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Papers by Babu Krishnan

Asian Journal of Medical Sciences, Dec 1, 2022

Background: Diabetic peripheral neuropathy remains asymptomatic until the late stages. Hence, a n... more Background: Diabetic peripheral neuropathy remains asymptomatic until the late stages. Hence, a need exists for a reliable and sensitive biomarker for the early diagnosis of diabetic peripheral neuropathy. Aims and Objectives: This study aimed to evaluate serum neuron-specific enolase (NSE) reliability as a biomarker in diagnosing diabetic peripheral neuropathy. Materials and Methods: In the department of biochemistry and internal medicine, a cross-sectional study was conducted at Government Villupuram Medical College from May 2018 to January 2020. One hundred diabetes patients with peripheral neuropathy were compared with 100 patients without peripheral neuropathy. A diabetic neuropathy symptom (DNS) questionnaire and diabetic neuropathy examination (DNE) score were used for diagnosis. In addition, vibration position sense and NSE values were compared between the two groups. For statistical analysis, R studio and coGuide were used. Results: Comparisons between groups were based on age, sex, and other baseline parameters. Statistically, significance was observed between the two groups in outcome parameters such as VPB (right), VPB (left), and DNS (P<0.05). There was a weak positive correlation between NSE and DNS (r s value: 0.514, P<0.001). On the other hand, there was a strong positive correlation between NSE and DNE (r s value: 0.937, P<0.001). The NSE of 6.50 and above had a sensitivity of 53% (95%CI 42.76-63.06%) and specificity of 57% (95% CI 46.71-66.86%). Conclusion: NSE acts as a biomarker for diabetic peripheral neuropathy. Therefore, NSE can be used for the early diagnosis of diabetic peripheral neuropathy, thereby preventing a severe form of the disease.

Journal of Current Research in Scientific Medicine

Journal of Evolution of medical and Dental Sciences, 2013

BACKGROUND: Fever is a burning issue in the tropics and the most common cause of morbidity. Quite... more BACKGROUND: Fever is a burning issue in the tropics and the most common cause of morbidity. Quite frequently this fever goes undiagnosed because of many reasons like the lack of diagnostic facilities, insufficient epidemiological data available on causes of fever, and so on. This research study was aimed to find out the etiology and clinical markers of Acute Undifferentiated Febrile Illness [AUFI] among the rural population of Southern India. METHODOLOGY: This prospective, observational study was conducted at Government Villupuram Medical College and Hospital, a rural tertiary care centre in Tamil Nadu, India. Consecutive hospitalised adult patients [>16 years] with AUFI[5-14 days fever] were enrolled into the study from August 2010 to February 2012 [18 months].Upon enrollment, detailed history was recorded, physical examination done and basic blood tests including biochemical examination, smear study for malaria, blood cultures and serology for the commonly encountered infection...

Journal of Evolution of Medical and Dental Sciences, 2017

BACKGROUND The prevalence of Vitamin D deficiency has steadily risen in last few years. Environme... more BACKGROUND The prevalence of Vitamin D deficiency has steadily risen in last few years. Environmental factors like temperate climate, indoor lifestyle, diet prejudice as well as human behavioural patterns among ethnic groups significantly influence Vitamin D3 levels. In this study, we aimed to compare Vitamin D3 levels between two ethnic populations. Group 1 comprised of Islamic ladies who strictly adhered to purdah lifestyle. Group 2 was made up of matched non-Islamic ladies of lower socioeconomic strata with predominant outdoor labour work. MATERIALS AND METHODS This is a cross-sectional comparative study. In view of financial and logistic constraints, the sample size was chosen for convenience; 50 Islamic women and same number of non-Islamic women who attended the female OP clinics at Government Villupuram Medical College were interviewed and eligibility ascertained. After obtaining informed consent, detailed physical examination was done and findings documented in standard case proforma. Their serum samples were collected and analysed for Vitamin D3 levels and serum calcium. The results were pooled and analysed using SPSS software version 20. Independent 't' test was used to compare two groups' age, BMI, Vitamin D3 levels and serum calcium variables to find out if there is any significant difference between them. The Pearson's correlation coefficient was used to derive relationship between BMI and Vitamin D3 levels. P value < 0.05 is considered for significant. RESULTS A total of 100 women were studied in the age group of 20-80 years. The mean age of the study group was 45.38. The Body Mass Index of Group 1 was 29.19 +/-5.18 [Mean +/-SD], whereas in Group 2 it was 24.84 +/-3.85; 82% of candidates in C1 were overweight or obese compared to only 48% in C2 [P < 0.001]. The mean Vitamin D3 in C1 was 22.35 +/-6.89 and that of C2 being 25.51 +/-7.47 [p < 0.05]; 96% of C1 candidates and 86% of C2 candidates had subnormal D3 values. There was a significant negative correlation between BMI and Vitamin D3 levels in C1 [r=-0.54, 2-tailed]. CONCLUSION This study revealed that the prevalence of Vitamin D3 deficiency was almost the same in two different ethnic groups of women. However, the magnitude of deficiency was much more in Islamic women. The strong negative relationship between obesity and Vitamin D3 levels was also ascertained.

Journal of Evolution of Medical and Dental Sciences, 2017

BACKGROUND Systemic Lupus Erythematosus (SLE) is a multisystem disease that is caused by tissue d... more BACKGROUND Systemic Lupus Erythematosus (SLE) is a multisystem disease that is caused by tissue damage resulting from antibody and complement-fixing immune complex deposition. There is a wide spectrum of clinical presentations, which are characterised by remissions and exacerbation. Aims and Objectives-To study the pleuropulmonary involvement in SLE patients by clinical examinations and investigations including Chest X-ray, High Resolution Computerised Tomography (HRCT) and Pulmonary Function Test (PFT). MATERIALS AND METHODS This is a descriptive case series study of 40 patients with SLE. By using IBM SPSS statistical software Version 20.0, the Nonparametric Fisher Exact test was used to determine the association between HRCT and other variables for SLE Patients. RESULTS There were a total of 40 patients all of whom were women. The age distribution was 13-42 years [Figure 1]. The duration of illness was between 3 months-10 years. The symptom analysis revealed 45% had symptoms like pleuritic pain, cough with or without breathlessness [Figure 2]. There is an association between HRCT, Respiratory symptoms, X-ray findings and PFT findings. CONCLUSION 1. Pulmonary manifestations are common in SLE patients with frequency of involvement being 65%, which is higher than that reported in an Indian Study-9 to 54% (API 2003 7 th edn.). 2. Pleurisy was the most common pulmonary manifestation in SLE (45%). 3. Pneumonitis secondary to infections were the second common pulmonary manifestation (20%). 4. ILD was the third common pulmonary manifestation in our study (15%). It was previously believed that ILD was common in scleroderma and rheumatoid arthritis and low in SLE due to inadequate screening technique like chest x-ray. In studies utilising HRCT, 38% of 45 SLE patients with normal chest radiographs demonstrated pulmonary abnormalities consistent with some form of ILD. This concluded that HRCT was the sensitive procedure to find out pulmonary changes. 5. Pulmonary nodules were also found in 10% of Patients. Presence of uraemia is attributed in 1 case and in the other case no detectable cause could be found. 6. PFT in SLE patients is insensitive and nonspecific than HRCT in detecting pulmonary changes.

Asian Journal of Medical Sciences, Dec 1, 2022

Background: Diabetic peripheral neuropathy remains asymptomatic until the late stages. Hence, a n... more Background: Diabetic peripheral neuropathy remains asymptomatic until the late stages. Hence, a need exists for a reliable and sensitive biomarker for the early diagnosis of diabetic peripheral neuropathy. Aims and Objectives: This study aimed to evaluate serum neuron-specific enolase (NSE) reliability as a biomarker in diagnosing diabetic peripheral neuropathy. Materials and Methods: In the department of biochemistry and internal medicine, a cross-sectional study was conducted at Government Villupuram Medical College from May 2018 to January 2020. One hundred diabetes patients with peripheral neuropathy were compared with 100 patients without peripheral neuropathy. A diabetic neuropathy symptom (DNS) questionnaire and diabetic neuropathy examination (DNE) score were used for diagnosis. In addition, vibration position sense and NSE values were compared between the two groups. For statistical analysis, R studio and coGuide were used. Results: Comparisons between groups were based on age, sex, and other baseline parameters. Statistically, significance was observed between the two groups in outcome parameters such as VPB (right), VPB (left), and DNS (P<0.05). There was a weak positive correlation between NSE and DNS (r s value: 0.514, P<0.001). On the other hand, there was a strong positive correlation between NSE and DNE (r s value: 0.937, P<0.001). The NSE of 6.50 and above had a sensitivity of 53% (95%CI 42.76-63.06%) and specificity of 57% (95% CI 46.71-66.86%). Conclusion: NSE acts as a biomarker for diabetic peripheral neuropathy. Therefore, NSE can be used for the early diagnosis of diabetic peripheral neuropathy, thereby preventing a severe form of the disease.

Journal of Current Research in Scientific Medicine

Journal of Evolution of medical and Dental Sciences, 2013

BACKGROUND: Fever is a burning issue in the tropics and the most common cause of morbidity. Quite... more BACKGROUND: Fever is a burning issue in the tropics and the most common cause of morbidity. Quite frequently this fever goes undiagnosed because of many reasons like the lack of diagnostic facilities, insufficient epidemiological data available on causes of fever, and so on. This research study was aimed to find out the etiology and clinical markers of Acute Undifferentiated Febrile Illness [AUFI] among the rural population of Southern India. METHODOLOGY: This prospective, observational study was conducted at Government Villupuram Medical College and Hospital, a rural tertiary care centre in Tamil Nadu, India. Consecutive hospitalised adult patients [>16 years] with AUFI[5-14 days fever] were enrolled into the study from August 2010 to February 2012 [18 months].Upon enrollment, detailed history was recorded, physical examination done and basic blood tests including biochemical examination, smear study for malaria, blood cultures and serology for the commonly encountered infection...

Journal of Evolution of Medical and Dental Sciences, 2017

BACKGROUND The prevalence of Vitamin D deficiency has steadily risen in last few years. Environme... more BACKGROUND The prevalence of Vitamin D deficiency has steadily risen in last few years. Environmental factors like temperate climate, indoor lifestyle, diet prejudice as well as human behavioural patterns among ethnic groups significantly influence Vitamin D3 levels. In this study, we aimed to compare Vitamin D3 levels between two ethnic populations. Group 1 comprised of Islamic ladies who strictly adhered to purdah lifestyle. Group 2 was made up of matched non-Islamic ladies of lower socioeconomic strata with predominant outdoor labour work. MATERIALS AND METHODS This is a cross-sectional comparative study. In view of financial and logistic constraints, the sample size was chosen for convenience; 50 Islamic women and same number of non-Islamic women who attended the female OP clinics at Government Villupuram Medical College were interviewed and eligibility ascertained. After obtaining informed consent, detailed physical examination was done and findings documented in standard case proforma. Their serum samples were collected and analysed for Vitamin D3 levels and serum calcium. The results were pooled and analysed using SPSS software version 20. Independent 't' test was used to compare two groups' age, BMI, Vitamin D3 levels and serum calcium variables to find out if there is any significant difference between them. The Pearson's correlation coefficient was used to derive relationship between BMI and Vitamin D3 levels. P value < 0.05 is considered for significant. RESULTS A total of 100 women were studied in the age group of 20-80 years. The mean age of the study group was 45.38. The Body Mass Index of Group 1 was 29.19 +/-5.18 [Mean +/-SD], whereas in Group 2 it was 24.84 +/-3.85; 82% of candidates in C1 were overweight or obese compared to only 48% in C2 [P < 0.001]. The mean Vitamin D3 in C1 was 22.35 +/-6.89 and that of C2 being 25.51 +/-7.47 [p < 0.05]; 96% of C1 candidates and 86% of C2 candidates had subnormal D3 values. There was a significant negative correlation between BMI and Vitamin D3 levels in C1 [r=-0.54, 2-tailed]. CONCLUSION This study revealed that the prevalence of Vitamin D3 deficiency was almost the same in two different ethnic groups of women. However, the magnitude of deficiency was much more in Islamic women. The strong negative relationship between obesity and Vitamin D3 levels was also ascertained.

Journal of Evolution of Medical and Dental Sciences, 2017

BACKGROUND Systemic Lupus Erythematosus (SLE) is a multisystem disease that is caused by tissue d... more BACKGROUND Systemic Lupus Erythematosus (SLE) is a multisystem disease that is caused by tissue damage resulting from antibody and complement-fixing immune complex deposition. There is a wide spectrum of clinical presentations, which are characterised by remissions and exacerbation. Aims and Objectives-To study the pleuropulmonary involvement in SLE patients by clinical examinations and investigations including Chest X-ray, High Resolution Computerised Tomography (HRCT) and Pulmonary Function Test (PFT). MATERIALS AND METHODS This is a descriptive case series study of 40 patients with SLE. By using IBM SPSS statistical software Version 20.0, the Nonparametric Fisher Exact test was used to determine the association between HRCT and other variables for SLE Patients. RESULTS There were a total of 40 patients all of whom were women. The age distribution was 13-42 years [Figure 1]. The duration of illness was between 3 months-10 years. The symptom analysis revealed 45% had symptoms like pleuritic pain, cough with or without breathlessness [Figure 2]. There is an association between HRCT, Respiratory symptoms, X-ray findings and PFT findings. CONCLUSION 1. Pulmonary manifestations are common in SLE patients with frequency of involvement being 65%, which is higher than that reported in an Indian Study-9 to 54% (API 2003 7 th edn.). 2. Pleurisy was the most common pulmonary manifestation in SLE (45%). 3. Pneumonitis secondary to infections were the second common pulmonary manifestation (20%). 4. ILD was the third common pulmonary manifestation in our study (15%). It was previously believed that ILD was common in scleroderma and rheumatoid arthritis and low in SLE due to inadequate screening technique like chest x-ray. In studies utilising HRCT, 38% of 45 SLE patients with normal chest radiographs demonstrated pulmonary abnormalities consistent with some form of ILD. This concluded that HRCT was the sensitive procedure to find out pulmonary changes. 5. Pulmonary nodules were also found in 10% of Patients. Presence of uraemia is attributed in 1 case and in the other case no detectable cause could be found. 6. PFT in SLE patients is insensitive and nonspecific than HRCT in detecting pulmonary changes.