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Biomedical subjects

T Kuruvilla

Publications and source records attributed to T Kuruvilla.

18 recordsLinked to original sources
PubMed2000

Case report. Paraphimosis due to erotic dancing.

Paraphimosis usually develops when a tight foreskin is retracted over the glans penis for a prolonged period. Many esoteric aetiologies have been implicated in the development of paraphimosis including piercing the foreskin, Plasmodium falciparum infection, application of celadine juice to the foreskin, chancroid, pessaries and the implantation of pearls. We report the first two cases of paraphimosis developing during wining, an erotic dance native to Trinidad & Tobago.

Adolescent↗
PubMed1999

Prospective study of primary anastomosis without colonic lavage for patients with an obstructed left colon.

BACKGROUND: Traditionally, left-sided colon obstruction is managed by a multistaged defunctioning colostomy and resection. However, there is growing acceptance of one-stage primary resection and anastomosis with on-table antegrade irrigation. This paper presents a series of patients managed prospectively by primary anastomosis without intraoperative colonic lavage. METHODS: Emergency resection of acutely obstructed left-sided colonic carcinomas was performed. This was followed by primary anastomosis without on-table lavage after bowel decompression using a new technique. RESULTS: Fifty-eight consecutive, unselected patients underwent bowel decompression, resection and primary colocolic anastomosis. Only one patient developed a leak at the anastomotic site, requiring pelvic abscess drainage and transverse loop colostomy. One death occurred 12 h following surgery. Autopsy confirmed that this was due to myocardial infarction. Mean hospital stay was 9.8 days. CONCLUSION: Emergency surgery on the obstructed left colon can be carried out safely after decompression alone, without intraoperative colonic lavage.

Aged↗
PubMed1998

Simple repair of fractured penis.

Though rare, fracture of the penis is associated with significant morbidity if early surgical repair is not carried out. A simple same-day surgical technique performed under local anaesthesia is presented that requires no pre-operative investigations. Careful clinical examination (rolling sign) is used to accurately identify the fracture site.

Adult↗
PubMed1997

Cerebellar atrophy after acute phenytoin intoxication.

There is some evidence that long-term phenytoin (PHT) use may occasionally give rise to irreversible cerebellar atrophy, but it is unclear whether such changes can occur after acute PHT intoxication. We describe a 38-year-old patient with accidental acute PHT overdose who developed severe cerebellar atrophy. This case provides evidence that acute PHT intoxication can, on rare occasions, result in irreversible cerebellar degeneration.

Acute Disease↗
PubMed1994

An epidemic of dengue haemorrhagic fever & dengue shock syndrome in & around Vellore.

This report describes an epidemic of dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS) in the North Arcot Ambedkar district and the adjoining districts in Tamil Nadu and Andhra Pradesh. Nineteen children who fulfilled the clinical criteria for the diagnosis of DHF/DSS were admitted to the Christian Medical College Hospital, Vellore, during June through November, 1990. The clinical presentation was similar to that described in South-east Asian children and the case fatality rate was 26.3 per cent. Serology was confirmatory or suggestive of recent dengue virus infection in 16 children, uninterpretable in 2 and not consistent with recent dengue virus infection in 1 child. All children over 1 yr of age had very high antibody titres suggesting a secondary response whereas infants had lower titres consistent with primary response. The occurrence of recurrent epidemics in this region in the last few years with associated high case fatality emphasizes the urgent need for public health measures to curtail further epidemics.

Child↗
PubMed1990

Beneficial effect of intravenous nitroglycerin in patients with non-Q myocardial infarction.

In 129 patients with acute myocardial infarction (MI) there was ST segment elevation on admission but no Q wave in the infarcted area: they were randomly divided into 2 groups. In a single blind study 62 patients received intravenous nitroglycerin, while another 67 patients were given placebo. The average time which elapsed since the beginning of symptoms to start of treatment was 157 +/- 82.17 min in nitroglycerin group and 169 +/- 66.9 min in placebo group (NS). The beneficial effect of nitroglycerin on mortality, extension of MI or occurrence of left ventricular failure (LVF) could be seen only if these conditions were combined. No significant difference could be detected if these conditions were analyzed individually. The size of MI assessed by peak of creatine kinase (CK) was similar in both groups. However, if Q and non Q MI were separately analyzed, the peak CK was significantly lower in non Q MI patients receiving nitroglycerin (523 +/- 161 IU/l compared to 1049 +/- 583 IU/l for placebo, p = 0.002) while the same beneficial effect could not be seen in Q MI. Although there was no difference in the final occurrence of Q MI and Q MI in both groups taking nitroglycerin or placebo, we found that non Q MI patients had significantly lower peak CK than Q MI patients (770 +/- 491.9 to 2783 +/- 1720.9, p = 0.001) and this peak CK was observed earlier for non Q MI patients (16.2 +/- 5.41 hours compared to 22.6 +/- 6.86 hours for Q MI patients, p = 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Comparative study of heparin and antiplatelets in treatment of preinfarction angina.

Heparin, aspirin with dipyridamole or placebo were given to 266 patients with pre-infarction angina treated with isosorbide dinitrate, beta blockers and nifedipidine. The number of patients who developed acute myocardial infarction (MI) in the next 72 hours was comparable in all 3 groups. However, patients on heparin developed only 3.2% (2 out of 61) Q MI compared with 20% (20 out of 100, p = 0.005) taking dipyridamole with aspirin and 19% (20 out of 105 on placebo, p = 0.006). Infarctions of patients treated with heparin as assessed by peak of serum creatine kinase (CK) were also smaller (810 +/- 538 IU/1) than in groups taking antiplatelets (1229 +/- 829 IU/1, p = 10.048) or placebo (1417 +/- 919 IU/1, p = 0.009). We defined a subgroup at high risk patients who had prolonged chest pain longer than 45 min and ECG changes with ST segment depression more than 1 mm within 6 hours of admission: 55% of these patients developed acute infarction in the following 72 hours. Aggressive management including coronary angiography and fibrinolysis should be considered in well equipped centers for patients with evolving coronary thrombus in a general hospital, heparin infusion should be part of routine treatment as patients on heparin developed smaller infarctions.

Adult↗