Browsing by Author "Kulkarni, B"

Now showing 1 - 17 of 17
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    Antiplatelet antibodies in cases of Glanzmann's thrombasthenia with and without a history of multiple platelet transfusion.
    (2009-01) Ghosh, Kanjaksha; Kulkarni, B; Shetty, S; Nair, S
    Antiplatelet antibodies are known to be present in a wide spectrum of patients, which include chronic Idiopathic Thrombocytopenic Purpura (ITP), infections, etc., including Glanzmann's thrombasthenia (GT) patients who receive multiple platelet transfusions. The presence of natural antibodies to platelet receptors is not studied in cases of GT. We studied the antiplatelet antibodies in 23 patients with GT, 15 of which had received multiple transfusions and eight that had not received transfusions, along with 50 cases of chronic ITP. The prevalence and specificity of platelet-bound antibodies were detected by inhibition assays using O-group platelets on flow cytometry. The mean antiplatelet antibodies in 15 patients of GT who had not received transfusions and eight patients with multiple transfusions was 8427 + 2131.88 and 9038 + 2856 antibodies/platelet, respectively, while in case of the 50 ITP patients studied, it was 22166 + 5616 antibodies/platelet (Normal Range 1500–3200 antibodies/platelet). We conclude that GT patients who have not received transfusions may develop antiplatelet antibodies to the missing/abnormal receptor. Whether this is due to a molecular mimicry or due to some other mechanism needs to be explored.
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    Cherubism in siblings: A case report.
    (2007-03-26) Sarda, D; Kothari, P; Kulkarni, B; Pawar, P
    Cherubism is a benign disease of bones affecting the jaws and giving a characteristic cherubic appearance to the patient. On radiography, the lesions exhibit bilateral multilocular radiolucent areas. Histopathology shows numerous multinucleated giant cells in the background of proliferating fibrous connective tissue. Cherubism can be a solitary case. The present report describe cherubism in two siblings and briefly review the literature on this subject.
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    Current Practice of Iron doses for Treatment of Iron Deficiency Anaemia - A Review
    (Indian Association of Preventive and Social Medicine, 2018-04) Rao, S; Thomas, T; Swaminathan, S; Varghese, JS; Kurpad, AV; Mondal, A; Kulkarni, B; Sachdev, HPS; Kapil, U
    Although functional impairment begins with iron deficiency in the absence of anaemia, the development of anaemia heralds a homeostatic dysfunction that impairs daily activity. Iron deficiency anaemia is often the reason for poor physical performance, maternal and child morbidity and referral to a healthcare professional. (1) Women in their reproductive years, pregnant women and children are most vulnerable to develop iron deficiency anaemia (IDA) and will be the focus of this review.
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    Cytomegalovirus pneumonia in a rheumatoid arthritis patient on low dose methotrexate.
    (1998-06-29) Kalke, S; Kulkarni, B; Balakrishnan, C; Mangat, G; Karve, S R; Deshpande, R B; Joshi, V R
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    Flowcytometric evidence of platelet activation in patients on aspirin following myocardial infarction.
    (2006-03-08) Ghosh, K; Khare, A; Shetty, S; Nair, S; Kulkarni, B; Mohanty, D
    BACKGROUND: Following a myocardial infarction, patients are usually started on long term antiplatelet therapy with aspirin in a dose of 80-150 mg/day. However, there are no quick and easy methods to assess the efficacy of the antiplatelet activity of aspirin. METHODS: We studied 60 consecutive patients (men, < 40 years of age) 8-10 weeks after they had had acute myocardial infarction. These patients were receiving 100 mg aspirin daily orally with or without b-blockers. We measured P-selectin expression and fibrinogen binding by flowcytometry at least 3 times over a period of 2 years in all the patients. We also studied 100 age- and sex-matched controls. RESULTS: Of the 60 patients, 30 (50%) showed both increased P-selectin and fibrinogen binding by platelets, suggesting platelet activation. Fourteen other patients had increased fibrinogen binding but normal P-selectin expression. Sixteen patients and all the controls had normal results of both tests. CONCLUSION: Our data show evidence of platelet activation in at least 50% of patients receiving 100 mg of aspirin daily. Flowcytometry for P-selectin expression and fibrinogen binding to platelets can be used to monitor antiplatelet therapy with aspirin following acute myocardial infarction.
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    Guidelines for iron supplementation for Prophylaxis of Anemia in a National Programme - A Review
    (Indian Association of Preventive and Social Medicine, 2018-04) Mondal, A; Thomas, T; Swaminathan, S; Rao, S; Varghese, JS; Kulkarni, B; Sachdev, HPS; Kapil, U; Kurpad, AV
    Recent National Family Health Survey-4 data shows that anaemia continues to be a major public health problem in India. In India much of the anaemia is due to iron deficiency, and women and children are at the greatest risk of anaemia. TheMinistry of Health and Family Welfare took a policy decision, in 2013, to develop the National Iron+ Initiative (NIPI) to address the prevailing iron deficiency anaemia. This initiative covered pregnant and lactating women, children and adolescents. However, the guidelines do not match the current World Health Organization (WHO) guidelines for prevention of iron deficiency anaemia in these population groups. The background evidence for the WHO and NIPI is thus reviewed to come to a common consensus on the optimum recommendation of iron supplementation for the population, while taking into consideration the feasibility of the program, without burdening the groups with iron over-dose. However, from the present review, there is a need for increased number of trials in India that could qualify for a high grade of evidence to support the guidelines of NIPI.
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    High resolution computed tomography of the lungs.
    (1996-09-01) Shetty, P G; Shroff, M M; Karmarkar, S S; Kulkarni, B
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    Immunoprofile of Hodgkin's lymphoma in India.
    (2008-04-16) Patkar, N; Mehta, J; Kulkarni, B; Pande, R; Advani, S; Borges, A
    Aims and Background: The immunoprofile of the Reed Sternberg cell with respect to immunoreactivity for CD20 and lack of CD15 has been described as a poor prognostic factor. Large scale studies analyzing the immunoprofile of Hodgkin's lymphoma (HL) from India are lacking. The aim of this study was to obtain baseline information on relative frequencies and immunoprofiles of the two major types of HL and comparing reports from developed and developing countries. Materials and Methods: 451 cases of HL were classified as per the WHO into classical (n= 397) HL (cHL) and nodular lymphocyte predominant HL (NLPHL) (n=54). Cases of cHL were divided into 5 immunophenotypic groups; Group A (CD15+,CD30+,CD20-), Group B (CD15-,CD30+,CD20-), Group C (CD15+,CD30+,CD20+), Group D (CD15-,CD30+,CD20+)and Group E (CD15-,CD30-,CD20+). In cases of NLPHL, the immunophenotype of lymphocytes in the background, whether T(CD3) or B(CD20) rich was observed. Results: Most cases of cHL belonged to Group A (44.58%) followed by Group B (40.05%), C(5.54%), D(9.57%) and E(0.25%). Half, (50.89%) the cases of cHL were immunonegative for CD15, whereas CD20 was expressed by 15.61% of the cases. Three (5.55%) cases of NLPHL showed a CD3 (T) cell rich background. Significant differences were also observed with respect to the age distribution of cHL as compared to the west. Conclusion: Our study demonstrates that India has a high number of CD15 negative and a relatively higher number of CD20 positive cHL cases as compared to the western population. Favorable treatment response and good cure rates that one sees in western cHL may not apply to India.
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    Nutrition rehabilitation of children with severe acute malnutrition: Revisiting studies undertaken by the National Institute of Nutrition
    (Indian Council of Medical Research, 2019-08) Kulkarni, B; Mamidi, RS
    Severe acute malnutrition (SAM) in children under five years is an important public health problem due to associated high mortality and long-term health consequences. Research on the dietary causes of SAM, especially the role and relative importance of dietary protein, in the aetiology of oedematous malnutrition, has led to considerable debates and controversies. The present article revisits some of the debates in this field, where the researchers at the National Institute of Nutrition (NIN), Hyderabad, India, with their pioneering work, have contributed to the global literature on the various facets of the disease. Highlighting the importance of energy as a bigger problem than protein malnutrition is a noteworthy contribution of NIN's research. It is, however, important to examine the protein quality of the diets in light of the new information on the lysine requirements. The article argues that the currently dominating hypothesis of free radical theory requires a critical review of the supporting evidence. Over the past few decades, the research has focused on low-cost diets using locally available foods. The article also argues that solutions based on local foods, being acceptable and sustainable, need to be strengthened for their effective delivery through the existing nutrition programmes. Recent evidence shows that the use of ready-to-use therapeutic foods (RUTF) with high micronutrient density may be linked with higher mortality possibly due to the high iron content, which could be counterproductive. There are several unaddressed concerns regarding the potential long-term impact of consumption of RUTF in children with SAM. More evidence and a cautious approach are, therefore, needed before implementing these solutions.
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    Prepyloric diaphragm detected following foreign body ingestion.
    (1996-07-01) Oak, S; Bhatnagar, M; Kulkarni, B; Nanivadekar, S; Karmarkar, S; Sawant, P
    Prepyloric diaphragms are unusual and are usually detected in adulthood. We report a five-year-old boy who presented with history of ingestion of a coin and was found to have a prepyloric diaphragms on laparotomy.
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    Prolapsing anterior urethral polyp.
    (2001-01-09) Jiwane, A; Kumar, T; Kothari, P; Kulkarni, B
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    Proximal jejunal obstruction due to eosinophilic gastroenteritis.
    (1996-10-01) Karande, T; Oak, S N; Trivedi, A; Karmarkar, S; Kulkarni, B; Kalgutkar, A
    Eosinophilic enteritis or gastroenteritis is a rare disease characterised by tissue eosinophilia which can affect different layers of bowel wall. It can affect any area of gastrointestinal tract from the esophagus to the rectum, although stomach and small intestine are sites most frequently reported. It is important to recognize this disease early and institute the necessary treatment. An eight year old girl presented with acute intestinal obstruction. Exploration revealed a structure of proximal jejunum. Histopathology demonstrated eosinophilic jejunitis. The case is reported owing to this rarity and relevant literature is reviewed.
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    Rectal duplication.
    (1995-04-01) Kulkarni, B; Oak, S N; Karmarkar, S J; Desai, A P; Deshmukh, S S
    Duplications of the alimentary tract are of a great rarity, particularly so in the rectum. Because of its rarity, the difficulty of making a correct diagnosis and of selection of proper approach for treatment, this entity bears a special significance. The present case report deals with a female newborn who presented with imperforate anus and a rectovestibular fistula and a mass prolapsing at the introitus. Complete excision of the mass was carried out through the perineal approach and the child then underwent, a PSARP for the correction of the rectal anomaly. Histology confirmed the mass to be a rectal duplication.
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    Research Priorities in the field of Anaemia in India
    (Indian Association of Preventive and Social Medicine, 2018-04) Sinha, A; Kulkarni, B; Mithra, P; Mahajan, P; Upadhyay, R; Nair, S kumar; Sharma, RS
    Anaemia is a health problem that caused most disability in India over a decade (2005-2016) according to the Global Burden of Disease study(1). India has the maximum number of anaemic women and children in the world(2). As per the recent National Family Health Survey-4 (2015-16), about 58% children (6-59 months), 53% women (15-49 y) and 23% men were suffering from various degrees of anaemia(3). Aanaemia affects the general health of the total population taking toll for high mortality as well as morbidity and attenuating the optimal expression of the potentials of both physical and mental capacity of our population. Improving nutritional status of the vulnerable sections of the population and reducing anaemia is of paramount importance for improving health and the human capital development in the country(4).
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    Thrombophilia in coronary artery disease: a double jeopardy.
    (2004-07-10) Mohanty, D; Ghosh, K; Khare, A; Kulkarni, B
    Thrombophilia can be defined as an increased risk of thrombosis. The central event to the pathogenesis of any thrombotic episode is the perturbation of haemostasis, the cause of which may be genetic or environmental. The clinical manifestations of the chronic development of coronary artery atheroma are angina and acute myocardial infarction. In recent years literature is emerging on the role of different factors of blood coagulation in arterial thrombosis. Different coagulation factors, natural anticoagulants, platelet antigens and other factors such as homocysteine, lipoprotein (a), have been studied as risk factors for coronary artery disease (CAD). The results of many of these studies are contradictory. In India, there is an alarming rise in the number of young patients with myocardial infarction (MI) and an interesting feature is that a large majority of these patients lack the conventional risk factors. There have been scattered studies on the thrombophilia status among Indians. The management of thrombophilia can be done by a regimen of different drugs which has been evaluated in different clinical trials. Since the cost of thrombophilia investigations is quite phenomenal for a developing country like India, the selection of these investigations assumes an utmost importance.
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    Xipho-omphalopagous twins--separation in the newborn.
    (1993-04-01) Birmole, B; Kulkarni, B; Shah, R; Karapurkar, S; Vaidya, A; Vaidya, M; Borwankar, S
    Male conjoined twins (thoraco-omphalopagous) were delivered by emergency Caesarean section performed in a full term, 3rd gravida who had presented in labour. On examination one of the twins had gross monstrosity and was threatening the survival of the better twin (twin A). The cannulation and dye studies through single umbilical vein demonstrated significant cross circulation across the connecting bridge. The vein was connected to liver of twin A. An emergency separation was performed to salvage the better twin.