Biomedical subjects

C Kirubakaran

Publications and source records attributed to C Kirubakaran.

7 recordsLinked to original sources

PubMed1992

Disappearing CT lesions in focal seizures.

A case of focal seizures with right hemiparesis in a 6-year-old Indian girl is presented. CT scan showed four ring-enhancing lesions in the left cortex. She was treated with phenytoin and a course of praziquantel. The hemiparesis recovered in 3 weeks and a repeat CT scan after 2 months was normal. Arbitrary use of anti-tuberculous therapy in Indian children with focal lesions in the brain is not recommended as the lesions are often due to cysticercosis.

Brain Diseases↗

PubMed1992

Occurrence of multiple antimicrobial resistance among Haemophilus influenzae type b causing meningitis.

Among the 157 children with culture proven pyogenic meningitis who were admitted during 1987-1991, in the Department of Child Health at the Christian Medical College and Hospital, Vellore, 40 had H. influenzae type b (HIB) meningitis; 17 of these had multiantimicrobial resistant HIB (MRHIB) and 23 others had usual susceptibility HIB (USHIB) meningitis. The two groups were compared. Children with MRHIB meningitis who received optimal treatment with cefotaxime had excellent recovery. When cefotaxime therapy was delayed, mortality was noted in all except one child who survived with severe neurological sequelae. MRHIB meningitis treated with drugs other than cefotaxime had 100 per cent mortality. Cefotaxime is therefore recommended in children below 3 yr of age presenting with purulent meningitis, as MRHIB is a possible causative agent in this group.

Anti-Bacterial Agents↗

PubMed1991

The relationship of microbial pathogens to acute infectious diarrhoea of childhood.

Bacterial, viral and parasitic enteric pathogens were detected in 692 of 916 children below 36 months of age with acute diarrhoea and in 289 of 587 matched controls. The rates of identification of only four groups of pathogens, rotavirus, Shigellae, Salmonella typhimurium and enterotoxigenic E. coli, were significantly higher in the patients. The prevalence of a variety of other enteric pathogens was similar in controls of patients. Shigellosis had a characteristic clinical profile but none of the other agents could be suspected on clinical grounds. The high prevalence of pathogens in controls suggested that the population may be partially protected against a variety of enteric pathogens and that final common pathways leading to diarrhoea may be activated by changes in the microbial ecology of the gut lumen.

Acute Disease↗

PubMed1985

Conjugated bile acids in serum and secretions in response to cholecystokinin/secretin stimulation in children with cystic fibrosis.

More than 80% of patients with cystic fibrosis have poor pancreatic function, and have large daily faecal bile acid losses. This has been postulated to lower luminal bile acid concentrations and adversely affect fat absorption. We studied, for the first time, quantitative individual conjugated duodenal bile acid secretion rates into the duodenum during cholecystokinin/secretin infusion in 55 cystic fibrosis patients and six controls, using a quantitative non-absorbable marker technique. We were able to show adequate duodenal total bile acid concentrations and normal secretion rates in these children. The bile acid secretion pattern in cystic fibrosis patients showed a marked increase in bile acid concentration during cholecystokinin/secretin infusion, to levels which were above the critical micellar concentration indicating that the gall bladder is a functional organ in this disease. The subsequent fall in secretion rate was similar to controls. We have documented a significantly raised glycine/taurine bile acid conjugation ration in duodenal juice from cystic fibrosis patients and suggest that the combined effects of lowered ileal pH and increased glycine conjugated proportion of bile acids may cause precipitation of bile acids leading to decreased fat absorption and large faecal bile acid losses. To further investigate bile acid secretion in children with cystic fibrosis, we modified the high performance thin layer chromatography/densitometry method to enable measurement of individual glycine and taurine conjugates in serum. In comparing cystic fibrosis patients and controls, we were able to determine a group of 18 (36%) with bile acid evidence of liver damage who also showed reduced bile acid secretion into the duodenum. We were unable to study changes in serum bile acids during cholecystokinin/secretin infusion because of the high level of bile acid contamination in Boots Secretin. Some patients showed raised fasting serum bile acid concentrations more than two years before changes in conventional liver function tests or clinically evident liver disease. We have shown fasting serum bile acids to be a sensitive measure of liver dysfunction in cystic fibrosis and postulate that raised proportions of glycine conjugated bile acids may be responsible for the high incidence of liver disease in cystic fibrosis.

Adolescent↗

PubMed1981

Campylobacter as a cause of acute enteritis in children in South Australia. I. A 12-month study with controls.

During a 12-month period, we tested faecal samples from 386 children with acute enteritis and 332 controls by light and electron microscopy, and by bacterial and viral culture for pathogens, especially to assess the importance of campylobacter. Campylobacter alone was responsible for the illness in 17 patients (5%), and was second to salmonella among the bacterial agents, which were predominant in summer. Overall, rotavirus was the commonest identifiable cause of acute enteritis and was especially important in winter (with a rate of 49% in August). Thirty-five patients showed two or more agents. In 117 patients (30%) no pathogen was isolated or identified, suggesting that there are as yet unidentified agents in acute enteritis.

Acute Disease↗

PubMed1981

Campylobacter as a cause of acute enteritis in children in South Australia. II. Clinical comparison with salmonella, rotavirus and non-specific enteritis.

The clinical features of 17 children with campylobacter enteritis were compared with 17 age- and sex-matched children with enteritis due to salmonella, rotavirus or those in whom there was no identifiable pathogen. Prominent clinical features of campylobacter enteritis included fever, diarrhoea, vomiting, blood in stools and periumbilical pain. Dehydration was uncommon, compared to rotavirus and non-specific enteritis. The acute illness was self-limited, in spite of prolonged asymptomatic faecal excretion of the organism. This prolonged carriage increases the risk of cross infection. No patient with campylobacter required antibiotic therapy. Recurrent epidoses of diarrhoea were seen in three children but on no occasion was campylobacter the cause. This study has demonstrated a marked similarity between campylobacter and salmonella enteritis, making clinical distinction virtually impossible. Bloody diarrhoea, a feature of bacterial infections, was absent in rotavirus and non-specific enteritis.

Acute Disease↗

PubMedDate not supplied

Neonatal pulmonary flow pattern--a pulsed Doppler echo study.

The pulmonary flow pattern was analysed by pulsed Doppler in 77 normal neonates, at < 48 hours (36 subjects), 49 to 96 hours (25 subjects) and 97 to 148 hours (16 subjects). From the flow velocity spectrum, using an built in computer system, the acceleration time and the ejection time were measured, and the ratio was calculated. This ratio was 0.24 +/- 0.08 in the subjects within 48 hours whereas this ratio was 0.53 +/- 0.11 in the subjects above 97 hours; thus the ratio increased with age. We noticed that the ratio obtained from the pulsed Doppler is useful in assessing the pulmonary vascular status, even in neonates.

Blood Flow Velocity↗