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J S Rana

Publications and source records attributed to J S Rana.

12 recordsLinked to original sources

Association of white blood cell count with systolic blood pressure within the normotensive range.

Hypertension and inflammation promote cardiovascular disease (CVD). Even high normal systolic blood pressure (SBP) is associated with increased CVD risk. We assessed the relationship of elevated SBP within the normotensive range and white blood cell (WBC) count. This is a cross-sectional study of 3484 white asymptomatic individuals (mean age: 43+/-8 years, 79% males) without hypertension with SBP<140 mm Hg. White blood cell count >or=75th percentile (8.35 x 10(9) cells/l) was considered cutoff for elevated WBC. Subjects were classified into three levels of SBP (first: <120 mm Hg, n=1,176, 34%; second: 120-129 mm Hg, n=1,654, 47%; third: 130-139 mm Hg, n=654, 19%). Mean WBC count increased linearly across SBP categories (first: 6.14+/-1.54, second: 6.20+/-1.52, third: 6.41+/-1.62, P=0.02 for trend). There was a linear increase in prevalence of elevated WBC across higher SBP categories (22, 24 and 28%, P=0.02). As compared to those with SBP<120 mm Hg, in multivariate linear regression analyses (adjusting for age, gender, smoking status, diabetes, body mass index, physical activity, cholesterol/high-density lipoprotein cholesterol ratio) WBC count was significantly higher among participants with SBP 130-139 mm Hg (regression coefficient: 2.64, 95% confidence interval: 1.04-4.24, P=0.001). Odds ratio for prevalence of elevated WBC with SBP<120 mm Hg as reference group was 1.14 (0.92-1.41) for SBP 120-129 mm Hg and 1.50 (1.15-1.92) for SBP 130-139 mm Hg. In conclusion, Higher SBP within the normotensive range is also associated with elevated WBC count. Further studies are needed to clarify the role of inflammation in high normal SBP and associated CVD risk.

Adult↗

Effect of diabetes mellitus and its treatment on ventricular arrhythmias complicating acute myocardial infarction.

AIMS: To evaluate the effect of diabetes mellitus and its treatment on the risk of arrhythmias among early survivors of acute myocardial infarction. RESEARCH DESIGN AND METHOD: The Onset Study was conducted in 64 US medical centres. Between August 1989 and September 1996, 3882 patients were interviewed after having an acute myocardial infarction. We used logistic regression models to examine the association of diabetes and its treatment with the risk of ventricular arrhythmia after adjustment for age, gender, hypertension, thrombolytic therapy, smoking, obesity, cardiac medicines and congestive heart failure. RESULTS: During the index hospitalization, patients with diabetes (n=814) were less likely to develop ventricular arrhythmias than patients without diabetes (6.8 vs. 13.3%, P<0.001). The risk of ventricular arrhythmia in patients treated with first generation sulphonylureas or diet alone was similar to patients without diabetes (OR=0.91; 95% CI, 0.39-2.15, and 0.76; 95% CI, 0.46-1.26, respectively). However, compared with patients without diabetes, the adjusted odds ratio (OR) for ventricular arrhythmias was lower among patients treated with insulin or patients treated with second generation sulphonylureas (OR=0.54, 95% CI 0.32-0.92; OR=0.45, 95% CI 0.27-0.75, respectively). CONCLUSIONS: Compared with patients without diabetes, the risk of ventricular arrhythmias complicating acute myocardial infarction is lower in patients with diabetes treated with second generation sulphonylureas or insulin, but not in those treated with first generation sulphonylureas or diet alone. This suggests that differences in the mechanism of action of different sulphonylureas may result in clinically relevant differences in arrhythmic risk.

Acute Disease↗

Intrauterine growth restriction: a perspective for Pakistan.

BACKGROUND: Intrauterine growth restriction (IUGR) is the second leading contributor to the prevailing perinatal mortality and morbidity. It affects 23.8% of newborns around the world and 75% of these affected infants are born in Asia. In Pakistan the incidence of IUGR is around 25%, more than the WHO criteria for triggering a public health action. INTRODUCTION: IUGR is implicated with profound long-term impacts in adult life; like coronary heart disease, NIDDM and abnormal cortisol levels. The effects of the short and long term sequelae are reviewed. ETIOLOGY: IUGR is associated with a wide variety of etiological factors. But the factor unique in its importance to Pakistan is maternal malnutrition. The fetal gene expression is under the influence of nutrition. Growth projection curves showing the interaction between the genetic and environmental factors are discussed. SURVEILLANCE: Identification of IUGR baby in a primary care setting and the options in diagnosis in secondary and tertiary care settings are overviewed. CONCLUSION: The roots of this problem, with multi factorial causes are in the socioeconomic infrastructure. This calls for a synergistic approach of reducing this public health issue. Women empowerment can help us to get out of this intergenerational cycle of growth failure. Availability of resources aside, it is also a matter of political will to change things for the better.

Fetal Growth Retardation↗

Clinico-pathological studies on the effect of different anti-neoplastic chemotherapy regimens on transmissible venereal tumours in dogs.

Thirty-two dogs affected with transmissible venereal tumour (TVT) were divided into three treatment groups. In group I vincristine sulphate at 0.025 mg/kg body weight, in group II vinblastine sulphate at 0.150 mg/kg body weight, and in group III vinblastine sulphate at 0.100 mg/kg body weight plus methotrexate at 0.35 mg/kg body weight were given intravenously at weekly intervals. Biopsies were performed on days 0, 3, 7 and 14. The tissues were preserved in 10% neutral buffered formalin and processed routinely for haematoxylin and eosin staining. Histopathologically, the untreated TVT was characterized by sheets or bundles of mostly rounded cells having a large, highly basophilic nucleus with a prominent, highly basophilic necleolus. Both vincristine and vinblastine primarily affected the nuclei of neoplastic cells, causing condensation, karyorrhexis and karyolysis within 3 days of chemotherapy. The regressing tumour mass showed marked infiltration by lymphocytes, lymphoblasts and macrophages by day 7. There was nearly complete regression of the tumour by day 14, as shown by the almost complete loss of neoplastic cells, with fibrous tissue substitution. However, in group III, the changes occurred more slowly and more injections were needed for complete regression. In both groups I and II, 11/12 of the animals responded completely to the chemotherapy within 3 weeks, while in group III, 6/8 of the dogs responded to the treatment by 21-28 days.

Animals↗

Clinico-pathological studies on experimental cryptococcal mastitis in goats.

Unilateral intramammary inoculation of 10 goats with Cryptococcus neoformans (2 x 10(6) yeast cells) resulted in the development of mastitis, with gross and microscopic lesions being restricted to the infected udder halves only and there was no dissemination of infection to the opposite uninfected udder halves as well as to other organs of the body. The experiment was continued for 40 days, with 2 animals each from the infected and control groups being killed on 5th, 10th, 20th, 30th and 40th day post-inoculation (DPI). Initial enlargement of the infected udder halves was followed by marked decrease in size leading to very small, firm and nodular udder halves. After infection, there was also sharp fall in the milk yield. Cryptococcal organisms were demonstrated in the mastitic milk and udder impression smears with special stains. C. neoformans was reisolated from the milk of the only infected udder halves up to 25th DPI. Microscopically, there was initially acute diffuse purulent mastitis which later on became chronic, characterised by marked infiltration of lymphocytes, macrophages, extensive fibrosis and development of multiple granulomas. The cryptococcal organisms could be demonstrated in the udder sections only up to 30th DPI. It is concluded that intramammary inoculation of Cryptococcus neoformans in goats leads to severe mastitis with sharp fall in milk yield.

Animals↗

Biochemical changes of the milk in experimental caprine mastitis induced by Mycoplasma serogroup 11 (2-D).

Biochemical changes of the milk were studied in 7 lactating goats. The right udder halves of the animals were inoculated through the teat canal with 1 ml of Mycoplasma ovine/caprine serogroup 11 (2-D) culture containing 6x10(6) colony forming units ml-1. The left udder halves of these goats were kept as control. The experiment was continued for 35 days during which period one goat was killed every 5th day. All the goats developed clinical mastitis within 24 h and the infected udder halves remained enlarged for 4-5 days. The milk from these halves was yellow-tinged and showed slight separation of proteins. Subsequently, there was marked reduction in the size and secretion of the infected udder halves, followed by agalactia from post-inoculation (PI) day 22. The mycoplasmas were reisolated from milk samples of the infected halves up to PI day 20. Histopathological examination of these halves revealed changes indicative of acute and chronic mastitis. Biochemical analysis of mastitic milk/mammary secretions showed a marked increase in the concentration of total proteins, immunoglobulins, free fatty acids and phospholipids, while the concentration of total lipids and glycerides initially underwent a considerable decrease as compared to the basal and control values. However, the level of total cholesterol decreased sharply during the initial days while later, from PI day 5, it markedly increased. This study shows that Mycoplasma ovine/caprine serogroup 11 is pathogenic to the lactating udder of goats and produces marked biochemical alterations in the milk.

Animals↗