Coccidioidomycosis and sarcoidosis. Multiple recurrences.
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Antifungal Agents↗
Biomedical subjects
A Arora
Publications and source records attributed to A Arora.
Double-blind, multicenter evaluation of lansoprazole and amoxicillin dual therapy for the cure of Helicobacter pylori infection.
BACKGROUND: Treatment with amoxicillin plus omeprazole results in disappointing cure rates of Helicobacter pylori infection. The minimal inhibitory concentration of lansoprazole for H. pylori in vitro is lower than that for omeprazole, prompting interest in treatment with amoxicillin plus lansoprazole. MATERIALS AND METHODS: H. pylori-infected patients with endoscopically documented duodenal ulcer either currently or within the past year were randomized to 14 days of (1) lansoprazole, 30 mg bid, plus amoxicillin, 1 gm tid; (2) lansoprazole, 30 mg tid, plus amoxicillin, 1 gm tid; (3) lansoprazole, 30 mg tid alone; or (4) amoxicillin, 1 gm tid alone. Endoscopy was done at enrollment and at 4 to 6 weeks after completion of treatment or for recurrent symptoms. H. pylori status was assessed by culture and histology. Ulcer prevalence was evaluated at follow-up endoscopy. RESULTS: Two hundred sixty-two patients met enrollment criteria and were treated. By per-protocol analysis, H. pylori infection was cured in 57% of those treated with lansoprazole twice daily plus amoxicillin and in 67% of those treated with lansoprazole three times daily plus amoxicillin, compared with 0% treated with lansoprazole alone or amoxicillin alone (p < .001 for dual therapy versus either monotherapy). Amoxicillin resistance was not observed. At follow-up endoscopy, ulcer prevalence was 17% in patients treated with lansoprazole twice daily plus amoxicillin, 23% in those treated with lansoprazole three times daily plus amoxicillin, 33% in those treated with lansoprazole alone, and 35% in those treated with amoxicillin alone (p = .024; lansoprazole twice daily plus amoxicillin versus amoxicillin alone). CONCLUSIONS: Treatment with amoxicillin plus lansoprazole, 30 mg tid, led to cure of H. pylori infection in 67% of patients with active or recently healed duodenal ulcer.
2-Pyridinylmethylsulfinylbenzimidazoles↗
A fluorometric assay for quantitating DNA strand breaks during apoptosis.
Few techniques exist for quantitating DNA fragmentation during apoptosis. Our aim was to develop a quantitative assay for DNA fragmentation in apoptosis by enzymatically labeling DNA with a fluorescent dideoxynucleotide. Terminal deoxynucleotidyl transferase was used to enzymatically label 3'-OH DNA ends with fluorescein-12-dideoxyuridine triphosphate in an assay referred to as fluorophore end-labeling. Because only one labeled dideoxynucleotide can be added per 3'-OH end of DNA, the fluorescence intensity is directly proportional to the number of DNA strand breaks. The sensitivity and validation of this approach were first established in isolated calf thymus DNA treated with the endonuclease, DNase I; and excellent correlation was observed between fluorophore end-labeling and an isotopic approach to quantitate 3'-OH ends of DNA. Quantitation of DNA strand breaks was then obtained in nuclei isolated from hepatocytes undergoing apoptosis using fluorescent digitized microscopy, flow cytometry, and fluorometry. In addition to its quantitative aspects, fluorophore end-labeling proved to be quite sensitive as it detected DNA strand breaks prior to the morphologic changes of apoptosis or the development of the hypodiploid state as assessed by fluorescence microscopy and flow cytometry, respectively. This assay should prove useful for studying the molecular mechanisms leading to DNA cleavage during apoptosis.
Animals↗
Incorporation of diaphyseal sequestra in chronic haematogenous osteomyelitis.
Seventeen patients with haematogenous osteomyelitis and long diaphyseal sequestra are reported. Treatment was incision and drainage with antibiotics for at least 6 to 8 weeks, the limb being protected in plaster for a long time. The sequestra became incorporated in every case. Sequestrectomy should only be undertaken when successive radiographs show no reduction in size of the sequestrum and an increase in the amount of the involucrum.
Adolescent↗
Lateral condylar fractures of the humerus in children: fixation with partially threaded 4.0-mm AO cancellous screws.
Thirty-seven children with fresh, displaced (more than 2 mm in any direction) fractures of the lateral condyle of the humerus were treated by open reduction and internal fixation with a partially threaded 4.0-mm diameter AO lag screw. They were reviewed at a mean follow-up of 4.8 years. Painless, full-elbow movements were obtained in 36 cases. Delayed union, with loss of 10 degrees of elbow motion, was observed in one case (2.72%). Radiologically, less than 4 degrees of varus deviation, compared with the contralateral side, was found in four cases (10.8%). Mild fishtailing was observed in three cases (8.18%). Nonunion, avascular necrosis or clinically significant premature epiphysial fusion was not observed. Elbow function was excellent, irrespective of minor radiologic abnormalities.
Bone Screws↗
Antituberculosis treatment-induced hepatotoxicity: role of predictive factors.
Antituberculosis drug-induced hepatotoxicity is quite common. However, factors predicting its development are still controversial. The objective of the present study was to evaluate the role of certain factors (age and sex of the patient, alcoholism, chronic liver disease, hepatitis B virus carrier status, acetylator status, nutritional status and antituberculosis treatment (ATT) regimen) in predicting the development of ATT-induced hepatitis. In a case-control study, 60 consecutive patients with evidence of ATT-induced hepatitis were studied to assess the possible association of the above-mentioned factors with ATT-induced hepatitis. Body mass index was found to be significantly lower in ATT-induced hepatitis patients (17.2 +/- 2.7) than in controls (19.5 +/- 3.3) (p < 0.05). Pyrazinamide was used in addition to isoniazid and rifampicin in a significantly higher percentage of patients in the ATT-induced hepatitis group (70%) as compared with those in the control group (42%). No significant differences were observed between the two groups with regard to the rest of the parameters.
Adolescent↗
Platelet function studies in Indian kala-azar.
Platelet function studies were conducted on 25 parasitologically positive cases of Indian kala-azar and 25 age and sex matched healthy controls. Ninety-two per cent of patients had thrombocytopenia of variable degree; in 44% of patients, platelets were less than 60,000 mm-3. The platelet adhesive index was less than 30% in 70% of patients with kala-azar (normal 31-60%). Platelet aggregation time with ADP and adrenaline was abnormally prolonged compared to the controls. Platelet factor III availability was poor in 40% of cases. There was a fair degree of correlation between platelet adhesiveness and platelet factor III availability in these patients: 50% of patients with poor platelet adhesiveness showed reduced platelet factor III availability.
Blood Platelets↗
Pseudoaneurysm in injecting drug abusers: cases from India.
Pseudoaneurysm, a known complication of arterial needle puncture, is also an uncommon complication of parenteral drug abuse. India is currently witnessing an upsurge of abuse of injectable drugs. Five cases of pseudoaneurysm developing as a complication of intra-arterial drug abuse are reported. The need for early recognition and proper timely intervention is highlighted.
Adult↗
Biliary strictures on ERCP: a study in northern India.
Case records of 82 patients with biliary stricture diagnosed on endoscopic retrograde cholangiopancreatography (ERCP) during a 7-years period (1983-89) were analysed for its aetiology, clinical presentation, laboratory abnormalities and radiological characteristics. The aetiology was found to be benign in 59 and malignant in 23 patients. Forty seven percent of all strictures were post cholecystectomy strictures (PCS). Presence of mucosal irregularity and incomplete stricture were commoner with malignancy. Malignant biliary strictures (MBS) were commonly seen in males, occurred at older age, had short history, had higher alkaline phosphtase and serum bilirubin values when compared to patients with benign biliary strictures (BBS).
Adult↗
Enterogenous intramedullary cyst.
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Cervical Vertebrae↗
Blood pressure variability and urinary electrolyte excretion in normotensive adults.
The principal aim of the present study was to determine the relationship of ambulatory blood pressure (BP) to urinary electrolyte excretion in normotensives. Twenty-five young adults underwent ambulatory BP and heart rate monitoring while collecting urine over 24 h. The correlations of 24 h urine sodium excretion and the ratio of sodium/potassium excretion with systolic BP in the laboratory (r = 0.12 and 0.24), ambulatory awake (r = 0.11 and 0.24), and ambulatory asleep (r = 0.24 and 0.31) settings were all in the positive direction but not significant. However, 24 h sodium excretion did correlate significantly and positively with awake and asleep ambulatory systolic (r = 0.45 and 0.41, P < .05) and diastolic (r = 0.42 and 0.43, P < .05) coefficients of variability. Thus, in normotensives on an unlimited diet, 24 h urinary sodium was more closely related to ambulatory BP variability than to BP level.
Adult↗
Comminuted femoral shaft fractures treated by closed intramedullary nailing and functional cast bracing.
Eighty-one patients with comminuted femoral shaft fractures were treated by closed unlocked Küntscher nailing and functional cast bracing for 1 to 4 weeks postoperatively depending on the degree of comminution. The mean follow-up period was 27.6 months. The average time required for fracture healing was 14 weeks. There was one delayed union. One fracture united with more than 10 degrees of rotational malalignment; shortening of more than 1 cm was present in four cases. Two patients had more than 20 degrees of limitation of hip and knee movement.
Adolescent↗
Effect of isabgol husk supplementation in a low-fibre diet on serum levels and calcium, phosphorus and iron balance in adolescent girls.
The investigation was conducted on 11 healthy, non-anaemic adolescent girls of 16-18 years of age. A balance study was conducted in two trials of 3 weeks each on low- and high-fibre diets. The high-fibre diet consisted of the low-fibre diet plus 25 g isabgol husk. The mean diet and nutrient intakes of the subjects were approximately the same during both trials. Addition of isabgol (Isphaghula) husk to the low-fibre diet significantly increased the urinary excretion of phosphorus and iron; faecal excretion of calcium, phosphorus and iron; and the serum calcium, phosphorus and iron levels decreased significantly (P < 0.05). The apparent retention of calcium, phosphorus and iron was significantly (P < 0.05) lowered on the high-fibre diet, but the balances of these nutrients were positive. Thus the isabgol does not have a desirable effect on mineral levels.
Adolescent↗
Hepatic coma as a presenting feature of constrictive pericarditis.
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Adult↗
Effect of Isabgol husk supplementation on trace minerals (Zn, Cu, Mn) levels in adolescent girls.
The study was conducted on eleven healthy non-anaemic adolescent girls of 16 to 18 years of age. Balance studies were conducted in two trials of three weeks each on low and high fibre diets. High fibre diet contained 25 g Isabgol husk in addition to low fibre diet. The mean diet and nutrient intakes of the subjects were approximately the same during both trials. Addition of Isabgol husk to low fibre diet significantly (P less than or equal to 0.05) increased faecal excretion of zinc, copper and manganese and lowered their apparent retention. The serum levels of these trace minerals decreased significantly (P less than or equal to 0.05). Thus the high level of Isabgol has undesirable effect on trace minerals.
Adolescent↗
Management of childhood femoral neck fractures.
Forty-three children with displaced transcervical femoral fractures were reviewed at a mean follow-up of 7.2 years and results were assessed using Ratliff's criteria. Of 22 patients treated by internal fixation alone, 10 had good, 6 had fair and 6 had poor results. The results in 21 children treated by internal fixation along with primary transverse intertrochanteric undisplaced osteotomy were: 14 good, 5 fair and 2 poor, but none improved to a statistically significant level (P = 0.139). However, the osteotomy improved the fracture union significantly and no delayed union or non-union was noted in this group (P = 0.05). There were no complications related to the osteotomy itself.
Adolescent↗
An unusual presentation of oesophageal tuberculosis.
Oesophageal tuberculosis secondary to tuberculous mediastinal lymphadenopathy is a very unusual presentation of adult tuberculosis. We report a young patient who presented with anorexia and weight loss. The chest radiograph and CT scan revealed mediastinal lymphadenopathy causing extrinsic oesophageal compression on the barium swallow. This was confirmed by upper gastrointestinal endoscopy. Four weeks later, because of spontaneous partial relief in dysphagia, upper gastrointestinal endoscopy was repeated and revealed an ulcerated lesion with nodular margins at the mid-oesophagus. Biopsy from the ulcer margin revealed non-caseating granulomas. The patient had complete relief of dysphagia and other symptoms within 3 weeks of start of antituberculosis therapy.
Adult↗
Superior sagittal sinus thrombosis--an unexpected cause of papilloedema.
Two patients with superior sagittal sinus thrombosis are reported. Papilloedema was an important diagnostic sign in both cases. Magnetic resonance imaging (MRI) provided the diagnosis in each case and proved to be the investigation of choice. Superior sagittal sinus thrombosis should be considered in the differential diagnosis of papilloedema as it is both potentially fatal and probably underdiagnosed.
Adult↗