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Biomedical subjects

B Kulkarni

Publications and source records attributed to B Kulkarni.

At least 19 recordsLinked to original sources
PubMed2006

Maternal lean body mass may be the major determinant of birth weight: A study from India.

This study explored the relationship of maternal body composition parameters to the birth weight of the offspring. Maternal anthropometric parameters (weight, height) and body composition by dual energy X-ray absorptiometry were measured in 76 women from low-income group during 12-21 days postpartum. The mean+/-s.d. height, weight of the mothers and birth weight of the newborns were 151.5+/-5.29 cm, 46.7+/-6.04 and 2.84+/-0.358 kg, respectively. When the relationship of maternal anthropometric and body composition parameters to the infants' birth weight was studied, maternal lean body mass was found to be the most important determinant of birth weight (R2 (%) = 21.3) (P < 0.001). This study highlights the importance of increasing lean body mass in young women for better pregnancy outcome.

Absorptiometry, Photon↗
PubMed2005

Large-scale synthesis of "Cpep" RNA monomers and their application in automated RNA synthesis.

Small interfering RNAs (siRNA) are the latest candidates for oligonucleotide-based therapeutics. Should siRNA be successful in clinical trials, a huge demand for synthetic RNA is anticipated. We believe that 1-(4-chlorophenyl)-4-ethoxypiperidin-4-yl (Cpep) is an ideal 2'-protecting group for large-scale syntheses. Unlike 2'-silyl groups, mild acid hydrolysis instead of fluoride ion is used for the 2'-deprotection. The syntheses of 2'-Cpep protected nucleosides (A, C, G, and U) has been accomplished on a 0.5 Kg scale. The 2'-Cpep monomers were transformed into 3'-O-phosphoramidites for conventional automated solid-phase synthesis. Cost-effective processes for large-scale synthesis of Cpep monomers and initial automated solid-phase synthesis are demonstrated.

Acrylic Resins↗
PubMed2005

Frequency distribution of human platelet antigens in the Indian population.

This study was undertaken with an aim of establishing the frequency distribution of various human platelet antigens (HPA) in Indian populations by means of DNA-based technology. A total of 1164 people belonging to various population groups were studied for the frequency distribution of HPA. DNA extraction was performed from peripheral venous blood samples. Polymerase chain reaction allele-specific amplification technique was used for HPA genotyping. The HPA bands were visualized by using ethidium bromide-stained agarose gel, after electrophoresis. The homozygosity of the HPA-1b/1b genotype was found to be significantly higher (P < 0.05) in the Parsi population group and Vatalia Prajapati population group, compared to Maharashtrians. Frequency distribution of HPA-1b in our populations was found to be slightly lower than that reported in some western populations. This study has established a DNA technique to diagnose cases of NAITP definitively and to treat these cases during the neonatal period, and also gives the frequency distribution of HPA in some of the Indian population.

Antigens, Human Platelet↗
PubMed2005

Attention to pain localization and unpleasantness discriminates the functions of the medial and lateral pain systems.

Functional imaging studies have identified a matrix of structures in the brain that respond to noxious stimuli. Within this matrix, a division of function between sensory-discriminative and affective responses has so far been demonstrated by manipulating either pain intensity or unpleasantness under hypnosis in two different normal volunteer groups studied on separate occasions. Our study used positron emission tomography (PET) to demonstrate this division of function under more natural conditions in a healthy group of volunteers, using a CO(2) laser to provide nociceptive stimuli that selectively activate A-delta and C-fibres without contamination by touch sensations. We measured the differential cerebral responses to noxious and innocuous laser stimuli during conditions of selective attention to either the unpleasantness or location of the stimuli. Attention to location increased responses in the contralateral (right) primary somatosensory and inferior parietal cortices. This result implies that these components of the lateral pain system are concerned mainly with the localization of pain. In contrast, attention to unpleasantness increased responses in bilateral perigenual cingulate and orbitofrontal cortices, contralateral (right) amygdala, ipsilateral (left) hypothalamus, posterior insula, M1 and frontal pole. These areas comprise key components of the medial pain and neuroendocrine systems and the results suggest that they have a role in the affective response to pain. Our results indicate the importance of attentional effects on the pattern of nociceptive processing in the brain. They also provide the first clear demonstration, within a single experiment, of a major division of function within the neural pain matrix.

Adult↗
PubMed2004

Differential effects on the laser evoked potential of selectively attending to pain localisation versus pain unpleasantness.

OBJECTIVE: To determine the effects on the laser evoked potential (LEP) of selectively attending to affective (unpleasantness) versus sensory-discriminative (localisation) components of pain. METHODS: LEPs, elicited by painful CO2 laser stimulation of two areas of the right forearm, were recorded from 62 electrodes in 21 healthy volunteers, during three tasks that were matched for generalised attention: Localisation (report stimulus location), Unpleasantness (report stimulus unpleasantness), Control (report pain detection). LEP components are named by polarity, latency, and electrode. RESULTS: N300-T7 peak amplitude was significantly greater during Localisation than Unpleasantness. The difference in N300-T7 amplitude between Localisation and Control approached significance, suggesting an increased amplitude in Localisation compared with Control, rather than a reduced amplitude in Unpleasantness. Peak amplitude, latency, and topography of N300-FCz, P450, P600-800 (early P3) and P800-1000 (late P3) did not differ significantly between tasks. CONCLUSIONS: These results suggest that the N300-T7 LEP peak reflects the activity of cerebral generators involved in the localisation of pain. The topography of N300-T7 is consistent with a source in contralateral secondary somatosensory cortex/insula and maybe primary somatosensory cortex. SIGNIFICANCE: This study confirms a role of the lateral pain system in the localisation of pain, and distinguishes it from stimulus novelty or attention.

Adult↗
PubMed2004

Thrombophilia in coronary artery disease: a double jeopardy.

Thrombophilia can be defined as an increased risk of thrombosis. The central event to the pathogenesis of any thrombotic episode is the perturbation of haemostasis, the cause of which may be genetic or environmental. The clinical manifestations of the chronic development of coronary artery atheroma are angina and acute myocardial infarction. In recent years literature is emerging on the role of different factors of blood coagulation in arterial thrombosis. Different coagulation factors, natural anticoagulants, platelet antigens and other factors such as homocysteine, lipoprotein (a), have been studied as risk factors for coronary artery disease (CAD). The results of many of these studies are contradictory. In India, there is an alarming rise in the number of young patients with myocardial infarction (MI) and an interesting feature is that a large majority of these patients lack the conventional risk factors. There have been scattered studies on the thrombophilia status among Indians. The management of thrombophilia can be done by a regimen of different drugs which has been evaluated in different clinical trials. Since the cost of thrombophilia investigations is quite phenomenal for a developing country like India, the selection of these investigations assumes an utmost importance.

Biomarkers↗
PubMed2003

Platelet function tests using platelet aggregometry: need for repetition of the test for diagnosis of defective platelet function.

Four hundred and ninety seven patients were referred to our center for platelet aggregation studies because of spontaneous mucocutaneous bleeds. All these patients had normal complete blood count, platelet count and peripheral smears except in ten patients of Bernard Soulier Syndrome where platelet count was marginally reduced in the presence of giant platelets. Two hundred and eighty patients were found to have normal platelet aggregation to ADP, collagen, ristocetin and arachidonic acid. Out of the remaining 217 patients, 62 patients were diagnosed to have Glanzmanns thrombasthenia, 10 Bernard Soulier Syndrome, 6 storage pool deficiencies, 7 cyclooxygenase deficiencies and 72 von Willebrand disease. In all the patients with GT and BSS, diagnosis was confirmed with flow cytometry using multiple monoclonal antibodies to GPIIb-IIIa and GPIb-IX. There were sixty patients where initial platelet aggregation studies showed reduced (<30%) aggregation to either ADP, collagen, ristocetin or arachidonic acid in its various combination, however in 12 such patients (20%) the platelet aggregation studies were normal on repetition. All our platelet aggregation studies were done only after assuring that the patient is not taking any medicine for at least 7-10 days which may affect the platelet function tests. The present study shows that single atypically abnormal platelet aggregation studies should always be repeated. Finally in 48/217 patients (22%) some aggregation abnormality to one or more of the agonists persisted, although we could not categorize these patients into any clear-cut platelet disorder. None of these 48 patients platelet associated immunoglobulin was increased by flow cytometry. It is possible that large number of patients from that disorder will finally prove to be some form of platelet secretory defect. In north India similar group of defect in a large number of patients have been reported as isolated PF3 abnormality or thrombasthenic thrombopathy.

Adenosine Diphosphate↗
PubMed2003

Pain mechanisms and their disorders.

The purpose of this article is to summarise how functional imaging techniques have changed our understanding of normal and abnormal pain mechanisms, how they inform a change in clinical practice and to speculate on possible future clinical uses.

Analgesics↗
PubMed2002

5-HT(2C) receptor activation by m-chlorophenylpiperazine detected in humans with fMRI.

Functional brain imaging using selective drug probes offers the opportunity to investigate regional neuronal activation linked to receptor stimulation or inhibition. In a placebo-controlled, balanced order design in eight male volunteers, the 5-HT(2c) agonist, m-chlorophenylpiperazine (mCPP) increased blood oxygen level dependent (BOLD) signal in the hypothalamus, caudate, pallidum, amygdala and pyriform cortex, anterior cingulate gyrus and choroid plexus (p < 0.001 uncorrected), areas with high density of 5-HT(2c) receptors. Activation in the hypothalamus correlated significantly with the prolactin response (p < 0.05 small volume corrected). In a subsequent Go/NoGo task, mCPP enhanced activation in right lateral orbitofrontal cortex (p < 0.05 small volume corrected). These findings suggest that pharmacoMRI is a potentially powerful tool for investigating neurotransmitter function in humans.

Brain↗
PubMed2002

Spectrum of inherited bleeding disorders from Western India.

OBJECTIVE: The study was undertaken to assess the magnitude and diversity of different bleeding disorders in Western India. MATERIALS AND METHODS: 768 cases referred to our Institute for evaluation of an underlying bleeding diathesis were investigated appropriately to detect the cause of the abnormal hemostatic function. RESULTS: 630 patients were diagnosed to have hereditary bleeding diathesis. Amongst these, 598 patients had a coagulation disorder while only 32 patients had a platelet function abnormality. Amongst the coagulation disorders, hemophilia A (70.5%) was the most common disorder followed by hemophilia B (14%) and VWD (10.8%). Glanzman's thrombasthenia (84.3%) was the most common platelet function disorder followed by Bernard-Soulier syndrome (12.5%). Some rare disorders have also been diagnosed. CONCLUSION: In spite of their apparent rarity, India has a substantial number of cases of inherited bleeding disorders. A large number of these patients is referred to many tertiary care institutions. It is therefore desirable that district hospitals must develop their laboratories to detect most of these disorders so that the patients need not travel long distances to get an appropriate diagnosis and proper management. All 1st degree female relatives of severe and moderate hemophilia must get factor assays done because some of them may be vulnerable to post-procedural or post-traumatic bleeding.

Blood Coagulation Disorders, Inherited↗
PubMed2001

Development of inhibitors in patients with haemophilia from India.

Four hundred and seven patients (352 haemophilia A and 55 haemophilia B) were investigated for the presence of factor VIII and IX inhibitors. Twenty-four out of 292 severe and two out of 36 moderate haemophilia A patients showed the presence of inhibitors. The mean age at development of inhibitors was 17.7 years (range 6-52 years). In 12 patients the inhibitors were detected due to suboptimal response to factor replacement therapy (symptomatic) and in the remaining 14 patients the inhibitors were detected during the routine screening of the patients' samples for inhibitors. They had, however, responded well to the usual doses of factor concentrates and there was no suspicion in these patients that they had developed an inhibitor (asymptomatic). There were two families in which the inhibitors were detected in more than one family member. The level of inhibitors in symptomatic patients ranged from 2.2 Bethesda units (BU) mL(-1) to 460.6 BU mL(-1), and in asymptomatic patients it ranged from 0.8 BU mL(-1) to 3.2 BU mL(-1). The inhibitors persisted in all patients except one, who developed an inhibitor postoperatively for a brief period of 3 months. All these patients were followed up from first factor exposure and were tested for inhibitors at least twice a year. The mean number of exposure days before they developed inhibitors was 47.5 exposure days (range 17-98 exposure days). No inhibitors appeared after more than 100 exposure days in any of the patients. When 50 consecutive patients were investigated for intron 22 inversions of the factor VIII gene, 17 patients were found to be positive for inversions (10 proximal inversion; seven distal inversion) out of whom four patients developed inhibitors, three patients belonging to the same family. Out of 35 haemophilia B patients, only one patient developed an inhibitor. The overall prevalence of inhibitors was thus 8.2%, which is similar to the reports from western countries, prior to the introduction of highly purified factor concentrate therapy.

Adolescent↗
PubMed1999

Color flow Doppler sonography: a reliable alternative to voiding cystourethrogram in the diagnosis of vesicoureteral reflux in children.

OBJECTIVES: In children with urinary tract infection, the incidence of vesicoureteral reflux (VUR) is nearly 30% to 40%. The standard for the diagnosis of VUR is voiding cystourethrography (VCUG). This study assessed the role of color flow Doppler sonography (CFDS) in the diagnosis of VUR and ureteral jets. METHODS: CFDS imaging was performed in 36 patients aged 6 months to 13 years during a 4-year period. All patients underwent CFDS and VCUG within 24 to 48 hours, but the findings of the VCUG were not reported to the sonologist. The ultrasound examinations were done using a color Doppler real-time machine. Representative images of the bladder events were recorded with a multiformat camera and on VHS videotape. RESULTS: The duration of the Doppler signal varied from 0.4 to 7.5 seconds. In 31 (86.1%) of 36 patients, the results of CFDS correlated well with VCUG findings. There were three false-negative and two false-positive results in the present study. Six patients underwent reimplantation during the course of their treatment. CFDS was used as a follow-up modality at the end of 6 months, and the results correlated well with standard VCUG in 4 of these patients. In the remaining 2 patients, only CFDS was performed and correlation with VCUG was not possible. VCUG was considered the reference standard in assessing the sensitivity of CFDS. CONCLUSIONS: CFDS of the bladder during the filling and micturating phases is a reliable and sensitive modality for identifying VUR and demonstrating ureteral jets. CFDS nullifies the danger of exposure to ionizing radiation and avoids the unpleasant catheterization many of these children fear.

Adolescent↗
PubMed1998

Presacral teratoma presenting with congenital urinary ascites.

Congenital teratomas occur most frequently in the sacrococcygeal region. Most grown into a large perineo-sacral swelling that is conspicuous externally. Infrequently, the neoplasm is contained almost entirely within the pelvis in the presacral space. Congenital urinary ascites is observed in patients with obstructive uropathy; posterior urethral valves in a newborn is one of the most prominent causes of urinary ascites. We report a case of presacral teratoma leading to rupture of the urinary bladder due to outflow obstruction and causing urinary ascites. The ascites was drained, the bladder was repaired, and the teratoma was successfully excised. A review of the literature did not reveal any similar case.

Ascites↗