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Biomedical subjects

M K Kutty

Publications and source records attributed to M K Kutty.

At least 19 recordsLinked to original sources
PubMed1991

The skeletal manifestations of brucellosis.

A prospective study of 33 patients with skeletal complications of brucellosis is reported. The diagnosis depends on the brucellar agglutination titre because the clinical, radiological and histological features are not specific, and blood culture and culture of synovial fluid are often negative. The commonest site is the sacroiliac joint, and brucellosis must be differentiated from tuberculosis as an important cause of backache. Treatment is with chemotherapy, the preferred combination being rifampicin and co-trimoxazole. Relapse can occur, but the chances can be reduced by careful clinical monitoring, and by repeated serological tests and gallium scanning; it is treated by further chemotherapy. Operation is indicated to relieve spinal cord compression or to drain a large paravertebral abscess.

Adolescent↗
PubMed1991

Differentiating medulloblastoma in adults.

We present two cases of medulloblastoma in adults patients showing extensive astrocytic differentiation. In one case, there was synchronous oligodendroglial differentiation, both changes appearing after treatment with radiotherapy. The possible role of radiotherapy in the differentiation is discussed.

Adult↗
PubMed1991

Unusual presentation of cancer.

The large bowel is the most frequent primary site for metastases in inguinal hernial sacs. We report four cases, two due to carcinoid of unknown primary, and one each due to adenocarcinoma of colon, stomach and pancreas. We recommend that all hernial sacs, particularly in the elderly, be examined microscopically.

Adenocarcinoma↗
PubMed1989

Dissemination in cutaneous leishmaniasis. 3. Lymph node involvement.

In a study of zoonotic cutaneous leishmaniasis (CL) due to leishmania major in an endemic focus in Saudi Arabia, lymph node enlargement was observed in 66 of 643 patients (10.26%). The epitrochlear lymph nodes were most commonly involved (68%), but cervical (11%), axillary (15%), and inguinal (18%) lymph nodes were also involved. In eight patients (12%), two lymph node areas were involved. The affected lymph nodes were typically solitary, firm, mobile, nontender, only moderately enlarged, and appeared to persist beyond the clinical healing of the associated skin lesions. The results of pathologic and immunopathologic studies carried out on eight lymph nodes obtained from this group of patients supported the leishmanial etiology. Although amastigotes were only demonstrated in two lymph nodes, the leishmanial antigen was found in all eight specimens. The lymph node involvement is another manifestation of dissemination in infection with a dermotropic leishmania. It appears that in some cases, instead of the parasite, it may be the leishmanial antigen that disseminates and produces lymphadenitis.

Adolescent↗
PubMed1988

Septic arthritis in sickle cell disease.

We report a prospective study of fourteen patients with sickle cell disease who were suffering from septic arthritis. They made up 11% of 129 patients with orthopaedic complications of the disease. The infecting organism in eleven was a staphylococcus, with salmonella in only two. The severity of the condition and its sequelae are described. The best treatment is open surgical drainage and intensive chemotherapy.

Adolescent↗
PubMed1988

Progressive subluxation of the wrist in sickle-cell disease.

Progressive subluxation of the wrist as a sequel to vasoocclusive crisis of sickle-cell disease is described. This shares many features with Madelung's deformity. The management depends on the functional disability and the cosmetic appearance. One of our patients needed surgical correction to improve the deformity and the range of motion.

Adolescent↗
PubMed1988

Dissemination in cutaneous leishmaniasis. II. Satellite papules and subcutaneous induration.

In a field study of cutaneous leishmaniasis (CL) due to Leishmania major, zymodeme Lon-4, in an endemic focus in Saudi Arabia, 80 patients in a group of 643 patients (12.44%) were found to have multiple, inflammatory, satellite papules (SP) around one or more CL lesions. The SP often appeared to erupt after commencement of antileishmanial treatment. They showed a range of morphology and pathology, and comparisons with corresponding CL lesions showed important differences. Amastigotes were seen in only one of seven biopsy specimens. Another morphologic feature, subcutaneous induration (SCI), was noted on routine palpation in 20 patients in the same patient group (3.11%). The SCI either was radiating all around the lesion and appeared as an "iceberg nodule" or was present as a "tonguelike" process proximal to the CL lesion. Amastigotes were seen in four of nine biopsy specimens of SCI. SP and SCI represent reactions to local dissemination of the parasite or its antigenic products, and as morphologic features aid in the clinical diagnosis of CL.

Humans↗
PubMed1987

Dissemination in cutaneous leishmaniasis. I. Subcutaneous nodules.

In a study of cutaneous leishmaniasis (CL) caused by Leishmania major in Saudi Arabia, 10% of the patients were found to have subcutaneous nodules (SCN). The SCNs were usually inconspicuous, painless, and proximal to the primary skin lesions; when multiple, they showed a "sporotrichoid" configuration or appeared as "beaded cords." Their number ranged from 1-16 (average 3 25 +/- 2.50; mean +/- 1 SD). In some patients, the SCNs seemed to be triggered by antileishmanial treatment. The clinical picture and pathologic findings suggest that SCNs in patients with CL represent lymphatic dissemination, a phenomenon not widely recognized.

Adolescent↗
PubMed1987

Peripheral nerve involvement in cutaneous leishmaniasis (Old World).

A review of 288 skin biopsy specimens from cutaneous leishmaniasis lesions caused by Leishmania major showed assorted nerve changes in 14 biopsy specimens (5%). Ten patients had perineural inflammatory cell infiltrate consisting of either lymphocytes or a mixture of lymphocytes, plasma cells, and macrophages. Four patients had inflammatory cell invasion of the nerves (neuritis), and in one of them the inflammation was granulomatous and associated with nerve destruction. Amastigotes were seen inside the nerves in two patients. Sensory testing of 50 consecutive patients with cutaneous leishmaniasis identified two patients with diminished sensations over the lesions.

Adult↗
PubMed1986

Immunohistological investigations in chronic cutaneous leishmaniasis in Saudi Arabia.

The distribution and numbers of IgG-, IgA-, IgM-, and lysozyme-positive cells were investigated by the immunoperoxidase method in paraffin-sections of 13 cases of chronic cutaneous leishmaniasis of low parasite load from Saudi Arabia. The majority of the peroxidase-positive plasma cells contained IgG, whereas the numbers of IgA+ and IgM+ plasma cells were not so numerous. Small groups of squamous epithelial cells showed immunoreactivity for IgG and IgA. Similar positive staining was observed extracellularly in the oedematous upper dermis, in the endothelial cells, and in the perivascular space. The activated macrophages showed strong and diffuse peroxidase staining for lysozyme, whereas epithelioid cells and multinucleated giant cells were negative or had finely granular and considerably weaker staining. It is suggested that humoral immunity also participates in the elimination of the parasites and an immunologically induced necrosis might be responsible for the ulceration of the skin in cutaneous leishmaniasis. It is also assumed that the lysozyme immunoreactivity can be a marker of the activation state of the macrophages.

Adolescent↗
PubMed1986

Alimentary malignancies in Arabs in the Eastern Province of Saudi Arabia.

A study was made of 89 cases of alimentary malignancies in Arab patients in the Eastern Province of Saudi Arabia. The pattern of alimentary involvement observed was colo-rectum 43%, stomach 34%, oesophagus 19% and small intestine 4.5%. This finding was in contrast to previous studies in Saudi Arabia which had reported the upper alimentary tract, particularly the oesophagus, as the site most frequently affected. Of the patients 80% were Saudis. The male:female ratio was 3.9:1. A striking feature was the youthfulness of several patients, 44% being under fifty years of age. There were only three cases of alimentary lymphoma. Although colo-rectal schistosomiasis was a moderately frequent finding in the population studied, there was no pathological evidence to support an aetiological association between bilharziasis and large bowel malignancy.

Adult↗
PubMed1985

Squamous cell carcinoma in chronic osteomyelitis. Report of a case and review of the literature.

Malignant change at the site of a chronic osteomyelitis, a rare condition, is reported in a 45-year-old man, along with a review of the literature. This patient with a 30-year history of chronic osteomyelitis of the right femur and an intermittently discharging sinus had a large abscess in the lower thigh. The abscess was drained, and an ulcer developed at the mouth of the sinus tract. Soon afterward, he sustained a pathologic fracture through the lower femur. Biopsy specimens of the ulcer showed a well-differentiated squamous carcinoma. An amputation was performed at the level of the proximal 10 cm of the femur. The patient remains well 18 months later with no clinical or radiologic evidence of metastases. Changes in character of a previously innocuous osteomyelitis sinus tract should arouse suspicion of neoplastic transformation. Biopsy of various depths of the sinus tract, including the bone marrow, is essential. Early amputation for squamous cell carcinoma is indicated and offers a good prognosis.

Carcinoma, Squamous Cell↗
PubMed1985

Malignant bone tumours, experience at King Fahd University Hospital Al-Khobar, Saudi Arabia.

Reports show striking regional and ethnic variations in the incidence and pattern of certain malignancies in the Middle East. In view of this, a study of 19 cases of malignant tumours of the bone seen at King Fahd University Hospital during the period 1981-1983 was carried out. Of these eight were primary and eleven secondary tumours. Lymphoma and Ewing's sarcoma formed 50% of the primary tumours. Breast and lungs were the chief sources of secondary deposits in the bone.

Adult↗
PubMed1984

The ultrastructural morphology of human cutaneous leishmaniasis of low parasite load.

The ultrastructural morphology of the inflammatory infiltrate in cutaneous leishmaniasis with low parasite load from seven patients was studied. Cells of the mononuclear phagocyte system (macrophages and epithelioid cells), plasma cells, and lymphocytes formed the infiltrate. Disseminated shrinkage necrosis or apoptotis as well as coagulative necrosis with loss of the plasma membrane of single macrophages occurred. An intimate contact was observed between macrophages and lymphocytes. The relationship of the morphological alterations to the persistence of the chronic inflammatory reaction and the possible explanations of the macrophage necrosis are discussed.

Adolescent↗