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Biomedical subjects

A Joshi

Publications and source records attributed to A Joshi.

At least 37 records · Page 2Linked to original sources
PubMed2005

Clinical impact of home automated telemanagement in asthma.

There is a great need to provide effective, on-going education and monitoring for the large numbers of asthmatic patients, in particular for those who have a history of aggravating asthma. The complex asthma self management and the busy modern lifestyles makes it unlikely that patients without outside help and support can effectively follow their self-care plans on a regular basis. This study, evaluated the impact of an asthma self-care support system, delivered by telecommunications and computer technology, which has the potential of making a significant contribution in the management of asthma. Analysis of 40 patients using the system showed a significant improvement in the asthma symptoms, lung function test, adherence to action plan and overall decrease in the use of quick relief inhaler.

Adult↗
PubMed2004

Optimizing the HIV/AIDS informed consent process in India.

BACKGROUND: While the basic ethical issues regarding consent may be universal to all countries, the consent procedures required by international review boards which include detailed scientific and legal information, may not be optimal when administered within certain populations. The time and the technicalities of the process itself intimidate individuals in societies where literacy and awareness about medical and legal rights is low. METHODS: In this study, we examined pregnant women's understanding of group education and counseling (GEC) about HIV/AIDS provided within an antenatal clinic in Maharashtra, India. We then enhanced the GEC process with the use of culturally appropriate visual aids and assessed the subsequent changes in women's understanding of informed consent issues. RESULTS: We found the use of visual aids during group counseling sessions increased women's overall understanding of key issues regarding informed consent from 38% to 72%. Moreover, if these same visuals were reinforced during individual counseling, improvements in women's overall comprehension rose to 96%. CONCLUSIONS: This study demonstrates that complex constructs such as informed consent can be conveyed in populations with little education and within busy government hospital settings, and that the standard model may not be sufficient to ensure true informed consent.

AIDS Serodiagnosis↗
PubMed2004

An investigation of post-operative morbidity following chin graft surgery.

AIM: The aim of this prospective study was to evaluate the morbidity at the donor site following harvest of chin bone for intra-oral augmentation. METHOD: The morbidity experienced by 27 consecutive patients who had undergone chin bone harvesting to augment intra-oral sites prior to implant placement at the Department of Oral and Maxillofacial Surgery, University Dental Hospital of Manchester was evaluated at one week, one, three and 12 months post-operatively. RESULTS: Nine (33%) patients suffered post-operative morbidity. One patient experienced paraesthesia of the chin and lower lip and a further patient, paraesthesia of the gingivae immediately post-operatively. Both patients had full recovery when reviewed at three months. Two patients experienced pain at the graft site for up to three months post-operatively. Five (18.5%) patients experienced woodiness/numbness of the lower anterior teeth at the first post-operative visit and at 12 months, two patients continued to have no sensitivity in the lower anterior incisor teeth. None of the patients reported altered contour or change in profile of the chin area. Twenty-three (85.2%) patients had successful grafts with placement of implants thereafter. CONCLUSION: It is important for GDPs and specialists to make patients aware of the possible morbidities following harvest of bone from the chin.

Adolescent↗
PubMed2004

An investigation of post-operative morbidity following iliac crest graft harvesting.

OBJECTIVE: A study which examined the morbidity experienced by patients who underwent iliac crest bone graft procedures. DESIGN: A post-operative questionnaire was forwarded to patients who underwent iliac crest bone graft procedures at a single centre. SUBJECTS: One hundred and fourteen patients underwent iliac crest bone grafts for intra-oral augmentation. RESULTS: Ninety-eight patients (80%) returned post-operative questionnaires. Eighty of the 98 (81.6%) patients suffered post-operative pain with 70% of patients being pain-free after four weeks. However, 10% of patients experienced pain for more than 16 weeks. Eighty-five (86.7%) patients were able to walk without any difficulties six weeks post-operatively. Gait disturbance was not related with age, however there was a significant association between pain and disturbance of gait (P< 0.001). Twenty two patients required the use of a walking stick and the use of such aids varied from 0.5 to 26 weeks. Women used walking aids for longer periods than men (P< 0.05). Twenty five patients had altered sensation with about half of them experiencing altered sensation in the distribution of the lateral femoral cutaneous nerve. Other morbidities included deformity at the hip site (2.4%), haematoma (2.4%), infection (3.2%), stress fracture (4.1%) and meralgia paraesthetica in one patient. Despite the above morbidities, 82 patients were willing to undergo the same procedure again and 89 patients would recommend the procedure to their relatives and friends. CONCLUSION: This study demonstrates considerable morbidity following anterior iliac crest bone harvest for intra-oral augmentation. Clinicians referring patients for such bone graft procedures must be aware of the above morbidities so that any patients referred for such procedures are fully informed.

Adolescent↗
PubMed2004

Genetic polymorphism of the CYP1A1, CYP2E1, GSTM1 and GSTT1 genes and lung cancer susceptibility in a north indian population.

CYP1A1, CYP2E1, GSTM1 and GSTT1 polymorphisms were evaluated in north Indian lung cancer patients and controls. The estimated relative risk for lung cancer associated with the CYP1A1*2C allele was 2.68. Apart from the CYP1A1*2C genotype, there was no attributable risk in relation to other genotypes when analyzed singly. However, in the presence of a single copy of the variant CYP1A1 (CYP1A1*1/2A) and null GSTT1 genes, there was a three-fold increased risk for lung cancer; when stratified histologically the relative risk increased to 3.7 in case of SQCC. Similarly individuals carrying the mutant CYP1A1*2C genotype and single copy of the variant CYP1A1 Mspl allele, had a relative risk of 2.85 for lung cancer. In case of the GSTM1 and CYP1A1 genotypes, null GSTM1 and variant Msp1 alleles had two-fold elevated risk for SQCC. On the other hand CYP1A1*2C and null GSTM1 genotype had a 3.5-fold elevated risk for SCLC. Stratified analysis indicated a multiplicative interaction between tobacco smoking and variant CYP1A1 genotypes on the risk for SQCC and SCLC. The heavy smokers (BI > 400) with CYP1A1*2C genotype were at a very high risk to develop SCLC with an OR of 29.30 (95% CI = 2.42-355, p = 0.008). Taken together, these findings, the first to be analyzed in north Indian population, suggest that combined GSTT1 , GSTM1 and CYP1A1 polymorphisms could be susceptible to lung cancer induced by bidi (an Indian cigarette) smoking.

Alleles↗
PubMed2004

T-cell modulation for the treatment of chronic plaque psoriasis with efalizumab (Raptiva): mechanisms of action.

Psoriasis is a chronic, incurable, auto-immune disorder with cutaneous manifestations. New evidence on the central role of the immune system in the pathogenesis of psoriasis increasingly provides insight into pathogenic steps that can be modulated to provide disease control. Numerous biological therapies are in various stages of clinical development, with expectation of providing enhanced safety and efficacy over currently available psoriasis therapies. Efalizumab, a recombinant humanized monoclonal IgG1 antibody, is a novel targeted T-cell modulator that inhibits multiple steps in the immune cascade that result in the production and maintenance of psoriatic plaques, including initial T-cell activation and T-cell trafficking into sites of inflammation, including psoriatic skin, with subsequent reactivation in these sites. This article reviews the pharmacodynamic, pharmacokinetic and clinical effects observed during phase I, II and III efalizumab trials in patients with moderate to severe chronic plaque psoriasis.

Adjuvants, Immunologic↗
PubMed2003

Sperm motion characteristics of Garole rams raised for a prolonged period in a semi-arid tropical environment.

The Garole is a prolific but less well known and rare breed of small sheep found in the hot and humid Sunderban region of West Bengal. An ability to breed throughout the year and to graze in knee-deep water, resistance to foot rot and a strong mothering instinct are some of the special features of this breed. Garole rams could provide germplasm to incorporate prolificacy traits by artificial insemination of the nonprolific sheep breeds found in abundance in the semi-arid and arid tropical climates of India. The aim of the present study was to evaluate the semen production by Garole rams maintained in a semi-arid climate for three years and to objectively assess their semen quality by a computer-assisted sperm analysis technique. The donor rams were randomly selected each year from the original flock procured from their natural habitat or from the offspring born at the Institute farm. Semen was collected weekly for three weeks each autumn for three consecutive years from 8 rams each year. The overall means (SD) of the traits that did not differ significantly with age or year were volume, concentration, curvilinear velocity, average path velocity, amplitude of lateral head displacement, beat frequency, motility and the percentages of rapid motile sperms and of slow motile sperms. The age of the rams had a significant effect (p<0.05) on the straight-line velocity but this was not significantly affected by the length of exposure to the semi-arid climate. However, the age and year had significant effects (p<0.05) on linearity, straightness and the percentage of medium motile sperms. It was concluded that Garole rams are capable of producing good-quality semen even after a prolonged period of exposure to a semi-arid tropical climate.

Animals↗
PubMed2003

Women's acceptability and husband's support of rapid HIV testing of pregnant women in India.

This study examined acceptability among pregnant women and their husbands for HIV testing within the antenatal clinic (ANC) and delivery room (DR) of a government hospital in Pune, India from September 2000 to November 2001. Acceptance of HIV counselling and testing was high with 83% of eligible women in the antenatal clinic (851 of 1025) and 68% of eligible women in the delivery room (417 of 613) getting tested on the same day. Structured interviews were conducted on 94 pregnant women in the ANC 50 women in the DR, and 100 husbands who accompanied their wives in the ANC. These data indicated that the majority of women agreed to be tested independently without the need for further consultation with family members, a view that was strongly supported in this sub-sample of accompanying husbands. For delivering women who were not progressing in their labour, counselling in the DR allowed for individual attention to questions and concerns thereby making counselling in the DR feasible.

Adolescent↗
PubMed2003

Awareness of HIV/AIDS and household environment of pregnant women in Pune, India.

Our objective was to determine the level of HIV/AIDS knowledge of pregnant women in India. In a sub-sample of these women, we documented the extent to which they experienced adverse social and physical difficulties within their home. The study was performed at an urban antenatal hospital clinic in Maharastra, India. From April to September 2001, structured interviews were conducted on 707 randomly selected antenatal clinic patients related to HIV/AIDS knowledge. Of these, 283 were further interviewed to document any social or physical difficulties they experienced. Over 75% of women displayed knowledge of primary transmission routes. Nearly 70% of women demonstrated knowledge of maternal to child transmission, however, only 8% knew of any methods of prevention. TV and written material were more strongly related to knowledge than access to radio messages or conversations with individuals. Thirty per cent of the women experienced physical or mental abuse or their spouse's alcohol and/or drug problems. Women reporting such abuse were more than twice as likely to have adequate HIV/AIDS knowledge compared with women reporting no such abuse. We found no relationship between reported household abuse and educational level of woman, husband, occupation of either partner, language or religion. We found no relationship between HIV status and knowledge of HIV and no relationship between HIV status and risk of abuse in the household. However, the total number of HIV patients in our sample was very small.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Unusual perianal tumours masquerading as abscesses.

Tumours of the perianal region and anal canal are uncommon and can present in a variety of ways. Acute anorectal sepsis is a common condition that usually presents as a painful lump close to the anal margin. Tumours in the perianal region may mimic the symptoms and signs of anorectal sepsis, thereby leading to a delay in diagnosis and management. We report three patients who presented to our department with symptoms and signs suggestive of perianal abscess but which on further investigation were discovered to be due to unusual perianal tumours. Only one of the tumours was found to be malignant--a primary perianal mucinous adenocarcinoma; the other two were benign, a leiomyoma and an aggressive angiomyxoma. A high index of clinical suspicion is required to the diagnosis of perianal tumours when assessing patients with painful perianal lumps, particularly those with a long history and those of ethnic origin. Every effort should be made to establish a preoperative diagnosis so that correct treatment can be delivered.

Abscess↗
PubMed2003

Acute superior mesenteric vein thrombosis associated with factor V 'Leiden' gene mutation.

OBJECTIVES: To study thrombophilia states in Indian patients with acute spontaneous superior mesenteric vein thrombosis (SMVT). METHODS: Two men with this condition, a 56 year old and a 31 year old presenting with acute SMVT, demonstrated on CT scan, were subjected to a thrombophilia screen consisting of Protein C, S, antithrombin levels, lupus anticoagulant, anticardiolipin antibodies, fibrinogen levels, factor VIII levels, factor V 'Leiden' gene mutation, and paroxysmal nocturnal hematuria screen. RESULTS: A thrombophilia screen showed factor V 'Leiden' gene mutation (heterozygous) in both cases. Additionally, the first patient had high fibrinogen levels and the second high factor VIII levels. Both patients are currently on long-term anticoagulation. CONCLUSION: Factor V 'Leiden' gene mutation in association with other thrombophilic factors may predispose to spontaneous superior mesenteric vein thrombosis.

Acute Disease↗
PubMed2002

Phase I study of the combination of losoxantrone and cyclophosphamide in patients with refractory solid tumours.

Losoxantrone is a DNA intercalator that was developed with the potential to replace anthracyclines. The recommended single agent dose of losoxantrone is 50 mg m(-2) every 3 weeks. We conducted a phase I study of losoxantrone and a fixed dose of cyclophosphamide on a q3 weekly schedule. Forty-nine patients were enrolled, of which 46 were evaluable for toxicity. The dose-limiting toxicity was neutropenia at the maximum tolerable losoxantrone dose of 45 mg m(-2). With granulocyte colony-stimulating factor support, significant further dose escalation of losoxantrone was achieved. Cardiotoxicity was seen with cumulative dosing. Pharmacokinetics of losoxantrone revealed linear kinetics and triphasic clearance, with significant interpatient variability. No objective responses were seen in this study. Neutropenia was dose-limiting in this combination with or without granulocyte colony-stimulating factor support. The recommended dose for further testing is cyclophosphamide 500 mg m(-2) followed by losoxantrone 95 mg m(-2) with granulocyte colony-stimulating factor support.

Adult↗
PubMed2002

Immunization with a plasmid DNA expressing rinderpest virus hemagglutinin protein protects rabbits from lethal challenge.

Rinderpest virus haemagglutinin (H) protein was expressed in eukaryotic cells and the plasmid encoding H gene was used for immunization of rabbits. The immunized rabbits were completely protected from lethal challenge with virulent lapinized rinderpest virus. Similar results were also observed in rabbits vaccinated with tissue culture rinderpest (TCRP) vaccine. About 80% of control rabbits vaccinated with empty vector (mock-vaccinated) died after challenge. The thermal reactions and clinical symptoms were less intense in H-DNA vaccinated rabbits as compared to the other two groups. Marked lymphopenia was observed in TCRP and mock-vaccinated rabbits after challenge, however, the H-DNA vaccinated rabbits showed lymphocytosis following challenge. The appearance of lymphocytosis in H-DNA vaccinated rabbits is an interesting finding which needs further investigation.

Animals↗
PubMed2002

Developmental plasticity of the locomotor activity rhythm of Drosophila melanogaster.

We used four replicate outbred populations of Drosophila melanogaster to investigate whether the light regimes experienced during the pre-adult (larval and pupal) and early adult stages influence the free-running period (tau(DD)) of the circadian locomotor activity rhythm of adult flies. In a series of two experiments four different populations of flies were raised from egg to eclosion in constant light (LL), in light/dark (LD) 12:12h cycle, and in constant darkness (DD). In the first experiment the adult male and female flies were directly transferred into DD and their locomotor activity was monitored, while in the second experiment the locomotor activity of the emerging adult flies was first assayed in LD 12:12h for 15 days and then in DD for another 15 days. The tau(DD) of the locomotor activity rhythm of flies that were raised in all the three light regimes, LL, LD 12:12h and in DD was significantly different from each other. The tau(DD) of the locomotor activity rhythm of the flies, which were raised in DD during their pre-adult stages, was significantly shorter than that of flies that were raised as pre-adults in LL regime, which in turn was significantly shorter than that of flies raised in LD 12:12h regime. This pattern was consistent across both the experiments. The results of our experiments serve to emphasise the fact that in order to draw meaningful inferences about circadian rhythm parameters in insects, adequate attention should be paid to control and specify the environment in which pre-adult rearing takes place. The pattern of pre-adult and early adult light regime effects that we see differs from that previously observed in studies of mutant strains of D. melanogaster, and therefore, also points to the potential importance of inter-strain differences in the response of circadian organisation to external influences.

Journal Article↗