Biomedical subjects

C M Pandey

Publications and source records attributed to C M Pandey.

At least 19 recordsLinked to original sources

PubMed2004

Problems and uncertainties with multiple point A's during multiple high-dose-rate intracavitary brachytherapy in carcinoma of the cervix.

AIMS: This study evaluates the consequences of point A as a dose prescription point during multiple high-dose-rate (HDR) intracavitary brachytherapy (ICBT) in cancer cervix. MATERIALS AND METHODS: Fifty patients who had received teletherapy were randomised into two groups of 25 to receive three HDR ICBT fractions of 6 Gy each at point A with either a flexible Ralstron (Shimadzu Corporation, Japan) or rigid Rotterdam (Nucletron, Netherlands) applicator. The orthogonal radiographs of the 150 applications were evaluated for applicator geometry and point A co-ordinates. RESULTS: Irrespective of the nature and rigidity of the applicators, its various components exhibited a highly significant variation during multiple fractionated HDR ICBT. The Cartesian co-ordinates of point A (left and right) for the applicator geometry also showed significant variation during multiple HDR ICBT procedures. This resulted in an average shift of 9.5 mm (SD= +/-4.4) and 11.1 mm (SD= +/-6.4) in right point A, 10.2 mm (SD= +/-4.5) and 10.8 mm (SD= +/-6.6) in left point A for Ralstron and Rotterdam applicator, respectively, during the three HDR ICBT. Consequently, doses to both right and left point A's showed significant variation during multiple ICBT application and were independent of the applicator type. CONCLUSION: Applicator variation in the components and spatial position in the pelvis during multiple HDR ICBT results in multiple point A's irrespective of the nature of applicator, leading to uncertainty in the dose prescription. These uncertainties, which have a bearing on clinical end points, could be minimised by shifting from point-based dose prescription to image-based target localisation and treatment planning in ICBT.

Adult↗

PubMed2003

Role of vascular access as a risk factor for infections in hemodialysis.

Infections are a major cause of morbidity and mortality in chronic hemodialysis patients. This single center prospective study was carried out to determine the incidence and risk factors for infection in hemodialysis patients and plan appropriate strategies to reduce the risk of infection. A total of 84 consecutive patients who were initiated on hemodialysis over a 2-year period were followed until they either received a kidney transplant or died. In our hospital, as a policy, patients are offered hemodialysis as a bridge therapy to a kidney transplant. The mean duration of follow up was 3 months (range 1-11.8 months). The factors associated with at least one episode of infection were evaluated. Statistical analysis was done by multivariate stepwise logistic regression method. Fifty-one patients had a total of 57 episodes (67.8%) of infection. Of the 44 episodes of acute bacterial infections, vascular access exit site infection was the commonest followed by septicemia (13 patients, 29.5%). Staphylococcus aureus was the commonest bacterial isolate observed in 14 patients. On multivariate analysis, three risk factors for infection were identified: (1) nonarteriovenous fistula (AVF) vascular access for hemodialysis (p = 0.02), (2) increased number of hemodialysis sessions (p = 0.03), and (3) lower serum calcium level (p = 0.02). NonAVF vascular access was found to be the most important risk factor for infection in hemodialysis patients. Creation of an AV fistula, preferably at an early stage, appears beneficial for minimizing the risk of infection even in patients who are on short-term hemodialysis as a bridge therapy towards a kidney transplant.

Adult↗

PubMed2003

Is neurocysticercosis a risk factor in coexistent intracranial disease? An MRI based study.

BACKGROUND: Previous reports have suggested that neurocysticercosis is associated with glioma and Japanese encephalitis, and that it is a risk factor for stroke. OBJECTIVE: To determine if neurocysticercosis has a significant association with, or is a risk factor for, coexistent pathologies such as Japanese encephalitis, glioma, abscess, tuberculoma, or infarction. SUBJECTS: 10 350 patients from the hospital population who underwent 1.5 T cranial magnetic resonance imaging during the previous 12 years were evaluated for the presence of neurocysticercosis and coexisting pathology. DESIGN: Retrospective cohort analysis. RESULTS: The prevalence of neurocysticercosis in cases with dual pathology was significantly less than in a control group (1.1% v 8.3%; z = 11.05; p < 0.001, power of test = 1). Neurocysticercosis lesions were less common (p < 0.05) in the different subgroups of coexistent pathology than in the control group except in the case of Japanese encephalitis, where the difference was non-significant (z = 0.69, p = 0.49). The relative risk was less than 1 in all subgroups except Japanese encephalitis, where it was 1.23. The location of neurocysticercosis lesions and the presence of perilesional oedema did not affect coexistent lesion location or severity on a particular side (p = 0.413 and 0.623 for location and perilesional oedema, respectively). When the above factors were analysed separately in patients with Japanese encephalitis, they also did not affect coexistent lesion location or severity (p = 0.659 and 0.548, respectively). CONCLUSIONS: The coexistence of neurocysticercosis and other lesions may be an incidental observation in a few patients referred from areas of high prevalence and endemicity. It appears unlikely that neurocysticercosis is a risk factor for other intracerebral pathology. The location of neurocysticercosis lesions and whether or not there is surrounding perilesional oedema do not appear to affect the location or severity of coexisting lesions.

Adolescent↗

PubMed2002

Drug sensitivity assay for leukaemic cells by flow cytometry.

BACKGROUND & OBJECTIVES: Drug sensitivity assays are useful in oncology practice for evaluating the sensitivity of malignant cells to anti-cancer drugs. The usefulness of such assays for the prediction of clinical response to therapy has also been demonstrated. The existing methods used for this purpose are time consuming and labour intensive. Here we report a simplified flow cytometry based assay for evaluating the in vitro drug sensitivity of leukaemic cells. METHODS: The chemo-sensitivity of three human leukaemic cell lines (a lymphoblastoid cell line, Jurkat; an erythroleukaemic cell line, K 562 and a myelomonocytic cell line HL-60) was investigated by flow cytometry. Flow cytometry was used to determine LD50 (50% inhibitory concentration) for prednisolone on Jurkat and daunorubicin on HL 60 and K 562 cell lines respectively. Per cent cell death could directly be assessed on a flow cytometer by measuring the fluorescence after staining with propidium iodide (PI). For comparison MTT assay was also performed using prednisolone on Jurkat and daunorubicin on HL-60. RESULTS: Cytotoxic effect of drugs was found to be dose dependent. Mean LD50 of prednisolone for Jurkat cells by flow cytometry was 0.805 +/- 0.058 mg/ml and by MTT assay 0.866 +/- 0.115 mg/ml. Mean LD50 of daunorubicin for HL-60 was 1.96 +/- 0.05 micrograms/ml by flow cytometry and 1.90 +/- 0.282 micrograms/ml by MTT assay. The mean LD50 of daunorubicin to K 562 was 0.49 +/- 0.049 mg/ml by the flow cytometry method. The inter-assay variation for the LD50 by flow cytometry based assay was found to be 6, 14 and 10 per cent for Jurkat, HL-60 and K 562 respectively. INTERPRETATION & CONCLUSION: We report a flow cytometry based drug-sensitivity assay for leukaemic cells, which uses a single dye staining and is rapid, technically simple and reproducible. The results compare well with the more commonly used MTT assay, which is labour intensive and time consuming. The limitation of our method is that it can only be used for studying cells in suspension and is therefore not suitable for adherent cell lines.

Antibiotics, Antineoplastic↗

PubMed2002

Management of persistent atrial fibrillation following balloon mitral valvotomy: safety and efficacy of low-dose amiodarone.

BACKGROUND AND AIM OF THE STUDY: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia encountered in clinical practice. In developing countries, rheumatic mitral stenosis (MS) is the most frequent underlying condition in patients with AF. Sinus rhythm (SR) is difficult to achieve and maintain in these patients, but would be more easily achieved with reduction of left atrial pressure after successful balloon mitral valvotomy (BMV). METHODS: Eighty-five patients with persistent AF following BMV received amiodarone (600 mg once daily for two weeks, 200 mg daily thereafter). Electrical cardioversion was performed in those with persistent AF (at six and 12 weeks of drug therapy). RESULTS: Among patients, 33 (39%) converted with amiodarone alone. Of 52 patients who underwent cardioversion at six weeks, 41 (79%) converted to SR. Overall, 87% of patients converted to SR. None of the 11 patients with persistent AF could be converted to SR, despite a second attempt with direct current (DC) cardioversion at 12 weeks. Those who converted to SR had significantly shorter AF duration (AFD) (2.7+/-1.1 versus 3.2+/-0.7 years) and smaller left atrial (LA) size (50.0+/-7.7 versus 57.9+/-4.7 mm). Patient age, gender, NYHA class, ejection fraction and post-BMV variables were comparable between the two groups. Successful maintenance of SR was possible in 61/74 (82%) patients at a mean follow up of 30.6+/-7.1 months (range: 16-43 months). Again, mean AFD was shorter (1.8+/-0.6 versus 3.0+/-0.7 years) and LA size smaller (48.9+/-7.5 versus 54.7+/-6.9 mm) among those who maintained SR. However, even in patients with AFD > or =2 years, successful conversion and maintenance of SR was possible in 74% and 62% of patients, respectively. Among patients with LA size > or =60 mm (n = 16), the corresponding value were 84% and 77%, respectively. On multivariate analysis, only AFD was a predictor of acute and long-term success. The probability of SR remaining in those with AFD <2 years at 21, 30 and 43 months was 96%, 95% and 94.6%, respectively, while for those with AFD > or =2 years these values were 62%, 48% and 40%. CONCLUSION: Low-dose amiodarone was safe and effective in restoring and maintaining SR in patients with AF and rheumatic heart disease.

Adult↗

PubMed2001

Variations of intracavitary applicator geometry during multiple HDR brachytherapy insertions in carcinoma cervix and its influence on reporting as per ICRU report 38.

PURPOSE: This paper examines the extent of variation in the applicator geometry during multiple high dose rate (HDR) intracavitary brachytherapy (ICBT) applications and its impact on reporting as per ICRU report 38. MATERIALS AND METHODS: Eighty orthogonal radiographs from 20 consecutive patients of carcinoma cervix (FIGO stages, IIA-IIIB) having four HDR ICBT applications of 6 Gy each at weekly intervals following teletherapy were evaluated. The applicator consisted of a flexible intrauterine tandem (IUT) independent of the ovoid assembly. The applicator geometry was evaluated in terms of: alpha angle, beta angle, intrauterine length (IUTL), interovoid (IOV), os to right ovoid (ORT) and os to left ovoid (OLT) distances along with vertical (VDL) and anteroposterior displacements (ADL) of the os with respect to the ovoids. The Cartesian co-ordinates (X, Y, and Z) of the IUT tip, centre of both ovoids and os were also measured. Doses to right point A (ARD), left point A (ALD), along with a reference volume of 6 Gy for ICRU height (IRH), width (IRW), thickness (IRT) and volume (IRV) were estimated for each application. RESULTS: Highly significant differences (P<0.001) between four insertions in any given patient across 20 patients for alpha angle, beta angle, IUTL, IOV, ORT, VDL, co-ordinates of the IUT, ovoids and os were observed, except for ADL (P=0.041) and OLT (P=0.247). As a consequence, variations were observed in ARD (P=0.027), ALD (P=0.017); IRH, IRW, IRT and IRV (all P<0.001). Applicator factors which influenced the various dose specification parameters were: beta angle and ORT for both ARD and ALD; UTLN, VDL and ORT for IRH; UTLN and IOV for IRW; UTLN for IRT and VDL for the 6 Gy IRV. CONCLUSIONS: A significant variation of the applicator geometry and its movement was observed in patients undergoing multiple HDR ICBT. This could have implications for reporting dose and volume specifications as required by ICRU report 38.

Brachytherapy↗

PubMed2001

Determinants of pancreaticoenteric anastomotic leak following pancreaticoduodenectomy.

BACKGROUND: The purpose of the present paper was to study the incidence, presentation and management of pancreaticoenteric anastomotic (PEA) leak following pancreaticoduodenectomy (PD) and to identify risk factors associated with PEA leak. METHODS: One hundred and twenty patients underwent PD for benign and malignant pancreatic and periampullary lesions from 1989 to 1998. Prospectively collected data were analysed for incidence and outcome of PEA leak. Four clinical, three laboratory parameters, preoperative biliary drainage (PBD), perioperative octreotide use, nine intraoperative parameters, site of tumour and stage of malignant tumours were analysed by univariate and multivariate logistic regression analysis to identify factors influencing PEA leak. RESULTS: Pancreatic leak developed in 15 (12.5%) patients. Nine patients (60%) had a PEA leak that manifested as controlled leak through the drain. All were managed conservatively and the leak stopped after a mean duration of 17 days (range: 6-32 days). Six (40%) patients had associated intra-abdominal complications, and three (50%) died in the postoperative period. Pancreatic fistula healed in the three remaining patients after a mean duration of 18 days (range: 15-25 days). Diabetes (P = 0.02; odds ratio (OR) = 4.60; 95% confidence interval (CI): 1.23-17.18), PBD (P = 0.03; OR = 4.82; 95% CI: 1.21-19.24), sequence of reconstruction (bilioenteric anastomosis as first anastomosis; P = 0.01; OR = 6.25; 95% CI: 1.45-26.83) and duration of surgery > 8 h (P = 0.01; OR: 5.61; 95% CI: 1.54-20.39) were associated with a significantly higher incidence of PEA leak. CONCLUSION: Pancreaticoenteric anastomotic leak occurred in 12% of patients undergoing PD for pancreatic and periampullary tumours. The majority of these were uncomplicated and healed with conservative treatment. Complicated leaks were associated with high mortality. Diabetes mellitus, PBD, prolonged surgery and the sequence of reconstruction were risk factors associated with an increased incidence of PEA leak.

Adult↗

PubMed2001

Prognostic factors for persistent distal renal tubular acidosis after surgery for posterior urethral valve.

Risk factors, including age at presentation, age at surgery, time between presentation and surgery, urodynamic abnormalities, and vesicoureteric reflux, were prospectively studied for the development of distal renal tubular acidosis (DRTA) before surgery and persistent DRTA after surgery in 24 boys with posterior urethral valve (PUV) with normal serum creatinine levels. DRTA was persistent in 11 of 17 boys (65%) at the end of follow-up after intervention. For the development of DRTA before surgery, only a longer time between presentation and surgery (intervening period) turned out to be a significant risk factor on multivariate analysis (beta = -0.13; P = 0.04). Boys with persistent DRTA after surgery had older age at presentation (P = 0.03), older age at surgery (P = 0.001), a longer intervening period (P = 0.0007), and bilateral or severe unilateral reflux (P = 0.04) before surgery. On univariate logistic regression, age at surgery (beta = -0.07; P = 0.04) and intervening period (beta = -0.13; P = 0.02) were found to be significant risk factors for persistent DRTA, but on multivariate analysis, only intervening period was found to be significant (beta = -0.13; P = 0.02). A delay in intervention after noticing voiding symptoms can predict a high incidence of DRTA before intervention and persistent DRTA after surgery in boys with PUV.

Acidosis, Renal Tubular↗

PubMed2001

Pulse cyclophosphamide therapy in frequently relapsing nephrotic syndrome.

BACKGROUND: The treatment of frequently relapsing (FR) and steroid-dependent (SD) idiopathic nephrotic syndrome (INS) with oral cyclophosphamide (OCP) poses problems of compliance, side-effects and infections. METHODS: We prospectively evaluated the usefulness of intravenous cyclophosphamide (IVCP) in children with steroid sensitive INS who were frequent relapsers or steroid dependent. Fifty-one children were included in the study of whom 22 were FR and 29 were SD. IVCP was administered in a dose of 500 mg/m(2)/month for 6 months after achieving a steroid-induced remission. The response to IVCP was evaluated in terms of remission, change in the steroid response status of the patient, duration of remission (i.e. proteinuria-free days), side effects and compliance with therapy. RESULTS: The proteinuria-free days (mean 19.9+/-3.5 before IVCP therapy vs 1256+/-167 days after IVCP therapy) (P<0.00001), and serum albumin levels (23+/-1.6 g/l before IVCP therapy vs 34+/-2 g/l after IVCP therapy) (P<0.001) were significantly higher following IVCP therapy. The cumulative remission rate in the study group was 49% at 5 years and was comparable to that achieved with oral cyclophosphamide at a 40% lower cumulative dose. CONCLUSIONS: We conclude that IVCP is a safe and effective therapeutic modality in children with INS who are FR and SD. Its efficacy is comparable to the results obtained with oral cyclophosphamide based on historical comparisons with previous studies.

Adolescent↗

PubMed2001

Effect of a subanesthetic dose of intravenous ketamine and/or local anesthetic infiltration on hemodynamic responses to skull-pin placement: a prospective, placebo-controlled, randomized, double-blind study.

Insertion of cranial pins for stabilization of the head can result in a marked hypertensive response, which may adversely affect cerebral hemodynamics. The efficacy of a subanesthetic dose of intravenous ketamine (0.5 mg/kg) and/or lidocaine infiltration (1%) at pin fixation sites before pinning was studied in a prospective, double-blind, placebo-controlled, randomized trial of 40 patients. The subjects were divided into four groups of 10. Patients belonging to the placebo and lidocaine groups received intravenous normal saline (NS), followed by local infiltration with NS at pin insertion sites in the placebo group and 1% lidocaine in the lidocaine group. Patients belonging to the ketamine and ketamine-lidocaine groups received intravenous ketamine followed by local infiltration with NS in the ketamine group, and lidocaine infiltration in the ketamine-lidocaine group. Heart rate (HR) and invasive mean blood pressure (MBP) were recorded before intravenous medication and then at various time intervals until 15 minutes after pin fixation. Intergroup comparison of MBP and HR by 2-way analysis of variance revealed a significant difference between the groups and various time points (P < .05). Post hoc analysis revealed maximum increase in MBP each hour in the placebo group. Mean blood pressure response in the ketamine group was similar to the placebo group. Significant attenuation of MBP and HR was observed in the lidocaine and ketamine-lidocaine groups (P < .05). A minimal increase in HR was observed in the lidocaine-ketamine group. The current study demonstrates maximum attenuation of hemodynamic responses when a subanesthetic dose of intravenous ketamine (0.5 mg/kg) is administered with 1% lidocaine infiltration.

Adolescent↗

PubMed2000

Modulation of autoimmune diseases by nitric oxide.

Nitric oxide (NO) is an intercellular messenger that performs a number of functions, including neurotransmission, vasodilatation, inhibition of platelet aggregation, and modulation of leukocyte adhesion. NO has recently been shown to act as a potent cytotoxic effector molecule as well as to play an important role in the pathogenesis of organ-specific autoimmunity. NO may also modulate the immune response by interfering with Th1/Th2 balance in autoimmune diseases. This review will discuss the role of NO and nitric oxide synthase (NOS) in pathophysiologic and therapeutic implications in various autoimmune diseases with particular reference to T helper-1 (Th1) and T helper-2 (Th2) cytokines.

Adjuvants, Immunologic↗

PubMed2000

Peritoneal equilibration test in Indian patients on continuous ambulatory peritoneal dialysis: does it affect patient outcome?

The variations in peritoneal equilibration test (PET) characteristics in various ethnic groups have been reported. Data are scarce regarding the pattern of membrane characteristics in Indian patients. The factors affecting PET and the PET, in turn, affecting patient outcome are controversial issues. We prospectively analyzed 41 patients to evaluate: (1) the pattern of PET characteristics in Indian patients; (2) the factors affecting the PET; (3) the effect of membrane characteristics on patient outcome. The mean period of follow up was 17.1 +/- 9.3 months. The PET results revealed 21 high transporters (51%), 13 high-average transporters (32%), 6 low-average transporters (15%), and 1 low transporter (2%). The distribution of the various PET categories in patients below the age of 60 years and those 60 years or above was not significant (p = 0.70). The sex distribution (p = 0.94) and prevalence of diabetes (p = 0.62) were not significantly different in various PET categories. On regression analysis, PET values were not affected by the age of patients (beta = 0.80, p = 0.61). Patient survival among high and high-average transporters was significantly less compared with low and low-average transporters (p = 0.01). We conclude that Indian patients on continuous ambulatory peritoneal dialysis (CAPD) have a higher proportion of high and high-average transporters. The pattern of membrane kinetics cannot be explained by differences in patient characteristics and diabetic status. Patients with high PET values have poorer patient survival on CAPD.

Adult↗

PubMed1996

Effect of elevated temperature on cytotoxic effector cells.

Several studies have shown a direct correlation between temperature and immune response. The effect of elevated temperature on cytotoxic effector functions is not well known. In the present study we have investigated the effect of elevated temperatures (38.5 and 40 degrees C) on cytotoxicity of lymphokine-activated killer cells (LAK), monocyte cytotoxicity, cytotoxic T lymphocytes (CTL) and tumor necrosis factor (TNF)-mediated cytotoxicity, and compared them with results at 37 degrees C. LAK cell cytotoxicity was inhibited significantly at 40 degrees C (p < 0.01) and there was no marked difference at 38.5 degrees C (p = 0.17) as compared to 37 degrees C when natural killer (NK)-sensitive K562 cells were used as target. When NK-resistant Raji cells were used as a target, cytotoxicity was inhibited at 40 degrees C (p = 0.33). Monocyte cytotoxicity was enhanced at 40 degrees C (p = 0.19) as well as at 38.5 degrees C (p = 0.38) as compared to 37 degrees C but differences were not statistically significant. Lipopolysaccharide (LPS) enhanced monocyte cytotoxicity. LPS-stimulated enhancement was further enhanced significantly at 40 degrees C (P < 0.05) and 38.5 degrees C (p < 0.05). Cytotoxicity of CTL was significantly inhibited at 38.5 compared to 37 degrees C (p < 0.0002). TNF-mediated cytotoxicity was significantly enhanced at 40 degrees C (p < 0.0004) and 38.5 degrees C (p < 0.001).

Animals↗

PubMed1995

Predictors of survival in patients with carcinoma of the gallbladder.

BACKGROUND: The role of resectional surgery in patients with advanced stages of gallbladder carcinoma has not been fully defined. It is generally believed that the survival depends on the stage of the disease, rather than on the treatment option. METHODS: Seventeen selected risk factors were analyzed using univariate and multivariate analyses to predict survival in 87 patients with gallbladder carcinoma who had undergone some form of surgical treatment. Similarly, a subset of 55 patients with American Joint Committee on Cancer Stage IV disease also was analyzed separately. RESULTS: Palpable mass, tumor (T) status, local infiltration, lymph node involvement, distant metastasis, TNM stage, and the type of surgical treatment (laparotomy alone, bypass, or resection) were significant risk factors by univariate analysis. In addition to palpable mass and the type of surgical treatment, age was also a significant predictor of survival by multivariate analysis. Multivariate analysis of patients with Stage IV disease revealed the same three factors to be significant. In this subset of patients, the median survival after resectional surgery was 16.3 months; after biliary and/or gastric bypass, 4.8 months; and after laparotomy alone, 1.6 months. CONCLUSIONS: The type of surgical treatment significantly influenced survival. Resectional surgery was associated with better survival compared with biliary and/or gastric bypass or laparotomy alone for patients with all stages of the disease, including those with advanced carcinoma of the gallbladder.

Adult↗

PubMed1995

The magnetic resonance renogram in renal transplant evaluation using dynamic contrast-enhanced MR imaging.

To assess the role of the dynamic gadolinium DTPA (Gd-DTPA) magnetic resonance (MR) renogram in differentiating various causes of renal allograft dysfunction, contrast-enhanced MR imaging studies were performed in 5 normal renal allografts, 5 patients with acute rejection (AR), and 7 patients with cyclosporine nephrotoxicity. Time-versus-signal intensity (SI) curves were plotted. Normal renal allografts showed a rapid increase and slow decay, with a definite peak in cortical (CX) SI curves (peak mean signal intensity (Amax 338.6 +/- 46.5). The outer medullary (OM) (Amax 306.5 +/- 59) and inner medullary (IM) (Amax 263.4 +/- 47.4) curves did not show a definite peak. The OM curve slowly reached a steady state and caught up with the CX curve. AR episodes were characterized by a blunted uprise and delayed peak of CX (Amax 180 +/- 70.9) and a low-amplitude vascular phase with a slow constant uprise of the inner medullary curve (Amax 120.35 +/- 42.4). The OM signal intensity curve (Amax 150.73 +/- 78) failed to catch up with the CX curve. The maximum amplitude of SI curves in CsA-induced allograft dysfunction were low, with no definite peak, and CX, OM, and IM curves ran parallel to each other with a constant gap. Dynamic Gd-DTPA, MR imaging is a noninvasive technique that shows distinct characteristics in acute rejection, cyclosporine nephrotoxicity, and normally functioning renal allografts.

Adult↗

PubMed1994

H reflex studies in neurolathyrism.

Sixteen patients with lathyrism, age ranging between 18 and 55 years and duration of illness between 2 and 25 years, underwent H reflex studies with the aim of studying motor neurone excitability. The patients had marked spasticity (Ashworth score ranging between 2 and 5) and mild to moderate leg weakness. Knee and ankle reflexes were exaggerated in all and the plantar response was extensor in 14 patients. The H reflex abnormalities included increased HM ratio indicating increased motoneurone excitability, significant lack of vibratory inhibition indicating altered transmission in the premotoneuronal portion of the H reflex pathway, and lack of reciprocal inhibition (P < 0.01). These H reflex abnormalities were not related to spasticity, weakness, clonus or plantar response. The H reflex recovery curve in 6 patients revealed increased excitability throughout the recovery curve. The secondary facilitation started and peaked slightly earlier than normal, and the late depression was not marked indicating change in excitability of motoneurones or of interneurones.

Adolescent↗

PubMed1994

A study of cognitive functions and event related potentials following organophosphate exposure.

To study the cognitive changes following chronic occupational exposure to organophosphate (OP) pesticides, a clinical and neurophysiological study was performed on 31 workers engaged in spraying fenthion, an OP pesticide. The mean age of the workers was 32.1 years (range 19-55) and mean duration of exposure 10.5 years (range 1-14). The workers reported mild transient symptoms after spraying. There was no clinical evidence suggestive of excessive cholinergic activity. Clinical psychometry revealed significant changes in Benton visual retention test, memory quotient, and Alexander's Passalong Test. Serum AChE level was 27% less in the exposed group compared to the controls. P3 of event related potentials were elicited in 28 subjects, P3 latency though was prolonged in one subject only but the group difference was significant. The amplitude of P3 however did not show significant difference. The results suggest subtle subclinical effect of chronic fenthion exposure on the cognitive functions and event related potentials.

Acetylcholinesterase↗

PubMed1989

An extension of a model for first birth interval and some social factors.

"A model for the time of first birth is presented under certain assumptions, which involve biological and socio-cultural factors." The model is illustrated using data from Rural Development and Population Growth--A Sample Survey, 1978, conducted in Varanasi, India, and involving some 3,514 households.

Asia↗