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Biomedical subjects

S S Kulkarni

Publications and source records attributed to S S Kulkarni.

47 records · Page 3Linked to original sources
PubMedDate not supplied

Experience with intrauterine transfusions for severe Rh alloimmunization in a developing country.

This study reports our experience with 67 intrauterine transfusions (IUTs) carried out for 27 cases of severe Rh alloimmunization, which could be useful to other developing countries with similar situations. Most of the mothers were from sections of India other than Mumbai, their socioeconomic status was low, and they were referred during the second or third trimester. The mean gestation age at first IUT was 27+/-2.9 weeks and maternal anti-D titer ranged from 1:32 to 1:512. Ultrasonography (USG) was normal in eight cases, but showed minimal or gross ascites in 8 and 11 cases, respectively. The mean +/- SD hematocrit (HCT) in three groups defined by USG was 23.5+/-1.7, 15.9+/-4, and 12+/-5.9, respectively. Amniotic fluid analysis, which proved to be an important investigation, indicated IUT in eight cases having normal USG. Six cases were severely anemic (Hb deficit >7 g/dl). By fetal cell staining, the percentage of the donor's red cells in the fetal circulation was determined. Besides Hb, blood group, direct antiglobulin test, and mean cell volume, this parameter was also useful in assessing efficacy of IUT and the need for an exchange transfusion after birth. Of 11 fetuses having gross ascites, eight and one each from the remaining two groups, were stillborn. One death may be procedure related. Two neonates died due to hemorrhagic disorder and prematurity. The overall survival rate was 55.6%. Late referral, severe Rh alloimmunization, volume overload, delay in IUT because of nonavailability of blood and use of nonirradiated blood could be the reasons for the poor outcome. Strategies for improving results are discussed.

Blood Transfusion, Intrauterine↗
PubMedDate not supplied

Structure based prediction of binding affinity of human immunodeficiency virus-1 protease inhibitors.

A series of computations were performed to derive a strategy for the prediction of binding affinities of non-peptidic human immunodeficiency virus-1 (HIV-1) protease inhibitors. This paper describes the development of a 3D quantitative structure-activity relationship (3D-QSAR) methodology by using receptor information of HIV-1 protease. The docking and molecular dynamics simulations were performed on a model ligand/enzyme complex to optimize the variables involved in the generation of ligand/enzyme models. The protonation scheme of the active site aspartic acid residues of HIV-1 protease was derived from a computational study. The active site aspartate is monoprotonated with a proton placed on the OD1 atom of the ASP B25. This protocol of docking and molecular dynamics (MD) simulation was then used to derive the ligand-enzyme complexes of the molecules used in the present study. The molecular mechanics interaction descriptors were calculated from these ligand/enzyme models. A partial least squares (PLS) method was used to derive a linear correlation between the interaction descriptors and the biological activity. A good correlation was observed when the change in the energy of the ligand upon complex formation and the electrostatic contributions to the solvation energy of the ligand were included in the QSAR analysis. A highest cross-validated q2 value of 0.649 was observed. This model had a conventional r2 of 0.725, and when this model was used to predict the activity of the external test set, it produced a r2pred of 0.761. The total interaction energy was partitioned into interactions in different subsites and interactions with each of the amino acid residues of the enzyme. The PLS analysis using these descriptors helped to identify the important interactions which can be exploited for the design of HIV-1 protease inhibitors.

HIV Protease↗
PubMedDate not supplied

Distal fibular giant cell tumour.

A patient who reported with a slowly growing swelling ovr thee lateral aspect of the left ankle, was investigated and diagnosed to have a giant cell tumour which was confirmed on FNAC. The tumour was managed with excision biopsy and reconstruction. The case is being reported for its rare site of occurrence.

Adult↗
PubMedDate not supplied

Solitary synovial osteochondroma of the knee.

A very rare case of solitary osteochondroma of the knee is reported. The patient presented with a slowly growing retropatellar bony tumour of 4 years duration following a minor trauma. An excisional biopsy with a total patellectomy was performed as the patellar articular surface was unsalvageable. A 20 month follow up revealed no recurrence and a functional knee. A brief review of literature is also presented.

Adult↗
PubMedDate not supplied

Total hip arthroplasty in healed tuberculous hip.

Total hip arthroplasty was performed in a patient who had tuberculous hip, quiescent for the last 15 years, without pre or postoperative anti-tuberculous chemotherapy. At a 27 month follow up, there has been no evidence of reactivation. A brief review of relevant literature is also presented.

Adult↗
PubMedDate not supplied

Idiopathic gingival fibromatosis - a case report.

A case of 4 a year old girl with the complaint of delayed eruption of teeth is presented. She had moderate to severe, diffuse gingival enlargement in the maxilla and mandible. No deciduous teeth had erupted even at the age of five years except for incisal edges of upper, and lower anterior teeth. The diagnosis was made based on clinical examination and after ruling out drug and family history. Surgical removal of the hyperplastic tissue was done under general anesthesia.

Journal Article↗
PubMedDate not supplied

Incidence of Rh immunization between 1981 and 1992.

BACKGROUND: The Institute of Immunohaematology has had an Rh clinic at the Nowrosjee Wadia Maternity Hospital since 1957. Between then and 1977, 5% Rh-negative women produced Rh antibodies. Between 1978 and 1980, the rate of immunization was reduced to 3.3%. In the present study we determined the incidence of Rh immunization between 1981 and 1992. METHODS: ABO and Rh grouping was carried out by standard methods on 139,635 samples collected from antenatal women. Six thousand nine hundred and fourteen (5%) Rh-negative women were screened for Rh antibodies using an enzyme technique. Analysis was carried out by dividing the data into four groups, each of three years duration. RESULTS: The number of women attending the antenatal outpatients increased steadily but the frequency of Rh-negativity remained at approximately 5%. The rate of Rh immunization among Rh-negative women declined from 3.1% during 1981-83 to 1.7% during 1990-92. The rate among pregnant women dropped from 0.16% to 0.09% and this was statistically significant (p < 0.05). The incidence of Rh immunization among Rh-negative women increased from 0.4% in the first pregnancy to 17.5% after four or more pregnancies (p < 0.01). Only 15 out of 167 Rh immunized women had received anti-D immunoglobulin previously. CONCLUSIONS: The incidence of Rh immunization has declined during the last 12 years possibly due to family planning and extensive use of anti-D immunoglobulin. However, complete eradication of Rh haemolytic disease of the newborn will be possible only if a comprehensive Rh prophylaxis programme is instituted.

Antibodies↗
PubMedDate not supplied

Co-existence of hypertension and abnormal lipid profile: a hospital-based retrospective survey.

Indian data on co-existence of coronary risk factors is scanty. This retrospective survey was carried out to estimate the prevalence of abnormal lipid profile and glucose metabolism in hypertensive patients. Records of persons coming for a health check-up were screened to obtain 500 consecutive evaluable records of persons with hypertension or those taking antihypertensive drugs. 57 percent of these subjects had cholesterol > or = 200 mg/dl. An elevated ratio of total to HDL cholesterol (> 4.5) was also present in 47 percent of the subjects. Serum triglycerides were > or = 200 mg/dl in 34 percent of the subjects, and > or = 400 mg/dl in 5 percent. These lipid abnormalities were more prevalent in males than females (p < 0.05). 20 percent of all the subjects were either on antidiabetic drugs or had fasting blood sugar more than 120 mg/dl.

Antihypertensive Agents↗
PubMedDate not supplied

Results of Austin Moore replacement.

Forty cases of Austin Moore Replacement done for transcervical fractures of the femur in patients were reviewed after a period of 12 to 48 months postoperatively (mean 26 mth). 30 cases (75%) had mild to severe pain of non-infective origin, starting as early as 6 months postoperatively. This was irrespective of the make, size or position (varus/valgus) of the prosthesis. Though the Aufranc and Sweet clinical scoring was satisfactory in 65% cases, radiological evidence of complications like sinking, protrusion, etc. were seen in majority of the cases. Calcar resorption was seen in 34 cases (85%) as early as 4 months postoperatively. Results of THR and bipolar replacement done for transcervical fractures in recent literature show 85% pain-free cases at 5 years. We feel that Austin Moore Replacement should be reserved for patients more than 65 years of age and those who are less active or debilitated because of other factors, because of increased acetabular wear with time in the younger individual. This is corroborated by unsatisfactory results in patients less than 65 years of age (p < 0.05).

Activities of Daily Living↗
PubMedDate not supplied

Total hip arthroplasty for giant cell tumour.

A 32 month follow up of an uncommon case of a Giant Cell Tumour affecting the proximal end of femur is presented. Following a wide excision, the hip was reconstructed using Charnley type of low friction total hip arthroplasty. At a 32 month review, there was no recurrence and the function was good.

Adult↗