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Biomedical subjects

A Kumar

Publications and source records attributed to A Kumar.

At least 163 records · Page 9Linked to original sources
PubMed2004

Laparoscopic live-donor nephrectomy: modifications for developing nations.

OBJECTIVE: To describe modifications to laparoscopic live-donor nephrectomy (LLDN) to make it more cost-effective for developing countries; LLDN was developed as a better alternative to conventional donor nephrectomy, with advantages of an earlier return to normal activities and smaller scars, but is not popular in developing countries because of high cost of disposable items. PATIENTS AND METHODS: From January 2000 to January 2002, 148 LLDNs were performed, of which two used a hand-assisted technique, 17 the standard technique, 79 a modified laparoscopically assisted cost-saving approach and 50 by the modified technique. In the latter approach the kidney was delivered through a 6-8 cm anterior subcostal flank incision. In last 50 patients we further modified the technique, clipping the hilum using endoclips and delivering the kidney by holding the lateral pararenal fat through a 5 cm iliac fossa incision. RESULTS: The mean age, operative duration, warm ischaemia time, blood loss, analgesic requirements, pain score and hospital stay were comparable among the various techniques used. Re-exploration was required in four patients (bleeding in two, trocar-induced bowel injury in two). Immediate complications after surgery occurred in 20% of patients. Using endoclips, the cost was considerably reduced, from $400 to $290. The iliac fossa incision was aesthetically pleasing and more acceptable to patients. CONCLUSION: These modifications are relevant in the context of a developing nation, as they provide all the benefits of LLDN at reduced cost and with better cosmetic results.

Adult↗
PubMed2004

Submitral aneurysm.

Explore the source record for details and available documents.

Cardiac Output, Low↗
PubMed2004

Prescription monitoring of anti-hypertensive drug utilisation at the Panjab University Health Centre in India.

INTRODUCTION: The present pilot study was conducted in order to establish the drug-prescribing trend of anti-hypertensive agents at the Panjab University Health Centre in India. METHODS: A pilot study of six-month duration was conducted at the Panjab University Health Centre. The information was collected from the patients attending the outpatient department through a random sample method. World Health Organisation-based prescription-auditing proforma was used for data collection. RESULTS: This study revealed that most of the male patients were on monotherapy (60 percent). In the monotherapy category, four classes of drugs were used. These were calcium channel blockers (48.1 percent), beta-blockers (46.2 percent), ACE inhibitors (3.9 percent) and diuretics (1.9 percent). Among monotherapy drugs, calcium channel blockers were prescribed most whereas diuretics were least used. Among those who were treated with drug combinations, 92.1% received two drugs and 7.9 percent received three drugs. In combination therapy, a two-drug combination consisting of beta-blockers and calcium channel blockers was given to the majority of the patients. Overall, 57.8 percent patients were treated with a single anti-hypertensive drug and 42.2 percent were treated with anti-hypertensive drug combinations. CONCLUSION: The present study represents the current prescribing trend for anti-hypertensive agents and it highlights certain shortcomings in the existing prescribing practice. There is a considerable scope for improvement, particularly the under-utilisation of diuretics in the present prescribing pattern of anti-hypertensive drugs.

Antihypertensive Agents↗
PubMed2004

Detection of pneumolysin in cerebrospinal fluid for rapid diagnosis of Pneumococcal meningitis.

BACKGROUND & OBJECTIVES: Pneumolysin, a toxin produced by Streptococcus pneumoniae is associated with virulence and is found in all invasive isolates. Its role as a diagnostic tool has recently been exploited. Most of the methods used are based on molecular techniques and are not cost-effective. The present study was undertaken to evaluate a simple, rapid and cost-effective method to detect pneumolysin in CSF as a diagnostic test for pneumococcal meningitis. METHODS: A total of 75 CSF samples from children with presumptive diagnosis of acute pyogenic meningitis or encephalitis were subjected to Gram stain, culture and pneumolysin detection by Cowan 1 staphylococcal protein A co-agglutination technique. RESULTS: Pneumolysin was detected in 26(78.8%) of 33 culture proven CSF samples and 4(9.5%) of 42 culture negative samples. Antigen detection by Co-A had a specificity of 90 per cent and a sensitivity of 79 per cent when compared with culture. Compared to Gram stain, pneumolysin Co-A had a specificity and sensitivity of 91.0 and 92.0 per cent respectively. INTERPRETATION & CONCLUSION: Detection of pneumolysin was found to be a simple, low cost antigen detection assay for rapid diagnosis of pneumococcal meningitis, for routine use in the developing countries.

Agglutination Tests↗
PubMed2004

Immunogenicity and safety of hepatitis B vaccine (Shanvac-B) using a novel pre-filled single use injection device Uniject in Indian subjects.

BACKGROUND: Hepatitis B is a major public health problem, which has now been controlled to some extent by vaccination especially with the recombinant hepatitis B vaccine, which has been proven to be safe and efficacious since its introduction in the 1990s. But problems of unsafe injection practices still persist. Now newer delivery devices like uniject are available for making vaccination very safe. OBJECTIVE: To evaluate the immunogenicity and safety of the Hepatitis-B (Shanvac-B) vaccine in Uniject pre-filled device administered to healthy adults and infants at 0, 1, 2 months schedule. METHODS: A total of 122 healthy subjects (62 adults and 60 infants) were administered three doses of the recombinant Hepatitis-B vaccine using Uniject pre-filled device. Blood samples for antibody titer estimation were taken before vaccination and 4-6 weeks after third dose. Subjects, parents or guardians were given diary cards to record any adverse reactions. RESULTS: Protective immune responses to the vaccine were seen in 96.4% of adults and 100% of infants who completed the study. The Geometric Mean Titers (GMT) in adults and infants were 518.5 and 385.41 mIU/ml respectively. Mild fever, itching, and swelling at injection site were the most common side effects observed. CONCLUSION: The safety and immunogenicity of the Hepatitis B Vaccine in the novel pre-filled device Uniject was effectively demonstrated in the present study.

Adolescent↗
PubMed2004

A preliminary survey of patients' views on awareness, information, choices and expectations in women undergoing hysterectomy.

A questionnaire-study was undertaken among 50 women to take note of their views on awareness, information, choices and expectations on various aspects of hysterectomy performed on them. Most women (92%) did not know the type of hysterectomy and none of them was offered the alternative treatment, various types of hysterectomy done, type of anaesthesia used and hormone replacement therapy. A total of 96% wanted the surgeon to spend time with them explaining to them about various aspects of surgery and 46% thought the staff was sympathetic to them. A total of 26 women (52%) preferred to solve their problems with self-help groups (association of women with similar problems) and 84% wanted a leaflet to be distributed to them about various aspects of hysterectomy. This study concluded that Indian women to be involved in the decision making about their healthcare.

Adult↗
PubMed2004

Frequency and role of hepatitis-C virus and type II cryoglobulinemia in membranoproliferative glomerulonephritis.

BACKGROUND: Many studies have claimed a major role of chronic hepatitis-C virus (HCV) infection in immune-mediated diseases such as membranoproliferative glomerulonephritis (MPGN). Chronic HCV infection is also known to produce essential mixed cryoglobulinemia (EMC), which in turn may manifest as vasculitis and cryoglobulinemic MPGN. OBJECTIVE: The aim of the study therefore, was to determine frequency of association and pathogenetic role of HCV infection as well as that of EMC in MPGN patients. METHODS: Fifty-three adult patients of MPGN were studied for HCV, HBsAg, EMC, C3, anti-nuclear antibody (ANA), rheumatoid factor serologically. Histopathology, immunofluorescence (IF) were conducted in all patients and electron microscopy (EM) in those who were found HCV positive. Simultaneously 37 follow-up patients of HCV associated chronic hepatitis were investigated for EMC, renal functions and urinalysis done for evidence of glomerulonephritis (GN). RESULTS: Thirteen percent MPGN patients were HCV positive, however, no viral particle could be seen in electron microscopy in glomeruli of these patients. There was no serologic evidence of HCV induced immune complex GN. None of the MPGN patients showed cryoglobulinaemia. Similarly none from HCV associated chronic hepatitis group had EMC nor showed evidences of glumerulonephritis. CONCLUSION: Thirteen percent of adult MPGN patients in north India were seropositive for HCV, indicating significant association. However, clear evidence in favour of its pathogenetic role was lacking in our study. Secondly, this study reveals that MPGN is non-cryoglobulinemic and HCV is not a major cause in our population compared to what is reported from other countries. These observations need confirmation by a larger study.

Adult↗
PubMed2004

Factors influencing refusal by relatives of brain-dead patients to give consent for organ donation: experience at a transplant centre.

To analyse the reasons for family refusal for donating the organs of their deceased relatives, 33 families were approached and interviewed as a part of the consent process. Thirty of these refused and their reasons for refusal were documented. In 83%, the principle reason for refusal to give consent was the non-acceptance of brain death. Superstitions relating to being reborn with a missing organ (that had been donated) in 40% or that tampering with the body would not free their dead relatives from the cycle of life-death-rebirth in 26% were next most frequently voiced. A delay in funeral (23%), lack of consensus within family members (17%), fear of social criticism (10%), dissatisfaction with the hospital staff (10%) and being unaware of their deceased relatives' wishes (6%) were the other reasons cited.

Attitude to Health↗
PubMed2004

Studies on persistence of temephos in sandy loam soil under field and laboratory conditions.

Persistence of temephos was studied in soils under field and laboratory conditions in sandy loam soil to evaluate the effect of moisture and formulations on persistence. The insecticide was applied as 50 EC and 1 % S.G. granules @1 kg a.i. ha-1 on surface of the soil' and residues were determined spectrophotometrically. The soil was fortified separately with dilute emulsion of EC and suspension of granular formulation at 5 ppm level and incubated at different moisture levels at 25:1:1 degrees C for 90 days. The residues of temephos from both the formulations persisted upto 55 days in soil when applied @1 kg a.i. ha(-1). In 40 days 92 and 91.43 per cent temephos was dissipated from soil treated with EC and granular formulations, respectively. There was no leaching or downward movement of the toxicant beyond 7.5 cm. The half-life of temephos under field condition for EC and granular formulations were 18.14 and 20.44 days, respectively. Statistically, there was no significant effect of two formulations of temephos on its persistence. But at three different moisture conditions viz. airdry, field capacity and sub-merged, the difference was significant at 5% level.

Environmental Monitoring↗
PubMed2003

Pressure tuning of electron-phonon coupling: the insulator to metal transition in manganites.

An extended temperature and pressure-dependent investigation is carried out on a La0.75Ca0.25MnO3 sample exploiting the infrared absorption technique coupled to a diamond anvil cell. The pressure dependence of the insulator to metal transition temperature T(IM) is determined for the first time up to 11.2 GPa. The T(IM)(P) curve we propose to model the present data has an exponential-like behavior with an associated characteristic pressure P* playing the role of a decay constant. It is found that the equivalence between an external and an internal (chemical) pressure holds over a limited range of pressure, namely, P< or =2P*. Moreover, a certain universality character is associated with the proposed model curve in its ability to account for a large class of low-disorder manganites characterized by intermediate electron-phonon coupling.

Journal Article↗
PubMed2003

Community based retrospective study of sex in infant mortality in India.

OBJECTIVE: To determine whether the imbalance in the sex ratio in India can be explained by less favourable treatment of girls in infancy. DESIGN: Analysis of results of verbal autopsy reports over a five year period. SETTING: Community health project in urban India. MAIN OUTCOME MEASURES: Deaths from all causes in infants aged less than 1 year. RESULTS: The sex ratio at birth was 869 females per 1000 males. The mean infant mortality was 1.3 times higher in females than in males (72 v 55 per 1000). Diarrhoea was responsible for 22% of deaths overall, though twice as many girls died from diarrhoea. There were no significant differences in the numbers of deaths from causes such as birth asphyxia, septicaemia, prematurity, and congenital anomalies. In 10% of deaths there was no preceding illness and no satisfactory cause was found. Three out of every four such deaths were in girls. CONCLUSIONS: The excess number of unexplained deaths and deaths due to treatable conditions such as diarrhoeal disease in girls may be because girls are regarded and treated less favourably in India.

Autopsy↗
PubMed2003

Degradation and detoxification of endosulfan isomers by a defined co-culture of two Bacillus strains.

The degradation of alpha and beta isomers of endosulfan by a two-member bacterial co-culture was studied. Results were similar whether the two isomers were present individually or together, as in technical endosulfan. The degradation of both isomers was accompanied by the formation of endosulfan diol and endosulfan lactone. Accumulation of the metabolite, endosulfan sulfate was, however, not observed during the reaction with either of the isomers. The microbial degradation of endosulfan isomers was also accompanied by a decrease in its toxicity to the test organism Tubifex tubifex Müller.

Animals↗
PubMed2003

NIR to UV absorption spectra and the optical constants of phthalocyanines in glassy medium.

Optical absorption studies of phthalocyanines (Pc-s) in borate glass matrix have been reported for the first time. Measurements have been done corresponding to photon energies between 1.1 and 6.2 eV for free base, manganese, iron, nickel, molybdenum, cobalt and copper phthalocyanines. Several new discrete transitions are observed in the UV-vis region of the spectra in addition to a strong continuum component of absorption in the IR region. Values of some of the important optical constants viz. absorption coefficient (alpha), molar extinction coefficient (epsilon), absorption cross-section (sigma(a)), band width (delta lambda), electric dipole strength (q2) and oscillator strength (f) for the relevant electronic transitions are also presented. All the data reported for Pc-s in the new matrix have been compared with those corresponding to solution, vapor and thin film media.

Borates↗