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Biomedical subjects

K S Chugh

Publications and source records attributed to K S Chugh.

At least 19 recordsLinked to original sources

Tuberculous pyomyositis in a renal transplant recipient.

Infections are a major cause of morbidity and mortality in renal transplant recipients. Although these patients are susceptible to many types of infection, soft tissue infections are rare. We report a case of tuberculous pyomyositis involving the left erector spinae muscle but with no other manifestations of tuberculosis. The diagnosis was suspected from the CT scan appearance and confirmed by microscopy and culture of the pus. Surgical incision and drainage, together with antituberculosis therapy, cured the infection. The relevant literature is briefly reviewed.

Adult

A 55-year followup of a patient with bilateral ureterosigmoidostomy.

We report on a patient with bilateral ureterosigmoidostomy who, despite many of the long-term complications associated with the procedure, was doing well 55 years after urinary diversion. This is one of the longest follow-ups reported in the literature. Despite the decreasing popularity of ureterosigmoidostomy, in well selected patients who desire a continent form of internal diversion it may still prove to be useful, as exemplified by our patient.

Aged

The diagnostic value of CT scan in acute renal cortical necrosis.

We report the characteristic CT scan findings of renal cortical necrosis in a patient of acute renal failure, which was confirmed on renal biopsy. CT scan is a useful, noninvasive investigative modality for an early diagnosis of renal cortical necrosis.

Acute Disease

Acute renal failure in severe hypothermia.

A patient who developed acute renal failure associated with severe hypothermia is reported. Warm peritoneal dialysis was initiated for core rewarming followed by intermittent hemodialysis till he entered the diuretic phase. The factors which led to acute renal failure in this patient included hypovolemia, hypotension, and acute pancreatitis.

Acute Kidney Injury

Wegener's granulomatosis: clinical experience with eighteen patients.

Wegener's granulomatosis is being recognised with increasing frequency in India. Our 18, histologically confirmed, patients had a clinical profile similar to that described from developed countries. Delayed diagnosis led to the death of nine patients, usually within days of hospital admission, due to extensive vasculitis and renal failure. Tuberculosis was the most frequently considered diagnosis and 12 patients had been treated for it in spite of progressive clinical deterioration. Those who could be adequately treated with low dose daily cyclophosphamide and corticosteroids did well. Six of seven such patients are alive and well 1-8 years later. We believe that if prompt lung biopsy and ANCA determination are resorted to in patients with "resistant tuberculosis", it will greatly expedite case detection, diagnosis and optimum treatment of this remediable disease.

Adolescent

Efficacy of oral fluconazole in Cryptococcus neoformans infection.

We report a renal allograft recipient who developed disseminated cryptococcosis, which was treated effectively, with oral fluconazole, a new triazole antifungal agent. The patient is doing well on maintenance therapy with fluconazole and immunosuppressive agents.

Administration, Oral

Spectrum of hospital-acquired acute renal failure in the developing countries--Chandigarh study.

The spectrum of hospital-acquired acute renal failure in the developing countries has not been documented. We undertook a prospective study to define the causes and outcome of hospital acquired acute renal failure as seen at a referral center in North India. Over a one year period, all patients who developed acute elevation in serum creatinine during the hospital stay were studied. One hundred and ninety of 29,503 admitted patients (0.64 per cent) satisfied the criteria for entering into the study. Nephrotoxic drugs (29 per cent), decreased renal perfusion (21 per cent), major surgery (18 per cent) and septicaemia (17 per cent) were the most frequent causes. Acute renal failure was non-oliguric in 52 per cent of patients. Non-oliguric patients had significantly fewer episodes of hyperkalaemia, neurological abnormalities, metabolic acidosis and gastrointestinal bleeding. They required fewer episodes of dialysis (p < 0.001) and had a significantly lower mortality (p < 0.001) compared to the oliguric patients. Other poor prognostic factors included severity of renal insufficiency, high baseline serum creatinine and presence of multiorgan failure. The present study shows that the spectrum of hospital-acquired acute renal failure in the developing countries is quite similar to that of technologically advanced countries, although the pattern of community acquired acute renal failure is vastly different.

Acute Kidney Injury

Ocular complications in renal allograft recipients.

Ocular complications in renal allograft recipients are a significant cause of morbidity. Of 80 renal transplant recipients, 42 (52.5%) developed ocular complications. These included posterior subcapsular cataract in 22 patients (27.5%), opportunistic ocular infections by CMV, cryptococcus, mucormycosis, herpes simplex and herpes zoster in five (6.25%), steroid-induced raised intraocular pressure in four (5%) and primary disease-related vascular complications in ten (12.5%). Our findings highlight the importance of regular ocular examination of all allograft recipients in the post-transplant period.

Adolescent

Coagulation abnormalities induced by Russell's viper venom in the rhesus monkey.

Coagulation studies were carried out in a group of non-human primates (rhesus monkeys) following envenomation with lethal and sublethal doses of Russell's viper venom. The envenomated animals showed significant fibrinogenopenia in association with or without disseminated intravascular coagulation. The findings offer a rational explanation for the bleeding manifestations seen in clinical cases of Russell's viper bite.

Afibrinogenemia