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Biomedical subjects

V N Kumar

Publications and source records attributed to V N Kumar.

At least 19 recordsLinked to original sources

Seroprevalence of Chlamydia trachomatis types in children with clinical trachoma in New Delhi, India.

Micro-immunofluorescence test with type specific antigens of ocular Chlamydial infection types A-D was used for serotyping the causative C. trachomatis serotypes in 32 inclusion positive school children suffering from trachoma. Single serotype associated infection was seen in six of the patients. The rest of them had antibodies against more than one serotype indicating simultaneous or previous infection by more than one serotype. By geometric mean titre determination, type C appeared to be the most prevalent serotype. However the highest antibody titres in individual cases were most frequently observed for serotype A. The use of geometric mean titre versus highest titre against specific serotype observed in individual cases for population survey is discussed. Isolation of organism for absolute determination of causative serotype from each patient is emphasised.

Antibodies, Bacterial↗

Ovarian cyst and autonomic dysreflexia.

Autonomic dysreflexia may present itself as a medical emergency in quadriplegics and paraplegics above the T6 level. Common causes are bladder/bowel dysfunction and pressure ulcers. A case study is presented in which an ovarian cyst was the cause of autonomic dysreflexia. Excision of the ovarian cyst stopped recurrence of paroxysmal hypertension and completely alleviated signs and symptoms of autonomic dysreflexia.

Adult↗

Diagnosis of hip pain, an anatomic approach.

The authors state that there are many varied causes of hip and thigh pain, the signs and symptoms of which are often misleading and confusing, thus making diagnosis difficult. They present a logical categorized anatomic and neurologic approach toward clinical examination, designed to assure the physician of a correct diagnosis.

Hip Joint↗

Spontaneous dislocation of the radial head in cerebral palsy.

A patient with spastic quadriparetic cerebral palsy and unilateral nontraumatic dislocation of the radial head is presented. The association of radial head dislocation with flexion contracture of the elbow and contracture of the pronators of the forearm is known to occur but is infrequently reported. Early recognition and management of elbow and forearm contractures in cerebral palsy patients is imperative to avoid radial head dislocation, since the outcome of both surgical and rehabilitative management are significantly influenced by its presence. Literature related to this problem and pathokinesiology is discussed.

Cerebral Palsy↗

Autonomic dysreflexia in the spinal cord-injured. What the physician should know about this medical emergency.

Autonomic dysreflexia is a potentially fatal condition occurring in quadriplegics and paraplegics whose spinal cord lesion lies above the greater splanchnic outflow. Prompt recognition of common and less common clinical findings and a search for the causative stimulus are essential. Bladder distention and fecal impaction are the two most likely causes. Should it persist after removal of the stimulus, hypertension requires aggressive drug therapy to control massive sympathetic outflow.

Autonomic Nervous System Diseases↗

Survey of alcohol and drug misuse in spinal cord injured veterans.

Although the spinal cord injured population is considered by many to be especially vulnerable to alcohol and drug misuse, there is little factual information regarding the prevalence of alcohol and drug misuse among this group. To survey alcohol and drug misuse in a large population of spinal cord injured veterans, a 61-item questionnaire was mailed to 2000 randomly selected members of the Paralyzed Veterans of America organization. Of 1083 questionnaires returned, 992 were usable. The results were analyzed with regard to sociodemographic data, level of injury, type of accident, current medication use and the use of alcohol and recreational drugs. Statistical analyses were performed using chi-square tests. The majority of respondents indicated the regular use of alcohol prior to age 21 and before the spinal injury (70.1%). Conversely, the majority who acknowledged the use of recreational drugs reported the use began after the injury (75%). In contrast to the notion that the spinal cord injured individual is at high risk for alcohol and drug misuse, this study indicates alcohol and drug use is far less than in the general population.

Adult↗

Effects of alcohol on bone, muscle and nerve.

The acute and chronic effects of alcohol on bone, muscle and peripheral nerves are not well appreciated. Bone complications include traumatic fractures, osteoporosis and osteonecrosis. In muscle, a sustained bout of heavy drinking may cause rhabdomyolysis, while chronic alcohol abuse may produce proximal myopathy. In peripheral nerves, acute alcohol intoxication may lead to pressure neuropathy and chronic abuse may cause peripheral neuropathy.

Acute Disease↗

Postpolio syndrome.

Postpolio weakness, a newly recognized clinical entity, is beginning to appear in patients some 30 years after their initial bout with the disease. Two such cases are presented. The difficulties in establishing an early and correct diagnosis and the emerging complications and uncertainty surrounding the postpolio patient are discussed. Recognition, early diagnosis, close scrutiny and constant vigilance are presented as the only defense, at this time, in combating the emerging latent complications of polio.

Asthenia↗

Management of the diabetic foot.

Foot disease in diabetics is caused by peripheral neuropathy and peripheral vascular disease. Initial evaluation involves repeated physical examinations, including careful inspection for infection, and Doppler analysis of perfusion. A tracing of the ulceration should be obtained so that healing can be monitored. Properly fitting shoes are imperative for prophylactic care. Shoe modification is possible using moldable plastics and metatarsal bars. Patient and family education are also important elements of management.

Anti-Bacterial Agents↗

Evaluation of Moto-Stand a new vehicle for upright ambulation in paraplegics.

The Moto-Stand is a motorised vehicle to propel paraplegics in the upright position. It safely allows handicapped persons a wide range of working capabilities and extends mobility far beyond the limits of a wheelchair. Twenty adults with spinal lesions were evaluated for using the Moto-Stand. The levels of lesion ranged from C6 to L1. The tetraplegics studied had incomplete lesions and they could get on the Moto-Stand but needed some assistance. All the paraplegics studied were able to use the Moto-Stand independently. The Moto-Stand was found to be superior for kitchen activities, especially when handling hot objects and reaching objects at different levels. As it turns in its own space it offers superior maneuverability in the limited space of a kitchen, workshop or even a trailer home. Subjects with moderate to severe spasticity appear to have difficulty in using the Moto-Stand, It was found to be safe and comfortable by the majority of subjects studied.

Adult↗

Rehabilitation of hip fractures in the elderly.

Hip fractures in the elderly carry a high rate of morbidity and mortality. Most hip fractures require immediate surgical intervention. An intensive period of rehabilitation helps reduce complications. Management of the whole patient--including treatment of any preexisting medical conditions, attention to nutrition and conditioning exercises--is essential for a good outcome. Success depends more on careful follow-up during rehabilitation than on the nature of the surgical repair.

Aged↗

Intractable foot pain following frostbite: case report.

This report describes a patient with intractable foot pain following frostbite in 1945. The patient continued to have progressively worsening foot pain, which eventually resulted in his losing his job and becoming wheelchair-bound. A combination of transcutaneous nerve stimulator, patellar, tendon weight-bearing/ankle foot orthoses (PTB/AFO), and crutches resulted in pain relief and good ambulatory status. A review of the literature regarding possible pathophysiology is made.

Crutches↗

Transcutaneous nerve stimulation in rheumatoid arthritis.

This study of the effects of transcutaneous nerve stimulation (TNS) on 20 wrists of 11 men with rheumatoid arthritis was designd to make an objective assessment of pain and also to evaluate placebo effects. Following determinations of the length of time each wrist could support a small weight before pain began or increased (loading time), a 3-part test was conducted using the same weight in each case. (1) Each wrist was treated by TNS for 15 minutes and then, with the stimulator still on, loading time was determined (TNS-1). (2) With the stimulator working on the same wrist as for TNS-1, the loading time of the opposite wrist was determined (TNS-2). (3) To study placebo effect, loading time was again determined with the same adjustment on the stimulator but with the battery removed (TNS-3). If the loading time doubled or more, the pain relief was considered to be 100%. From the results (70% of the TNS-1 wrists had 50 to 100% pain relief; 10% of the TNS-2 and 15% of the TNS-3 wrists had some improvement), TNS appears to reduce joint pain and to offer a supplement to antiinflammatory drugs.

Arthritis, Rheumatoid↗

Physiatrists: career development and professional interests.

A total of 1,080 physiatrists were asked to respond to a questionnaire which covered various aspects of career development and vocational interests in Physical Medicine and Rehabilitation (PM&R). The data from the 486 usable responses were analyzed on the basis of several factors including nationality, mode of entry into the specialty, time distribution between graduation and entry into specialty, and professional interests. A large majority (98.8%) expressed good job satisfaction and optimism about the specialty's future. Of the 486 responders. 68 (14%) were women and 481 (98.2%) were MDs of whom 170 (35%) were foreign trained. Nearly 78.4% of the sample had left another medical field in favor of PM&R. As compared with a similar study in 1968, the present study showed a threefold increase in physiatrists going into private practice, a twofold increase in participation in a purely rehabilitation setting, and a decline in the percentage of physiatrists in academic and research areas.

Adult↗