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Biomedical subjects

A Kumar

Publications and source records attributed to A Kumar.

At least 73 records · Page 4Linked to original sources
PubMed2005

Floating knee injuries: long-term results of four treatment methods.

One hundred twenty-four consecutive patients with true floating knee injury presented between 1987 and 2001. They were treated with non-operative, operative (external fixation and intramedullary nailing) and combined modalities. Sixty patients were followed up, at an average of 7.2 years, for age, gender, type of trauma and fracture; time to fracture union and time to mobilisation. Complications that were encountered and return to normal activities were recorded. Better and comparable union rates of fractures, earlier return to activities and higher excellent and good long-term functional results were observed among combined and operative (intramedullary nail) groups. Using combined modalities of treatment is an affordable, practicable and effective approach, especially for a resource-poor environment. External fixation of the fractured femur resulted in a decreased range of movement at the knee due to quadriceps muscle fixation. Fractured tibia, treated by any of the method, did not interfere with patient's joint mobilisation whereas associated injuries did.

Adolescent↗
PubMed2005

Environmental exposure to lead and its correlation with biochemical indices in children.

Lead is a global concern because of its ubiquity in the environment and known to be associated with abnormal neurobehavioral and cognitive development of young children. There is no study from India to describe a composite profile of blood lead and its biochemical influences in children. The present study was aimed at determining the proportion of children with >10 mug/dL blood lead levels (BLLs), association between BLLs, and sociodemographic characteristics, if any, and alterations in biochemical indices in the blood as an underlying mechanism of lead intoxication. A total of 62 children (4--12 y) of Lucknow and nearby areas were recruited to determine BLLs, delta-amimolevulinic acid dehydratase (delta-ALAD) activity, catalase (CAT) activity, and malondialdehyde (MDA) and glutathione (GSH) levels in the blood. Mean level of blood lead was 7.47+/-3.06 microg/dL (2.78--15.0) and 29%-exceeded 10 microg/dL, CDC intervention level. The BLLs were found to be significantly influenced by social status, area of residence, source of water supply, maternal educational status (p<0.001), type of house, and proximity to traffic density (p<0.01). delta-ALAD was significantly lower in the group of children with BLLs 11.39+/-1.39 microg/dL when compared to children with BLLs 7.11+/-1.25 microg/dL and 3.93+/-0.61 microg/dL (p=0.0007, 0.0005, respectively). However, CAT activity was higher in the groups of children with higher blood levels than with lower BLLs (p=0.0159, 0.0001, respectively). There was an increase in MDA level with a concomitant decrease of GSH in children with BLLs 11.39+/-1.39 microg/dL compared with those of children with BLLs 7.11+/-1.25 microg/dL and 3.93+/-0.61 microg/dL (p=0.0001, 0.0002, and p=0.0001, respectively). There was statistically significant correlation of BLLs with delta-ALAD (r=-0.44, p=0.00035), MDA (r=0.46, p=0.00018), GSH (r=-0.62, p=0.00001), and CAT (r=0.44, p=0.00035). Significantly, CAT activity, MDA, and GSH levels were in turn, found to be correlated with delta-ALAD (r=-0.45, p=0.00024; r=-0.43, p=0.00053; r=0.43, p=0.00053, respectively). Results of the present study indicate a declining trend of BLLs in children when compared with those reported from metropolitan cities of India when leaded gasoline was in practice and that the BLLs were significantly associated with biochemical indices in the blood which have the potential to be used as biomarkers of lead intoxication.

Biomarkers↗
PubMed2005

Wet-chemical templateless assembly of metal nanowires from nanoparticles.

We describe a new, simple, room-temperature wet-chemical approach for assembling Au and Ag nanoparticles into nanowire networks, without the use of lithographic templates. Five to 35 nm-diameter nanowires passivated with a thin organic layer were synthesized by mechanically agitating a biphasic liquid mixture of an aqueous hydrosol containing the nanoparticles, and toluene. Nanowire structure and surface chemistry are discussed based on electron microscopy, UV-visible spectroscopy and thermogravimetric analyses.

Journal Article↗
PubMed2005

Anorectal malformations and their impact on survival.

OBJECTIVE: To evaluate the incidence, types and the effect on outcome of associated anomalies in neonates with anorectal malformations (ARM). METHODS: This retrospective study was carried out on all neonates with ARM admitted to the neonatal surgical intensive care unit (NSICU) from 1998 through 2003. RESULTS: Of the 754 neonates admitted to the NSICU during the study period of 6 years, there were 124 (16.4%) neonates with anorectal malformations. Of these 110 were included in the study. 73 % were male and 27% female. 86% of these were high ARM (HARM) while only 14% were low ARM (LARM). Associated anomalies were seen in 68% of patients. The incidence was 72% for HARM and 50% for LARM. The major associated anomalies consisted of esophageal (13%), gastrointestinal (GIT) (11%), genitourinary (GUT) (32%), skeletal (26%), cardiac (33%) and miscellaneous 26%. The overall survival rate was 84% (82% for HARM and 94% for LARM). The survival among those with associated esophageal anomalies was 43%, GIT 67%, GUT 80%, cardiac 61%, skeletal 76% and miscellaneous 79% respectively. This difference in survival was significant only for those with esophageal (p=0.004) and cardiac anomalies (p=0.0026). The survival rates among those with one, two or more than two organ systems involved with associated anomalies were 88%, 82% and 58% respectively. This difference was significant only for more than two organ systems involvement (p=0.003). CONCLUSION: Associated anomalies are common in neonates with ARM, the incidence being similar for HARM and LARM. The survival depends upon the number and severity of associated anomalies both in patients with LARM and HARM. Neonates with more number of organ systems involved have a poorer survival specially when associated with esophageal and cardiac anomalies. All neonates with ARM merit a meticulous search for associated anomalies so that the management can be tailored for each baby.

Abnormalities, Multiple↗
PubMed2005

Experience with aspiration in cases of amebic liver abscess in an endemic area.

The study presented here was performed to evaluate the need for aspiration in patients with amebic liver abscess (ALA). Patients older than 12 years with a diagnosis of ALA based on clinical features, ultrasound results, and positive amebic serology were included in the study (n=144). Serological testing was performed to detect the presence of immunoglobin G antibody against Entamoeba histolytica, and a value of more than 0.4 optical density units was considered positive. All patients were given intravenous metronidazole (500 mg every 8 h) and their clinical progress and need for abscess aspiration was documented. Fever, pain in the upper abdomen, and tender hepatomegaly was seen in 133 (92.3%), 128 (88.8%), and 144 (100%) patients, respectively. Multiple abscesses were seen in 40 (27.7%) patients. Six (4.1%) patients died. Seventy-one (49.3%) patients responded to metronidazole alone. A total of 73 (50.69%) patients required aspiration of the abscess. This study shows that almost 50% of the patients with amebic liver abscess failed to respond to metronidazole and required aspiration.

Adolescent↗
PubMed2005

Monitoring of hydrocarbon emissions in a petroleum refinery.

In a petroleum refinery the hydrocarbon emissions which are mostly fugitive in nature are emitted from process, offsites and periodic accidental releases such as: materials storage & handling, process, equipment leaks, solvent evaporation, combustion sources, waste treatment etc. In India, the monitoring of such emissions in a refinery are limited as also the standards are not set for its limit in ambient air. Hence there is an urgent need for generating a database for such emissions. Recently in India, MoEF/CPCB has set some guidelines under CREP rules for monitoring such emissions in a refinery. A detailed monitoring of the hydrocarbon emissions from different sources in a typical 10.5 MMTPA Indian refinery is undertaken during 1999-2001 and the results are presented. It is observed that the storage tank emissions alongwith process leaks form the major contributor towards fugitive hydrocarbon emissions.

Air Pollutants↗
PubMed2005

Can the complicated forgotten indwelling ureteric stents be lethal?

INTRODUCTION: The forgotten ureteral stents remain a urological dilemma and complications related to it can be lethal for the patient. The management of such stents require lithotripsy and endourological techniques. MATERIALS AND METHODS: We retrospectively reviewed the records of 19 cases of forgotten stents managed between 1998 and 2003. The mean patient age was 32 +/- l2 years, male to female ratio 17:2 and the mean duration of stents in urinary system was 24.2 months (7 months to l0 years). The stent were complicated in 14 patients and 5 patients had uncomplicated stents. The stents were severely calcified and encrusted in 6 patients, large stone formation seen at upper end of stent in 2 patients and at lower end of stents in 2 patients. The stents were spontaneously fragmented in 2 patients. The advanced renal failure secondary to hydroureteronephrosis because of severe encrustation and stone formation over the stent in solitary kidney was seen in 1 patient and 1 patient had upmigrated stent with infected hydronephrosis, but the duration of upmigration in this case was unknown. RESULTS: The stents were removed by retrograde approach in all 5 uncomplicated cases. In 6 patients of severely calcified and encrusted stents, the retrograde stent removal could be done in 4 patients while stent got broken in proximal ureter in 2 cases when they were being removed. In these 2 cases the stents were removed by percutaneous nephrostomy. The percutaneous nephrolithotomy and stent removal was done in 2 patients who had large stone at the upper end of stent in renal pelvis. In 2 patients who had large stone formation at lower end, stones were fragmented by mechanical lithotripsy in one and by laser lithotripsy in another case and stents removed by retrograde approach. Two cases of spontaneous fragmented stents were managed by retrograde endoscopic approach. The patient of advanced renal failure refused treatment and died. The patient of infective hydronephrosis with upmigrated stent died because of complications related to operative intervention. CONCLUSIONS: The management of complicated forgotten ureteral stents need judicious use of endourological techniques and lithotripsy. The stent related complication can be directly lethal for the patient or indirectly can cause death because of complications related to operative intervention.

Adult↗
PubMed2005

An audit of postoperative radiotherapy after non-curative resection for cancer of the oesophagus.

AIMS: The role of postoperative radiotherapy (PORT) after non-curative resections for cancer oesophagus is not well defined. A policy of offering PORT after non-curative resections for cancer oesophagus has been followed at our institution, and we report an audit of our experience. MATERIAL AND METHODS: Between March 1990 and September 2002, 139 patients underwent resections for cancer oesophagus. Of these, 86 patients received PORT to a dose of 45-50.4 Gy/25-28 fractions. Eleven of these patients also received concurrent and adjuvant 5-fluorouracil (5-FU). Disease-free survival and overall survival were computed from the day of surgery using the Kaplan-Meier method. RESULTS: Seventy-six per cent (65/86) of patients had squamous cell carcinoma and 69% (59/86) of patients had tumours in the lower-third of the oesophagus. The median interval between surgery and PORT was 41 days, and 93% of patients received doses as planned. Strictures at the anastomotic site and ulcerations in the stomach mucosa were seen in 17% and 5% of patients, respectively. The median and 5-year disease-free survival was 12 months (95% CI 9.9-14.1) and 14%; whereas the median and 5-year overall survival was 17 months (95% CI 12.4-21.6) and 17%, respectively. Local and distant failures were seen in 29% and 45% of patients, respectively. CONCLUSIONS: PORT, after a non-curative resection of cancer oesophagus, is well tolerated with acceptable morbidity and survival.

Adenocarcinoma↗
PubMed2005

Adjuvant chemo-radiotherapy in ampullary cancers.

PURPOSE: Patterns of failure following surgical treatment of ampullary cancers indicate that up to 45% of patients develop loco-regional recurrence. The effect of adjuvant chemo-radiotherapy on survival and loco-regional control is not yet established in this malignancy. PATIENTS AND METHODS: From January 1989 to December 2000, 113 patients underwent pancreatico-duodenectomy for ampullary cancer. One hundred and four patients who survived the operation were available for analysis to study the effect of adjuvant chemo-radiotherapy on survival and loco-regional control. Forty-nine patients received adjuvant chemo-radiotherapy (median dose 50.4 Gy with concurrent 5-Flurouracil) and long-term outcome in these patients was compared with those 55 who did not receive adjuvant therapy. RESULTS: The overall median survival was 30.1 (range 1.6-140.0) months with actuarial 1, 3 and 5-year survival rates of 79, 43 and 33%, respectively. No significant difference in median survival (34.6 vs 24.5 months; P=0.3) and actuarial 5-year survival rates (38 vs 28%) was seen between those who received and those who did not receive adjuvant therapy. Adjuvant chemo-radiotherapy did not influence the survival in high-risk patients (P=0.84), in various T and N stages and had no impact on loco-regional recurrence (P=0.6). CONCLUSIONS: Adjuvant chemo-radiotherapy did not improve the long-term survival or decrease recurrence rates in patients with ampullary cancers who had undergone pancreatico-duodenectomy.

Adult↗
PubMed2005

Radiation induced MMP expression from rectal cancer is short lived but contributes to in vitro invasion.

AIMS: Matrix metalloproteinase (MMP) activity is increased after radiation. The aims of this study were to assess the time course of this increase and its effects on malignant cell invasion. METHODS: Colorectal cancer (HCT 116, LoVo, C 170 HM 2, CaCO-2), fibroblast (46-BR.IGI, CCD-18 Co) and fibrosarcoma (HT1080) cell lines were irradiated at 4 gray (4 Gy) and matrix metalloproteinase gene and protein expression examined over a 96 h period by real time polymerase chain reaction and gelatin zymography. Invasion was assessed on Matrigel. Human rectal tumour MMP expression was compared before and after long course radiotherapy. RESULTS: Radiation increased MMP gene expression of tumour cell lines, and resulted in increased MMP protein activity in the HT1080 line. HT1080 and HCT 116 in monoculture and LoVo in co-culture were more invasive after radiation at 48 h in vitro, but long course radiotherapy did not result in a consistent increase in MMP expression from human rectal tumour biopsies. CONCLUSIONS: Radiation results in increased MMP expression for a limited time period. This results in an early increase in cell line invasion. Further clinical research is required to clarify if MMP inhibition given perioperatively following radiotherapy decreases local recurrence rates.

Adenocarcinoma↗