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Biomedical subjects

B S Singh

Publications and source records attributed to B S Singh.

At least 19 recordsLinked to original sources
PubMed2001

Gigantiform cementoma: clinicopathologic presentation of 3 cases.

Gigantiform cementoma is a rare, benign fibro-cemento-osseous disease of the jaws, seen most frequently in young girls. Radiographically, it typically presents as multiquadrant, expansile, mixed radiolucent-opaque lesions that cross the midlines of the jaws. Although cases with a familial pattern are noted in a few publications, sporadic cases have been reported without a family history. The term gigantiform cementoma has been used interchangeably with designations of other fibro-osseous entities, yet its application should be restricted by the criteria defined herein. In this article, we report 3 cases of gigantiform cementoma. Clinical, radiographic, and microscopic features of these lesions are presented, along with criteria to differentiate gigantiform cementoma from other fibro-osseous diseases of the jaws. A possible pathogenetic mechanism and treatment recommendations are discussed.

Adolescent↗
PubMed2001

Tibiocalcaneal fusion for avascular necrosis of the talus.

Between 1994 and 1999, we treated six patients with avascular necrosis of the talus by excision of the necrotic body of the talus and tibiocalcaneal fusion using an Ilizarov frame. This was combined with corticotomy and a lengthening procedure. Shortening was corrected in all patients except two, who were over 60 years of age. All patients had previous operations which had failed. All achieved solid bony fusion, with five out of six having either a good or an excellent result. We conclude that this is an effective reconstructive technique which gives a good functional result.

Adult↗
PubMed2000

Schizophrenia today.

Explore the source record for details and available documents.

Cost-Benefit Analysis↗
PubMed1999

Health and well-being of women family carers: a comparative study with a generic focus.

OBJECTIVE: To examine differences between women family carers of people with chronic illnesses or disabilities and a group of women 'non-carers' in self-reported physical health, psychological well-being, life satisfaction, social support and feelings of overload. METHOD: Using a computer-assisted telephone interviewing system, a random survey of more than 26,000 households was conducted in Victoria to identify and then interview a representative sample of family carers of people with disabilities or chronic illnesses. The women in the sample (n = 857) were then compared with a sample of women with 'usual family responsibilities' (n = 219) in terms of physical and emotional states. RESULTS: We found higher rates of self-reported ill-health and use of medication, more negative effect, and less life satisfaction and perceived social support, among carers than among women in the comparison group. Even though the latter were more likely to be caring for one or more children, compared with the carers they reported less overload. Irrespective of carers status, women without partners expressed less life satisfaction, and more social isolation and negative effect. CONCLUSIONS AND IMPLICATIONS: The poorer health status and emotional well-being of carers compared with non-carers among women, and associations between overload, social isolation, negative effect and health problems within carers, point to a number of practical interventions such as promoting an awareness in GPs and other health professionals of the impact of caregiving on the health of their patients; informing them about relevant community services; and encouraging appropriate referrals.

Adaptation, Psychological↗
PubMed1998

The Second National Mental Health Plan: an opportunity to take stock and move forward.

In the first five years of Australia's National Mental Health Strategy (including the National Mental Health Plan), there has already been a 55% increase in spending on community health services, and overall funding for mental health services has increased by 24%. However, the broadening of the Plan's objectives warrants further increases in mental health funding. The focus has been on people with psychotic disorders (who represent a minority of those with mental disorders); in the Second National Mental Health Plan, endorsed in July 1998, the focus is broadened to include depressive disorders, and promotion of mental well-being in the broader community is a key theme. These initiatives will require partnerships, particularly with primary care.

Australia↗
PubMed1998

Managing somatoform disorders.

The management of somatoform disorders is a confusing and difficult area. There are many iatrogenic complications, including unnecessary and repetitive investigations and surgery, drug dependence and "doctor shopping". Somatisation is a world wide phenomenon and a common presentation of psychological distress. Three main groups of patients are encountered in general practice: those with high levels of somatic symptoms, those with illness fear, and those with somatic presentations of other psychiatric illnesses. Management is straightforward for the acute cases and consists of trying to get the patient to accept a link between the psychosocial conflicts and the symptoms. Management is very difficult for chronic cases, where care, not cure, is the goal, as is an attempt to limit harm to the patient and limit the cost to the health system.

Adult↗
PubMed1998

Adenosquamous carcinoma: a case report with immunohistochemical evaluation.

The histogenetic origin of adenosquamous carcinoma, a high-grade variant of malignant epithelial neoplasm, has long been debated. We report a case that clearly demonstrated a mucosal surface epithelial origin. This concept was supported through histologic analysis of hematoxylin- and eosin-stained sections, as well as by the pattern of immunohistochemical reactivity with antibodies directed against low and high molecular weight cytokeratins, cell adhesion molecules (CAM 5.2), and carcinoembryonic antigens. The histologic differential diagnosis, biological behavior, and prognosis of adenosquamous carcinoma are also examined.

Adult↗
PubMed1997

Intronic sequences are involved in neural targeting of human dopamine transporter gene expression.

Dopamine transporter (DAT) plays a key role in terminating synaptic dopaminergic transmission. DAT acts exclusively on the plasma membrane of presynaptic dopaminergic neurons and DAT gene is an appropriate model for the study of dopaminergic neuron-specific regulation of gene activity. DAT represents an important target for widely used neuroleptic drugs and psychostimulants and for catecholamine-selective neurotoxins. Functional abnormalities of DAT have been implicated in diverse neurologic and psychiatric disorders. Understanding the mechanisms regulating human DAT gene activity is an important step towards elucidation of the molecular bases of a number of disorders and psychostimulant drug abuse and dependence. In this study we have cloned and characterised a 7-kb segment of the human DAT gene which includes at least 4 kb of its 5'-flanking region, localised its essential, or core-promoter, and identified the region involved in regulation of DAT neurospecific expression.

Carrier Proteins↗
PubMed1997

Insulin gene expression in immortalized rat hippocampal and pheochromocytoma-12 cell lines.

Employing reverse transcription-polymerase chain reaction and clonal cell lines derived by retroviral transduction of the temperature sensitive simian virus 40 large T-antigen into dispersed rat embryonic hippocampal cells, we detected the ancestral gene-insulin II mRNA in three progenitor subcloned cell lines. These cell lines upon differentiation are known to express markers indicative of commitment to either neuronal (H19-7; NF + , GFAP -), glial (H19-5; GFAP +, NF -), or bipotential (H583-5, NF +, GFAP + ) lineages. No duplicated, i.e., insulin I gene expression, was observed in any of the three cell lines. Induction of differentiation was associated with the persistence of insulin II mRNA and in the cells expressing a neuronal phenotype (H19-7; NF +, GFAP -) a relative doubling in insulin II mRNA level was present (P < 0.05). Minimal cellular insulin immunoreactivity was detected only in a subpopulation of cells with a differentiated neuronal phenotype. Radioimmunoassayable insulin peptide in the H19-7 cellular conditioned medium revealed a 5-fold increase in the differentiated state. In contrast, peripheral sympathetic PC-12 neuronal cells both in the undifferentiated and nerve growth factor-driven differentiated states, failed to express both insulin I and insulin II genes. We conclude that insulin II is expressed by cultured rat hippocampal clonal cell lines, and not by the peripheral sympathetic PC-12 neuronal cell line.

Animals↗
PubMed1997

Maternal diabetes-induced hyperglycemia and acute intracerebral hyperinsulinism suppress fetal brain neuropeptide Y concentrations.

We examined the effect of streptozotocin-induced maternal diabetes of 6-day duration and 4- to 24-h intracerebroventricular and systemic hyperinsulinism on fetal brain neuropeptide Y (NPY) synthesis and concentrations. Maternal diabetes (n = 6) leading to fetal hyperglycemia (5-fold increase; P < 0.05) and normoinsulinemia caused a 40% decline (P < 0.05) in fetal brain NPY messenger RNA (mRNA) and a 50% decline (P < 0.05) in NPY radioimmunoassayable levels compared to levels in streptozotocin-treated nondiabetic (n = 7) and vehicle-treated control (n = 8) animals. In contrast, systemic hyperinsulinemia (n = 7) of 5- to 100-fold increase (P < 0.05) over the respective control (n = 7) with normoglycemia caused an insignificant (20-30%) decrease in fetal brain NPY mRNA and protein concentrations. However, fetal intracerebroventricular hyperinsulinism (n = 7) with no change in fetal glucose concentrations caused a 50-60% decline (P < 0.05) in only the NPY peptide levels, with no change in the corresponding mRNA amounts. We conclude that fetal hyperglycemia of 6-day duration and intracerebroventricular hyperinsulinism of 4-24 h suppress fetal brain NPY concentrations, the former by a pretranslational and the latter by either a translational/posttranslational mechanism or depletion of intracellular secretory stores. We speculate that fetal hyperglycemia and intracerebroventricular hyperinsulinism additively can inhibit various intrauterine and immediate postnatal NPY-mediated biological functions.

Acute Disease↗
PubMed1995

Basal and haloperidol-stimulated prolactin and symptoms of nonaffective and affective psychoses in neuroleptic-free men.

The prolactin (PRL) response to 0.5 mg of intravenous haloperidol (HPL) IV may be a measure of tuberoinfundibular dopaminergic activity. Our earlier reports, using multidiagnostic strategies in schizophrenia, suggested that psychoses characterized by the absence of affective syndromes (Keks et al 1990) and the presence of thought disorder and passivity delusions (Keks et al 1992) are linked to blunted PRL responses. In this paper we evaluated the relationships between basal and HPL-stimulated PRL concentrations, and a number of potentially relevant symptom measures. Basal PRL was lower in patients without a depressive syndrome and suicidal ideation. Stimulated PRL was lower in patients without neurovegetative symptoms (versus patients with neurovegetative symptoms and controls), with depression (versus patients with no depression and controls) and those with disorder of associations (versus patients without association disturbance and controls). These findings can be interpreted as indicating a link between endocrine measures of dopaminergic function and a subtype of schizophrenic psychosis characterized by the presence of thinking disturbance in the absence of depression.

Adult↗
PubMed1995

Inappropriate secretion of antidiuretic hormone in acute bacterial meningitis.

Sixty children aged from 1 month to 12 years (mean (SD) 3.18 (3.49) years) with acute bacterial meningitis were studied for the incidence, clinical manifestations and outcome of the inappropriate secretion of antidiuretic hormone syndrome (SIADH). Serum sodium levels and osmolality of serum and urine were estimated on admission and on days 3 and 10. SIADH was diagnosed in 22 out of 60 cases (36.7%) on admission and in six of 48 cases (12.5%) on day 3. Hyponatraemia without SIADH, attributed to vomiting and fever, was detected in seven cases (11.7%). Serum sodium levels returned to normal within 48 hours in these cases. Serum osmolality and sodium levels took longer to return to normal values in patients with SIADH. However, none of the cases showed any evidence of SIADH on the 10th day. A significant correlation with SIADH was observed in cases with evidence of severe meningeal inflammation (p < 0.001). The incidence of SIADH was highest with Streptococcus pneumoniae (75%), followed by Haemophilus influenzae (57.1%). Overall mortality was 26.7%, and mortality was significantly higher (p < 0.001) in cases with SIADH, all of whom died during the 1st 72 hours. Ten out of 22 cases (45.4%) with SIADH who survived beyond the 1st 72 hours had an uneventful course even though all of them had biochemical evidence of SIADH on the 3rd day. Mortality was quite high also in children with severe malnutrition (75%) and in those with S. pneumoniae as the aetiological organism (75%).

Acute Disease↗
PubMed1994

Latent trait modelling of symptoms of schizophrenia.

Latent trait models were fitted to data for 149 schizophrenic or schizophreniform inpatients rated on the Scale for the Assessment of Positive Symptoms (SAPS) and the Scale for the Assessment of Negative Symptoms (SANS) using the Rasch Extended Logistic Model. It was found that a reduction in the numbers of rating categories, from six to three or four led to consistencies in response while deletion of several items led to consistent scales of symptoms that accorded with an item response characterization. Behaviours included in the final scales varied in the numbers of categories, and in the range of symptom level covered by a category. Relationships between scores representing symptoms were found to be modelled better by a factor structure that included a third overlapping 'cognitive' factor in addition to the now traditional positive and negative factors, than by the original positive and negative factors alone.

Adult↗
PubMed1994

Serum sodium and osmolal changes in tuberculous meningitis.

Twenty children from 2 months to 7 years (mean age 2.74 years +/- 1.62) diagnosed to have tuberculous meningitis (TBM) were evaluated for serial serum sodium levels and osmolality of cerebrospinal fluid (CSF), serum and urine on admission and the results compared with 20 age and nutritionally matched controls, and these investigations repeated on day 3 and day 10. Mean serum sodium levels (130.7 +/- 6.26 mEq/L), and osmolality of CSF (272.0 +/- 7.0 mOsm/kg) and serum (275.5 +/- 6.09 mOsm/kg) were significantly lower (p < 0.001) than in controls. Hyponatremia was detected in 65% of cases on admission, 47% on day 3 and in 30.8% on day 10. All the patients with hyponatremia had biochemical evidence of syndrome of inappropriate secretion of antidiuretic hormone (SIADH) on admission. Incidence of SIADH gradually decreased to 41.2% on day 3 and 15.4% on day 10. In some of the cases serum sodium levels and osmolality of serum and CSF took about 3 weeks to return to normal. CSF osmolality was lower than concomitant serum osmolality in patients as well as in controls. In patients with SIADH, CSF osmolality followed the same trend as serum values and returned to normal in 2-3 weeks. Overall mortality was 25%. Two out of 3 patients who expired during first 3 days had SIADH but in those cases who survived there was no correlation with degree of meningeal inflammatory changes or ultimate outcome. SIADH is commonly associated with TBM and should be diagnosed early in order to modify the fluid therapy in these cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Case-Control Studies↗
PubMed1993

Insulin II gene expression in rat central nervous system.

Controversy persists concerning the origin of insulin in the central nervous system. While there has been convincing evidence in vitro to demonstrate the presence of neuronal insulin mRNA, conventional assays have failed to detect the same in whole brain preparations. Here we employed RNAse-protection and sensitive reverse transcription-polymerase chain reaction (RT-PCR) assays in attempts to detect insulin I and II mRNAs in rat brains obtained from different developmental stages. The RNAse-protection assay did not detect insulin I or insulin II transcripts in fetal (13 to 21 day gestation) or adult brains. RT-PCR, while detecting low amounts of insulin I transcripts in other extrapancreatic tissues such as the rat yolk sac and fetal liver previously shown to express insulin II, failed to detect insulin I in brain at any age examined. Insulin II mRNA was detected by RT-PCR in fetal, neonatal and adult rat brains, just as in yolk sac, fetal and adult livers. We conclude that while the duplicated insulin I gene is not expressed, the ancestral insulin II gene is expressed in fetal, neonatal and adult rat brains. Our observations support the concept of de novo brain insulin II synthesis beyond the pre-pancreatic stage of embryonic development.

Aging↗
PubMed1993

Positive and negative symptoms in the psychoses. Re-analysis of published SAPS and SANS global ratings.

The validity of the simple dichotomy between positive and negative symptoms was examined by reanalysing the results of published studies using global ratings from Andreasen's SAPS and SANS. Global ratings from our own sample of 114 diagnostically heterogenous psychotic patients were also analysed. In none of the studies was a simple positive-negative dichotomy an adequate representation of symptom structure. The most commonly occurring structure consisted of three independent groups: Hallucinations/Delusions, Positive Thought Disorder and Negative Symptoms. These findings applied to both manic and schizophrenic groups of patients. An important implication of these results for future studies is that combining positive symptoms into a single scale is inappropriate because possibly differential relationships between Hallucinations/Delusions and Thought Disorder and a variety of external measures may be obscured by such a means of data reduction.

Affective Symptoms↗
PubMed1993

Cerebrospinal fluid osmolal changes in bacterial meningitis.

Sixty children with acute bacterial meningitis (ABM) were prospectively studied for their serum sodium values and cerebrospinal fluid (CSF), serum and urinary osmolality. The results have been compared with 20 age and nutritionally matched controls. Even though mean serum osmolality (283.2 +/- 13.84 mOsm/kg) and serum sodium levels (130.5 +/- 8.15 mEq/L) were significantly lower in ABM in comparison to controls (p < 0.05 and < 0.001, respectively), the overall mean CSF osmolality in patients with ABM (282.5 +/- 12.3 mOsm/kg) was not significantly different as compared to controls (288.2 +/- 7.89 mOsm/kg). As expected, cases of ABM with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) had significantly lower CSF osmolality (272 +/- 9.42 mOsm/kg) as compared to those without SIADH (288.5 +/- 9.34 mOsm/kg) and controls (288.2 +/- 7.89 mOsm/kg). However, our observations indicate that whereas the mean CSF osmolality was lower than the serum osmolality in the control group as well as in ABM without SIADH, it was greater than serum osmolality in ABM with SIADH (p < 0.05). Our results suggest that in the presence of SIADH, hypo-osmolality of serum may eventually result in hypo-osmolality of CSF, but the fall in CSF osmolality is not of the same degree as that of serum. Low CSF osmolality was observed to be associated with an unfavorable prognosis (p < 0.05).

Child↗