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Biomedical subjects

M Kumar

Publications and source records attributed to M Kumar.

At least 235 records · Page 13Linked to original sources
PubMed1993

Evaluation of amphotericin B as a first line drug in comparison to sodium stibogluconate in the treatment of fresh cases of kala-azar.

A total of 150 patients of kala-azar matched for age and sex and parasitologically proved were randomly allocated to two equal treatment groups. Patients in one group received amphotericin B(AMB) in a dose of 1 mg/kg body weight (BW) on alternate days starting with 0.05 mg/kg/bw on first day with daily increments, till a total dose of 20 mg/kg/bw was given; the patients in the second group received sodium stibogluconate (SAG) in the dose of 20 mg/kg/bw, im daily for 30 days. The efficacy, safety and cost-effectiveness of the two drugs were compared. Apparent cure (afebrile at the end of therapy) in 75 (100%) and 69 (92%) patients and ultimate cure (no relapse in six months of follow up) in 75 (100%) and 60 (80%) patients occurred in the AMB and SAG groups respectively. The difference between the ultimate cure in the two groups was significant (P < 0.001). Six (8%) and 9(12%) patients of SAG group showed primary (with no response to SAG during treatment) and secondary unresponsiveness (with no response to SAG after relapse) respectively and they were cured with amphotericin B.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Molecular genetic, cytogenetic, and immunohistochemical characterization of alveolar soft-part sarcoma. Implications for cell of origin.

BACKGROUND: Alveolar soft-part sarcoma is a rare tumor of uncertain histogenesis. METHODS: The authors report a patient who was studied using immunohistochemistry, cytogenetic analysis, and molecular probes for MyoD1 and MYCN (N-myc proto-oncogene). RESULTS: By immunoperoxidase, the tumor was focally positive for vimentin, neuron-specific enolase, and S-100 protein but negative for muscle-specific actin, desmin, and low-molecular-weight keratin. Direct chromosome analysis of primary tumor cells using G-banded preparations yielded two clonally abnormal lines: one demonstrated trisomy 47,XX+5; the other demonstrated 46,XX,1p-,17q+. Expression of the MYCN RNA was detectable at a low level, and MYCN was single copy at the DNA level. Expression of the myogenic molecular marker MyoD1 was not detected by Northern blotting analysis. CONCLUSIONS: This is the first detailed study to address the molecular biology and tumor cytogenetics of alveolar soft-part sarcoma. The results of this study indicate a neurogenic origin for this unusual tumor and fail to provide support for the notion of a myogenic origin.

Adolescent↗
PubMed1992

Phenytoin as a coanalgesic in cancer pain.

The efficacy of phenytoin (PHT), buprenorphine (Bu), and Bu+PHT for the relief of cancer pain of various etiologies was evaluated in a randomized, double-blind study of 3 groups, each comprised of 25 patients. Treatment duration was 1 month. PHT (100 mg by mouth twice daily) provided greater than 50% pain relief to 18 patients (72%) and greater than 75% relief to 4 (16%). Bu (0.2 mg sublingually twice daily) gave 21 patients (84%) greater than 50% relief and 15 patients (60%) greater than 75% relief. Of the Bu-treated patients, 8 had major side effects, while none of the PHT-treated patients experienced significant untoward reactions. Combined therapy (PHT, 50 mg PO+Bu 0.1 mg SL twice daily) provided greater than 50% pain relief to 22 patients (88%) and greater than 75% to 18 (72%); only 3 patients experienced a significant side effect. This study suggests that phenytoin has mild-to-moderate pain-relieving properties of its own and can significantly enhance buprenorphine analgesia. By permitting a lower opioid dose, it may reduce the occurrence of opioid-related side effects. PHT's lack of serious side effects, as well as its documented anxiolytic and antidepressant actions, may add to its comparative usefulness. Further clinical trials of PHT as a coanalgesic and/or adjuvant agent in cancer pain are warranted.

Adult↗
PubMed1992

Observations on the effect of verapamil with sodium stibogluconate in kala azar.

40 parasitologically confirmed cases of kala azar, were randomly allocated into four treatment groups to assess the effect of verapamil on fresh and antimony resistant cases of kala azar. Untreated patients received sodium stibogluconate only or in combination with oral verapamil. Antimony-resistant patients were treated with sodium stibogluconate combined with oral verapamil or pentamidine. The patients were followed up for six months. Verapamil neither shortened the duration of treatment nor increased parasitological cure rate nor improved the ultimate cure. In antimony unresponsive patients it did not reverse unresponsiveness.

Administration, Oral↗
PubMed1992

Tropical pyomyositis in India: a clinico-histopathological study.

Eighteen cases of tropical pyomyositis, aged 12-45 years, were seen over a 3-year period. There was clustering of cases in January, February and July to October. Male:female ratio was 14:4. Multiple muscular lesions (greater than 2) were common (67%). Extramuscular complications were present in 50% of the cases. Cardio-pulmonary involvement was most frequent. Muscle biopsies, done in 16 cases, showed suppurative changes (pus) in 15 cases and one case of non-suppurative myositis. Muscle necrosis, cellular infiltration with polymorphs and haemorrhage in-between muscle fibres were common.

Adolescent↗
PubMed1992

Cytodiagnosis of rhinosporidiosis.

Two clinically suspected cases of nasal rhinosporidiosis were studied cytologically using a wipe out technique. The smears showed the typical spores of the fungus and the cytological diagnosis of rhinosporidiosis was confirmed by excisional biopsy. The smear is recommended as a routine preliminary screening technique in the diagnosis of suspected cases of rhinosporidiosis.

Adolescent↗
PubMed1991

Experience with a potent LH-RH agonist, buserelin, alone and in combination with testosterone for antispermatogenic activity, reversibility and toxicity in langur monkey.

Chronic intermittent treatment of LH-RH superagonist Buserelin alone or in combination with testosterone enanthate were given to adult male langurs for 90 days to evaluate antispermatogenic activity of alone and combination therapy, maintenance of normal androgenicity, possible toxic effects of agonist treatment, related side effects of testosterone supplementation and complete reversibility of the procedure. A gradual decrease in sperm count was recorded in both treatment groups, along with reduced motility and vitality of the spermatozoa. In the combination group, oligospermia was achieved in 4 out of 5 animals, whereas, only 2 animals became oligospermic in the agonist alone group. Significant decrease in serum testosterone levels along with impaired libido and other testosterone withdrawal symptoms were observed in the Buserelin alone group, conversely normal testosterone levels and libido were observed in the combination group. An elevation in haematological variables and serum total protein concomitant with a slight gain in body weight of the animals were recorded in the combination group; these changes were not encountered in the agonist alone group. Reversibility of all the altered parameters to control range was observed in both treatment groups following 75 to 90 days of treatment withdrawal.

Acid Phosphatase↗
PubMed1991

Sepsis and septic shock. Deadly complications that are on the rise.

Most patients are already hospitalized when sepsis and septic shock develop, and in spite of therapy, at least 50% die. Although newer therapeutic agents are being evaluated, current management consists of antibiotics, fluids for volume resuscitation, inotropic agents, and surgery for septic foci. Greater emphasis on preventive measures is recommended.

Anti-Bacterial Agents↗
PubMed1991

The potential for renal salvage in nonmetastatic unilateral Wilms' tumor.

The potential for resection with renal salvage, and the ability of computed tomographic (CT) criteria to predict this potential, were evaluated retrospectively in 43 children with nonmetastatic unilateral Wilms' tumor (stage I, II, or III at diagnosis). CT criteria for renal salvage were (a) tumor involving only one pole and occupying less than one third of the kidney; (b) functioning kidney; (c) no invasion of collecting system or renal vein; and (d) clear margins between tumor, kidney, and surrounding structures. Preoperative CT scans met these criteria in only two of the 43 cases. Surgical and/or pathologic reports confirmed CT-based findings in all cases. Most of the tumors were large (median vertical and transverse diameters both = 10 cm), and only three patients were estimated to have more than 50% functioning renal tissue. A prospective trial would be necessary to evaluate the long-term benefits and possible complications of renal salvage procedures in patients with Wilms' tumor. Given the small proportion of patients likely to be eligible for such procedures, and the currently excellent cure rates in low-stage disease, such as trial would be difficult to implement.

Child↗
PubMed1991

Comparison of regimes of treatment of antimony-resistant kala-azar patients: a randomized study.

Three hundred twelve patients with antimony-resistant kala-azar were randomized into three groups. The first group (A) received pentamidine isethionate intravenously three times each week until parasitological cure was achieved. Group B received pentamidine concomitantly with a 20-day regimen of sodium stibogluconate. Group C received pentamidine injections that were followed by 20 days of sodium stibogluconate therapy. All patients became afebrile after 10 injections of pentamidine. Parasitologic cure was achieved in approximately 98% of the patients who had 33 or more injections of this drug. The addition of the antimony compound did not appear to enhance the rate of parasitologic cure. Three patients continued to have parasites after 40 injections of pentamidine. After six months, the rate of parasitologic cure was significantly higher in Group C (pentamidine followed by sodium stibogluconate) than in either Group A or B. Forty patients relapsed after apparent parasitologic cure and were successfully treated with five additional injections of pentamidine, followed by a course of antimony therapy. Minor side effects with pentamidine included an uneasy feeling during intravenous injection (12%), intestinal disturbances (6%), cellulitis (5%), abscess formation (1%), and allergic manifestations (2%). Major reactions to this drug included hyperglycemia (10%; reversible in 6% and irreversible in 4%), and delayed hypoglycemia (8%). Four deaths were associated with the administration of this compound. It is concluded that pentamidine is an effective but toxic drug for the treatment of antimony-resistant kala-azar.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Evaluation of efficacy of longer durations of therapy of fresh cases of kala-azar with sodium stibogluconate.

The efficacy and safety of three regimens of treatment for kala-azar (visceral leishmaniasis) with sodium stibogluconate were evaluated in a randomised clinical trial to ascertain the optimal duration of treatment for Indian patients. The study included a total of 312 (226 male, 86 female) patients with fresh kala-azar, confirmed by demonstration of parasites in aspirates from bone marrow or spleen, who were randomly allocated into three treatment groups of 104 patients in each to receive sodium stibogluconate intramuscularly. The dose of the drug was 20 mg/kg/body weight/daily with a maximum of 8.5 ml for 20, 30 and 40 days (groups A, B, C respectively). The response of treatment was assessed under blind conditions and patients were followed up each month for a period of six months. The number of patients who were apparently cured (i.e., those whose temperature had returned to normal at the end of their respective regimen and aspirates were free of parasites) was 91 (87%) in group A, 98 (94%) in group B, and 102 (98%) in group C. The difference between groups A and C was significant (P less than 0.01). The number of patients who were ultimately cured at six months was 74 (71%) in group A, 86 (83%) in group B and 98 (94%) in group C. These patients had not relapsed and were cured as confirmed by a bone marrow aspirate which was free of parasites. The difference between groups A and C (P less than 0.001) and groups B and C (P less than 0.05) were significant. However, the difference between groups A and B was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Norepinephrine response in early HIV infection.

Norepinephrine response to a cold pressor test was investigated in 95 homosexual men in a longitudinal study of human immunodeficiency virus (HIV) infection. The baseline data obtained from 76 HIV+ and 19 HIV- subjects are included in this report. After the insertion of a venicatheter and following a 30 min rest, subjects immersed one of their hands in ice water for 2 min, and serial blood samples were obtained for the determination of catecholamine levels. The results show that the norepinephrine response in HIV+ subjects compared to that of HIV- subjects was blunted. Examination of the responses using linear and quadratic orthogonal polynomials suggested that these differences between the two groups were primarily a function of their rate of increase in norepinephrine levels. It was observed also that in HIV+ subjects, norepinephrine level peaked earlier than that in HIV- subjects. The data suggest that autonomic dysfunction is present in the early stages of HIV infection.

Autonomic Nervous System↗
PubMed1991

Role of allogenic vesical mucosa in inducing neo-osteogenesis in guineapigs.

Fresh allogenic mucosa lining the urinary bladder was transplanted into a 1 cm gap of right ulna bone in 24 guineapigs. The 1 cm, bone gap in the left ulna served as control. At regular intervals, the implanted and control sites were studied grossly with naked eye, radiologically and histopathologically to ascertain the role of allogenic vesical mucosa in inducing neo-osteogenesis. The bone gaps were uniformly bridged by bone in 10-12 wk at the implanted sites and fibrous tissue at control sites. There was no evidence of graft rejection. The study thus suggests the potential of the use of stored allogenic vesical mucosal grafts for neo-osteogenesis in clinical practice.

Animals↗