Browsing by Author "Vijayakumar, M"
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Item Acute and crescentic glomerulonephritis.(2002-12-01) Vijayakumar, MAcute nephritic syndrome is clinically characterized by hematuria, proteinuria, oliguria, and volume overload with or without azotemia and histologically be acute proliferative glomerulonephritis. Acute post streptococcal glomerulonephritis is the commonest cause in children. There is a preceding infection prior to this condition in majority. This is one of the comonest causes of renal edema in children. Early recognition, prompt and aggressive therapy and adequate follow-up are mandatory. Prognosis is usually good unless associated with severe renal failure and crescentic glomerulonephritis where the outcome is relatively poor unless treatment is early and adequate. Pathologically acute proliferative nephritis is with diffuse proliferative glomerulonephritis with or without crescents. Immunosuppressive therapy is not needed in simple acute proliferative glomerulonephritis but is essential in modifying the outcome of crescentic glomerulonephritis. Delayed resolution, severe renal failure at onset, progressive renal failure and associated systemic features like skin rashes, joint pains, hepatosplenomegaly and persistent fever are the indications for biopsy. Overall the prognosis in classical post streptococcal acute proliferative glomerulonephritis is good.Item Benefits of maternal participation in newborn nurseries.(2005-10-08) Sasidharan, C K; Gokul, E; Anoop, P; Vijayakumar, MOBJECTIVE: To evaluate the outcome of active involvement of mothers/mother substitutes in day-to-day care of high risk neonates admitted in a level II newborn care unit. METHODS: An observational study was carried out over a period of eleven years incorporating active participation of mothers/substitute in the day to day care of their sick neonates. The outcome is assessed in terms of mortality due to the three major illnesses (asphyxia, sepsis and prematurity) during this phase. The data is compared with that of a similar level II care centre where conventional neonatal care is practised. RESULTS: There is a significant and sustainable reduction in neonatal mortality due to the three major illnesses when the mothers are also involved in the neonatal care, in spite of a considerable increase in the number of admissions during this period. CONCLUSION: The concept of active participation of mother/substitute in neonatal nursery ensures 1:1 care at all times. It is a cheap and effective alternative to inadequacy of bed:nurse ratio (BNR).Item Cognitive decline among older adults who developed acute coronary syndrome during hospitalization for non-cardiac illness(The Indian Academy of Geriatrics, 2023-01) Vijayakumar, Priya; David, Arun; Vijayakumar, MBackground: Atypical presentations of acute coronary syndrome (ACS) delay its recognition and treatment in the elderly patients. Functional decline and delirium which are common to the elderly during hospitalization, leads to cognitive impairment and poor health outcomes. Steps taken for its prevention is usually not considered the top priority by the cardiologist. The present study was conducted to identify cognitive decline among elderly patients who developed ACS during hospitalization for noncardiac illness and their outcome. Materials and Methods: Three hundred and ten elderly patients above 60 years of age with ACS were included from June 26, 2020 to October 13, 2020. Subjects were divided into those admitted primarily due to an ACS (Group I, n = 94) and those developing ACS following admission for noncardiac illness (Group II, n = 216). Co-morbidities, medications, investigations, management, clinical outcome, and Montreal Cognitive Assessment scale were compared between the two groups at the time of admission, after 30 days and after 6 months. Results: Majority of the subjects were admitted due to acute kidney injury (27.1%) in Group II and had a non-ST elevation ACS (90.2%). Optimum management was given to a lesser extent due to the clinical condition of these patients. Poor clinical outcome, cognitive impairment during hospitalization and cognitive decline during follow-up was more in Group II. Conclusion: Clinicians must be vigilant for the development of cognitive impairment and cognitive decline when an elderly patient is admitted to the hospital, as early detection and optimum management provides better clinical and cognitive outcome.Item Complications during enalapril and diuretic therapy for congestive cardiac failure.(2009-09) Mehta, Sheetal; Vijayakumar, MItem Congenital hypoaldosteronism.(2008-08-30) Sethupathi, Vanathi; Vijayakumar, M; Janakiraman, Lalitha; Nammalwar, B RCongenital hypoaldosteronism due to an isolated aldosterone biosynthesis defect is rare. We report a 4 month old female infant who presented with failure to thrive, persistent hyponatremia and hyperkalemia. Investigations revealed normal serum 17 hydroxy progesterone and cortisol. A decreased serum aldosterone and serum 18 hydroxy corticosterone levels with a low 18 hydroxy corticosterone: aldosterone ratio was suggestive of corticosterone methyl oxidase type I deficiency. She was started on fludrocortisone replacement therapy with a subsequent normalization of electrolytes. Further molecular analysis is needed to ascertain the precise nature of the mutation.Item Consensus statement on evaluation of hematuria.(2006-11-08) Phadke, K D; Vijayakumar, M; Sharma, Jyoti; Iyengar, Arpana; ,Item Crusted (Norwegian) scabies in leprosy.(2001-01-01) Vijaikumar, M; Thappa, D M; Vijayakumar, MItem Dexamethasone pulse therapy for extensive alopecia areata: to use or not to use.(2002-01-28) Vijayakumar, M; Thappa, D MItem Diagnosis of anomalous origin of left coronary artery from pulmonary artery in an adult by 64-slice CT angiography.(2008-07-27) Krishnamoorthy, A; Venkatesh, G; Vijayakumar, M; Preeetham, K; Ramanathan, MAnomalous origin of Left Coronary Artery from Pulmonary Artery (ALCAPA) presenting in adult age is a rare entity. We report an adult patient with exertional angina, who was diagnosed to have ALCAPA conclusively and non-invasively by 64-slice CT angiography.Item Diagnostic approach to a child with hematuria.(1998-06-27) Vijayakumar, M; Nammalwar, B RItem Effect of phenytoin sodium in reducing blistering of epidermolysis bullosa report of four cases.(2002-07-28) Sasidharan, C K; Vijayakumar, M; Vinodkumor, M STo evaluate the effect of phenytoin in reducing of patients with epidermolysis bullosa four newborn babies were studied after thorough clinical evaluation including detailed history and relevant investigations. All of them were put on oral phenytoin sodium, in the usual antiepileptic dose and were followed up. All of the babies had significant reduction in the number of lesions.Item End stage renal disease presenting with acute renal failure.(2009-01-31) Pragnya, R; Vijayakumar, MItem Evaluation and management of hypertension.(2007-02-14) Bagga, Arvind; Jain, Rupesh; Vijayakumar, M; Kanitkar, Madhuri; Ali, UmaItem Evaluation of the use of DMSA in culture positive UTI and culture negative acute pyelonephritis.(2005-07-09) Nammalwar, B R; Vijayakumar, M; Sankar, Janani; Ramnath, B; Prahlad, NThis prospective study was done to assess the frequency of acute pyelonephritis (APN) in febrile children with positive urine culture as documented by Tc99m DMSA scintigraphy (DMSA) and the frequency of vesicoureteric reflux (VUR) in these children. Secondly, to determine the frequency of APN, in febrile children with supportive evidence for UTI but with negative urine culture, as documented by DMSA and frequency of VUR in them. Thirdly to stress the utility of DMSA to diagnose APN in urine culture negative febrile children and to suggest DMSA as a clinical tool in evaluation of fever of unknown origin (FUO). This study included 42 children with positive urine culture and 26 children with negative urine culture who had supportive evidence of UTI as determined by the predetermined criteria and diagnosed to have APN by DMSA. All of them had ultrasonogram (USG), DMSA and voiding cystourethrogram (VCU). They were followed up for a minimum period of 6 months. Out of the 42 children with positive urine culture 92.9% had features of APN in the DMSA of whom 82.1% had vesicoureteric relux (VUR). The DMSA was abnormal in 26 children with negative urine culture, of whom 65.4% had VUR. Ultrasound suggestive of parenchymal change was observed in 47.6% in the culture positive group and 65.4% in the culture negative group. In conclusion, it is suggested, that DMSA is a useful investigation for the diagnosis of APN in febrile UTI. DMSA is indicated in febrile children with negative urine culture but with supportive evidence of UTI and in FUO. An abnormal DMSA is a strong indication for work up for VUR.Item Free radical scavenging potential of Picrorhiza kurrooa Royle ex Benth.(2003-08-14) Govindarajan, R; Vijayakumar, M; Rawat, A K S; Mehrotra, ShantaFor assessing free radical scavenging potential of P. kurrooa, the antioxidant activity of P. kurrooa extract was studied by lipid peroxidation assay using rat liver homogenate. The extract (1 mg/ml) showed marked protection (up to 66.68%) against peroxidation of liver phospholipids. Besides, reduced glutathione showed very encouraging activity. The extract also exhibited significant scavenging activity. Thus augmenting the wide use of plant in the indigenous system of medicine, which may partly be due to antioxidant and free radical scavening activity of the extract.Item Gastrointestinal bleeding in a toddler secondary to chronic renal failure and hyper-gastrinemia.(2008-01-05) Ganesh, R; Suresh, N; Prahalad, N; Vijayakumar, M; Nammalwar, B R; Sathiyasekaran, MalathiA 3-year-old girl with H. pylori negative duodenal ulcer with hypergastrinemia secondary to chronic renal failure presenting with upper gastrointestinal bleed as the cardinal manifestation is unusual in toddlers and the case is presented for its rarity.Item Glomerulocystic disease.(2006-05-01) Vijayakumar, M; Prahlad, N; Nammalwar, B RWe report a 9 month old girl with renal failure. The kidneys were of normal size with increased echogenecity. Kidney biopsy showed features suggestive of glomerulocystic disease. The patient is on conservative management.Item Hypereosinophilic syndrome.(2006-03-29) Venkatesh, C; Mahender, E; Janani, S; Malathi, S; Vijayakumar, M; Nammalwar, B RHypereosinophilic syndrome is a leukoproliferative disease characterised by sustained overproduction of eosinophils. The three diagnostic criteria for this disorder are (1) Eosinophilia of greater than 1500 cells/ml, persisting for longer than 6 months, (2) lack of another diagnosis to explain the eosinophilia and (3) signs and symptoms of organ involvement. We report a 15-year-old boy who was diagnosed as Hypereosinophilic syndrome based on these criteria.Item In vitro and in vivo hepatoprotective activity of Cissampelos pareira against carbon-tetrachloride induced hepatic damage.(2011-12) Surendran, S; Eswaran, M Bavani; Vijayakumar, M; Rao, Ch VAdministration of hydroalcoholic extract of Cissampelos pareira roots (CPRE) and standard drug silymarin in rats showed significant hepatoprotective action against CCl4 induced hepatotoxicity. Elevated serum marker enzymes of AST, ALT, ALP and serum bilirubin were significantly reduced to near normal level in CPRE treated rats. Lipid peroxidation level was decreased significantly in CPRE 100, 200, 400 mg/kg doses treatment groups. In case of antioxidant enzymes SOD, catalase levels were increased significantly after CPRE 200, 400 mg/kg doses, similarly it increased the enzyme levels of GST, GPx, and GSH. CPRE 200, 400 mg/kg decreased cholesterol level, and increased triglyceride level. In vitro hepatoprotective activity of the extract was evaluated at 20, 40, 60, 80 and 100 µg/ml concentration against CCl4 (1%) induced toxicity in freshly isolated rat hepatocytes. HepG2 cells showed significant dose dependent increase in percentage viability at the doses 20, 40, 60, 80 and 100 µg/ml of CPRE compared to CCl4 exposed HepG2 cells. Results of this study strongly demonstrate Cissampelos pariera having good hepatoprotective potential.Item Kidwai Memorial Institute of Oncology.(2000-09-24) Kumar, R V; Kumaraswamy,; Vijayakumar, M