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Biomedical subjects

A Kumar

Publications and source records attributed to A Kumar.

At least 109 records · Page 6Linked to original sources
PubMed2005

Serum inhibin B and follicle-stimulating hormone levels as markers in the evaluation of azoospermic men: a comparison.

Inhibin B is a glycoprotein hormone produced mainly by Sertoli cells of the testes in the adult male. It selectively suppresses the secretion of pituitary follicle-stimulating hormone (FSH) and has local paracrine actions in the testes. Its measurement is useful for investigating the role of inhibin B in male gonadal dysfunction. The objective of this study was to investigate the efficacy of serum inhibin B in men with nonobstructive azoospermia in comparison with FSH. Serum concentration of FSH was measured using microparticle enzyme immunoassay, inhibin B by specific solid phase sandwich enzyme-linked immunosorbent assay in men with nonobstructive azoospermia (n = 46) and control fertile men (n = 5). Mean inhibin B and FSH level was 104.6 pg ml(-1) and 4.0 mIU ml(-1) in control men whereas the value for nonobstructive azoospermic men was 17.06 pg ml(-1) and 31.1 mIU ml(-1) respectively. Inhibin B and FSH levels were significantly different in azoospermia than controls (P < 0.0001). There were six cases of nonobstructive azoospermia with normal inhibin B. Testicular histology did not find any evidence of spermatogenesis in three cases with normal inhibin B. This demonstrated that inhibin B was not a superior predictor for testicular function in our study.

Adult↗
PubMed2005

Mutation and polymorphism analysis of TSC1 and TSC2 genes in Indian patients with tuberous sclerosis complex.

OBJECTIVE: To find the mutation and polymorphism spectrum of TSC1 and TSC2 genes in patients affected with tuberous sclerosis complex from the Indian population. MATERIAL AND METHODS: All coding exons and promoter regions of both TSC genes were screened for mutations and polymorphisms in 24 TSC families using polymerase chain reaction-single strand conformation polymorphism and DNA sequencing techniques. RESULTS: A single previously known mutation, c.2111_2112delAT was identified in the TSC1 gene. A total of 11 mutations were identified in the TSC2 gene. Of these, seven mutations, c.137_138delGA, c.2070delC, c.2087_2088insAA, c.3080T>C (p.L1027P), c.648+1G>A, c.3131+1G>A and c.5034C>G were novel. The remaining four mutations, c.4544_4547delACAA, c.1941_1942insT, c.1831C>T (p.R611W) and c.1832G>A (p.R611Q) had been reported previously in other populations. The novel mutation, c.137_138delGA was predicted to result in the production of a very small tuberin protein of 64 amino acids lacking all seven functional domains. In addition, we also detected three and 10 polymorphisms in the TSC1 and TSC2 genes respectively. DNA sequence analysis of promoter regions of both TSC genes in 24 families did not show any variation. CONCLUSIONS: This is the first molecular genetic study of TSC in an Indian population. A total of 12 mutations were detected in 24 Indian TSC families in TSC genes. All except one mutation were detected in the TSC2 gene. No variation was found in the promoter regions of either gene. As observed in the western and Japanese populations, the mutations were scattered across the TSC2 gene.

Amino Acid Sequence↗
PubMed2005

Genetic linkage of a novel autosomal dominant restrictive cardiomyopathy locus.

BACKGROUND: In recent years, non-syndromic idiopathic cardiomyopathies have increasingly been characterised as autosomal dominant conditions caused by single gene mutations. Loci have been identified for hypertrophic and dilated cardiomyopathy, and in some cases the same loci are associated with restrictive cardiomyopathy (RCM). In a kindred with RCM that we previously reported, we ruled out the known cardiomyopathy loci and other candidate genes by linkage analysis and mutation screening. METHODS AND RESULTS: Here we report a genome-wide analysis in this family that has resulted in linkage to a region on chromosome 10. CONCLUSIONS: There are no genes in the interval that are known to cause idiopathic cardiomyopathy, and thus this linkage represents localisation of a new RCM locus.

Cardiomyopathy, Restrictive↗
PubMed2005

Asymmetry of critical closing pressure following head injury.

OBJECTIVE: Critical closing pressure (CCP) is the arterial pressure below which the vessels collapse. Hypothetically it is the sum of intracranial pressure (ICP) and vessel wall tension in the cerebral circulation. This study investigated transhemispherical asymmetry of CCP by studying its correlation with radiological findings on computed tomography (CT) scans in head injury patients. METHOD: ICP, arterial blood pressure, and middle cerebral artery blood flow velocity were recorded daily in 119 ventilated patients. Waveforms were processed to calculate CCP. CT scans were analysed according to a system based on the Marshall classification. RESULTS: Left-right differences in CCP correlated with midline shift on the CT scan (r = 0.48; p<0.02). Asymmetry of CCP also corresponded with the side of the head lesion (p<0.007) and the side of the craniotomy where it was performed (p<0.006). Absolute CCP weakly correlated with brain swelling (r = -0.23; p<0.03) and arterial pressure (r = 0.21; p<0.02) but did not correlate with ICP. Cerebral perfusion pressure calculated as the difference between mean arterial pressure and CCP did not correlate with outcome, but "traditional" cerebral perfusion pressure (mean arterial pressure minus intracranial pressure) did. CONCLUSIONS: Critical closing pressure is disturbed by localised brain lesions. Its asymmetry corresponds to asymmetrical findings on CT scans. CCP seems to describe vascular resistance better than ICP.

Adolescent↗
PubMed2005

Clinicohematologic spectrum in patients with lupus anticoagulant.

A retrospective analysis of clinicohematologic parameters of 25 patients with lupus anticoagulant was carried out. The hematologic tests included dilute Russel viper venom test (dRVVT), kaolin clotting time (KCT), activated partial thromboplastin time, and prothrombin time. The diagnosis of lupus anticoagulants was based on the presence of prolonged KCT/dRVVT, its absence of correction with normal plasma and correction by phospholipids. Specific factor assays and platelet aggregation studies were performed wherever required. Ten patients (40%) had thrombosis, which was venous in 5 (50%) and arterial in 4 (40%). One patient (10%) had both arterial and venous thrombosis and presented with catastrophic antiphospholipid syndrome. Eighteen female patients conceived. Four (22%) of these had recurrent first trimester abortion. Five (20%) patients had bleeding manifestations. One (4%) of these had hypoprothrombinemia and was diagnosed to have hypoprothrombinemia lupus anticoagulant syndrome. However in two of these patients, no cause of bleeding could be identified other than the presence of lupus anticoagulants. It is concluded that patients with lupus anticoagulant have a varied spectrum of hemostatic disorders. Bleeding may sometimes occur in these patients due to associated thrombocytopenia or associated factor inhibitors. Rarely, it may occur due to presence of lupus anticoagulants alone.

Adolescent↗
PubMed2005

Ganglion cyst of the anterior cruciate ligament: a case report.

A ganglion is a cystic swelling that usually arises close to tendons or joints. Its occurrence inside a joint is rare, and its diagnosis is usually incidental during magnetic resonance imaging or arthroscopy. It may be painful or asymptomatic. Some patients may have a trauma history. Ganglia may mimic intra-articular lesions like tears of the anterior cruciate ligament or meniscus. Magnetic resonance imaging is the investigation of choice for diagnosis. Ganglia commonly arise from the anterior cruciate ligament, but can also arise from other structures such as the posterior cruciate ligament or meniscus. Ganglia are typically treated by arthroscopic excision and debridement. We report a case of ganglion cyst of the anterior cruciate ligament in a 16-year-old man.

Adolescent↗
PubMed2005

Pseudomonas cervical osteomyelitis with retropharyngeal abscess: an unusual complication of otitis media.

We present the unusual case of a 54-year-old diabetic man with chronic suppurative otitis media, presenting with cervical osteomyelitis and retropharyngeal abscess. This was treated with decompression, debridement and fusion from C2 to C4 with external halo-frame stabilization. Pseudomonas aeruginosa was cultured from the ear and the osteomyelitis specimen. Exploration of the left ear showed evidence of mucosal disease, with granulations in the middle ear and oedematous mucosa in the mastoid antrum, but no evidence of dural-plate dehiscence. Haematogenous spread probably led to cervical osteomyelitis and retropharyngeal abscess formation. Cervical osteomyelitis may develop as a rare complication and present as a cause of severe neck pain in patients with otitis media.

Cervical Vertebrae↗
PubMed2005

Diagnosis of ectopic gastric mucosa using 99Tcm-pertechnetate: spectrum of scintigraphic findings.

We highlight the spectrum of scintigraphic findings likely to be encountered in patients with ectopic gastric mucosa with illustrative cases for each such finding. 11 children (aged 4 months to 120 months, all males) underwent (99)Tc(m)-pertechnetate scintigraphic evaluation for ectopic gastric mucosa. Functioning ectopic gastric mucosa was detected in Meckel's diverticulae in three patients, in small bowel duplications in four, in a gastric duplication in one, and in intrathoracic foregut duplication cysts in three. Ectopic functioning gastric mucosa in Meckel's diverticulum, and gastric duplication is visualized simultaneously with the stomach while in intestinal duplications tracer activity can be visualized in the dynamic sequence and even before gastric tracer visualization. In the three patients with intrathoracic duplication cysts, the functioning ectopic gastric mucosa was evident only in the delayed (99)Tc(m)-pertechnetate images, much later than the visualization of stomach activity. Therefore, acquisition of delayed images are useful when the initial images are equivocal or negative in children with intrathoracic foregut duplication cysts. In addition, we suggest a hypothesis of a possible mechanism for the uptake of pertechnetate in ectopic gastric mucosa in some patients with intrathoracic forget duplication cysts. In conclusion, a variety of scintigraphic patterns may be found in patients with ectopic gastric mucosa undergoing (99)Tc(m)-pertechnetate scintigraphy depending upon the location and size of the ectopic tissue.

Child↗
PubMed2005

Adrenal and renal metastases from follicular thyroid cancer.

Patients with differentiated thyroid cancer may have asymptomatic involvement of renal and/or adrenal gland, particularly if they are elderly and have associated metastases to other organs, which may remain undetected if these patients are not subjected to radioiodine treatment. Our experience also emphasises the role of routine post-radioiodine therapy whole body scan with high degree of clinical suspicion, which may reveal lesions otherwise not discernable in low dose whole body scan. All suspicious lesions should be subjected to structural imaging like ultrasound, CT or MRI for confirmation. In this setting, the role of radioiodine therapy is primarily aimed at palliation that might prolong their survival, probably reduce further spread and thus overall improve the quality of life.

Adenocarcinoma, Follicular↗
PubMed2005

Protective effects of nimesulide (COX Inhibitor), AKBA (5-LOX Inhibitor), and their combination in aging-associated abnormalities in mice.

Several inflammatory processes play a critical role in brain aging and are associated with increased vulnerability to neurodegeneration. Cyclooxygenase-2 (COX-2) and 5-lipoxygenase (5-LOX), two enzymes involved in the oxygenation of the arachidonic acid, are upregulated in the central nervous system during aging and are associated with different aging-related brain pathologies. The present experiment was performed to study the effects of 5-LOX inhibitor, acetyl-11-keto-beta-boswellic acid (AKBA), nimesulide (preferential COX-2 inhibitor), and their combination on cognitive performance of young and aged mice, using elevated plus maze test. Chronic administration of AKBA (100 mg/kg, p.o.) and nimesulide (2.42 mg/kg, p.o.) for 15 days significantly reversed the aging-induced retention deficit in mice. Coadministration of AKBA and nimesulide enhanced the cognitive performance in aged mice when compared with that in per se treatment. The aging-related increase in oxidative damage (increased LPO and decreased GSH) was reversed by AKBA, nimesulide, and their combination. Further, per se COX and LOX inhibitors and their combination did not produce any alteration in gastrointestinal parameters; they also reversed the aging-induced motor dysfunction in the aged animals. On the basis of these observations, present findings indicated that the combination of COX and LOX inhibitors (dual inhibitors) may provide a new therapeutic innovation for the treatment of aging-related brain disorders such as Alzheimer's disease and different motor dysfunctions with adequate gastrointestinal tolerability.

Aging↗
PubMed2005

A descriptive study of HIV-infected long-term surviving children in Barbados--a preliminary report.

OBJECTIVES: To describe the clinical and immunologic characteristics of human immunodeficiency virus type-1 (HIV-1)-infected children surviving to more than eight-years of age (long-survivors) before the introduction of antiretroviral therapy. METHODS: This report is based on all the long-term survivors from a prospective cohort of HIV-infected children born to HIV-positive women in Barbados during 1986-1995. Infants born to HIV-infected women were enrolled into this cohort at birth or at the time of diagnosis of HIV exposure in the postnatal period and followed-up at regular intervals. RESULTS: From a cohort of 44 HIV-infected children, 17 (38.6%) children survived to the age of eight years and beyond and were classified as long-term survivors. Median age of the sixteen long-term surviving children alive at the time of this report was 12 years (age range 8 - 16.7 years). At the age of 8 years, 17.6% of these children remained asymptomatic. Nine (52.9%) children had no immunodeficiency (CD4 counts >500 cells x 10(6)/L). Of the 16 long-term surviving children who were alive and had a median follow-up of 4.1 years (range 0.1 year to 8.5 years) after their eighth birthday, 37.5% had a CD4 cell count greater than 500 cells x 10(6)/L and had either no symptoms or only mild symptoms of HIV infection and were therefore categorized as the long-term non-progressors. CONCLUSIONS: In a small cohort of HIV-infected children, in the absence of antiretroviral therapy, only about one-third survived beyond eight years of age. On further follow-up of these long-term surviving children, over one-third had a slow rate of disease progression.

Adolescent↗
PubMed2005

Synthesis and anti-inflammatory activity of some heterocyclic derivatives of phenothiazine.

Some new 10-{[5'-amino-(1"-ace tyl-5"-substituted aryl-2"-pyrazolin-3"-yl)-1',3',4'-thiadiazol-2'-yl] methyl}-phenothiazines (11-16) and 10-{[5'-amino-(1"-acetyl-5"-substituted aryl-2"-pyrazolin-3"-yl)-1',3',4'-oxadiazol-2'-yl]methyl}phenothiazines (26-31) have been synthesized from 10-{[5'-substituted benzylideneacetylamino-(1',3',4'-thiadiazol-2'-yl)]methyl}phenothiazines (5-10) and 10-{[5'-substituted benzylideneacetylamino-(1',3',4'-oxadiazol-2'-yl)]methyl}phenothiazines (20-25), respectively. All these compounds of the present series have been screened in vivo for their anti-inflammatory and acute toxicity. Compounds 16 and 31 were found to be potent members of the present series, which showed 46.2% and 48.0% anti-inflammatory activity, respectively, at a dose of 50 mg/kg p.o., while standard drug, phenylbutazone, exhibited 44.52% anti-inflammatory activity at same dose. However, 10-{[5'-amino-(1"-acetyl-5"-(o-methoxyphenyl)-2"-pyrazolin-3"-yl)-1',3',4'-oxadiazol-2'-yl]methyl}phenothiazine (31) was found to be most active and less ulcerogenic compound of this series. The structure of these compounds have been elucidated by IR, 1H NMR, mass spectroscopy and elemental analysis.

Algorithms↗
PubMed2005

Study of bone marrow abnormalities in patients with HIV disease.

AIM: Present work was carried out to study the bone marrow abnormalities in patients with HIV/AIDS and to find their association with peripheral hematological abnormalities. METHODS: Seventy four patients of HIV/AIDS were included in the study. The patients had anemia, leucopenia, thrombocytopenia or pyrexia of unknown origin (PUO) as indications for bone marrow examination. A complete blood count, relevant biochemical investigations, HIV RNA load and CD4 positive lymphocyte counts were done, besides a thorough history and clinical examination. HIV positive patients were classified as those having AIDS and those without AIDS according to NACO criteria. RESULTS: Majority of patients (72.9%) had AIDS. Bone marrow was normocellular in 78.95% of non-AIDS and 74.55% of AIDS, hypocellular in 5.26% of non-AIDS and 7.27% of AIDS, hypercellular in 15.79% of non-AIDS and 18.18 % of AIDS patients. Myelodysplasia was present in 21.05% of non AIDS and 36.46% of AIDS and the most common series affected was granulocytic (15.79% of total in non-AIDS and 30.9% in AIDS). Dysplasia was statistically significantly associated with lower CD4 count (p = 0.031) and anemia (p = 0.013). Myelodysplasia was apparent even before patients developed anemia (16.67%). Increased plasma cells in bone marrow were observed in 57.89% of non-AIDS and 65.45% of AIDS, whereas decreased lymphoid cells were seen in 36.84% of non AIDS and 60.00% of AIDS patients. CONCLUSIONS: Myelodysplasia is found in 32.43% of cases of HIV/AIDS and is more common in AIDS than in non AIDS patients. Granulocytic series is most commonly associated with evidence of dysplasia. Myelodysplasia is more common in patients with CD4 count < 200/microl and in patients with anemia. 54.05% of patients had decreased lymphoid cells in bone marrow and it was more commonly seen in AIDS than in non AIDS.

AIDS-Related Complex↗
PubMed2005

Bioremediation of pulp and paper mill effluent with Phanerochaete chrysosporium.

The present study reports on the treatment of pulp and paper mill effluent by Phanerochaete chlysosporium and the same has been compared at two different pH, 5.5 and 8.5. At both the pH, colour, COD, lignin content and total phenols of the effluent significantly declined after bioremediation. However, greater decolourisation and reduction in COD, lignin content and total phenols were observed at pH 5.5. Such bioremediated effluent of pulp and paper mill could gainfully be utilized for crop irrigation.

Biodegradation, Environmental↗
PubMed2005

Induction-intubation response--smokers vs non-smokers--.

BACKGROUND AND OBJECTIVES: Tobacco smoking has been established to be a hazardous activity. Changing social attitude is bringing a decline in tobacco consumption but a significant proportion of patients presenting for surgery still continues to smoke, putting themselves at risk of perioperative complications. We evaluated induction-intubation response in 40 male patients (ASA-I) divided into two groups of 20, each consisting of smokers and non-smokers. METHODS: All patients received standard premedication and general anesthesia. Heart rate, blood pressure and rate-pressure product were measured prior to induction, just before intubation and at 1, 3, 5 and 10 minutes after intubation. Continuous electrocardiography (EKG lead II) monitoring was done. Carboxyhemoglobin and total hemoglobin were estimated at the time of securing venous access. Arterial blood gases were analysed 5 minutes before and after the tracheal intubation. RESULTS: Incidence of arrhythymias (30%) was higher in smokers compared to non-smokers (10%). Mean carboxyhemoglobin (COHb) level in smokers was 3.81 +/- 2.17 gdL(-1) as compared to 2.95 +/- 1.33 gdL(-1) in non-smokers. Four patients who continued to smoke till the day of surgery had higher COHb levels (8.2, 5.9, 6, 8.8 gdL(-1)). PaO2 and PaCO2 levels were comparable in both groups. CONCLUSIONS: During induction-intubation period, heart rate; systolic, diastolic and mean arterial pressure and rate-pressure product showed more pronounced fluctuations in smokers than in non-smokers (p < 0.05).

Adult↗
PubMed2005

Phenotypic characteristics of clinical isolates of Klebsiella pneumoniae & evaluation of available phenotypic techniques for detection of extended spectrum beta-lactamases.

BACKGROUND & OBJECTIVES: Identifying organisms that harbour extended spectrum beta lactamases (ESBLs) is a major challenge for a diagnostic clinical microbiology laboratory. Wide variety of ESBLs produced and lack of a sensitive phenotypic method for their detection make the detection of ESBLs difficult and is responsible for under-recognition. The present study was undertaken to evaluate phenotypic characteristics, initial screening tests and established confirmatory phenotypic methods for detection of ESBLs Klebsiella pneumoniae isolates prevalent in a hospital in north India. METHODS: One hundred, non-repeat clinical isolates of K. pneumoniae collected over a period of six months were included in the study. Susceptibilities of the isolates to 20 different antimicrobial agents were determined. Agar dilution and broth dilution methods were used to determine minimum inhibitory concentrations (MICs) of ceftazidime (CAZ) and cefotaxime (CTX). CAZ and CTX were used with and without clavulanic acid to detect ESBL harbouring isolates. Using agar dilution and broth dilution, MIC reduction of two and three doubling dilutions were evaluated as a criterion for ESBL harbouring isolates. Standard double disk synergy test (DDST) with disks placed at 30 mm and modified DDST with disks placed at 16 mm center-to-center distance, using at least two different third generation cephalosporins and combined disk method were also performed to detect ESBL harbouring isolates. RESULTS: Multi-drug resistance (resistance to three or more antimicrobials of different classes) was found among 94 per cent of the isolates. Pooling the results of all the three confirmatory techniques MIC reduction of >3 doubling dilutions using broth dilution method (using CTX and CAZ), combined disk method [(using CTX, ceftriaxone [(CRO), CAZ and aztreonam)] and standard DDST (using CTX, CRO, CAZ and aztreonam), revealed as many as 87 per cent of the isolates as ESBL producers. CTX had greater sensitivity in identifying isolates that harboured ESBLs. Modified DDST using CTX was as sensitive method as broth dilution method and combined disk method in detecting ESBL harbouring isolates. MIC reduction technique using agar dilution method and standard DDST had lowest overall sensitivity in detecting ESBLs. INTERPRETATION & CONCLUSION: Modified DDST using at least two different third generation cephalosporins was considered to be the best technique for detection of ESBL producing K. pneumoniae at our hospital. MIC reduction test with >2 doubling dilution reduction in MICs was found to be a better criterion than the presently recommended >3 doubling dilution reduction. For screening of potential ESBL producers, MIC determination using agar dilution was as good as that using broth dilution method. However, while performing MIC reduction test agar dilution method was found highly unreliable for detection of ESBL harbouring isolates.

Humans↗