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Biomedical subjects

R Kumar

Publications and source records attributed to R Kumar.

At least 487 records · Page 27Linked to original sources

Parents' judgements about young children's problems: why mothers and fathers might disagree yet still predict later outcomes.

Correlates of parents' ratings of behavioural problems were explored in a sample of 93 British families, in which mothers and fathers rated their children at the time of the fourth birthday on the Achenbach Child Behavior Checklist. As in other samples, there was moderate convergence in mothers' and fathers' total problem scores, but also signs that they were reporting different sorts of problems linked to different influences. The father's rating was primarily associated with the child's cognitive ability. The mother's rating was primarily affected by her own mental state and view of her marriage. The father's but not the mother's rating provided unique information that predicted teachers' reports of the children's problems 7 years later. In general, parents' ratings of preschool children's problems reflect particular informants' perspectives on family life.

Affective Symptoms↗

Unilateral hydrocephalus in paediatric patients, a trial of endoscopic fenestration.

Two uncommon cases of unilateral, asymmetrical hydrocephalus secondary to membranous occlusion of foramen of monro are described. Both the cases presented with clinical features of raised intracranial pressure and their cranial computerized scans (CT) revealed asymmetrical dilatation of lateral ventricles with displacement of septum pellucidum towards the side of smaller ventricle. Neuroendoscopic fenestration of septum pellucidum and foramen of monro was tried in both the cases, which remained successful in first, while the second case required unilateral ventriculoperitoneal shunt, due to failed endoscopic negotiation of narrowed foramen of monro and intraoperative bleeding during endoscopic intervention.

Adolescent↗

Primary malignant rhabdoid tumours of brain, clinicoradiological findings of two cases.

Malignant rhabdoid tumours (MRT) are extremely malignant, highly aggressive and uncommon renal neoplasms of childhood with very poor prognosis. About fifteen cases of primary intracranial MRT (with their clinical details) are reported in English literature, following the recognition of this entity in 1978. Two cases of MRT are reported here. The first case, one year male baby was admitted with a very large, infiltrative, posterior fossa mass. He required elective ventilation, following the tumour decompression but ultimately died of respiratory failure during the process of weaning from the ventilator. The second child was operated for an extremely vascular, very friable, solid and lobulated tumour of temporal lobe. Radical microsurgical decompression of mass was achieved, however the child developed massive recurrence, documented five weeks after the surgery while on radiotherapy. His recurrence showed partial response to radiotherapy and chemotherapy. The child is alive at 8 month's follow up, but probably passing the terminal days of his life. Hence the recognition of this entity is very essential for the aggressive management and prognostication of the patient, which obviously seems to be different from primitive neuroectodermal tumour.

Brain Neoplasms↗

Peduncular hallucinosis: an unusual sequel to surgical intervention in the suprasellar region.

Peduncular hallucinations are formed visual images often associated with sleep disturbance, and are caused by lesions in the midbrain, pons and diencephalon. In the present study, we report two patients who developed peduncular hallucinations following surgery in the suprasellar region. In one of these, the peduncular hallucinations were a sequel to endoscopic third ventriculostomy, while in the other, they were due to diencephalon and mid-brain compression by a postoperative clot following excision of a hypothalamic astrocytoma.

Astrocytoma↗

Lithium neurotoxicity at therapeutic level--a case report.

A 30 years old Hindu male presenting with symptoms of lithium toxicity. On investigation, serum lithium level was found to be 0.5 meq/l. Though toxicity at this level of lithium is unusual, still neurotoxicity happened to be the cause of his hospital admission. He was debarred from taking lithium further and carbamazepine was started as mood elevator. He responded favourably.

Adult↗

Health awareness and treatment compliance of high blood pressure among women in a peri-urban colony of Chandigarh, India.

Health awareness is a central issue in the control of hypertension. In a cross-sectional survey among 1727 women of > 30 years, 2 blood pressure recordings were done in 1686 cases. The prevalence of hypertension was found to be 13.1% (221 out of 1686 cases). A random sub sample of 72 hypertensive women above 30 years of age from a peri-urban colony of Chandigarh was selected to find out health awareness and treatment compliance of hypertension. Sixty-three (87.5%) of the selected women were aware of their high blood pressure. However, only 12 women (16.7%) who were on treatment had achieved control of blood pressure (< 140/90 mm Hg). Main reasons for discontinuing the treatment were ignorance about the need of regular treatment (33.3%), high cost of medicines (19.44%) and non-availability of a family member who can go with the patient to hospital (9.72%). Twenty-six (36.1%) hypertensive women did not know the importance of weight reduction for controlling high blood pressure. Twenty-three (31.9%) hypertensive women were currently smoking. A comprehensive health education approach involving health care professionals, patients and general population should be launched to improve the care of hypertensives in the community.

Adult↗

Dynamics of contraceptive use in a rural community of Haryana.

A cross-sectional survey was carried out to study the dynamics of contraceptive use in three villages of Raipur Rani block in district Panchkula, Haryana. A female social worker interviewed 600 ever-married women aged 15-44 years using a semi-structured interview schedule. More than 75% of the respondents were aware about modern contraceptives. Fifty-nine percent of the couples had used contraceptives. Among the 351 ever-users, the first contraceptive method used was sterilization in 41.3%, condom in 35.6%, IUD in 17.9%, and oral pills in 5.1%. Subsequently, many of them either discontinued or shifted to other methods. At the time of survey, 236 (39.3%) were using a contraceptive. Most of the current users (225) had opted for tubectomy, and only a few (4) had accepted vasectomy. Supplies of contraceptives were obtained mainly from government hospitals and sub-health centres. Common reasons for discontinuation were perceived untoward effects (37.1%), desire for more children (32.6%), and failure of the contraceptive method (19.0%). Most of the respondents obtained contraceptives from Government health posts. Counselling and follow-up services should should be strengthened so that contraceptives are used regularly and effectively for longer periods.

Adolescent↗

CHARGE association.

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Abnormalities, Multiple↗

Investigation of an epidemic of Reye's syndrome in northern region of India.

OBJECTIVE: To determine the extent, epidemiological and clinical features of an epidemic of non-inflammatory encephalopathy in northern region of India. DESIGN: Surveillance of referred cases having unconsciousness after a short bout of fever during October and November 1997. Case control study in 7 most affected villages. METHODS: Active case finding was done to assess the extent and severity of the epidemic by interviewing health professionals and by reviewing mortality records in 10 districts of Haryana, Punjab and Chandigarh. A house to house survey was conducted in seven most affected villages. A case was defined as any child of less than 15 years of age, who had prodromal fever followed by vomiting and unconsciousness with subsequent recovery or death. Two age and sex matched controls who had fever without unconsciousness were taken for each case, one from nearby house and another staying furthest from the affected house. These groups were compared for various epidemiologic factors, clinical features and treatment pattern. Residual medicines used by affected patients were tested for presence of salicylate. Local village practitioners were interviewed for their knowledge and attitude towards use of aspirin in a febrile child. RESULTS: Information regarding 129 affected children (M: F=1 : 1) could be obtained. Age ranged between 1 to 12 years (mean 5.8 years). Most were from rural or semi-suburban areas. Attack rate was 5.4/1000 and case fatality rate was 72%. Multiple sibs were affected in 9.3%. History of fever was reported by 83%, vomiting preceding unconsciousness by 83% and abnormal behavior by 65%. Abnormal posturing was reported in 55%. Seventeen (61%) of 28 samples had IgM antibodies in serum/CSF against measles. Twelve (36%) of 33 serum samples tested positive for Varicella zoster virus. None gave history of aspirin intake and 10 samples of residual drugs did not contain salicylate. However, 6 out of 19 blood samples taken from affected patients contained salicylate. Environmental factors were in favor of Japanese encephalitis (JE) but brain biopsy and serology disproved it. Based on earlier report of JE from this area, the cases in present epidemic were being reported as JE before this study was undertaken. Intensive fogging with malathion was being undertaken as antimosquito measure, specially around the affected houses. Local village practitioners (n = 37) were unaware of contraindications of aspirin in a febrile child. CONCLUSION: Measles and varicella zoster emerged as the probable etiologies for the viral prodrome precipitating these cases of Reye's syndrome. Aspirin might have a contributory role. Malathion is another putative cofactor.

Case-Control Studies↗

Hypochromic anaemia in chronic renal failure--role of aluminium.

BACKGROUND: Anaemia is a cardinal feature of chronic renal failure and classically it is normochromic normocytic. Hypochromic anaemia in these patients is often attributed to iron deficiency. AIM: This study was aimed to find the contribution of aluminium in causation of anaemia in CRF patients. METHODS: Dialysis dependent patients of chronic renal failure with adequate dietary intake (> 1500 Cals/day) and no apparent source of blood loss were evaluated for type of anaemia. (During period of this study centre didn't have reverse osmosis plant for water treatment). Evaluation included upper GI endoscopy, complete hemogram, serum proteins, serum iron, total iron binding capacity, and bone marrow iron status. For aluminium evaluation serum aluminium levels were done. RESULTS: Sixty-four patients were evaluated for type of anaemia. Mean age of patients was 41.19 years (15-76 years) with male:female ratio 2.3:1. Classical normochromic picture was seen in 28.5% while rest had hypochromic picture. On bone marrow aspiration study two patients had zero iron stores while all others had normal/excessive iron stores. In 10 patients with hypochromic picture, mean serum aluminium levels were 170 micrograms/L (30-310 micrograms/L). CONCLUSIONS: This study highlights the high prevalence of hypochromic anaemia in patients with adequate dietary intake and aluminium overload in Indian CRF patients.

Adult↗

Breast self examination for early detection of breast cancer.

Breast cancer is the commonest form of cancer in women in Western countries and second most common in women of developing countries like India. In the absence of an exact aetiological agent for breast cancer, the most appropriate way of controlling it is by early detection and treatment. Of the various methods of screening for breast cancer, mammography is the method of choice but its use is limited due to high cost and unavailability. Considering this, breast self examination (BSE) is an ideal method which can be done by every woman at her leisure time with little training. Medical and paramedical professionals can act as trend setters in promoting BSE for control of breast cancer in the community.

Adult↗

A study of changes in the status of autonomic nervous system in primary open angle glaucoma cases.

Control of Intra Ocular Pressure (IOP) is influenced by both divisions (sympathetic and para-sympathetic) of Autonomic Nervous System (ANS). The present study was conducted to confirm existence of any association of ANS with primary open angle glaucoma (POAG), if present. Systemic autonomic function tests were assessed in fifty patients of POAG with fifty normal subjects matched for sex and age as control using several well established tests based on cardiovascular reflex responses to standardised stimuli viz. Resting heart rate (RHR), Corrected QT Interval (QTc), T-wave amplitude, Standing to Lying Ratio (SLR); Valsalva Ratio; Galvanic Skin Resistance (GSR) and Cold Pressor Test (CPR). Tests were conducted in the Department of Physiology, Maulana Azad Medical College and associated Glaucoma Clinic of Guru Nanak Eye Centre from june '94-May '95. Subjects were randomly chosen from known POAG cases with IOP--25 +/- 5.08 mm Hg. The results showed decrease in both sympathetic and para-sympathetic activity of autonomic function tests in POAG suggesting associated autonomic dysfunction. Sympathetic under-activity is seen in 36 patients out of 50 (73%), POAG subjects while para-sympathetic activity is decreased in 43 of 50 (86%) of the POAG subjects when compared with normal control group. The results help concluding that POAG is associated with autonomic dysfunction with decreased activity of both sympathetic and para-sympathetic divisions of ANS.

Autonomic Nervous System Diseases↗

Community based study of reproductive tract infections among ever married women of reproductive age in a rural area of Haryana, India.

A community based study was carried out to estimate the load of reproductive tract infections (RTIs) among ever married rural women aged 15-44 years and utilisation of a mobile village based treatment facility by them, during 1997. Complete household survey was done in 10 randomly selected villages of Mahindergarh district in Haryana, India. A total of 2325 women were interviewed by auxiliary nurse midwives and were invited for medical examination in a health camp set-up in their village. Sixty-one percent (1415/2325) women reported symptoms of RTIs. Only 35% (812/2325) had their per-speculum examination done. Out of those examined, 32% (263/812) had vaginitis, 21% (175/812) had cervicits, and 19% (156/812) had pelvic inflammatory disease. Vaginal smear of those having discharge revealed that 48% (231/476) had bacterial vaginosis, 0.8% (4/476) had fungal infection 9% (44/496) had trichomonal infection and none was found to be having gonococcal infection. Tests for chlamydial infection could not be performed as the cost was not affordable. Eighty-nine percent of women who reported symptoms of RTIs had not consulted anyone for their problem prior to our village based camp. Only 42% symptomatic and 24% asymptomatics availed the services even in the village based camps. Study revealed high load of reproductive tract infections and low utilisation of treatment facility. In-depth studies are required to understand for high RTI morbidity load and low treatment seeking rate so as to design an appropriate RTI control programme.

Adolescent↗