PubMed Health⌕ Search

Biomedical subjects

J Krishna

Publications and source records attributed to J Krishna.

11 recordsLinked to original sources
PubMed1997

Case report: denovo inherited 18p deletion in a mother-fetus pair with extremely variable expression, confirmed by fluorescence in situ hybridization (FISH) analysis.

Denovo deletions of 18p without other associated rearrangement are uncommon. For such a deletion to profoundly affect the fetus of a near normal phenotypic carrier would be rarer. We present such a case in which the chance of a cryptic rearrangement was ruled out by fluorescence in situ hybridization (FISH) analysis. Possible explanations for wide variations in clinical expression are discussed.

Adult↗
PubMed1997

Interstitial deletion of long arm of chromosome no. 5 with growth hormone deficiency--an emerging syndrome?

5p- is a well-defined syndrome, but phenotypic correlations of 5q are poorly described in the literature. We present a case of a female child with interstitial deletion in the 5q13.1q15 region. Comparison of the clinical features of this patient with others reported in the literature suggests an emerging clinical syndrome defined by short stature, failure to thrive, mental retardation, slanting palpebral fissures, malformed ears, short neck and depressed nasal bridge. Based on our endocrine testing, we hypothesize that the short stature could be, in part, due to growth hormone deficiency. The recent assignment of growth hormone receptor gene to the short arm of chromosome 5 and the presence of several genes for growth factors and growth factor receptors on 5q raise interesting possibilities for the explanation of short stature in such cases.

Adult↗
PubMed1996

Unusual development of granulomas on the healing surface of burn wounds associated with MRSA infections.

Ten patients with a mean age of 14.5 years and partial skin thickness burns involving 3-5 per cent body surface areas developed rapidly proliferating tumour-like growths on the surface of their healing wounds within 10-21 days of sustaining the injuries. The number of tumours on every patient was either single or multiple and each increased in size daily. The growths were unique in their fulminating-type fleshy mass, with a consistency varying from soft to firm, absence of purulent material or head, and extension up to the fibrous layer covering the musculatuve. Histopathology was suggestive of granulomatous rather than a suppurative nature of the lesions. Isolation of MRSA from the burn wounds of four cases on the first day of dressing and then from the surface of the tumours of all of them and the excised tissues, as well as from the environment of the dressing room, indicated its involvement in the causation of the growths through contaminations of wounds with a hospital endemic strain while handling or dressing. The organisms were resistant to most antibiotics except vancomycin and teicoplanin. The growths in four cases subsided within 72 h with daily dressing, using an injectable solution of either vancomycin or teicoplanin, while the rest required radical excision and immediate cover with split skin grafts and systemic administration of either of the antibiotics. The wounds healed over a period of 8-10 days.

Adolescent↗
PubMed1993

Liposarcomatous differentiation in diffuse pleural mesothelioma.

A case history is presented of a woman who died eight hours after hospital admission with severe breathlessness. At necropsy the right lung was encased in a thickened pleura with a large tumour. Histological examination of the tumour showed pleural mesothelioma with liposarcomatous differentiation. The lungs showed changes of asbestosis and the asbestos fibre count was significantly raised. Liposarcomatous differentiation in pleural mesothelioma has not been reported previously.

Aged↗
PubMed1991

Water supplementation in exclusively breastfed infants during summer in the tropics.

This study was designed to determine the need for water supplementation to maintain water homoeostasis in exclusively breastfed infants during summer in a tropical country. A prestudy questionnaire revealed that 97% of 34 nurses and 63% of 70 doctors advocated such supplementation. 45 healthy, male, exclusively breastfed babies, aged 1-4 months, were recruited from a well-baby clinic. 9 who had never received supplemental water plus a random selection of 14 others were allocated to group I (breastmilk only); the remaining 22 infants were allocated to group II (breastmilk plus supplemental fluid according to the mother's usual practice). The babies were studied at the hospital for 8 h; breastmilk intake was measured by weighing the infant before and after each feed, water intake by calibrated bottles, and urine output by accurate collection and measurement. The maximum room temperatures were 34-41 degrees C and relative humidities 9-60% (below 50% in all but 3 infants). In group II the mean water intake was 11% (95% confidence interval 7-16%) of the total fluid intake. Both breastmilk intake (274 vs 210 ml) and total fluid intake (274 vs 233 ml) were higher in group I than in group II (p = 0.003, p = 0.073, respectively), after adjustment for age, weight, length, room temperature, and humidity. However, there were no significant differences between the groups in urine output, urine or serum osmolality, weight change, or rectal temperature whether or not the factors adjusted for included total fluid intake. Thus, exclusively breastfed infants do not need supplemental water to maintain water homoeostasis; a reduced breastmilk intake is a potential disadvantage of this practice.

Attitude of Health Personnel↗
PubMedDate not supplied

A rational approach to short stature: focus on use and abuse of growth hormone.

The abundant supply of recombinant growth hormone has raised interesting possibilities of several new applications. While supplementation of the missing hormone in patients with growth hormone deficiency is still the undisputed primary indication for its use, there is now convincing evidence of its usefulness in the therapy of short stature due to Turner syndrome and pre-transplant chronic renal failure in childhood. Numerous studies on patients with other causes of short stature have failed to show any significant benefit in final adult height. Social pressures notwithstanding, it is still premature to advocate the use of this expensive therapy for indications other than the three stated above especially since our understanding of potential long-term complications from such treatment is far from complete.

Adult↗
PubMedDate not supplied

Recent advances in management of diabetic ketoacidosis.

Diabetic ketoacidosis is the most common endocrine emergency in children and frequently it is the initial presentation of insulin dependent diabetes mellitus. Despite sophisticated technology and our improved understanding of the pathophysiology of this disease, the mortality from intracranial complications remains constant over the past two decades. Several management protocols are used all over the world but the recent trend in opinion seems to be one of the slower rates of initial hydration aimed at matching the osmolarity of the infusion solutions with the patient's serum osmolarity. It remains to be seen if widespread use of this rehydration strategy will improve morbidity in the future. A protocol for managing diabetic ketoacidosis is suggested.

Adolescent↗
PubMedDate not supplied

A report of a rare chromosome 9 variant with an unusual G-banding pattern in the 9qh region.

We present a case of a Caucasian multigravida with advanced maternal age who showed evidence of an unusual heterochromatin banding pattern on chromosome 9 and a similar fetal karyotype on amniocentesis. Although unusual banding patterns of this region have been described earlier, we report a new, clinically insignificant pattern. This case illustrates the care needed in analysing the heterochromatin region for accurate clinical interpretation of chromosome 9 polymorphisms.

Adult↗
PubMedDate not supplied

Bizarre delusions and first-rank symptoms in a first-admission sample: a preliminary analysis of prevalence and correlates.

This report examines the prevalence and correlates of bizarre delusions and Schneider's first-rank symptoms (FRS) in a first-admission sample with psychosis. A total of 196 patients were assessed with the Structured Clinical interview for DSM-III-R (SCID) and given a consensus diagnosis. Project psychiatrists blind to the consensus diagnoses coded each delusion and hallucination in the sample for both FRS and DSM-III-R bizarreness. Interrater reliability of bizarreness was lower than that of FRS (kappa = .681 v 861). The majority of symptoms (72%) were neither bizarre nor FRS, and of the remainder, bizarre delusions that were not also FRS were extremely uncommon. The prevalence of FRS was 70% in schizophrenia, 29% in psychotic bipolar disorder, and 18% in psychotic depression. For seven schizophrenic patients (7.45%), diagnosis of that disorder depended on the presence of a DSM-III-R bizarre delusion to meet criteria. There was a trend for FRS to be associated with poorer prognostic features in the schizophrenic sample. We concluded that although the constructs of bizarre delusions and FRS overlap, FRS were a more important feature in schizophrenia than bizarreness. The rarity of bizarre delusions that were not FRS, combined with the lower reliability of their assessment as compared with that of FRS, raises questions about the continued emphasis on this phenomenon in the definition of schizophrenia.

Adolescent↗