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Biomedical subjects

L Kumar

Publications and source records attributed to L Kumar.

At least 145 records · Page 8Linked to original sources
PubMed1993

Studies on the pathophysiological mechanism of Campylobacter jejuni-induced fluid secretion in rat ileum.

Calcium has been reported to play an important role in regulating the intestinal electrolyte transport via Ca2+/calmodulin (CaM) and/or protein kinase C (PKC) systems. The role of Ca2+, CaM and PKC in the pathogenesis of Campylobacter jejuni-induced fluid accumulation was studied in vivo in ligated rat ileal loops. Calcium ionophore A23187 (5 microM) and PKC activator, phorbol-12-myristate-13-acetate (PMA, 100 micrograms kg-1) when injected alone induced fluid accumulation in the control loops. However, these modulators did not enhance further C. jejuni-induced fluid accumulation when injected along with C. jejuni live culture in the experimental loops. Both 1-verapamil (100 microM) and PKC antagonist, H-7 (15 micrograms/ml-1) significantly reduced C. jejuni-induced fluid accumulation (P < 0.001). The effect of CaM antagonist W-7 (60 microM) on C. jejuni-induced fluid secretion was not significant (P > 0.05). Our findings suggest that both Ca2+ and PKC appear to be the important second messengers involved in the stimulation of intestinal fluid accumulation in C. jejuni infection.

Animals↗
PubMed1993

Infective endocarditis in children: profile in a developing country.

With the object of studying the profile of infective endocarditis in Indian children younger than 16 years of age, a retrospective study of 37 patients with infective endocarditis admitted to this hospital between January 1984 and December 1990 was carried out. There were 26 boys and 11 girls (aged 2-16 years (mean (SD) 10.3 (3.8)). Eighteen (48.6%) patients had underlying congenital heart disease, 13 (35.1%) had associated rheumatic heart disease whilst the remaining six had no pre-existing heart disease. All six patients with a normal heart and infective endocarditis had preceding extra-cardiac bacterial illnesses (epididymitis and orchitis in one, pneumonia in five). Blood cultures were positive in only 16 (43.2%): Staphylococcus aureus was grown in nine, Streptococcus viridans in six and Candida albicans in one. Sixteen (43.2%) of the 37 patients died owing to worsening cardiovascular haemodynamics, uncontrolled septicaemia and our inability to offer emergency surgery. The profile of infective endocarditis in developing countries is different from that in Europe and the United States of America, and the disease carries a very high mortality.

Adolescent↗
PubMed1993

Acute intravascular haemolysis in glucose-6-phosphate dehydrogenase deficiency.

Thirty-five children with G6PD deficiency, who presented with acute intravascular haemolysis, were evaluated to define its aetiology, clinical features and ultimate outcome. All were boys with ages ranging from 6 months to 12 years. Pallor of abrupt onset and passage of cola-coloured urine were universal presenting symptoms. Incriminating factors responsible for haemolysis include hepatitis (7), malaria (4), bacterial sepsis (3) and drug intake (24), with more than one predisposing condition existing in some children. Marked elevations in serum bilirubin, coinciding with intravascular haemolysis, was a feature in all the seven children with hepatitis. Azotaemia was noted in 20 patients, of whom 14 did not have oliguria. All four children with malaria presented with protracted renal failure. Therapy focused on maintaining a high urine output in those without oliguria. A total of 15 peritoneal dialyses and five haemodialyses were required in six patients with acute renal failure, all of whom were oliguric. Supportive therapy consisted of blood transfusions and treatment of the predisposing diseases. Thirty-two children recovered completely while three died, the cause of death being severe anaemia and congestive cardiac failure, malaria with oliguric renal failure and hepatic encephalopathy, respectively.

Acute Disease↗
PubMed1993

"Insular" carcinoma of thyroid. A subset of anaplastic thyroid malignancy with a less aggressive clinical course.

Insular carcinoma of the thyroid appears to represent an entity situated morphologically and biologically in an intermediate position between the well-differentiated and undifferentiated (anaplastic) tumors. The retention of I-131 concentrating ability by this variant, unlike anaplastic, is very encouraging and amenable to detection and therapy by radioiodine after initial aggressive surgery. A 46-year-old man with a histologic label of anaplastic thyroid carcinoma has had an unusually prolonged disease-free survival and histopathologic review confirmed insular carcinoma. Postoperative radioiodine evaluation revealed avid concentration of tracer in the thyroid bed. Thus, it is possible to ablate with radioiodine. The insular carcinoma should be considered as a distinct clinicopathologic entity and widespread awareness of this variant of tumor may help pathologists, surgeons, and nuclear medicine practitioners to aggressively treat the condition after initial diagnosis.

Carcinoma↗
PubMed1993

Cisplatin, vinblastine and bleomycin in advanced and relapsed germ cell tumours of ovary.

Seventeen patients with germ cell tumours of ovary were treated with 4 cycles of cisplatin, bleomycin and vinblastine (PVB) chemotherapy (CT). All patients had undergone prior surgery: hysterectomy + bilateral salpingo-oophorectomy + omentectomy-5, salpingo-oophorectomy + debulking surgery-10 and biopsy alone in 2 patients. Four of seventeen patients had relapsed earlier and received PVB as second line therapy. FIGO staging revealed: stage IIB in one, III C in 12 and stage IV in 4 patients. Gross residual disease (> 2 cm) was present in 13 patients. The most common cell types were dysgerminoma-5, endodermal sinus tumour-5, immature teratoma-5, choriocarcinoma and mixed germ cell tumour in one patient each. Twelve patients (70.5%) achieved significant response; complete response-11, partial response in one patient. The common side effects of CT were nausea/vomiting, myelosuppression, fever, mucositis, diarrhoea and alopecia. One patient died due to CT toxicity. Three complete responders underwent second look surgery and were found free of disease. This study confirms that PVB is an effective combination in the treatment of advanced and recurrent germ cell tumours of ovary and can be given over brief period. The toxicity of the regimen is moderate.

Adolescent↗
PubMed1993

Continuous nebulised salbutamol and oral once a day prednisolone in status asthmaticus.

A trial was conducted of continuous nebulised salbutamol and oral once a day prednisolone in a group of 11 children with status asthmaticus (group A) and compared with a conventional protocol comprising aminophylline infusion and intravenous hydrocortisone every six hours in a matched control group (group B). Monitoring by a clinical asthma score, pulse oximetry (oxygen saturation, SaO2), and peak expiratory flow rate (PEFR) revealed earlier improvement in these parameters in group A. Significant differences in mean SaO2 values appeared after 12 and 18 hours respectively. Mean PEFR percentage values were higher in group A compared with group B. A larger number (9/11) of patients could be discharged from hospital within 24 hours in group A compared with group B where only 3/11 could be discharged. All patients recovered without any side effects. It is concluded that continuous nebulised salbutamol and oral once a day prednisolone is safe and effective in treatment of children with status asthmaticus.

Administration, Inhalation↗
PubMed1993

Chronic myeloid leukemia: management of relapse after allogeneic bone marrow transplantation.

The management of chronic myeloid leukemia (CML) patients who relapse after allogeneic bone marrow transplantation (BMT) is difficult. Hydroxyurea, alpha interferon, second BMT and leukocytes infusion are various options but none of these approaches is clearly optimal. Hydroxyurea controls the symptoms in most patients without any apparent survival benefit. Alpha interferon (IFN) results in haematological remission in most cases with partial or total Philadelphia negativity in 20-30% of patients. Whether IFN therapy prolongs survival is not yet certain. Second BMT results in successful outcome in about half of the patients, however toxicity to the preparatory regimen, post transplant venocclusive disease and acute graft versus host disease are all major complications. An interval of less than 6 months between the initial and second BMT is generally associated with a poor outcome. Buffy coat infusions from the original donor have resulted in a cytogenetic remission in most patients. Less intensive preparatory regimes, donor buffy coat infusion and the use of biological response modifiers post transplant in order to augment the graft versus leukemia effect in high risk patients may indeed be possible areas of improvement in future studies.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1993

Immunoglobulin deficiency.

Twenty three patients with primary immunoglobulin(Ig) deficiency were seen during the last ten years. Nine had hypogamma globulinemia (hypo-Ig) and the rest, selective Ig deficiency. Most were in pediatric age group. There was preponderance of males with only one female. Clinical symptoms pertaining to gastrointestinal and sinupulmonary infections were most common. Complete absence of B cells was not observed in any patient with hypogammaglobulinemia. They could be typed as physiological in one patient, X-linked immunodeficiency in 2 patients and common variable immunodeficiency in the remaining six. Three patients with selective IgA deficiency were above 20 years of age. Two had only secretory IgA deficiency, confirmed by jejunal fluid examination and the rest had both secretory and serum IgA deficiency. Low IgM was seen in one patient. We see a spectrum of immunoglobulin deficiencies varying from subtle defects like absence of secretory IgA only, to severe depletion of all immunoglobulins. Therapy is still not ideal due to economic reasons.

Adolescent↗
PubMed1992

Analysis of upstream sequences of the human estrogen receptor gene.

An upstream region of the human estrogen receptor gene (ER) spanning from -2776 to -38 in relation to a previously described exon 1 was sequenced and analyzed for the possible presence of open reading frames (ORF) and regulatory motifs. We identified a long 459 bp ORF beginning at -2301. Most of the transcriptional regulatory motifs present within the ER upstream sequence are distributed either upstream or downstream of this long ORF which displays a TATA box, a CACC motif and a canonical cap site in the 5' flanking region.

Base Sequence↗
PubMed1992

Intracranial metastases from carcinoma cervix and review of literature.

Brain metastases from primary cervical carcinoma are uncommon. Only 41 cases have been reported so far in the English literature. We have seen 2 cases over the last 2 years among 481 patients with cervical cancer. Brain metastases developed 7 and 35 months after the primary diagnosis. One patient with solitary metastasis had no evidence of disease elsewhere and is free of disease after surgery and radiation therapy 7 months after the brain metastasis. Another patient with multiple brain metastases and cervical disease is alive 2 months after palliative radiation therapy.

Adenocarcinoma↗
PubMed1992

Multi-drug-resistant Salmonella typhi--a need for therapeutic reappraisal.

Enteric fever caused by Salmonella typhi resistant to all the standard first-line antibiotics is emerging as a major problem in developing countries. Fifteen such culture-proven cases were treated with ceftriaxone (6), cefotaxime (5) or ciprofloxacin (4). The earliest defervescence occurred with ceftriaxone (mean 3.3 days). Clinical cures were obtained with all three drugs with only one child having a relapse. Ciprofloxacin, by virtue of its cost and an oral route of administration, is the ideal choice in a developing country.

Cefotaxime↗
PubMed1992

Bone metastasis in ovarian cancer.

Bone involvement in carcinoma of ovary occurs rarely. In a review of 103 patients over last 3 years we have seen 4 such patients (serous-2, mucinous-1, mixed germ cell tumour-1). Patients presented with severe localized bone pain, bony swelling and difficulty in walking. The common sites of involvement were vertebrae, pelvic bones and skull. Radiologically the osteolytic lesions were commonest. Bone lesions were associated with abdomino-pelvic disease in 3 patients. Cisplatinum based chemotherapy in addition to local radiation resulted in significant response in 2 patients; one complete and one partial response. The median survival was 7.5 months (range 6-39 months) after bone metastasis. We conclude bone involvement in cancer ovary is associated with poor prognosis.

Adenocarcinoma, Mucinous↗
PubMed1992

High density lipoprotein cholesterol and total cholesterol in children with asthma and allergic rhinitis.

Serum high density lipoprotein cholesterol and total cholesterol were studied in 15 children with allergic rhinitis, 45 asymptomatic asthmatic children and 16 children with acute asthmatic attacks. The latter were also studied in their asymptomatic phase. Two control groups of children with minor anatomical defects and those with acute pneumonia with respiratory distress were also studied. The serum concentrations of high density lipoprotein cholesterol were significantly higher (p less than 0.001) and those of total cholesterol lower (p less than 0.001) in children with respiratory allergy when compared to controls. The concentration of high density lipoprotein cholesterol increased and that of total cholesterol decreased during acute asthma.

Acute Disease↗