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Biomedical subjects

S Kurian

Publications and source records attributed to S Kurian.

16 recordsLinked to original sources
PubMed2006

Multiple cavitating masses in an immunocompromised host with rheumatoid arthritis-related interstitial lung disease: an unusual expression of cytomegalovirus pneumonitis.

Cytomegalovirus is a known opportunistic infection in immunocompromised individuals. We document multiple cavitating lung masses caused by cytomegalovirus in a patient with rheumatoid arthritis-induced interstitial lung disease on immunosuppressant medication, an unusual expression of CMV pneumonitis. With increasing use of immunosuppressive therapy and increase in AIDS, pulmonary cytomegalovirus infection is expected to be a more frequently encountered disease and familiarity with its uncommon radiological manifestations will be advantageous.

Aged↗
PubMed2004

A stepped approach for prediction of obstructive sleep apnea in overtly asymptomatic obese subjects: a hospital based study.

BACKGROUND AND PURPOSE: Prevalence of obstructive sleep apnea (OSA) is high in obese subjects, many of whom may not be overtly symptomatic. Polysomnography (PSG) is a costly and time-consuming investigation. Since it is not feasible to subject all obese individuals to PSG, it is useful to define predictors of OSA among these subjects. PATIENTS AND METHODS: One hundred and eighteen obese subjects [body mass index (BMI)> or =25 kg/m(2)] presenting to the hospital with non-sleep related complaints were included, of which 53 subjects with PSG evidence of OSA [apnea-hypopnea index (AHI)> or =15/h] were defined as cases and 65 subjects without any evidence of OSA (AHI<15/h) were defined as controls. Anthropometry, biochemical investigations, blood gas analysis, pulmonary function tests, and PSG were performed for all subjects. RESULTS: Waist hip ratio (WHR) (as percentage of a standard) [odds ratio (95% CI): 1.07 (1.00-1.14); P = 0.049] male gender [odds ratio (95% CI): 3.97 (0.99-15.81); P = 0.046] and neck circumference (NC) [odds ratio (95% CI): 1.23 (1.03-1.47); P = 0.023] were found to be independent predictors of OSA. Overnight oxygen desaturation data were evaluated in patients selected as having OSA on the basis of these clinical markers, and the best cut-off for level of desaturation (10%) was defined. The stepped approach had a specificity, sensitivity, positive and negative predictive value of 89.2, 88.5, 86.8 and 90.6%, respectively, for the diagnosis of OSA. CONCLUSIONS: Male gender, WHR and NC are independent predictors of OSA in overtly asymptomatic obese subjects. A stepped approach to diagnose OSA should be used, as it is accurate and cost-effective.

Adult↗
PubMed2002

Reliability of epigastric auscultation to detect gastric insufflation.

BACKGROUND: We studied the reliability of epigastric auscultation to detect gastric insufflation in 30 anaesthetized, paralysed intubated patients. METHODS: A 16FG gastric tube was positioned with the tip in the mid-oesophagus with the proximal end attached to an injection port with a one-way valve. Four observers participated in the study. Observers were paired and each pair studied 15 patients. Each patient underwent four test sequences in random order, two by each observer. Each test sequence comprised one observer injecting different volumes of air (0.25 ml, 0.5 ml, 1 ml, 2 ml, 3 ml, 4 ml, 5 ml, 10 ml, 15 ml and 0 ml as a control) in random order whilst the second blinded observer listened with a stethoscope over the epigastrium. Each randomized volume was injected rapidly at 5 s intervals for 1 min. The number of injections required to detect air entering the stomach was recorded. The stomach was deflated between each test sequence. RESULTS: To detect air entering the stomach with 95% confidence, 11 injections were required for 0.25 ml; 7 for 0.5 ml; 3 for 1 ml; 2 for 2 ml and 3 ml, and I for > or =4 ml. The mean (range) inter- and intraobserver reliability was 0.73 (0.71-0.75) and 0.76 (0.76-0.89), respectively. The incidence of false positives was 21% (25/120) and the incidence of false negatives was 10% (103/1080), making the specificity and sensitivity 79% and 91%, respectively. CONCLUSIONS: We conclude that epigastric auscultation can detect gastric insufflation of 0.25 ml air after 11 breaths and > or = 4 ml air after one breath with 95% confidence. Inter- and intraobserver reliability is moderate to excellent. Epigastric auscultation should be repeated to reduce the risk of false positives.

Adolescent↗
PubMed2002

Modulatory effect of Cyclea peltata Lam. on stone formation induced by ethylene glycol treatment in rats.

The inhibitory effect of the root of Cyclea peltata Lam. on nephrolithiasis induced in rats by feeding with ethylene glycolated water (1%) for 35 days was summarized. Ethylene glycol administration led to oxalate stone formation, as indicated by its high level in urine. Complementary to this anion, the cation calcium level in urine was elevated. These two ions may have contributed to the formation of calcium oxalate stones. In addition to high serum potassium, a low serum magnesium level contributed to stone formation. Simultaneous administration of the powdered root of Cyclea peltata resulted in decreased urinary oxalate and calcium. Likewise, serum potassium was lowered and magnesium was elevated. These observations provided the basis for the conclusion that this plant inhibits the stone formation induced by ethylene glycol treatment.

Animals↗
PubMed1998

Tumor necrosis factor activates a nuclear inhibitor of vitamin D and retinoid-X receptors.

Tumor necrosis factor-alpha (TNF) is an important contributor to the pathophysiology of bone loss in osteoporosis. Previous work has revealed that TNF inhibits 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) action. We have shown that TNF decreases binding of the vitamin D receptor (VDR) and its heterodimeric partner, the retinoid-x receptor (RXR), to the vitamin D response element (VDRE) of the osteocalcin gene. Here we test the hypothesis that TNF induces a nuclear inhibitor of RXR/VDR binding to DNA and that this inhibitor can have independent effects on RXR. The effect of TNF on RXR and VDR binding to their cognate response elements and stimulation of transcription was studied in VDR deficient CV-1 and COS-7 cells. In CV-1 cells transfected with VDR and RXR expression vectors, TNF-alpha inhibited 1,25(OH)2D3 stimulated transcription of a VDRE-CAT reporter and 9-cis-retinoic acid (9cRA) stimulated transcription of an RXRE-CAT reporter. Inhibition of transcription was associated with decreased binding of VDR and RXR to their cognate response elements. To determine if TNF-alpha induced a nuclear inhibitor of VDR and RXR binding to DNA, nuclear extract was isolated from TNF treated receptor deficient COS cells and mixed with nuclear extract from ligand treated receptor replete COS cells. Receptor binding to DNA was inhibited by the extract from TNF treated COS-7 cells. The inhibitory activity rapidly appeared in nuclear extracts following TNF stimulation. We conclude that TNF activates a nuclear inhibitor of VDR and RXR.

Alitretinoin↗
PubMed1997

Linear IgA bullous dermatosis in south India.

BACKGROUND: A study of five cases of linear IgA dermatosis (LABD) in a referral hospital in South India is presented. METHODS: A dermatologic examination, skin biopsy, and direct immunofluorescence were carried out on all patients. Patients were then followed up. RESULTS: All five cases showed linear IgA deposits at the dermo-epidermal junction. One case in addition showed IgG and C3 deposits. All cases responded to treatment with dapsone. The treatment duration varied from 14 to 16 months and the fifth patient is still on treatment after 37 months. CONCLUSIONS: Linear IgA bullous dermatosis is a self-limiting bullous disorder. To the best of our knowledge this is the first report of LABD from India.

Adolescent↗
PubMed1995

Diagnostic evaluation of the lupus band test in discoid and systemic lupus erythematosus.

BACKGROUND: The usefulness of the lupus band test (LBT) in the diagnosis of cutaneous lupus erythematosus remains controversial. The study was done to determine the sensitivity, specificity, and predictive value of the LBT in discoid lupus erythematosus (DLE) and systemic lupus erythematosus (SLE). METHODS: During the study period, 32 patients with SLE and 28 patients with DLE were included. The final classification of cases was based on the American Rheumatism Association Criteria (ARA) for SLE, histopathology, and consensus of the clinical staff. Thirty controls, 15 each for DLE and SLE, were chosen from a group of patients, who had lesions clinically simulating DLE and SLE, but could be excluded by histopathology, laboratory tests, and follow-up. Histopathologic examinations and direct immunofluorescence (DIF) tests were done on lesional skin. RESULTS: In DLE, the sensitivity of the LE band test was 58% and the specificity 87%. The positive predictive value was 95% and negative predictive value was 32%. In SLE the sensitivity was 93% and specificity 87%. The positive predictive value was 64% and negative predictive value 98%. CONCLUSIONS: The high negative predictive value of LBT in SLE suggests that it is valuable in excluding diseases clinically similar to SLE.

Adolescent↗
PubMed1992

Cutaneous lupus erythematosus in India: immunofluorescence profile.

The clinical profile and cutaneous lesions of 65 patients with lupus erythematosus (LE) are described. This included 28 discoid LE (13 disseminated, 15 localized), five subacute cutaneous LE, and 32 systemic LE. The need to recognize a pigmented macular form constituting 25% of discoid LE is emphasized. Increased incidence of involvement of the lower lip in discoid LE and pigmentation in systemic LE is noted. Lupus band test was found to be highly sensitive; it was positive for lesional skin of all untreated patients with subacute cutaneous LE and systemic LE, it was, however, not useful on nonlesional skin.

Adolescent↗
PubMed1985

Clear cell hepatocellular carcinoma: sudden death from severe hypoglycemia.

Hypoglycemia is a frequent paraneoplastic complication of hepatocellular carcinoma occurring in up to 30% of cases of this neoplasm. The clear cell carcinoma, a notable histological subtype of hepatocellular carcinoma, however, has been associated with hypoglycemia in only two previously reported patients from Japan. We report herein the first American case of clear cell hepatocellular carcinoma with severe hypoglycemia. The patient also suffered from hypercholesterolemia and erythrocytosis. Fine needle aspiration cytology, conventional histopathology, and immunohistochemical studies of this neoplasm are described. Possible explanations for the clear cell appearance and a comparison of the clinical and morphological features of clear cell and nonclear cell hepatocellular carcinoma is made. Potential pathophysiological mechanisms for the paraneoplastic complications of hypoglycemia, hypercholesterolemia, and erythrocytosis are discussed.

Adenocarcinoma↗