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Biomedical subjects

S Kumar

Publications and source records attributed to S Kumar.

At least 73 records · Page 4Linked to original sources
PubMed2006

The use of immunomodulators as an adjunct to antituberculous chemotherapy in non-responsive patients with osteo-articular tuberculosis.

We studied 51 patients with osteo-articular tuberculosis who were divided into two groups. Group I comprised 31 newly-diagnosed patients who were given first-line antituberculous treatment consisting of isoniazid, rifampicin, ethambutol and pyrazinamide. Group II (non-responders) consisted of 20 patients with a history of clinical non-responsiveness to supervised uninterrupted antituberculous treatment for a minimum of three months or a recurrence of a previous lesion which on clinical observation had healed. No patient in either group was HIV-positive. Group II were treated with an immunomodulation regime of intradermal BCG, oral levamisole and intramuscular diphtheria and tetanus vaccines as an adjunct for eight weeks in addition to antituberculous treatment. We gave antituberculous treatment for a total of 12 to 18 months in both groups and they were followed up for a mean of 30.2 months (24 to 49). A series of 20 healthy blood donors served as a control group.Twenty-nine (93.6%) of the 31 patients in group I and 14 of the 20 (70%) in group II had a clinicoradiological healing response to treatment by five months. The CD4 cell count in both groups was depressed at the time of enrolment, with a greater degree of depression in the group-II patients (686 cells/mm(3) (sd 261) and 545 cells/mm(3) (sd 137), respectively; p < 0.05). After treatment for three months both groups showed significant elevation of the CD4 cell count, reaching a level comparable with the control group. However, the mean CD4 cell count of group II (945 cells/mm(3) (sd 343)) still remained lower than that of group I (1071 cells/mm(3) (sd 290)), but the difference was not significant. Our study has shown encouraging results after immunomodulation and antituberculous treatment in non-responsive patients. The pattern of change in the CD4 cell count in response to treatment may be a reliable clinical indicator.

Adjuvants, Immunologic↗
PubMed2006

Multiple cranial nerve palsies associated with type 2 diabetes mellitus.

Although isolated cranial nerve palsies are common in patients with diabetes mellitus, multiple simultaneous cranial neuropathies are rare. We report a 48-year-old man, a known case of diabetes mellitus, who presented with facial palsy, foot drop and painful ophthalmoplegia of the left eye. The initial differential diagnosis included diabetic polyneuropathy, septic cavernous sinus thrombosis, mucormycosis and the Tolosa Hunt syndrome. Magnetic resonance (MR) imaging findings were consistent with those of the Tolosa Hunt syndrome. The patient had a remarkable complete resolution of his ophthalmoplegia after four weeks of steroid treatment, with repeat MR imaging showing resolution of the initial changes.

Comorbidity↗
PubMed2006

Virological investigation of a hepatitis E epidemic in North India.

INTRODUCTION: Hepatitis E virus (HEV) infection is of major public health concern in the developing countries, including the Indian subcontinent, due to epidemics of large proportions, increased morbidity and high mortality, especially in pregnant women. This study shows the findings of two different epidemics that occurred due to HEV. METHODS: Blood samples were collected from 116 suspected HEV patients. Sera were separated and tested for hepatitis A virus HAV immunoglobulin M (IgM), hepatitis B virus surface antigen, hepatitis C virus (HCV) antibody and HEV IgM by Micro ELISA. 15 acute samples were subjected to reverse transcriptase polymerase chain reaction (RT-PCR) for the detection of HEV ribonucleic acid (RNA). RESULTS: Of the 116 blood samples collected, 68 (58.6 percent) were positive for HEV IgM antibodies. Mixed infections of HEV with HAV and HCV were detected in three (4.4 percent) and five (7.4 percent) cases, respectively. 15 HEV IgM-positive acute blood samples subjected to RT-PCR showed the presence of specific 343 bp amplified HEV ORF1 gene product in five cases. No untoward effects were observed in the five HEV-infected pregnant women during their follow-up. CONCLUSION: This study confirms the HEV aetiology and highlights a major disease outbreak that occurred due to mixing of drinking water with sewerage.

Adolescent↗
PubMed2006

Extensive bone metastases from basal cell carcinoma of the eye.

The incidence of metastases from basal cell carcinoma is rare. We report a 66-year-old woman who had basal cell carcinoma of the outer canthus of the left eye. Six months following radical radiotherapy, she developed local recurrence for which an orbital exenteration was done. Four months later, she developed rapidly-progressive multiple skeletal metastases and died soon after.

Aged↗
PubMed2006

Hallerborden Spatz disease.

Hallervorden Spatz disease is a rare disorder characterized by progressive extrapyramidal dysfunction. We report a case of a 18 year old boy who presented with cervical dystonia, pigmentary retinal degeneration and MRI brain showing the "eye-of-the-tiger" appearance. Renamed recently as "Neurodegeneration with brain iron accumulation", we present this case for its rarity and interesting features.

Adolescent↗
PubMed2005

Sublingual misoprostol versus oxytocin infusion to reduce blood loss at cesarean section.

OBJECTIVE: To compare the effectiveness of sublingual misoprostol administered immediately after delivery of the neonate at cesarean section, with intravenous oxytocin infusion in prevention of uterine atony and thereby reducing blood loss at cesarean section. METHODS: One hundred women with singleton term pregnancy undergoing elective or emergency lower segment cesarean section under spinal anesthesia were included in this study. They were randomly allocated to receive either misoprostol 400 mug sublingually or intravenous infusion of 20 units of oxytocin soon after delivery of the neonate. The main outcome measures were blood loss at cesarean section, change in hemoglobin levels, need for additional oxytocics and drug related side effects. RESULTS: The mean blood loss estimated was significantly lower in misoprostol group compared to oxytocin group (819 ml versus 974 ml; p = 0.004). The number of women who had blood loss exceeding 500 ml and the change in hemoglobin, however, was comparable between the two groups. There was a need for additional oxytocic therapy in 16% and 18% after use of misoprostol and oxytocin respectively (p = 0.673). The incidence of side effects such as pyrexia, shivering and metallic taste was significantly higher in misoprostol group compared to oxytocin group. CONCLUSION: Sublingual misoprostol appears to be as effective as intravenous infusion of oxytocin in reducing blood loss at cesarean section. However, occurrence of transient side effects such as shivering and pyrexia were noted more frequently with the use of misoprostol.

Administration, Sublingual↗
PubMed2005

Determination of /Vub/ from measurements of the inclusive charmless semileptonic partial rates of B mesons using full reconstruction tags.

We present a measurement of the Cabibbo-Kobayashi-Maskawa matrix element /Vub/, based on 253 fb(-1) of data collected by the Belle detector at the KEKB e+ e- asymmetric collider. Events are tagged by fully reconstructing one of the B mesons, produced in pairs from Gamma(4S). The signal for b --> u semileptonic decay is distinguished from the b --> c background using the hadronic mass Mx, the leptonic invariant mass squared q2 and the variable P+ [triple bond] Ex - /px/. The results are obtained for events with p(l)* > or = 1 GeV/c, in three kinematic regions (1) Mx < 1.7 GeV/c2, (2) Mx < 1.7 GeV/c2 combined with q2 > 8 GeV2/c2, and by (3) P+ < 0.66 GeV/c. The matrix element /Vub/ is found to be (4.09 +/- 0.19 +/- 0.20(+0.14) -0.15 +/- 0.18) x 10(-3), where the errors are statistical, systematic including Monte Carlo modeling, theoretical, and from shape function parameter determination, respectively.

Journal Article↗
PubMed2005

Non-invasive measurement of cardiac output: evaluation of new infrared absorption spectrometer.

The mass spectrometer (MS) traditionally has been the instrument of choice for measuring cardiac output (Q (T)) non-invasively using the foreign gas uptake method. However, the size and cost of the MS has hampered widespread adoption of this technique outside of the laboratory. Here, we present results, from six normal human subjects at rest and during exercise, of simultaneous Q (T) measurements by an MS and a new, portable infrared (IR) device developed in our laboratories. These measurements are made using on the open-circuit acetylene uptake method. The IR device measures inspired and end-tidal concentrations of acetylene, sulfur hexafluoride, and carbon dioxide by IR absorption spectroscopy with a 10-90% response time of 43 ms; accurate measurements were made down to sample flow rates of 50 mL min(-1). Excellent correlation [Q (T)(IR)=0.98 Q (T)(MS), R(2)=0.94] was observed between instruments across the range from rest to heavy exercise. These results suggest that the IR device, which is small, light-weight, and rugged may enable the foreign gas uptake method to be used in clinical, field, and point-of-care settings for Q (T) measurement.

Adult↗
PubMed2005

Crystallization and preliminary X-ray diffraction studies of the WW4 domain of the Nedd4-2 ubiquitin-protein ligase.

Ubiquitin-mediated protein modification via covalent attachment of ubiquitin has emerged as one of the most common regulatory processes in all eukaryotes. Nedd4-2, closely related to neuronal precursor cell-expressed developmentally down-regulated 4 (Nedd4), is a multimodular ubiquitin-protein ligase comprised of four WW domains and a Hect domain. The WW domains recognize the proline-rich motifs on the multi-subunit amiloride-sensitive epithelial sodium channel (ENaC). To gain insights into the binding of the WW domain to proline-rich peptides, a protein fragment (78 amino acids) containing the fourth WW domain (WW4) of the Nedd4-2 protein was purified and crystallized and X-ray diffraction data were collected. A data set was obtained to 2.5 A resolution from a cryocooled single crystal at a synchrotron source. The crystals belong to the tetragonal space group P4(1)2(1)2 (or P4(3)2(1)2), with unit-cell parameters a = b = 113.43, c = 103.21 A. Analysis of the self-rotation function suggests the presence of four WW4 molecules in the asymmetric unit, with a high unit-cell solvent content of 74%.

Amiloride↗
PubMed2005

Spinal tuberculosis with concomitant spondylolisthesis: coexisting entities or 'cause and effect'?

STUDY DESIGN: Report of three unusual cases of coexisting spondylolisthesis and tuberculosis in the same patient. OBJECTIVES: To document the rare occurrence and attempt to postulate the probable reasons for such an association. SETTING: Tertiary care teaching hospital in a developing country. METHODS: This communication reports the outcome of three cases where there was spondylolisthesis and spinal tuberculosis in the same patient. The probable reason for such an occurrence is discussed along with a literature review relevant to this topic. RESULTS: The cases responded favorably to conservative treatment with multidrug antitubercular chemotherapy and spinal braces. CONCLUSIONS: Association of spondylolisthesis and spinal tuberculosis is extremely rare. If the tubercular process is fulminant, spondylolisthesis secondary to destruction of posterior elements by the infective process can occur. Gross destruction of anterior elements secondary to tuberculosis in some patients may place excessive stresses on the posterior elements and may precipitate a spondylolisthesis even if there was no active infection in the posterior elements. However, there remains a distinct possibility that pars defect may have existed prior to infective pathology.

Adult↗
PubMed2005

Bovine tuberculosis in India: potential basis for zoonosis.

Our laboratory has designed a specific nested-PCR (N-PCR) assay, based on the hupB gene of Mycobacterium tuberculosis (Rv2986c) and Mycobacterium bovis (Mb3010c) as a method to differentiate these closely related species. The present paper deciphers the utility of this assay for identification of pathogenic Mycobacteria in clinical samples. Extra-pulmonary clinical samples obtained from cattle and humans were investigated. Pre-dominance of M. tuberculosis (15.7%) and M. bovis (26.8%) was seen in humans and cattle, respectively. However, more importantly, both mycobacterial pathogens (mixed infection) were identified in a number of samples. In humans 8.7% of the samples and 35.7% in cattle were classified as mixed infection. The detection of mixed infection with the mycobacterial pathogenic duo in humans and bovines denotes the prospect of potential transmission of these pathogens from humans to cattle (zoonosis) and vice versa (reverse zoonosis).

Animals↗
PubMed2005

Bilateral intraparotid and extraparotid Warthin's tumours.

Warthin's tumour is a benign adenoma in the parotid gland, but extraparotid and synchronous bilateral Warthin's tumours may occur. In this report, we describe a patient with simultaneous bilateral involvement of the parotid glands and neck by multiple Warthin's tumours, an occurrence not previously described.

Adenolymphoma↗
PubMed2005

Human osteoarthritis synovial fluid and joint cartilage contain both aggrecanase- and matrix metalloproteinase-generated aggrecan fragments.

OBJECTIVE: To identify the major aggrecanase- and matrix metalloproteinase (MMP)-generated aggrecan fragments in human osteoarthritis (OA) synovial fluid and in human OA joint cartilage. METHOD: Aggrecan fragments were prepared by CsCl gradient centrifugation. Fragment distributions were compared with aggrecanase-1 (ADAMTS-4) and MMP-3 digested human aggrecan by analysis with neoepitope antibodies and an anti-G1 domain antibody, using Western immuno-blots. RESULTS: The overall fragment pattern of OA synovial fluid aggrecan was similar to the fragment pattern of cartilage aggrecan cleaved in vitro by ADAMTS-4. However, multiple glycosaminoglycan (GAG) containing aggrecanase and MMP-generated aggrecan fragments were identified in OA synovial fluid and some of these fragments were produced by the action of both types of proteinases. The synovial fluid content of large size aggrecan fragments with (374)ARGS- and (342)FFGV- N-terminals was about 107 and 40 pmoles per ml, respectively, out of a total concentration of aggrecan fragments of about 185 pmoles per ml. OA synovial fluid contained insignificant amounts of the G1-IPEN(341) fragment as compared to the G1-TEGE(373) fragment, while OA cartilage contained significant amounts of both fragments. OA cartilage contained several GAG-containing aggrecan fragments with N-terminals of G1- or (342)FFGV- but no fragments with an N-terminal of (374)ARGS-. CONCLUSIONS: The overall pattern of aggrecan fragments in human OA synovial fluid and cartilage supports an important role for aggrecanase in aggrecan degradation. However, the fragment patterns and their differential distribution between cartilage and synovial fluid are consistent with the existence of at least two proteolytic pathways for aggrecan degradation in human OA, generating both (342)FFGV- and (374)ARGS-fragments.

Aggrecans↗
PubMed2005

Ectopic expression of alkaline phosphatase in proximal tubular brush border membrane of human renal cell carcinoma.

The present study was conducted to find out any alteration in the expression and activity of alkaline phosphatase in the brush border membrane (BBM) from renal cell carcinoma (RCC) in comparison to normal renal BBM. The specific activity of alkaline phosphatase was drastically reduced in homogenate as well as BBM from RCC kidney when compared to ALP activity in BBM of normal kidney. Kinetic studies revealed that diminished activity of alkaline phosphatase in BBM isolated from RCC was fraternized with decrease in maximal velocity (V(max)) and increase in affinity constant (K(m)) of the enzyme. SDS-PAGE studies showed that the BBM proteins having molecular weights ranging from 95 to 170 kDa were poorly expressed in RCC BBM in relative to normal kidney BBM. Incubation of SDS-PAGE gel with BCIP/NBT dye clearly showed that the expression of ALP in tumor renal BBM was markedly reduced as compared to normal kidney. Further, Western blot analysis using anti-alkaline phosphatase antibody also confirmed the reduced expression of ALP in tumor renal BBM. Lipid composition in reference to phospholipids, glycolipids and cholesterol in tumor renal BBM was altered to that of normal renal BBM, indicating alteration in membrane fluidity of tumor renal BBM.

Adult↗
PubMed2005

Emergency eye care in rural Australia: role of internet.

PURPOSE: Significant differences exist in the utilization of emergency eye care services in rural and urban Australia. Meanwhile, influence of internet-based technology in emergency eye care service utilization has not been established. This study aims to demonstrate, from a health provider perspective, an internet-based service's impact on emergency eye care in rural Australia. METHODS: The teleophthalmology service was initiated in the Carnarvon Regional Hospital (CRH) of the Gascoyne region in Western Australia. A digital, slit lamp and fundus camera were used for the service. Economic data was gathered from the Department of Health of Western Australia (DOHWA), the CRH and the Lions Eye Institute. RESULTS: During the study period (January-December, 2003) 118 persons took part in teleophthalmology consultations. Emergency cases constituted 3% of these consultations. Previous year, there were seven eye-related emergency evacuations (inter-hospital air transfers) from the Gascoyne region to City of Perth. CONCLUSIONS: Analysis demonstrates implementation of internet-based health services has a marked impact on rural emergency eye care delivery. Internet is well suited to ophthalmology for the diagnosis and management of acute conditions in remote areas. Integration of such services to mainstream health care is recommended.

Adolescent↗
PubMed2005

An investigation of the relationship between raw coal characteristics and effluent quality of Kedla and Rajrappa Washeries, Jharkhand, India.

An attempt was made to investigate the relationship between raw coal characteristics and effluent quality in two coking coal washeries of Central Coalfields Limited, Kedla and Rajrappa in Jharkhand State, India. Coal samples-raw coal feed, washed fine clean coal, washed coarse clean coal, middlings and rejects were collected. Similarly, raw water (intake to washery) and effluent samples generated in the washeries, namely, fine coal jig under water, coarse coal jig under water and slurry pond water were also collected over a period of 6 months. Parameters outlined in Ministry of Environment and Forest (MoEF) Schedule VI Indian standards were determined, both in coal samples and water/washery effluent samples. Apart from the parameters listed in the standard, sodium, potassium, calcium, magnesium, sulphate and chloride found to be present in coal were also determined in coal and water samples. The processing results essentially in production of huge quantities of suspended material, which is beyond the stipulated limit of 100mg/l as specified in the Standard. Lowering of pH was observed in both the washeries. The trace/heavy elements were found to be concentrated in the heavier fractions in rejects produced from the washery. The concentrations of major elements in coal-Na, K, Ca, Mg, and minor elements in coal-Mn; F, SO4 and Cl were found to be higher in process water than in raw water indicating that these elements are transferred from coal to the water in washeries. However, only in the case of Mn, the stipulated limit of the effluent standard was exceeded. Trace elements like As, Se, Hg, Cd, though found to be present in coal, were absent in the process water indicating that these elements are not released by coal during washing.

Coal↗