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Biomedical subjects

M Kannan

Publications and source records attributed to M Kannan.

29 records · Page 2Linked to original sources

Type I Glanzmann thrombasthenia: most common subtypes in North Indians.

The expression of GPIIb/IIIa on the platelet surface was assessed in 10 patients with Glanzmann thrombasthenia and their families by flow cytometry to determine the common subtype in North Indians. Glanzmann thrombasthenia was diagnosed in patients with bleeding manifestations accompanied by absent/reduced platelet aggregation, secondary to ADP, ADR, arachidonic acid, and collagen. Flow cytometry revealed variable GPIIb/IIIa expression by CD61 and CD41 in patients with Glanzmann thrombasthenia on the basis of CD61 levels, six patients were subtyped as type I because they had absent GPIIb/IIIa, three patients were subtyped as type II because their GPIIb/IIIa levels varied from 7.72% to 20.40%, and one patient was diagnosed as type III, because his clot retraction was 60% and GPIIb/IIIa was 46.0% of normal. Four fathers, three mothers, and five siblings were found to have GPIIb/IIIa levels less than 35% of normal. It is possible that low GPIIb/IIIa levels in family members may reflect their carrier status. It is postulated that flow cytometric estimation of GPIIb/IIIa in parents/siblings may detect carrier status in Glanzmann thrombasthenia.

Adolescent↗

Pro CR global: an effective screening test for thrombophilia.

In the present study, the Pro C(R) Global test was evaluated as a screening test for estimation of the activity of the main plasma components of the anticoagulant protein C (PC) / protein S (PS) pathway; 300 patients with a history of thrombosis were investigated for Pro C(R) Global. It was positive in 74 patients. Tests for estimation of PC, PS, activated protein C resistance (APCR), and lupus anticoagulant (LAC) were performed in all the patients with abnormal Pro C(R) Global and in 10 patients with normal Pro C(R) Global. In all, 66 of the 74 patients had a defect in PC/PS/APCR or LAC; 18 patients had both PC and PS deficiency, 25 had PS deficiency alone, 10 had PC deficiency alone, one had APCR alone, eight had PS, PC deficiency with APCR, and four had PS deficiency with APCR. In the 10 patients who tested negative with the Pro C(R) Global test, PC, APCR, and LAC were negative in all. However, PS deficiency was seen in two of them. The sensitivity and specificity of Pro C(R) Global, calculated with respect to positivity of PC, PS, LAC, or APCR as the gold standard, were 97% and 50%, respectively. The diagnostic accuracy of the assay was 88.1%. It is thus recommended that Pro C(R) Global can be used effectively as a screening test to detect abnormality in the PC/PS/APCR/LAC pathway.

Case-Control Studies↗

Neonatal thrombosis.

Neonatal thrombosis is a serious event that can cause mortality or result in severe morbidity and disability. The most important risk factor for the development of thrombosis during the neonatal period is the presence of an indwelling central line and consequently the vessels involved tend to be those most frequently used for catheterization. Other documented risk factors for the development of neonatal thrombosis include asphyxia, septicemia, dehydration, maternal diabetes and cardiac disease. Main laboratory findings for the diagnosis of hypercoagulable states, include shortened aPTT, decreased levels of inhibitors (AT III, Protein C and Protein S), increased resistance to activated protein C, defective fibrinolysis (basal and after stimuli), increased levels of clotting factors (fibrinogen, factor VII, factor VIII, etc.), increased and/or hyperactive platelets, increased whole blood and/or plasma viscosity, Antiphospholipid antibodies and presence of prothrombotic molecular defects like FV Leiden, P20210 and MTHFR. Approximately 4% and 2% respectively of Caucasians are heterozygous for these gene defects. Their causative role in neonatal thrombosis is unknown but they may have a contributory role in the pathogenesis of thrombosis in neonates.

Disseminated Intravascular Coagulation↗

Contribution of iron deficiency to anemia in chronic renal failure.

Prevalence of iron deficiency in anemia of chronic renal failure (CRF) has long been the subject of interest, because the patients of CRF with coexistent iron deficiency anemia need to be treated with iron preparations before starting erythropoietin therapy. Prevalence of iron deficiency in CRF is higher in Indian patients as compared to the West. Diagnosis of iron deficiency in patients with CRF is difficult. Bone marrow iron which is considered to be the gold standard is a painful and invasive procedure. In the present study we used serum transferrin receptor and serum ferritin levels, since not much Indian data is available on this.

Adult↗

Venous thrombosis: prevalence of prothrombotic defects in north Indian population.

431 patients with thrombosis of different venous system were evaluated for underlying acquired and inherited prothrombotic states. Associated acquired risk factors were observed to be present in 28.7% patients and possible inherited in 32.3%, in the rest, no cause could be identified. Major acquired risk factors included coexistence of liver disease (12.2%), oral contraceptives (4.1%), puerperium (2.5%), malignancy (2.3%) and lupus anticoagulant (2%). Low levels of protein C were detected in 21.1% and of which 11.3% were attributed to acquired factors. Protein S deficiency was found in 19.0% and of these 10.4% cases were associated with acquired risk factors. Antithrombin III (AT III) deficiency was detected in 6.4% of patients, of which 4.8% were secondary to acquired factors. In the rest, deficiency of protein C, protein S and AT III were attributed to inherited factors as no associated acquired risk factor was present. Activated protein C resistance (APC-R) was present in 12.5% cases.

Adolescent↗

Effects of intramuscular or interpleural administration of morphine and interpleural administration of bupivacaine on pulmonary function in dogs that have undergone median sternotomy.

OBJECTIVE: To evaluate effects of interpleural or IM administration of morphine and interpleural administration of bupivacaine on pulmonary function in dogs that have undergone median sternotomy. DESIGN: Experimental trial. ANIMALS: 18 healthy dogs. PROCEDURE: Dogs underwent median sternotomy and were randomly assigned to groups of 6 dogs each. Group-A dogs were given morphine (1.0 mg/kg of body weight) i.m.; group-B dogs were given 0.5% bupivacaine (1.5 mg/kg) interpleurally; and group-C dogs were given morphine (1.0 mg/kg) interpleurally. Heart rate; systolic, diastolic, and mean arterial pressures; rectal temperature; pain score; and arterial blood gas partial pressures were measured and pulmonary function testing was performed immediately after extubation (time 0) and up to 48 hours later. Serum cortisol and morphine concentrations were measured at time 0 and up to 12 hours after surgery. RESULTS: There was a significant decrease in pH, PaO2, mean oxygen saturation of hemoglobin, and dynamic compliance; and a significant increase in PaCO2, alveolar-arterial difference in partial pressure of oxygen, pulmonary resistance, and work of breathing for dogs in all groups after surgery. Serum cortisol concentrations were significantly increased, compared with preoperative values, in all dogs. Serum cortisol concentrations were significantly higher in group-B dogs between 3 and 5 hours after surgery, compared with group-A dogs. CONCLUSIONS: Median sternotomy was associated with significant alterations in pulmonary function. Effects of interpleural administration of bupivacaine and morphine were similar to effects of i.m. administration of morphine.

Analgesics, Opioid↗

Ultrastructural studies on the neuromuscular control of human tracheal and bronchial muscle.

This study presents an ultrastructural analysis of neural and myogenic control of smooth muscle in human trachea, in small (approximately fourth to seventh order) bronchi. A moderate frequency of gap junctions between smooth muscle cells and a sparse innervation was observed in trachea. In contrast, small junctions without identifiable gaps were identified in bronchi along with a dense, sometimes close innervation of muscle. Most profiles of nerve varicosities in both types of airways were of two types: (1) those containing mostly small agranular and few or no large granular vesicles; and (2) nerves (probably adrenergic) with some small granular vesicles along with other vesicles present in bronchi. In the bronchi some mast cells were found near nerve profiles and in close proximity to smooth muscle. These morphological findings suggest that tracheal muscle may be organized for more neural and less myogenic control of activity. Interactions between mast cells, nerves and muscles in bronchi could influence airway function. These findings imply that a single type of airway muscle may not adequately represent the structural and functional properties of human airway.

Bronchi↗