Biomedical subjects

A Biswas

Publications and source records attributed to A Biswas.

At least 19 recordsLinked to original sources

PubMed1996

Biological activity of 4-(4-bromophenyl)-thiosemicarbazide.

The two molecules (A and B) in the asymmetric unit of the title compound, C7H8BrN3S, display different conformation. In both molecules, the S atom is trans to the NH2 group. The Br atoms of the two molecules approach each other at a distance of 3.573(2) A. The crystal structure of the bromine compound is isomorphous with that of its chlorine analogue. In the crystal structure, intramolecular N-H...N and intermolecular N-H...S hydrogen bonds help stabilize the molecular packing. The increased antibacterial activity of the title compound compared to that of its chlorine analogue may be attributed to the increase in electron density on the hydrazinic end of the thiosemicarbazide chain.

Anti-Bacterial Agents↗

PubMed1996

Menstrual bleeding patterns in Norplant-2 implant users.

The objective of the present study was to analyze the patterns of menstrual bleeding in Singaporean women using Norplant-2 contraceptive implants over a five-year period. Of the 100 women recruited for the study, 62 were still using the implant at the end of five years. Only 9 women discontinued for menstrual reasons and they did so within the first 21 months of implant use. Although a normal menstrual bleeding pattern was uncommon during the first three months of use, 69.4% had normal menstruation at the end of five years. Irregular bleeding was the most common form of menstrual abnormality throughout the study period. Infrequent periods and amenorrhoea were distinctly uncommon, especially after the first two years of use. The pattern of bleeding with Norplant-2 was not significantly different from that previously observed with Norplant.

Adolescent↗

PubMed1996

Assessment of fetal health should be based on maternal perception of clusters rather than episodes of fetal movements.

OBJECTIVE: To determine the level of correlation between mother and machine detected episodes and clusters of fetal movements and their association with fetal heart rate acceleration. METHODOLOGY: An observational study conducted on health pregnant women between 29-40 weeks gestation who were admitted in spurious labour to the Department of Obstetrics and Gynaecology, National University Hospital, Republic of Singapore. A continuous record of fetal heart rate and fetal movement was obtained using the fetal actocardiograph. Fetal movements felt by mother were also noted. If a continuous series of fetal movements were perceived over a period of 15 secs or more it was termed clusters of fetal movement. The presence or absence of acceleration in relation to these movements were noted. RESULTS: There was a highly significant correlation between mother and machine in detection of clusters of fetal movements (r = 0.77, p < 0.001); for episodes of fetal movements, the correlation was weaker (r = 0.23, p < 0.05). All clusters of fetal movements perceived by the mother were recorded by the machine and were associated with fetal heart rate accelerations. Two or more accelerations within 3 minutes of the fetal movements were seen with 87.8% of clusters felt by mother compared with 66.7% detected by the machine (p = 0.01). In the 2,263 minutes of recording in 42 women, a cluster of fetal movements was felt at least every 25 minutes by the mother. CONCLUSION: Maternal perception of 1 or 2 clusters of fetal movements in 30 to 60 minutes may be as reliable as a non-stress test in reassuring good health. It would be less time consuming than the traditional count to 10 fetal movement chart and a more reliable indicator of fetal health than counting episodes of fetal movements. Thus, our study suggests that clusters rather than episodes of fetal movements should be considered for evaluating fetal health based on fetal movements.

Adult↗

PubMed1996

Direct fetal therapy for hydrops secondary to congenital atrioventricular heart block.

BACKGROUND: The outcome for the fetus with hydrops fetalis secondary to complete congenital heart block is almost uniformly poor. Transplacental fetal therapy with inotropic drugs may be unreliable in the hydropic fetus. We describe our experience of direct fetal therapy with digoxin and furosemide in three cases. CASES: In the first two cases, fetal hydrops secondary to congenital heart block was detected at 33 and 31 weeks. Direct fetal therapy with digoxin and furosemide was given and the mothers received digoxin concurrently. The neonates were born normally at 35 weeks and 33 weeks; one required ventricular pacing, but both are currently alive and well. In the third case, fetal hydrops was detected at 24 weeks, when furosemide was used alone for direct fetal therapy. The mother developed chorioamnionitis at 29 weeks and was delivered by cesarean; the infant died of cardiac failure after 48 hours. CONCLUSION: Initial direct fetal therapy with digoxin and furosemide followed by transplacental treatment with digoxin and direct fetal therapy with diuretics might improve the perinatal salvage of hydropic fetuses with congenital heart block. Treatment must be individualized because development of infection and preterm labor might defeat the objective.

Adult↗

PubMed1996

Eye changes in non-specific aorto-arteritis.

Non-specific aorto-arteritis or Takayasu's arteritis is fairly common and has been reported from all parts of India. The disease presents with various eye symptoms such as transient or permanent blindness, headache and signs including neovascularisation, retinal anastomosis, rubeosis iridis, cataracts. Eye manifestations depend on stage of disease and degree of involvement of cervical arteries. This review consists of an indepth impression of eye involvement in non-specific aorto-arteritis.

Eye Diseases↗

PubMed1996

A comparative study of the efficacy and safety of synthetic prostaglandin E2 derivative and 15-methyl prostaglandin F2 alpha in the termination of midtrimester pregnancy.

A comparative study of a synthetic prostaglandin E2 (PGE2) derivative and 15-methyl prostaglandin F2 alpha (PGF2 alpha) in the termination of midtrimester pregnancy of 13-20 weeks of gestation by intramuscular route, showed 97.5% success rate in both the groups but in comparison to 15-methyl PGF2 alpha which produced severe side-effects eg. diarrhoea and vomiting, synthetic PGE2 derivative had minimal or no side-effects.

Abortifacient Agents, Nonsteroidal↗

PubMed1995

Towards improved perinatal care--perinatal audit.

Perinatal audit is a measure of quality of care given in pregnancy and it gives an idea as to how the resources need to be allocated for better outcome. The perinatal mortality data in the National University Hospital over a 7-year period (1986-1992) were compiled and compared with that of the year 1982. The perinatal mortality rate (PNMR) of 14.6/1000 in 1982 declined to 8.9/1000 for the period 1986 to 1992 and the reduction was noticeable in all ethnic groups, particularly in the Malays. When lethal congenital malformations (LCMs) were excluded, the PNMR decreased to 5.7/1000. Such reduction is due to easy availability and acceptance of antenatal care, improvement in antenatal and intrapartum fetal surveillance and advances in neonatal care. Neonatal audit was extended beyond the first 7 days of birth which showed that the majority (65%) of deaths occurred in the first week and 15% occurred after the first month. The fear that intensive neonatal care serves to postpone death is not entirely substantiated. There was nearly a ten-fold rise in PNMR between the non-low birthweight and low birthweight groups. The important causes of perinatal mortality during the review period were LCMs (35.7%), complications of prematurity (17.9%) and asphyxia (15.3%). No cause was identifiable in 28.5%. Detailed analysis revealed that the standard of care could have been improved in a third of the cases (83/235) which could have led to further reduction of perinatal mortality rate.

Asphyxia Neonatorum↗

PubMed1995

Risk factors and angiographic profile of coronary artery disease in young.

A total of 124 patients of ischaemic heart disease under 40 years of age (96 with myocardial infarction and 28 with angina) were studied for risk factors of coronary artery disease. Electrocardiogram, treadmill test, lipid profile and coronary arteriography were done in all cases. Smoking (56.4%) and hyperlipidaemia (30.6%) emerged as the major risk factors. Further stratification of lipid profile revealed that predictive value of hypercholesterolaemia could be enhanced by considering the different ratios of lipoproteins and indices of atherogenicity. Coronary arteriography revealed a preponderance of single vessel disease (48.4%)-left anterior descending being most commonly involved (71.8%). Increase in low density lipoprotein fraction was related to multivessel involvement.

Adult↗

PubMed1995

Vaginismus and outcome of treatment.

Vaginismus is a condition of involuntary spasm of the muscles surrounding the outer third of the vagina that is brought about by real, imagined or anticipated attempts at vaginal penetration and often leads to non-consummation of marriage. It is a classic psychosomatic disorder where phobia of vaginal penetration often stems from sexual ignorance, previous traumatic experiences or religious orthodoxy. Management of vaginismus aims at helping the woman to regain voluntary control of her pelvic floor muscles. The treatment utilises a behavioural method aimed at teaching relaxation of pelvic floor muscles together with a systematic desensitization of the fear of vaginal penetration. There are two approaches to vaginal desensitization. The first is gradual desensitization using vaginal self-dilatation, and the second method utilises rapid desensitization brought about by vaginal mould insertion. Of these, the rapid method is preferred at our institution. Surgical correction is almost never required and may be detrimental to achieving success. Management of these conditions requires a warm, empathetic attitude and demands great patience and understanding on the part of the physician. Between 1985 and 1991, 19 patients with vaginismus were treated at the National University Hospital, with a rapid desensitization programme using vaginal moulds. All 19 women could achieve satisfactory vaginal intercourse within 2 to 6 weeks of commencement of therapy.

Adolescent↗

PubMed1995

Efficacy and safety of oral iron chelating agent deferiprone in beta-thalassemia and hemoglobin E-beta thalassemia.

OBJECTIVES: To assess efficacy and safety of oral iron chelating agent deferiprone (DFP) in patients with beta thalassemia and hemoglobin E-beta thalassemia. DESIGN: Non-randomized study. SETTING: Hematology Out-Patient Department. SUBJECTS: Forty-one patients of beta thalassemia and hemoglobin E-beta thalassemia. INTERVENTIONS: DFP was given to 20 patients, 10 patients of beta thalassemia and 10 with hemoglobin E-beta thalassemia; the rest were taken as controls. RESULTS: A significant fall in serum ferritin was observed in the study group along with rise in urinary iron excretion (p < 0.05). Adverse effects of DFP were nausea and vomiting (30%), significant arthropathy requiring stopping of the drug (30%), and reversible neutropenia in one patient. All these complications could be managed easily with medical supervision and no death or permanent disability was seen. CONCLUSIONS: DFP is an effective and fairly well tolerated oral iron chelating agent. The side effects that occur can be tackled easily if monitored properly.

Administration, Oral↗

PubMed1994

Disorders of platelets in pregnancy.

No significant change in platelet number, function or life-span occurs during pregnancy. However, pregnancy may be complicated by various platelet abnormalities or platelets may be involved in pregnancy pathologies. Thrombocytopenia is the most common platelet disorder to affect pregnancy. It may occur in a number of clinical conditions and both immune and nonimmune mechanisms may be involved. Apart from the risks to the mother, the fetus may be secondarily affected, especially in cases of immunogenic thrombocytopenia. Management of the mother may not necessarily improve fetal prognosis. Improvement in diagnostic techniques like percutaneous umbilical blood sampling (PUBS) has greatly improved in utero diagnosis and management of the affected fetus. The diagnosis and management of the various platelet disorders affecting the pregnant woman and the fetus are discussed in this overview.

Blood Platelet Disorders↗

PubMed1993

Topography of serotonin neurons in the dorsal raphe nucleus that send axon collaterals to the rat prefrontal cortex and nucleus accumbens.

Diverse physiological actions have been reported for 5-hydroxytryptamine (5-HT, serotonin) in the medial prefrontal cortex (MPFC) and the nucleus accumbens (Acb) suggesting that the 5-HT innervation of these forebrain areas may be derived from different populations of neurons. We examined this possibility by mapping the distribution of 5-HT-immunoreactive (ir) and non-5-HT-ir neurons containing retrograde labeling following injections of different tracers into both these target regions. The analysis was focused in the dorsal raphe nucleus (DRN) of the midbrain, since 5-HT pathways to the MPFC and Acb primarily originate from this area. Volume microinjections of the fluorescent retrograde tracer, Fluoro-Gold (FG), were placed into the MPFC and microinjections of cholera toxin B subunit coupled to 15 nm gold particles (CT-Au) were placed into the Acb of the same animal. Sections through the DRN containing retrogradely labeled neurons were further processed for immunofluorescent localization of 5-HT using a rhodamine marker. Neurons retrogradely labeled from the Acb were greater in number overall than those projecting to the MPFC. In addition, Acb-projecting neurons extended into the lateral wings of the DRN, whereas MPFC-projecting neurons were more restricted to the midline. Both groups of retrogradely labeled neurons, however, were more numerous in the caudal aspect of the dorsal raphe nucleus and were scattered amongst 5-HT immunoreactive perikarya. Of 783 +/- 69 CT-Au labeled cells, 15% also contained the FG label and 11% contained FG and 5-HT immunoreactivity. Of 613 +/- 48 FG labeled cells, 24% also contained the CT-Au label and 21% were also immunoreactive to 5-HT. The results suggest a more prominent input to the Acb from both 5-HT-ir and non-5-HT-ir neurons in the caudal aspect of the DRN and further indicate that while most 5-HT-ir and non-5-HT-ir neurons project differentially to both forebrain regions, a few cells also show collateralization to the MPFC and Acb. Such collateralization of single serotonergic neurons to divergent targets may integrate cognitive and motor activities in response to pharmacological manipulations of ascending serotonergic pathways.

Animals↗

PubMed1993

Should assessment of amniotic fluid volume form an integral part of antenatal fetal surveillance of high risk pregnancy?

This study was conducted to evaluate the role of the Amniotic Fluid Index (AFI), used along with nonstress cardiotocography (NST) and fetal acoustic stimulation test (FAST), when required, in prediction of adverse pregnancy outcome. Over a 3-year period 565 pregnant women had antepartum fetal surveillance due to various high risk pregnancy factors and delivered within 7 days of the test. Antepartum fetal surveillance included nonstress cardiotocography together with estimation of AFI. Need for induction of labour, presence of meconium at rupture of membranes, Caesarean section for fetal distress, Apgar score at 5 minutes, need for neonatal endotracheal intubation, admission to neonatal special care unit and perinatal death were the main outcome measures. Nonreactive nonstress tests and Caesarean sections for fetal distress were more common and neonatal outcome was significantly poorer in patients with AFI < 5 cm than in those with higher AFI values. Of the 4 perinatal deaths in the group with AFI < 5 cm, 3 had a reactive NST within 7 days of fetal death. It is concluded that pregnancy outcome is often poor in the presence of very low AFI and in these cases a reactive NST loses its usual reassuring value. It is suggested that AFI estimation should be included as an integral part of antepartum fetal surveillance of high risk pregnancies.

Acoustic Stimulation↗

PubMed1993

Term breech delivery: does X-ray pelvimetry help?

Over a 3-year period a retrospective audit was performed of all uncomplicated singleton breech presentations at term to assess the role of X-ray pelvimetry. The review included 267 term breech presentations. Seventy-seven women (Group A) delivered in a consultant unit where X-ray pelvimetry was not used for decision making regarding the mode of delivery; 125 women (Group B) delivered in 2 consultant units where X-ray pelvimetry was always used, and 65 women (Group C) delivered in a fourth consultant unit where X-ray pelvimetry was used selectively. Obstetric outcome was measured in terms of mode of delivery. Short-term neonatal outcome was assessed by Apgar score at 5 minutes, evidence of birth trauma and admission to the neonatal special care unit for more than 24 hours. Significantly fewer women (12.9%) had an elective Caesarean section in group A compared with the other 2 groups (27.2% in group B and 33.8% in group C; p < 0.05). The vaginal delivery rates following a trial of labour were not significantly different (79.1% for group A, 65.9% for group B and 65.1% for group C) and neonatal outcome was similar in all groups. It is concluded that fewer Caesarean sections were done, without adversely affecting the neonatal outcome, when X-ray pelvimetry was not used to select the mode of delivery of uncomplicated singleton breech presentation at term. Satisfactory progress in labour is the best indicator of pelvic adequacy.

Adult↗

PubMed1993

Profile of women undergoing medical termination of pregnancy in hospital.

The present study was undertaken to find out the profile of women undergoing medical termination of pregnancy (MTP) in Hospital, 1000 consecutive cases undergoing MTP at RG Kar Medical College and Hospital were studied. 95.6% cases were married and 4.4% cases were unmarried. In the whole series, 7.6% cases were teenagers though in unmarried group 90.9% cases were teenagers. In 56% of married group the monthly family income was more than Rs 500/- whereas majority in unmarried group had family income less than Rs 500/- per month. In the whole series, 44.4% cases were illiterate, 48.2% cases were educated up to primary school and only 7.3% cases up to high school and above. In the married group, 204 cases undergoing MTP with one living issue, 388 cases with 2 living issues and 396 cases with 3 living issues. In the whole series, 88% cases were 1st trimester MTP and 12% were 2nd trimester MTP cases, whereas in the unmarried group 72.7% cases were in the 2nd trimester, and 5.7% cases had history of previous MTP. Effective contraception was only 6% before MTP whereas it increased to 90.6% after MTP.

Abortion, Induced↗

PubMed1992

A case report: vesico-rectal fistula with ano-urethral atresia.

Vesico-rectal fistula is a rare congenital abnormality causing severe early second trimester oligohydramnios. Prenatal diagnosis of such a case is reported here. Ultrasound diagnosis could be aided by transabdominal amnio-infusion and, if necessary, fetal intraperitoneal saline installation. In a karyotypically normal fetus with normal somatic growth, demonstration of normal fetal kidneys together with a functioning urinary bladder, in presence of severe oligohydramnios, is very suggestive of the diagnosis. Since pulmonary hypoplasia is the major cause of neonatal mortality in these cases, restoration of normal amniotic fluid volume by serial amnio-infusion was attempted. Although amnio-infusion is an important diagnostic aid in the evaluation of severe midtrimester oligohydramnios, the role of multiple therapeutic amnio-infusion in improving lung growth remains to be evaluated.

Abnormalities, Multiple↗

PubMed1991

Do catechol estrogens participate in the initiation of labor?

To assess the role of catechol estrogens in the initiation of labor, we compared the levels in amniotic fluid during the second and third trimesters and from women undergoing cesarean section at term not in labor and those with spontaneous labor at term. Catechol estrogen concentrations in amniotic fluid increased significantly with the progress of pregnancy. Further, concentrations (mean +/- SE) were significantly higher in spontaneous labor at term (468.6 +/- 29.5 pg/ml) compared with those obtained during cesarean section (242.6 +/- 22.3 pg/ml) at term not in labor. We suggest that catechol estrogens, through their stimulating effects on prostaglandin synthesis, participate in the initiation of labor.

Adult↗

PubMed1991

Identification of 19-norprogesterone in pregnant rat urine.

The existence of biosynthetic pathways leading to the formation of 19-nor-androgens and corticoids have been established in animals and humans. The exact biologic function of the products of these pathways in vivo has yet to be established; however, it has been shown that they possess pronounced biologic activity when administered exogenously. This report describes the identification of 19-nor-progesterone isolated from the urine of pregnant rats. The procedures used included isolation as the underivatized material and methoxime derivative by thin-layer and high-performance chromatography. The identity was further confirmed by gas chromatography/mass spectral analysis of the isolated product as the 3,20-bis-methoxime derivative. The spectra obtained from the urinary product and the authentic 19-norprogesterone-3,20-bis-methoxime were identical. A possible biologic role for 19-norprogesterone or its precursors is discussed.

Animals↗