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Biomedical subjects

K Sriram

Publications and source records attributed to K Sriram.

At least 55 records · Page 3Linked to original sources
PubMed1982

Childhood versus adult onset obesity in a comprehensive, multidisciplinary weight reduction program.

The weight loss of 16 obese patients (greater than 130% ideal body weight) who participated for three months in a comprehensive, multidisciplinary weight reduction program was studied. Patients were divided into two groups based on the reported time of onset of their obesity. Childhood-onset obesity was defined in this study as marked weight gain by the age of 11. Adult-onset obesity was defined as weight gain occurring at 18 years of age or later. Each group of patients consisted of two males and six females. The childhood-onset obesity group lost significantly more weight than the adult-onset obesity group during this three-month period (19.45 +/- 3.6% versus 16.17 +/- 2.8%). This preliminary study suggests that patients with childhood-onset obesity tend to lose more weight in a comprehensive multidisciplinary weight reduction program than patients with adult onset obesity.

Adult↗
PubMed1981

Battered baby syndrome: a review of eight cases.

A review of eight cases of the Battered Baby Syndrome, diagnosed in the Orthopaedic Department of a large childrens' hospital in India during a three year period is presented. Majority of the cases had major fractures due to repetitive child abuse. Most of the children were undernourished and psychoanalysis of the parents revealed that with regard to child abuse, conditions in India do not differ materially from the Western World. This review does not include minor injuries to the children or solitary fractures in children as a results of child abuse. This may indicate that many cases have been missed. The importance of early detection of this condition and multidisciplinary approach in the management have been stressed. This condition has yet to gain wide recognition in Indian.

Battered Child Syndrome↗
PubMed1981

Sciatic nerve palsy in the new born.

Twelve new born children with sciatic nerve paralysis are reported in this paper. Complete paralysis was present in six and partial paralysis in six neonates. In all cases of breech delivery, a definite history of prolonged labour and forceful extraction by pulling the leg of the fetus was obtained. explained. The relevant literature has been reviewed. Follow up radiological examination in two children showed delayed ossification of the femoral head on the affected side. Recovery was incomplete in most of the cases with total sciatic nerve palsy.

Follow-Up Studies↗
PubMed1979

Phenothiazine effect on gastrointestinal tract function.

Clinical evidence indicates that phenothiazines, specifically chlorpromazine (CPZ), used extensively in the treatment of patients with mental and/or neurologic disorders produce an ileus characterized by pseudoobstruction with an extended barium transit time of eight to ten days. Postoperatively, these patients have a protracted ileus, lasting from ten to fourteen days. In our present study we investigated the mechanism of action by which phenothiazines block gastrointestinal tract function as well as the possible reversal of this effect by pharmacologic agents. Guinea pigs were injected intraperitoneally with CPZ at a dose of 30 mg/kg/day for five to seventeen days. This caused deleterious effects in the gastrointestinal tract, such as cessation of peristalsis of small intestine and colon, and marked distension of the cecum. In vitro pharmacologic studies were performed on the electrically stimulated longitudinal muscle-myenteric plexus of the guinea pigs. We found that phenothiazines interfered with the neuromuscular mechanism of the intestine, as exemplified by a lack of response to electrical current stimulation. The effect was protracted, lasting at least 24 hours. These effects were reversed by the administration of the anticholinesterase, physostigmine (PGM), provided the block was less than 80 per cent. The paralytic ileus produced was similar to that found in man.

Animals↗
PubMed1975

Acute neurological complications in the treatment of scoliosis. A report of the Scoliosis Research Society.

A survey conducted by the Scoliosis Research Society found eighty-seven patients with acute neurological complications resulting from the treatment of scoliosis. The incidence of these complications was determined to be 0.72 per cent. Seventy-four major complications involving the spinal cord were reported, half of them complete paraplegia and half partial paraplegia. Thirty-six per cent recovered completely, 32 per cent had partial recovery, and 32 per cent had no return of function. Thirteen minor complications involving cranial and peripheral nerves were reported. Major complications occurred in forty-two cases of posterior spine fusion with Harrington instrumentation and in twenty cases of posterior spine fusion without instrumentation. Six patients became paraplegic following skeletal traction alone.

Adolescent↗
PubMedDate not supplied

Loss of zinc and selenium does not occur through peritoneal dialysis.

A prospective study was done to determine whether zinc (Zn) and selenium (Se) loss occurs in patients on continuous ambulatory peritoneal dialysis through their dialysate effluent. Fifty pairs of aliquots of dialysis fluid were collected from 29 patients. Each paired set of specimens consisted of the dialysate fluid before instillation into the peritoneal cavity and a specimen of the spent effluent after dialysis for comparison. Zn and Se concentrations were measured using inductively coupled plasma atomic emission spectrophotometry. The range of dialysate fluid Zn concentration before instillation was 0 to 1.75 microg/mL and that for Se was 0 to 0.33 microg/mL. Ranges for Zn and Se in the postdialysis effluent were 0 to 0.60 and 0 to 0.56 microg/mL, respectively. The concentration differences in 50 pairs of samples were analyzed with Wilcoxon's test. The difference in Zn levels between the predialysis specimen and the effluent was 0.009 +/- 0.036 microg/mL (P = 0.154). The difference for Se was 0.018 +/- 0.21 microg/mL (P = 0.118). In conclusion, no significant loss or gain of Zn or Se occurs in patients undergoing continuous ambulatory peritoneal dialysis.

Dialysis Solutions↗
PubMedDate not supplied

Neutropenia due to copper deficiency in total parenteral nutrition.

Copper (Cu) deficiency has been reported both in pediatric and adult patients on total parenteral nutrition (TPN). Manifestations of Cu deficiency are usually hematologic in the adult. A 56-yr-old patient with a history of subtotal gastrectomy underwent massive small bowel resection and partial colectomy in 1977. TPN was initiated. Intravenous (iv) trace mineral supplements were not available in 1977 at our institution. By June 1978, the patient manifested neutropenia with a white blood cell (WBC) count of 2000/mm3 and 39% neutrophils or a total neutrophil count (TNC) of 780/mm3. The serum Cu level at that time was 5 micrograms/dl (normal, 70-140), and the serum zinc (Zn) level was low, although within normal limits. Oral supplementation with Cu and Zn tablets proved ineffective. Twice weekly infusions of fresh frozen plasma were begun in April 1979, and intravenous chromium supplementation started in September 1979, but neither the WBC count nor the TNC improved. Intravenous Cu and Zn were approved in October 1979, and were added to the TPN formula. Within 2 weeks, the WBC count rose to 6300/mm3, and the neutrophils increased to 83% with a TNC of 5229. After 12 weeks, the serum Cu level rose to 80 micrograms/dl. The increase in WBC count and percentage of neutrophils can be attributed to the addition of Cu to the TPN infusate.

Agranulocytosis↗
PubMedDate not supplied

Prophylactic locking of enteral feeding tubes with pancreatic enzymes.

BACKGROUND: Obstruction of feeding tubes is a common mechanical complication associated with enteral feeding. Standard methods of flushing are not always effective. METHODS: This study was conducted with patients receiving enteral feeding via nasogastric, nasoenteral, gastrostomy, or jejunostomy tubes to determine if prophylactic use of pancreatic enzymes would maintain patency of feeding tubes. Interrupted feeding regimens were used. Control patients (n = 24) received only water for flushing. After water flushing of the tube, study patients (n = 33) received a 5-mL suspension of pancreatic enzyme containing the following enzyme activity (in Federation Internationale Pharmaceutique [FIP] units): lipase, 2000; amylase, 1500; and protease, 100. The suspension also contained 90 mg of NaHCO3 to maintain a pH of 7.5. The mean duration of observation in the control and study groups was 25 and 48 days, respectively. RESULTS: Compared with eight episodes (23.5%) of tube occlusions in the control group (n = 34), there was only one episode (2.6%) in the study group (n = 38). This difference was significant by the test of proportions (z = 2.68, p = .01). CONCLUSIONS: In addition to routine water flushing, the routine prophylactic use of pancreatic enzyme-sodium bicarbonate suspension (pH 7.5) prevents occlusion of feeding tubes.

Amylases↗