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Biomedical subjects

K A Krishnamachari

Publications and source records attributed to K A Krishnamachari.

At least 19 recordsLinked to original sources
PubMed1986

Skeletal fluorosis in humans: a review of recent progress in the understanding of the disease.

Endemic skeletal fluorosis is a chronic metabolic bone and joint disease caused by ingesting large amounts of fluoride either through water or rarely from foods of endemic areas. Fluoride is a cumulative toxin which can alter accretion and resorption of bone tissue. It also affects the homeostasis of bone mineral metabolism. The total quantity of ingested fluoride is the single most important factor which determines the clinical course of the disease which is characterized by immobilization of joints of the axial skeleton and of the major joints of the extremities. A combination of osteosclerosis, osteomalacia and osteoporosis of varying degrees as well as exostosis formation characterizes the bone lesions. In a proportion of cases secondary hyperparathyroidism is observed with associated characteristic bone changes. Contrary to earlier thinking, severe crippling forms of skeletal fluorosis are seen in paediatric age group too. Increased metabolic turnover of the bone, impaired bone collagen synthesis and increased avidity for calcium are features in fluoride toxicity. Osteosclerotic picture is evident when small doses of fluoride are ingested over a long period of time during which calcium intakes are apparently normal while osteoporotic forms are common in paediatric age group and with higher body load of the element. Alterations in hormones concerned with bone mineral metabolism are seen in fluorosis. Kidney is the primary organ of excretion for fluorides. Age, sex, calcium intake in the diet, dose and duration of fluoride intake and renal efficiency in fluoride handling are the factors which influence the outcome. Serum parameters rarely help in the diagnosis. Elevated urinary fluoride and increased bone fluoride content are indicators of fluoride toxicity. Fluorosis is a preventable crippling disease. No effective therapeutic agent is available which can cure fluorosis. Industrial fluorosis is on the increase on a global basis. Bone density measurement is a tool for early diagnosis.

Bone Diseases↗
PubMed1985

Nutritional status and diarrhoeal morbidity: a longitudinal study in rural Indian preschool children.

Malnutrition and diarrhoeal diseases are important interrelated health problems of preschool children in the developing countries. For a prospective study to determine the effect of malnutrition on diarrhoeal morbidity 721 children under 5 years, living in two villages near Hyderabad were registered. The children were classified into different nutritional grades based on initial body weights and heights; and diarrhoea morbidity was recorded during the subsequent one year. The aetiology of diarrhoea was determined in a subsample. The incidence of diarrhoea was observed to be about 1.6 episodes/child/year and was similar in children with different nutritional grades. The percentage of episodes leading to severe dehydration was, however, significantly higher (P less than 0.05) in children with grade III malnutrition. The isolation of ETEC was also higher in this group indicating a greater bacterial load in the gut. Although pre-existing malnutrition did not affect the incidence of diarrhoea it seems to have a significant impact on the severity of the disease.

Age Factors↗
PubMed1979

47Ca turnover in endemic fluorosis and endemic genu valgum.

1. Calcium turnover was determined after intravenous injection of radioactive 47Ca in patients with fluorosis and endemic genu valgum and in age-matched controls. Total Ca turnover in the body, loss of Ca from the body in urine, faeces and sweat (external turnover) and bone mineralization rate were calculated from whole-body retention of 47Ca and specific activity of 47Ca in serum. 2. Total Ca turnover was significantly higher in younger subjects than in older subjects. 3. Total Ca turnover was significantly higher in patients with fluorosis and in those with endemic genu valgum than in age-matched controls, but the external turnover of Ca was lower in both groups of patients than in controls. 4. Bone mineralization rate was significantly higher in patients with fluorosis and in those with genu valgum as compared to age-matched controls. 5. Total body Ca turnover and bone mineralization rates were significantly higher in patients with endemic genu valgum than in those with fluorosis. The differences persited even after adjusting for differences in age between patients with fluorosis and those with genu valgum.

Adolescent↗
PubMed1978

Effect of calcium supplementation to undernourished mothers during pregnancy on the bone density of the bone density of the neonates.

Eighty seven pregnant women belonging to poor socioeconomic groups of population were investigated to find out the effect of calcium supplementation during pregnancy on the bone density of the mother as well as of the neonate. Supplements of 300 and 600 mg of elemental calcium administered daily from the 20th week of gestation onward until term, brought about a significant increase in the bone density of the neonates born of such mothers compared to that of the neonates born to unsupplemented mothers. Although no significant difference was observed between the initial and final values for bone densities among the mothers, there was a tendency for an increase in the bone density of the mothers who received 600 mg of calcium supplements. Individual variation of different neonatal bones in their response to maternal calcium supplements was observed. Bone density of the neonate was not related to the birth weight, crown-heel, or crown-rump lengths.

Adolescent↗
PubMed1978

Endemic familial arthritis of Malnad an outbreak in Southern India.

An outbreak of a peculiar joint disease affecting the hip and knee had occurred during the last decade or so, afflicting about 140 families in parts of Malnad in Southern India. Results of epidemiological studies suggest that a recent change in the environment had perhaps precipitated the disease in a genetically susceptible population.

Adolescent↗
PubMed1977

The problem of aflatoxic human disease in parts of India-epidemiological and ecological aspects.

An outbreak of a disease characterised by jaundice, rapidly developing ascites and portal hypertension associated with 20 p. 100 mortality rate was investigated in 1974. Analysis of food samples revealed that the disease outbreak was due to the consumption of maize (corn) heavily infested with the fungus Aspergillus flavus. Unseasonal rains prior to harvest, chronic drought conditions, poor storage facilities and ignorance of dangers of consuming fungal contaminated food seem to have caused the outbreak. The level of aflatoxin in food samples consumed during the outbreak was ranging between 2.5 and 15.6 microgram/g. Anywhere between 2 and 6 mg of aflatoxin seems to have been consumed daily by the affected people for many weeks. In contrast, during 1975, analysis of corn samples from the same areas revealed very low levels of aflatoxin, viz., less than 0.1 microgram/g. This was in line with the absence of major outbreak in 1975.

Adolescent↗
PubMed1976

Anaemia and immune response.

Nutritional anaemia is a major public-health problem in many parts of the world, and iron deficiency appears to be the most important cause. The immune response is believed to be impaired in anaemia. The results of the present study, carried out in young children, indicate that both the cell-mediated immune response and the bactericidal activity of leucocytes are impaired when levels of haemoglobin fall to 10 g/dl or less.

Adolescent↗
PubMed1976

Circulating levels of immunoreactive parathyroid hormone in endemic genu valgum.

Circulating levels of immunoreactive parathyroid hormone (PTH) were estimated in fifteen normal subjects and twenty-five subjects suffering from the skeletal fluorosis, ten of whom had associated endemic genu valgum. Levels of PTH were high in all the subjects with fluorosis as compared to normals, but among fluorosis subjects, those who had endemic genu valgum had values strikingly higher than those without. It is suggested that secondary hyperparathyroidism may have a significant role to play in the pathogenesis of osteoporosis seen in patients with endemic genu valgum.

Adolescent↗
PubMed1975

Hepatitis due to aflatoxicosis. An outbreak in Western India.

Parts of Western India have experienced an outbreak of hepatitis affecting man and dogs and characterised by jaundice, rapidly developing ascites, portal hypertension, and a high mortality-rate. The disease was associated with the consumption of maize contaminated heavily with Aspergillus flavus. Analysis of contaminated samples showed that affected people could have consumed between 2 and 6 mg. of aflatoxin daily over a period of a month. A specimen of liver obtained at necropsy showed bileduct proliferation and giant cells. The disease appears to be a result of aflatoxicosis.

Adult↗