the time of his retirement it had grown to one of the largest departments in the country. Prof. Mathan was actively involved in research from his registrar days and has published over 140 papers. He became the Head of The Wellcome Trust Tropical Disease Research Unit at Vellore from 1975. In 1992 this unit was recognized as the Indian Council of Medical Research Centre of Advanced Research on Enteric Diseases. Prof. Mathan’s research work has been recognized by a variety awards and academic distinctions including Honorary Membership and Fellowship of the Royal College of Physicians of London, Honorary Memberships of the British Society of Gastroenterology and The Royal Society of Tropical Medicine and Hygiene. He was elected a Fellow of the Indian National Science Academy in 1991 and awarded the Dr. Ambedkar Medal for lifetime Research Contributions in 1996 by the Indian Council of Medical Research. In addition to his clinical and research activities, Prof. Mathan has been a distinguished Medical Administrator. He headed the department of Gastroenterology at Vellore from its start in 1972 to 1993. He was Medical Superintendent of the Christian Medical College Hospital from 1988 to 1993 and it’s Director from 1993 to 1997 when he retired on superannuation. Subsequent to that Prof. Mathan was the Associate Director of the International Centre for Diarrhoeal Disease Research in Dhaka, Bangladesh for three years and a Senior Consultant to UNAIDS working with the National AIDS Control Organization in Delhi for a year. He occupied the Indian Council of Medical Research Chair of Epidemiology at the National Institute of Epidemiology, Chennai till Sep. 2007. Currently he is Hon. ICMR Consultant, and is the Chair of the Project Advisory Committee on Health Sciences of the Department of Science and Technology, the Scientific Advisory Group of the Division of Epidemiology and Communicable Diseases of the Indian Council of Medical Research and the Technical Committee for the Establishment of Model Rural Health Research Units of the Department of Health Research, Government of India. For his pioneering research work on Tropical Enteropathy, Tropical Sprue, Epidemiology of Enteric Infections and Acute Diarrhoea, Vitamin B12 Absorption. The role of Luminal Endotoxin in determining the Severity of Diarrhoea and the identification of potential antagonists of Endotoxin and developing a research team which has continued to be productive for nearly two decades after his re tirement. Prof. V I. Mathan is awarded the Annual Research Day distinguished retirted faculty medal and oration for the year 2013. 3 Abstracts of Annual Research Day 2013 ABSTRACTS FOR ORAL PRESENTATION 4 Abstracts of Annual Research Day 2013 “DIVING INTO THE UNKNOWN REALM: STRENGTHENING EMERGENCY CARE AT PRIMARY HEALTHCARE LEVEL WITH A HANDY TOOL KIT.” (A proposal to the Indian Government) Alen Thomas, MBBS 2010, CMC Vellore Dr. Suresh David, Professor, EM Dept, CMC Vellore Dr. Moses Kirubairaj, Assistant Professor, Department of Family Medicine Aim: Trauma or Emergency situations can strike anytime in this fast moving world and people lose their lives much before they reach the Taluk level hospital. There are numerous published papers that emphasize on the fact that early intervention can significantly bring down Discussion: the mortality rate. Organised positioning will help the health This concept note paper focuses on care professional to be more alert and training, equipping and empowering effective. Handy-kit would be helpful and enthusiastic health professionals at effective for early intervention purposes. primary healthcare level to provide first Essential Emergency drugs are available aid and to expedite rapid transfer to for on-site stabilisation. The provision of hospitals. a Global Positioning Service device would be useful to provide pin-point location of Methodology: the emergency as informed by the call PART 1 Training of EM Commando centre team. It is also useful for identifying potential accident-prone areas PART 2: Putting into practice in their respective areas. However, recruiting people for this purpose may be initially difficult as this is a whole new approach at the primary health care level. Budget: BUDGET for entire kit is approximately. Rs 5000/- 5 Abstracts of Annual Research Day 2013 Results: 7. Retd. Professor, Dept of Clinical Epidemiology, Christian Medical College, The results have not yet been released as Vellore the concept is under study and pilot study would be conducted soon with the help of Background and objectives: the government. Rapid Diagnostic tests (RDTs) are used in Conclusion: most dengue endemic resource limited centres for early and economical I strongly urge that Emergency medicine diagnosis. Hence, we evaluated the should be strengthened at the Primary performance of four commercially care centre and followed effectively with available RDTs during an outbreak season the training of EM commandos and in a tertiary hospital in south India utilization of the recommended handy kit. against a consensus clinical criterion as This would significantly reduce mortality reference standard and establish their and morbidity and together we can build ability to differentiate between acute a better world. primary and secondary infection. Methods: “EVALUATION OF THE PERFORMANCE 281 adult patients presenting with OF SERODIAGNOSTIC KITS FOR community acquired acute febrile illness DENGUE INFECTION IN A TERTIARY (< 14 days duration) during the outbreak CARE CENTRE OF SOUTH INDIA. “ season were recruited for the study. The reference standard, to group patients into Rajat Choudhari1, Harshita Nori1, dengue or non dengue, was based on the Shubhanker Mitra2 K.P.P Abhilash2, above clinical criteria with any of the Vishali Jeyaseelan3, Asha Mary constitutional symptoms - myalgia, Abraham4, O.C Abraham5, John A Jude6, headache and rash and supportive Jayaprakash Muliyil7 laboratory findings - thrombocytopenia and leucopoenia with other etiologies like 1. Second year medical student (batch of scrub typhus, leptospirosis, malaria and 2011), MBBS, Christian Medical College, enteric fever proven negative by reliable Vellore tests. The samples were tested using 2. Assistant Professor, Dept of Medicine, Panbio, SD, J. Mitra and Reckon to Christian Medical College, Vellore compare their performance. SPSS version 3. Assistant Professor, Dept of 16.0.1 was used for statistical analysis. Biostatistics, Christian Medical College, Vellore Results: 4. Professor and Head, Dept of Virology, Christian Medical College, Vellore 132 cases were classified as dengue and 5. Professor, Dept of Medicine, Christian 149 as non-dengue. Comparing the IgM Medical College, Vellore results against the reference standard, the 6. Professor, Dept of Microbiology, sensitivities of Panbio, SD, Reckon and Christian Medical College, Vellore J.Mitra were 97.7%, 64.3%, 14% and 36.4% and specificities were 87.8%, 96.6%, 99.3% and 68.7% respectively. 6 Abstracts of Annual Research Day 2013 plasma levels due to variability in volume NS1 detection sensitivities of the SD, of distribution and clearance among these Reckon, and J.Mitra (Panbio doesn’t patients. Since meropenem is a time detect NS1) were 20.9%, 18.6% and dependant antibiotic, extended infusion 27.1% while specificities were 97.3%, seems be a better alternative to short 96.6% and 92.5%, respectively. infusion in achieving adequate plasma The RDTs could not adequately concentrations. differentiate between acute primary and secondary dengue. Methods: In series combination, Reckon with Panbio and SD gave a specificity of 99.9 % This was an observational study in and 100 % respectively while, in parallel critically ill patients who were prescribed Panbio and SD gave the best sensitivity 1 gm meropenem thrice daily. Dose and (99.2%) duration of infusion were according to treating doctor’s discretion. Meropenem Conclusion: plasma concentrations were assessed using high performance liquid In a dengue endemic resource limited set chromatography and analyzed. The up, IgM assay of Panbio RDT is a reliable, percentage of time (60% and 100% of easily available, economical test whose inter-dose interval), the plasma specificity can be increased by series concentrations were above