Search PubMed⌕ Search

Biomedical subjects

R Kumar

Publications and source records attributed to R Kumar.

At least 1,063 records · Page 59Linked to original sources
PubMed1990

The feasibility of using EMLA (eutectic mixture of local anaesthetics) cream in pediatric outpatient clinics.

EMLA is a eutectic mixture of local anaesthetics, lidocaine and prilocaine, effective in alleviating the pain of venous puncture in children. The lag time of 60 minutes, which is necessary to achieve effective anaesthesia after skin application, may be an important obstacle to the use of EMLA. In this study we recorded the routine practice of six pediatric outpatient clinics which may use EMLA. Our data show a large variability in the feasibility of using EMLA: In the Hematology-Oncology clinics 85% of the patients could benefit from EMLA without prolonging their hospital stay; in the Neurology clinic the mean waiting time is 60.2 +/- 45 minutes, and an additional 15 minutes would be required for only 26 percent of the patients. In four other clinics where the blood work is performed at the phlebotomy station, the waiting time before venous puncture ranges from five to 12 minutes and the use of EMLA would require major changes in the organization of the clinic, or a longer waiting time. In children suffering from chronic diseases, for whom painful medical procedures are a major cause of anxiety, the additional waiting time may be acceptable by both patients and their parents.

Anesthetics, Local↗
PubMed1990

Comparative study of out-reach immunization strategies in rural area.

Efficiency of out-reach immunization strategies operationalised in a rural area of district Ambala (Haryana) was evaluated. Till year 1984-85 immunization delivery was 'sporadic'. Annual cluster immunization campaigns were conducted during 1985-86 and 1986-87. This comprised of delivery of oral polio vaccine (OPV) and/or measles once in a year to all eligible children, other vaccine continued to be delivered by health workers during routine beats. Regular immunization sessions were undertaken in 1987-88 and 1988-89. All the vaccines were delivered on 4 fixed days (one day per week) of each month, covering village at least once a month. Significant increase in immunization coverage was observed after cluster campaigns. OPV increased from 46.5 to 73.6%, DPT from 49.1 to 75.5%, BCG from 48.7 to 72.2%, measles from 8.6 to 45.8% and tetanus toxoid (TT) for pregnant women (PW) from 41.8 to 65.3%. Under regular programme the coverage levels were maintained at OPV 79.4%, DPT 78.2%, BCG 70.6%, measles 48% and TT (PW) 76.2%. Regular out-reach immunization strategy was found to be better than cluster campaigns as it was 'regular' and high coverage level could be maintained.

Child, Preschool↗
PubMed1990

Activation of H-ras oncogenes in preneoplastic mouse mammary tissues.

The mammary hyperplastic outgrowth (HOG) line C4, resulted from serial transplantation of a hyperplastic alveolar nodule which arose in a dimethylbenz(a)anthracene (DMBA) treated mouse. The immortalized C4 outgrowth line, on transplantation into syngeneic mice, develops as preneoplastic, hyperplastic outgrowths and subsequently into malignant carcinomas after a long latent period (greater than 6 months). Treatment of mice carrying C4 HOG transplants with DMBA resulted in a reduced latent period for tumor development (less than 3 months) and an increased tumor incidence. DNA's from C4 HOGs and mammary carcinomas of untreated as well as DMBA-treated mice were analyzed for the presence of oncogenes by the NIH3T3 focus forming assay. Transforming H-ras genes were detected in two of 6 preneoplastic HOGs and 10 of 12 carcinomas from DMBA-treated mice. DNAs from neither the HOGs nor the tumors from untreated mice were positive in this assay. The H-ras locus was then directly examined in the 61st codon by in vitro amplification of each of the tissue DNAs using PCR. The location of the activating mutation was determined by hybridization of amplified DNA to mixed sequence oligonucleotide probes. The specific nature of the mutation was defined by RFLPs using XbaI, TaqI and Sau96I restriction enzymes. Six of the H-ras oncogenes in DMBA-promoted tumors were activated by commonly observed A to T transversions at the 61st codon, while five (including an additional tumor with H-ras oncogene revealed by PCR analysis) contained novel A to G transitions. The H-ras oncogene in one DMBA-treated HOG sample was activated by A to T while the second contained an A to G mutations, representative of both modes of mutational activation involved in this model of mammary tumorigenesis. In summary, DMBA-induced point mutated H-ras oncogenes appear to potentiate the progression of hyperplastic outgrowths (HOG) to mammary carcinomas.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed1990

Rapid diagnosis of Japanese encephalitis by immunofluorescent examination of cerebrospinal fluid.

An indirect immunofluorescent technique for rapid diagnosis of patients of Japanese encephalitis (JE) was developed by demonstrating the viral antigen in CSF cells. The CSF samples of 31 consecutive patients admitted with acute viral encephalitis during 1987 were studied. In 15 patients the diagnosis of JE virus infection was made on the same day. Classical techniques for virus detection and antibody serology were also conducted in these patients. The indirect immunofluorescence for JE virus antigen detection in CSF cells proved to be a rapid and simple procedure for making a quick diagnosis of infection.

Acute Disease↗
PubMed1990

Effects of low perfusate Ca2+ concentration on newborn myocardial function after ischemia.

A greater dependence on transsarcolemmal Ca2+ flux and immaturity of Ca2+ sequestration capacity may potentiate Ca2(+)-mediated reperfusion injury in the newborn myocardium. The effect of serum ionized Ca2+ concentration on left ventricular systolic and diastolic function after ischemia was studied in 5-7-day-old piglets undergoing a 90-minute period of cold-blood cardioplegic arrest. In the control group, Ca2+ was maintained at 1.2 mM (Group A [n = 6]). The cardioplegic solution and bypass perfusate were modified to achieve a low Ca2+ concentration, 0.25 mM, in Group B (n = 6). Left ventricular pressure-volume loops were acquired by using high-fidelity pressure-sensor-tipped and volume-conductance catheters. Ventricular function was assessed from the slope of end-systolic (Ees) and end-diastolic (k) pressure-volume relations during transient caval occlusion. Both groups showed a significant reduction in Ees after ischemia (p less than 0.05). Intergroup comparison of Ees after ischemia demonstrated a better recovery of the systolic function in the low Ca2+ group, 64 +/- 7% versus 49 +/- 6% in the normal Ca2+ group (p = 0.05). There was a significant increase in chamber stiffness index in group A (k, 0.48 +/- 0.06 to 0.65 +/- 0.05 ml-1, p less than 0.01) versus no significant change in group B. This study shows 1) the feasibility of acquiring continuous pressure-volume data in neonatal hearts by using a conductance catheter system, and 2) better preservation of systolic function and diastolic compliance in normal newborn myocardium by low Ca2+ concentration in the peri-ischemic period.

Animals↗
PubMed1990

Clinical features & prognostic indicators of Japanese encephalitis in children in Lucknow (India).

This communication reports the clinical features of 92 children with Japanese encephalitis diagnosed on the basis of viral isolation from brain or cerebrospinal fluid and/or a 4-fold or higher rise in antibody titre in paired sera by haemagglutination inhibition (HI) test, followed by detection of specific IgM HI antibody. More than a third of the patients (38%) were from urban areas. A high incidence of fever (94.5%), coma (100%) and convulsions (84.7%) was seen. Focal neurological deficit was found in 29.3 per cent of patients and pleocytosis in the cerebrospinal fluid in 32.3 per cent. An extrapyramidal syndrome developed in 21.3 per cent patients during the convalescent stage. Thirty four (36.9%) patients died while in hospital. Mortality was significantly related to a short prodromal stage, deep coma, abnormalities in tone and breathing and decerebrate posturing. Japanese encephalitis represents a severe disease in children with a high early mortality.

Child↗
PubMed1990

Renal osteodystrophy.

Renal osteodystrophy is a complex disorder which can be divided into five distinct bone histologic subtypes: mild bone disease, hyperparathyroid bone disease, mixed bone disease, osteomalacia, and low-turnover bone disease. Hyperparathyroidism develops in renal failure due to two principal abnormalities: 1,25(OH)2D3 deficiency and hyperphosphatemia. Treatment of these problems is important in order to prevent hyperparathyroidism. Most cases of osteomalacia, mixed bone disease, and low-turnover bone disease are influenced by aluminum status and parathyroid hormone. Aluminum-associated bone disease can be treated with termination of aluminum exposure and/or deferoxamine therapy. Numerous diagnostic pitfalls exist in the evaluation of renal osteodystrophy, and the bone biopsy is extremely important to avoid these problems and plan proper therapy.

Bone Diseases↗
PubMed1990

An overview of postpartum psychiatric disorders.

The purpose of this review is to highlight reasons why increased attention should be paid to the prevention and treatment of psychiatric disorders at childbirth. The two main psychiatric disorders that are associated with childbirth--postnatal depression and postpartum psychosis--are reviewed, together with a discussion of the maternity blues. An overview of each condition is presented, identifying incidence rates, clinical manifestations, and appropriate treatment approaches. Recommendations are made for coordination and development of services as a means to achieve prevention and treatment of postpartum psychiatric disorders.

Female↗
PubMed1990

Human enterocyte adhesion of enteroadherent Escherichia coli.

Esch. coli strains manifesting localised (17), diffuse (8) or aggregative (17) phenotypes of adherence to HEp-2 cells were tested for their ability to adhere to human enterocytes isolated from duodenal biopsies of adult volunteers to obtain further evidence of their enteropathogenecity. Esch. coli strains H10407+; CFAI+ and LT+ STp+ STh+, F 294 B; a localised adherent strain positive with entero-adherent factor probe reported previously to attach to small intestinal enterocytes and F 582 C; LT- STp+ STh+ were the positive controls: H10407P (CFAI- mutant of H10407+) and K12 served as negative control strains. Adherence of variable degree was seen with 35.3 per cent of enteroaggregative Esch. coli (EAggEc) and with 58.8 per cent of enteroadherent Esch. coli localised (EAEC-L); EAEC-diffuse (EAEC-D) did not adhere to the human enterocytes. The possibility that EAgg EC and diffuse phenotypes may adhere better to lower small intestine or the large intestine, needs to be investigated.

Adult↗
PubMed1990

T and B cell status in bronchiolitis and bronchial asthma.

Immunologic status of 43 children, 13 with bronchiolitis and 30 with bronchial asthma was studied, and compared with 10 infants and 16 healthy children of respective control groups. Humoral immunity was assessed by absolute eosinophil count and B cell count (EAC rosette method) and cellular immunity by T cell count (E rosette method) and DNCB skin test. B cell subset of lymphocytes were raised in both the study groups but associated significant eosinophilia was seen only in bronchial asthma. The study demonstrated significantly lower mean T cell count and depressed DNCB reactivity in children of bronchial asthma. Children with bronchiolitis too had significantly lower mean T cell count. Thus both humoral and cellular immunity were altered in children with bronchial asthma and bronchiolitis.

Asthma↗
PubMed1990

An ELISA for quantitation of tetanus toxin.

A sandwich ELISA for quantitation of tetanus toxin was devised using commercially available horse antitetanus antiserum and its HRP-conjugate. With commercial toxoid as a standard the assay had a lower sensitivity of 100 ng/ml and was linear up to 100 micrograms/ml. In terms of Lf equivalents the ELISA assay was linear from 0.02 to 20 Lf/ml. The Lf activity in 20 preparations of tetanus toxin as determined by ELISA was comparable to the activity measured by conventional flocculation tests (r = 0.987).

Enzyme-Linked Immunosorbent Assay↗
PubMed1990

Value of adenosine deaminase estimation in the diagnosis of tuberculous ascites.

Adenosine deaminase was estimated in ascitic fluids of 49 patients with ascites (19 tuberculous, 20 cirrhotic, and 10 malignant). The adenosine deaminase concentration in tuberculous ascitic fluid was 98.8 +/- 20.1 U/L (mean +/- SD), which was significantly more than that noted in cirrhotic (14 +/- 10.6 U/L) or malignant (14.6 +/- 6.7 U/L) ascitic fluids (p less than 0.001 for each). At a cut-off value of greater than 33 U/L, the sensitivity, specificity, positive and negative predictive value, and the overall diagnostic accuracy for diagnosing tuberculous ascites were 100%, 96.6%, 95%, 100%, and 98%, respectively. We conclude that estimation of adenosine deaminase in ascitic fluid is an easy and reliable method for diagnosing tuberculous ascites.

Adenosine Deaminase↗