Search PubMed⌕ Search

Biomedical subjects

S S Kumar

Publications and source records attributed to S S Kumar.

At least 37 records · Page 2Linked to original sources
PubMed1999

Body piercing in the accident and emergency department.

Recently an increasing number of patients with complications related to pierced body jewellery have been seen. Often removal of the jewellery is indicated. Removal of these items may also be required for radiological purposes. If the doctor is familiar with the opening mechanism of the item, removal is not usually difficult. Uninformed attempts at removal may cause unnecessary trauma and distress. In a survey of 28 accident and emergency doctors, only six were able accurately to describe the opening mechanisms of all three commonly used types of jewellery. Descriptions of the types of jewellery currently used are not available in the medical literature. The aim of this article is to familiarize doctors with the types of jewellery used, describe their opening mechanisms, and suggest techniques for their removal. The complications of body piercing and the indications for the removal of body jewellery are also outlined.

Adolescent↗
PubMed1999

An intrasubject comparison of two doses of succinylcholine in modified electroconvulsive therapy.

UNLABELLED: The electroconvulsive therapy (ECT) guideline of the Royal College of Psychiatrists recommends a 0.5 mg/kg of succinylcholine for ECT modification. Our clinical experience suggests that this dose is insufficient for Indian patients. The dose recommended by the Royal College of Psychiatrists (0.5 mg/kg) and a larger dose (1 mg/kg) were compared in 50 patients referred for ECT. In one ECT session, patients were equally randomized to receive one of the two doses and in the next session they were switched to the other dose. The extent of motor seizure modification was rated on a five-point scale by two independent raters who were blinded to the succinylcholine dose. The interrater reliability was good (K = 0.85). "Poor" seizure modification occurred in 48% and 12% of patients with the 0.5 and 1 mg/kg doses, respectively. Of the 24 patients who had poor modification with 0.5 mg/kg, 20 had "good" modification in the session with 1 mg/kg (P < 0.001). A small delay (mean = 55 s) occurred in time to recover from the respiratory paralysis with the 1 mg/kg dose of succinylcholine. No patient, however, had prolonged apnea requiring special measures. We recommend 1 mg/kg of succinylcholine dose be used in the first ECT session. For subsequent sessions, the dose may be altered, depending on the response for optimal motor seizure modification. IMPLICATIONS: The dose of muscle relaxant (succinylcholine) recommended in modified electroconvulsive therapy is not based on empirical research. In the same patients (n = 50), two doses-0.5 mg/kg and 1 mg/kg-were compared during different electroconvulsive therapy sessions. The larger dose was more effective in modifying the peripheral convulsion.

Adult↗
PubMed1998

Use of prokaryotically expressed nucleocapsid protein as positive antigen in ELISA.

A cDNA library of Rinderpest vaccine virus was prepared in Zap Express vector (Stratagene). The Rinderpest 'N' gene specific clones were selected, characterized and thereafter expressed in E. coli XLOLR strain. The expressed protein was found to be immunogenic in western blot with hyperimmune sera. It reacted with rinderpest and 'N' protein specific monoclonal antibodies in Enzyme Linked Immunosorbent Assay (ELISA). Prokaryotically expressed 'N' protein also gave precipitin band in counter immunoelectrophoresis test (CIE). The expression of N protein was sufficient for its utility as positive antigen in CIE and ELISA used for rinderpest diagnosis.

Animals↗
PubMed1998

Laparoscopic cholecystectomy in the densely scarred abdomen.

Extensive intra-abdominal adhesions are a possible contraindication to laparoscopic cholecystectomy and are known to occur after peritonitis because of perforated hollow viscus or multiple abdominal operations. Four such patients, who had undergone three or more previous abdominal operations, and had additional complicating factors, were successfully treated by laparoscopic cholecystectomy. An initial subxiphoid incision with blunt finger dissection was used to place the primary port. This approach achieves greater success and is safer than the traditional open umbilical dissection, because it avoids extensive lysis of small bowel and transverse colon adhesions from the anterior abdominal wall.

Abdomen↗
PubMed1998

Laparoscopic management of a cholecystocutaneous abscess.

Spontaneous cholecystocutaneous abscess or fistula is a rare complication of gallbladder disease that has been known since the time of Thilesus in 1670. We describe the case of a 72-year-old white woman who presented with a large subcutaneous abscess in the right upper quadrant of the abdomen accompanied by fever and leukocytosis. There was no history of diabetes or trauma. An abdominal CT scan revealed communication of the abscess cavity with the gallbladder. Laparoscopic cholecystectomy followed by open drainage of the abdominal wall abscess were accomplished without complication. Traditional treatment for a cholecystocutaneous abscess has consisted of abdominal wall incision and drainage followed by staged cholecystectomy. One-stage treatment of the cholecystocutaneous abscess is a preferred option, and a laparoscopic approach appears feasible.

Abdominal Muscles↗
PubMed1992

Laparoscopic cholangiography: a new method and device.

Laparoscopic cholangiography is invaluable in the detection of bile duct stones, visualization of ductal anomalies and discovery and prevention of iatrogenic injuries to the bile ducts. The use of this procedure is, however, limited by the technical difficulties of cystic duct cannulation. A method of laparoscopic cholangiography that avoids cystic duct cannulation is described. It consists of a Kumar I Cholangiography Clamp that is applied across the gallbladder just above the Hartmann's pouch and divides the gallbladder into a medial and lateral compartment. A Kumar Cholangio Catheter is then introduced through the side-channel of the clamp, puncturing the medial compartment (i.e. the Hartmann's pouch) with a short #22 gauge needle for aspiration, followed by dye injection. Cholangiography was obtained with remarkable ease in 49 of the first 50 cases (98%) without complication.

Cholangiography↗
PubMed1991

Continuous infusion of high doses of atropine in the management of organophosphorus compound poisoning.

Forty five cases of organophosphorus poisoning were studied to evaluate the results of continuous infusion of high doses of atropine as against the conventional intermittent therapy. A statistically significant reduction in mortality (23.5% to 8.8%; p less than 0.05) was evident in this study as compared to previous years. Pseudocholinesterase levels below 10% of normal were associated with a poor prognosis and increased mortality.

Adolescent↗
PubMed1990

Acute renal failure due to acute diarrhoeal diseases.

Fifty four patients with acute renal failure (ARF) due to acute diarrhoeal diseases (ADD) were treated between August 1987 and May 1988. There were 39 males and 15 females. The mean age was 46.25 years. These patients were referred by general practitioners (GP's) and private nursing homes during an epidemic of ADD in Madras city in 1987-'88. Investigations revealed plasma urea (mean +/- SD) 129 +/- 52.8 mg/dl. and plasma creatinine (mean +/- SD) 7.51 +/- 4.3 mg/dl. 42 patients underwent peritoneal dialysis. 3 had haemodialysis. 29 patients died (mortality, 53.7%). The most significant factor for high mortality was the time interval from onset of ADD to diagnosis of ARF which was 5.2 +/- 2.17 days in the patients who survived compared to 8.5 +/- 3.1 days in the patients who died (P less than 0.01). It is concluded that (a) GP's had given inadequate fluid therapy before admission and (b) were initially not aware of renal failure and so referred them late to hospital.

Acute Disease↗
PubMed1989

Assessment of progression of chronic renal failure--using reciprocal of serum creatinine.

Twenty-seven patients with chronic renal failure (CRF) were studied over a period of 6 to 57 months. The mean serum creatinine (Scr.) was 4 mg/dl. All patients were started on conservative therapy. The rate of progression of renal failure was assessed by least square linear regression analysis using reciprocal of Scr. (1/Scr.) versus time plots. Group I (13 patients) showed steady progression to end-stage renal failure (mean slope 0.013328). 7 of 13 patients had chronic glomerulonephritis. 11 had nephrotic proteinuria. In group II (14 patients), the regression line remained static indicating arrest of progression of renal disease (mean slope 0.0087858). 6 of 14 had nephrosclerosis. 3 had nephrotic proteinuria. We conclude that (1) assessment of progression of CRF by linear regression analysis of 1/Scr. vs time is a useful method. (2) persistent nephrotic proteinuria is an adverse longterm risk factor. (3) conservative therapy has a definite role in the management of CRF.

Adolescent↗
PubMed1987

Dithiocarbamate inhibition of cadmium-induced changes in spermatozoan acetyltransferases.

The administration of sodium N-methyl-N-dithiocarboxy-D-glucamine (NaG) subsequent to the administration of CdCl2.2.5H2O to male rats, inhibits the cadmium-induced decreases in spermatozoan acetyltransferase (AT) levels and provides marked protection against the cadmium-induced morphologic testicular changes in the cauda and corpus and partial protection against the changes in the caput.

Acetyltransferases↗
PubMed1987

Plasma sialic acid alterations in neoplastic diseases.

The several types of neoplastic transformations are accompanied by alterations in the composition of cell glycoproteins, which are major structural components of cell surfaces. One such observed alteration is in the level of sialic acid on the cell surface. In the present investigation, plasma sialic acid levels were measured in normal volunteers and neoplastic patients using thiobarbituric acid spectrophotometric methods. The mean plasma sialic acid level from 124 normal volunteers was 3.0 mumol/ml. The mean for 20 non-malignant patients was 3.2 mumol/ml. Such observed mean values of sialic acid were 3.7 mumol/ml in 64 breast cancer patients, 5.1 mumol/ml in 22 lung cancer patients, 4.1 mumol/ml in 20 colon patients, and 5.0 mumol/ml in 26 patients having ovarian, cervix, pancreas, prostate, thyroid, uterine, squamous cell, esophageal and endometrial cancers. Serial determinations of plasma sialic acid in 15 patients correlated well with the progression and regression of disease. These results indicate that plasma sialic acid levels are elevated over control levels in the different types of cancer patients studied. Assay of plasma sialic acid is not sensitive enough to be used for screening, but could be used as a prognostic determinant in a variety of neoplastic conditions.

Age Factors↗
PubMed1985

Tube gastrostomy. A routine adjunct in major abdominal operations.

In this study of 217 major and varied abdominal operations (larger than cholecystectomy), tube gastrostomy was performed as a routine adjunct. Satisfactory gastrointestinal (GI) decompression was maintained in more than 98 per cent of patients. Advantages of this approach over the use of a nasogastric tube are discussed. Important technical aspects are also highlighted. Complications other than malfunction of the gastrostomy tube were few and included minor bleeding in four patients and percutaneous ascites fluid drainage in two patients. Considering that a tube gastrostomy is simple to perform, functionally effective, has many advantages including enhanced patient comfort, is versatile in its possible uses including nutritional support or supplementation if needed, and carries a low morbidity and complication rate: a case is made for its use as a routine adjunct in major abdominal operations.

Abdomen↗
PubMed1983

Amyloidosis of the colon. Report of a case and review of the literature.

A case of amyloidosis of the colon associated with multiple myeloma is presented. The unusual situation was that of obstructive signs with radiologic features of "megacolon and volvulus." A high index of suspicion and meticulous histologic search will demonstrate involvement of the gastrointestinal tract in 98 per cent of patients with systemic amyloidosis. Amyloidosis may mimic other gastrointestinal disorders. Rectal biopsy is diagnostic in 75 per cent of the patients. Treatment of amyloidosis of the colon involves treating the cause with the hope of reversing or at least retarding the process. The results of treatment based on the available experience have been dismal.

Aged↗
PubMed1983

A simple method for operative cholangiography.

Operative cholangiography is a useful adjunct and should be used routinely during most cholecystectomies. The most popular methods for this procedure involve cystic duct cannulation followed by injection of contrast material. A simple method that facilitates holding of the cholangiogram catheter within the cystic duct, without having to tie it in place, is described. This technique has been successfully used in over 250 patients without any related complications and it appears to be adaptable to most situations.

Catheterization↗
PubMed1978

Influenza vaccination in renal transplant recipients.

Renal transplant recipients receiving immunosuppressive therapy are prone to major pulmonary infections. Development of influenza virus infection may lead to renal allograft damage or rejection. These patients should therefore be protected against influenza viruses by vaccination. A satisfactory antibody response was found in 12 (60%) of 20 renal transplant recipients vaccinated. Among 15 control subjects, the antibody response was satisfactory in all participants (100%). Factors that might play a role in suppression of antibody response include use of immunosuppressive drugs and renal allograft function. Immunization is safe and does not appear to affect renal allograft function.

Adolescent↗