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Biomedical subjects

M Kumar

Publications and source records attributed to M Kumar.

At least 289 records · Page 16Linked to original sources
PubMed1992

Observations on the effect of verapamil with sodium stibogluconate in kala azar.

40 parasitologically confirmed cases of kala azar, were randomly allocated into four treatment groups to assess the effect of verapamil on fresh and antimony resistant cases of kala azar. Untreated patients received sodium stibogluconate only or in combination with oral verapamil. Antimony-resistant patients were treated with sodium stibogluconate combined with oral verapamil or pentamidine. The patients were followed up for six months. Verapamil neither shortened the duration of treatment nor increased parasitological cure rate nor improved the ultimate cure. In antimony unresponsive patients it did not reverse unresponsiveness.

Administration, Oral↗
PubMed1992

Tropical pyomyositis in India: a clinico-histopathological study.

Eighteen cases of tropical pyomyositis, aged 12-45 years, were seen over a 3-year period. There was clustering of cases in January, February and July to October. Male:female ratio was 14:4. Multiple muscular lesions (greater than 2) were common (67%). Extramuscular complications were present in 50% of the cases. Cardio-pulmonary involvement was most frequent. Muscle biopsies, done in 16 cases, showed suppurative changes (pus) in 15 cases and one case of non-suppurative myositis. Muscle necrosis, cellular infiltration with polymorphs and haemorrhage in-between muscle fibres were common.

Adolescent↗
PubMed1992

Cytodiagnosis of rhinosporidiosis.

Two clinically suspected cases of nasal rhinosporidiosis were studied cytologically using a wipe out technique. The smears showed the typical spores of the fungus and the cytological diagnosis of rhinosporidiosis was confirmed by excisional biopsy. The smear is recommended as a routine preliminary screening technique in the diagnosis of suspected cases of rhinosporidiosis.

Adolescent↗
PubMed1991

Experience with a potent LH-RH agonist, buserelin, alone and in combination with testosterone for antispermatogenic activity, reversibility and toxicity in langur monkey.

Chronic intermittent treatment of LH-RH superagonist Buserelin alone or in combination with testosterone enanthate were given to adult male langurs for 90 days to evaluate antispermatogenic activity of alone and combination therapy, maintenance of normal androgenicity, possible toxic effects of agonist treatment, related side effects of testosterone supplementation and complete reversibility of the procedure. A gradual decrease in sperm count was recorded in both treatment groups, along with reduced motility and vitality of the spermatozoa. In the combination group, oligospermia was achieved in 4 out of 5 animals, whereas, only 2 animals became oligospermic in the agonist alone group. Significant decrease in serum testosterone levels along with impaired libido and other testosterone withdrawal symptoms were observed in the Buserelin alone group, conversely normal testosterone levels and libido were observed in the combination group. An elevation in haematological variables and serum total protein concomitant with a slight gain in body weight of the animals were recorded in the combination group; these changes were not encountered in the agonist alone group. Reversibility of all the altered parameters to control range was observed in both treatment groups following 75 to 90 days of treatment withdrawal.

Acid Phosphatase↗
PubMed1991

Sepsis and septic shock. Deadly complications that are on the rise.

Most patients are already hospitalized when sepsis and septic shock develop, and in spite of therapy, at least 50% die. Although newer therapeutic agents are being evaluated, current management consists of antibiotics, fluids for volume resuscitation, inotropic agents, and surgery for septic foci. Greater emphasis on preventive measures is recommended.

Anti-Bacterial Agents↗
PubMed1991

The potential for renal salvage in nonmetastatic unilateral Wilms' tumor.

The potential for resection with renal salvage, and the ability of computed tomographic (CT) criteria to predict this potential, were evaluated retrospectively in 43 children with nonmetastatic unilateral Wilms' tumor (stage I, II, or III at diagnosis). CT criteria for renal salvage were (a) tumor involving only one pole and occupying less than one third of the kidney; (b) functioning kidney; (c) no invasion of collecting system or renal vein; and (d) clear margins between tumor, kidney, and surrounding structures. Preoperative CT scans met these criteria in only two of the 43 cases. Surgical and/or pathologic reports confirmed CT-based findings in all cases. Most of the tumors were large (median vertical and transverse diameters both = 10 cm), and only three patients were estimated to have more than 50% functioning renal tissue. A prospective trial would be necessary to evaluate the long-term benefits and possible complications of renal salvage procedures in patients with Wilms' tumor. Given the small proportion of patients likely to be eligible for such procedures, and the currently excellent cure rates in low-stage disease, such as trial would be difficult to implement.

Child↗
PubMed1991

Comparison of regimes of treatment of antimony-resistant kala-azar patients: a randomized study.

Three hundred twelve patients with antimony-resistant kala-azar were randomized into three groups. The first group (A) received pentamidine isethionate intravenously three times each week until parasitological cure was achieved. Group B received pentamidine concomitantly with a 20-day regimen of sodium stibogluconate. Group C received pentamidine injections that were followed by 20 days of sodium stibogluconate therapy. All patients became afebrile after 10 injections of pentamidine. Parasitologic cure was achieved in approximately 98% of the patients who had 33 or more injections of this drug. The addition of the antimony compound did not appear to enhance the rate of parasitologic cure. Three patients continued to have parasites after 40 injections of pentamidine. After six months, the rate of parasitologic cure was significantly higher in Group C (pentamidine followed by sodium stibogluconate) than in either Group A or B. Forty patients relapsed after apparent parasitologic cure and were successfully treated with five additional injections of pentamidine, followed by a course of antimony therapy. Minor side effects with pentamidine included an uneasy feeling during intravenous injection (12%), intestinal disturbances (6%), cellulitis (5%), abscess formation (1%), and allergic manifestations (2%). Major reactions to this drug included hyperglycemia (10%; reversible in 6% and irreversible in 4%), and delayed hypoglycemia (8%). Four deaths were associated with the administration of this compound. It is concluded that pentamidine is an effective but toxic drug for the treatment of antimony-resistant kala-azar.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Evaluation of efficacy of longer durations of therapy of fresh cases of kala-azar with sodium stibogluconate.

The efficacy and safety of three regimens of treatment for kala-azar (visceral leishmaniasis) with sodium stibogluconate were evaluated in a randomised clinical trial to ascertain the optimal duration of treatment for Indian patients. The study included a total of 312 (226 male, 86 female) patients with fresh kala-azar, confirmed by demonstration of parasites in aspirates from bone marrow or spleen, who were randomly allocated into three treatment groups of 104 patients in each to receive sodium stibogluconate intramuscularly. The dose of the drug was 20 mg/kg/body weight/daily with a maximum of 8.5 ml for 20, 30 and 40 days (groups A, B, C respectively). The response of treatment was assessed under blind conditions and patients were followed up each month for a period of six months. The number of patients who were apparently cured (i.e., those whose temperature had returned to normal at the end of their respective regimen and aspirates were free of parasites) was 91 (87%) in group A, 98 (94%) in group B, and 102 (98%) in group C. The difference between groups A and C was significant (P less than 0.01). The number of patients who were ultimately cured at six months was 74 (71%) in group A, 86 (83%) in group B and 98 (94%) in group C. These patients had not relapsed and were cured as confirmed by a bone marrow aspirate which was free of parasites. The difference between groups A and C (P less than 0.001) and groups B and C (P less than 0.05) were significant. However, the difference between groups A and B was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Norepinephrine response in early HIV infection.

Norepinephrine response to a cold pressor test was investigated in 95 homosexual men in a longitudinal study of human immunodeficiency virus (HIV) infection. The baseline data obtained from 76 HIV+ and 19 HIV- subjects are included in this report. After the insertion of a venicatheter and following a 30 min rest, subjects immersed one of their hands in ice water for 2 min, and serial blood samples were obtained for the determination of catecholamine levels. The results show that the norepinephrine response in HIV+ subjects compared to that of HIV- subjects was blunted. Examination of the responses using linear and quadratic orthogonal polynomials suggested that these differences between the two groups were primarily a function of their rate of increase in norepinephrine levels. It was observed also that in HIV+ subjects, norepinephrine level peaked earlier than that in HIV- subjects. The data suggest that autonomic dysfunction is present in the early stages of HIV infection.

Autonomic Nervous System↗
PubMed1991

Role of allogenic vesical mucosa in inducing neo-osteogenesis in guineapigs.

Fresh allogenic mucosa lining the urinary bladder was transplanted into a 1 cm gap of right ulna bone in 24 guineapigs. The 1 cm, bone gap in the left ulna served as control. At regular intervals, the implanted and control sites were studied grossly with naked eye, radiologically and histopathologically to ascertain the role of allogenic vesical mucosa in inducing neo-osteogenesis. The bone gaps were uniformly bridged by bone in 10-12 wk at the implanted sites and fibrous tissue at control sites. There was no evidence of graft rejection. The study thus suggests the potential of the use of stored allogenic vesical mucosal grafts for neo-osteogenesis in clinical practice.

Animals↗
PubMed1990

Limitations in developing gossypol acetic acid as a male contraceptive.

Highly purified gossypol acetic acid (5 mg/day; oral) alone and in combination with potassium chloride (0.25 mg/day; oral) was tested in adult male langurs for 120 days to evaluate reversibility of its antifertility action and possible hypokalemia. The treatment resulted in severe oligospermia with impairment of sperm motility. Sperm morphological defects were evident. The functional activities of accessory sex glands and libido remained unimpaired. Occurrence of hypokalemia was found more pronounced in the gossypol alone group. Extensive renal potassium loss was evident and conversely the renal excretion of sodium decreased markedly. The activities of serum transaminases increased significantly. Other parameters of blood and of urine did not show any marked alterations. Complete reversal of the above changes was evident following 90 to 105 days of withdrawal of treatment. In conclusion, the oligospermia achieved was reversible and the hypokalemic response of langurs is similar to human and not related to impurity of the drug.

Administration, Oral↗
PubMed1990

A modified HPLC technique for simultaneous measurement of 5-hydroxytryptamine and 5-hydroxyindoleacetic acid in cerebrospinal fluid, platelet and plasma.

A sensitive, reliable and simplified HPLC assay for simultaneous measurement of 5-hydroxytryptamine (5-HT) and 5-hydroxyindoleacetic acid (5-HIAA) in human cerebrospinal fluid (CSF), platelets and plasma is described. Perchloric acid is used for one step precipitation of proteins and extraction of 5-HT and 5-HIAA. Precision of the assay has been increased by calibration of the instrument using serotonin-free plasma spiked with known amount of standards and N-w-methyl-5-hydroxytryptamine as internal standard. Integration of the peaks and calculations are achieved by a preprogrammed data module using ratio method. As little as 20 pg/ml of serotonin in the deproteinated sample can be detected using this procedure. In a group of surgical patients, plasma 5-HT concentration is (Mean +/- S D) 3.4 +/- 2.7 ng/ml and that of platelet 748.3 +/- 448.3 ng/10(9) platelets. In CSF, 5-HT is found to be 3.3 +/- 3.4 ng/ml and 5-HIAA is 15.1 +/- 7.3 ng/ml. A good correlation (r = 0.648, p less than .0001) is observed between 5-HT and 5-HIAA in CSF.

Adult↗
PubMed1990

A comparison of placement techniques and complications of externalized catheters and implantable port use in children with cancer.

The complications associated with the placement and use of Hickman catheters (n = 120), Broviac catheters (n = 146), and implantable ports (n = 93) in children with cancer were analyzed. Percutaneously placed central venous access devices (CVADs) tended to fail less often (P = .86) and to develop infections less often (P = .056) than surgically placed CVADs. The difference in complications with percutaneous versus surgically placed CVADs requires confirmation in a randomized trial to assure they are not a result of differences in patient characteristics. When all catheter failures (removal due to infection, obstruction, or dislodgement) were considered, ports had a significantly longer failure-free duration of use than externalized Hickman and Broviac catheters (P = .0009). Ports also remained infection-free longer than externalized catheters (P = .0014). The greatest risk of infection occurs in the first 100 days of use, particularly for ports. This study demonstrates that for long-term use (greater than 100 days) ports are superior to externalized catheters in children with cancer.

Bacterial Infections↗