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Biomedical subjects

A Nair

Publications and source records attributed to A Nair.

At least 55 records · Page 3Linked to original sources
PubMed1994

Dementia in elderly patients: can the 3R mental stimulation programme improve mental status?

The aim of this study was to determine whether the 3R mental stimulation programme can improve the mental status score (MSS) of a group of patients with dementia attending a day care centre. Fifteen patients with dementia attending a day care centre were exposed to the 3R stimulation programme over eight weeks while 15 controls were not. All patients from both groups were subjected to pre- and post-exposure questionnaires modified from the Mental Status Questionnaire of Kahn et al. A mental status score (MSS) was thus calculated on both occasions. All patients in the exposed group showed an improved mental status score, with the mean 'pre-exposure' and 'post-exposure' scores of 4.4 and 7.3, respectively (p < 0.001; paired t test). In contrast, the mental status scores of 12 control patients had deteriorated and mean 'pre-exposure' and 'post-exposure' scores were 4.1 and 3.4, respectively (p < 0.05; paired t test). Using multiple covariance analysis, the adjusted 'post-exposure' mean mental status score was 7.1 for the exposed and 3.6 for the controlled group (p < 0.001). The 3R programme appears to be effective for short-term mental stimulation of demented elderly people.

Aged↗
PubMed1994

Do long-standing nodular goitres result in malignancies?

The records of 506 patients with histologically proven nodular goitre treated by thyroidectomy between January 1966 and July 1988 were reviewed. There were 21 patients with thyroid carcinoma in nodular goitre giving a proportion of 4.1%. There was an almost equal ratio of papillary to follicular carcinomas in the patients with malignancy occurring in a multinodular goitre (11 papillary to 9 follicular). One had an anaplastic lesion. These patients had swelling for a longer period, 9.11 years, as compared with an average of 5.48 years for those with only nodular goitre (P = < 0.01) using the Student's t-test. The male to female ratio in those with multinodular goitre alone was 1:10.8 while in those with carcinoma in multinodular goitre was 1:3.2. Comparing these two groups, the odds ratio of malignancy among males was 2.82 (95% confidence limits of the odds ratio being 1.4-5.5). This indicates that males with multinodular goitre had a significantly higher chance of developing a malignancy, Chi-squared value 5.74 (P < 0.05).

Adenocarcinoma, Follicular↗
PubMed1993

Difficult to control epilepsy in childhood--a long term study of 123 cases.

One hundred and twenty three children with difficult to control epilepsy (DCE) were studied. Etiological factors which predominated included an age of onset less than 2 years (71.5%), male sex (69%), mixed, secondarily generalized, or complex partial seizures (77%), mental retardation (64%) and neurological abnormalities (52%). Static neurological disease was seen in 63%, with only 17% having idiopathic disease. Identifiable epileptic syndromes were noted in less than half the children. The surface EEG was abnormal in 84%, and correlated with the clinical seizure type in 81%. CT and MRI were helpful in diagnosis in only 38 and 48%, respectively, and even less so in therapy decisions, 7 and 16%, respectively. Prior therapy revealed the use of polytherapy in 61% and suboptimal dosages in 78%. In the 100 patients with adequate follow up, 67% showed a good response, i.e., 35% complete and 32% more than 50% reduction in seizures. Only 11% were total nonresponders, and most were severely retarded. Major treatment strategies employed included switching to monotherapy, supranormal dosages and avoidance of sedative anticonvulsants. Side effects were noted in 41% with 8 cases being life threatening. Overall mortality was 4%. We concluded that risk factors for DCE included early age of onset, mental retardation and certain seizure types. EEG was more helpful than neuroimaging. Treatment responses were favorable, especially in those with normal intellect and the use of normal or high dose monotherapy.

Age of Onset↗
PubMed1993

Primary hyperaldosteronism--diagnostic approach and management.

Primary hyperaldosteronism was detected in 1% of patients evaluated for secondary hypertension in a referral hospital in Southern India. The presence of hypokalemia with inappropriate kaliuresis (24 hr. urine K > 20mEq) was an important diagnostic clue. High resolution CT scans were found to be useful for localising the tumour. Preoperatively nifedipine and spironolactone were employed to correct hypertension and hypokalemia. The same drugs were also found to be excellent for long-term control of hypertension and hypokalemia in patients who had bilateral adrenal hyperplasia and aldosteronism.

Adult↗
PubMed1992

Trends in ambient levels of DDT and HCH residues in humans and the environment of Delhi, India.

Monitoring of DDT and HCH residues in abiotic and biotic components of the environment of Delhi during 1988 to 1989 revealed low to moderate levels of these insecticides in soil, earthworms, birds, buffalo milk, water, freshwater clams, fish, human fat, human blood and breast milk samples. Total HCH residues were less than those of DDT in all the samples. This survey indicates (in spite of the continued use of DDT and HCH in the country) a general decline in the levels of DDT residues in most of the samples studied when compared to previous surveys. Although the levels of DDT and HCH residues in fish and river water were below the permissible limits, those in human samples remained fairly high.

Animals↗
PubMed1992

Anovaginal and rectovaginal fistula in patients with Crohn's disease.

Between 1971 and 1991, details of 67 women with perianal Crohn's disease were recorded prospectively using the Cardiff classification. Two groups were identified according to the presence (n = 29) or absence (n = 38) of anorectal Crohn's fistula involving the vagina. Patients in both groups were of a similar age and had had Crohn's disease for a similar period before diagnosis of perianal involvement. The incidence of associated perianal lesions, superficial ulcers, cavitating ulcers, other fistulas and strictures was not significantly different between the two groups. A greater proportion of patients with anorectal-vaginal fistulation (n = 15) had distal intestinal Crohn's disease (rectal or contiguous colorectal) compared with women with no vaginal fistulation (n = 14). A range of therapies was used to manage women with perianal Crohn's disease, from local surgery to a defunctioning stoma and/or proctectomy. Only 13 of 38 women with perianal Crohn's disease but no vaginal fistula required a defunctioning stoma or proctectomy, whereas 18 of 29 with anorectal-vaginal fistulation underwent these procedures (P < 0.05). A vaginal fistula has a considerable adverse effect on the outcome of perianal Crohn's disease.

Adult↗
PubMed1992

Necrotizing enterocolitis in a perinatal centre.

Thirty-five neonates developed radiologically proven necrotizing enterocolitis (NEC) over a 40 month period. They were 28 +/- 2 weeks gestation, and weighted 1094 +/- 411 g at birth. Eighteen infants (51%) required surgery and three (8.5%) died. The incidence was 6.7% in the very low birthweight (VLBW) infants. A large proportion of NEC (60%) presented beyond 10 days of life. An inverse relationship between gestation and age of onset was observed. The age of presentation was 22 +/- 13 days (range 10-53 days) for the 18 infants less than or equal to 28 weeks compared with 7 +/- 5 days for those over 28 weeks (P less than 0.01). Five NEC infants had bacteraemia which occurred 2-7 days prior to gastrointestinal symptoms of NEC, and four were staphylococcal. Compared with infants controlled for gestation, there was no significant differences observed in perinatal events or feeding history. We concluded that an immature gastrointestinal system is vulnerable to NEC even beyond the early neonatal period.

Enterocolitis, Pseudomembranous↗
PubMed1992

Treatment with hypertonic dextrose and insulin in severe hyperkalaemia of immature infants.

Over a three-year period, 12 infants received dextrose/insulin infusions for severe hyperkalaemia from a mean age of 24 h. The infants were born after 24 to 26 weeks of gestation and weighed 730 +/- 172 g (mean +/- SD) at birth. Serum potassium concentration ranged from 7.4 to 8.4 mmol/l (7.7 +/- 0.4 mmol/l; mean +/- SD). Four had cardiac arrhythmias. All infants showed an initial response, serum potassium concentration decreased below 6.5 mmol/l in 5 +/- 2 h. In two infants, rebound hyperkalaemia occurred and was resistant to treatment; both infants died, one during an exchange transfusion. In the other 10 infants, infusions were ceased at a mean postnatal age of 53 h. Hyperglycaemia was the major problem during infusion and was resistant to increases in insulin concentrations. Normoglycaemia was achieved in 10 infants. The hypertonic solution consisted of a dextrose/insulin ratio of 2.2 +/- 0.6 g/IU, which delivered glucose at a rate of 0.46 +/- 0.15 g/kg/h, in addition to the pre-existing stable maintenance glucose intake.

Blood Glucose↗
PubMed1992

Aldrin and dieldrin residues in human fat, milk and blood serum collected from Delhi.

1. Aldrin and dieldrin residues were monitored in the fat, breast milk and blood serum from female residents of Delhi. 2. The average aldrin and dieldrin contents were 0.048 and 0.099 ppb in adipose tissue, 0.003 and 0.060 ppb in breast milk and 0.004 and 0.002 ppb in blood serum, respectively. 3. The older donors contained higher levels of aldrin and dieldrin in their adipose tissue. 4. Primagravidae contained more of these chemicals in their breast milk. 5. A positive correlation was observed between the aldrin concentration in adipose tissue and breast milk, and that in adipose tissue and blood serum. Similarly, a significant correlation was found between dieldrin in adipose tissue and blood serum. 6. The levels of aldrin and dieldrin were low in samples from residents of Delhi when compared to those in developed countries.

Adipose Tissue↗
PubMed1991

Levels of aldrin and dieldrin in environmental samples from Delhi, India.

Aldrin and dieldrin residues in soil, earthworms, water, fish and clams from different sites in Delhi were monitored. Concentrations of aldrin and dieldrin were found to be higher in earthworms than in soil. Concentrations of dieldrin were higher in fish than the ambient water, but the concentration of aldrin in the ambient water was the same as that in fish and clams.

Aldrin↗
PubMed1991

Clinical aspects of health screening for senior citizens.

Out of a total of 1,224 subjects aged 55 years and above who attended the Senior Citizens' Health Care Centres for health screening, new medical conditions were picked up for the first time in 472 subjects, giving an overall pick-up rate of 38.6%. This rate increased with age rising from 29.4% among those aged 55-64, to 45.8% among those aged 65-74 and to 51.4% in the 75 years and above. This trend was found to be of statistical significance (p greater than 0.001). The objective of the health screening programme in the Senior Citizens' Health Care Centres is to detect geriatric problems early in order to take adequate steps to prevent disability and dependency states, so that the elderly may continue to live at home. In this paper, we studied the 472 subjects with abnormal medical conditions. The pick-up rates (per 100) of medical conditions were as follows: cataract 13.8, other eye conditions 6.5, deafness 4.5, other ear conditions 2.7, diabetes mellitus 2.5, hypertension 2.2 and osteoarthritis 1.6. The socio demographic profile and the medical conditions of the 472 subjects were also studied, with implications on their quality of life in future. We recommend that physicians specifically screen for diabetes mellitus, hypertension, eye and ear abnormalities in all asymptomatic elderly, during periodic health check ups.

Aged↗
PubMed1991

The elderly reach independence through a community stroke rehabilitation programme.

Cerebrovascular disease resulting in stroke had shown a rising trend in the last decade among the elderly population in Singapore. To prevent dependency states, a home stroke rehabilitation programme was implemented in 1988 with the help of staff nurses trained to provide rehabilitation for stroke patients at home. These nurses were specially trained by experienced physiotherapists. A simple format was used to identify patients with good rehabilitation potential, while they were in the acute hospitals. The 244 stroke patients were studied by their age, sex, the status of motivation to go through rehabilitation and the level of family support. Out of the 224, 139 patients who had good and fair rehabilitation potential were referred to the Senior Citizens' Health Care Centres (SCHCCs) directly, as they already had sitting and standing balance. Twenty-two patients with poor rehabilitation potential were provided home nursing care. The rest of 83 patients with good and fair rehabilitation potential needed home rehabilitation before being referred to the SCHCC, as they had no sitting and standing balance. These 83 patients followed-up at home, were studied by their age, sex, rehabilitation potential, family support, number of nurse home visits and duration of rehabilitation required to gain independence in mobility. By 12 weeks, 84% of the patients improved in their goals towards independence irrespective of age. Marked improvement were shown in all the ten areas studied namely concentration, head control, return of tone, sitting balance, standing balance, mobility, power of upper and lower limbs, co-ordination and continence.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1991

Health screening for the elderly--the Singapore Senior Citizens' Health Care Centres' experience 1986-1989: an overview.

A systematic health screening programme for the elderly aged 55 years and above was implemented in the first Senior Citizens' Health Care Centre (SCHCC) in 1986. This programme was expanded to two more SCHCCs by 1989. The first 1,224 clients aged 55 years and above, who attended this programme in the first three SCHCCs were studied in this paper. The characteristics of the elderly who voluntarily attended the SCHCCs for health screening were studied with respect to their referrals, socio demographic status, whether they had regular physician care, the existing medical problems and the new medical problems picked up at health screening. Of those screened, 49.6% were referred for the programme by relatives and self, and 28.2% by community centres, thus, showing that community and family supported the programme. Only 7.2% of referrals to the screening programme came from general practitioners and 4% from polyclinic doctors. It is interesting to note that 40% of clients had no regular physician care. About two thirds (57.2%) had one or more existing chronic medical conditions or disability at the time of screening. The majority with existing conditions had hypertension (24.8%) and diabetes (15.5%). Other existing conditions were ischaemic heart disease (6.2%), cataract (3.9%) and asthma (3.6%). The pick-up rate of medical conditions among the clients at the time of health screening was 38.6% for the whole group. This showed a rising trend from the younger to the older age groups being 29.4% in the age group 55 to 64, to 45.8% in the age group 65 to 74, and 51.4% in the age group 75 years and above (p less than 0.001). Some of the topical issues related to a health screening programme for the elderly have been discussed.

Aged↗
PubMed1990

Pregnancy outcome in women exposed to toxic gas at Bhopal.

A study was undertaken to compare the effects of exposure to the toxic gas in pregnant women in Bhopal with pregnant women in a similar, unexposed area. A high incidence of spontaneous abortions (24.2%) in the pregnant women exposed to the toxic gas was observed as compared to those in the control area (5.6%). Other indices of adverse reproductive outcome, such as the rate of still birth and congenital malformation were not found to be different. The perinatal and neonatal mortalities were significantly higher in the affected area (6.9 and 6.1% respectively), as compared to the control area (5.0 and 4.5% respectively).

Accidents, Occupational↗
PubMed1990

Evaluation of care of the elderly in the Senior Citizens' Health Care Centre.

In an effort to expand the community based services for the elderly, the Senior Citizens' Health Care Centre (SCHCC) was developed in 1986, with the support of the Ministry of Health providing the policy direction and staff, and the Home Nursing Foundation bearing some of the operating expenditure. The first 171 clients with impaired physical functions who attended the centre for day care and rehabilitation were studied. They were exposed to a programme package inclusive of health and social areas. Specific areas covered were Activities of Daily Living (ADL), simple mental status examination and use of mobility aids. The average duration of treatment at the centre required by the 95 day care clients was 84 days or 20 visits, while the 76 rehabilitation clients required 71 days or 13 visits. The 68.4% of the clients who completed their treatment at the centre successfully, reached the goals towards independence set for them well within 3 months of their admission into the centre. This was noted when scores were compared at admission and discharge. Due to various reasons, 31.6% did not complete the treatment. This study shows how the elderly with physical impairments may benefit from the programmes in the SCHCC.

Activities of Daily Living↗