Search PubMed⌕ Search

Biomedical subjects

K S Chugh

Publications and source records attributed to K S Chugh.

At least 37 records · Page 2Linked to original sources
PubMed1994

Hyponatremia in sick children seeking pediatric emergency care.

This prospective study evaluated the frequency, clinical characteristics and causes of hyponatremia (serum sodium < 130 mEq/L) in 727 children upto 12 years of age, who were brought for emergency care, and needed hospitalization. Hyponatremia was found in 29.8% and was more frequent in summer (36%; 123/341) than in winter (24%; 94/386) (p < 0.001). Acute lower respiratory infections (pneumonia) and acute diarrhea each accounted for 20% cases of hyponatremia; others were accounted for by meningitis/encephalitis (12%) septicemia (8%), and renal, heart and liver diseases (6-7% each). Clinical evaluation and concurrent plasma and urinary osmolality and urine sodium suggested that hyponatremia associated with pneumonia, meningitis/encephalitis, septicemia, seizures and miscellaneous diseases was of hypotonic-euvolemic (dilutional) type in more than 80% patients while in all children with acute diarrhea it was of hypovolemic type. The study has shown that hyponatremia occurs frequently in sick children requiring emergency care, especially in summer months, and should receive appropriate attention in the management plan.

Child↗
PubMed1993

Pancreatic pseudocyst. A rare complication of polyarteritis nodosa.

An 18-year-old male who developed a pancreatic pseudocyst during the active phase of polyarteritis nodosa is described. Cytotoxic therapy with cyclophosphamide and prednisolone was unable to control the manifestation of this disease, and he required percutaneous drainage of the pseudocyst. The drainage resulted in complete resolution.

Adolescent↗
PubMed1993

Renal mucormycosis: computerized tomographic findings and their diagnostic significance.

Isolated renal involvement by mucormycosis has been reported rarely in immunocompromised individuals. We describe four patients with mucormycosis confined to the kidneys, three of whom did not exhibit any predisposing factors. Only one patient had acute viral hepatitis with fulminant hepatic failure as the preceding disease. Two patients presented with oliguric renal failure of undetermined etiology and investigations revealed bilateral extensive involvement of the kidneys. Computerized tomography showed diffuse enlargement of the kidneys and multiple low-density areas. Treatment included systemic amphotericin B therapy in all four patients and nephrectomy in three patients. Two patients recovered completely. Our experience emphasizes the need for a high index of suspicion and recognition of computed tomographic scan appearances for making a prompt diagnosis. Early surgical intervention and systemic antifungal therapy are necessary for survival in this life-threatening condition.

Adolescent↗
PubMed1993

Ischaemic central retinal vein occlusion in the young.

Little is known about the behaviour of central retinal vein occlusion (CRVO) in the young. We studied the course and visual outcome in 25 patients with CRVO aged less than 40 years with special reference to the association with underlying systemic disorders. Eight patients had ischaemic CRVO while 17 had non-ischaemic CRVO. Systemic disorders associated with ischaemic CRVO included end-stage renal disease in 3, and hypercholesterolaemia, beta-thalassaemia and hypertension in 1 each. All patients with ischaemic CRVO had unusually severe disease and a rapid downhill course. Management included panretinal photocoagulation in 7 eyes, trabeculectomy with 5-fluorouracil in 3 eyes and cyclocryopexy in 2 eyes. Despite this 3 eyes became phthisical and the final visual acuity in all eyes ranged from no light perception to 6/60. Three patients with end-stage renal disease died within 15 months of diagnosis of venous occlusion.

Adult↗
PubMed1993

Hereditary nephritis (Alport's syndrome)--clinical profile and inheritance in 28 kindreds.

Sixty-three patients, (52 males and 11 females) from 28 kindreds of hereditary nephritis (Alport's syndrome) were identified over a 14-year period from 1977 to 1991. Group I included 51 patients with (a) positive family history of haematuria with or without chronic renal failure, (b) characteristic GBM changes on electron-microscopy, (c) characteristic ocular signs, and (d) high-frequency sensorineural deafness. Group II included 12 patients with a negative family history. All of them had evidence of renal disease with characteristic ocular signs and deafness and four had characteristic GBM changes on electron-microscopy. The main clinical features were haematuria in 96.8%, deafness in 82.5%, and diminished visual acuity in 66.7% of affected subjects. Hypertension was present in 71.4% patients. Pure tone audiometry revealed high-frequency sensorineural deafness in 96.8%. Ocular examination showed bilateral anterior lenticonus in 37.8%, retinal flecks in 22.2%, cataract in 20%, and keratoconus in 6.7% patients. Proteinuria (> 2.0 g/24 h) was detected in 31.8%. Sixteen (57.1%) of the 28 index patients (all males) were diagnosed for the first time when they presented with end-stage renal disease. Serum creatinine in the overall group ranged from 0.9 to 18.7 mg/dl(7.81 +/- 5.37 mg/dl). Adequate renal tissue was obtained by biopsy in 14 patients. Light-microscopy revealed focal segmental glomerulosclerosis in five, mesangial proliferation in four, chronic interstitial nephritis in three, and mesangiocapillary and crescentic glomerulonephritis in one each. Electron-microscopy showed characteristic changes in the GBM in seven specimens.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Corticotropin-dependent Cushing's syndrome in a patient with chronic renal failure--a rare association.

Corticotropin-dependent Cushing's syndrome was detected in a 32-year-old male suffering from membranous nephropathy and chronic renal failure. Cortisol dynamics revealed high basal cortisol, loss of circadian rhythm, and nonsuppressibility with low-dose dexamethasone. However, the latter was suppressible with high-dose dexamethasone. Treatment with ketoconazole led to a remarkable response both clinically and biochemically. The occurrence of Cushing's syndrome in a patient with chronic renal failure is extremely rare and poses significant diagnostic and therapeutic problems.

Adrenocorticotropic Hormone↗
PubMed1993

Transport of amino-acids across renal brush border membrane vesicles in Mycobacterium leprae infected Swiss albino mice--effect of Convit vaccine.

Brush border membrane vesicles prepared from kidneys of Mycobacterium leprae infected (non-vaccinated) and vaccinated-infected Swiss albino mice were used to assess the effect of Convit's combined vaccine (BCG + M. leprae) on amino acid transport activity across the tubular basement membrane. The protective effect of Convit's vaccine was more pronounced with respect to the uptake of L-alanine than L-aspartate. Uptake of L-lysine showed no significant difference in the different groups. Footpad counts followed characteristic growth curves in the non-vaccinated infected group but showed a lag in the development of peak levels in the vaccinated group. Further Convit's vaccine appeared to have a protective effect on renal impairment in the mouse model of leprosy in the initial stages of infection only, as indicated by the transient reversal of amino acid uptake and a diminution in the footpad counts induced by M. leprae infection. No significant (P > 0.05) protective effect of the vaccine was found in the advanced disease state.

Amino Acids↗
PubMed1993

Invasive pulmonary aspergillosis and nocardiosis in an immunocompromised host.

A case of invasive pulmonary aspergillosis and nocardiosis following high dose prolonged steroid therapy given for suspected rapidly progressive glomerulonephritis is reported. A favourable response was achieved with a combination of amphotericin B and cotrimoxazole. A high index of suspicion and aggressive investigations are necessary for confirmation of diagnosis and early institution of appropriate therapy.

Amphotericin B↗
PubMed1993

Disseminated tuberculosis in a renal transplant recipient presenting as a non-healing skin ulcer. A case report.

Cutaneous tuberculosis in renal allograft recipients is rare. A 33 year old recipient of a second renal allograft developed a painless ulcer on the left foot two months after surgery, followed by the appearance of a cold abscess in the left inguinal region. Smear from the pus aspirated from this abscess revealed acid fast bacilli, and biopsy from the edge of the ulcer showed an epithelioid cell granuloma with Langhans type of giant cells. X-ray of the chest revealed miliary mottling in both lung fields. Antitubercular therapy lead to a complete resolution of the tuberculous lesions.

Adult↗
PubMed1993

High mortality in systemic fungal infections following renal transplantation in third-world countries.

Amongst 310 recipients of live related renal transplants, systemic fungal infections were observed in 19 patients (6.1%). These included cryptococcosis in eight (42%), candidiasis in seven (37%), mucormycosis in two (11%), aspergillosis in one (5.5%), and a mixed cryptococcal and Aspergillus infection in one patient (5.5%). Infections occurred within 12 months of transplantation in seven patients and after 13-37 months in the remaining patients. Prolonged fever not responding to antibiotics was the most common presentation. Central nervous system was involved in all patients with cryptococcosis, while Candida infection primarily involved the urinary tract. Both patients with mucormycosis exhibited signs and symptoms of florid rhinocerebral disease and a rapid downhill course. Pulmonary manifestations were the most prominent features of patients with aspergillosis. Parenteral amphotericin B with or without 5-fluorocytosine was started in all, but three patients could receive the therapy only for 1-3 weeks. Three patients with cryptococcosis developed amphotericin-related complications and were changed to oral fluconazole. Seven patients recovered and 12 (63%) died. None of the patients had cytomegalovirus infection preceding the onset of fungal disease. The high frequency of fungal infections amongst our allograft recipients could not be ascribed to over immunosuppression, since 16 patients (84%) were only on maintenance doses of immunosuppressive drugs and in 13 (68.4%) graft function was normal at the time of diagnosis. The high frequency of fungal infections in our patients was most probably related to the poor hygienic and sanitary conditions which continue to be prevalent in the tropical environment of third-world countries. Delays in the diagnosis and late institution of therapy result in a high mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

Aspergillosis↗
PubMed1993

Emphysematous pyelonephritis and cystitis in a renal transplant recipient--computed tomographic appearance.

A 35-year-old nondiabetic renal allograft recipient developed emphysematous pyelonephritis and cystitis emphysematosa necessitating graft nephrectomy. The patient received cyclosporin and prednisolone as immunosuppressive therapy. He developed the first episode of urinary tract infection one week after transplantation and another episode 3 months later. Abdominal CT scan revealed presence of gas in the graft kidney, urinary bladder, and surrounding tissues. Despite appropriate antibiotic therapy, his renal function deteriorated rapidly and he died on the first postoperative day.

Adult↗
PubMed1993

Class specific antinuclear antibodies in systemic lupus erythematosus.

The incidence and significance of class specific antinuclear antibodies (ANA), specially with relevance to clinical manifestations of arthritis, renal disease and serositis was studied in 40 patients of systemic lupus erythematosus by the indirect immunofluorescent method. Clinical activity was scored by Morimoto's scoring system. A significant correlation was obtained between IgD ANA and clinical activity of the disease and IgG ANA exhibiting lupus pattern of immunofluorescence and serositis.

Antibodies, Antinuclear↗