Biomedical subjects

B Shahi

Publications and source records attributed to B Shahi.

10 recordsLinked to original sources

PubMed2005

Therapeutic efficacy of antimalarial drugs along the eastern Indo-Nepal border: a cross-border collaborative study.

This collaborative cross-border study was performed to determine the therapeutic efficacy of antimalarial drugs used by the National Programmes for falciparum malaria along the eastern Indo-Nepal border where there is unregulated population movement across the border. The study was conducted at sites in Jhapa District, Nepal and Darjeeling District, India. The study was conducted from August 2003 to February 2004, following the WHO 28 day treatment protocol. The efficacy of chloroquine was tested in India among 91 subjects and of sulfadoxine-pyrimethamine in Nepal among 107 subjects with laboratory-confirmed Plasmodium falciparum malaria. Of the 102 subjects who completed the study in Nepal, there were 21 (20.6%) treatment failures comprising 7 (6.9%) early treatment failures (ETF) and 14 (14.7%) late treatment failures (LTF) (5 late clinical failures [LCF] and 9 late parasitological failures [LPF]). Of the 89 subjects who completed the study in India, there were 46 (51.7%) treatment failures comprising 7 (7.9%) ETFs and 39 (43.8%) LTFs (13 LCFs and 26 LPFs). Based on WHO guidelines both countries need to review their drug policy urgently and make appropriate changes, taking into account aspects of cross-border collaboration in the control of drug-resistant malaria.

Adolescent↗

PubMed1995

Deltamethrin impregnated bednets against Anopheles minimus transmitted malaria in Assam, India.

Of the 20 Anopheles species caught in villages in Sonapur, Assam, only An. minimus was incriminated as a malaria vector by finding sporozoites in the salivary glands. It was found to be endophagic and endophilic in Assam and because its biting peaked after midnight it was a suitable target for insecticide impregnated bednets. After the withdrawal of DDT spraying and collecting a year's baseline data, deltamethrin impregnated nets were distributed in 3 villages, untreated nets were distributed in 6 villages and 3 were held as untreated controls. The population of each of these groups of villages was about 1700. The nets were well received by the local tribal population. Human landing catches with baits unprotected or under partially lifted nets showed that the nets provided a high degree of personal protection against all the local species of human biting mosquito. In addition, there was evidence for suppression of the An. minimus population in a village with treated nets. Malaria was monitored by weekly active surveillance in all the villages. In the untreated control villages the slide positivity rate and monthly parasite index rose significantly during the trial. In the villages with untreated nets, these parameters showed no significant change, but in the villages with treated nets they declined significantly. On the basis of these results, the widespread distribution of impregnated nets was recommended to the state health authorities.

Animals↗

PubMed1993

Long-term Outcome in a Series of Jejunoileal Bypass Patients.

In 65 jejunolleal (JI) bypasses done from 1973-1979, there were nine Scott and 56 Payne (with Y-shaped anastomosis). Preoperative excess body weight (EBW) translated to the 1983 Metropolitan Tables was 112 +/- 30%. Eight patients are lost to follow-up. We reversed seven patients for renal stones (12%) accompanied by a vertical banded gastroplasty (VBG) and one because she demanded a VBG. Five patients were reversed by surgeons elsewhere for minor problems (three with an accompanying gastric reduction operation), and all five regained and requested a JI bypass again, which we now refused to undertake. This leaves 44 JI bypass patients being followed: loss of EBW is 71 +/- 22% at 12-18 years. The eight reversed by us accompanied by a VBG regained some weight (loss of EBW from initial weight is 56 +/- 18%). Liver biopsies were done for 5 years in 31 patients, and showed improvement by 36 months. Patients took predigested collagen capsules plus high protein and multivitamins. Injections of B12 are indicated in 18 patients, given every 3 months. Liver dysfunction has not occurred in the long-term. Low serum carotene levels persist. Migratory arthraigias were controlled by oral metronidazole and did not occur after the fifth year. Oxalate crystals remain on urinalysis. Potassium and magnesium replacement is not required now, and a mean of 2.5 stools per day is not a problem, with infrequent diarrhea after greasy foods. Metronidazole is continued in 33 patients to prevent foul flatus. One patient developed a brain tumor, one myxedema, and one primary hyperparathyroidism, thought to be complications of the bypass until diagnosed. Most patients appear to be doing well.

Journal Article↗

PubMed1993

Foreign bodies in the rectum.

Although infrequent, rectal foreign bodies present a challenge in management. The authors report on their experience with 29 patients who had rectal foreign bodies. Emergency-department procedures included rectal examination, proctoscopy and abdominal radiography. Soft or low-lying objects having an edge could be grasped and removed safely in the emergency department, but grasping hard objects was potentially traumatic and occasionally resulted in upward migration toward the sigmoid. Operating-room procedures included anal dilatation under general anesthesia, transrectal manipulation, bimanual palpation if necessary and withdrawal of the foreign body. In two cases, rectal mucosa was trapped--in an open deodorant bottle in one patient and in a curtain rod in the second patient; operative release of the mucosa enabled safe removal. Two patients presented with peritonitis; both had "broomstick" injuries and required proximal colostomy. Five patients had perianal sepsis due to inadvertently ingested pieces of wood (three) and chicken bones (two). The mean hospital stay was 3 days (range from 6 hours to 6 days). There were no deaths. Because of the potential complications, rectal foreign bodies should be regarded seriously and treated expeditiously.

Adolescent↗

PubMed1992

Morbid obesity: selection of patients for surgery.

Massive obesity is associated with serious co-morbidities. After failure of extensive conservative measures, surgical procedures have developed as the only successful method for sustained weight loss. Criteria for operation are: presence of serious diseases associated with morbid obesity; greater than 45 kg above ideal weight or body mass index greater than 40 kg/m2 for usually greater than 5 years; failure of sustained weight loss on extensive conservative regimens; commitment to lifelong follow-up; and acceptable operative risk. Angina pectoris itself is not a contraindication to these operations. Patients who do not quite meet the weight criteria may still be candidates for an obesity operation in certain instances, e.g., debilitating musculoskeletal pains in weight-bearing joints, diabetes, significant hypertension, reflux esophagitis, urinary stress incontinence. Although current operations result in lasting weight loss of greater than 50% of excess weight in the majority of patients, the surgical candidate must understand and accept the principles of the procedures, the potential for serious complications, the dietary necessities, and occasional failures.

Body Mass Index↗

PubMed1992

Sleep-related Disorders in the Obese.

Obesity is a well-known cause of upper airway narrowing, respiratory failure and resulting hypoxemia and hypercapnia, and cardiac arrhythmias during sleep. Obese patients are prone to snore loudly and to develop obstructive sleep apnea syndrome and also obesity-hypoventilation syndrome. Repeated nocturnal upper airway obstruction may cause respiratory failure and cor pulmonale and frequent awakenings, and result in nocturnal choking, with daytime drowsiness, somnolence and irritability. The purpose of this article is to review the evidence for these accepted facts and to consider a variety of new information that relates to the pathogenesis, symptomatology and treatment of sleep disorders caused by obesity.

Journal Article↗

PubMed1991

Effect of Weight Loss in the Morbidly Obese Patient with Severe Disability.

An impairment can result in disability which can result in handicap. In Canada, disabilities have been based on 17 activities of daily living (ADL), nine of which may be due to massive obesity. Severe disability (SD) is inability to perform three or more of these ADL. During 1985, all patients with SD who underwent weight loss surgery were surveyed. Of 120 morbidly obese patients, 44 fulfilled the SD criteria. Effect of weight loss was observed over 5 years in 42 SD patients (initial mean body mass index 47.8 final 27.8), two being lost to follow-up. Disability became moderate (unable to do one or two of the ADL) in three, mild (difficult but able to perform) in 17, and disappeared in 22 patients. Two who regained lost weight redeveloped SD.

Journal Article↗

PubMed1991

Radiological Features after Vertical Banded Gastroplasty.

More than 1300 vertical banded gastroplasty operations have been performed at our hospital since November 1982. We describe the radiologic findings based on 159 of these patients, who were referred for radiologic contrast studies. Patients were referred because of abdominal pain, excess vomiting, excess weight loss, inadequate weight loss or regain of weight. The pre-contrast plain film was an important indicator of staple-line abnormalities. The radiographic findings could be divided into: abnormalities of the partition, abnormalities of the banded outlet, and ulcers and extragastric leaks.

Journal Article↗

PubMed1991

An Apparatus for Visualizing and Videotaping Obesity Operations.

A video camera has difficulty in gaining access for obesity operations. A 7-ft aluminum arm (boom) has been mounted on a sturdy tripod. A camera at one end of the boom enables easy direct videotaping, without interfering with the operating table

Journal Article↗

PubMed1991

Microorganisms in the Stomach During Vertical Banded Gastroplasty.

Vertical banded gastroplasty involves the cutting of a stapled window against an Ewald tube Passed perorally, and creation of a vertical staple-line partition. The channel at the window is banded by a polypropylene mesh collar. A study of the gastric rings removed at this operation found that the bacterial colonization rate was 46.8%, so that the potential for infection of the collar exists. The actual significance of this finding is unknown.

Journal Article↗