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Biomedical subjects

L Kumar

Publications and source records attributed to L Kumar.

At least 73 records · Page 4Linked to original sources
PubMed1999

Clinico-immunological profile of juvenile rheumatoid arthritis at Chandigarh.

OBJECTIVE: To study the clinical and immunological profile of children with juvenile rheumatoid arthritis (JRA). DESIGN: Retrospective hospital based study. SETTING: Tertiary level center of North India. SUBJECTS: 74 patients attending the Pediatric Rheumatology and Immunology Clinic over last 5 years. RESULTS: The patients were aged between 9 months to 12 years with male female ratio of 1.8:1. Eleven (14.9%) patients had systemic onset JRA, 28 (37.8%) had polyarticular onset type and 35(47.3%) had pauciarticular onset type JRA. Uveitis was present only in one patient and rheumatoid nodules were present in 4(5.4%) patients. Rheumatoid factor was positive in 2(2.7%) and antinuclear antibody was present in one patient only. HLA-B27 was positive in 4 children. Two patients developed amyloidosis. CONCLUSION: The clinico-immunological profile of JRA at Chandigarh appears to be some what different from that reported from other centers in India.

Age Distribution↗
PubMed1998

Outbreak of nosocomial Acinetobacter baumannii bacteremia in a high risk ward.

Acinetobacter baumannii is emerging as a major cause of nosocomial infections particularly in high risk patients. Being resistant to adverse environmental conditions, it can stay for prolonged periods in the hospital environment. We report an outbreak in the medical oncology ward where nine patients suspected of bacteraemia were blood culture positive for A. baumannii from the two samples each, one collected through the i.v. cannula and another through the peripheral veneous puncture. The bacteria was also isolated from the environmental sources from the various samples collected. The biotype, antibiogram, cellular protein profiles on SDS-PAGE and the restriction enzyme analysis patterns of the patient isolates and the environmental isolates were similar. This points to the environment as a source of infection. With reinforcement of proper barrier nursing and use of disposable heparine ampoules it was possible to control the outbreak.

Acinetobacter Infections↗
PubMed1998

Arteriovenous malformation of knee masquerading as juvenile arthritis.

This is a rare case of involvement of knee joint by an arteriovenous malformation. A nine year old girl had recurrent monoarticular pain and swelling of long duration and had been treated as juvenile rheumatoid arthritis. Angiographic and histological features suggested an arteriovenous malformation of lower thigh with knee joint involvement.

Angiography↗
PubMed1998

Neoadjuvant chemotherapy in locally advanced cervical cancer: two randomised studies.

Between August 1990 and January 1992, 184 patients with squamous cell carcinoma of the cervix, FIGO stage II B IV A were randomised (study 1) to receive either two cycles of bleomycin, ifosfamide-mesna and cisplatin (BIP) chemotherapy (CT) followed by radiotherapy (RT) 'CT-RT Group' n = 94 or RT alone, RT Group n = 90. In the 'CT-RT Group', of evaluable 89 patients, 64 responded: complete response (CR) four (4.5%) and partial response (PR) 60 (67.5%). Of the remaining 25 patients 23 had stable disease and two progressed. Eighty of 89 patients completed RT as planned. Following RT 56 (70%) achieved CR, 19 (23.7%) had residual disease and five (6.3%) had progressed. Patients aged > 45 and those with Hb > 10 gm/dL had significantly better response to CT. Further, CT responders had a better response to RT; 83% (49/59) vs 33.3% (seven/21), p < 0.01. In the 'RT Group' 88 patients were evaluable; 61 (69.3%) patients achieved CR, 25 had residual disease and two progressed. The estimated overall survival at 48 months in the 'CT-RT Group' and the 'RT Group' is 38% +2.01 (SE) and 36% +1.85 (SE), p = 0.59 respectively. In a subsequent randomised study (study 2) 36 patients with stage III B cervical cancer received three cycles of BIP (as above) followed by RT vs 36 patients who received RT alone. In the 'CT-RT Group' 29 patients responded; CR-8 (22.2%), PR-21 (58.3%). Six patients had no response to CT and one patient died of CT toxicity. Following RT-24 of 35 (68-6%) patients achieved CR, eight had residual disease and three patients progressed while on RT. In the 'RT Group'-21 of 36 (58.4%) achieved CR, 12 had residual disease and three progressed. Estimated survival was 71% in the 'CT-RT Group' and 69% in the 'RT Group', p = ns. Nausea/vomiting, alopecia, grade I-II myelosuppression, diarrhoea and mucositis were the major side effects of CT. Three patients died of CT toxicity-two in study 1 and one in study 2. Cystitis, proctitis and local skin reaction after RT occurred equally in the two groups in both the studies. BIP CT prior to RT in patients with locally advanced cervical cancer results in a high response rate. Response to CT predicts response to RT. There is no increase in the toxicity to subsequent RT. Our studies have failed to demonstrate any significant difference in overall and disease-free survival when neoadjuvant CT is added prior to the standard RT regimen.

Adult↗
PubMed1998

Non-Hodgkin's lymphoma presenting as a primary lesion in uterine cervix: case report.

Non-Hodgkin's lymphoma (NHL) arising from extra nodal tissue and staying localized to that region is rare. Rarer still is primary NHL of the uterine cervix. We describe a patient with primary extra nodal NHL of the uterine cervix and vagina who was treated successfully with chemotherapy and radiotherapy. She is free of disease 17 months after treatment. Data of 52 patients collected from the literature (Medline, National Library of Medicine, Bethesda, MD) is reviewed.

Female↗
PubMed1998

Single agent versus combination chemotherapy in recurrent cervical cancer.

OBJECTIVE: Cisplatin and ifosfamide are two most active agents in patients with recurrent and metastatic cervical cancer. Combination of bleomycin, ifosfamide and cisplatinum (BIP) was compared with cisplatinum alone. PATIENTS AND METHODS: One hundred and six patients with recurrent/persistent and metastatic cervical cancer received either a combination of bleomycin, ifosfamide and cisplatinum, (Group A, n = 50) or cisplatinum alone (Group B, n = 56) every 3 weeks for up to 6 courses. Ninety-seven patients were evaluable and were analysed for response and survival. RESULTS: Patients receiving BIP (Group A) had a higher response rate (complete and partial responses), 52.2% vs 29.4%, p < 0.01 with overall median survival, 8 months (1 to 92+ months) vs 6 months (1 to 40+ months), p = 0.18. Chemotherapy responders had a significantly higher survival in both groups compared to the non-responders (Group A: 17 vs 6 months, p < 0.001, Group B: 20.5 months vs 5 months, p < 0.001). Patients in good performance status (ECOG, 0-2) had a significantly higher response rate to chemotherapy (Group A: 70.3% vs 26.3%, p < 0.01, Group B: 38.2% vs 11.7%, p < 0.05). In Group A, patients with extrapelvic disease responded better compared to pelvic disease (83.3% vs 34.5%, p < 0.01). Chemotherapy side effects were mainly nausea/vomiting, alopecia, myelosuppression, reversible encephalopathy (in Group A), and impaired renal functions. Chemotherapy toxicity was higher for patients receiving BIP, 2 patients died of BIP toxicity. Currently, in 'Group A' 8 patients are alive, 7 disease-free and one with disease at a median interval of 51 months after chemotherapy treatment. While in Group B, 3 patients are alive, 2 disease-free and one with disease. CONCLUSIONS: Bleomycin, ifosfamide and cisplatin improved the response rate in recurrent and metastatic cervical cancer compared with cisplatinum alone. However, the toxicity was moderate and survival was not significantly improved. These results need to be confirmed in a phase III, randomized study in larger number of patients.

Adult↗
PubMed1998

Characterization of cogon grass (Imperata cylindrica) pollen extract and preliminary analysis of grass group 1, 4 and 5 homologues using monoclonal antibodies to Phleum pratense.

BACKGROUND: Previous studies have established the role of Imperata cylindrica (Ic) pollen in type I allergic disorders. However, no systematic information is available on the allergen composition of Ic pollen extract. OBJECTIVES: To characterize the IgE-binding proteins of Ic pollen extract and to detect the presence of grass group 1, 4 and 5 allergen homologues, if any. METHODS: Pollen extract of Ic was analyzed by in vivo and in vitro procedures such as intradermal tests (ID), enzyme-linked immunosorbent assay (ELISA), ELISA-inhibition, thin-layer isoelectric focusing (TLIEF), sodium dodecylsulfate polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting. Dot blot assay was carried out to check the presence of well-known group 1, 4, and 5 allergen homologues in Ic pollen extract. RESULTS: Out of 303 respiratory allergies patients skin-tested, 27 showed sensitivity to Ic pollen extract. Specific IgE levels were elevated in all 15 serum samples tested. The extract prepared for this study was found to be highly potent since it required only 400 ng of homologous proteins for 50% inhibition of binding in ELISA inhibition assays. TLIEF of Ic pollen extract showed 44 silver-stained bands (pI 3.5-7.0) while SDS-PAGE resolved it into 24 Coomassie-Brilliant-Blue-stained bands (MW 100-10 kD). Immunoblotting with individual patient sera recognized 7 major IgE-binding bands (MW 85, 62, 57, 43, 40, 28 and 16 kD) in Ic pollen extract. A panel of monoclonal antibodies, specific to group 1, 4 and 5 allergens from Phleum pratense pollen extract identified group 5 and group 4 homologues in Ic pollen extract. CONCLUSION: Ic pollen extract was characterized for the protein profile by TLIEF and SDS-PAGE. IgE reactivity was determined by ELISA and immunoblot. Monoclonal antibodies to group 5 and group 4 allergens reacted weakly showing that this pollen contains group 5 and group 4 homologous allergens.

Adolescent↗
PubMed1998

Henoch-Schonlein purpura: the Chandigarh experience.

OBJECTIVE: To determine the clinical profile of children with Henoch-Schonlein purpura (HSP). DESIGN: Hospital based descriptive follow-up study. SUBJECTS: 45 patients attending the Pediatric Rheumatology and Immunology clinic over the last 4 years. RESULTS: The patients were aged between 2.5-12 years with a male to female ratio of 2:1. All cases had palpable purpura. Gastrointestinal involvement was seen in 38 patients, with abdominal pain in 35 (78%) and lower GI bleed in 21 (47%). Large joint arthritis occurred in 60%. Renal involvement was seen in 14 subjects (31%). Major renal involvement occurred in 9 patients, with nephritic syndrome in 6 and nephrotic syndrome in 3 cases. Five patients had minor urinary abnormalities; 6 patients with major renal involvement and crescentic glomerulonephritis were treated with high dose pulse steroid therapy followed by oral prednisolone and azathioprine for 12-18 months. Normalization of urinary abnormalities occurred in these patients over 4-8 months and presently all are normotensive and off antihypertensive drugs. CONCLUSIONS: HSP in children is a common form of vasculitis. Though short term results in HSP nephritis have been good, long term prognosis in those with major renal involvement would remain guarded.

Adolescent↗
PubMed1998

Plasma zinc status in Indian childhood tuberculosis: impact of antituberculosis therapy.

SETTING: Department of Paediatrics and Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India. OBJECTIVE: To assess the plasma zinc status in children with tuberculosis and to correlate it with nutritional status, activity and severity of disease in relation to antituberculosis therapy. DESIGN: The plasma zinc status of 50 children with different forms of tuberculosis was compared with 10 healthy and 10 malnourished children without tuberculosis at 0, 1, 2, 3 and 6 months of antituberculosis therapy. RESULT: The mean plasma zinc concentration in children with pulmonary tuberculosis (n = 20) was 68.65+/-2.50 microg/dl, central nervous system (CNS) tuberculosis (n = 10) was 64.20+/-3.82 microg/dl, tuberculous lymphadenitis (n = 10) was 63.2+/-3.77 microg/dl and disseminated tuberculosis (n = 10) was 59.0+/-2.75 microg/dl at 0 months. The mean plasma zinc level of healthy children was 129.10+/-3.01 microg/dl and in malnourished non-tuberculous children it was 108.40+/-3.16 microg/dl. Thus children with tuberculosis had significantly lower plasma zinc level than those without tuberculosis, irrespective of their nutritional status (P < 0.001). There was a significant rise in zinc level at the end of 6 months of antituberculosis therapy (P < 0.001). CONCLUSION: Plasma zinc status may prove to be a good objective marker for monitoring the severity of the disease and the response to therapy.

Antitubercular Agents↗
PubMed1998

Normothermic cardiopulmonary bypass & post-operative blood loss.

Normothermic cardiopulmonary bypass (CPB) has been shown to have less disruptive effects on coagulation factors and platelet function. Ninety patients undergoing valvular heart surgery were randomly divided into two groups of 45 patients each to undergo normothermic (35 degrees C-37 degrees C) or hypothermic (28 degrees C) bypass. We found normothermic bypass to significantly reduce bypass time and requirements of fluid and blood post-operatively. However, there was no reduction in post-operative blood loss, re-exploration rate or blood product requirements by use of normothermic cardiopulmonary bypass.

Adolescent↗
PubMed1997

Dynamics of conjunctival impression cytologic changes after vitamin A supplementation.

To investigate the chronological changes in conjunctival epithelium after supplementation with a massive oral dose of vitamin A, conjunctival impression cytology (CIC) with transfer was carried out repeatedly among 200 children aged 6-120 months in a randomized, double-blind, placebo-controlled study in Chandigarh (India). Significant conversion to normal CIC started 71-80 d after vitamin A supplementation and by 101-110 d conversion had taken place in all children. Compared with the placebo group, plasma retinol concentration at 100 d post-supplement was found to be significantly higher in the vitamin A-supplemented group P = 0.04. This study demonstrates that CIC responds to a massive oral dose of vitamin A 3-4 months after supplementation. These findings should guide future studies and evaluations in which CIC is used to assess response to vitamin A interventions.

Administration, Oral↗