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Biomedical subjects

D K Pal

Publications and source records attributed to D K Pal.

At least 37 records · Page 2Linked to original sources
PubMed1999

Methodologic issues in assessing risk factors for epilepsy in an epidemiologic study in India.

OBJECTIVES: To test a field questionnaire for epilepsy risk factors in rural India. BACKGROUND: Case-control studies are necessary to plan appropriate prevention and intervention strategies against epilepsy but difficult to mount in developing countries for various logistic and cultural reasons. Recent studies have proposed nutritional and infective risk factors not reported in Western studies. METHODS: A structured questionnaire including known and putative risk factors was administered to parents of 61 children with epilepsy and 59 randomly selected population control subjects in rural West Bengal. ORs of effect were calculated using a multiple logistic regression model with 95% CIs. RESULTS: Socioeconomic status, febrile convulsions, and reproductive history were easily assessable. Ages, dates, and some proxy infection markers were unreliable. Febrile convulsions were an independent risk factor (OR 6.45; 95% CI, 1.45 to 28.66). Associations with family history and infective symptoms were suggested. No association was demonstrated with socioeconomic status or reproductive factors. CONCLUSIONS: Known risk factors were confirmed, and novel factors were suggested. A retrospective questionnaire does not allow accurate study of infective exposures. Greater statistical power is needed to study weaker associations and interacting effects.

Adolescent↗
PubMed1999

Validation of a Bengali adaptation of the Conners' Parent Rating Scale (CPRS-48).

BACKGROUND: The Conners' Parent Rating Scales (CPRS) have been used to measure behavioural problems in drug trials in children for many years. This study in rural India aimed to validate a translated version of the CPRS-48 for use in a study of anti-epileptic drug side-effects. METHOD: The Scale was translated into local dialect, back-translated, and piloted among healthy families. The revised version was then administered to mothers of 60 healthy children and 63 children with epilepsy. Tests of internal reliability, test-retest reliability and factor analysis were performed. RESULTS: Cronbach's alpha ranged from 0.60 to 0.75 for the subscales, and correlation coefficients after retesting from 0.84 to 0.99. The overall factor structure was very similar to that reported in the original USA sample. CONCLUSION: The Bengali version of the CPRS-48 and its Hyperactivity Index have validity for rural Bengali children, and the process demonstrates that such instruments can be usefully adapted for local purposes.

Analysis of Variance↗
PubMed1998

Randomised controlled trial to assess acceptability of phenobarbital for childhood epilepsy in rural India.

BACKGROUND: The use of phenobarbital for childhood epilepsy is controversial because of reported behavioural side-effects; however, whether this research can validly be extrapolated to developing countries is not clear. We undertook a randomised comparison of phenobarbital and phenytoin to assess the acceptability and efficacy of phenobarbital as monotherapy for childhood epilepsy in rural India. METHODS: Between August, 1995, and February, 1996, 109 unselected children aged 2-18 years with partial and generalised tonic-clonic epilepsy were identified by population screening. 15 families declined to take part. 94 children were randomly allocated treatment with phenobarbital (1.5 mg/kg daily for 2 weeks; maintenance dose 3.0 mg/kg daily; n = 47) or phenytoin (2.5 mg/kg daily then 5.0 mg/kg daily; n = 47). Children were followed up for 12 months. The primary outcome measure was the frequency of behavioural side-effects; behaviour was assessed by the Conners parent rating scale for children aged 6 years and older, and by the preschool behaviour screening questionnaire (BSQ) for those aged 2-5 years, at 12 months or at withdrawal from treatment. Analysis was by intention to treat. FINDINGS: The mean log-transformed scores on the behaviour rating scales did not differ significantly between the phenobarbital and phenytoin groups (Conners 2.64 [SD 0.71] vs 2.65 [0.89], p = 0.97; n = 32 in each group: BSQ 2.12 [1.31] vs 2.18 [1.02], p = 0.94; n = 4 vs 3). The odds ratio for behavioural problems (phenobarbital vs phenytoin) was 0.51 (95% CI 0.16-1.59). There was no excess in parental reports of side-effects for phenobarbital. We found no difference in efficacy between the study drugs (adjusted hazard ratio for time to first seizure from randomisation 0.97 [0.28-3.30]). INTERPRETATION: This evidence supports the acceptability of phenobarbital as a first-line drug for childhood epilepsy in rural settings in developing countries.

Adolescent↗
PubMed1998

Comparison of key informant and survey methods for ascertainment of childhood epilepsy in West Bengal, India.

BACKGROUND: This study aimed to compare efficacy and cost of key informants and survey for ascertainment of childhood epilepsy within a treatment context in rural India. METHODS: The study was set in a non-governmental, community programme for the functional and socioeconomic rehabilitation of children with disabilities in rural West Bengal, India. Ascertainment was by two methods: house-to-house survey of 15000 households and also by 430 key informants including village leaders, health workers and 670 schoolchildren. Methods were compared for positive predictive value, and sensitivity by capture-recapture technique. Ninety four children were enrolled into treatment. Predictors of treatment success were determined by multiple logistic regression analysis, giving adjusted odds ratios for remission. The costs of identifying one case and one treatment success were measured by costing personnel, materials and overheads. RESULTS: The survey was four times as sensitive as key informants although the positive predictive values were similar (36%, 40%). The survey had an absolute sensitivity of only 59%. Identification by key informants strongly predicted successful treatment outcome (odds ratio [OR] = 4.74, 95% confidence interval [CI] : 1.19-18.85). The cost of finding one case was US$11 and US$14, and of finding one successful treatment outcome US$35 and US$67 for informants and survey respectively. Key informants were essential in attaining longer term programme objectives. CONCLUSIONS: In the context of a treatment programme, key informants were the more cost-effective method, but community involvement was traded against low sensitivity in the short term. Overall ascertainment costs were significant in the context of primary health care in India.

Child↗
PubMed1998

Preliminary validation of a parental adjustment measure for use with families of disabled children in rural India.

Parental adjustment is an important outcome in child disability interventions, as well as an important mediating variable for other child and family outcomes. This is just as true in developing countries using models of community-based rehabilitation. Previous experience with Western instruments indicated that an appropriate new measure was required. A questionnaire containing 34 attitude statements rated on a five point scale was administered to the mothers of 46 children with epilepsy in a treatment programme in rural West Bengal, India. Factor analysis was performed on the dataset. Mothers reported feelings of rejection, low self-esteem and guilt. Four domains were derived from the factor analysis. All these attitudes are consistent with previous indian studies on childhood disability. These preliminary findings have implications for social support and counselling intervention. Further research is necessary to validate this instrument for field studies of intervention.

Adaptation, Psychological↗
PubMed1998

Evaluation of best surgical procedures in typhoid perforation--an experience of 60 cases.

The results of treatment of 60 cases of typhoid perforation were reviewed over a period of 4.5 years. Closure of the perforation was the method of treatment in 28 (46.66%) cases and closure of the perforation with side-to-side ileotransverse anastomosis was done in 32 (53.33%) cases. Faecal fistula was the most severe post-operative complication following simple closure of the perforation, causing death in all patients and leading to a 25% mortality in those treated by this technique. No fistula was found following closure of the perforation with side-to-side ileotransverse anastomosis, leading to a much lower mortality of 6.22%. The overall mortality in this series was 15%. Apart from toxaemia, surgical failure was the main contributory factor to such a high mortality. In this series, closure of the perforation with side-to-side ileotransverse anastomosis was the better surgical procedure.

Adolescent↗
PubMed1997

Association of enterotoxigenic Bacteroides fragilis with childhood diarrhoea.

This study was conducted in a hospital setting to determine whether enterotoxigenic strains of Bacteroides fragilis (ETBF) were associated with childhood diarrhoea. ETBF was isolated from 6 (2.6%) of 226 patients and 3 (1.7%) of 172 controls and was found mostly in children between 1-5 yr of age. The syndrome associated with ETBF was secretory in nature with watery diarrhoea and of mild severity. ETBF may be associated with diarrhoeal illness in children but is not a major problem in this part of the country.

Bacteroides Infections↗
PubMed1997

Simple renal cyst: an observation.

In the present study 1500 patients having abdominal ultrasonography were included. Unsuspected renal cysts were detected in 76 patients (5.06%). The age range was between 8 and 86 years with a maximum incidence being at 41-60 years age group. These asymptomatic cysts were observed commonly in the upper pole of right kidney. Incidence as well as size increased with age. Usually these cysts do not require any surgical intervention unless complicated.

Adolescent↗
PubMed1996

Quality of life assessment in children: a review of conceptual and methodological issues in multidimensional health status measures.

STUDY OBJECTIVE: To clarify concepts and methodological problems in existing multidimensional health status measures for children. DESIGN: Thematic review of instruments found by computerised and manual searches, 1979-95. SUBJECTS: Nine health status instruments. MAIN RESULTS: Many instruments did not satisfy criteria of being child centered or family focussed; few had sufficient psychometric properties for research or clinical use; underlying conceptual assumptions were rarely explicit. CONCLUSIONS: Quality of life measures should be viewed cautiously. Interdisciplinary discussion is required, as well as discussion with children and parents, to establish constructs that are truly useful.

Adolescent↗
PubMed1993

Effect of propranolol hydrochloride on blood cell lipids in relation to partition coefficient and biological activity.

Considering the high lipophilicity of propranolol (log P = 3.56), its interactions with the cell membrane lipids of goat blood have been investigated. It is observed that lipid loss after incubation of blood cells with propranolol hydrochloride in salt glucose medium for varying periods of time was accompanied with significant increases in PUFAs. Amongst the PUFAs studied the omega 3 and omega 6 fatty acids, the two important precursors of eicosenoids, have shown increase in varying amounts. This phenomenon is presumably responsible for the significant cardiovascular activity of this drug.

Animals↗
PubMed1993

Possible antineoplastic agents: Part XIII. Synthesis, biological evaluation and QSAR studies of some 1-(substituted benzenesulphonyl)-5-oxopyrrolidine-2-carboxylic acid derivatives.

Twelve analogues of 1-(substituted benzenesulphonyl)-5-oxopyrrolidine-2- carboxylic acid have been synthesized and tested for antineoplastic activity in Swiss albino mice with an Ehrlich ascites carcinoma (EAC) cell line. The values of percent inhibition of growth, both in ascitic cell count and fluid weight, have been taken as activity parameters. Quantitative structure-activity relationships (QSAR) have been studied using the LFER model. The best correlation (R2 = 93.0%) was found using molar refractivity (MR), which measures the molar volume and polarizability of the substituents.

Animals↗
PubMed1993

Correlation of phospholipid loss in goat whole blood with solvochromic properties of antiamebics like emetine, metronidazole and diloxanide furoate.

Phospholipid content of whole blood lipid decreases significantly when goat blood is incubated for different length of time with different amebicidal agents (e.g., emetine, metronidazole and diloxanide furoate). The plots of relative per cent phosphate loss against incubation period show biphasic nature and suggest that the rates of phospholipid loss bears some relation with the drug's lipophilicity (log P in 1 octanol/water system). The absolute phospholipid loss seems to be governed by the drug's aquasolubility. Implication of these finding were discussed in terms of their clinical profiles assuming that the loss of phospholipid is due to drug's binding with the phospholipid layer in amebic cyst-coat, being the first step which may trigger a chain of events leading to the onset of drug action.

Amebicides↗