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M R Nampoory

Publications and source records attributed to M R Nampoory.

31 records · Page 2Linked to original sources
PubMed1996

Nocardiosis in renal transplant recipients in Kuwait.

BACKGROUND: Nocardiosis has emerged as an important bacterial disease among renal transplant recipients, leading to considerable morbidity and mortality. Apart from the increasing problem of resistance in pathogenic nocardiae, the spectrum of species causing disease has enlarged in recent years. There are no published reports on nocardiosis from Middle-East countries. METHODS: A retrospective review of case records of 513 renal transplant recipients between January 1989 and January 1995 was done in the transplant unit of our hospital. Information was collected on clinical details, type of donor, immunosuppressive therapy, prophylaxis, and outcome. Isolation of Nocardia species from appropriate clinical specimens was the sole criterion for diagnosis. RESULTS: Nocardiosis was diagnosed in six recipients with a disease incidence of 1.2%. Four patients had received unrelated kidneys. Co-morbid conditions were diabetes mellitus (3), viral hepatitis (2) and neutropenia (1). Clinical manifestations included deep-seated skin abscesses and pulmonary disease in three each. Cerebral abscess and meningitis were found in two patients with pulmonary disease. Pathogens were Nocardia asteroides in four and N. otiti discaviarum and N. farcinica in one each. In contrast to in vitro susceptibility results, clinical response was different in that five patients who received trimethoprim-sulphamethoxazole (TMP-SMX) alone (2) or in combination with cefuroxime (3) responded well. CONCLUSIONS: The study stresses a high index of suspicion for nocardiosis in susceptible hosts who present with cutaneous abscess, pulmonary infiltrative lesions, and cerebral manifestations. TMP-SMX in combination with cefuroxime seems to be a highly effective therapy. It does not appear mandatory to reduce or discontinue immunosuppressive therapy during treatment of nocardiosis.

Adult↗
PubMed1995

Liver abscess and disseminated intravascular coagulation in tuberculosis.

We report the case of a 55-year-old man with chronic renal failure, and a history of prolonged fever and jaundice. Radiological studies revealed a multiloculated irregular liver abscess. Mycobacterium tuberculosis was isolated from the abscess on smear and culture of aspirated pus. Haematological studies revealed the presence of disseminated intravascular coagulation. A detailed search failed to identify any reason for this other than the tuberculous infection. The treatment of tuberculous liver abscess and pathogenesis of disseminated intravascular coagulation in tuberculosis are discussed.

Disseminated Intravascular Coagulation↗
PubMed1994

End-stage renal disease and renal replacement therapy in Kuwait--epidemiological profile over the past 4 1/2 years.

Data on end-stage renal disease (ESRD) patients in Kuwait were collected retrospectively and prospectively starting in mid-1988. The study period covered 4 1/2 years from 1 January 1986 to 30 June 1990. Epidemiological characteristics of ESRD patients and their disposal by dialysis and transplantation were analysed and compared with previous reports from Kuwait, neighbouring countries, Europe, and USA. A total of 647 patients received renal replacement therapy (RRT) in Kuwait during the study period. This gave an incidence rate of 72 patients per year per million of population. The prevalence rate for patients on maintenance dialysis was 80.6 per million population in mid-1988. Nearly one-fifth of total patients (19.6%) were older than 60 years of age and one-third (30.8%) were identified as 'high risk' category. As for Kuwaiti nationals alone on RRT 29.7% were above 60 years of age and 44.2% were high-risk patients. We have noticed a steady decline in the number of patients who accepted continuous ambulatory peritonial dialysis (CAPD) for dialytic support. Chronic tubulointerstitial disease resulting from atrophic pyelonephritis was the leading cause of ESRD amongst both Kuwaiti nationals and expatriates. Though diabetic nephropathy was only the third leading cause of ESRD (14.7%) in the total population, it was more frequent (21.2%) among Kuwaitis. The gross mortality rate on dialysis was 14.7%. The major causes of death were related to cardiovascular diseases (60%) and sepsis (24.2%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

The impact of Iraqi occupation on end-stage renal disease patients in Kuwait, 1990-1991.

This paper describes the impact of Iraqi invasion and occupation on 196 end-stage renal failure (ESRD) patients maintained on dialysis treatment in Kuwait. Seventeen patients were abroad on holidays at the time of invasion, 77 fled the country for safety, and the rest (102) remained in Kuwait. Nearly half of those patients who remained in Kuwait died during the period of occupation. The mortality rate was as high as 95% in the intermittent cycler peritoneal dialysis (IPD) patients and 41% in haemodialysis patients compared to only 12.7% for those who left the country for treatment. Failure to reach dialysis centres, sepsis, myocardial infarction, and cerebral haemorrhage were the major causes of death. Shortage of skilled nurses was the major detrimental factor which necessitated major policy changes in the treatment programme. Those were (1) restriction of haemodialysis treatment hours and (2) discontinuation of IPD and transfer of patients to continuous ambulatory peritoneal dialysis (CAPD). The incidence of new ESRD Kuwaiti patients entering dialysis programme during the occupation period and soon afterwards was only 37 per million Kuwaiti population compared to 60 per million in the previous years.

Humans↗
PubMed1992

Quantitative estimation of urinary protein excretion by refractometry.

Quantitative estimation of proteinuria done by the refractometric method was compared with that done by the sulphosalycilic acid method and biuret method in 102 urine samples. The analysis of results by students' t test showed no statistically significant difference between the three methods. It is concluded that quantitative estimation of urinary protein excretion by refractometric method is a simple cheap and reliable method and can be performed easily in the outpatient clinic. The instrument is quite handy and can be carried in the pocket.

Benzenesulfonates↗
PubMed1989

Paraquat poisoning with acute renal failure--a case report.

Paraquat poisoning is relatively rare and is associated with mortality varying from 35 to 50%. A patient who consumed paraquat developed features of non-oliguric acute renal failure and recovered following haemodialysis. Renal biopsy done during the early recovery phase showed features of acute tubulo-interstitial nephritis with no disruption of tubular basement membrane. On recovery the patient had no evidence of proximal renal tubular dysfunction.

Acute Kidney Injury↗
PubMed1982

Conservative vs. surgical management of septic abortion with renal failure.

The role of surgery in the management of postabortum renal failure complicated with extensive uterine sepsis, perforation or peritonitis is controversial. This study compares the course and final outcome of 14 patients (66.6%) conservatively managed with appropriate antibiotics, fluid or blood replacement and dialysis, with seven patients (33.3%) for whom hysterectomy or laparotomy was undertaken in addition. Whereas all 14 patients treated conservatively died as the result of uncontrolled septicemia, three of the seven surgical patients recovered completely. Extensive necrosis with perforation of the uterine wall was confirmed either at laparotomy or at autopsy in all 21 women. To reduce mortality, the authors recommend early surgical intervention for patients suffering from postabortum renal failure complicated with uterine sepsis or perforation.

Abortion, Septic↗
PubMedDate not supplied

Hypergammaglobulinemic purpura of Waldenström: report of 3 cases with a short review.

Benign hypergammaglobulinemic purpura of Waldenström (HGPW) is an uncommon cause of non-thrombocytopaenic purpura that may create diagnostic difficulties. The presence of constitutional symptoms associated with prominent immunological abnormalities may raise alarm, leading to extensive and often unnecessary investigations. This report describes 3 young women with HGPW. Clinical features were characterised by recurrent episodes of bilateral asymmetrical palpable purpuric lesions on the lower extremities that were precipitated by a prolonged increase in hydrostatic pressure (e.g. prolonged standing, tight stockings etc.) associated with constitutional features. In one patient the condition was secondary to Sjögren's syndrome with type IV renal tubular acidosis. Laboratory abnormalities included a persistently elevated erythrocyte sedimentation rate, marked polyclonal hypergammaglobulinemia, and high titers of rheumatoid factor and anti-nuclear antibody of the anti-SSA (anti-Ro)/anti-SSB(anti-La) subsets. This topic is reviewed briefly with the emphasis that in its 'primary' form this condition could be considered a 'benign' systemic immunoinflammatory disease that requires neither extensive investigations nor any aggressive form of therapy. Greater awareness of HGPW may increase the frequency of its diagnosis, especially in the patient group with non-thrombocytopenic purpura or the so-called cutaneous vasculitic syndromes with 'palpable purpura'.

Adolescent↗