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Biomedical subjects

J Ramesh

Publications and source records attributed to J Ramesh.

At least 19 recordsLinked to original sources

Video assisted thoracoscopic surgery at the Queen Elizabeth Hospital Barbados.

Video assisted thoracoscopic surgery (VATS) is now an established technique for diagnostic and therapeutic intervention in patients with thoracic pathology at the Queen Elizabeth Hospital (QEH). This article reviews the experience with 50 patients over the period May 1996 to February 2003, looking at various factors and outcomes in an attempt to ascertain the viability of this procedure at this institution. It serves as a follow-up article to the publication of the initial experience in 1999 (1). There were 24 males and 26 females included in the study. Video assisted thoracoscopic surgery was used for diagnosis in 27 cases (54%), therapeutic indication in 17 cases (34%) and as both a diagnostic and therapeutic modality in six cases (12%). In 92% of cases, the operations were completed thoracoscopically with a conversion rate of 8%. The morbidity and mortality rates were 18% and 2% respectively. Video assisted thoracoscopic surgery is an effective tool for the treatment and investigation of selected thoracic pathology at the QEH with complications and mortality rates comparable to other institutions (2, 3).

Adult↗

CADB-2.0: Conformation Angles Database.

The Conformation Angles Data Base (CADB) is a comprehensive, authoritative and timely knowledge base with a powerful query engine developed to facilitate the retrieval of information related to the conformational angles (main chain and side chain) of the amino-acid residues present in non-redundant (both 25 and 90%) data sets. The updated version has improved options for determining the dependency of the conformation angles of a particular residue upon the flanking residues, doublet analysis, triplet analysis and analysis of a particular protein structure. It is worth mentioning that for all options a user-friendly and convenient Java graphical user interface (GUI) has been provided to display the output on the client machine. The database is accessible at the URL http://cluster.physics.iisc.ernet.in/cadb/ or http://144.16.71.148/cadb/.

Amino Acids↗

SSEP-2.0: Secondary Structural Elements of Proteins.

The Secondary Structural Elements of Proteins (SSEP) database is an integrated and comprehensive knowledge base for accessing information related to all the secondary-structural elements present in non-redundant (25 and 90%) protein chains. The new version 2.0 of the database contains 2485 and 8595 protein chains from the 25 and 90% non-redundant data sets, respectively. The necessary web interfaces have been developed that enable users to visualize the three-dimensional structure of the secondary-structural element in the client machine using the free molecular-visualization program RASMOL. This source is updated at regular intervals and can be accessed through the bioinformatics web server at the URL http://cluster.physics.iisc.ernet.in/ssep or http://144.16.71.148/ssep/.

Artificial Intelligence↗

Conventional cutting vs. internal anal sphincter-preserving seton for high trans-sphincteric fistula: a prospective randomized manometric and clinical trial.

BACKGROUND: Cutting setons have been used in complicated perirectal sepsis with good effect, although there is a moderately high incidence of fecal leakage after their use. The aim of this study was to compare a modified cutting seton, which repaired the internal anal sphincter muscle and re-routed the seton through the intersphincteric space, with a conventional cutting seton. METHODS: A total of 34 patients were randomized between 1998 and 2002. They were prospectively assessed by continence score and anorectal manometry, and for anal function, clinical sepsis and fistula recurrence. RESULTS: There was no difference in postoperative continence score, incidence of recurrent fistula or healing time between groups after a mean follow-up of 12 months. Resting anal manometric pressures and vector volumes were consistently higher with the modified seton (although not statistically significant), as was the area under the inhibitory curve during elicitation of the rectoanal inhibitory reflex across the full sphincter length. ( p<0.05). CONCLUSION: A larger prospective study of internal anal sphincter-preserving seton use in cryptogenic high transshincteric fistula-in-ano appears justified.

Adult↗

Studies on the aggregation and possible channel formation in membranes of a cyclic hexapeptide, cyclo (D-Ala-L-Pro-L-Ala)2.

The interaction of zwitterionic lipid DMPC and DPPC with cyclic hexapeptide, cyclo (D-Ala-L-Pro-L-Ala)2 was studied using circular dichroism (CD) and differential scanning calorimetry (DSC). Preliminary membrane conductance results showed that the peptide has a tendency to form channels inside the lipid bilayer. CD studies indicated that as the lipid/peptide (L/P) ratio (DMPC/peptide) was increased, the magnitude of the negative CD band having a lambda(max) around 200 nm decreased. At a L/P ratio of 210:1, this band disappeared completely, indicating dramatic conformational changes in the peptide on interaction with the lipid bilayer. Reduction of the phase transition temperature and the maximum heat capacity of the lipid bilayer (DPPC) for gel-to-liquid crystalline phase transition indicates a strong interaction of the peptide with the lipid bilayer.

Biological Transport↗

An audit of upper gastrointestinal bleeding at Seremban Hospital.

We retrospectively analyzed all patients presenting with upper gastrointestinal bleeding to Seremban Hospital over a one-year period. A quarter of the oesophagogastro-duodenoscopies (OGD) performed were performed as emergency for upper gastrointestinal tract bleeding. Gastric ulcers and duodenal ulcers were the two most common findings. Our results suggest that there is a male preponderance of 2:1, the Chinese were more likely to be affected and the elderly (> 60 years) were at highest risk.

Adolescent↗

Tolerability and efficacy of single dose albendazole, diethylcarbamazine citrate (DEC) or co-administration of albendazole with DEC in the clearance of Wuchereria bancrofti in asymptomatic microfilaraemic volunteers in Pondicherry, South India: a hospital-based study.

BACKGROUND: The tolerability and efficacy of single dose albendazole (400 mg), diethylcarbamazine citrate (DEC) (6 mg/kg bodyweight) or co-administration of albendazole (400 mg) + DEC (6 mg/kg bodyweight) was studied in 54 asymptomatic Wuchereria bancrofti microfilaraemic volunteers in a double blind hospital-based clinical study. RESULTS: There was no significant difference in the overall incidence of adverse reactions between the three drug groups [42.1% (albendazole), 52.9% (DEC) and 61.1% (albendazole + DEC); P > 0.05]. The mean score of adverse reaction intensity did not differ significantly between the DEC and albendazole + DEC groups. However, the values in these two groups were significantly higher compared to that of albendazole alone [1.8 +/- 3.0 (albendazole) vs. 5.6 +/- 7.1 (DEC), 6.7 +/- 6.6 (albendazole + DEC); P < 0.05]. By day 360 post-therapy there was no significant difference between the three drug groups in relation to the clearance of microfilaria [26.3% (albendazole), 17.6% (DEC), 27.8% (albendazole + DEC)], reduction in geometric mean parasite density [94.7% (albendazole), 89.5% (DEC), 95.4% (albendazole + DEC)] or reduction in filarial antigenaemia [83% (albendazole), 87% (DEC), 75% (albendazole + DEC)]. Furthermore, there was a significant decrease in mean geometric parasite density (P < 0.05) as well as antigenaemia optical density values (P < 0.01) between pre-therapy levels and day 360 post-therapy in all three groups. CONCLUSIONS: This study has shown that single dose albendazole (400 mg) has similar efficacy in the clearance of microfilaria as that of DEC or the co-administration of the two drugs. The results strengthen the rationale of using albendazole for mass annual single dose administration for the control of transmission of lymphatic filariasis.

Journal Article↗

Novel methodology for the follow-up of acute lymphoblastic leukemia using FTIR microspectroscopy.

In this report, we present a novel spectroscopic method of follow-up during chemotherapy treatment for B- and T-cell childhood leukemia patients. We isolated peripheral lymphocytes from blood drawn from patients before and after the chemotherapy and collected Microscopic FTIR (FTIR-MC) spectra of the isolated lymphocytes. Our results showed that nucleic acids content decreased in both types of patients. Changes in phospholipids and proteins level could be observed. The overall effects of drugs administered to the patients can be understood at the molecular level using FTIR-MC and these results are expected to stimulate wider applications of spectroscopy in leukemia research.

Adolescent↗

Application of FTIR microscopy for the characterization of malignancy: H-ras transfected murine fibroblasts as an example.

Recently, microscopic FTIR is widely used in the field of biology and medicine. FTIR can detect biomolecular changes in the cells and tissues responsible for various disorders. In this report, we characterize the H-ras transfected fibroblasts and its normal control using microscopic FTIR. The intensity of the normal fibroblasts was higher than that of H-ras transfected fibroblasts. Our studies showed significant differences occur in the concentration of vital metabolites upon transformation. The DNA and carbohydrates level decreased in the transformed cells compared to the controls. A linear correlation could be found between the levels of carbohydrates and phosphate, while the RNA/DNA ratio varied inversely with glucose/phosphate levels.

3T3 Cells↗

FTIR microscopic studies on normal and H-ras oncogene transfected cultured mouse fibroblasts.

Infrared absorption spectra are well known for their sensitivity to composition and three-dimensional structure of biomolecules. The biochemical changes in the sub-cellular levels developing in abnormal cells, including a majority of cancer forms, manifest themselves in different optical signatures, which can be detected by IR spectroscopy. We measured the IR absorption spectra of monolayers of cultured normal and H-ras transfected mouse fibroblasts, using a microscopic Fourier transform IR (micro-FTIR) technique. The absorption of normal cells was found to be higher than the malignant ones in the spectral range 600-3200 cm(-1). The carbohydrate and phosphate contents were higher in normal cells relative to H-ras transfected cells. An increase in the RNA/DNA ratio was observed for H-ras transfected fibroblasts, which correlates with the increased transcriptional activity expected for the cancerous cells. In part, the variation in absorbance between normal and ras transfected fibroblasts may be due to changes in the cell dimensions.

3T3 Cells↗

FT-IR microscopic characterization of normal and malignant human colonic tissues.

Fourier-transform infrared spectroscopy (FT-IR) employs a unique approach to optical diagnosis of tissue pathology based on the characteristic molecular vibrational spectra of the tissue. In this study, we report infrared absorption spectra of formalin fixed, paraffin embedded normal and malignant human colonic tissues from ten different patients. Our method is based on microscopic infrared study (FT-IR-microscopy) of thin tissue specimens in parallel with normal histopathological analysis, which serves as a reference. Our results indicate that the normal colonic tissue has a stronger absorption than the cancerous type over a wide region in all ten cases. The detailed analysis showed that there is a significant decrease in carbohydrate levels, total phosphate and also possibly creatine contents for cancerous tissue in comparison to the controls. Also, RNA/DNA ratio increased in cancerous tissues relative to the normals in all the patients. The results of Linear Discriminant Analysis (LDA) showed that the normal and malignant cells could be identified with about 89% accuracy.

Colon↗

Acute myoedema: an unusual presenting manifestation of hypothyroid myopathy.

We describe a patient with primary hypothyroidism due to autoimmune thyroiditis, presenting with acute myoedema and spontaneous rhabdomyolysis. During his hospital stay, he developed altered sensorium due to hypo-osmolal hyponatraemia and later developed bilateral foot drop that responded to appropriate treatment.

Acute Disease↗

Blood sugar and serum insulin response in protein-energy malnutrition.

Blood sugar and serum insulin levels in the fasting state and following an oral glucose load in children with protein-energy malnutrition (PEM) were studied. Twenty-nine children with PEM (15 marasmus, 7 kwashiorkor, and 7 marasmic kwashiorkor) and eight healthy children aged between 6 and 60 months were the subjects of the study. Fasting samples were collected after a 6 h fast. Post-glucose samples were collected after an oral glucose load of 1.75 g/kg. Serum insulin was estimated by radioimmunoassay and glucose by the glucose oxidase method. In malnourished children, the mean fasting blood glucose levels were significantly lower. Two hours following an oral glucose load, only marasmus and marasmic kwashiorkor patients showed significantly higher blood glucose levels. Similarly, the fasting serum insulin levels were significantly lower in malnourished children. Two hours after the oral glucose load, serum insulin levels increased significantly in malnourished children but fell well short of the control values. The insulin:glucose ratio was consistently low in all cases but was more marked in PEM patients, both in the basal state as well as oral glucose loading

Blood Glucose↗

Blood glucose and serum insulin response in protein-energy malnutrition following nutritional rehabilitation.

Fifteen children with protein-energy malnutrition and eight healthy children between the ages of 6 months and 60 months were studied for blood glucose and serum insulin levels in the fasting state and 120 minutes following oral glucose load. The measurements were repeated after normalization of the body weight following 6 weeks of nutritional rehabilitation. The fasting blood glucose increased significantly in the post-treatment period and became comparable to the control value. The abnormal blood glucose response to oral glucose load also normalized. The serum insulin level rose significantly (p < 0.001) in the post-treatment period but failed to normalize. The response to oral glucose load was similar. The observed lower insulin response, despite normoglycemia, after 6 weeks of nutritional rehabilitation indicates persistence of hormonal imbalance which may need a longer duration of rehabilitation for full recovery.

Blood Glucose↗

Spontaneous rupture of the spleen.

A 10 year old boy presented to the surgical service of the Queen Elizabeth Hospital with spontaneous rupture of the spleen and was later discovered to have chronic myeloid leukaemia. He has been in haematological remission for five years followed splenectomy and alpha-interferon therapy.

Child↗

Quality of care of patients with diabetic foot problems in Barbados.

In Barbados diabetics with foot problems account for 80% of the patients in the female and 50% of those in the male general surgery wards, and many patients have major amputations for preventable problems. A six month prospective study was undertaken of all cases admitted with foot problems to the general surgical wards of the Queen Elizabeth Hospital (QEH) in order to determine the quality of foot care, particularly among diabetics. 67.5% of the 195 patients (55% female) admitted to the study were diabetic, most of whom were diagnosed 10 to 19 years previously. Most of the patients were 70 to 80 years old, but significantly more diabetics than non-diabetics were 40 to 70 years old. Foot problems in diabetics were precipitated by events that are considered trivial in non-diabetic patients. 87 (58%) of 150 responding patients had their feet inspected by health personnel in the previous year. 47 (63.5%) of the 74 who responded about the care of their nails said that they took care of their nails themselves. Nearly 40% of diabetic and non-diabetic patients had no reported source of care before their admission. 14 patients (10 diabetic) sought care the same day and 11 (nine diabetics) the day after noticing foot problems. Most patients presented with infection as part of their problem; recognition of the early signs of infection should be an integral part of the education of the diabetic patient. Educational efforts for patients must be continually reinforced because many patients said they had had no education about the care of their feet in the previous year.

Adult↗