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Biomedical subjects

M Kulkarni

Publications and source records attributed to M Kulkarni.

At least 19 recordsLinked to original sources
PubMed1995

Double clostridial mycotic aneurysms of the aorta.

Mycotic aortic aneurysm continues to present challenging and difficult management issues with a significant morbidity and mortality. The offending organism in the etiology of this aneurysm can be variable and unusual. The first report of two mycotic aortic aneurysms caused by Clostridium septicum in the same patient is described here. Presentation and management as well as conditions commonly associated with Clostridium septicum infection and a review of all clostridial mycotic aortic aneurysms in the English literature are discussed.

Aged↗
PubMed1994

Heparinized saline versus normal saline in maintaining patency of the radial artery catheter.

OBJECTIVE: To compare the ability of normal versus heparinized saline infusion to maintain patency of the radial artery catheter used for monitoring or multiple blood sampling. DESIGN: Randomized double-blind trial. SETTING: A university-affiliated hospital. PATIENTS: All 108 patients admitted to the surgical intensive care unit who required radial arterial line catheters. Excluded were patients who required emergency admission, those who refused to give consent, those who needed anticoagulants, thrombolytic or platelet therapy, those whose cannulation site was other than the radial artery, inadvertent discontinuation of the arterial line or incomplete data collection. This resulted in a sample of 78 adults, randomized according to date of admission. INTERVENTIONS: Forty patients admitted on odd-numbered dates received heparinized normal saline (2 units/mL), and 38 patients admitted on even dates received normal saline, both as continuous flush solutions. MAIN OUTCOME MEASURES: Measurement of radial artery flow and pressure before and after cannulation, and catheter patency during cannulation. RESULTS: The type of flush solution did not adversely affect the radial artery or the hand in any measurable way. Catheter blockage occurred in three patients receiving heparinized saline and seven patients receiving normal saline as the flush solution (p = 0.06). At 96 hours of cannulation, 92% of the catheters in the heparinized saline group were patent compared with 74% in the normal saline group. Intra-arterial blood pressure was inaccurate compared with the brachial cuff pressure in 6 patients in the heparinized saline group compared with 14 patients in the normal saline group (p < 0.03). CONCLUSIONS: There is no significant difference between flushing with normal saline and heparinized saline in the maintenance of radial arterial line patency. However, the use of a continuous heparinized flush solution in pressurized arterial lines is beneficial in that it results in greater accuracy of blood pressure monitoring than normal saline infusion.

Adult↗
PubMed1989

Coomassie brilliant blue R-250 as a highly sensitive pre-stain for immediate visualization of human serum proteins on polyacrylamide gel disc electrophoresis and raising monospecific antibodies.

We hereby describe electrophoretic analysis of normal human serum pre-stained with Coomassie Brilliant Blue R-250 (CBB). The proposed method was optimized by studying as many as 450 disc electrophoretic separations and 30 variables. The method when compared with the post-electrophoretic staining by Amido Black (AB) revealed that the pre-stained discs were intensely well defined and resolved within 2 hours with a transparent gel. Gels stained with AB, despite a prolonged destaining, showed a residual dye retention making identification of the faint components difficult. Protein eluted from the CBB pre-stained gels retained its purity and immunoreactivity and conjugates of the two prototype proteins namely the albumin and the transferrin produced high-titre monospecific antisera in immunized rabbits.

Amido Black↗
PubMed1989

[Preliminary report on the use of MRI in acute spinal trauma].

Forty three Magnetic Resonance (MR) studies were performed on 28 patients using a 1.5 Tesla magnet and surface coil. Imaging was performed between day 1 and day 16 after suspected cord injury. In several patients, repeat MR studies were performed to evaluate the resolution of the cord lesions. Three types of MR signal patterns were seen in association with the cord injuries. Patients with intraspinal hemorrhage did not have significant neurological recovery while patients with cord edema/contusion recovered significant neurological function. MR imaging would seem extremely useful in the diagnosis of acute cord injury and also appears to demonstrate the potential for predicting neurological recovery.

Acute Disease↗
PubMed1988

The role of three-dimensional computed tomography in the management of maxillofacial trauma.

Open reduction and internal fixation of facial fractures demand a detailed understanding of the three-dimensional pattern of injury. This is difficult if not impossible to obtain with present radiographic methods. The purpose of this study was to define the role of three-dimensional computerized tomography (3DCT) in surgical management of facial fractures. The two-part investigation: 1) compared the diagnostic accuracy of 3DCT with conventional CT and plain film studies; and 2) examined the clinical usefulness of 3DCT to surgeons. Twenty-four acute trauma patients suspected of having facial fractures were examined radiographically with analysis of every facial bone and specific facial regions. Particular attention was directed to the course of the fracture lines and the number, size, and displacement of fracture fragments. The surgeons were then asked to conceptualize the reported and the personally observed radiographic information and document their impressions on preprinted diagrams of the facial skeleton. They also completed questionnaires designed to indicate whether patient management would be influenced by the 3DCT. The radiographic findings were correlated with intraoperative observations. The 3DCT provided superior definition of fracture lines (especially horizontal) and the extent of comminution was better appreciated. This additional information improved the surgeons' ability to plan placement of interfragmentary wires and/or plates. Surgeons were also able to more accurately predict those patients requiring immediate bone grafting. Large, life-size 3D images of the facial skeleton made intraoperative conceptualization of the injury pattern easier. The accuracy of the 3DCT images corroborated the intraoperative findings in all cases. The following conclusions are offered: 1) The diagnosis of most mandibular fractures can be made equally well with conventional and 3DCT techniques. 2) Improved diagnosis of fracture lines and the specific patterns of comminution in midface fractures is made possible with 3DCT. 3) If open reduction and internal fixation is the mode of treatment, 3DCT is desirable because the added information makes preoperative planning more accurate and thereby facilitates surgical intervention.

Facial Injuries↗
PubMed1988

Traumatic epidural hematoma of the cervical spine: diagnosis with magnetic resonance imaging. Case report.

A traumatic epidural hematoma of the cervical spine is reported in a 13-year-old girl. The patient recovered spontaneously over several days without surgical intervention. The diagnosis was made on magnetic resonance (MR) imaging, which also demonstrated subsequent resolution of the hematoma. The etiological factors of spinal epidural hematomas are reviewed and the utility of MR imaging in differentiating other causes of acute spinal cord injury is emphasized.

Adolescent↗
PubMed1988

Cerebral involvement in systemic lupus erythematosus.

Four patients with central nervous system lupus erythematosus (SLE), were studied with nuclear magnetic resonance imaging (NMRI) and positron emission tomography (PET) to assess cerebral blood flow and glucose metabolism. The NMRI showed brain atrophy and demyelinating defects. The PET scan showed cerebral blood flow and metabolic abnormalities that improved in one patient after neuropsychiatric recovery. These preliminary findings demonstrate cerebral derangements in patients with SLE cerebritis.

Adult↗
PubMed1988

Radiological and neurological changes in the drug abuse patient: a study with MRI.

Chronic abuse of drugs may lead to pathological changes within the nervous system. In this article we present the neurological and Magnetic Resonance Imaging (MRI) findings in a group of seven drug abuse patients. The MRI for three of the patients showed areas of demyelination in white matter. Of the four patients with normal MRI, two showed seventh nerve paresis, one showed abnormal cerebral blood flow when measured with Positron Emission Tomography and one patient had no evidence of neurological impairment. We hypothesize that some of the neurologic and psychiatric complications of drug abuse may be due to its effects on the cerebral circulation.

Adult↗
PubMed1980

Sexing the human sternum.

For differentiating a male from a female sternum, a metrical study of 400 adult North Indian sterna (312 males and 88 females) obtained from medicolegal postmortems was made. If the combined length of the manubrium and mesosternum was more than 140 mm. the sternum was male, and if less than 131 mm. it was female. No opinion could be given if the length was between 131 and 140 mm. By this measurement 72.12% male and 62.50% female sterna could be sexed with 100% accuracy. The length of the mesosternum alone could also determine the sex correctly in 50.32% male and 29.55% female specimens. The length of the manubrium, manubrium-corpus index, width of the first or third sterebra or their index, were not found to be useful in sexing a given sternum. By using multivariate analysis the probability of correctly identifying the sex of a sternum was over 85%.

Adult↗
PubMed1978

Treatment of amoebic liver abscess with tinidazole and metronidazole.

20 patients with amoebic liver abscess, confirmed by aspiration of typical amoebic 'pus', were treated in random order with either tinidazole or metronidazole in a dose of 2g once daily for 2 days. Clinical, radiological, and biochemical follow-up was done for 1 month. One patient, given metronidazole, absconded and 19 completed the trial. Complete recovery occurred in all 10 patients given tinidazole but in only 5 of the 9 given metronidazole (p = 0.05). Patients on tinidazole required repeat aspirations less frequently than those on metronidazole. Mild gastrointestinal side-effects occurred in 1 patient on metronidazole but in none on tinidazole. From the present study, tinidazole appears to be a more effective, better tolerated drug with a more rapid therapeutic effect than metronidazole.

Adult↗
PubMed1977

Comparative study of tinidazole and metronidazole in amoebic liver abscess.

Twenty proven cases of amoebic liver abscess were treated at random with either tinidazole or metronidazole. The dose of both was 2 g once daily for 2 days. Clinical, radiological, and biochemical follow-up was done for 30 days. Of the 19 patients who completed the trial, complete recovery was observed in all 10 patients given tinidazole and in 5 of 9 patients given metronidazole (p=0.05). Moreover, patients on tinidazole required repeat aspirations less frequently than those on metronidazole. Mild gastrointestinal side-effects occurred in 1 patient on metronidazole. The results suggest that tinidazole is a more efficacious drug than metronidazole, with rapid therapeutic effect.

Adult↗