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Biomedical subjects

V Kumar

Publications and source records attributed to V Kumar.

At least 1,027 records · Page 57Linked to original sources
PubMedDate not supplied

A multicentric evaluation of recombinant DNA hepatitis B vaccine of Cuban origin.

INTRODUCTION: Hepatitis B infection is an important public health problem all over the world. As no specific treatment is available, greatest emphasis is placed on prevention through immunization. OBJECTIVE: To evaluate the immunogenicity (sero-protection rate) and reactogenicity of a novel recombinant DNA hepatitis B vaccine of Cuban origin (Enivac HB). POPULATION AND METHODS: The study was conducted at two independent centres (New Delhi and Jaipur) and 111 healthy volunteers without any symptomatic or serological evidence of HBV infection were administered the vaccine intramuscularly in a dose of 20 ug at day 0, day 30 and day 180. Blood samples were collected for evaluation of sero-protection on days 30, 60, 90 and 210 at both centres and, in addition, at day 120 at New Delhi. All subjects were evaluated for any adverse event for 120 hours subsequent to each dose of the vaccine. RESULTS: The mean age of the volunteers was 24 years and the male:female ratio was 61:50. An overall sero-protection rate of 24.3% was obtained at day 30, 68.5% at day 60, 94.5% at day 90 and 99.1% by day 120. Following the third dose of the vaccine (at day 180), we lost one subject to follow up and further evaluation could be done in a total of 110 volunteers. The sero-protection rate by day 210 was found to be 100% (110/110). The vaccine was well tolerated with no serious adverse reactions. Minor side effects such as injection site tenderness, erythema and/or low grade fever were observed in 4.5% of the subjects. CONCLUSIONS: The recombinant DNA hepatitis B vaccine of Cuban origin is safe, well tolerated and highly immunogenic.

Adolescent↗
PubMedDate not supplied

Complications of cholecystectomy in the era of laparoscopic surgery.

Both open and laparoscopic cholecystectomy are highly safe and effective procedures for patients with symptomatic cholelithiasis. Today, adverse outcomes after open cholecystectomy are limited to the elderly patients with comorbid conditions and complicated biliary tract disease. Though underreported, major biliary tract complications still occur, more so with laparoscopic cholecystectomy and continue to be the main cause of morbidity after cholecystectomy.

Cholecystectomy↗
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Percutaneous transluminal angioplasty with cutting balloon and stenting for isolated bilateral aorto-coronary ostial stenosis in a young female.

Coronary artery disease involving both coronary ostia (left main and right coronary) is extremely rare in a premenopausal female, without pre-existing coronary risk factors. We report a case of tight bilateral coronary ostial disease which presented in unusual clinical circumstances in a young female, which was successfully revascularized by single-stage aorto-ostial cutting balloon angioplasty and stenting.

Adult↗
PubMedDate not supplied

Ruptured idiopathic pulmonary artery aneurysm: unusual case of hemothorax treated by selective embolization.

Aneurysm of the peripheral pulmonary arteries is rare. Rupture of pulmonary artery aneurysms manifesting as recurrent hemoptysis with exsanguination is well recognized. We report the case of a young woman who presented with massive hemothorax and shock at the sixth month of pregnancy due to a ruptured lingular artery aneurysm. She was treated with selective coil embolization of the lingular artery to achieve hemostasis. Subsequently, clot evacuation from the pleural space was done. This case is reported for its unsuspected presentation, rarity and to highlight the use of catheter coil embolization to achieve control of bleeding and exclusion of the aneurysm from the pulmonary circulation.

Adult↗
PubMedDate not supplied

Pancreatic divisum with choledochal cyst and calculus: MR appearance.

Pancreatic divisum is the most common congenital anomaly of the pancreas but its association with choledochal cyst is extremely rare. We describe here a case of pancreatic divisum with choledochal cyst with a stone which was successfully treated at surgery. The common congenital pancreaticobiliary abnormalities are briefly discussed.

Adult↗
PubMedDate not supplied

Cardiac amyloidosis: hemodynamic, echocardiographic and endomyocardial biopsy studies.

Six patients with cardiac amyloidosis (four males, two females; age 27-60 years) were evaluated by us. Four patients presented with congestive heart failure, while one patient each presented with effort angina and giddiness. Extracardiac clues to the diagnosis in the form of involvement of other systems were present in only two patients. The electrocardiogram was abnormal in four patients while three exhibited roentgenographic evidence of cardiomegaly or pulmonary venous hypertension. Echocardiography suggested the diagnosis of amyloidosis in only two patients, restrictive cardiomyopathy in two other patients and dilated and hypertrophic cardiomyopathy in one patient each. Cardiac catheterisation and angiography suggested restrictive heart disease in four patients and hypertrophic cardiomyopathy in one. One patient, whose initial haemodynamic study was normal, had features of dilated cardiomyopathy at repeat study after 11 months. Endomyocardial biopsies showed amyloid deposits in all patients. We emphasise the varied clinical manifestation of cardiac amyloidosis and the need for a high index of suspicion. The diagnosis can be safely and reliably confirmed by endomyocardial biopsy.

Adult↗
PubMedDate not supplied

Osteoradionecrosis of mandible in patients treated with definitive radiotherapy for carcinomas of oral cavity and oropharynx. A retrospective study.

A retrospective analysis of 1140 cases of cancer of oral cavity and oropharynx treated with definitive radiotherapy was carried out with regard to the incidence and precipitating factors of mandibular osteoradionecrosis. 14 cases developed osteoradionecrosis out of which 10 had spontaneous mandibular necrosis and 4 had dental extractions in the area where osteoradionecrosis developed. Amongst the 10 cases of spontaneous osteoradionecrosis, 8 patients received doses of 6500 cGy in 6 1/2 weeks or 7000 cGy in 7 weeks by megavoltage cobalt 60 teletherapy and the remaining two patients received the doses of 6000 cGy in 6 weeks. The aforesaid 4 patients of osteoradionecrosis in the area of dental extractions had received doses of only 6000 cGy in 6 weeks.

Carcinoma, Squamous Cell↗
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Getting the most out of all your customers.

Companies spend billions of dollars on direct marketing, targeting individual customers with ever more accuracy. Yet despite the power of the myriad data-collecting and analytical tools at their disposal, they're still having trouble optimizing their direct-marketing investments. Many marketers try to minimize costs by pursuing only those customers who are cheap to find and cheap to keep. Others try to get the most customers they possibly can and keep all of them for as long as they can. But a customer need not be loyal to be highly profitable, and many loyal customers turn out to be highly unprofitable. Companies can get more out of direct marketing if they see it as a single system for generating profits than if they try to maximize performance measures at each stage of the process. This article describes a tool for doing just that. Called ARPRO (Allocating Resources for Profits), the tool is essentially a complex regression analysis that can estimate the impact of a company's direct-marketing investments on the profitability of its customer pool. With data that companies already gather, the tool can show managers how much to spend on acquisition versus retention and even what percentage of their funds they should allocate to the different direct-marketing channels. Using the model, companies can easily see that even small deviations from the optimal levels of customer profitability are expensive. Applying it to one catalog retailer showed, for instance, that a 10% reduction in marketing costs would lead to a 1.8 million dollar drop in long-term customer profits. Conversely, spending 69% less on marketing would actually increase average customer profitability at one B2B service provider by 42%. What's more, the tool can show that finding the optimal balance between investments in acquisition and retention can be more important than finding the optimum amount to invest overall.

Budgets↗
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Association of HLA phenotype with primary non-response to recombinant hepatitis B vaccine: a study from north India.

The hepatitis B vaccine is considered to be highly immunogenic and has a good safety profile. In adults, it has a primary non-response rate of 5%-10%. Causes of nonresponse to hepatitis B vaccine include age, sex, obesity smoking. Certain human leucocyte antigen (HLA) phenotypes have been known to be associated with responsiveness to the vaccine, and found to be different in different ethnic groups, such as Caucasians and Orientals. The study was designed to identify the HLA phenotypes that are associated with non-responsiveness to hepatitis B virus (HBV) vaccination amongst a cohort of Indian subjects who agreed to participate in the vaccination programme. The study was offered to 107 volunteers, of whom 102 were found to be negative for HBV markers (hepatitis B surface antigen [HBsAg], anti-HBc, anti-HBe, anti-HBs, hepatitis Be antigen [HBeAg]) . All 102 volunteers were offered recombinant hepatitis B vaccine (20 microg) at 0, 1, and 6 months. Anti-HBs antibody titres were tested on days 90 and 210 of the first vaccine dose. HLA typing was done using standard microlymphotoxicity tests. The seroconversion rate of the hepatitis B vaccine was 86.3% (88/102). Fifteen nonresponders (15/102) and 15 of the 88 responders were randomly selected after age and sex matching for the purpose of studying the HLA phenotypes. HLA subtypes A1, B15, B40, A10 and DQ2 were found to be increased among nonresponders while HLA- A11, C3, DR10, DR51 (p>0.05) were the most common phenotypes amongst the responders. Further studies are needed to characterize the HLA phenotypes amongst the responders in different ethnic groups in India with respect to HBV vaccination.

Adult↗
PubMedDate not supplied

An ultrastructural study of Schwann cells in peripheral nerves of leprosy patients.

An ultrastructural study of peripheral nerves in leprosy patients was carried out of ascertain the changes in Schwann cells containing myelinated and nonmyelinated axons. Axonal multiplication was noticed in nonmyelinated axons in specimens from both tuberculoid and lepromatous leprosy. The Schwann cells in tuberculoid nerves were devoid of M. leprae in contrast to those in lepromatous nerves in which large number of bacilli were seen. These observations suggest that the Schwann cells containing nonmyelinated axons may be affected more frequently in either type of leprosy.

Axons↗
PubMedDate not supplied

Hepatic tuberculosis mimicking carcinoma gall bladder.

We report a 50-year-old man with tuberculosis of the liver with calculous cholecystitis. The diagnosis was made when the patient underwent cholecystectomy. He responded to antitubercular therapy.

Antitubercular Agents↗
PubMedDate not supplied

Sturge - Weber syndrome.

Sturge - Weber syndrome (SWS) is a rare disorder that occur with a frequency of approximately 1 per 50,0001. It isa neurocutaneous syndrome, characterized by a facial vascular birthmark and neurological abnormalities. The hallmark is intracranial vascular angioma, most often involving the occipital and posterior parietal lobes, but it can also affect the other cortical regions. An ipsilateral facial cutaneous vascular malformation (port wine nevus)usually affects the upper face. Other clinical findings associated with SWS are seizures, glaucoma, hemiparesis,mental retardation and delayed developmental milestones. This article reports a case of 8 years old boy who presented with weakness of right half of body since birth, mental retardation and delayed developmental milestones. Clinical examination revealed deep purple nevus on left lower face, and less power of left upper & lower limbs.X-ray skull showed calcification. C.T. Scan of brain revealed curvilinear calcification with focal atrophy.

Brain↗