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Biomedical subjects

K S Chugh

Publications and source records attributed to K S Chugh.

At least 19 recordsLinked to original sources
PubMed1992

Tuberculous pyomyositis in a renal transplant recipient.

Infections are a major cause of morbidity and mortality in renal transplant recipients. Although these patients are susceptible to many types of infection, soft tissue infections are rare. We report a case of tuberculous pyomyositis involving the left erector spinae muscle but with no other manifestations of tuberculosis. The diagnosis was suspected from the CT scan appearance and confirmed by microscopy and culture of the pus. Surgical incision and drainage, together with antituberculosis therapy, cured the infection. The relevant literature is briefly reviewed.

Adult↗
PubMed1992

A 55-year followup of a patient with bilateral ureterosigmoidostomy.

We report on a patient with bilateral ureterosigmoidostomy who, despite many of the long-term complications associated with the procedure, was doing well 55 years after urinary diversion. This is one of the longest follow-ups reported in the literature. Despite the decreasing popularity of ureterosigmoidostomy, in well selected patients who desire a continent form of internal diversion it may still prove to be useful, as exemplified by our patient.

Aged↗
PubMed1992

The diagnostic value of CT scan in acute renal cortical necrosis.

We report the characteristic CT scan findings of renal cortical necrosis in a patient of acute renal failure, which was confirmed on renal biopsy. CT scan is a useful, noninvasive investigative modality for an early diagnosis of renal cortical necrosis.

Acute Disease↗
PubMed1992

Acute renal failure in severe hypothermia.

A patient who developed acute renal failure associated with severe hypothermia is reported. Warm peritoneal dialysis was initiated for core rewarming followed by intermittent hemodialysis till he entered the diuretic phase. The factors which led to acute renal failure in this patient included hypovolemia, hypotension, and acute pancreatitis.

Acute Kidney Injury↗
PubMed1992

Wegener's granulomatosis: clinical experience with eighteen patients.

Wegener's granulomatosis is being recognised with increasing frequency in India. Our 18, histologically confirmed, patients had a clinical profile similar to that described from developed countries. Delayed diagnosis led to the death of nine patients, usually within days of hospital admission, due to extensive vasculitis and renal failure. Tuberculosis was the most frequently considered diagnosis and 12 patients had been treated for it in spite of progressive clinical deterioration. Those who could be adequately treated with low dose daily cyclophosphamide and corticosteroids did well. Six of seven such patients are alive and well 1-8 years later. We believe that if prompt lung biopsy and ANCA determination are resorted to in patients with "resistant tuberculosis", it will greatly expedite case detection, diagnosis and optimum treatment of this remediable disease.

Adolescent↗
PubMed1992

Efficacy of oral fluconazole in Cryptococcus neoformans infection.

We report a renal allograft recipient who developed disseminated cryptococcosis, which was treated effectively, with oral fluconazole, a new triazole antifungal agent. The patient is doing well on maintenance therapy with fluconazole and immunosuppressive agents.

Administration, Oral↗
PubMed1992

Spectrum of hospital-acquired acute renal failure in the developing countries--Chandigarh study.

The spectrum of hospital-acquired acute renal failure in the developing countries has not been documented. We undertook a prospective study to define the causes and outcome of hospital acquired acute renal failure as seen at a referral center in North India. Over a one year period, all patients who developed acute elevation in serum creatinine during the hospital stay were studied. One hundred and ninety of 29,503 admitted patients (0.64 per cent) satisfied the criteria for entering into the study. Nephrotoxic drugs (29 per cent), decreased renal perfusion (21 per cent), major surgery (18 per cent) and septicaemia (17 per cent) were the most frequent causes. Acute renal failure was non-oliguric in 52 per cent of patients. Non-oliguric patients had significantly fewer episodes of hyperkalaemia, neurological abnormalities, metabolic acidosis and gastrointestinal bleeding. They required fewer episodes of dialysis (p < 0.001) and had a significantly lower mortality (p < 0.001) compared to the oliguric patients. Other poor prognostic factors included severity of renal insufficiency, high baseline serum creatinine and presence of multiorgan failure. The present study shows that the spectrum of hospital-acquired acute renal failure in the developing countries is quite similar to that of technologically advanced countries, although the pattern of community acquired acute renal failure is vastly different.

Acute Kidney Injury↗
PubMed1991

Effect of dialysis and renal transplantation on autonomic dysfunction in chronic renal failure.

Autonomic functions were evaluated in 25 nondialyzed patients with chronic renal failure and eight controls. Eight patients were reassessed after 6.6 +/- 1.0 weeks of hemodialysis and 12 patients were restudied 24 +/- 4.0 weeks after renal transplantation. In addition, six patients who had been on maintenance hemodialysis for a duration of 21.5 +/- 3.0 weeks were also studied. Autonomic function tests, including blood pressure and heart rate response to sudden loud noise, mental arithmetic, hand immersion in cold water, Valsalva maneuver, change in posture and respiration, were performed using brachial artery cannulation and continuous monitoring by electrocardiogram. Baroreceptor sensitivity slope was determined using bolus injections of phenylephrine. Supine and standing plasma norepinephrine levels were measured. The cold pressor test, response to sudden loud noise and mental arithmetic were normal in nondialyzed patients with chronic renal failure, suggesting an intact efferent sympathetic pathway. The plasma norepinephrine concentration varied widely but the mean value was similar to the control group (P greater than 0.05). Expiration/inspiration ratio, lying/standing ratio, Valsalva ratio and the baroreceptor sensitivity slope were significantly abnormal (P less than 0.001) in nondialyzed patients. This indicates a defective efferent parasympathetic pathway and depressed baroreceptor sensitivity. The blood pressure response to phenylephrine was lower in the uremics, suggesting a reduced end-organ responsiveness to alpha agonists. The presence of hypertension did not affect autonomic function. The heart rate response to standing and the baroreceptor sensitivity were significantly lower (P less than 0.05) in patients who developed hypotension during hemodialysis. Lower baroreflex sensitivity could contribute to hypotension during dialysis. Autonomic functions remained unaltered after short- and long-term dialysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Ocular complications in renal allograft recipients.

Ocular complications in renal allograft recipients are a significant cause of morbidity. Of 80 renal transplant recipients, 42 (52.5%) developed ocular complications. These included posterior subcapsular cataract in 22 patients (27.5%), opportunistic ocular infections by CMV, cryptococcus, mucormycosis, herpes simplex and herpes zoster in five (6.25%), steroid-induced raised intraocular pressure in four (5%) and primary disease-related vascular complications in ten (12.5%). Our findings highlight the importance of regular ocular examination of all allograft recipients in the post-transplant period.

Adolescent↗
PubMed1991

Sigmoid colon conduit urinary diversion in a renal transplant recipient.

Renal allotransplantation is the treatment of choice for patients with end-stage renal disease (ESRD). With increasing technical expertise, it has been realised that presence of a normal lower urinary tract is not a necessity for transplantation. Advanced genito-urinary tuberculosis frequently leads to a small-capacity bladder. Herein, we present a case of ESRD due to urinary tuberculosis in whom sigmoid colon conduit urinary diversion was carried out. The immunosuppressed status did not increase the complications of a sigmoid colon conduit urinary diversion.

Adult↗
PubMed1991

Myoglobinuric acute renal failure following electrical injury.

Eight patients with acute renal failure (ARF) following electrical injury were studied. The mean area of cutaneous burns was 23 +/- 16% (range 6-60%) and extensive tissue necrosis with gangrene was uniformly present. Oliguria developed 9.3 +/- 7 h (range 3-24 h) after the injury in 7 patients (88%). Urinalysis revealed presence of myoglobin in 75% of the patients. The mean duration of oliguria among those who recovered was 16 +/- 6 days (range 11-23 days) and the mean interval between the onset of oliguria and recovery of renal function was 25 +/- 6 days (range 21-34 days). Four patients died. The cause of death was Klebsiella septicemia in 1, hyperkalemia associated with extensive myonecrosis in 2 patients, and uncertain in 1 patient. Our observations showed that myoglobinuric acute renal failure associated with electrical injury carries a high mortality. Early detection and aggressive management of hyperkalemia and sepsis are necessary to reduce mortality among these patients.

Acute Kidney Injury↗
PubMed1991

Does Convit vaccine (BCG + Mycobacterium leprae) afford protection against biochemical changes in renal brush border membrane in experimental leprosy?

Renal functional status in Mycobacterium leprae infected mice can be best studied by examining the enzymatic status of brush border membrane vesicles from proximal convoluted tubule. The role of vaccination in modulation of the renal status brought by the disease has been studied using this technique. The characteristic marker enzymes of renal brush border membrane--namely alkaline phosphatase, leucine aminopeptidase and gamma-glutamyl transpeptidase decreased significantly (p less than 0.01) in due course in M. leprae infection over a period of 9 months. The combined vaccine (BCG + M. leprae) may have a protective effect on renal abnormalities only in the initial stages of infection as indicated by a significant rise in enzymatic levels. However, no significant (p greater than 0.05) protective effect of vaccine was found in a more advanced disease state after 9 months in infected mice.

Animals↗