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Biomedical subjects

L Kumar

Publications and source records attributed to L Kumar.

At least 91 records · Page 5Linked to original sources
PubMed1997

Granulocytic sarcoma of uterine cervix as presentation of acute myeloid leukemia: a case report and review of literature.

Localized extramedullary collection of leukemic cells is termed as granulocytic sarcoma. Incidences of 2-8% in acute myeloid leukemia have been reported in various autopsy studies. In female it usually involves ovary. Since most of such tumors are asymptomatic, they are detected only at autopsy. We report here a case who manifested as abnormal vaginal bleeding, large cervical mass, renal failure, and aspergillous fungaemia. The patient died before she could be treated. From the present report it would appear that granulocytic sarcoma at times may precede other manifestations of leukemia.

Adult↗
PubMed1997

Pulmonary capillary haemangiomatosis as a cause of pulmonary hypertension in Takayasu's aortoarteritis.

Pulmonary hypertension is known to occur in Takayasu's aortoarteritis. It may be either due to pulmonary arterial involvement or elevated left ventricular end diastolic pressure, or both. In our case, the cause of pulmonary hypertension was a recently described rare lesion termed pulmonary capillary haemangiomatosis. This entity has a very distinct histopathologic picture. Although 19 cases have been reported in the English literature, this is the first report on pulmonary capillary haemangiomatosis producing pulmonary hypertension in Takayasu's aortoarteritis.

Child↗
PubMed1997

Blood stem cell transplantation: current concepts.

Mobilized peripheral blood haematopoietic progenitor cells are increasingly being used as against bone marrow (BM) transplants, following high dose chemotherapy and/or radiotherapy for the management of chemosensitive malignancies. Rapid haematopoietic reconstitution as evidenced by reduced duration of neutropaenia, fewer donor platelet infusions, shorter hospital stay and reduced cost of treatment are the advantages of this procedure. Reduced tumour cell contamination of mobilized blood compared to bone marrow however, has not been substantiated. Mobilization of lymphokine activated killer cells (LAK), use of blood stem cells (BSC) for allogeneic transplants and ex vivo expansion of the mobilized cells are emerging as the future areas for research. Addition of interleukin-3 (IL-3), stem cell factor (c-kit ligand) and PIXY-321 appear to open-up new vistas by enforcing trilineage and multilineage haematopoietic reconstitution.

Blood Specimen Collection↗
PubMed1997

Electrolyte disturbances due to ouabain sensitive sodium potassium pump in erythrocytes of children with sepsis.

The possible mechanism of hyponatraemia in septicaemic children was studied by measuring the intracellular red cell sodium in relation to ouabain sensitive Na(+)-K(+) pump by flame photometry. Hyponatraemia and hyperkalaemia were observed in most of the patients. There was a marked elevation in serum sodium levels and a significant reduction in serum potassium levels on recovery following therapy. The alteration in the distribution of electrolytes between plasma and erythrocytes resulted in significantly high levels of sodium and low levels of potassium within the erythrocytes of septicaemic patients which normalized on recovery. The ouabain sensitive sodium efflux rate and ouabain sensitive efflux rate constant were significantly decreased in the membranes of erythrocytes of septicaemic patients which also normalized on recovery. Our findings suggest that it is the intrinsic alterations in the transport capacity of Na(+)-K+ pump which could account for the rise in intracellular erythrocyte sodium and fall in intracellular potassium contents in septicaemic children.

Child↗
PubMed1997

Juvenile dermatomyositis in north India.

OBJECTIVE: To determine the clinical profile and therapeutic response of patients with juvenile dermatomyositis (JDM). DESIGN: Hospital based descriptive follow-up study. SAMPLE: 12 patients attending the Pediatric Rheumatology and Immunology Clinic over last five years. RESULTS: The patients were aged between 3 1/2 years to 12 years with a male to female ratio of 2:1. All patients had proximal muscle weakness at presentation. Distal muscle weakness and masseter atrophy was seen in 2 patients and neck flexor weakness and pharyngeal weakness was seen in 1 case. Muscle pain, tenderness or swallowing difficulties were not observed. Classical skin manifestations of JDM were present in all except one patient. Vasculitic lesions were not noted. One patient had diffuse lipoatrophy. Two patients developed calcinosis cutis while on treatment. All patients were put on oral corticosteroids (prednisolone 2 mg/kg/day) initially which were gradually tapered while monitoring clinical response. Early initiation of steroid therapy resulted in an excellent response. Two patients who did not show significant improvement even with prolonged steroid therapy were given oral weekly methotrexate (10 mg/m2/week). CONCLUSIONS: Most of the children with JDM showed good response to steroid therapy which needs to be continued for a prolonged period. Children who do not respond to this therapy may be given oral weekly methotrexate.

Adrenal Cortex Hormones↗
PubMed1997

Intravenous magnesium sulfate in acute severe asthma not responding to conventional therapy.

OBJECTIVE: To evaluate the effectiveness of early administration of intravenous Magnesium sulfate (i.v. MgSO4) in children with acute severe asthma not responding to conventional therapy. DESIGN: Randomized double-blind, placebo-controlled trial. SETTING: Pediatric emergency service of a large teaching hospital. SUBJECTS: 47 children aged between 1-12 years with acute severe asthma showing inadequate or poor response to 3 doses of nebulized salbutamol given at an interval of 20 min each. INTERVENTION: The MgSO4 group received 0.2 ml/kg of 50% MgSO4 as intravenous (i.v.) infusion over 35 minutes and the placebo group received normal saline infusion in the same dose and at the same rate. MgSO4 solution and normal saline were coded and dispensed in identical containers. Decoding was done at the completion of the study. All the patients received oxygen, nebulized salbutamol, i.v. aminophylline and corticosteroids. RESULTS: MgSO4 group showed early and significant improvement as compared to placebo group in PEFR and SaO2 at 30 min and 1, 2, 3 and 7 hours after stopping the infusion (p ranging from < 0.05 to < 0.01). The clinical asthma score also showed significant improvement in the MgSO4 group 1, 2, 3 and 11 hours after stopping the infusion (p < 0.01). CONCLUSION: Addition of MgSO4 to conventional therapy helps in achieving earlier improvement in clinical signs and symptoms of asthma and PEFR in patients not responding to conventional therapy alone.

Acute Disease↗
PubMed1997

Acute leukemia presenting as pericardial effusion--a case report.

We report a patient with acute lymphoblastic leukemia, who presented with pericardial effusion. There was no haematologic evidence of leukemia at the time of presentation. The pericardial effusion resolved with chemotherapy. Although a common finding at autopsy, clinically evident pericardial effusion is rare in leukemia. It is also extremely rare for pericardial effusion to be the presenting feature or to antedate haematologic evidence of leukemia. Physician awareness is important to make a correct diagnosis.

Adult↗
PubMed1997

Clinical and immunological profile of SLE: some unusual features.

OBJECTIVE: To study the clinical and immunological profile of children with systemic lupus erythematosus (SLE). DESIGN: Retrospective hospital based study. SETTING: Tertiary level center of North India. SUBJECTS: Sixteen children in the age group 4-12 years. METHODS: Medical records of children with SLE were analyzed. Clinico pathological features were compared with 2 other series from India. RESULTS: Mean age of children at the time of diagnosis was 10 yr and 8 (50%) children were less than 10 yr of age. The female to male ratio was 7:1. Fever (56.2%), rash (87%) and arthritis (87%) were the common clinical manifestations, Renal involvement was noted in 56.2% of cases. Other clinical features included hemolytic anemia (31.2%), thrombocytopenia (18.6%) and Raynaud's phenomenon (12.5%). Cardiac involvement in the form of severe myocarditis and endocarditis occurred in one patient each. Pulmonary hypertension was the presenting feature in one child with right heart failure. One child had multiple sclerosis along with SLE--a rare combination. ANA positivity was seen in all children. Five children died; two had severe cardiac involvement. Three children had renal involvement and one died of pulmonary hypertension. Two-thirds of subjects with renal involvement improved after therapy according to NIH, Bethesda protocol. CONCLUSIONS: SLE must be considered in any child with multisystem disease, as the disease may have certain unusual presentations.

Child↗
PubMed1997

Reiter's syndrome.

Explore the source record for details and available documents.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1996

Epithelial ovarian carcinoma metastatic to the central nervous system: a report on two cases with review of literature.

Metastasis to the central nervous system (CNS) from ovarian malignancy is rare. We describe two such patients who developed CNS metastasis in the form of multiple deposits in brain parenchyma after an interval of 27 and 16 months from the diagnosis of ovarian carcinoma. Both patients received cranial radiotherapy but survived only 2 weeks and 5 months, respectively. Data on 99 patients collected from the literature (Medline, National Library of Medicine, Bethesda, MD) are reviewed and an attempt is made to suggest therapeutic guidelines depending on the extent of the intracranial and extracranial disease and performance status of the patients.

Brain Neoplasms↗
PubMed1996

Palliative treatment of malignant pericardial effusion: report of two cases and a review of the literature.

Malignancy accounts for 40%-60% of pericardial effusions. Two individuals with malignant pericardial effusions secondary to lung, cancer, managed with the help of a percutaneous balloon pericardial window (PBPW), are discussed in this report. Clinical benefits in terms of reduction of breathlessness and improved diastolic function of the heart were documented in both. There were no procedure-related complications. The PBPW provides quick relief, appears diagnostically superior to an invasive technique and has a low rate of recurrence and complications.

Fatal Outcome↗
PubMed1996

Conjunctival impression cytology with transfer (CICT) to detect pre-clinical vitamin A deficiency among slum children in India.

In order to establish a method usable in the field for diagnosis of pre-clinical vitamin A deficiency, conjunctival impression cytology with transfer (CICT) was used in 200 normal slum children aged 6-120 months in Chandigarh, India. Conjunctival impressions taken on cellulose acetate paper were transferred to glass slides which were fixed in ethanol and stained with alcian blue and carbol fuchsin. Sixty samples of cellulose acetate paper were preserved after transfer of impression and were stained later. Transfer was complete in forty-eight samples and in the other twelve it was incomplete. Conjunctival impressions on paper and slide of these twelve cases were comparable. At a plasma retinol concentration of < 0.70 mumol/l measured by HPLC the sensitivity, specificity and positive predictive values of CICT were 90.59%, 100% and 100% respectively. Compared with conventional conjunctival impression cytology, CICT is less time consuming, cheaper and comparable in validity. It is thus more suitable than the conventional method for mass screening.

Child↗