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Biomedical subjects

K R Sundaram

Publications and source records attributed to K R Sundaram.

At least 55 records · Page 3Linked to original sources
PubMed1989

Antibodies to extractable nuclear antigens in connective tissue disorders in India: prevalence and clinical correlations.

Antibodies to Extractable Nuclear Antigens (ENAs) namely Sm, nRNP, SS-A and SS-B were studied in 397 patients with various connective tissue diseases (CTD), 146 patients with inflammatory polyarthropathies, 16 cases of systemic vasculitides, and 39 normal subjects using counterimmunoelectrophoresis and double immunodiffusion methods. Anti-ENA antibodies were positive in 40.8 percent cases of Systematic lupus erythematosus (SLE) (n = 191), 36.4 percent of overlap CTD (OCTD, n = 44), 27.8 percent of Sjogren's syndrome (n = 18), 10.6 percent of progressive systemic sclerosis (PSS, n = 66) and 2.7 percent of rheumatoid arthritis (n = 111) patients. The correlation of these antibodies with disease features was done. The significant finding was negative association of anti-nRNP antibodies (when present alone) with renal involvement. Anti-Sm antibodies did not correlate with any disease feature. The other associations included correlation of anti-nRNP with pulmonary parenchymal lesions, anti-SS-A with serositis and pulmonary hypertension, and anti-SS-B with myocarditis and recurrent diarrhoea. We conclude that Anti-ENAs may correlate with certain subsets of these diseases but the subject is controversial.

Adolescent↗
PubMed1989

Sclerotherapy after variceal hemorrhage in noncirrhotic portal fibrosis.

Sixty patients with variceal bleeding due to noncirrhotic portal fibrosis were treated by repeated endoscopic injection sclerotherapy. During each session, the varices were injected with a mean volume of 14.4 ml of 1% polidocanol intravariceally. This decreased rebleeding, as evidenced by a reduction in mean bleeding risk factor and transfusion requirement. Difference between pre- and post-sclerotherapy parameters were significant (p less than 0.001). Variceal obliteration was achieved in 53 (88%) patients. The mean sclerotherapy sessions required for eradication were 8.43 (SD = 2.41). Minor complications related to the procedure occurred in 12% of patients. Cumulative survival for 5 yr was 86%. Survival was significantly related to Child's status, being 97.5% for Child's A and 64% for Child's B patients. Recurrence of varices occurred in 15% of patients after a mean interval of 19 months. We conclude that endoscopic sclerotherapy is an effective method of treatment for variceal bleeding due to non-cirrhotic portal fibrosis, and is a reasonable alternative to surgery.

Adult↗
PubMed1988

Correlation of estrogen receptor protein and carcinoembryonic antigen with lymphnodal metastasis in breast carcinoma.

Estrogen receptor protein (ERP) content and carcinoembryonic antigen (CEA) positivity were analysed in 50 cases of primary breast carcinoma. Relationship of pathological features known to be of prognostic significance and combined CEA and ERP status were examined. It was found that CEA + ERP--tumours had significantly higher frequency of axillary lymphnodal metastasis in comparison to CEA - ERP + cases. Presence of CEA - or ERP + status showed significant lower frequency of metastasis in comparison to CEA + ERP - tumours.

Axilla↗
PubMed1988

Simple tricoloured measuring tapes for identification of low birthweight babies by community health workers.

A total of 446 singleton neonates were subjected to measurements of birthweight, chest circumference (CC) and mid-arm circumference (MAC). A high degree of correlation between birthweight and CC as well as MAC was observed. Chest circumference correlated better with birthweight than MAC. Further analysis of data showed that CC measurements of less than or equal to 30.0 cm and less than or equal to 27.5 cm reliably identify neonates less than 2500 g and less than 2000 g, respectively, with a high degree of specificity and predictive value. The corresponding values for MAC were less than or equal to 9.0 cm and less than or equal to 8.5 cm, respectively. Using these inferences, two tricoloured measuring tapes, one each for CC and MAC, are proposed as simple screening tools for use by primary health workers for identifying low-birthweight neonates in the community without resorting to weighing scales.

Anthropometry↗
PubMed1988

Profile of alcoholic liver disease in an Indian hospital. A prospective analysis.

To study the profile of alcoholic liver disease in India, 144 consecutive, histologically diagnosed patients were prospectively studied. The patients were divided into those having alcoholic fatty liver (AFL) (Gr. I, n = 32), alcoholic hepatitis (AH) (Gr. II, n = 42) and alcoholic cirrhosis (AC) (Gr. III, n = 70) on the basis of their histological findings. All the patients were males, those with fatty liver being younger than those with cirrhosis. The amount of alcohol consumed by patients with AFL, AH and AC was not significantly different. Similarly, the duration of alcohol consumption was not significantly different between the three groups of patients. The clinical features of the patients were quite similar to those reported from the West, except that AH was relatively milder in our patients. Intake of poor quality country liquor was quite common (60%), but its use was not found to be associated with more severe liver injury as compared with the use of good quality foreign varieties of liquor.

Adult↗
PubMed1988

Young v adult cirrhotics: a prospective, comparative analysis of the clinical profile, natural course and survival.

In order to assess the frequency and profile of cirrhosis in the young, 169 consecutive patients with cirrhosis were studied. Sixty three (37%) patients of less than or equal to 35 years age were defined as young and the remaining 106 (63%) patients (greater than 35 years) as adult cirrhotics. Men predominated significantly (p less than 0.01) in the young cirrhotic group. The aetiology, the frequency of positive hepatitis B markers and initial clinical presentation were similar in the two groups. During the follow up period (30.6 +/- 29.7 months for the young and 25.8 +/- 21.7 months for the adult group), except for abdominal distension and pedal oedema which occurred significantly more often in the adult compared with the young cirrhotics, no difference was noted in the two groups. Twenty seven (39.7%) deaths (40% as a result of hepatic failure and 52% due to variceal bleeding) occurred in the young and 47 (44.3%) deaths (63.8% because of hepatic failure and 26% because of variceal bleeding) occurred in the adult cirrhotics during the follow up (difference NS). The five year survival (61.9% v 55.7%) and the probability of survival within the same Child's grade of liver disease were comparable. In both the groups, however, the probability of survival was significantly higher in Child's A compared with Child's B and C and in Child's B compared with Child's C grade of liver disease. Survival was not influenced by sex of the patient and aetiology of cirrhosis. Results of this prospective study indicate that cirrhosis is not uncommon in young adults. The aetiology, clinical presentation, natural history of the disease and the survival rates in young cirrhotics do not differ significantly from adult cirrhotics.

Adolescent↗
PubMed1988

Bumetanide, spironolactone and a combination of the two, in the treatment of ascites due to liver disease. A prospective, controlled, randomized trial.

There are few studies available comparing the efficacy of loop and distal diuretics and a combination of the two groups, in the treatment of ascites due to liver disease. Thirty-seven nonazotemic cirrhotic patients with ascites were randomly allocated to receive for 2 weeks bumetanide (group A, n = 13), spironolactone (group B, n = 12) or a combination of the two drugs (group C, n = 12) after a 5-day stabilization period. The response to the treatment was 69, 42 and 83% in groups A, B and C, respectively; the difference was not significant. Hypokalemia was seen in 4 patients of group A and mild hyperkalemia in 2 patients of group B. Electrolyte disturbances were minimal in patients of group C. The response to diuretic treatment was prompt in groups A and C. It can be concluded that a combination of loop and distal diuretics is superior to a one-drug regimen in achieving a rapid and better diuretic response with fewer side effects.

Administration, Oral↗
PubMed1987

Differentiation of patients with rheumatic fever from those with inactive rheumatic heart disease using the artificial subcutaneous nodule test, myocardial reactive antibodies, serum immunoglobulin and serum complement levels.

Thirty patients with acute rheumatic fever, and 20 with inactive rheumatic heart disease were studied in order to determine parameters which differentiate the two groups. Subcutaneous nodules developed following the subcutaneous injection of autologous blood in 16 of 26 patients with rheumatic fever but in none of the 20 with inactive rheumatic heart disease (P = 0.00001). Myocardial reactive antibodies were found in 14 of 30 patients with rheumatic fever, and in 4 of 20 with inactive rheumatic heart disease (P = 0.0505). Significantly higher values of IgG (P less than 0.001), IgA (P less than 0.01), C3 (P less than 0.001) and C4 (P less than 0.001) were observed in rheumatic fever patients. There was no significant difference in IgM levels. A combination of three variables (artificial subcutaneous nodules, IgA, and C3) had a sensitivity of 87% and a specificity of 100% for rheumatic fever. A combination of two variables (artificial subcutaneous nodules and IgA) had a sensitivity of 84% and a specificity of 100% for rheumatic fever.

Adolescent↗
PubMed1986

Prognostic assessment of various parameters in chronic myeloid leukemia.

In 152 cases of chronic myeloid leukemia (CML) (actuarial median survival [MS], 59.2 months), the statistical relation of individual parameters with survival was studied to ascertain their prognostic value. The following parameters were found to be unrelated to the survival: age, sex, duration of symptoms, sternal bone tenderness, degree of hepatomegaly, level of hemoglobin, and leukocyte and platelet counts at the time of diagnosis. Splenomegaly of less than 10 cm and duration of first remission of 6 months or more were associated with significantly longer survival (MS, 70.5 and 68.5 months, respectively) as compared to bigger spleen size and duration of remission of less than 6 months (MS, 50.5 and 26 months; P less than 0.01 and P less than 0.05, respectively). The most significant prognostic parameter was the time required to achieve first remission. MS was 70 months in patients who achieved first remission in 2 months or less; it was 23.5 months in the remaining patients. This difference was statistically highly significant (P less than 0.001).

Adolescent↗
PubMed1986

A study of drug abuse in rural areas of Punjab (India).

In 1976 an epidemiological survey of drug abuse was conducted in 24 rural villages of four Community Development Blocks (CDB) in three districts of Punjab State bordering Pakistan covering 1276 households. The majority of households had one user. Both men and women reported the use of traditional drugs, i.e. alcohol, tobacco, opium and cannabis. In males, the commonest drug used was alcohol (58.3%), followed by tobacco (19.3%), opium (6.3%) and cannabis (1.2%). The majority of the female respondents were non-users, but a very small number reported use of tobacco, alcohol and opium. The observations are compared with other studies and implications discussed.

Alcohol Drinking↗
PubMed1985

Vitamin B12, folate, and iron studies in homozygous beta thalassemia.

The efficacy of serum folate (SF), red blood cell folate (RCF), and serum B12 in diagnosing folate and B12 deficiency, and the effect of iron overload on hemoglobin, were studied in 157 cases of homozygous beta thalassemia (HBT). The patients had lower SF compared with normal subjects (NS) (P less than 0.001) and higher RCF than their parents (P less than 0.001) and NS (P less than 0.001). Forty percent of patients had both low SF (less than 3 ng/mL) and high RCF (greater than 600 ng/mL). Homozygous beta thalassemia patients are known to have folate deficiency. Yet, both folate and B12 deficiency status were similar in the authors' patients and NS. These deficiencies apparently were less in patients compared with their parents, who shared the same nutritional milieu (P less than 0.001). Mean hemoglobin in patients with iron overload (transferrin saturation, TS greater than 50%) was lower than in those without (P less than 0.005). The following is concluded: (1) diagnosis of folate and B12 deficiency based on SF, RCF and serum B12 is vitiated in HBT and needs a therapeutic trial; (2) iron overload of a magnitude indicated by TS greater than 50% can aggravate anemia in HBT.

Blood Transfusion↗