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Biomedical subjects

D Chaudhary

Publications and source records attributed to D Chaudhary.

At least 19 recordsLinked to original sources
PubMed2005

Experience with aspiration in cases of amebic liver abscess in an endemic area.

The study presented here was performed to evaluate the need for aspiration in patients with amebic liver abscess (ALA). Patients older than 12 years with a diagnosis of ALA based on clinical features, ultrasound results, and positive amebic serology were included in the study (n=144). Serological testing was performed to detect the presence of immunoglobin G antibody against Entamoeba histolytica, and a value of more than 0.4 optical density units was considered positive. All patients were given intravenous metronidazole (500 mg every 8 h) and their clinical progress and need for abscess aspiration was documented. Fever, pain in the upper abdomen, and tender hepatomegaly was seen in 133 (92.3%), 128 (88.8%), and 144 (100%) patients, respectively. Multiple abscesses were seen in 40 (27.7%) patients. Six (4.1%) patients died. Seventy-one (49.3%) patients responded to metronidazole alone. A total of 73 (50.69%) patients required aspiration of the abscess. This study shows that almost 50% of the patients with amebic liver abscess failed to respond to metronidazole and required aspiration.

Adolescent↗
PubMed2005

Arthroscopic reconstruction of the anterior cruciate ligament using bone-patellar tendon-bone autograft: experience of the first 100 cases.

PURPOSE: To review the results of patients who underwent arthroscopic reconstruction of the anterior cruciate ligament (ACL) via a single incision technique using a bone-patellar tendon-bone autograft. METHODS: Patients with ACL-deficient knees who were symptomatic and wanted to maintain an active lifestyle or continue sporting activities were included. ACL reconstruction using the bone-patellar tendon-bone graft was performed on 100 patients. One-year follow-up was completed in 78 patients who were then reviewed. The mean age of patients reviewed was 26.8 years (range, 21-39 years), of whom 35 (44.9%) were aged between 26 and 30 years. There were 73 men and 5 women (ratio, 14.6:1). Injuries on the right side outnumbered those on the left (44 versus 34). Sports injuries accounted for 66.7% (n = 52) of patients, motor vehicle accidents and household injuries accounted for 30.8% (n = 24) and 2.6% (n = 2), respectively. RESULTS: Excellent and good-to-excellent results were achieved in 7 (9%) and 61 (78.2%) of patients. Residual anterior knee pain (n = 18) was the most common complication, followed by difficulty in regaining full range of motion (n = 10) and divergence of femoral screw (n = 9). CONCLUSION: This procedure provides consistent and reproducible results in carefully selected patients and allows them an early return to sporting activities with minimal residual morbidity.

Adult↗
PubMed2003

Anthropometry and body composition in northern Asian Indian patients with type 2 diabetes: receiver operating characteristics (ROC) curve analysis of body mass index with percentage body fat as standard.

AIMS: To determine the anthropometric profile and appropriate cut off of body mass index (BMI) to define obesity in Asian Indians with Type 2 diabetes mellitus (T2DM). METHODS: Three hundred and eighty T2DM patients (213 males and 167 females) in northern India were subjected to anthropometric and body fat analysis (derived from skinfold thickness). The latter was considered as "standard" for defining obesity. Receiver Operating Characteristics (ROC) curves were drawn for males and females to determine the appropriate limits of BMI to define obesity. RESULTS: Mean values of percentage of body fat (%BF) were 40.2 +/- 6.2% and 29.4 +/- 7.1% in females and males, respectively. Of particular note, substantial percentage of patients had high values of waist-hip ratio (W-HR) [males > 0.95 (53.9%), and females > 0.80 (88.6%)] indicating significant abdominal obesity, and high % BF [males > 25 % BF (73.2%), females > 30% BF (92.2%)] indicating generalized obesity as well. Significantly higher prevalence of obesity was observed in both males (p < 0.001) and females (p < 0.001) when estimated by %BF (males > 25%, females > 30%), as compared to BMI (> 25 kg/m2 in both males and females). ROC curve analysis showed that with %BF taken as the 'standard' for determining obesity, sensitivity and specificity of BMI of > 25 kg/m2 were low. For BMI > 22 kg/m2 in males and > 23 kg/m2 in females, sensitivity increased and there was decrease in overall misclassification. CONCLUSIONS: The data of current study suggest strikingly high prevalence of abdominal obesity, and generalized obesity as determined by %BF in T2DM patients, and that cut offs for defining obesity by BMI are lower than the suggested limit of 25 kg/m2. Revised definition of obesity using lower cut off of BMI, or based on %BF in northern Asian Indian T2DM patients will lead to a more rational application of dietary restriction, lifestyle measures, and use of metformin.

Abdomen↗
PubMed2001

PD-L2 is a second ligand for PD-1 and inhibits T cell activation.

Programmed death I (PD-I)-deficient mice develop a variety of autoimmune-like diseases, which suggests that this immunoinhibitory receptor plays an important role in tolerance. We identify here PD-1 ligand 2 (PD-L2) as a second ligand for PD-1 and compare the function and expression of PD-L1 and PD-L2. Engagement of PD-1 by PD-L2 dramatically inhibits T cell receptor (TCR)-mediated proliferation and cytokine production by CD4+ T cells. At low antigen concentrations, PD-L2-PD-1 interactions inhibit strong B7-CD28 signals. In contrast, at high antigen concentrations, PD-L2-PD-1 interactions reduce cytokine production but do not inhibit T cell proliferation. PD-L-PD-1 interactions lead to cell cycle arrest in G0/G1 but do not increase cell death. In addition, ligation of PD-1 + TCR leads to rapid phosphorylation of SHP-2, as compared to TCR ligation alone. PD-L expression was up-regulated on antigen-presenting cells by interferon gamma treatment and was also present on some normal tissues and tumor cell lines. Taken together, these studies show overlapping functions of PD-L1 and PD-L2 and indicate a key role for the PD-L-PD-1 pathway in regulatingT cell responses.

Amino Acid Sequence↗
PubMed2001

Relation between plasma leptin and anthropometric and metabolic covariates in lean and obese diabetic and hyperlipidaemic Asian Northern Indian subjects.

This study investigated the relationship of plasma leptin to obesity, diabetes and hyperlipidaemia in Asian Northern Indian subjects, considered to have a predisposition to abdominal obesity and metabolic syndrome. A total of 72 subjects, subcategorised into lean and obese healthy subjects, lean and obese Type 2 diabetic and lean and obese non-diabetic hyperlipidaemic subjects were recruited. High leptin values were observed in all obese groups, and obese diabetic patients showed the highest levels. In lean and obese diabetic subjects, plasma leptin did not show any correlation to any index of glycaemia. When all lean and all obese subjects were analysed in two separate groups, body mass index (BMI), percent total body fat, and body density significantly correlated with the plasma leptin levels (p<0.05). Leptin values, when correlated to all variables in all patients taken together, showed the greatest magnitude of correlation with BMI (r=0.64), percent total body fat (r=0.67), and waist circumference (r=0.51). Strong inverse correlation was seen with body density (r=-0.67). Levels of serum insulin did not show any correlation with leptin levels in all subjects combined, and separately in various groups. Multiple linear regression analysis performed in obese, non-diabetic and normolipidaemic subjects, all Type 2 diabetic and all non-diabetic hyperlipidaemic subjects separately showed that percent total body fat is the only significant predictor of plasma leptin concentration in all the 3 groups. The present study suggests that plasma leptin has a strong positive correlation with percent total body fat in Asian Northern Indian subjects. Among other components of metabolic syndrome, only abdominal obesity is weakly correlated to serum leptin levels.

Adipose Tissue↗
PubMed1999

Comparative evaluation of the inflammatory mediators in patients undergoing laparoscopic versus conventional cholecystectomy.

BACKGROUND: Injury induces systemic inflammatory response. The degree of response is proportionate to the trauma. METHODS: Patients with ultrasound-proven gall stones posted for operation were randomized into two groups. Laparoscopic cholecystectomy was performed in one group while the other group underwent conventional cholecystectomy. Peripheral venous blood samples for inflammatory mediators, namely tumour necrosis factor, C-reactive protein, oxygen release from monocytes and polymorphonuclear leucocytes were drawn 1 day before surgery and repeated on the first and third days after surgery. Partial pressure of arterial oxygen was also measured in both groups. Only patients who met selection criteria and had uncomplicated postoperative courses were included in the study. There was a total of 40 patients for the final analysis, 20 in each group. RESULTS: There was no significant difference (P > 0.1) in age, sex or body mass index in both groups of patients. The level of all of the inflammatory mediators was elevated on the first postoperative day; however, the elevation was significantly less following laparoscopic cholecystectomy compared to conventional cholecystectomy (P < 0.01). Although the values came down on the third postoperative day, they remained above the respective controls. Postoperative hypoxaemia was significantly more in patients of conventional than laparoscopic cholecystectomy (P < 0.001). CONCLUSIONS: Trauma-induced inflammatory response is significantly less following laparoscopic cholecystectomy compared to conventional cholecystectomy. It appears to be related to degree of trauma.

Adult↗
PubMed1998

The death inhibitory molecules CED-9 and CED-4L use a common mechanism to inhibit the CED-3 death protease.

The apoptotic machinery of Caenorhabditis elegans includes three core interacting components: CED-3, CED-4, and CED-9. CED-3 is a death protease composed of a prodomain and a protease domain. CED-4 is a P-loop-containing, nucleotide-binding molecule that complexes with the single polypeptide zymogen form of CED-3, promoting its activation by autoprocessing. CED-9 blocks death by complexing with CED-4 and suppressing its ability to promote CED-3 activation. A naturally occurring alternatively spliced form of CED-4 that contains an insertion within the nucleotide-binding region (CED-4L) functions as a dominant negative inhibitor of CED-3 processing and attenuates cell death. Domain mapping studies revealed that distinct regions within CED-4 bind to the CED-3 prodomain and protease domain. Importantly, the CED-4 P-loop was involved in prodomain binding. Disruption of P-loop geometry because of mutation of a critical lysine (K165R) or insertional inactivation (CED-4L) abolished prodomain binding. Regardless, K165R and CED-4L still retained CED-3 binding through the protease domain but were unable to initiate CED-3 processing. Therefore, the P-loop-prodomain interaction is critical for triggering CED-4-mediated CED-3 processing. Underscoring the importance of this interaction was the finding that CED-9 contacted the P-loop and selectively inhibited its interaction with the CED-3 prodomain. These results provide a simple mechanism for how CED-9 functions to block CED-4-mediated CED-3 processing and cell death.

Apoptosis↗
PubMed1996

Hyperhomocysteinemia confers an independent increased risk of atherosclerosis in end-stage renal disease and is closely linked to plasma folate and pyridoxine concentrations.

BACKGROUND: A high level of total plasma homocysteine is a risk factor for atherosclerosis, which is an important cause of death in renal failure. We evaluated the role of this as a risk factor for vascular complications of end-stage renal disease. METHODS AND RESULTS: Total fasting plasma homocysteine and other risk factors were documented in 176 dialysis patients (97 men, 79 women; mean age, 56.3 +/- 14.8 years). Folate, vitamin B12, and pyridoxal phosphate concentrations were also determined. The prevalence of high total homocysteine values was determined by comparison with a normal reference population, and the risk of associated vascular complications was estimated by multiple logistic regression. Total homocysteine concentration was higher in patients than in the normal population (26.6 +/- 1.5 versus 10.1 +/- 1.7 mumol/L; P < .01). Abnormally high concentrations (> 95th percentile for control subjects, 16.3 mumol/L) were seen in 149 patients (85%) with end-stage renal disease (P < .001). Patients with a homocysteine concentration in the upper two quintiles (> 27.8 mumol/L) had an independent odds ratio of 2.9 (CI, 1.4 to 5.8; P = .007) of vascular complications. B vitamin levels were lower in patients with vascular complications than in those without. Vitamin B6 deficiency was more frequent in patients than in the normal reference population (18% versus 2%; P < .01). CONCLUSIONS: A high total plasma homocysteine concentration is an independent risk factor for atherosclerotic complications of end-stage renal disease. Such patients may benefit from higher doses of B vitamins than those currently recommended.

Aged↗
PubMed1996

Wildervanck syndrome.

We report a case of the Wildervanck (cervico-oculo-acoustic) syndrome exhibiting Klippel-Feil anomaly, congenital sensorineural deafness and bilateral sixth nerve palsy. Associated anomalies included short stature, microcephaly, mental retardation, and cleft palate.

Abducens Nerve↗
PubMed1995

The c-myc promoter binding protein (MBP-1) and TBP bind simultaneously in the minor groove of the c-myc P2 promoter.

The c-myc promoter binding protein (MBP-1) is a DNA binding protein which negatively regulates the expression of the human c-myc gene. MBP-1 binds to a sequence which overlaps the binding site for the general transcription factor TBP, within the c-myc P2 promoter region. Since TBP binds in the minor groove, MBP-1 might inhibit c-myc transcription by preventing the formation of a functional preinitiation complex. In support of this hypothesis, we have demonstrated that MPB-1 is a minor groove binding protein. In order to characterize MBP-1 binding, we substituted A-T base pairs in the MBP-1 binding site with I-C base pairs, which changes the major groove surface without altering the minor groove surface. This substitution did not inhibit the sequence-specific binding of MBP-1 and TBP. On the other hand, G-C to I-C substitution within the MBP-1 binding site alters the minor groove and prevents MBP-1 binding. Competitive electrophoretic mobility shift assays were used to show that berenil, distamycin, and mithramycin, all of which bind in the minor groove, compete with MBP-1 for binding to the MPB-1 binding site. These minor groove binding ligands also effectively inhibit the simultaneous DNA binding activity of both MBP-1 and TBP. We conclude that both MBP-1 and TBP can bind simultaneously in the minor groove of the TATA motif on the c-myc P2 promoter. This suggests that MBP-1 may negatively regulate c-myc gene expression by preventing efficient transcription initiation.

Base Sequence↗
PubMedDate not supplied

Splenic abscess following blunt abdominal trauma.

A rare case of splenic abscess occurring after blunt abdominal trauma in a previously healthy boy is reported. The diagnosis was made by ultrasonography. The patient recovered after splenectomy and drainage of subphrenic and intraperitoneal pus.

Abdominal Abscess↗