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Biomedical subjects

K R Sundaram

Publications and source records attributed to K R Sundaram.

At least 37 records · Page 2Linked to original sources
PubMed1993

Differential cell-mediated immune response to S. mutans in children with low and high dental caries.

Role of cell-mediated immune response (CMI) in dental caries was studied in 171 subjects, comprising of 86 children with low caries (LC), 31 with high caries (HC), and 54 age matched controls. [3H]thymidine mediated lymphoblast transformation test (LTT) using mutans streptococci antigen as stimulant was used to study the stimulation index (SI) of in vitro cultured lymphocytes from these children. The analysis revealed low stimulation index in high caries children whereas low caries children exhibited high stimulation index normally ranging between 2 to 6. The findings indicated that low caries children had strong CMI response as compared to high caries children. Although, the findings are based on limited number of samples, it certainly lays emphasis on protective or regulatory role of CMI in different phases of dental caries.

Adolescent↗
PubMed1993

Studies on antibacterial properties of gentian violet impregnated silastic.

The antibacterial activity of gentian violet (GV) impregnated silastic discs was studied by measuring the zone of inhibition (ZOI), (in mm) produced by the discs planted on Staphylococcus epidermidis seeded agar plates. The effect of varying concentration of GV, the duration of antibacterial activity and effect of autoclaving were studied. The mean ZOI for 1 per cent GV was 19.28 +/- 0.89 mm and for 2 per cent GV it was 22.55 +/- 0.71 mm (P < 0.001). There was no significant difference between GV concentrations of 2-5 per cent. Over a period of 1-5 wk, no significant difference was found in the antibacterial activity of GV for any of the concentrations. In each of the concentrations there was a significant reduction in the ZOI after multiple autoclavings. The study thus indicates that it is possible to impart antibacterial properties to silastic implants so that their colonization with Staph. epidermidis can be prevented and this finding has obvious clinical implications.

Cerebrospinal Fluid Shunts↗
PubMed1993

Postoperative pulmonary complications in patients with preoperative lung disease.

A prospective study was carried out on the incidence of pulmonary complications in 728 patients who underwent major surgical procedures at a reputed hospital in New Delhi. These patients were preoperatively assessed on the basis of history, clinical examination and bedside pulmonary function tests including PEFR, VC, FVC and FEV1. On the basis of these criteria, 212 patients had significant preoperative pulmonary disease, while 516 had normal lung functions. Postoperative pulmonary complications developed in 7.69 per cent of the patients. They were more frequent in smokers (P < 0.001) and in those with preoperative pulmonary dysfunction (P < 0.001). Their incidence was greater following thoraco-abdominal and musculoskeletal and miscellaneous operations compared to lower abdominal surgery (P < 0.001). The incidence was also higher following exposure to general anaesthesia compared to regional anaesthesia (P < 0.05). Pneumonia and atelectasis were the most common postoperative pulmonary complications. It was observed that the recovery of pulmonary functions was delayed in patients who developed postoperative pulmonary complications.

Adult↗
PubMed1992

Pulsed Doppler echocardiographic indices of left ventricular diastolic function in normal subjects.

To establish the normal limits for various pulsed Doppler echocardiographic indices of left ventricular diastolic function, 92 healthy volunteers aged from 5 to 75 years were prospectively studied. The influence of various variables including age, gender, body surface area, fractional shortening, and left ventricular mass on these parameters was also assessed. Mean (2SD) values for 15 direct and 11 derived parameters were analyzed from transmitral inflow velocity waveform. No statistically significant differences were observed between males and females for any of these parameters. On stepwise multivariate linear regression analysis, age was found to be an independent strong determinant (p less than 0.001) of peak velocity of early diastolic filling wave, area of atrial filling period, deceleration slope, normalized peak filling rate, and early filling fraction. There was a significant correlation between heart rate and time to peak early diastolic velocity, total diastolic time period, early diastolic period, atrial filling period, and atrial filling fraction. It was further observed that a significant correlation (p less than 0.001) persisted between both age and heart rate with area of early filling period, one-third filling area, one-half filling area, ratio of early to atrial peak velocity and area, atrial filling fraction, and one-third filling fraction. None of the parameters were found to correlate with fractional shortening or left ventricular mass. Thus an effort was made to establish normal limits for various Doppler-derived parameters in healthy volunteers for future comparison in diseased states.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

A prospective randomized trial comparing repeated endoscopic sclerotherapy and propranolol in decompensated (Child class B and C) cirrhotic patients.

A prospective randomized study was conducted to compare the efficacy of long-term endoscopic sclerotherapy vs. propranolol in Child class B and C patients with variceal bleeds within the 30 days before the study. Forty-five and 46 patients were randomized to receive sclerotherapy and propranolol, respectively, after preentry stratification for Child scores. Sclerotherapy was administered with 1% polidocanol at 10-day intervals until obliteration of varices was achieved. Propranolol was administered to achieve a reduction in resting pulse rate of 25%. Rebleeding occurred in 19 patients undergoing sclerotherapy and in 31 receiving propranolol (p less than 0.05). The number of episodes of rebleeding was higher (p less than 0.05) in the propranolol group (n = 64) than in the sclerotherapy group (n = 35). The mean bleeding risk factor, number of hospitalizations for rebleeding and blood transfusion requirement were also significantly higher in the propranolol-treated patients. The median bleed-free period was more than 36 mo in the sclerotherapy group and 2.5 mo in the propranolol group (p less than 0.01). The median survival time was significantly longer in the sclerotherapy group (greater than 36 mo) than in the propranolol group (greater than 24 mo). We conclude that in decompensated cirrhotic patients, long-term endoscopic sclerotherapy is superior to propranolol in preventing rebleeding and improving survival.

Adult↗
PubMed1992

Role of prophylactic antibiotics in surgery for advanced head and neck cancer.

Four regimens of prophylactic antibiotics were utilized in 122 consecutive patients of stages III and IV carcinoma of the upper aero-digestive tract undergoing major resections in a randomized single-blind study. Ampicillin, gentamicin, cephalexin and metronidazole were used in different combinations for periods of 5 or 10 days. A cephalexin-metronidazole protocol for 10 days was associated with lowest post-operative infection rate. Oral-oropharyngeal resection and use of pectoralis major myocutaneous flap were the most important factors contributing to infection.

Adult↗
PubMed1991

Results of endoscopic variceal sclerotherapy: influence of etiology of portal hypertension and hepatic functional status.

In India 50% of patients with gastrointestinal bleeding bleed from esophageal varices. Causes of portal hypertension includes hepatic cirrhosis, non-cirrhotic portal fibrosis and extrahepatic portal obstruction. Endoscopic sclerotherapy is the treatment of choice to control continued active bleeding. Immediate hemostasis was not influenced by the etiology of portal hypertension. However, rebleeding episodes were lower, in extrahepatic portal vein obstruction than non-cirrhotic portal fibrosis and cirrhotic patients. Child's status significantly influenced recurrence of bleeding and mortality which was lower in child's A than B and lower in B than C irrespective of etiology. Results of long term sclerotherapy were also influenced by the etiology of portal hypertension and hepatic functional status. Sclerotherapy was most effective in patients of (EHO), than (NCPF) followed by cirrhosis of the liver.

Chi-Square Distribution↗
PubMed1991

Hemopoietic improvement following fetal liver infusion in aplastic anemia.

41 (38 males, 3 females) patients with aplastic anemia received fetal liver infusion (FLI) from 74 abortuses with gestation periods of 8-32 (Median(M)-16) weeks and cell dose of 0.004-11.1 x 10(8) (M-2.3 x 10(8)) from September, 1976 until November, 1987. 35 persons received single FLI; those with recurrence or no response received two or more FLI. 8 received two; 7, three; 2, four; and 1, six FLI. There was a slow and incomplete autologous hematopoietic improvement in 40% and expected survival of 52% at 1 year, 45% at 2 yr, and 37% at 5 yr (Kaplan Meier estimate). There was rise in fetal hemoglobin (Hb), 0-15.7%, (M-3.5) among responders in 3-20 (M-6) months. Patients who survived for more than 12 months had, on average, a longer duration of disease (4 months or more), and higher granulocyte and platelet counts. Statistically, however, these differences were not significant. Reticulocyte count was significantly lower in those who survived beyond 12 months. 1 patient developed acute undifferentiated leukemia 3 yr post-FLI. The study indicates that fetal liver infusion is likely to benefit about 40% of individuals suffering from severe aplastic anemia. Longer surviving patients, however, may be at risk of developing clonal diseases.

Adolescent↗
PubMed1991

Neurodevelopmental outcome of asymptomatic & symptomatic babies with neonatal hypoglycaemia.

A total of 107 babies with hypoglycaemia were studied over a period of 15 months. Symptomatic hypoglycaemia was found in 43 while it was asymptomatic in the others. Asymptomatic hypoglycaemia occurred at a relatively earlier post-natal age (4.5 +/- 2.2 h), as compared to symptomatic hypoglycemia (18.5 +/- 5.4 h, P less than 0.001). The mean blood glucose in hypoglycaemic babies with seizures was found to be significantly lower (P less than 0.001) when compared to those with other features as well as asymptomatic ones. Hypoglycaemia lasted for a significantly longer duration in symptomatic babies as compared to those without symptoms (P less than 0.001). On neurodevelopment follow up the mental developmental index (MDI) and the psychomotor developmental index (PDI) of symptomatic babies with seizures were significantly lower (P less than 0.001) as compared to those with other features of hypoglycaemia as well as asymptomatic babies. The neurodevelopmental status of babies with symptoms other than seizures was also significantly poorer (P less than 0.001), when compared to asymptomatic hypoglycaemic babies. The duration of hypoglycaemia was directly related to the MDI (r = -0.74, y = 102.5 - 0.69x) and PDI (r = -0.81, y = 105.6 - 0.86x). This study indicates that there is a need to identify babies vulnerable to symptomatic hypoglycaemia more precisely.

Humans↗
PubMed1990

Construction of growth reference standards for urban slum children in developing countries.

A cross-sectional sample of 2987 children in the age group of 1 to 10 years were selected from urban slums of Delhi for measurement of weight and height. Males and females were 53 and 47% respectively. Mean weight and height were calculated for both the sexes. Comparison of percentiles of weight and height with NCHS and ICMR standards showed that the 75th percentiles weight and height of the present study were comparable with 80 and 90% of 50th percentile of NCHS respectively. Hence, upper 25% of the sample arranged in ascending order of magnitude were used for the construction of reference standards of weight and height. Comparison of percentiles drawn from the top 25% of the sample demonstrated that 50th percentile of the present study corresponded to 80% of 50th percentile of the NCHS for weight and 90% of 50th percentile of NCHS of the height for both boys and girls. Also the 50th percentile of ICMR for weight and height for both the sexes. Standards constructed from such sample would be better suited for two important uses: (i) monitoring of Nutrition Programme, and (ii) to detect a child with abnormal growth at the earliest.

Body Height↗
PubMed1990

Polycythemia in the newborn: do asymptomatic babies need exchange transfusion?

A total of 2288 infants were screened for hematocrit over a period of 15 months. Polycythemia was diagnosed in 27 cases (1.2%). Preterm and term babies had more or less equal risk to develop polycythemia (1.5% and 1.1% respectively) while postterm infants had at least three times increased risk (3.4%) when compared to their term counterparts. Large-for-dates (LFDs) and small-for-dates (SFDs) infants had increased risk of manifesting polycythemia which was nearly four times (2.2%) and twenty-five times (13.2%) respectively, as compared to appropriate-for-dates (AFDs) babies (0.5%). About one-third of polycythemic infants had one or more symptoms. The most common symptoms observed was jitteriness (25.9%) followed by respiratory distress (14.8%) and lethargy (11.1%). The mean (+/- SD) hematocrit of symptomatic newborns (76.0 +/- 4.04) was found to be significantly higher (p less than 0.001) as compared to asymptomatic babies (70.84 +/- 2.73). Partial exchange transfusion with plasma was performed in all the symptomatic cases within 8 hours of onset of symptoms. No such intervention was performed in asymptomatic cases. On neurodevelopment follow-up, the development indices (MDI and PDI) of both asymptomatic and symptomatic cases were found to be comparable.

Growth↗
PubMed1989

Predictors of variceal bleeding: an analysis of clinical, endoscopic, and haemodynamic variables, with special reference to intravariceal pressure.

To assist in the prediction of variceal bleeding we examined 12 clinical, endoscopic and haemodynamic variables in 126 patients with portal hypertension (72 bleeders and 54 non-bleeders). Multiple regression and discriminant analysis were utilised for 101 patients. Stepwise regression among the 12 variables explained only 54% of the variability existing between bleeders and non-bleeders. Six of the 12 variables accounted for 51% of the total bleeder/non-bleeder variability. A predicting equation was evolved [Yp = -0.60 + 0.19 X1 (colour of varices) + 0.16 X2 (cherry red spots) + 0.03 X3 (red wale, markings) + 0.01 X4 (haematocystic spots) + 0.15 X5 (Conn's grading of variceal size) + 0.03 X6 (intravariceal pressure)]. Of the six variables used, variceal size indicated 35%, and intravariceal pressure accounted for 12%, of the explained variability between bleeders and non-bleeders. The presence of the three red colour signs and the colour of the varices accounted for only 3% and 1% respectively of the total explained variation. Using the discriminant function analysis, we were able to correctly identify 85% of the bleeders and 81% of the non-bleeders. Additional studies are required to detect the variables responsible for the unexplained variability (46%) between bleeders and non-bleeders.

Adolescent↗
PubMed1989

Psychiatric disorders among medical in-patients in an Indian hospital.

Psychiatric symptoms among medical in-patients in an Indian hospital were assessed: the SRQ was used as a screening instrument, and those with probable psychiatric disorders were given the PSE and MSE, for further, detailed assessment. The prevalence of psychiatric disorders was 34%, with a further 15% reporting distressing psychiatric symptoms only. The most frequent complaints were delirium and adjustment disorders. They were largely associated with connective tissue, as well as cardiovascular and endocrine, disorders, and were characterised by depression, worrying and irritability. The reliability of the SRQ varied with the cut-off score, which gave optimal specificity and sensitivity when set at 9.

Adjustment Disorders↗
PubMed1989

Ocular manifestations of rheumatoid arthritis.

One hundred and seven patients of definite rheumatoid arthritis were screened for the presence of ocular manifestations of which 21 (19.63%) were observed to have ocular changes. Of these keratoconjunctivitis sicca in 19 (17.7%) patients and episcleritis in one (0.93%) were attributable to rheumatoid arthritis. Bilateral retinal haemorrhage in one patient was due to grade 3 hypertensive retinopathy. Absence of posterior subcapsular cataract in 106 (99.06%) patients who did not receive corticosteroids supports the hypothesis that steroids are the aetiologic agents and not rheumatoid arthritis.

Adolescent↗
PubMed1989

Glucose-6-phosphate dehydrogenase deficiency & neonatal hyperbilirubinaemia.

Seventy four neonates with hyperbilirubinaemia and 47 non-jaundiced (control) neonates were studied for evidence of G6PD deficiency by spectrophotometric assays and 3 screening tests viz., ascorbate cyanide test, methaemoglobin reduction test and fluorescent spot test. The incidence of G6PD deficiency was significantly higher (P less than 0.001) in the hyperbilirubinaemic neonates (35.1%) as compared to non-jaundiced neonates (6.4%). The G6PD levels in the hyperbilirubinaemic neonates were significantly lower than in the non-jaundiced neonates (P less than 0.05). In 9(12.2%) hyperbilirubinaemic neonates G6PD deficiency was present, without evidence of any other factor known to cause hyperbilirubinaemia. Results of screening tests were essentially similar. However, even with all the screening tests, 11 of 29 neonates (37.9%) with mild G6PD deficiency were not detected showing the limitation of these tests.

Female↗