Biomedical subjects
Publications and source records attributed to R Kumar.
Esophageal candidiasis was diagnosed at endoscopy in two patients receiving omeprazole therapy. There was no clinical evidence of immunosuppression or any obstructive lesion in the esophagus. There was prompt response of oral ketoconazole. These cases suggest that marked acid reduction may predispose to esophageal candidial infection.
The streptococcal infection that leads to rheumatic heart disease, which accounts for one third to half of the cardiac admissions in developing countries, appears to spread especially rapidly in overcrowded living conditions. Rheumatic fever can be prevented by antibiotic treatment for streptococcal sore throat in children (primary prophylaxis), and its progression towards rheumatic heart disease can also be stopped by antibiotic therapy (secondary prophylaxis). At present, the most cost-effective control strategy appears to be secondary prophylaxis.
UNLABELLED: Premature closure of cranial sutures (primary craniosynostosis) in children leads to characteristic skull deformities and prevents the constricted brain from growing normally. Although the cause remains unknown, several etiological factors have been cited. Recently, hypovascularity has been reported as a possible cause of craniosynostosis. METHODS: In a prospective study regional cerebral blood flow studies were carried out with 99mTc-HMPAO SPECT in seven children with craniosynostoses. Five preoperative and six postoperative studies were conducted and the results correlated with radiological and surgical findings. RESULTS: Preoperative studies revealed regional hypovascularity in the underlying cerebral hemisphere, corresponding to the fused sutures. Postoperative studies revealed disappearance of these perfusion defects in most cases, indicating normalization of perfusion following surgical decompression. CONCLUSION: This study establishes the presence of cerebral hypovascularity in craniosynostoses and suggests that early surgery and release of craniostenosis is essential to achieve optimum perfusion and brain development.
We tested different types of clot for their ability to provoke procoagulant activity in platelets: normal clots from platelet poor plasma (des AABB- or fibrin II clots), similar clots in which the adsorbed thrombin has been inhibited by hirudin, and clots obtained by the action of two snake venom enzymes that release only fibrinopeptide A (des AA- or fibrin I clots). Analogous clots from fibrinogen solutions were also tested. In platelet rich plasma (PRP), where platelet coagulant phospholipids (PCP) are rate limiting for thrombin generation, the addition of any type of clot enhances the generation of thrombin thus it induces the appearance of PCP. Clots containing active adsorbed thrombin are the most potent ones in this respect. Lactate dehydrogenase (LDH) levels do not increase in the course of the thrombin generation so the platelets are not damaged in the process. Non-centrifugable PCP could be demonstrated to appear during the process, so the production of procoagulant phospholipid microparticles must be part of the mechanism. Membrane transbilayer phosphatidyl serine movement (flip-flop) can not be demonstrated in PRP as the activated platelets are caught in the emerging clot. In order to demonstrate flip-flop, we tried to investigate the influence of clots on washed platelets. However, contrary to platelets in a plasma milieu, isolated platelets are damaged by fibrin clots, especially in the presence of thrombin, as can be judged from the appearance of LDH. We conclude that, in PRP, clots induce the appearance of PCP from platelets by vesiculation, possibly accompanied by flip-flop and that thrombin accelerates the process but is not an absolute requirement.
A comparative study of myosin light chains (MLCs) has been made in the aorta, uterine and cardiac muscles (auricle, ventricle) of mice, pig, sheep and goat. Analysis of myosin light chains by sodium dodecyl polyacrylamide gel electrophoresis (SDS-PAGE) has revealed that (a) aorta myosin from mice, goat and pig has identical myosin light chains profile but pig aorta myosin lacks LC-2f; (b) uterine smooth muscle myosin depicts absence of LC-1f in sheep. Whereas satellite bands of LC-1f and LC-2f fractions are absent in pig uterine myosin, mice shows duplets for both the myosin light chains; (c) the auricular myosin in pig and goat is identical to chicken gizzard myosin used as reference and exhibits ALC-2s and ALC-1s fractions only while sheep auricular myosin lacks in ALC-1f; (d) the mice ventricular myosin depicts two satellite MLCs associated with fast migrating VLC-1s.
Tumors such as sclerosing hemangiomas are sometimes associated with hypophosphatemia and osteomalacia, both of which disappear on removal of the tumor. We identified a heat labile, 8,000-25,000 dalton, inhibitor of renal epithelial phosphate transport in supernatants of cultured sclerosing hemangioma cells obtained from a patient with oncogenic osteomalacia and hypophosphatemia. The inhibitor does not alter glucose or alanine transport in renal epithelial cells, and has a mechanism of cellular action distinct from that of parathyroid hormone (PTH) in that it inhibits phosphate transport in renal epithelia without increasing concentrations of cyclic 3',5' adenosine monophosphate (cAMP); it's activity is not blocked by a PTH receptor antagonist. Sclerosing hemangioma cells also produce a material that cross-reacts with antisera directed against PTH and tumor tissue sections immunostain with PTH antibodies. We have characterized a cDNA that encodes the PTH immunoreactive material. In its longest open reading frame the cDNA encodes a protein of 381 amino acids that does not resemble PTH in its primary structure. Opossum kidney cells transfected with the cDNA do not produce a product that inhibits phosphate transport. Dialysates from patients with end-stage renal disease also contain a substance(s) that inhibits phosphate and glucose transport in opossum kidney cells. The inhibitor(s) of phosphate uptake in dialysates is a heat labile, approximately 30,000 dalton substance that inhibits phosphate transport by a cAMP-independent mechanism. Determination of the structures and physiology of these phosphate transport inhibitors is likely to yield insights into the control of phosphate homeostasis.
The position of hyoid bone and atlas vertebra in 29 established mouth breathers (17 boys and 12 girls) in the age group of 10-14 years were cephalometrically evaluated and compared with 23 nose breathers (11 boys and 12 girls). The children of both the groups were selected on the basis of history and clinical examination. The comparisons were made using univariate analysis for male and female groups separately as well as combined. It was observed that mouth breathers do maintain an extended head posture, which was evident from a decrease in distance between the occiput and dorsal arch of atlas vertebra. However the results of the present study did not reveal any distinct characteristics of hyoid bone and atlas vertebra that can be used to predict or associate the craniofacial pattern of mouth breathers.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Two hundred and eighteen preterm neonates had ultrasonography (USG) brain done on third, and/or seventh and fourteenth day of life. Fifty eight (26.3%) had intraventricular/ periventricular hemorrhage, 3 had parenchymal lesions. 46 had Grade I hemorrhage, 9 had Grade II, 2 had Grade III and 1 had Grade IV hemorrhage. Grade III and IV hemorrhages occurred in neonates below 34 weeks gestation. There was an inverse relationship between gestation age and hemorrhage (p = 0.0001). A comparison of incidence of hemorrhage between preterms who were appropriate for gestational age was not significant. Out of the 63 neonates who had serial USGs on the third and seventh day of life, 15 of the 16 bleeds (94%) were detected on the third day itself, indicating it to be a opportune time for doing an USG. USG at term (40 weeks postconceptual age) was done in 99 infants to see if it could correctly predict the neurodevelopmental outcome using the Bayley Scales of Infant Development. Out of these 99 infants, 72 came for the developmental assessment at one year. One neonate who had periventricular leucomalacia with cystic changes on USG at term, was grossly abnormal with cerebral palsy and mental retardation. Six infants showed delayed development with a mean mental development quotient of 79.1 +/- 1.72 at 2 years. The specificity of USG at term for predicting outcome was 89.2% and negative predictive outcome was 90%, indicating that a normal USG at term predicted a good neurodevelopmental outcome.
The extent and nature of reproductive health problems, and the actions taken for prevention/management of these problems were studied in rural area of district Ambala, Haryana. Maternal mortality rate was found to be 230/100,000 live births. Only 31% had died in hospitals; 64% cases were not referred. Main reason for non referral was ignorance about the nature of the complication in 54%. In another study done in 4 villages, 61.2% (367/600) married women of 15-44 years reported to be suffering from symptoms suggestive of gynecological disorders. Out of the 228 who had delivered in past 2 years, 103 (45.2%) reported to have suffered from illnesses in the maternity period, 19.3% had a major maternity complication. Government doctors were consulted in 29.2%, private doctors in 43.1%, health auxiliaries in 16% and traditional birth attendants (TBAs) in 11.8% of the episodes. Average cost of treatment was Rs 211 per episode. For management of maternity related complication, 65.8% could identify a proper hospital. For conducting the delivery, 10% preferred doctors, 60.2% nurse-midwife, and 29.3% TBAs. Although 93.8% of the respondents knew about the places where pregnancy can be terminated, but only 13.8% knew that doctors conduct abortion. In view of the lack of proper understanding about the reproductive health problems, health education campaign should be launched so that maternity care facilities being upgraded in the country are utilised. Programmes for prevention and treatment of gynecological morbidity should also be initiated.
Cholesterol was estimated in ascitic fluid of 44 patients (29 malignant and 15 tubercular). Mean ascitic cholesterol level was significantly higher in malignant ascites (89.52 mg/dl) as compared to tubercular ascites (35.07 mg/dl). At a cut off value of 54.5 mg/dl (mean in tubercular ascites + 2SD), the sensitivity, specificity, positive and negative predictive value and overall diagnostic accuracy for differentiating malignant from tubercular ascites was found to be 89.65%, 100%, 100%, 83.33% and 93.18% respectively. Ascitic fluid cholesterol estimation is a reliable and simple test for differentiating malignant ascites from tubercular ascites.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A case with bile leak into the lesser sac of peritoneum is reported. Although bile leak following biliary surgery or trauma is not uncommon, isolated bile leak into the lesser sac is rare. This information may be vital for appropriate placement of the drainage tube in the abdomen. A hepatobiliary study, as reflected in this report, is extremely useful in guiding the surgeon in this respect.
Two cases of Cryptococcal meningitis were encountered in the recent past. History of predisposing factors was available in both the patients. The diagnosis of these patients was made on the basis of smear, culture and animal pathogenicity tests.
Malignant peripheral nerve sheath tumours of orbit is rare entity. Only sixteen cases are reported in world literature. Bengin schwannomas of the orbit are found in 1.5 to 18 percent of patients with von Recklinghausen's disease (VRD) and form 1 percent of all orbital tumours1. The incidence of malignant transformation in VRD is varies from 5-15 percent of all the cases1.