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Biomedical subjects

A Kuruvilla

Publications and source records attributed to A Kuruvilla.

106 records · Page 6Linked to original sources
PubMed1981

Synthesis and pharmacological evaluation of sulfonium analogues of dopamine: nonclassical dopamine agonists.

In order to test whether the nitrogen/ammonium moiety in the dopamine molecule is required for dopaminergic activity, we have synthesized two sulfonium analogues of dopamine and tested them for biological activity in an in vivo and in an in vitro system. These analogues have provided a means of investigating (1) the ability of the sulfonium function to serve as a bioisostere for the dopamine amino group and (2) whether charged molecules have the ability to bind to dopamine receptors. Both sulfonium analogues, 1 and 2, as well as dopamine, when injected directly into the striatum of rats, previously lesioned unilaterally with 6-hydroxydopamine (6-OHDA), produced circling behavior. The potency of the sulfonium analogues was approximately one-tenth that of dopamine. The effects of all three compounds on circling were inhibited by the dopamine antagonist haloperidol. In addition, both sulfonium analogues inhibited the high affinity binding of radiolabeled dopamine to a crude membrane fraction prepared from the striatum. This study suggests that the nitrogen atom found in th dopamine molecule is not essential for dopaminergic activity, since the nitrogen can be replaced by a sulfonium functional group for this activity.

Animals↗
PubMed1975

Arsenic poisoning in childhood. An unusual case report with special notes on therapy with penicillamine.

An unusual care of arsenic ingestion involving five children is reported, which involved the process of sublimation. As2O3 was inadvertently heated in a charcoal barbecue, and the meat cooked thereon was contaminated. It is possible that the sublimation may have potentiated the toxicity of the usually mildly toxic, relatively unsoluble As2O3. Penicillamine was used in the latter part of the therapy in three cases after initial dimercaprol, and the clinical effect of penicillamine was particularly dramatic in one case in which dimercaprol discontinuation had been accompanied by recurrent symptoms. Remarks on the mode of action of penicillamine are made. More work needs to be done to establish the possible role of penicillamine in arsenic poisoning.

Adolescent↗
PubMedDate not supplied

Spinal muscular atrophy--a clinicopathologic analysis.

In this retrospective study the clinical features in 16 children with spinal muscular atrophy (SMA) were reviewed and classified into three stages. The muscle biopsy specimen were routinely processed with liquid-nitrogen-isopentane and 8 micron thick frozen-sections were studied for histochemical changes. The clinical features in Type III SMA resembled with limb-girdle muscular dystrophy and the muscle biopsy was useful in distinguishing these two entities. It is being evaluated that prenatal diagnosis of SMA is possible with DNA technology developed recently in our country.

Biopsy, Needle↗
PubMedDate not supplied

Patients' reference for evening pay clinic at a tertiary care hospital.

To lessen overcrowding in the regular morning OPD and obtain better patient satisfaction, Evening Pay Clinic in a tertiary care hospital with daily OPD attendance between 1000 and 1200 patients was conceptualised. To elicit patients' response to the proposed system a survey with a structured questionnaire among 202 randomised sample of patients was conducted. Patient preference depended on distance of their home from the hospital as well as availability of suitable transport to reach the pay clinic and the likelihood of their being able to go back by the same evening after their encounter with the hospital was over. The majority of the patients preferred the proposed system as it promised quick and personalised service and the attendance by the doctors of their choice.

Choice Behavior↗
PubMedDate not supplied

An expert system for the diagnosis of epilepsy: results of a clinical trial.

BACKGROUND: Artificial intelligence is an area where computer systems are used to solve real-life problems that require expert human intelligence. Expert systems serve as an effective alternative to supplement the dearth of human experts in a narrow domain of applications. We developed an expert system named SEIZ using DIAGNOS (an expert system shell for diagnostic applications) for the diagnosis and management of epilepsy. METHODS: A clinical trial was done to test the reliability of SEIZ. The clinical and demographic data from the medical records of 50 patients with epilepsy who attended an epilepsy clinic were provided to the expert system. The system-generated diagnosis was compared with the clinical diagnosis. RESULTS: The seizure types and epileptic syndromes for the 50 patients included generalized -tonic-clonic seizure (14), absence (4), complex partial seizure (18), simple partial seizure (4), juvenile myoclonic epilepsy (5) and other epileptic syndromes (3). There were two cases of hysterical conversion reaction. There was concordance in the diagnosis between the expert system and clinician in 47 cases (94%). The overall sensitivity was 94% and the specificity was 100% for absence, generalized tonic-clonic seizures, simple partial seizures and juvenile myoclonic epilepsy; 94% for complex partial seizures and 98% for hysterical conversion reaction. CONCLUSION: This expert system could generate reliable diagnoses for patients with epilepsy. Such a system may be useful for a doctor in a remote or peripheral area where an expert on epilepsy is not available.

Adult↗
PubMedDate not supplied

Explanatory models and common mental disorders among patients with unexplained somatic symptoms attending a primary care facility in Tamil Nadu.

BACKGROUND: Patients with unexplained somatic symptoms are commonly seen in primary care. We assessed the explanatory models and common mental disorders in patients with unexplained somatic symptoms attending a primary care facility in a rural area of south India. METHODS: One hundred consecutive patients diagnosed to have unexplained somatic symptoms attending a primary care facility were examined. The Tamil version of the Revised Clinical Interview Schedule was used to assess common mental disorders and the Tamil version of the Short Explanatory Model Interview was used to assess their explanatory models. RESULTS: Ninety-eight patients thought that their problem was serious. Sixty-nine, 41 and 40 claimed that it affected their work, family and social lives, respectively. Forty-two of the patients believed in black magic. Forty-four patients satisfied the ICD-10 PC criteria for common mental disorders. Depression was the commonest diagnosis (63.6%). Patients with psychiatric diagnoses admitted to emotional problems (chi2 = 46.9; p < 0.001), and felt that their problems affected their family (chi2 = 38.5; p < 0.001), social life (chi2 = 28.6; p < 0.001) and work (chi2 = 34.4; p < 0.001). More patients who satisfied criteria for psychiatric diagnosis felt that their problems were moderate or very serious (chi2 = 21.5; p < 0.001) and they feared they might become disabled or die (chi2 = 12.2; p < 0.001). Psychiatric syndromes were significantly associated with belief in black magic (chi2 = 7.01; p < 0.01). These associations remained statstically significant after adjusting for age, gender, literacy and socioeconomic indices using logistic regression. CONCLUSION: The majority of patients held strong beliefs regarding the physical nature of their complaints, believed In the serious nature of the problem and feared disability or death. There is a need to elicit specific explanatory models regarding the nature of illness in patients who present with somatic symptoms without organic causes. Understanding the patient's perspectives is a prerequisite for providing the necessary treatment and to dispel fears.

Adult↗
PubMedDate not supplied

Prescription patterns and cost analysis of drugs in a base hospital in south India.

BACKGROUND: In the rural areas of developing countries the cost of drugs is a major concern to both physician and patient; yet there are few data on prescribing patterns and expenditure. We examined the cost of commonly prescribed drugs in a community health care programme in a base hospital of the Christian Medical College, Vellore. METHODS: The study was carried out over a period of 3 months during which 2756 prescriptions were analysed. The number and type of drugs prescribed and the frequency and total cost of the prescriptions were noted. RESULTS: The number of drugs prescribed for each patient ranged from 1 to 7 with a mean (SD) of 2.4 (1.1). The most commonly prescribed groups of drugs were vitamins, analgesics, antibiotics, sulphonamides and anti-inflammatory agents. The mean (SD) cost per prescription was Rs 8.8 (8.6). The expenditure on the most commonly used drugs was approximately 50% of the total cost. The cost per prescription was less than Rs 10 in 70% of the cases. All the drugs were from the World Health Organization's essential drugs list. CONCLUSIONS: Most prescriptions for drugs given at our hospital could be afforded by villagers.

Costs and Cost Analysis↗