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Biomedical subjects

Virendra Kumar

Publications and source records attributed to Virendra Kumar.

At least 19 recordsLinked to original sources
PubMed2007

Transrectal ultrasound-guided biopsy of prostate voxels identified as suspicious of malignancy on three-dimensional (1)H MR spectroscopic imaging in patients with abnormal digital rectal examination or raised prostate specific antigen level of 4-10 ng/ml.

Results of the evaluation of transrectal ultrasound (TRUS) guided needle biopsy of voxels identified as suspicious of malignancy on magnetic resonance spectroscopic imaging (MRSI) in a large cohort of men (n = 83) with abnormal digital rectal examination (DRE) [prostate specific antigen (PSA) 0-4 ng/ml] or PSA less than 10 ng/ml, are reported. Three-dimensional (1)H MRSI was carried out at 1.5 T using a pelvic-phased array coil in combination with an endorectal surface coil. Voxels were classified as suspicious of malignancy based on Cit/(Cho + Cr) metabolite ratio. TRUS-guided biopsy of suspicious voxels was performed using the z- and x-coordinates obtained from MR images and two to three cores were taken from the suspected site. A systematic sextant biopsy was also carried out. MRSI showed voxels suspicious of malignancy in 44 patients while biopsy revealed cancer in 11 patients (25%). Patients who were negative for malignancy on MRSI were also negative on biopsy. An overall sensitivity of 100%, specificity of 54%, negative predictive value of 100% and accuracy of 60% were obtained. The site of biopsy was confirmed (n = 20) as a hypo-intense area on repeat MRI while repeat MRSI revealed high choline and low citrate. The overall success rate of MRI-directed TRUS-guided biopsy of 25% was higher compared with a 9% success rate achieved without MR guidance in another group of 120 patients. Our results indicate that TRUS-guided biopsy of suspicious area identified as malignant from MRSI can be performed using the coordinates of the voxel derived from MR images. This increases the detection rate of prostate cancer in men with PSA level <10 ng/ml or abnormal DRE and also demonstrates the potential of MR in routine clinical practice.

Adenocarcinoma↗
PubMed2006

Fatal burns in Manipal area: a 10 year study.

The purpose of this study was to record and evaluate the causes and the magnitude of the fatal burn injuries retrospectively. An analysis of autopsy records revealed 19.4% cases of burn injuries amongst the total autopsies done over 10years period (1993-2002) in the mortuary of the department of Forensic Medicine of Kasturba medical College, Manipal. The majority of deaths (78.5%) occurred between 11 and 40years of age group with preponderance of females (74.8%). The flame burns were seen in 94.1% of the victims followed by scalds and electrical burns in 2.8% and 2.5% cases, respectively. The majority of burn incidents were accidental (75.8%) in nature followed by suicidal (11.5%) and homicidal (3.1%) deaths. The percentage of burn (TBSA) over 40% were observed in most of the cases (92.5%). The majority of deaths occurred within a week (69.87%) and most the victims died because of septicemia (50.9%).

Accidents↗
PubMed2006

A study of sudden natural deaths in medico legal autopsies in University Malaya Medical Centre (UMMC), Kuala Lumpur.

The main aim of this study is to determine the causes and the epidemiological aspects of sudden natural deaths. Data were collected from 545 sudden natural autopsies in UMMC, Kuala Lumpur over a five-year period, from 1st January 2000 to 31st December 2004. There were 475 males and 70 females. The largest number of sudden natural deaths was in the age group of 41-50 years. 35.8%, 30.5% and 11.7% of the patients were Chinese, Indian and Malay, respectively. A majority of the patients were married (59.8%) and came from the semiskilled-unskilled group (30.6%). The monthly distribution was almost constant. Cardiovascular diseases were the most important cause contributing 64.9% in sudden natural deaths.

Adolescent↗
PubMed2006

Hanging without knot in the noose.

Death by hanging is believed to be a painless method of committing suicide. In most cases the noose has a knot and on this basis only it can be labeled as atypical or typical hanging. A 35 year Chinese man committed suicide by hanging with a ligature material made of electric wire where there was no knot present on the noose.

Adult↗
PubMed2006

Correlation between metabolite ratios and ADC values of prostate in men with increased PSA level.

Proton magnetic resonance spectroscopic imaging (MRSI) and diffusion-weighted imaging (DWI) were carried out in men with increased prostate-specific antigen (PSA) level. Forty subjects [controls (Group I) and patients (Groups II and III with PSA >20 and 4-20 ng/ml, respectively)] were investigated using endorectal coil at 1.5 T prior to transrectal ultrasound (TRUS)-guided biopsy. Metabolite ratio [citrate/(choline+creatine)] and apparent diffusion coefficient (ADC) were calculated for identical voxels. In patients, voxels that showed lower metabolite ratio showed reduced ADC in the peripheral zone (PZ) of the prostate, and voxels with increased metabolite ratio showed higher ADC. Metabolite ratios were used to predict areas of malignancy if the ratio was <1.4 and if ADC value was <1.17 x 10(-3) mm(2)/s. Patients in Group II had lower metabolite ratio and ADC in the PZ compared to controls and Group III. All 13 were positive for malignancy in MR, while 12 of 13 were positive on TRUS-guided sextant biopsy. In Group III, certain voxels of PZ that showed reduced metabolite ratio also showed lower ADC. A positive correlation was observed between metabolite ratio and ADC. MR predicted areas of malignancy in PZ in 15 of 20 patients; however, only six were positive on TRUS-guided biopsy perhaps due to high false-negative rate of TRUS-guided biopsy. Results show positive correlation between MRSI and DWI and their potential in detection of malignancy, thereby improving the diagnosis especially in patients with PSA level of 4-20 ng/ml.

Aged↗
PubMed2005

A study of homicidal deaths in medico-legal autopsies at UMMC, Kuala Lumpur.

The main aim of this study was to determine the causes and epidemiological aspects of homicidal deaths. Data were collected on 217 homicidal victims from the total number of 2762 autopsies performed in UMMC, Kuala Lumpur over a five-year period, from year 1999 to 2003. There were 194 male victims and 23 female victims. The largest number of victims (63.6%) were in the age group of 20-39 years. Indians comprised the maximum proportion of victims (28.1%). Approximately 71.9% of victims came from the semiskilled and unskilled group. A majority of victims were married (47%). Injuries caused by sharp weapons (41%) were the most common cause of death, followed by blunt trauma and firearm injuries.

Adult↗
PubMed2005

Amino acid conjugates as kappa opioid receptor agonists.

A novel series of kappa (kappa) opioid receptor agonists were synthesized by incorporating the key structural features of known kappa opioid agonists while replacing the aryl acetamide portion with substituted amino acid conjugates. Compounds 3j (Ki = 6.7 nM), 3k (Ki = 3.6 nM), 3l (Ki = 4.6 nM), 3m (Ki = 0.83 nM) and 3o (Ki = 2 nM) possessed potent affinities for the kappa opioid receptor in vitro with reasonable selectivity over other opioid receptors.

Amino Acids↗
PubMed2005

Synthesis and evaluation of novel peripherally restricted kappa-opioid receptor agonists.

A series of 3-substituted analogs (3) of the parent kappa agonist, 1, were prepared to limit access to the central nervous system. With the exception of compound 3j, all other compounds bound to the human kappa opioid receptor with high affinity (K(i)=0.31-9.5 nM) and were selective for kappa over mu and delta opioid receptors. Compounds 3c, d, and 3g-i produced potent antinociceptive activity in the rat formalin assay (i.paw) and the mouse acetic acid-induced writhing assay (s.c.), with weak activity in the mouse platform sedation test. The peripheral restriction indices of 3c, d, 3g, and 3i were improved 2- to 7-fold compared to the parent compound 1, and these compounds were approximately 2- to 5-fold more potent than the peripheral kappa agonist ICI 204448.

Amides↗
PubMed2005

Subclinical inflammation and soleus muscle intramyocellular lipids in healthy Asian Indian males.

OBJECTIVES: The relationship between C-reactive protein (CRP), a marker of subclinical inflammation, and intramyocellular lipid (IMCL) content, a novel correlate of insulin resistance, has not previously been investigated. METHOD AND DESIGN: We estimated IMCL content in soleus muscle in 30 healthy Asian Indian males using proton magnetic resonance spectroscopy ((1)H MRS), and correlated it with body mass index (BMI), measures of abdominal obesity, percentage of body fat (%BF), serum lipoproteins, fasting and post-oral glucose load serum insulin levels and other surrogate markers of insulin resistance. RESULTS: Soleus muscle IMCL content was significantly correlated with age (rho=0.64, P<0.001), BMI (rho=0.41, P<0.05), %BF (rho=.53, P<= 0.01), waist circumference (rho=0.45, P<0.05) and waist-to-hip circumference ratio (rho=0.58, P<0.01) but did not correlate significantly with insulin resistance measured by the homeostasis model assessment (HOMA-IR) or CRP levels. CRP levels did not correlate with the HOMA-IR value. CONCLUSIONS: Soleus muscle IMCL content correlated significantly with measures of generalized and abdominal obesity but not with insulin sensitivity or CRP levels in healthy Asian Indian males. Studies are needed in other ethnic groups to corroborate these data.

Asian People↗
PubMed2004

Poisoning deaths in married women.

Unnatural deaths of married women amongst the total female deaths have been an increasing trend in Indian society during the recent past years. These unnatural deaths may be suicide, homicide or even accidents. But these suicides and homicides are currently more commonly associated with the dowry disputes. In India, dowries are a continuing series of gifts endowed before and after the marriage. When dowry expectations are not met, the young bride may be killed or compelled to commit suicide, either by burning, poisoning or by some other means. Here, in the study, the main objective is to present the different epidemiological and medicolegal aspects of poisoning deaths in the married women. In a cohort of 200 married female deaths, 35 (18%) were poisoning deaths and these were analyzed from both epidemiological and medicolegal aspects. In this series, most of the women consumed organophosphorus compound and died within 10 days. The majority of the affected wives due to dowry problems were below 35 years of age. Most incidents occurred either during morning hour or during daytime.

Adolescent↗
PubMed2004

Bride burning.

Explore the source record for details and available documents.

Burns↗
PubMed2004

Proton magnetic resonance spectroscopy and single photon emission computed tomography study of the brain in asymptomatic young hyperlipidaemic Asian Indians in North India show early abnormalities.

OBJECTIVE: To evaluate brain metabolism and cerebral blood flow in young patients with hyperlipidaemia. PATIENTS AND METHODS: Proton magnetic resonance spectroscopy ((1)H MRS) and single photon emission computed tomography (SPECT) of the brain was carried out in 19 asymptomatic young patients with hyperlipidaemia (mean age 32.6 +/- 6.0 years, range 22-45 years) and 21 age-matched healthy controls divided into the following three groups; (i) hyperlipidaemics on pharmacological treatment (group 1, n = 13), (ii) hyperlipidaemics not on pharmacological treatment (group 2, n = 6) and (iii) control group of healthy subjects (group 3, n = 21). RESULTS: No statistical difference was observed in the brain metabolite ratios between controls and hyperlipidaemic patients (both treatment naive and treated) in the (1)H NMR study. Two hyperlipidaemic patients showed a lactate peak and one had a lipid peak. The SPECT study was abnormal in seven hyperlipidaemic patients. In the pooled data, 50% subjects with high serum triglyceride (TG) levels as opposed to 14% subjects with normal serum TG levels showed cerebral hypoperfusion. The choline/creatine (Cho/Cr) ratio of the occipital region of the brain showed correlation with the excess percentage of body fat (%BF) and low levels of high density lipoprotein cholesterol (HDL-C) compared to those with normal %BF and normal HDL-C levels, respectively, in pooled data of all subjects. The N-acetyl aspartate (NAA)/Cho ratio also showed correlation with hypercholesterolaemia. Serum TG levels were positively correlated with the NAA/Cr ratio (r = 0.62, P < 0.05) and the Cho/Cr ratio (r = 0.63, P < 0.05) in the parieto-temporal area in group 1 patients. CONCLUSION: The study revealed no difference in the brain metabolite ratios between controls and hyperlipidaemic patients, while some hyperlipidaemic patients showed abnormalities of cerebral blood flow. Brain metabolite ratios were also influenced by certain parameters of body composition and lipids. As abnormal body composition, hypertriglyceridaemia and low levels of HDL-C are prevalent in Asian Indians, such data are important and indicate a need for further study.

Adult↗
PubMed2004

Burnt wives: a study of homicides.

The death of married females nowadays is very common in India, usually being associated with dowry disputes. In India, dowries are a continuing series of gifts endowed before and after the marriage. When dowry expectations are not met, the young bride may be killed or compelled to commit suicide, most frequently by burning. In a cohort of 152 burned wives, 47 (31%) were homicidal burns and these cases were analyzed in view of epidemiological and medicolegal aspects. Homicide by burning amongst women is a major concern in India as it has become pervasive throughout all social strata and geographical areas. In this series, most women were from extended families (i.e. multigenerational groups of related individuals living under a single roof) and the homicides occurred within the first few years of their marriages. The majority of the affected wives were 16-25 years of age (77%) at the time of the incident and sustained more than 70% total body surface area (TBSA) burn injuries. Many of them were doused with kerosene and set alight. Most died at the time of the incident or within the subsequent 24 hours, most commonly from shock.

Adolescent↗
PubMed2004

Radiation effect on poly(vinylbenzyltrimethylammonium chloride) in aqueous solution: pulse radiolysis and steady-state study.

Poly(vinylbenzyltrimethylammonium chloride) (PVBT) has been synthesized by radiation-induced polymerization of Vinylbenzyltrimethylammonium chloride (VBT). The viscosity average molecular weight of synthesized polymer was estimated to be approximately 10(5) by viscosity measurements. The radiation-induced affects on PVBT have been investigated by steady-state and pulse radiolysis (PR) techniques. The reactions of primary radicals (*)OH, e(aq)(-), and H(*) generated by the radiolysis of water with PVBT were studied. The reactions of some other species such as N(3)(*), Cl(2)(*-), Br(2)(*-), SO(4)(*-), and CO(2)(*-) with PVBT were also investigated. The results indicate that the reactivity of these species toward PVBT is lower then that with the monomer VBT. The rate constants for the reactions of OH radical and H atom with PVBT were evaluated both by competition kinetics and by direct observation of the buildup of transient species. The difference in the rate constant values evaluated by the two methods indicated that (*)OH and H(*) react with PVBT to give more than one species. It was observed that the OH radical and H atom react with PVBT in different manners. Near neutral pH, the OH radicals react to form an adduct and to generate a radical by abstracting methylenic H atom. The H atom, however, also abstracts the H atom from the PVBT backbone. The rate constant value for the reaction of hydrated electron with PVBT was found to be 3.1 currency 10(9) dm(3) mol(-1) s(-1). Steady-state irradiation studies of the aqueous PVBT solution indicated that PVBT predominantly undergoes cross-linking on irradiation. Cross-linking is a function of dose rate, concentration, and ambient of irradiation. At concentrations < 2%, only intramolecular cross-linking takes place, whereas beyond this concentration, the intermolecular cross-linking of polymer chains takes place to form a soft gel. The gel dose (D(gel)) is a function of the ambient of irradiation.

Biocompatible Materials↗
PubMed2004

An analysis of poisoning deaths in Manipal, India.

To determine the various factors involved in poisoning deaths, a 10-y retrospective review of 335 cases were carried out. There was an increasing trend in number of poisoning deaths from 1993-94 to 1999-2000, followed by a decline trend the last 2 y (2001-02). Ninety-one percent of the deaths were due to self-poisoning, with 77.6% of the fatalities due to insecticide consumption. Most cases occurred during winter and in the victim's rural home. Amongst all the poisoning deaths, 249 were males and 86 were females, most in the of 20-29 y age group. Suggestions have been made for the prevention of insecticide poisoning.

Accidents↗
PubMed2003

Periligature injuries in hanging.

Hanging is a common mode of suicide while ligature strangulation is a common way of homicide. Ligature marks (patterned abrasion caused by ligature material) can be of great significance to the forensic pathologist in determining the cause and manner of death. Ligature material usually produces a prominent mark over the bight area, which is opposite to the knot and an inverted 'V' pattern at the site of the knot. Apart from ligature mark, sometimes findings such as rope burns & nail marks may be seen around the ligature mark and can be termed as 'periligature injuries'. Nail marks over the neck are usually suggestive of throttling. But they can also be self inflicted by the victim while trying to extricate himself/herself from the strangling grip of hanging or ligature strangulation. Such injuries, when present may mislead the forensic pathologist in drawing conclusion as to whether it is due to hanging or manual strangulation. Rope burn is caused by friction of rope against skin leading to blister formation. Thus it is an antemortem feature. We present two cases of hanging with periligature injuries.

Journal Article↗
PubMed2003

Burnt wives--a study of suicides.

Ritual self-immolation has long been practiced in India. Although in the past the practice has been related to the act of sati, it is currently more commonly associated with dowry disputes. In India, dowries are a continuing series of gifts endowed before and after the marriage. When dowry expectations are not met, the young bride may be killed or compelled to commit suicide, most frequently by burning. In a cohort of 152 burned wives, 32 (21%) were immolation suicides and these cases were analyzed from both epidemiological and medicolegal aspects. Suicide by burning amongst women is a major concern in India as it has become pervasive throughout all social strata and geographical areas. In this series, most women were from joint families (i.e. multigenerational groups of related individuals living under a single roof) and the suicides occurred 2-5 years after marriage. The majority of the affected wives were 21-25 years of age (69%) at the time of the suicide and sustained more than a 50% TBSA burn injury after dousing themselves with kerosene. Most died at the time of the incident or within the subsequent 24h, most commonly from shock.

Adolescent↗