Biomedical subjects

S Rajasekaran

Publications and source records attributed to S Rajasekaran.

42 records · Page 3Linked to original sources

PubMed1986

A cold staining method for acid-fast bacilli.

The Ziehl-Neelsen method is probably the best known and most frequently used procedure for staining tubercle bacilli. The method requires controlled heating for its success. However, in developing countries, such as India, where most laboratories rely mainly on spirit lamps as a source of heat, the Ziehl-Neelsen method often cannot be carried out because rectified spirit is difficult to obtain. The study describes a cold staining technique that uses the same staining solutions as the conventional Ziehl-Neelsen method. For direct smears, the correlation of results of the cold staining procedure with those of the Ziehl-Neelsen method was 97% and for concentrated smears was 99%. The method described is suitable for use in basically equipped laboratories.

Cold Temperature↗

PubMedDate not supplied

Preemptive analgesia for postoperative pain relief in lumbosacral spine surgeries: a randomized controlled trial.

BACKGROUND CONTEXT: Administration of analgesic medication, before the actual onset of painful stimulus, is more effective than that after the onset of painful stimulus. This is the principle of preemptive analgesia. Although it is often considered superior to other forms of analgesia, its role in postoperative pain relief after lumbosacral spinal surgery has not been fully investigated. PURPOSE: To analyze the efficacy of preemptive analgesia with a single caudal epidural injection for patients undergoing surgeries on the lumbosacral spine by the posterior approach. STUDY DESIGN/SETTING: Randomized, double-blinded and controlled clinical trial. PATIENT SAMPLE: Eighty-two patients who underwent discectomy in the lumbosacral spine by the posterior approach, with or without instrumentation, were randomized to the control group (n=40) and to the study group (n=42). METHODS: Patients in control group received a single caudal epidural injection of 20 ml of normal saline. Patients in study group received a single caudal epidural injection of 20 ml containing bupivacaine and tramadol as the active agents. The time interval between this injection and the surgical incision was never less than 20 minutes in either of the groups. This facilitated enough time for the drug to get fixed to the nerve roots, leading to effective preemptive analgesia. OUTCOME MEASURES: Patients were monitored for postoperative pain immediately after surgery when they had completely recovered and regained consciousness from general anesthesia, and subsequently 4, 8, 12 and 24 hours thereafter. Pain was quantified using the visual analog scale (VAS) and the verbal rating scale (VRS). The time at which supplemental analgesic medication was first demanded in the postoperative period by the patient was also noted. RESULTS: The two groups were comparable for age, sex, body weight and the type of surgery they underwent. Because the data did not have a normal Gaussian distribution, the one-tailed Mann-Whitney test, being a nonparametric test, was adopted for statistical analysis. Accordingly, VAS and VRS values at all time intervals were significantly lower (p<.0001) in the study group as compared with the control group. This indicated significantly better pain relief in the study group. There was also a significant delay (p=.0041) in the first demand for supplemental analgesic medication in the postoperative period in the study group. No complication specific to the procedure was noted except for the development of postoperative urinary retention, which was transient and appropriately managed with urinary catheterization. CONCLUSIONS: Preemptive analgesia with a single caudal epidural injection of bupivacaine and tramadol is a safe, simple and effective method for postoperative pain relief.

Adolescent↗

PubMedDate not supplied

Morphological changes during growth in healed childhood spinal tuberculosis: a 15-year prospective study of 61 children treated with ambulatory chemotherapy.

STUDY DESIGN: A retrospective clinical study for prognostic purposes. OBJECTIVE: To study the morphological changes that dictate the variable progression of childhood spinal tuberculosis. SUMMARY OF BACKGROUND DATA: Posttuberculous kyphosis in children either improves or deteriorates during growth. Associated morphological changes in the kyphosis fusion mass and the uninvolved adjacent levels have not been described in literature. METHODS: The study group consisted of 61 children with 63 spinal lesions selected from a prospective multicenter clinical trial. These children were followed up for a uniform period of 15 years at regular intervals. Anterior and posterior heights of the kyphosis fusion mass were measured. Relative difference in anteroposterior growth was analyzed by calculating the anteroposterior ratio of heights. Wedge angle and height-width ratio of uninvolved adjacent vertebrae along with changes in the morphology of disk spaces above and below the lesion were also analyzed. RESULTS: An increase in the anteroposterior ratio of kyphosis fusion mass leading to a decrease in kyphosis was seen in 30 lesions. A decrease in the anteroposterior ratio leading to an increase in kyphosis was noticed in 16 lesions. Overgrowth of the kyphosis fusion mass resulting in formation of large vertebral bodies was noticed in 7 lesions. No change was noticed in 10 lesions. Interestingly, changes were also noticed in 234 adjacent vertebral bodies uninvolved by the disease process: anterior wedging (n = 53), growth alteration of ring apophysis (n = 26), decrease in anteroposterior diameter (n = 26), longitudinal overgrowth (n = 40), attrition at the point of contact resulting in irregular bodies (n = 44), and posterior wedging in the region of compensatory curve (n = 45). Changes in disk spaces were noted at 136 levels, the most common finding being an opening of the disk space anteriorly (n = 126) due to formation of compensatory lordotic curves. The secondary changes leading to an increase in deformity were observed significantly more in lesions with a deformity angle of more than 30 degrees and a vertebral body loss of more than 1, and in lesions of the thoracolumbar region. Children younger than 10 years differed from those 11 years or older by having a significantly more severe disease and more number of morphological changes with growth in both the fusion mass and the adjacent segments. CONCLUSIONS: Notable morphological changes occurred in both the kyphosis fusion mass and the uninvolved levels above and below the lesion in children with healed spinal tuberculosis. These changes occurred during growth, after complete healing of the disease was achieved, and were responsible for the variability in progression of the deformity during growth seen in these children. Our results imply that all children with spinal tuberculosis must be followed up regularly till the entire growth potential is completed.

Adolescent↗

PubMedDate not supplied

Electrochemically synthesized polymer of the plant substance embelin (2,5-dihydroxy-3-undecyl-1,4-benzoquinone).

Among the possible new materials for microelectronics, quinones have a number of significant advantages. Similarly, polymers with quinone functionality possess biodegradability. Because natural polymers are promising candidates for functional materials for the future, we have initiated studies on the polymers of natural products. In the present study, a natural quinone (a plant substance) extracted from Embelier libes distributed in the Kerala state of India was electrochemically polymerized and its properties were investigated. The redox activity, electrical conductivity, and biodegradability are discussed.

Analgesics↗

PubMedDate not supplied

Prevalence of acquired MDR-TB and HIV co-infection.

BACKGROUND: Mounting prevalence of primary and acquired multidrug-resistant tuberculosis in India is a sorry reminder of all round failure in our fight against tuberculosis and also of the necessity for new effective strategies. OBJECTIVES: (1) To assess the prevalence and pattern of drug resistant pulmonary tuberculosis among treated patients or on those on treatment without adequate response and (2) to evaluate HIV seropositivity among MDR-TB patients. METHODS: Pulmonary TB patients, who had at least six months of unsuccessful anti-tuberculous treatment were selected for the study. Their sputum specimens were examined for M. tuberculosis culture and drug sensitivity pattern and serological examinations for HIV infection were carried out. RESULTS: Sputum specimens of 618 patients' (61.8%) of a total of 1000 examined had shown culturable M. tuberculosis. Four hundred ninty-five patients (49.5%) were found to expectorate tubercle bacilli resistant to one or more anti TB drugs. MDR-TB was detected in 339 patients (33.9%). HIV seropositivity among MDR-TB was 4.42%. Significantly, 245 patients (24.5%) had tubercle bacilli resistant to one or more reserve drugs too (ethionamide, kanamycin and/or ofloxacin). CONCLUSIONS: Prevalence of MDR-TB was high in the study population. It is essentially an acquired condition. Its association with HIV disease was at present on the lower side, an observation contrary to published western literature. Higher rates of resistance for reserve drugs (ethionamide, kanamycin and/or ofloxacin) in patients who never had these drugs in their earlier treatment schedules suggest the possibility of emerging spontaneous drug resistant mutants.

AIDS-Related Opportunistic Infections↗

PubMedDate not supplied

Primary lung cancer in non-tuberculous upper lobe lesions.

Tuberculosis is not only the commonest infectious disease of the lungs in India, but it is also the most commonly overdiagnosed entity whenever upper lobe lesions are seen on a chest roentgenogram. Over a two year period (1990-1992), 150 non-tuberculous upper lobe lesions in high risk group patients (middle aged and elderly; chronic smokers) were investigated Sixty-two patients (41.3%) were found to have primary malignant tumours of whom 67.7% had squamous cell carcinoma. Routine screening for malignancy in high risk patients with non-tuberculous upper lobe lesions should be undertaken.

Adult↗