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Biomedical subjects

V Kumar

Publications and source records attributed to V Kumar.

At least 1,045 records · Page 58Linked to original sources
PubMedDate not supplied

Poliomyelitis control by annual immunization campaigns with oral polio-virus vaccine in a rural area of India.

The effectiveness of Oral Polio Vaccine (OPV) delivered in annual immunization campaigns in reducing the prevalence of poliomyelitis was evaluated in January 1989 by conducting a sample survey in 66 villages in Northern India with a population of 42,000. The prevalence of residual paralytic poliomyelitis was 13.4 per 1,000 children born during 1974-1978; this is 2.7 times higher than the rate of 5.0 per 1,000 born in 1979-1983 and 9.6 times higher than the rate of 1.4 per 1,000 born during 1984-1988. The marked decline in disease prevalence in recent years may be related to the rise in OPV immunization. The vaccination rate was less than 26% before 1978, 38-75% during 1979-1983 and 77-89% during 1984-1987. The annual immunization strategy can be used to control poliomyelitis in developing countries where the health care infrastructure is not well developed.

Adolescent↗
PubMedDate not supplied

Psychedelic effects of a subanesthetic concentration of nitrous oxide.

The subjective effects of nitrous oxide were examined by administering questionnaires to volunteers (16 men and 16 women) breathing 30% nitrous oxide or 100% oxygen. Nitrous oxide produced a variety of subjective effects, including some that are characteristic of psychedelic drugs, such as happy, euphoric mood changes, changes in body awareness and image, alterations of time perception, and experiences of a dreamy, detached reverie state. The subjective effects, including those of a psychedelic nature, were very similar to the subject effects we observed in a previous study of nitrous oxide. However, euphoric mood changes were more pronounced, and adverse effects were less pronounced, in the present study, possibly due to the shorter duration of gas inhalation or the minimal tests of performance involved. Some other differences in subjective effects between the present and previous studies were identified by a discriminant analysis and seemed related to specific differences in experimental conditions. This suggests that the environment can influence which drug effects emerge, or at least their relative prominence. Clinicians should be familiar with the range of subjective effects that patients inhaling nitrous oxide may experience.

Adult↗
PubMedDate not supplied

Assessment of the effect of training on management of acute diarrhoea in a primary health care setting.

Health care providers were trained to treat patients with acute diarrhoea using WHO-recommended oral rehydration therapy (ORT) in a rural area of Haryana, India. One year after the completion of the training programme, the diarrhoea management practices of these trainees were observed while they were treating 240 children with acute diarrhoea. The patients were treated by 12 Multipurpose Health Workers (MPHW), 12 Community Health Guides (CHG), and 11 childcare volunteers, called Anganwadi Workers (AWW), in 12 randomly selected villages. In addition, 9 doctors practising in Primary Health Centres and in a 50-bed hospital were also studied. The assessment of patients on the basis of the history of illness taken and the results of physical examinations varied significantly between the various health functionaries. Doctors assessed dehydration in 80% of patients, MPHWs in 65%, CHGs in 60% and AWWs in only 45% of patients (p less than 0.05). Oral rehydration solution (ORS) was given to every case. However, anti-microbial and anti-diarrhoeal drugs were used at a significantly higher rate by doctors than by other functionaries (p less than 0.05). The method of ORS preparation was explained to most (85-90%) of the parents by all types of functionaries but the quantity to be given to the child was told by doctors to 67%, MPHWs to 60%, CHGs to 63% and AWWs to only 43% of patients. Advice on feeding normal food during diarrhoea was either not given or restrictions to food intake were suggested by all types of functionaries. However, continuation of breast feeding during treatment was advised by all types of functionaries for the majority of patients.

Acute Disease↗
PubMedDate not supplied

Growth hormone and diabetic retinopathy.

Growth hormone has been considered to be the cause of diabetic retinopathy. However the relationship between growth hormone responses and diabetic retinopathy has not been consistent. Moreover, the correlation (if any) between the severity of retinopathy and growth hormone changes are also not well defined. In the present study 23 diabetics (16 with retinopathy, 7 without retinopathy) and 8 non-diabetic healthy controls were studied. Serum growth hormone was measured in the fasting state and one hour after levodopa administration. The mean growth hormone levels were significantly higher in the diabetics as compared to controls, however there was no correlation between the mean growth hormone levels (either in the fasting state or after levodopa stimulation) and presence or absence of diabetic retinopathy although diabetics with retinopathy had significantly greater mean growth hormone response. The mean growth hormone was found to have no correlation with the fasting blood sugar levels. Diabetics with back ground retinopathy had significantly greater mean growth hormone levels than those with proliferative retinal changes.

Diabetic Retinopathy↗
PubMedDate not supplied

Desyndactyly without skin graft: case presentation and literature review.

Many articles have been written on the correction of syndactyly, most of which refer to the fingers. The use of skin grafts appears necessary to obtain satisfactory correction in much of the literature. The authors present a case of desyndactyly without using a skin graft.

Adolescent↗
PubMedDate not supplied

Pulmonary diffusion indices in ageing adults.

The lung transfer factor (Tl) was measured by the single breath holding CO technique in 147 apparently healthy males and 88 females of 35-70 years of age, belonging to similar middle class of socio-economic and nutritional status. They were non-smokers, non-alcoholics and had no cardio-respiratory problems at the time of study. The male subjects with average age of 46.9 years, weight 63.9 Kgs, Height 168.9 cms, surface area 1.73 m2, Hb 12.7 gm% had Tl 29.41 +/- 1.78 mlCo/min/mmHg whereas female subjects with average age of 45-60 years, with Wt 63.2 Kgs, Ht. 155.5 cms, Surface area 1.57 m2, Hb 10.88% had Tl 22.49 +/- 1.28 mlCo/min/mmHg. Simple and multiple regression equation for age, Ht, Hb were worked out and their correlation with Tl discussed.

Adult↗
PubMedDate not supplied

Gene therapy.

Gene therapy replaces or supplements the activity of a resident defective or missing gene by a cloned functional one. A functional gene may be delivered to the target tissues ex vivo or in vivo using various physical methods and several chemical and biological vehicles. In this article we present an overview of different experimental models and the progress made in clinical studies on gene therapy and discuss the prospects of the antisense approach and the ethical concerns related to the technique.

Genetic Therapy↗
PubMedDate not supplied

Percutaneous ureterolitholapaxy: the best bet to clear large bulk impacted upper ureteral calculi.

OBJECTIVES: The outcome of treating impacted upper ureteral calculi by extra corporeal shock wave lithotripsy was less satisfactory than antegrade litholapaxy in our earlier experience. During a four year period (October 1988 to September 1992) 86 reno-ureteral units with impacted upper ureteral calculi were treated by percutaneous litholapaxy. We review our methods and results of this accumulated experience. METHODS: Moderate to severe proximal hydronephrosis on excretory urography or ultrasound was taken as evidence of impaction. Antegrade extraction was performed in a single stage, except in patients who presented with anuria, severe azotemia and urosepsis where the system was decompressed by initial nephrostomy drainage. RESULTS: 86 impacted upper ureteral calculi in 80 patients were treated by the percutaneous antegrade approach. Eleven were in a solitary functioning unit; 33% presented with moderate to severe renal failure. The average stone size was 256 sq mm. Associated renal calculous disease was present in 22 ipsilateral and 28 contralateral units. Total clearance was achieved in 74 units (86%) by antegrade litholapaxy alone. Adjunct ESWL (5) and ureteroscopy (4) rendered 96% of the units free; 3 units with recurrent calculi were salvaged by ESWL (2) and ureterolithotomy (1). Complications encountered in 17 (20%) patients were fewer in 13 (16%), ureteric perforation in 7 (9%), hematuria in 6 (7%) and ureteric stricture 1 (1%). Hospital stay was 5 days in uncomplicated cases; prolongation of stay (average 8.8 days) was necessitated in staged procedures (sepsis, renal failure), treatment of the contralateral unit or due to postoperative morbidity. The majority of the stones (80%) were of the calcium oxalate monohydrate variety. CONCLUSION: It is concluded that failing a retrograde manipulation, percutaneous ureterolitholapaxy offers the best bet to clear large bulk impacted upper ureteral calculi.

Adolescent↗
PubMedDate not supplied

Clinical presentation and predictors of outcome in adult patients with community-acquired pneumonia.

BACKGROUND: Community-acquired pneumonia in adults has a morbidity and mortality ranging between 10% and 25%. Increasing age is associated with a higher mortality. The factors influencing the outcome in elderly patients are thought to be different from those in young adults. We, therefore, studied the clinical profile and predictors of outcome in adults with community-acquired pneumonias. METHODS: Seventy-two consecutive patients with community-acquired pneumonia were included in the study over a period of 18 months. A detailed history was obtained and physical examination done. A chest X-ray was done to establish the diagnosis and haematological, biochemical and arterial blood gas estimations were carried out. The data of survivors and non-survivors as well as those > or = 50 years of age and < 50 years were analysed to determine the clinical profile and outcome in these groups. RESULTS: The clinical features, laboratory parameters and complications from pneumonia were similar in 43 elderly (group I, age > or = 50 years) and 29 young (group II, age < 50 years) subjects. Thirty-five per cent of elderly patients and 14% of young patients succumbed to fulminant sepsis or respiratory failure (p < 0.05). Old age, history of smoking, presence of chronic obstructive airways disease, late presentation to hospital, systolic and diastolic hypotension, high blood urea, low serum albumin and development of septic shock were associated with a higher incidence of complications and a poorer prognosis. In addition, older patients with a poor outcome also had symptoms for a longer duration and a poor neutrophilic response to infection. CONCLUSIONS: The presence of certain factors leads to a higher incidence of complications and a poorer prognosis. These factors are good predictors of outcome in adults of all age groups.

Adolescent↗
PubMedDate not supplied

Neurotoxic effects of rubber factory environment. An auditory evoked potential study.

The effects of rubber factory environment on functional integrity of auditory pathway have been studied in forty rubber factory workers using Brainstem Auditory Evoked Potentials (BAEPs) technique to detect early subclinical impairments. Results indicate that 47 percent of the workers showed abnormalities in prolongations of either peak latencies or interpeak latencies when compared with age and sex matched control subjects not exposed to rubber factory environment. The percent distribution of abnormalities (ears affected) were in the order of extrusion and calendering (75%) > vulcanising (41.66%) > mixing (28.57%) > loading and dispatch (23.07%) > tubing (18.75%) sections of the factory. This incidence of abnormalities may be attributed to solvents being used in these units of rubber factory. These findings suggest that rubber factory environment does affect auditory pathway in the brainstem.

Adolescent↗