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Biomedical subjects

K Buckshee

Publications and source records attributed to K Buckshee.

At least 55 records · Page 3Linked to original sources
PubMed1992

Hypothyroidism complicating pregnancy.

In this report we describe 26 pregnancies complicated by hypothyroidism cared for over 6.5 years at AIIMS, New Delhi. In 2 women hypothyroidism was diagnosed during pregnancy; others were diagnosed before pregnancy and continued to receive thyroxine replacement therapy throughout pregnancy. The thyroxine treatment needed readjustment in 7 (26.9%) pregnancies to maintain euthyroidism. Maternal complications included anaemia (23.0%), pregnancy induced hypertension (26.9%), postpartum haemorrhage (7.7%), intrauterine growth retardation (15.4%), postdatism (30.8%), and deficient lactation (19.2%). Perinatal mortality was 3.9%. No case of stillbirth occurred probably because of intensive fetal monitoring and timely termination of pregnancies on evidence of intrauterine fetal compromise. One neonatal death occurred due to fetal thyrotoxicosis. In these cases close surveillance during pregnancy is needed to maintain optimum thyroid hormone concentration, and intensive fetal monitoring is required to achieve a good perinatal outcome.

Adult↗
PubMed1992

Studies on mitogen-induced lymphocyte transformation and the effect of pregnancy serum on mitogen-induced normal lymphocyte culture.

It is recognised that there is a non-reactive status in the maternal immune system during normal pregnancy as it fails to recognise the fetus which is an allograft. The present study was aimed to understand the nature of cell-mediated immune response and the presence of immunosuppressive factors during human pregnancy. The functional reactivity of lymphocytes was found to be reduced during pregnancy, particularly in the third trimester, as phytohaemagglutinin- and concanavalin-A-induced lymphocyte transformation was affected. It was also observed that in primigravidae and pregnant women with a history of repeated abortions the lymphocyte reactivity was not reduced during the first and second trimesters, but there was a marked reduction in the third trimester. However, in the case of multigravidae there was no change in lymphocyte transformation between the trimesters. When pregnancy serum from various trimesters was tested for its suppressive activity, it was found to suppress the mitogen-induced proliferation of lymphocytes from normal donors. Sera from primigravidae and patients with a history of abortion showed the highest suppressive activity in the third trimester, whereas sera from multigravidae showed high suppression in all the trimesters.

Concanavalin A↗
PubMed1992

Studies on the immunosuppressive role of steroid hormones during pregnancy.

It has been recognised that steroids can exert a profound influence over immunological reactivity. The present study analyzes the role of steroid hormones--estrogen, progesterone and cortisol--and their involvement in immunoregulation during pregnancy. As is known, the endogenous levels of all the three hormones increase during pregnancy. When the steroid levels in pregnancy serum were correlated with the lymphocyte response to mitogen, no correlation was observed. The suppressive effect of pregnancy serum was found to have no correlation with its steroid content. In general, steroids did not seem to affect the maternal immune system as evidenced by the present study.

Estradiol↗
PubMed1992

Rubella infection: a cause of foetal wastage.

A study was conducted on 180 women with 2 or more obstetric losses totalling 410 foetal wastages. Control cases included 100 women without obstetric losses. Significant titre of immunoglobulin M against rubella was found in 17.77% patients with 2 or more obstetric losses in contrast to 9% of control patients (p less than 0.005). Significant titre of immunoglobulin M was observed in cases of abortions (5.75%), preterm deliveries (12.67%), macerated stillbirths (8.19%), fresh stillbirths (8.69%) and neonatal deaths (8.34%).

Adult↗
PubMed1992

Congenital adrenal hyperplasia among peripubertal girls with hyperandrogenism.

Fifteen girls with severe hyperandrogenism were investigated by us during the last 6 years. Thirteen of these were cases of untreated congenital adrenal hyperplasia (CAH) and 2 were cases of tumoral (one sertoli leydig cell tumor of the ovary and one adrenal adenoma) hyperandrogenism. Here we present the clinical profile and laboratory data of those with congenital adrenal hyperplasia. All the girls had masculinization of genitalia (clitoromegaly alone 5, clitoromegaly with varying degree of posterior labial fusion 8). Eleven cases had hirsutism and 9 had short stature. Two patients underwent unilateral adrenelectomy with diagnosis of adrenal adenoma. Hormonal profile confirmed the diagnosis of CAH with 21 hydroxylase deficiency (elevated 17 OHP levels with exaggerated 17 OHP response to ACTH) in 12 cases and 3 beta hydroxy steroid dehydrogenase deficiency (elevated DHEAS and 17 pregnenelone levels and exaggerated DHEAS and 17 pregnenelone response to ACTH) in one case.

Adolescent↗
PubMed1991

Use of serum prolactin for monitoring the therapeutic response in ovarian malignancy.

Serum prolactin level was estimated in 20 women with ovarian malignancy. High prolactin level was observed in 13 out of 20 women. However, no correlation was seen between prolactin level and the stage of the disease. Serial measurement of prolactin showed a correlation of prolactin level with tumor mass in three patients in which serial tumor mass volume measurements were available. A rise in serum prolactin level was observed in women who had recurrence of the disease. Although the current study is based on a relatively small number of patients, it may be concluded that serum prolactin level might be used as a tumor marker to monitor the therapeutic response in cases of ovarian malignancy.

Adolescent↗
PubMed1991

Percutaneous ultrasound-guided fetal skin biopsy: a new approach.

Our preliminary experience with this unreported percutaneous ultrasound guided method using a fine needle system showed 100% success (seven cases) in obtaining fetal skin biopsies. The fetal scalp was chosen for biopsy. This technique is easy, less invasive, simple, has minimum procedural difficulties and complications and thus it may replace fetoscopy for obtaining fetal skin biopsy.

Biopsy, Needle↗
PubMed1991

Oral ketoconazole and miconazole vaginal pessary treatment for vaginal candidosis.

This prospective study was carried out on 250 patients having clinical and mycological evidence of vaginal candidosis. One hundred patients received ketoconazole orally (400 mg/day for 5 days), another 100 patients received miconazole vaginal pessary treatment (one 100 mg tablet locally for 14 days), while the other 50 patients received combination therapy of oral ketoconazole and miconazole vaginal tablets. Although all 3 regimens were significantly effective in relieving patients symptoms and physical signs, the combination therapy gave the best results. There was 98% symptomatic relief with the combination therapy in contrast to 82% and 78% in the oral ketocanozole and vaginal micronazole groups respectively (p less than 0.001). Mycological cure rates were also significantly higher in the combination therapy group (94% versus 80% and 76%). The relapse rate was least in the combination group 2% versus 8% and 12%. The combination therapy is recommended for the best results in vaginal candidosis.

Administration, Oral↗
PubMed1990

Contraceptive vaginal ring--a rising star on the contraceptive horizon.

Two studies were carried out at AIIMS to judge efficacy, side-effects and acceptability of the contraceptive vaginal ring, a Silastic ring with an inner core containing 6.0 mg levonorgestrel mixed with Silastic and an outer core of Silastic only. It releases levonorgestrel at a constant rate of 20 micrograms/day and remains effective for 90 days. The first study of 50 women lasted for 12 months and the second study of 46 women lasted 24 months. Menstrual irregularity in 36% of women was the commonest reason for discontinuation. The majority of women experienced menorrhagia or irregular spotting per vaginum. Vaginal irritation or increased vaginal discharge was the second commonest reason for discontinuation and was noted in 23% of subjects. Repeated spontaneous expulsions accounted for discontinuation in 6% of subjects. No method-related failure was noted in the study. Follow-up study revealed users to be happier with the ring than with any other method and no spouse complained of feeling the ring during coitus. With its ease of administration, absence of gastrointestinal side-effects and a high success rate, the contraceptive vaginal ring is a promising contraceptive method for the last decade of the 20th century.

Adolescent↗
PubMed1990

Current method for first and second trimester prenatal diagnosis: transabdominal chorionic villi sampling.

Transabdominal CVS (chorionic villi sampling) was performed in 40 patients belonging to first or second trimester of pregnancy with 97.5% success, using a double and later single needle technique with no immediate complications. Karyotyping by direct method was successful in 75% of samples thus indicating the feasibility of cytogenetic analysis using villus tissue from first and second trimesters of pregnancy. It is a safe, simple, rapid and practical method of prenatal diagnosis in first and second trimesters of pregnancy with a potentially lower risk for fetal and maternal complications.

Chorionic Villi Sampling↗
PubMed1990

Pseudo-Meigs' syndrome secondary to broad ligament leiomyoma: a case report.

An unusual and rare case of broad ligament leiomyoma with massive ascites and bilateral pleural effusion is described. The ascites and pleural effusion resolved dramatically following removal of the tumor. Patients with pseudo-Meigs' syndrome may present a diagnostic problem as they masquerade as carcinoma with malignant effusions. Thus they should always be considered for exploratory laparotomy.

Ascites↗
PubMed1989

Fetal foot length--a new parameter for assessment of gestational age.

Ultrasonographic measurement of fetal foot length, a new parameter, was correlated with the gestation age. One hundred and five ultrasonographic measurement of fetal foot length was performed between 13 and 42 weeks gestation. Comparison of linear regression of foot length versus gestational age demonstrated a strong correlation with an r2 value of 0.84 (P less than 0.001). Ninety-five percent confidence intervals at each week compared favorably with both biparietal diameter and femur length data. Mean foot lengths at each week of gestation compared favorably with data based on pathological specimens described in 1920 (Streeter GL: Weight, sitting height, head size, foot length and menstrual age of the human embryo. Contrib Embryol Carnegie Inst. 11: 143, 1920). Measurement of fetal foot length is of particular use when other parameters do not accurately predict gestational age, e.g. hydrocephalus, anencephaly, short limb dysplasia. It can also be used in conjunction with biparietal diameter and femur length in the management of patients with premature labor in order to patients with premature labor in order to accurately predict gestational age. Hence the present study demonstrates that the ultrasonographic measurement of foot length is a reliable indicator of gestational age.

Embryonic and Fetal Development↗
PubMed1989

An antiprogestin steroid and PGE2 for an early pregnancy termination.

A non-surgical, preferably self-administered, procedure would be an attractive alternative to vacuum for the termination of early pregnancy. 20 patients with 49 days of amenorrhea and confirmation of pregnancy by ultrasound, urine testing and human chorionic gonadotrophin (beta-hCG) analysis, were administered RU 486, 25 mg twice daily for 4 days, (Group I). A further 20 patients received the same dose of RU 486 for 3 days (Group II). All patients received an intramuscular injection of the prostaglandin derivative sulprostone, 0.25 mg, on the last day of RU 486 treatment. Outcome of therapy was assessed on the second follow up visit (day 15) on the basis of clinical courses, ultrasound findings and hCG levels. In Group I, all patients had a complete abortion with a success rate of 100%. In Group II, a success rate of 95% was achieved. Side effects were minimal and did not require any medication. A dramatic fall was observed in the plasma beta-hCG and progesterone levels on days 8 and 14, correlating with the clinical course of abortion. Plasma cortisol levels remained within the normal range. It is concluded that sequential therapy with RU 486 and prostaglandin is a highly safe, simple and effective non-surgical method for termination of early pregnancy.

Abortifacient Agents↗
PubMed1988

Pelvic fibromatoses--a rare gynecological entity.

A rare case of pelvic fibromatoses is reported. This condition is rarely encountered in gynecological practice but when encountered, creates a diagnostic and therapeutic challenge. The reported patient highlights the difficulties encountered in surgical excision (done twice) and illustrates the local aggressive growth behavior of this entity.

Adult↗
PubMed1987

DDT and its metabolites in leiomyomatous and normal human uterine tissue.

Residues of dichlorodiphenyltrichloroethane (DDT) and its metabolites were monitored in leiomyomatous and normal human uterine tissue by gas-liquid chromatography (GLC). The metabolites detected were: 2,2-bis-(p-chlorophenyl)-1,1-dichloroethylene (p,p'-DDE), 2-(o-chlorophenyl)-2-(p-chlorophenyl)-1,1,1-trichloroethane (o,p'-DDT), 2,2-bis-(p-chlorophenyl)-1,1-dichloroethane (p,p'-DDD) and 2,2-bis-(p-chlorophenyl)-1,1,1-trichloroethane (p,p'-DDT). Total DDT ranged from 0.245 to 1.982 ppm, with a mean value of 0.845 ppm in leiomyomatous tissue. In normal human uterine tissue, total DDT ranged from 0.030 to 0.282 ppm, with a mean value of 0.103 ppm. Significantly higher levels of DDT and its metabolites in leiomyomatous tissue as compared to normal uterine tissue suggest their involvement in uterine leiomyomas. The data is discussed in the light of existing knowledge on estrogenic activity of DDT analogs and estrogen-influenced growth of uterine leiomyomas.

Adult↗