Biomedical subjects
Publications and source records attributed to D N Srivastava.
A 25-year-old male with severe haemophilia A developed deep vein thrombosis of the left upper limb. Venography showed thrombosis of the basilic vein. There was no underlying prothrombotic condition. He was successfully treated with low-molecular weight heparin.
Porous nickel and cobalt oxides were prepared using NiSO4.6H2O and anhydrous Co(CH3COO)2, a precursor other than alkoxides and cetyltrimethylammonium bromide as organic surfactant. The sonication method has been used for such synthesis. The surfactants were removed by calcination, as well as by solvent extraction and it is extent was examined by IR spectroscopy. The trend of removal of surfactant was followed by TGA studies and the change in phases by DSC. The products were identified by XRD. Peak in low angle XRD indicates the porous nature of the oxides. The morphology of the pores was studied by transmission electron microscopy. The pores were found less ordered, having an average size of 4-6 nm. The Brunauer-Emmet-Teller surface areas of the as-prepared, as well as the treated samples are reported having H2 and H4 type hysteresis for Ni and Co, respectively.
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Patients with differentiated thyroid cancer may have asymptomatic involvement of renal and/or adrenal gland, particularly if they are elderly and have associated metastases to other organs, which may remain undetected if these patients are not subjected to radioiodine treatment. Our experience also emphasises the role of routine post-radioiodine therapy whole body scan with high degree of clinical suspicion, which may reveal lesions otherwise not discernable in low dose whole body scan. All suspicious lesions should be subjected to structural imaging like ultrasound, CT or MRI for confirmation. In this setting, the role of radioiodine therapy is primarily aimed at palliation that might prolong their survival, probably reduce further spread and thus overall improve the quality of life.
Porous nickel and cobalt oxides were prepared using their alkoxides as inorganic precursors. The stabilization of the mesostructure is especially critical for divalent elements such as Ni and Co, which do not form any network structure, like silicates. The lack of a network-forming multivalent bond is the probable reason why no stable mesoporous oxides have been synthesized for divalent elements yet. Here we have reported our attempt to synthesize porous oxides of Ni and Co. Octadecylamine has been used as the organic structure-directing agent. The product obtained was put under solvent extraction and calcination at various temperatures to remove the surfactant, followed by characterization using XRD, TEM and BET measurements. The FT/IR and thermal analyses (TGA and DSC) were also carried out for supporting information, such as extent of removal of surfactant from the pores of the metal oxide. A relatively better surface area has been obtained for the Co oxide, but in Ni the surface area found is not as good. A possible reason for that has been discussed. The porous (solvent extracted) cobalt oxide has been used as a catalyst in the oxidation reaction of cyclohexane in mild conditions. The catalyst has shown relatively better conversion of cyclohexane into cyclohexanone and cyclohexanol than the nanostructured cobalt oxide catalyst of regular structure.
We report an unusual case of spontaneous resolution of bladder adenocarcinoma without any treatment. To our knowledge this is the first case of bladder adenocarcinoma that showed spontaneous regression, in English literature.
We present the study of colour duplex Doppler ultrasonography on Indian patients with non-vasculogenic erectile dysfunction. Patients with a history suggestive of psychogenic impotence along with a normal clinical response to intracavernosal papaverine were presumed to have non-vasculogenic erectile dysfunction. In our patients, the incidence of psychogenic impotence was much higher and the mean age of patients presenting with erectile dysfunction was lower as compared to patients from developed countries reported in research. The Doppler flowmetry showed much higher mean peak systolic velocities (PSVs) with a negative correlation between age and PSV. End diastolic velocity, resistive index and acceleration time values conformed to the literature.
Eighteen cases of laparotomy-proven acute necrotizing jejunoileitis were treated during the period 1992-1998. Routine laboratory investigations and bacteriological studies were non-contributory towards establishing an etiological basis for the diagnosis. Superior mesenteric artery digital subtraction angiography, carried out in five patients, demonstrated extensive neovascularization. IgG, IgM and IgA were normal in all eight children in whom it was measured; IgE levels were grossly elevated (mean 900 IU/ml; normal range 0-100 IU/ml). Four cases had evidence of hypersensitivity reactions (type I in one patient and type III in three patients) on histopathological examination of the resected small bowel. In addition, histopathological examination also showed the neovascularization observed on angiography. The evidence suggests an immunologically mediated insult resulting in intense vasculitis, which in turn causes ischemic damage to the bowel wall.
Undifferentiated spondylarthropathy is one of the common disease subsets in the group of so-called seronegative spondarthritides. It is not exactly known how often it differentiates into ankylosing spondylitis or other well-defined disease subsets over time. The present study was designed to find out the long-term outcome in this subset. Thirty-five patients diagnosed with undifferentiated spondylarthropathy between January 1987 and December 1988 were recruited. Twenty-two (63%) of them were available for detailed assessment 11 years after the original diagnosis. Their baseline characteristics did not differ from those of the original cohort of 35 patients and were as follows: male:female ratio 19:3, median age of onset 17 years (range 8-39), and median duration of disease 8 months (range 4-24). Clinical features were enthesitis (45%) and inflammatory pain in the back (100%), buttock (77%), hip (64%), shoulder (18%), knee (82%), ankle (77%), and hand and wrists (50%). There was no restriction in spinal movement. Family history was positive in two cases. Radiologically, the only finding was grade I sacroiliitis in 17 patients (77%). Human leukocyte antigen (HLA)-B27 was positive in all. Functionally, all were in class I. During follow-up, one patient developed psoriatic skin lesions after 9 years. Uveitis developed in four patients (18%). After a median follow-up of 11 years, 15 (68%) had ankylosing spondylitis, one developed psoriatic arthritis, four remained undifferentiated, and two had natural remission. Functionally, 19 patients (86%) were in class I and three (14%) were in class III. No patient had bamboo spine, but three underwent total hip replacement. Thus, a majority of patients (68%) with undifferentiated spondylarthropathy gradually developed ankylosing spondylitis of mild severity.
PURPOSE: Sonography has been used to evaluate children with dengue hemorrhagic fever, but to our knowledge no such studies have been conducted with adults. We present the sonographic findings in 40 adults with severe (grade III) dengue hemorrhagic fever (DHF). METHODS: Forty patients (30 men and 10 women, aged 16-65 years) given a presumptive diagnosis of grade III dengue hemorrhagic fever during a documented regional epidemic underwent abdominal sonography. Ten also underwent chest radiography. Serologic confirmation was obtained in 5 patients, and in the rest the diagnosis was based on epidemiologic and clinical findings. RESULTS: Sonographic findings included pleural effusion in 21 patients (53%), thickening of the gallbladder wall in 17 (43%), and mild ascites in 6 (15%). These findings were similar to those of previous studies of severe DHF in children, although the incidence of pleural effusion and ascites was slightly lower in our series. Neither pleural effusion nor ascites was apparent on clinical examination. Of the 10 patients who underwent both sonography and chest radiography, sonography detected pleural effusion in all 10, whereas radiography detected it in only 3. CONCLUSIONS: Sonographic findings in DHF in adults (pleural effusions, ascites, and gallbladder wall thickening) were similar to those described for children but seem to be of lesser severity. Abdominal sonography is a useful diagnostic tool for confirming suspected cases of DHF. Sonography was found to be superior to chest radiography in detecting pleural effusions in the 10 patients in whom radiographs were available.
Fifty-four patients with focal liver lesions were evaluated with colour Doppler flow imaging (CDFI) and CT to assess whether CDFI could be used to differentiate various types of lesions based on the flow pattern in terms of peritumoral and intratumoral blood flow. Peritumoral flow was found to be of no significance in the differential diagnosis of various liver lesions. Intratumoral flow was graded into mild, moderate or marked depending on the relative number of blood vessels demonstrated within the lesion. Marked intratumoral flow on CDFI was seen in 12.5% of primary hepatic malignancies and in infantile haemangioendothelioma, while a moderate flow pattern was seen in 56.2% of primary hepatic malignancies and in 18.7% of metastases. Mild flow was seen in 33.3% of primary malignancies; 18.7% of metastases; and 16.7% of haemangiomas. No intratumoral flow was seen in 100% of inflammatory lesions; 83.3% of haemangiomas; 62.5% of metastases; and only one hepatocellular carcinoma (5.6%). It was therefore concluded that the presence or absence of flow on CDFI is not a reliable feature for differential diagnosis of focal liver lesions when it is used alone. The flow pattern as assessed on CDFI may point to the nature of the lesion and, when used along with other morphological imaging features, can assist in diagnosis or in narrowing the list of different diagnoses in a particular clinical situation.
Choledochal cyst is a rare congenital anomaly of the biliary system, presenting in infancy. Two cases of choledochal cyst (one infected) with grossly deranged liver function tests and associated biliary atresia, which were successfully managed pre-operatively by sonoguided percutaneous choledochalcystostomy, are reported here. The use of this technique in the treatment of patients such as these is proposed.
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Tuberculosis (TB) of the spleen is rare, especially in the immunocompetent. Recently there has been an increase in the incidence of splenic TB, primarily attributable to the raging HIV epidemic. Almost all cases of splenic TB present as multiple hypoechoic foci (< 2 cm) on ultrasonography. We present a case of a large solitary splenic tuberculoma in a middle-aged, non-immunosuppressed female, an employee at the local TB hospital. To the best of our knowledge, only two such cases have been described on ultrasound before. We suggest that, regardless of immune status, splenic TB should be considered as a diagnostic possibility when dealing with the solitary nodules of the spleen, especially when there is a history of exposure to or evidence of tuberculous foci elsewhere in the body.
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Chyluria is a urological manifestation of lymphatic system disease. Sclerotherapy of the renal pelvis (RPIS) using 1% silver nitrate, along with diethyl carbamazine, is the treatment most frequently used. Massive haematuria due to intrarenal aneurysm following RPIS has not been reported. A case is described here of arterial haemorrhage following instillation of silver nitrate which was treated by coil embolization. The haematuria was immediately stopped and the renal function returned to normal gradually.
Klippel-Trenaunay syndrome (KTS) is a congenital vascular abnormality consisting of a cutaneous naevus, varicose veins and bone and soft-tissue hypertrophy affecting one or more limbs. A case is presented here with some unusual associated findings seen on MR that, to the best of the authors' knowledge, has not been reported in the literature. Although colour Doppler in addition to venography is frequently used in demonstration of the KT vein, MRI may well have an important role in complete assessment.
A case of symptomatic cavernous haemangioma of the liver with an unusual arterio-portal shunting, which was treated by pre-operative angiographic embolization, is described. The arterio-portal shunting has been reported previously in only two cases.