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Biomedical subjects

Ashok Shah

Publications and source records attributed to Ashok Shah.

31 records · Page 2Linked to original sources
PubMed2003

Asthma caused by human seminal plasma allergy.

Human seminal plasma allergy (HSPA) in women is a rare phenomenon and can be life-threatening. Hypersensitivity reactions occur during or immediately after coitus and are usually caused by sensitization to proteins in the seminal fluid. This can be very distressing for the patients and their partners. Young, married female patients with episodic asthma dating to their marriage with a history of difficulty in conceiving were specifically asked for local and systemic symptoms chronologically related to coitus. This methodology was adopted keeping in view our social conditions and sensitive nature of the information sought. Two patients thus detected were evaluated further. Condom usage, on our advice, abolished both local and systemic postcoital symptoms. Both patients tested positive to intradermal skin test with the seminal plasma antigen (SPA) derived from their respective husbands and, in patient 1, was accompanied by intense burning, irritation, and itching of the skin. Specific IgE against SPA was demonstrated in the serum of both patients. Elevated levels of total IgE were also detected. A high index of suspicion is needed to diagnose HSPA, especially the local forms, which can easily be overlooked due to patient embarrassment and lack of physician awareness.

Adult↗
PubMed2003

Celecoxib associated esophagitis: review of gastrointestinal side effects from cox-2 inhibitors.

BACKGROUND: With the extensive use of COX-2 inhibitors to treat inflammatory and pain syndromes, gastrointestinal adverse effects are being increasingly observed. CASE REPORT: An 87-year-old white man with chronic peptic esophageal stricture presented to us with dysphagia and odynophagia. The patient was taking Celecoxib for 5 months for trigeminal neuralgia. An upper endoscopy revealed severe desquamative esophagitis. Celecoxib was discontinued and the patient was started on esomeprazole. The patient's symptoms improved in 1 month. Three months later, EGD revealed complete healing of the esophageal mucosa. DISCUSSION: Because recent studies have shown that COX-2 inhibitors are similar to NSAIDs with regards to absorption, in contrast to premarketing trials, extensive use of COX-2 inhibitors is likely to demonstrate gastrointestinal adverse effects similar to those caused by traditional NSAIDs. Our patient had severe esophagitis caused by Celecoxib and aggravated by reflux of achlorhydric gastric contents after dilatation of the stricture. SUMMARY: We report for the first time severe esophagitis caused by the COX-2 inhibitor Celecoxib.

Aged↗
PubMed2002

Allergic bronchopulmonary aspergillosis: a review of a disease with a worldwide distribution.

Allergic bronchopulmonary aspergillosis (ABPA), an immunologically mediated lung disease, occurs predominantly in patients with asthma. This chronic relapsing disorder ranges clinically from mild asthma to fatal destructive lung disease and is caused by hypersensitivity to colonized Aspergillus fumigatus (Af). The immunopathogenesis of the disease is yet to be understood clearly. Specific IgE-Af and IgG-Af, the serological markers, contribute to the diagnosis. Radiologically, ABPA is characterized by fleeting pulmonary infiltrates often confused with pulmonary tuberculosis. However, central bronchiectasis on computed tomography is considered to be the hallmark of the disease. Early diagnosis and therapy with prednisolone, the cornerstone of management, could alter the course of the disease and prevent the development of end-stage lung fibrosis.

Anti-Inflammatory Agents↗
PubMedDate not supplied

Isoniazid associated, painful, bilateral gynaecomastia.

Gynaecomastia is a rarely reported adverse drug reaction due to isoniazid therapy. We describe a 25-year-old, human immunodeficiency virus (HIV)--negative man, who was started on antituberculosis treatment (ATT) with isoniazid (H), rifampicin (R), pyrazinamide (Z) and ethambutol (E) in the combination RHZE for the first two months and RH there on. After four months, while receiving RH, he developed painful bilateral gynaecomastia. ATT had to be stopped because of this adverse drug reaction. Gynaecomastia, however, persisted even after three months of cessation of therapy. A year later, the patient reported complete disappearance of pain and swelling, although right breast continued to appear larger than the left.

Adult↗
PubMedDate not supplied

Hydrocarbon pneumonitis following diesel siphonage.

In our country, siphoning of diesel/petrol from fuel tanks is a common practice. We describe a 50-year-old farmer, who accidentally aspirated fuel while siphoning from his tractor. A diagnosis of diesel induced aspiration pneumonitis was confirmed by the presence of foam cells on bronchial biopsy. The patient showed gradual recovery with the symptomatic therapy. However two weeks later, he developed sudden chest pain and irregularly irregular pulse that proved fatal. Diesel aspiration leading to bilateral pneumonitis is yet to be reported in our country.

Air Pollutants↗
PubMedDate not supplied

Asthma and aspergillus.

Explore the source record for details and available documents.

Aspergillosis, Allergic Bronchopulmonary↗
PubMedDate not supplied

Assessment of sensory perceptions and patient preference for intranasal corticosteroid sprays in allergic rhinitis.

BACKGROUND: Long-term intranasal corticosteroid sprays (INCSs), the mainstay of therapy in allergic rhinitis, differ little in efficacy and safety. Compliance to therapy is strongly influenced by patients' perceptions and preferences. We evaluated the acceptability, based on sensory perceptions, of beclomethasone, budesonide, fluticasone propionate (FP), and mometasone furoate (MF) nasal sprays. METHODS: A single-blind (patient), crossover study was performed; 114 patients with allergic rhinitis, categorized as "sneezers and runners" (group 1) and "blockers" (group 2) were assessed for their sensory perceptions (nasal spray evaluation questionnaire, 14 sensory attributes, and 100-point scale). RESULTS: Significantly more patients preferred MF because of its less irritation, liking of odor, more moistness, and less aftertaste. FP rated significantly higher odor strength and amount of irritation. Seventy-two (63%) patients were in group 1 and 42 (37%) patients were in group 2. MF was the most preferred drug in both group 1 (40 patients, 56%; p < 0.05) and group 2 (21 patients, 50%). Liking the odor was the strongest attribute that affected choice in group 1 (52 patients, 58%), and strength of aftertaste in group 2 (13 patients, 31%). Significantly more patients in group 1 (55 patients, 76%) could appreciate differences in attributes than in group 2 (27 patients, 64%). Ninety-one (80%) patients predicted a better compliance with their preferred drug. CONCLUSION: MF was the most preferred INCS in our patients. This was ascribed to less irritation, odor, and aftertaste along with superior moistness. "Sneezers and runners" appreciated significant differences in INCS. In patients with allergic rhinitis, assessment of sensory perceptions could play a crucial role in promoting compliance with therapy.

Administration, Intranasal↗
PubMedDate not supplied

Nocturnal symptoms and sleep disturbances in clinically stable asthmatic children.

Presence of nocturnal symptoms is related to asthma severity. Clinically stable asthmatic children, too, report frequent nocturnal symptoms and sleep disturbances. The study determined these parameters in stable, asthmatic children, in their home environment. This case-control, questionnaire-based study in 70 school-going children comprised 40 asthmatics (Group 1) and 30, age/gender matched, healthy children (Group 2). Parents maintained peak expiratory flow (PEF) and sleep diaries for one week. Group 1 had significantly lower mean morning (250.3 vs. 289.1 I/minute) and mean evening PEF values (261.7 vs. 291.3 I/minute). Group 1 (38.95%), reported frequent nocturnal symptoms like cough (36.90%), breathlessness (32.80%), wheeze (27.68%) and chest tightness (14.35%). Sleep disturbances, significant in Group 1 (38, 95% vs. 14.35%), included daytime sleepiness (24.60%), daytime tiredness (20.50%), difficulty in maintaining sleep (15.38%), early morning awakening (14.35%), struggle against sleep during daytime (12.30%), and involuntarily falling asleep (17.43%). On a scale of 1-6, Group 1 scored significant sleep disturbances/patient (3 vs. 0.8); lethargy/tiredness in morning (2.9 vs. 2.2), poorer sleep quality (4.7 vs. 5.4), less parents' satisfaction with child's sleep (4.5 vs. 5.5) and daytime fitness (4.1 vs. 5.3). Group 1, when exposed to environmental tobacco smoke (22, 55%), reported significant nocturnal symptoms (18/22, 81%) and reduced mean morning and evening PEF values (17/22, 77%). It is concluded that clinically stable, asthmatic children reported increased nocturnal symptoms, sleep disturbances and poorer sleep quality. Lack of awareness of asthma-sleep association and its clinical implications could lead to poor asthma control and impaired daytime activity.

Adolescent↗