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Biomedical subjects

S N Khosla

Publications and source records attributed to S N Khosla.

14 recordsLinked to original sources

Lymphocytic adenosine deaminase activity in typhoid fevers.

Lymphocyte adenosine deaminase (L-ADA) activity, a measure of lymphocyte activity, was estimated in 10 healthy controls and 30 patients with typhoid fever (20 uncomplicated and 10 complicated) at the time of admission, at onset of complications and weekly until recovery. Mean L-ADA activity in healthy controls was 20.49 +/- 3.62 mU/10(6) cells. In uncomplicated patients L-ADA activity was 36.33 +/- 5.09 mU/10(6) cells at time of admission, which is significantly raised as compared to controls. It remained high at the height of the fever and at defervescence. In complicated patients L-ADA activity was significantly low at admission (15.33 +/- 2.35 mU/10(6) cells) and fell further with development of complications (7.86 +/- 4.07 mU/10(6) cells). At defervescence L-ADA activity increased significantly above the control activity (31.24 +/- 5.37). Serial L-ADA activity can be of prognostic significance. A cut-off value of 24 mU/10(6) cells is suggested to predict prognosis and severity of disease. Activity below this indicates a probability of a severe, prolonged course and may help in instituting early and energetic treatment.

Adenosine Deaminase

Aluminium phosphide poisoning.

Aluminium phosphide is a solid fumigant pesticide widely used in the Indian subcontinent as a grain preservative. Over the last 5 years there has been a dramatic increase in the number of cases of aluminium phosphide poisoning in India. Ninety-two patients with aluminium phosphide poisoning due to ingestion were studied over a period of 3 years. Abdominal pain, vomiting and restlessness were the common initial features followed by alteration in sensorium and shock unresponsive to conventional treatment. Electrocardiographic abnormalities were very common and highly variable. Routine serum biochemistry was usually unremarkable. Severe metabolic acidosis was common and mortality high (49%). The survivors recover completely without any residual organ damage. There is no known antidote.

Adolescent

Gamma glutamyl transpeptidase in meningitis.

Gamma glutamyl transpeptidase (GGTP) was measured serially in cerebrospinal fluid (CSF) and serum in 23 cases of meningitis (15 pyogenic and 8 tuberculous meningitis) and an equal number of age and sex matched healthy controls, to find out its diagnostic and prognostic significance in meningitis. GGTP activity was significantly elevated (p less than 0.001) in CSF and serum in meningitis as compared to control subjects. Levels were significantly higher in pyogenic as compared to tuberculous meningitis (p less than 0.001) and in CSF than in serum (p less than 0.001). The maximum elevation was seen on the 1st day and thereafter the activity declined in the majority (65.2%) of cases. However, in 3 cases of pyogenic meningitis and 5 cases of tuberculous meningitis, the GGTP activity on subsequent estimation increased serially; all these 8 cases died. It is concluded that CSF GGTP activity is significantly elevated in meningitis and serial rise in its activity is associated with poor prognosis and even fatal outcome.

Adult

Autonomic function tests and clinical significance of dysautonomia in chronic liver disease.

Autonomic function in 20 patients with chronic liver diseases was assessed clinically and by various tests like Valsalva ratio, expiratory-inspiratory ratio, postural tachycardia index, atropine ratio, blood pressure response to assumption of erect posture, hand immersion in cold water, and finger wrinkling response to hand immersion in warm water. Eighty per cent of the patients showed some clinical evidence of dysautonomia. While a good correlation between various clinical complaints of dysautonomia and the extent of parasympathetic dysfunction was observed in the individual patient, a significantly greater impairment of sympathetic function tests was observed in oliguric cirrhotics as compared to their non-oliguric counterparts.

Adult

Lipid profile in enteric fever.

Lipid profile is known to alter in patients with severe sepsis, but few studies regarding the status of lipid levels in enteric fever are available. Twenty patients with enteric fever, belonging to different age groups and both sexes, along with an equal number of matched patients with fever due to non-enteric causes, were studied with regard to alterations in lipid profile. We observed a severe and protracted hypertriglyceridaemia, decrease in HDL-cholesterol levels and increase in LDL-cholesterol levels in patients with enteric fever at the peak of fever. The values returned to normal on recovery and convalescence. This study serves to highlight the complexity of lipid variation during Salmonella typhi infection.

Adolescent

Neuro-psychiatric manifestations of typhoid.

The clinical pattern of typhoid fever is changing, and in particular the incidence of neuro-psychiartic manifestations is on the increase. In 246 cases of enteric fever we found 124 with confusional states, delirium, coma, generalized myoclonus, Parkinsonian rigidity or psychoses. We further distinguished two major sub-groups with an acute and an insidious onset. The apparent increase in the frequency of neuro-psychiatric complications of typhoid could represent a change in the pathogenicity of S. typhi or the increasing recognition of a biochemical defect caused by a bacterial endotoxins and provoked by poor nutrition.

Adolescent

Typhoid perforation.

Out of 270 cases of enteric fever observed over a period of 5 years there were 30 cases of enteric perforation (11.1%). Their clinical features, mode of presentation and various diagnostic and prognostic parameters have been described. Out of 30 patients, 18 died (60%) and 12 (40%) survived. Various factors regarding conservative and surgical management have been briefly discussed.

Adolescent

Heart in Friedreich's ataxia.

Most articles on Friedreich's ataxia report that cardiac complications are almost universal in patients with this disease. However, the present study of 30 cases, observed for two to ten years, seems to belie the experience of other writers in the field. Only six (20 per cent) of these patients showed electrocardiographic abnormalities. Only one patient had cardiac enlargement and congestive heart failure. One other patient had paroxysmal tachycardia. Seventy-four family members were also studied and the results were similar. It is suggested that this impressive difference may be a racial one and indeed very few reports on Friedreich's ataxia have come from India. Further study of this group of patients is in progress. The author also includes a review of the literature of neuromyopathic diseases and their relationship to myocardial involvement.

Adolescent