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Biomedical subjects

A Prakash

Publications and source records attributed to A Prakash.

At least 19 recordsLinked to original sources
PubMed2006

Laparoscopic esophagogastrectomy without thoracic or cervical access for adenocarcinoma of the gastroesophageal junction: an Indian experience from a tertiary center.

BACKGROUND: The phenomenal progress of minimally invasive surgery has imparted its influence on conventional esophagectomy. Currently, more esophagectomies are being performed by laparoscopic and/or thoracoscopic methods. Esophagogastrectomy for the adenocarcinoma of the gastroesophageal (GE) junction has been a conventional treatment. The literature is limited regarding the laparoscopic approach to esophagogastrectomy. The aim of this study was to evaluate the outcome of laparoscopic esophagogastrectomy in the management of adenocarcinoma of the GE junction. METHODS: From January 1997 to February 2005, laparoscopic esophagogastrectomy was performed in 32 patients. Indication for operation was adenocarcinoma of the GE junction in all patients. Neo-adjuvant therapy was used in two patients (6.88%) only. Initially, our approach to intrathoracic anastomosis without thoracic and cervical access was to introduce the anvil of circular stapler through minilaparotomy incision (n = 22), but later we switched to trans-oral placement of anvil into the distal end of the esophagus (n = 10). RESULTS: There were 22 men and 10 women. Median age was 61.8 years (range, 39-72). There was no conversion. The laparoscopic esophagogastrectomy was completed in all patients. The pyloromyotomy and feeding jejunostomy were performed in all cases. The median intensive care unit stay was 1 day (range, 1-28); hospital stay was 7 days (range, 5-42). Mean estimated blood loss and mean operative time were 150 ml and 200 min, respectively. At mean follow-up of 14 months (range, 2-40), stage-specific survival was similar to that of other series. CONCLUSION: In selected cases of adenocarcinoma of the GE junction, laparoscopic esophagogastrectomy offers as good as or better results than open operation in our institution with extensive advance endoscopic and open experience. This study shows that laparoscopic esophagogastrectomy has potential to meet oncologic criteria of clearance and provide the benefits of minimally invasive surgery as well.

Adenocarcinoma↗
PubMed2006

Ataxia and deafness in a young male: an unusual aetiology.

We report here a case of 18 year old male with tremors of hands, deafness, tendency to fall while walking, drowsiness and double vision of total duration 1(1/2) years. He had internuclear ophthalmoplegia, broken saccades, hypertonia and hyperreflexia of all four limbs, intention tremors, signs of gait and limb ataxia. Pupillary reactions and fundus examination were normal and signs of meningeal irritation or sensory neurological deficit were absent. MRI head and cervical spine with gadolinium enhancement revealed demyelination as evident from multiple oblong foci isointense on T1-weighted images and hyperintense on T2-weighted and fluid attenuated inversion recovery sequences in corpus callosum, sub-cortical white matter, right thalamus, pons and periaqueductal region of midbrain. Ill-defined linear hyperintense signals were observed in cervical spinal cord. No skeletal abnormality was noted in the skull or cervical spine. Oligoclonal bands were present in the cerebrospinal fluid. Brainstem auditory evoked potentials were abnormal, although visual evoked potentials were in normal range. A diagnosis of primary progressive multiple sclerosis (PPMS) was made fulfilling the revised criteria as laid down. In view of its presentation, it is a unique case of PPMS from India.

Adolescent↗
PubMed2006

International livestock markets and the impact of animal disease.

Escalating and pervasive outbreaks of animal diseases are posing considerable challenges to livestock producers, industries, and policy-makers around the globe in a context of steadily rising demand for locally produced and imported livestock products. This paper reviews the factors and trends underpinning the growth in meat trade over the past decade and assesses the impact of animal diseases on international markets. The factors shaping the transmission of the impact of animal disease to global markets and back into domestic markets are identified and the potential global market impact of further animal disease outbreaks evaluated.

Animal Diseases↗
PubMed2005

Acid-adaptation does not increase the resistance of Listeria monocytogenes to irradiation in a seafood salad.

Stress adaptation of microbial cells enables the cells to survive better when they are subsequently exposed to other types of stresses. In the food industry, pathogens are commonly stressed during food processing and this is a concern where pathogens such as Listeria monocytogenes are involved. Research was conducted to determine if acid adaptation of L. monocytogenes provides resistance to ionizing irradiation. Three different strains of L. monocytogenes were acid-adapted using three different acids (acetic, citric, lactic) in Tryptic Soy Broth, at a pH 5.5 for 1 h, 4 h, or continuous acid exposure. The acid-adapted L. monocytogenes were then exposed to a low level of gamma irradiation (0.59-0.72 kGy) along with a non-acid adapted L. monocytogenes control. In a test tube study, the 1-h acetic acid-adapted L. monocytogenes strains showed the greatest difference from the control, a reduced kill of 1.1 log CFU/g but this difference was not significant by ANOVA (p=0.054). The reduction achieved after 4 h and continuous acid exposure also did not significantly differ from the control. To determine whether acid adaptation affected radiation resistance within a food product, a refrigerated storage shelf-life study was completed. Acetic acid was used to acid adapt a three-strain cocktail of L. monocytogenes for a period of 1 h. The organisms were then inoculated into a seafood salad (pH 5.15) and subsequently exposed to low dose gamma irradiation (0.7 to 4.5 kGy). L. monocytogenes was reduced or eliminated by irradiation regardless of acid adaptation; no increased resistance was observed.

Acetic Acid↗
PubMed2005

Tuning the reactivity of energetic nanoparticles by creation of a core-shell nanostructure.

This article presents a novel method for tuning the reactivity of nanoenergetic materials by coating a strong oxidizer nanoparticle (potassium permanganate; approximately 150 nm) with a layer of a relatively mild oxidizer (iron oxide). The measured reactivity for a nano-Al/composite oxidizer could be varied by more than a factor of 10, as measured by the pressurization rate in a closed vessel (psl/micros), by changing the coating thickness of the iron oxide. The composite oxidizer nanoparticles were synthesized by a new aerosol approach in which the nonwetting interaction between iron oxide and molten potassium permanganate aids the phase segregation of a nanocomposite droplet into a core-shell structure.

Aluminum↗
PubMed2005

Malaria transmission risk by the mosquito Anopheles baimaii (formerly known as An. dirus species D) at different hours of the night in North-east India.

The risk of acquiring malaria transmitted by Anopheles baimaii Sallum & Peyton, 2005, formerly known as An. dirus species D (Sallum et al., 2005) (Diptera: Culicidae), at different hours of the night in a forest-fringed village of Assam, North-east India was assessed through all-night mosquito landing catches during 1995-2000. An estimated overall mean biting rate of 36.1 bites/person/night (95% CI = 26.2-45.8), a sporozoite rate of 1.9% (95% CI = 1.1-2.9%) and a parous rate of 58.7% (95% CI = 55.3-62.0%) were recorded. Parous and sporozoite-positive females tended to be caught mainly before midnight. The effective entomological inoculation rate was the highest (0.249 positive bites/person/night) from 21.00 to 24.00 hours, suggesting that the second quartile of the night is the most risky period for malaria transmission by An. baimaii. Considering that approximately 21% of mean inoculations take place before 21.00 hours, it appears that there is a need for appropriate protective measures during the pre-bed time period to supplement the impact of insecticide-treated nets against An. baimaii in north-east India.

Animals↗
PubMed2004

Wandering spleen with torsion of vascular pedicle: early diagnosis with multiplaner reformation technique of multislice spiral CT.

Wandering spleen is a rare clinical radiologic entity characterized by splenic hypermobility due to laxity or maldevelopment of the supporting splenic ligaments. The cause for hypermobility may be hormonal changes during pregnancy or failure of fusion of the dorsal peritoneum. Patients may be asymptomatic, present with a movable lump in the abdomen, or present with acute, chronic, or intermittent symptoms due to torsion of the wandering spleen. Early clinical diagnosis is difficult, so imaging modalities play an important role. We report a case of wandering spleen in which multiplanar reformation of thin maximum intensity projection images played a pivotal role in its precise diagnosis.

Abdominal Pain↗
PubMed2004

Misoprostol vs. oxytocin for induction of labor at term.

Efficacy of misoprostol was studied for induction of labor at term. Seventy patients were randomized to Group A (n = 36, oral misoprostol 50 microg four hourly to maximum of 5 doses) and B (n = 34, continuous oxytocin infusion). Induction-delivery interval was shorter with misoprostol (7.7 +/- 2.8 h against 14.3 +/- 4.8 h with oxytocin) but the rates of vaginal delivery, cesarean, neonatal outcome variables were similar. Hence, misoprostol is an effective agent for induction of labor at term.

Administration, Oral↗
PubMed2004

Motif discovery in heterogeneous sequence data.

This paper introduces the first integrated algorithm designed to discover novel motifs in heterogeneous sequence data, which is comprised of coregulated genes from a single genome together with the orthologs of these genes from other genomes. Results are presented for regulons in yeasts, worms, and mammals.

Algorithms↗
PubMed2004

Role of the prevalent Anopheles species in the transmission of Plasmodium falciparum and P. vivax in Assam state, north-eastern India.

In north-eastern India, Anopheles minimus, An. dirus and An. fluviatilis are considered the three major vectors of the parasites causing human malaria. The role in transmission of the other Anopheles species present in this region is not, however, very clear. To examine the vectorial role of the more common anopheline mosquitoes, the heads and thoraces of 4126 female Anopheles belonging to 16 species (collected using miniature light traps set in human dwellings in a foothill village in the Jorhat district of Assam state) were tested, in ELISA, for the circumsporozoite proteins (CSP) of Plasmodium falciparum or the VK-210 and VK-247 polymorphs of P. vivax. Sixty-five pools of head-thorax homogenates, representing 10 different species of Anopheles, were found reactive, giving an overall minimum prevalence of infection (MPI) of 1.58%, with a 95% confidence interval (CI) of 1.21%-2.0%. Among the CSP-reactive pools of mosquitoes, 31% were positive only for P. falciparum, 45% only for P. vivax VK 247, 6% only for P. vivax VK 210, and 18% for both P. falciparum and P. vivax VK 247. The results indicate that not only the proven vector, An. minimus s.l. (MPI = 0.71%), but also several species of Anopheles previously considered unimportant in the epidemiology of malaria, especially An. aconitus (MPI = 3.95%), An. annularis (MPI = 5.8%), the An. hyrcanus group (MPI = 0.48%), An. kochi (MPI = 1.28%), the An. philippinensis-nivipes complex (MPI = 0.94%), and An. vagus (MPI = 3.87%), are important vectors in the foothills of Assam.

Animals↗
PubMed2003

Efficacy of GM-CSF as an adjuvant to hepatitis B vaccination in patients with chronic renal failure--results of a prospective, randomized trial.

BACKGROUND: Chronic renal failure patients on hemodialysis are at an increased risk of acquiring hepatitis B infection. Hence vaccination against hepatitis B assumes great importance in these patients. However, the response to hepatitis B vaccination is poor, even when 4 double doses (40 microg) of the vaccine are given. This study was conducted to determine the efficacy of GM-CSF as an adjuvant to hepatitis B vaccine in CRF patients. METHODS: CRF patients including both hemodialysis (HD) and non-dialysis (ND) patients were randomized to receive either placebo or a single injection of GM-CSF (in varying doses of 50 microg, 100 microg, 150 microg) a day prior to the 1st dose of recombinant hepatitis B vaccine (40 microg). Three more doses of the vaccine were given at 1, 2, and 6 months. The anti-HBs antibody titres were measured by ELISA at 3 and 7 months. Patients having antibody titres less than 10 IU/L were considered non-responders. The response rate and mean antibody titers were compared between the control (I) and GM-CSF (II) groups. RESULTS: In group I, 31 and 27 patients were available for evaluation at 3 and 7 months respectively. In group II, 33 and 28 patients could be evaluated at the same time points. Within the control group (group I), the response rate in hemodialysis patients (63.6%) was lower as compared to non-dialysis patients (81.2%). The response rate in group II was higher than that in group I at both 3 months as well as 7 months (78.1% vs. 62.3% and 89.3% vs. 74.1%, p = ns). The best response rates in group II were observed when GM-CSF was used in a dose of 150 microg (90.9% at 3 months and 100% at 7 months). The mean antibody titers were also found to be higher in the group II as compared to group I (409.6 vs. 243.9 IU/L, p = 0.01). CONCLUSION: The results of this randomized, prospective study suggest that: 1. Patients with chronic renal failure should be vaccinated for hepatitis B as chronic renal insufficiency is established. 2. GM-CSF is an effective adjuvant to hepatitis B vaccine in these patients especially when a priming dose of 150 microg is used prior to 1st dose of hepatitis B vaccination.

Adult↗
PubMed2003

Plummer's nails.

Explore the source record for details and available documents.

Adult↗
PubMed2003

Mediastinitis presenting as pyrexia of unknown origin.

A 55 year old female was admitted as a case of pyrexia of unknown origin (PUO) of 2 months duration. She had developed throat ache, progressive dysphagia for both solids and liquids, dry cough and retrosternal pain for one week. Examination revealed fever, tachycardia, tachypnoea and a soft tissue warm tender, erythematous, non-fluctuant swelling in lower anterior neck with chest findings suggestive of bilateral pleural effusion. Plain X-rays of the neck and chest strengthened the clinical suspicion of cellulitis of lower neck with bilateral pleural effusion. CT scan confirmed the radiologic findings and also revealed pericardial effusion and thickening; small mediastinal lymphadenopathy and mediastinitis. Patient responded to parenteral antibiotics (ceftriaxone and metronidazole) and hydrocortisone with complete resolution in 10 days.

Anti-Bacterial Agents↗
PubMed2003

Effect of losartan on albuminuria, peripheral and autonomic neuropathy in normotensive microalbuminuric type 2 diabetics.

BACKGROUND: Angiotensin converting enzyme (ACE) inhibitors are emerging as effective agents for preventing microvascular complications of diabetes. Losartan (angiotensin II antagonist) has an antihypertensive efficacy equivalent to ACE inhibitors, however its role in microvascular complications is not yet known. MATERIAL AND METHODS: We studied the efficacy of losartan (50 mg once daily for 12 weeks) on albuminuria, peripheral and autonomic neuropathy in 25 normotensive microalbuminuric type 2 diabetics who were asymptomatic for neuropathy. RESULTS: Mean age was 46.6 +/- 4.34 years with the average duration of diabetes being 8.1 +/- 1.54 years. Albuminuria improved significantly from 54 +/- 9.35 mg/L to 32.8 +/- 25 mg/L (Paired student's t-test, P=0.0005) after therapy. Autonomic neuropathy was observed in 64% while 76% had peripheral neuropathy; but there was no improvement with losartan. The duration of diabetes had a negative correlation with autonomic neuropathy. It also had a similar negative correlation with median and common peroneal nerve motor conduction velocities (Pearson's correlation coefficient, r = -0.53, P<0.01 and r = -0.56, P<0.01 respectively) implying that autonomic and peripheral neuropathy worsen as a diabetic ages. However, no correlation existed between albuminuria and autonomic or peripheral nerve function. CONCLUSION: Autonomic and peripheral neuropathy are highly prevalent in normotensive microalbuminuric diabetic patients. Losartan remarkably improves albuminuria but a similar benefit in autonomic or peripheral neuropathy is not seen over 12 weeks. The future may see a defining role for losartan in microvascular complications in normotensive diabetics.

Adult↗
PubMed2003

Drug-induced kidney diseases.

Drug-induced kidney disease constitutes an important cause of acute renal failure and chronic kidney disease in present day clinical practice. Different classes of drugs, by virtue of immunological mechanisms or direct toxicity initiate certain stereotyped renal responses. For most patients suffering from drug-induced nephropathy common risk factors which precipitate the adverse effects include: old age, volume -depleted state, pre-existing renal dysfunction and coexisting use of other nephrotoxins. Although it is impossible to present all the drugs causing renal disease, a few prototype drugs are mentioned. In a case of undiagnosed renal disease a possibility of drug-induced renal failure should be kept as the prompt removal of the drug and supportive management can reverse the renal dysfunction to a large extent.

Humans↗