Biomedical subjects
Publications and source records attributed to K S Chugh.
Acute renal failure developed in a young female having puerperal sepsis due to beta-haemolytic streptococci. The patient succumbed to her illness and an autopsy revealed extensive crescentic glomerulonephritis. The association between chronic visceral sepsis and glomerulonephritis is discussed.
Spontaneous rupture of the oesophagus presenting as a pyopneumothorax in an elderly male is described. Delayed presentation of the patient led to serious complications to which he succumbed.
In a young adult male with chronic renal failure from focal segmental glomerulosclerosis, massive proteinuria appeared within two weeks after transplantation. Although allograft biopsy at eight weeks was normal, a second biopsy eight months after transplant showed focal segmental glomerulosclerosis again. Sixteen months after transplantation maintenance hemodialysis had to be restarted.
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A total of 854 patients (640 children and 214 adults) admitted with acute or chronic diarrhoea suspected of non-invasive overgrowth of fungi in intestine were screened during a period of 3 years. Fungal proliferation was noted in 54.8% of these patients (53.6% in children, 58.4% in adults). The predominant fungal species isolated were Candida albicans (64.5%), followed by C. tropicalis (23.3%) C. krusei (6.9%). Torulopsis glabrata (1.6%). Trichosporon sp. and Geotrichum sp. were found to be responsible in 2.3% of adults. As seen in bacterial diarrhoea, higher incidence was noted in children from April to August. No such seasonal variation was noted in adults.
An 18-month-old infant presented with haemolytic uraemic syndrome following a prodrome of colitis. Incomplete recovery of renal function occurred after 4 weeks of anuria and was associated with extensive renal cortical calcification. During the recovery phase he had two relapses of colitis, microangiopathic haemolytic anaemia and thrombocytopenia without any deterioration in renal function.
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Two patients with ulcerative colitis associated with Takayasu's arteritis are described. Gangrene of a limb was the presenting feature in one patient and renovascular disease in the other. Angiography showed vascular occlusions affecting several medium or large sized vessels in both patients.
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The renal brush border membrane vesicles (BBMV) were used to elucidate the early biochemical functional status during the course of experimental M. leprae infection in mice. The activities of the characteristic brush-border enzymes viz: alkaline phosphatase, leucine amino peptidase and gamma-glutamyl transpeptidase were found to be significantly decreased (p less than 0.001) at 3 and 6 months after infection. The transport of nutrients viz: D-glucose, L-alanine, L-lysine and L-aspartate across BBMV showed similar pattern. The activity of brush border enzymes and transport of nutrients across the membrane returned to normal at 9 months post-infection suggesting regeneration of the brush border membrane.
Antibodies to human immune deficiency (HIV) virus were studied in 2000 individuals including cases of non-Hodgkin's lymphoma, systemic lupus erythematosus (SLE), leprosy, chronic renal failure on haemodialysis and patients attending STD clinics. A group of blood donors was also screened, ELISA kits provided by Wellcome Diagnostics were used. Results indicate that the ELISA values were far above the cut off figure in all except in a couple where the husband who had stayed in Uganda for several years, and had features of full blown AIDS died 4 months after the diagnosis. The spouse contacted AIDS within a relatively short incubation period and died within 6 months of diagnosis. The North Indian population thus appears to be free of this virus so far. This observation will be an important lead mark in the future epidemiology of HIV infection in India.
Renal papillary necrosis in 4 diabetic patients is described. Two of them had underlying diabetic nephropathy. Urinary tract infection was present in all of them. Three patients had passed fleshy material in the urine while in one the diagnosis was established by excretory urography. Two patients required haemodialysis for acute renal failure caused by sloughed papillae. The condition should be suspected in diabetic subjects who develop recurrent episodes of urinary tract infection, renal colic, haematuria or obstructive uropathy.
One hundred and fifty consecutive percutaneous renal biopsies were performed using ultrasonography to localise the site and depth of the lower pole of the left kidney. Renal tissue was obtained in 95% of cases and an accurate histopathological diagnosis was reached in 89% of patients. Gross haematuria following the procedure occurred in 6%, but was usually transient. No other complications were encountered. Ultrasonographic marking of the biopsy site and depth is a quick, simple, accurate and safe method of localizing the kidney for the purpose of a biopsy.
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Gastrointestinal complications constitute an important cause of morbidity and mortality in renal transplant recipients. The present communication is based on our experience with 10 living related donor kidney transplant recipients who suffered from severe acute colitis in the posttransplant period. A specific etiological factor was detected in only one (atypical mycobacteria). Six patients succumbed to the illness in the acute stage, thus highlighting its seriousness. Various factors involved in etiology have been discussed, and early therapeutic intervention emphasized.