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Biomedical subjects

K Subramani

Publications and source records attributed to K Subramani.

12 recordsLinked to original sources
PubMed2005

Laryngospasm during subarachnoid block.

Central neuraxial block is associated with increased vagal tone. We report a patient who developed laryngospasm and stridor under spinal anaesthesia. This was treated successfully with i.v. atropine and fluids. We propose that the laryngospasm was secondary to increased vagal tone under the spinal anaesthetic. Such a manifestation of increased vagal tone under spinal anaesthesia has not been reported previously.

Adult↗
PubMed2000

Silent spread of dengue and dengue haemorrhagic fever to Coimbatore and Erode districts in Tamil Nadu, India, 1998: need for effective surveillance to monitor and control the disease.

Dengue fever (DF) or dengue haemorrhagic fever (DHF) has not previously been reported in Coimbatore and Erode districts in Tamil Nadu in India. In 1998, 20 hospitalized cases of fever tested positive for dengue virus IgM and/or IgG antibodies. All of them had dengue-compatible illness, and at least four had DHF. Two of them died. Sixteen cases were below 10 years of age. The cases were scattered in 15 distantly located villages and 5 urban localities that had a high Aedes aegypti population. Although the incidence of dengue-like illness has not increased recently, almost 89% (95/107) of samples from healthy persons in the community tested positive for dengue IgG antibodies. The study showed that dengue has been endemic in the area, but was not suspected earlier. A strong laboratory-based surveillance system is essential to monitor and control DF/DHF.

Adolescent↗
PubMed1996

Patterns of postoperative recurrence in fistulizing and stenotic Crohn's disease. a retrospective cohort study of 71 patients.

To compare the time course of clinical recurrences and reoperations following primary resections for fistulization versus fibrostenotic obstruction in ileal Crohn's disease, we performed a retrospective cohort study of 71 patients undergoing their first resection at The Mount Sinai Hospital between 1961 and 1984. Among these 71 patients, 35 were classified as fistulizing and 36 as fibrostenotic. Follow-up was 93% complete through 1990, with a median follow-up of 73 months to reoperation and 105 months to last contact. The fistulizing and fibrostenotic patients experienced virtually identical numbers of clinical recurrences: 25 from the former group and 24 from the latter. The recurrences appeared very slightly earlier among the fistulizing than among the fibrostenotic group, but the difference did not approach statistical significance. Only 18 patients came to reoperation during follow-up: 12 from the fistulizing and 6 from the fibrostenotic group. The earliest reoperation in the fistulizing group occurred at 14 months and in the fibrostenotic group at 44 months. There was a trend for earlier reoperation in the fistulizing group, but the difference was not statistically significant. Different clinical patterns of Crohn's disease have yet to be correlated with distinctive subclinical biologic markers.

Adult↗
PubMed1993

Refractory pouchitis: does it reflect underlying Crohn's disease?

Typical 'pouchitis' is a well recognised complication of ileal pouches in ulcerative colitis. Infrequently, a refractory pouchitis (RP) presents with certain clinical, endoscopic, and pathological features resembling Crohn's disease and is often ascribed to misdiagnosis of the initial colitis. To test that hypothesis and to identify risk factors for RP, this study reviewed cases of presumed ulcerative colitis with ileal pouches constructed at The Mount Sinai Hospital between 1973 and 1986. Twenty four cases with RP (16 Kock pouches and eight pelvic pouches) and 21 controls were compared for eight clinical variables. The original colectomy slides from 15 RP and 18 control cases were reviewed blindly, classified into five histological categories (corresponding to definite ulcerative colitis, definite Crohn's disease, and three indeterminate groups), and scored for 23 histological features. There were no significant clinical differences between RP and control cases except for more frequent extraintestinal manifestations (38% v 5%) and male preponderance (79% v 43%) in RP. There were also no significant differences between the distributions of RP cases and controls among the five histological categories or in the 23 histological features studied. Refractory pouchitis therefore does not seem to reflect underlying Crohn's disease, but may be linked to immunological mechanisms that are manifested clinically as extraintestinal complications.

Adult↗
PubMed1991

The irritable bowel syndrome. A continuing dilemma.

This article deals with the dilemmas in the definition, diagnostic work-up, and treatment of patients with the irritable bowel syndrome. The data presented are a blend of scientific insight to date and more than four decades of clinical experience with this disorder.

Colonic Diseases, Functional↗
PubMed1990

ACTH-induced adrenal hemorrhage: a complication of therapy masquerading as an acute abdomen.

Four patients developed adrenal hemorrhage during treatment with intravenous adrenocorticotropic hormone (ACTH) for severe inflammatory bowel disease (IBD). This complication presented suddenly with upper abdominal and flank pain mimicking an acute surgical abdomen. In each patient the symptoms of the underlying bowel disease had subsided under the ACTH therapy. In our first patient the diagnosis was not made until laparotomy, but in the subsequent three patients the diagnosis was suspected by the strikingly similar clinical presentation. In each of these three latter patients the diagnosis was confirmed by sonography or computed tomography (CT) scan, and surgery was avoided. All four of our patients are doing well at 1-58 months of follow-up. Signs of adrenal insufficiency occurred only in the one of our four patients, and in those six of 11 previously reported patients, who had bilateral adrenal hemorrhage. ACTH-induced adrenal hemorrhage requires stopping ACTH and maintaining corticosteroid support. The diagnosis of adrenal hemorrhage should be considered in the patient treated with ACTH who develops unexplained acute abdominal or flank pain. Failure to recognize this complication of ACTH therapy can lead to unnecessary surgery or the dangerous continuation of the offending agent.

Abdomen, Acute↗
PubMed1988

Thrombocytosis elevates serum potassium.

Spurious elevation of the serum potassium can be seen if the platelet count exceeds 1,000 x 10(9)/L in patients with myeloproliferative disease. To see if serum potassium is increased at more modest elevations of the platelet count we studied these parameters in 283 controls and 161 patients with reactive thrombocytosis. The incidence of hyperkalemia was 34% in patients with over 500 x 10(9) platelets/L compared with 9% if the platelet count was below 250 x 10(9)/L. Over this range there was a significant correlation of potassium increasing with the platelet count. The higher potassium values could not be explained on the basis of leukocytosis, renal insufficiency, or acidosis, suggesting that the elevated serum levels were often spurious. In support of this conclusion, the serum potassium exceeded plasma potassium by a larger amount in patients with thrombocytosis. We conclude that serum potassium rises in direct proportion to the platelet count in normal patients and in those with thrombocytosis, and that this increment is an artifact.

Humans↗
PubMed1986

Metal-ion assisted detergent action on bacterial growth: detergent specificity and mechanism of inhibition.

Detergents in general inhibit bacterial growth. The anionic detergent, sodium lauryl sulphate (NaLS), seems to have a more specific inhibitory effect on growth of the Gram-positive Bacillus subtilis than on growth of the Gram-negative Escherichia coli. The specificity of anionic detergent towards B. subtilis has been traced to the difference in the nature of the cell wall. The inhibitory action of the detergent is markedly increased by the presence of metal ions like Cd++ or Mg++, due probably to the increase in the micellar phase, facilitating the solubilisation of bacterial species in the inner core of micelles. While metal ions like Cu++ do not influence the activity of NaLS, Na+, Ca++ or Mn++ ions seem to act against the detergent action on bacterial growth, probably by altering the structure of micelles.

Bacillus subtilis↗