Biomedical subjects
L Kumar
Publications and source records attributed to L Kumar.
Low dose cytosar in the treatment of chronic granulocytic leukaemia--blast crisis.
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Fetal liver infusion in aplastic anaemia.
Forty patients with severe aplastic anaemia received an intravenous infusion of 0.004 to 11.1 x 10(8) (median: 8 x 10(8) hematopoietic cells prepared from the fetal livers of 8-32 week old abortuses. Five patients, who died within 15 days of fetal liver infusion, are excluded from analysis. Twenty-two of the 35 evaluable patients (62%) responded favourably. Six of the 7 patients with good response were alive after 9 to 44 months (median: m = 20); one died 106 months after fetal liver infusion due to renal lithiasis. Four of the 7 with moderate response were alive after 9 to 31 months; 3 died within 16 months. Of 8 patients with minimal response, one was lost to follow-up and the others died in 3.4 to 10 months (m = 6). Median survival of responders was 15.7 months. Bone marrow cellularity became normal in 12 patients following fetal liver infusion. In seven patients, there was a relapse; 6 regained a normal bone marrow cellularity after a second or third fetal liver infusion. These data strongly suggest a role of fetal liver infusion in inducing bone marrow recovery. Of 13 non-responders, 4 were lost to follow-up and 9 died within 20 days-4.3 months (m = 1.6). Fetal liver infusion appears to be an effective therapy in patients with severe aplastic anaemia.
Fetal liver infusion in acute myelogenous leukaemia.
Forty-five patients with acute myelogenous leukaemia (AML) received induction chemotherapy with either a conventional dose of cytarabine and daunorubicin (27 patients) or a low dose of cytarabine (18 patients). Maintenance chemotherapy was given to all responders. In 14 of 39 evaluable patients, infusion of fetal liver cells from 10-24 weeks old foetuses was given following induction as well as maintenance therapy. Six of 14 patients (43%) achieved a complete remission; 2 showed evidence of transient engraftment documented by analysis of sex chromosomes and RBC antigens (1 patient each). Fetal liver infusion within 6 days of completing induction chemotherapy appeared more effective than when given later. Five of 25 patients (20%) who did not receive fetal liver infusion achieved a complete remission. The present work suggests that fetal liver infusion given following induction chemotherapy may increase the remission rate in AML either by temporary engraftment or by accelerating the rate of haematological recovery.
Rapidly filling pleural effusion due to a subarachnoid-pleural fistula.
Only five cases of subarachnoid-pleural fistula in children have been reported previously. All had a history of trauma and associated neurologic deficit which gave clue to the diagnosis. The authors present a child who presented with a massive, rapidly filling, clear pleural effusion in whom there was no neurologic deficit. The history of an automobile accident in the past had almost been forgotten. A subarachnoid-pleural fistula was discovered on exploratory thoracotomy. The entity should be thought of, and actively investigated, in a child with a history of trauma and a pleural effusion of obscure etiology, even if there is no associated neurologic deficit.
Application of case management to the control of acute respiratory infections in low-birth-weight infants: a feasibility study.
The feasibility of introducing a case management programme for acute respiratory infections among low-birth-weight infants at the primary health care level was investigated in 37 villages in the Indian state of Haryana. Twenty-one of the villages served as the intervention area, while the remaining 16 formed the control area. All low-birth-weight infants born in the two areas between January 1982 and September 1983 (199 in the intervention area and 211 in the control area) were included in the study. Primary health care workers were contacted in 38% of episodes of acute respiratory infections in the intervention area, in contrast to only 1% of episodes in the control area. Also, the mean duration of infections in the intervention area was significantly lower (P<0.01), while the case fatality was about 33% of that in the control area. The results indicate that the programme can be successfully incorporated into existing primary health care infrastructures.
Acute renal failure amongst children in a tropical environment.
The pathogenetic factors leading to acute renal failure (ARF) in 223 children between the ages of 20 days and 14 years were studied. Diarrhoeal diseases were responsible for ARF in 49.8%, acute glomerulonephritis in 34.1%, drug induced intravascular hemolysis in glucose -6-phosphate dehydrogenase deficiency in 4.5%, snake bite in 4%, hemolytic uremic syndrome in 2.2%, and miscellaneous causes in 5.4%. Dialysis was instituted in 178 children and the others were treated conservatively. Renal histology in 39 out of 76 children who presented with an acute nephritic illness revealed acute endocapillary proliferative glomerulonephritis in 27 and crescentic glomerulonephritis in 12. The histology in 79 out of 147 remaining patients showed acute tubular necrosis in 64, acute cortical necrosis in 13, and acute interstitial nephritis in 2. Overall mortality was 27.4%. This high incidence of ARF due to infective diarrhoeas and dysentery reflects poor socio-economic and hygienic conditions, inadequate facilities in rural areas, delays in seeking medical advice, and lack of knowledge about fluid and electrolyte therapy amongst the staff.
Bronchial asthma in children: recent knowledge.
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Bone lesions in chronic granulocytic leukaemia: report of 3 cases.
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Effect of Rumex nepalensis extracts on histamine, acetylcholine, carbachol, bradykinin, and PGs evoked skin reactions in rabbits.
The antihistaminic, anticholinergic, antibradykinin, and/or antiprostaglandin activity of aqueous and the alcoholic leaf extracts of the plant Rumex nepalensis were tested on the prepared site on the back of rabbits, using a control and a test site. Aqueous extract was found to reduce the mean size of the wheal produced by histamine, acetylcholine, carbachol, and bradykinin. The alcoholic extract reduced the size of the wheal produced by histamine, acetylcholine and carbachol. The results indicate that Rumex nepalensis may have antihistaminic, anticholinergic, and/or antibradykinin activity.
Synthesis and spectroscopic studies of potential anticancer [platinum(II)(2,2'-bipyridine)(amino acid)]n+ (n = 1 or 2) complexes.
Six new platinum complexes of the formula [Pt(2,2'-bipyridine)(amino acid)]n+, where n = 1 to 2 and amino acid is an anion of L-histidine, L-lysine, L-asparagine, L-phenylalanine, L-tryptophan, or L-tyrosine, have been prepared by interaction of [Pt(2,2'-bipyridine)Cl2] and an appropriate amino acid (sodium salt) in water or water-methanol mixture. They have been characterized by chemical analyses and spectral methods such as ultraviolet-visible, infrared, and 1H NMR spectroscopy. The 1H NMR studies of these complexes ascertain the modes of binding of amino acids to platinum. The histidine binds to platinum through the nitrogen of a -NH2 group and another nitrogen of heterocyclic ring. All other amino acids bind to platinum through nitrogen of a -NH2 group and oxygen of a -COO- group. The mode of binding of some amino acids to platinum in these complexes has been further confirmed by infrared spectroscopy, and the formulations of these complexes have been supported by conductivity measurements. These six amino acid complexes and also other complexes of glycine, alanine, leucine, serine, cysteine, methionine, and glutamine have shown growth inhibition against P-388 lymphocytic leukemic cells.
Effect of Rumex nepalensis extracts on histamine, acetylcholine and carbachol evoked responses on isolated guinea pig ileum, frog rectus abdominis muscle, rabbit heart and blood pressure of dog.
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The etiology of lobar pneumonia and empyema thoracis in children.
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Primary immunodeficiency defects seen in PGI--one year study.
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Child care practices in the management of acute respiratory infections.
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