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Biomedical subjects

A Joshi

Publications and source records attributed to A Joshi.

At least 127 records · Page 7Linked to original sources
PubMed1998

Falciparum malaria and pregnancy.

Falciparum malaria in pregnancy is a significant health problem in India. Pregnant women constitute an important high risk group for malaria infection which may cause abortion, still births, intra uterine growth retardation (IUGR), and pre-mature labour. Two hundred eighty-eight admitted female patients of falciparum malaria were included in the study out of which 45 were pregnant. The mortality rate was highly significant in pregnant females (37.77%) in comparison to non-pregnant females (14.81%); (p < 0.001). The incidence of various pernicious syndromes including cerebral malaria, severe anaemia (Hb < 5 g%) hepatic and renal failure were more in pregnant females in comparison to non-pregnant females. The incidence of infection was higher among primigravida and second gravida 30/45 (66.66%) as compared to multigravida 15/45 (33.33%) and the greater incidence of infection was seen during 14-28 wk of gestation 23/45 (51.11%). Pregnancy related complications in the form of preterm live birth (20%). Intra uterine death (IUD 31.11%), still births (13.33%) and abortions (11.11%) were more pronounced in primiparous women as compared to multiparous. Weight of placenta in majority of patients ranged between 200-400 g (22/31; 70.96%). Normal pregnancy continued in only 11 out of 45 pregnant females, out of which seven had low birth weight body (63.63%). As the pregnancy is associated with increased incidence and adverse outcome of falciparum malaria infection, chemoprophylaxis should be made an integral part of antenatal care along with antianaemic therapy to reduce the risk of serious maternal and fetal complications.

Female↗
PubMed1998

The spectrum of chronic autoimmune hepatitis.

Autoimmune hepatitis (AIH) is characterised by the presence of periportal hepatitis coupled with the presence of autoantibodies in the serum. We report our experience with 10 cases (females--8, males--2) who presented to the rheumatology clinic with either articular or extra-articular manifestations. Three patients (1 SLE, 1 Sjogren's and 1 RA), satisfied the criteria for an underlying rheumatic disease (secondary AIH) while, others had primary AIH. Median duration of hepatic involvement was 6 months and the varied presentations were noted. Articular disease ranged from arthralgias, palindromic arthritis to persistent non-erosive/non-deforming arthritis (Jaccoud's arthritis). Autoimmune thrombocytopenia was seen in 2 and autoimmune hypo and hyperthyroidism were seen in 3 patients each. Anti-nuclear antibody was positive in 9/10 (6 with speckled pattern and 3 with homogenous pattern) and anti-mitochondrial antibodies were positive in three. Hepatitis C virus (HCV) markers were positive in 1, who probably had viral hepatitis with dominant autoimmune features. All have been started on steroids (5 patients--1 mg/kg dose, 1 patient--0.5 mg/kg dose and 3 patients--0.25 mg/kg dose). The HCV positive patient was on a low dose steroid (0.25 mg/kg) and interferron treatment was contemplated before she was lost to follow up. Four patients are also on azathioprine in the dose of 2 mg/kg/day. Of the 6 patients who are under regular follow up, the liver parameters have normalised in 5 and one showed hypoalbuminaemia with normal enzyme levels at the last follow up.

Adolescent↗
PubMed1998

Herpes zoster and post-herpetic neuralgia--a clinical trial of aspirin in chloroform for anodyne.

Pain associated with Herpes Zoster (HZ) and Post-herpetic Neuralgia (PHN) has been a challenging task to manage with ease. Topical aspirin dissolved in chloroform is an effective means of reducing pain due to HZ and PHN in most patients. The locus of pain origin and analgesia induced by topical aspirin is supposed to be at cutaneous free nerve ending pain receptors. The present study was conduced in fifty two patients of HZ and PHN. Pain intensity before and after the application of drug was measured with help of Sort Form McGill Pain Questionnaire (SE-MPQ). Most of the patients experienced relief of pain within 1-5 minutes after the aspirin-chloroform application. Maximum relief was achieved in about 30-40 minutes and persisted for 5-6 hrs. In the beginning 3-4 applications were required but frequency decreased gradually as the pain abated.

Administration, Topical↗
PubMed1998

Humeral fracture secondary to civilian gunshot injury.

Violence is the leading cause of death in the USA. The cost of violence due to gunshot wound is about $425 billion. While the closed fracture of the humerus is common, humeral shaft fractures caused by gunshot wound occur infrequently. There is much controversy regarding their management, i.e. should these injuries be treated surgically or can they be safely treated with minimal intervention. The aim of this study is to review our experience in the management of fourteen patients with a humeral fracture due to gunshot wounds. Of fourteen, seven patients were treated with local debridement, oral antibiotics and fracture brace. The remaining seven patients underwent surgical stabilization of the fracture. The time to union was similar in both groups (6 weeks in non-operative to 9 weeks in open treatment). In conclusion, fracture of the humeral shaft secondary to low velocity gunshot wound in the civilian setting can safely be treated as a closed fracture with local wound care and oral antibiotics.

Adolescent↗
PubMed1997

Pseudodefect of the talar dome: an anatomic pitfall of ankle MR imaging.

PURPOSE: To identify a normal groove in the posterior aspect of the talus as a potential pitfall in interpretation of ankle magnetic resonance (MR) images. MATERIALS AND METHODS: In 40 patients, T1-weighted spin-echo and T2-weighted fast spin-echo sagittal MR images were retrospectively reviewed from 47 consecutive routine ankle examinations. The patients were referred for evaluation of ligament and tendon abnormalities, such as tendinitis and tear, and suspected osseous and osteochondral injuries. Images were assessed for the presence of an erosion-like defect in the posterior aspect of the talar dome. Radiographs were available in 13 cases. Sagittal T1-weighted spin-echo sequences were also performed in 14 embalmed cadaveric ankles, followed by sectioning and dissection of three specimens. RESULTS: A defect was seen in 45 of 47 ankle MR imaging examinations. Radiographs did not show the defect. All 14 cadaveric ankles demonstrated the defect at MR imaging. At anatomic dissection, the defect was a normal groove for the passage of the posterior talofibular ligament. CONCLUSION: The pseudodefect of the talar dome is a normal groove for the posterior talofibular ligament and should not be misinterpreted as an articular erosion or osteochondral defect.

Adolescent↗
PubMed1997

Experimental model of obstructive jaundice in mongrel dog: study of subsequent pathological changes in liver.

BACKGROUND: Attempts at creating an experimental model of obstructive jaundice in large animals have been unsuccessful because of frequent fistulization of the ligated bile duct. OBJECTIVES: To produce a model of obstructive jaundice in mongrel dogs and to study subsequent serial pathological changes in the liver. METHODS: Four techniques were evaluated in four dogs to produce obstructive jaundice. After creation of a successful model, subsequent clinical and biochemical outcome and serial pathological changes in the liver were studied in another 14 dogs. RESULTS: Complete extrahepatic biliary dissection produced a model of persistent obstructive jaundice. Serial histological changes included inflammation and edema in the first 14 days followed by lymphocytic infiltration at 28 days. Fibrosis started by day 7 and resulted in architectural distortion by day 21. CONCLUSION: An acute, complete and irreversible model of obstructive jaundice can be produced by extrahepatic biliary tree excision and ligation. Serial pathological changes showed acute inflammation, followed by fibrosis and architectural distortion.

Animals↗
PubMed1996

Fatty acid synthase: in vitro complementation of inactive mutants.

The animal fatty acid synthase is a dimer of identical, multifunctional 272 kDa subunits oriented antiparallel such that two centers for fatty acid synthesis are formed at the subunit interface. In order to clarify the interdomain and intersubunit communications necessary for the operation of the two centers, we have explored the possibility of reassembling catalytically-active fatty acid synthase heterodimers from pairs of inactive dimers carrying mutations in different functional domains. To this end, rat fatty acid synthase mutants, defective in either the beta-ketoacyl synthase, C161T or K326A (KS- FAS), or the acyl carrier protein, S2151A (ACP- FAS), domains, were engineered by site-directed mutagenesis, expressed in insect Sf9 cells using a baculovirus expression system, and purified. A novel procedure was devised to facilitate rapid production and isolation of a population of mixed mutant dimers that had undergone randomization of its constituent subunits. Homodimeric mutants (KS- FAS/KS- FAS and ACP- FAS/ACP- FAS) and KS- FAS heterodimers consisting of paired C161T and K326A mutant subunits were unable to synthesize fatty acids, confirming the essential nature of residues C161, K326, and S2151A. However, KS- FAS/ACP- FAS heterodimers regained partial activity. Formation of these heterodimers necessitated prior dissociation and reassociation of the homodimers, indicating that the rate of spontaneous exchange of subunits in the dimer is negligible. The formation of catalytically-active heterodimers from pairs of inactive, complementary homodimers affords a useful method for testing the validity of the current model for the multifunctional complex.

3-Oxoacyl-(Acyl-Carrier-Protein) Synthase↗
PubMed1996

Sex dependent immune responses by allogenic LDH isozymes.

Regulatory effects on polyclonal activation of primed splenocytes have been studied following immunization through the intrarectal route with allogenic sperm specific lactate dehydrogenase (LDH-C4) and somatic LDH from kidney. Results indicate that LDH primed cell proliferation by mitogens is dependent on the nature of the isozyme and sex of donor cells. Compared to somatic LDH, LDH-C4 was immunosuppressive for T cell proliferation in vitro and the effect was more significant with female splenocytes as compared to male spleen cells. However, the suppressive effect of LDH-C4, on B cell function was identical in both males and females. In contrast to the somatic LDH which did not produce alloantibody in significant amount, LDH-C4 was highly immunogenic in production of humoral antibody in female mice. Alloantibody formation in dams was substantiated with a similar degree of immune regulation of B cell functions as shown by lipopolysaccharide stimulation. The role of LDH-C4 in protection of allogenic sperm in the female genital tract has been suggested. However, it is concluded that recipients of sperm constituents through the intrarectal route are at greater risk for immune suppression and bacterial/viral infection.

Animals↗
PubMed1996

Complete edentulism and denture use for elders in New England.

The purpose of this study was to collect information about the oral health of a representative group of elders in the New England states. This study provides the most current descriptive analysis of completely edentulous noninstitutionalized elders to date. In-home examinations and interviews were conducted for a representative sample of elders over 70 years of age. The oral examinations and interviews were conducted by calibrated dentists and trained interviewers, respectively. Of 1156 study participants, 424 (36.7%) were edentulous. Edentulous rates were similar for men and women and were negatively related to levels of education and income. Of the completely edentulous individuals, 89.9% had maxillary and mandibular complete dentures. Most of these dentures (83.2%) were worn during the day. More than one third of the respondents reported wearing one or both of their dentures while sleeping at night. For 77 of the completely edentulous individuals, examination revealed denture irritations, most of which were on the hard palate.

Aged↗
PubMed1996

Predictive factors for acute renal failure in thoracic and thoracoabdominal aortic aneurysm surgery.

PURPOSE: The purpose of this study was to analyze the factors associated with acute renal failure in total descending thoracic and thoracoabdominal aortic aneurysm surgery. METHODS: A total of 234 patients underwent thoracoabdominal aortic aneurysm or total descending thoracic aneurysm repair between January 1991 and January 1994. Eighty-five women and 149 men were evaluated. The median age was 67 years (range 8 to 88 years). Seventy-seven patients had type I thoracoabdominal aortic aneurysm, 99 had type II, 51 had type III or IV, and 7 had total descending thoracic aneurysm. Factors such as age, sex, aneurysm type, and visceral and distal aortic perfusion were examined with univariate fourfold table and multivariate logistic regression analysis. RESULTS: Acute renal failure, defined as an increase in serum creatinine by 1 mg/dl per day for two consecutive days after surgery, occurred in 41 (17.5%) of 234 patients. Thirty-six (15%) of 234 patients required dialysis. Twenty (49%) of 41 patients with acute renal failure died. Of the 21 survivors with renal failure, renal failure resolved in 18 (86%) within 30 days of surgery. The univariate odds ratio of death, given acute renal failure, was 6.7 (95% confidence interval [CI] 3.2 to 14.2, p < 0.0001). No significant association was found between the probability of acute renal failure and age, sex, hypertension, right renal artery reattachment, or renal bypass. Factors associated with increased risk of acute renal failure in multivariate analysis were visceral perfusion (odds ratio [OR] = 3.6 95%, CI 1.2 to 11.0, p < 0.02), left renal artery reattachment (OR = 4.4 95%, CI 1.6 to 11.9, p < 0.004), preoperative creatinine > or = 2.8 mg/dl (OR = 10.3, 95% CI 12.0 to 411.8, p < 0.0001), and simple clamp technique (OR = 3.4 95%, CI 1.07 to 10.76, p < 0.04). Direct univariate correlation was seen between preoperative creatinine and acute renal failure (OR = 3.2 per mg/dl increase, 95% CI 2.7 to 10.1, p < 0.0001). CONCLUSION: Postoperative acute renal failure after thoracoabdominal and total descending thoracic aortic aneurysm surgery is associated with preoperative creatinine level, visceral perfusion, left renal artery reattachment, and simple cross-clamp technique.

Acute Kidney Injury↗
PubMed1996

Genetics of larval urea tolerance in Drosophila melanogaster.

The genetic control of larval tolerance to urea, a nitrogenous waste-product occurring naturally in crowded Drosophila cultures, was investigated in a set of five laboratory populations of D. melanogaster that had been successfully subjected to selection for increased larval urea tolerance. Larva to adult survivorship and development time at three different levels of urea were assayed on the five selected populations, their five matched controls and a set of 10 F1 hybrid populations derived from reciprocal crosses between pairs of selected and control populations. As expected from the results of previous studies, the selected populations exhibited greater larval tolerance to the toxic effects of urea, relative to their controls. Comparison of the hybrid and parental populations with respect to both survivorship and development time indicated that the genetic control of urea tolerance in the selected populations is largely dominant, and has a significant X-linked component. The data also suggested that females from the selected populations exercise a nongenetic maternal effect on the development time of their progeny, regardless of urea level.

Adaptation, Physiological↗
PubMed1996

Regression of pyuria during the treatment of symptomatic urinary tract infection in patients with spinal cord injury.

Pyuria is frequently present in patients who require bladder instrumentation. Using the hemocytometer chamber method, we prospectively studied the regression of pyuria in 29 spinal cord-injured (SCI) men with symptomatic urinary tract infection (UTI) who were grouped according to the method of bladder drainage: (a) Intermittent catheterization program (ICP; 10 patients); (b) Suprapubic tube (SPT; 10 patients); and (c) Indwelling foley catheters (IFC; 9 patients). All of the patients experienced relief of presenting symptoms within 3-4 days of receiving appropriate antibiotic therapy. The clinical response was associated with > or = 65% and > or = 87% reduction in the levels of pyuria at mid-therapy and after completion of antimicrobial therapy, respectively. Using a one-way analysis of variance, the group of patients who underwent ICP had significantly lower residual levels of pyuria at mid-therapy and after completion of therapy when compared to the other two groups (P < 0.05). The findings of relatively lower absolute levels of pyuria in the ICP group vs the SPT and IFC group of patients suggest that the response of pyuria to appropriate therapy for symptomatic UTI can be assessed better and earlier in patients who undergo ICP.

Adult↗
PubMed1996

Consequences of success: do more teeth translate into more disease and utilization?

OBJECTIVES: Increased tooth retention coupled with increased numbers of older adults means that the actual number of teeth at risk to dental disease will increase sharply. Whether this increase in the number of teeth will translate into more disease and utilization in unknown. The purpose of this study was to test this "more teeth, therefore more dental disease" theory using cross-sectional data. METHODS: In-home personal interview and oral examination data were obtained on a probability sample of elders aged 70 years and older living in the six New England states using the Medicare beneficiary list as a sampling frame. Data on dental utilization, number of teeth, dental caries, and periodontal disease were included in the current analysis. RESULTS: Analysis of variance on subjects with 1-10 (Group 1), 11-24 (Group 2), and 25-32 (Group 3) teeth show that the extent of bleeding on probing, pocket depth, and loss of attachment all increase as numbers of teeth increase. Similarly, a greater number of restored coronal and root surfaces were found in Group 3 relative to the other two groups. Mean numbers of decayed and filled coronal surfaces were 8.4 in Group 1.33.0 in Group 2, and 50.3 in Group 3. In contrast, unrestored coronal and root surface were significantly higher in Group 1 (mean root DS = 1.3) than Group 3 (mean root DS = 0.3). Utilization patterns of those with successful aging dentitions (Group 3) show that they are visiting dentists more frequently than the compromised group (Group 1). CONCLUSIONS: These cross-sectional data obtained from a probability sample of New England elders show that subjects who retained higher numbers of teeth have more periodontal disease and dental caries experience, and visit the dentist more frequently.

Aged↗
PubMed1996

A new method for determining corneal epithelial barrier to fluorescein in humans.

PURPOSE: To derive the value of corneal epithelial barrier to fluorescein in humans from experiments in which the fluorophore in instilled in a single drop. METHOD: A commercial scanning fluorophotometer, the Fluorotron Master, was used to scan through an anterior segment. It could not resolve the tear film from the cornea, but in the early stages of measurement, the tear component predominated. After 20 minutes, the remaining fluorescein was washed out of conjunctival sac, and the amount that penetrated into the cornea was estimated. Because the resolution was not sufficient to estimate the concentrations, the total masses in the tear film and in the cornea derived from the area under the profile were used to calculate the epithelial permeability. A value for the tear film thickness had to be assumed. RESULTS: The technique led to reproducible values for epithelial permeability-a range of 2:1 in a subject. High concentrations of fluorescein were required to achieve a sufficient penetration into the cornea, and this led to error in estimating the tear film concentration of the dye. A method is presented that corrects for this effect. For 17 normal subjects, the corrected permeability was 0.15 nm/second, and the tear turnover was 0.15/minute ( +/- 0.016, standard error.) CONCLUSIONS: This technique is convenient and yields two useful physiological parameters from a single clinical procedure. The permeability values are considerably higher than those found by previous workers, and the source of the discrepancy is discussed.

Absorption↗
PubMed1995

Male gamete output of asexuals and the dynamics of populations polymorphic for reproductive mode.

Most asexual plants retain male sexual function, albeit at levels much lower than their sexual counterparts. This phenomenon has not typically received full representation in mathematical models of the cost of sex. We formulate and analyze a genetic model of reproductive mode in order to study the evolutionary dynamics of populations consisting of both sexual and asexual individuals. Our model incorporates levels of production and fertility of male gametes produced by individuals that are asexual in their female function, that vary from zero to a level equal to that in a sexual individual. This encompasses a range of naturally occurring situations that has been beyond the scope of most previous theoretical studies. We show that the cost of sex is frequency-dependent in many biologically relevant situations. Consequently, the fitness advantage needed for sexuals to resist invasion by asexuals may frequently be much less than twofold. However, the fitness advantage required for sexuals successfully to invade an asexual population may be much higher. Moreover, the viability/fertility advantage required by sexuals to equal the fitness of asexuals is not necessarily equal to the intrinsic cost of sex, but may be greater when asexual individuals produce fertile male gametes. We also show that panmictic populations cannot be stably polymorphic for reproductive mode when fitnesses are constant, and that the conditions for the fixation of sexual or asexual genotypes are not affected by the degree of dominance at the locus determining reproductive mode. With frequency-dependence, and no possibility of stable polymorphism, the reproductive mode that finally evolves will, in many cases, depend upon the initial frequencies of asexual and sexual individuals.

Biological Evolution↗