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Biomedical subjects

K Kumar

Publications and source records attributed to K Kumar.

At least 37 records · Page 2Linked to original sources
PubMed1991

Treatment of chronic pain by epidural spinal cord stimulation: a 10-year experience.

Epidural spinal cord stimulation by means of chronically implanted electrodes was carried out on 121 patients with pain of varied benign organic etiology. In 116 patients, the pain was confined to the back and lower extremities and, of these, 56 exhibited the failed-back syndrome. Most patients were referred by a pain management service because of failure of conventional pain treatment modalities. Electrodes were implanted at varying sites, dictated by the location of pain. A total of 140 epidural implants were used: 76 unipolar, 46 Resume electrodes, 12 bipolar, and six quadripolar. Patients were followed for periods ranging from 6 months to 10 years, with a mean follow-up period of 40 months. Forty-eight patients (40%) were able to control their pain by neurostimulation alone. A further 14 patients (12%), in addition to following a regular stimulation program, needed occasional analgesic supplements to achieve 50% or more relief of the prestimulation pain. Pain secondary to arachnoiditis or perineural fibrosis following multiple intervertebral disc operations, when predominantly confined to one lower extremity, seemed to respond favorably to this treatment. Uniformly good results were also obtained in lower-extremity pain secondary to multiple sclerosis. Pain due to advanced peripheral vascular disease of the lower limbs was well controlled, and amputation below the knee was delayed for up to 2 years in some patients. Pain due to cauda equina injury, paraplegic pain, phantom-limb pain, pure midline back pain without radiculopathy, or pain due to primary bone or joint disease seemed to respond less well. Patients who responded to preliminary transcutaneous electrical nerve stimulation generally did well with electrode implants. Notable complications included wound infection, electrode displacement or fracturing, and fibrosis at the stimulating tip of the electrode. Three patients in this series died due to unrelated causes. Epidural spinal cord stimulation has proven to be an effective and safe means of controlling pain on a long-term basis in selected groups of patients. The mechanism of action of stimulation-produced analgesia remains unclear; further studies to elucidate it might allow spinal cord stimulation to be exploited more effectively in disorders that are currently refractory to this treatment modality.

Chronic Disease↗
PubMed1991

Changes observed in antioxidant system in the blood of postmenopausal women with breast cancer.

From experimental studies and epidemiological data, it can be inferred that lipid peroxidation is increased in cancer patients. Cases of post-menopausal, untreated women with benign and malignant breast tumours, were compared with their age matched controls in their serum lipid peroxides, antioxidant vitamins (E and C), serum selenium and serum ceruloplasmin. Erythrocyte and its membrane lipid peroxidation and antioxidant enzymes (catalase, superoxide dismutase, glutathione peroxidase and glutathione-S-transferase) levels were also analyzed. Significant increase in circulating lipid peroxides, ceruloplasmin and significant decrease in antioxidant vitamins and selenium were observed in breast cancer women. The erythrocyte and its membrane lipid peroxidation was increased significantly and severe impairment of antioxidant potential was observed in breast cancer women.

Aging↗
PubMed1991

Studies on the changes in plasma lipids and lipoproteins in patients with benign and malignant breast cancer.

Experimental studies and epidemiological data suggest that, high fat diet increases the risk of developing breast cancer, both in animal and in human population. Cases of postmenopausal, untreated women with malignant and benign breast tumors, were compared for their age, body weight, plasma lipid fractions and lipoproteins. There was a significant increase in body weight, total plasma lipids, total cholesterol, LDL--cholesterol, VLDL--cholesterol, phospholipids, triacylglycerols, free fatty acids in malignant breast cancer patients. HDL--cholesterol had been significantly decreased in benign and malignant patients when compared with the control subjects.

Body Weight↗
PubMed1991

The effects of antihypertensive agents on the quality of life in Indian hypertensives.

Effects of commonly used antihypertensive agents like nifedipine, atenolol, propranolol and captopril on quality of life was studied. Fourty-four patients with essential hypertension entered and 26 completed the full protocol of the study. Each drug was given separately in a random fashion in fixed dosage for 4 weeks with a washout period of 2 weeks in between the drugs. Assessment of quality of life was done under following measures: satisfaction with life and sense of well being, physical state, emotional state, intellectual function, social life and sexual life; each assessed on a prestandardized 5 point scale. All the 4 drugs resulted in significant and similar blood pressure control but the incidence of adverse effects was maximum with nifedipine (40.9%), followed by atenolol (18.4%), propranolol (14.3%) and captopril (3.6%). There was significant improvement in various aspects of quality of life with all the 4 drugs. Captopril and propranolol scored significantly better than atenolol and nifedipine on measures like sense of well being and satisfaction with life, physical state, intellectual function and emotional state. Improvement in sexual life was maximum with captopril, moderate with propranolol and nifedipine and least with atenolol. In conclusion, captopril closely followed by propranolol was the most acceptable drug with fewer adverse effects and improved sexual as well as other aspects of quality of life compared to nifedipine and atenolol.

1-Propanol↗
PubMed1990

Use of interactive videodisc for teaching of pathology laboratory cases.

Images from a generic videodisc called the 'Slice of Life' were utilized to develop computer-assisted interactive videodisc instruction (IVI) units for supplemental independent review of the laboratory cases studied in the general pathology course for year 1 medical students. Four units based on laboratory cases (two on 'inflammation' and two on 'neoplasia') were developed for a dual-screen Macintosh system. With this dual-screen system, specific picture frames from the videodisc could be retrieved on one screen while the other screen displayed the corresponding text. Each unit contained a number of case studies, each of which consisted of a clinical profile, gross picture and description of the tissue removed, sequential photomicrographs at successively higher magnifications from various fields of slides and their descriptions, comparison with the normal histology of the organ involved, interpretation of the observations and comments, final diagnosis, and a quiz at the end. Histopathological features were specifically emphasized. Evaluation of the units obtained from three consecutive classes of students indicated that these units were received as valuable supplemental tools for independent review of the laboratory cases.

Computer-Assisted Instruction↗
PubMed1990

Deep brain stimulation for control of intractable pain in humans, present and future: a ten-year follow-up.

Deep brain stimulation with chronically implanted electrodes has provided satisfactory control of pain in patients with intractable chronic pain syndromes, which have been refractory to medication and other conventional modalities of management. In this series the authors present their experience with 48 patients who have been followed for periods ranging from 6 months to 10 years. Long-term pain control was achieved in 30 patients (63%). Both the periventricular gray and specific sensory thalamic nuclei have been used as targets. Our results indicate that there is an initial 2-year fall-off of pain control caused by idiopathic tolerance, with stable results thereafter, regardless of site of the implant. This is suggestive of some biochemical modification of tissues around the electrode. Patients with failed-back syndrome secondary to multiple disc operations fared well; those with pain secondary to progressive neurological disorders or cancer had only short-term pain relief, and those with thalamic pain, cauda equina injury, or phantom limb pain usually had a poor result. Deep brain stimulation, in selected patients, appears to provide long-term pain control safely with few side effects or complications.

Adult↗
PubMed1990

Giant axonal neuropathy: clinical, electrophysiologic, and neuropathologic features in two siblings.

Giant axonal neuropathy is a progressive central-peripheral axonopathy characterized by distention of axons by aggregated neurofilaments. We report two female siblings with giant axonal neuropathy. Both patients developed symptoms of a chronic progressive polyneuropathy at age 3 years. Clinical evidence of central nervous system involvement was present in both cases. Autopsy neuropathologic examination of the older sibling at the age of 11 years revealed numerous giant axons, Rosenthal fibers, and gliosis throughout the brain and spinal cord and typical giant axons in the peripheral nerves. Electrophysiologic studies in the younger sibling indicated brain stem dysfunction, and her sural nerve biopsy revealed enlarged axons packed with neurofilaments. These patients illustrate that neurologic deficits of giant axonal neuropathy result from widespread lesions in the central, as well as peripheral (including autonomic), nervous systems. This occurrence of giant axonal neuropathy in two siblings supports a genetic origin of this disease. This is the first report of autopsy findings in giant axonal neuropathy in an affected sibling.

Axons↗
PubMed1990

Efficacy of prolonged therapy with stibogluconate in post kala-azar dermal leishmaniasis.

Fifty three (30 male and 23 female), previously untreated, patients with post kala-azar dermal leishmaniasis (PKDL) were treated with sodium stibogluconate, at the dose of 20 mg/kg/bw/d/im/(with a maximum of 8.5 ml) for 120 days (or more, if necessary). All the patients were followed up for 12 months. The patients were assessed after 40 days and thereafter at an interval of 20 days. The mean age of onset was 24 yr, maximum number of patients developed the disease within 3 yr of apparent cure of kala-azar. Maximum number of patients sought treatment within 5 yr of the onset of PKDL. The disease affected the face (98%), trunk (83%), upper limb (72%), lower limb (40%), genetalia (6%), and mucus membrane of the tongue 40%. The lesions observed were nodules (19%), papules (30%), and hypopigmented (45%) and reddish macules (7%). The parasites could be demonstrated in the nodules (100%), papules (69%) and macules (59%). The response to treatment started in 72 per cent of patients in the first 20 days and in 40 days in all patients. All the nodules and papules disappeared in 120 days, and the macules within 200 days. The side effects of treatment noted were changes in S T and T in electrocardiogram (7%), arthralgia (11%), allergic rash (7%), swelling at the site of injection (5%), neuralgia (4%) and metalic taste (6%). The S T and T changes reverted to normal when the drug was discontinued for 20 days. Arthralgia improved with indomethacin. The higher dosages and longer course of treatment were well tolerated and resulted in a cure in all patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Standardisation of multiple-choice questionnaire for evaluating medical officers' training in psychiatry.

This study reports the standardisation of a multiple choice questionnaire (MCQ) for evaluating the training of primary care physicians in psychiatry. An item pool of 104 multiple-choice questions of the 'single best response' type was written. This item pool along with an 'MCQ assessment sheet' was mailed to 90 psychiatrists with a request to evaluate the questionnaire. Twenty five psychiatrists responded to the enquiry, of which 22 gave their detailed comments regarding the MCQ. Based on the responses that were received, 14 items were discarded, 77 items were modified and 13 items accepted without any modification. The final pool of 90 items was split into two comparable sets, one for pre-training assessment and the other for post-training assessment. The questionnaire was administered to a group of 32 medical officers and was found to be sensitive in detecting gains in knowledge following training.

Educational Measurement↗
PubMed1989

Anomalous course and branches of human coronary arteries.

132 hearts obtained from cadavers were dissected in order to study anomalies in the course and branches of human coronary arteries. Only in 1 heart was a deviation of the circumflex branch of the left coronary artery taking a course inferior to the coronary sulcus observed. The right coronary artery travelled the entire length of the coronary sulcus on the back of the heart and gave both a posterior ventricular and a collateral branch. Circumflex branches of the right and left coronary arteries did not anastomose.

Arteries↗
PubMed1989

Experimental selenium toxicity in guinea pigs: biochemical studies.

Biochemical studies were conducted in experimentally induced selenium toxicity in recently weaned guinea pigs. A significant drop in blood glucose level, in comparison to controls, was observed in animals fed selenium-enriched barley (organic form) as well as those fed ordinary barley mixed with sodium selenite (inorganic form). Estimation of total serum proteins also revealed a significant drop in both these groups. SGOT (EC 2.6.1.1) activity was comparatively lower but no significant alteration was noticed in SGPT (EC 2.6.1.2). The erythrocytic glutathione peroxidase activity was significantly increased in inorganic selenosis followed by that in organic one, in comparison to controls. All these alterations were of mild degree in guinea pigs which were given sodium arsenite (10 ppm) along with sodium selenite (30 ppm) in the feed.

Animals↗
PubMed1989

Glycosylated haemoglobin(HbA1C) and serum protein bound hexose in diabetes mellitus.

Glycosylated haemoglobin (HbA1C) and serum protein bound hexose (SPBH) levels were estimated in 35 healthy control subjects and 35 diabetic subjects. The mean levels of SPBH in control subjects was 161.69 +/- 3.84 mg/dl. The SPBH levels in diabetic subjects were found to be increased (P less than 0.001). It was not influenced by age and sex of the patients, complications, type of diabetes and treatment received. HbA1C levels in control subjects were 5.33 +/- 0.38/dl. The HbA1C levels in diabetic subjects was found to be markedly elevated (11.95 +/- 0.46/dl) and was found to be highly significant (P less than 0.001). The levels were found to be on higher side in juvenile diabetics. A progressive linear correlation was observed between fasting blood sugar levels and concentration of SPBH and glycosylated haemoglobin concentration. A significant correlation was also observed between the levels of glycosylated haemoglobin and SPBH levels (P less than 0.05).

Blood Glucose↗
PubMed1988

Diazinon toxicity: effect on protein and nucleic acid metabolism in the liver of zebrafish, Brachydanio rerio (Cyprinidae).

Four-month old adult siblings of zebrafish were exposed to four concentrations of diazinon for up to 168 h. DNA, RNA, protein and total free amino acid content were monitored in the liver. The DNA, RNA and protein contents were significantly reduced, whereas the amino acid content was significantly enhanced. All these changes showed dose- as well as time-dependent response.

Animals↗
PubMed1988

Cypermethrin toxicity: effect on the carbohydrate metabolism of the Indian catfish, Heteropneustes fossilis.

Toxicity tests revealed that the Indian catfish, Heteropneustes fossilis, is highly sensitive to cypermethrin, a synthetic pyrethroid. The LC50 value decreased with increasing exposure time, revealing a time-dependent action of cypermethrin. Biochemical studies confirmed this, showing that the effects on carbohydrate metabolites also revealed a time-dependent response. The probable reasons for the disturbance in the homeostatic mechanisms of carbohydrate metabolism are discussed.

Animals↗
PubMed1988

Multifocal osteoarticular tuberculosis.

Multifocal osteoarticular tuberculosis is uncommonly reported despite its incidence of 7 to 10% in the Indian population. We describe the clinical features and management of 48 patients seen in the last nine years.

Adolescent↗
PubMed1988

The effect of cardiopulmonary bypass on plasma protein binding of alfentanil.

The effect of cardiopulmonary bypass (CPB) on plasma concentration and protein binding of alfentanil was studied during continuous infusions in five cardiac surgical patients. Patients were given a loading infusion of 10 micrograms.min-1.kg-1 lean body mass (LBM) over 30 s followed by a fixed rate maintenance infusion of 1 microgram.min-1.kg-1 LBM for the duration of surgery. Prior to the commencement of CPB the total plasma alfentanil concentration was 177 micrograms.l-1. This fell to 92 micrograms.l-1 2 min after commencement of CPB and rose to 155 micrograms.l-1 at the end of CPB 2.01 h later. During the same period the unbound fraction of alfentanil rose from 0.16 to 0.35 two min after the start of CPB and fell gradually to 0.22 at the end of CPB. The unbound concentration prior to CPB was 29 micrograms.l-1 and was essentially unchanged by the onset of CPB, being 35 micrograms.l-1 at two min and then 31 micrograms.l-1 at the end of CPB. There was a good correlation between alfentanil bound/unbound concentration ratio and plasma albumin concentration (r = 0.57) and plasma alpha 1-acid glycoprotein concentration (r = 0.80), indicating that the decrease in binding during CPB was due primarily to haemodilution. In assessing the effects of CPB on plasma drug concentrations, it is therefore necessary to monitor unbound as well as total concentrations because the effects on these differ greatly.

Aged↗