PubMed Health⌕ Search

Biomedical subjects

M Prakash

Publications and source records attributed to M Prakash.

At least 19 recordsLinked to original sources
PubMed2005

Comparative evaluation of magnetization transfer contrast and fluid attenuated inversion recovery sequences in brain tuberculoma.

AIM: To compare T1-weighted magnetization transfer (MT) with fluid attenuated inversion recovery (FLAIR) imaging for evaluating conspicuity and number of lesions in individuals with brain tuberculoma. MATERIALS AND METHODS: In all 28 patients with brain tuberculoma underwent MR examination using fast spin-echo (FSE) T2, spin-echo (SE) T1, T1-weighted MT and FLAIR imaging. Post-contrast T1-weighted MT imaging was taken as the gold standard for assessing the number of lesions. Tuberculomas detected both on T1-weighted MT and FLAIR imaging were examined for the wall to be defined, and were divided into two groups on the basis of presence (group 1) or absence (group 2) of perilesional oedema visible on FLAIR imaging. The mean signal intensity of the wall of the lesions and adjacent oedema or brain parenchyma was analyzed qualitatively and quantitatively. RESULTS: The number of lesions detected on T1-weighted MT was higher than on FLAIR imaging (209 versus 163). Conspicuity in both groups was better on T1-weighted MT images qualitatively as well as quantitatively. The difference in the signal intensity of the wall of the lesion and perilesional oedema was statistically significant only on T1-weighted MT images in group 1 (p=0.0003 versus 0.3), whereas in group 2 it was statistically significant both on T1-weighted MT and FLAIR imaging (p=0.009 versus 0.05). CONCLUSION: FLAIR imaging is not helpful in the examination of brain tuberculomas compared with T1-weighted MT imaging, as it neither contributes to the characterization of lesion nor assesses the true disease load.

Adolescent↗
PubMed2004

The physics of neutron stars.

Neutron stars are some of the densest manifestations of massive objects in the universe. They are ideal astrophysical laboratories for testing theories of dense matter physics and provide connections among nuclear physics, particle physics, and astrophysics. Neutron stars may exhibit conditions and phenomena not observed elsewhere, such as hyperon-dominated matter, deconfined quark matter, superfluidity and superconductivity with critical temperatures near 10(10) kelvin, opaqueness to neutrinos, and magnetic fields in excess of 10(13) Gauss. Here, we describe the formation, structure, internal composition, and evolution of neutron stars. Observations that include studies of pulsars in binary systems, thermal emission from isolated neutron stars, glitches from pulsars, and quasi-periodic oscillations from accreting neutron stars provide information about neutron star masses, radii, temperatures, ages, and internal compositions.

Journal Article↗
PubMed2004

Protein thiol oxidation and lipid peroxidation in patients with uraemia.

BACKGROUND: Patients with uraemia are exposed to increased oxidative stress. In this study, a series of oxidative stress markers were measured in patients with chronic renal failure (CRF) and patients with CRF on haemodialysis (HD) compared to normal controls to establish whether there is enhanced oxidative stress on HD therapy in uraemic subjects. METHODS: Protein thiol oxidation, lipid hydroperoxides, albumin and uric acid concentrations were estimated in patients receiving HD and patients with CRF and compared with those in healthy controls. RESULTS: There was a significant decrease in the level of protein thiols in CRF (p = 0.0001) and HD patients (p = 0.0001) compared with that in controls. Lipid hydroperoxides were significantly higher in CRF (p = 0.026) and HD patients (p = 0.003) than in controls. However, there was no significant difference in protein thiols and lipid hydroperoxides between CRF and HD patients. Serum protein thiols correlated negatively with lipid hydroperoxides and positively with serum albumin. CONCLUSIONS: These findings suggest that both CRF and HD patients have increased plasma protein oxidation and lipid peroxidation. However, HD therapy per se did not contribute to oxidative stress already present in uraemia. Owing to the variability in lipid peroxidation products as markers of oxidative stress and the vital role played by thiol antioxidants in the biological system, it is suggested that protein thiol oxidation may be a better marker of oxidative stress.

Adult↗
PubMed2001

Evaluation of the cervical cytobrush sampling technique for the preparation of CD45+ mononuclear cells from the human cervix.

A cytobrush technique developed to prepare mononuclear cells from the intraepithelial layer of the endocervix has been evaluated. Specimens yielded approximately 4-6x10(6) cells, of which 10-15% were CD45+. Between 10% and 15% of these CD45+ cells were mononuclear leukocytes. The non-leukocyte cell fraction exhibited high levels of autofluorescence and for flow cytometry analysis, it was necessary to exclude these cells by gating. Macrophages constituted approximately 60% and T lymphocytes, 40% of the mononuclear cells in cytobrush samples. The CD4/CD8 T-cell ratio was similar to that observed in blood. In 9 of 13 specimens, B lymphocytes constituted less than 1% of the mononuclear cell fraction suggesting that the mononuclear cells were derived from the intraepithelial compartment rather then the deeper lamina propria. Lack of B lymphocytes also indicates minimal blood contamination in these samples, a conclusion supported by labelling for the red blood cell (RBC) glycoprotein glycophorin A. However, the need to monitor all samples for possible blood contamination was indicated by 4 of 13 samples in which B lymphocytes accounted for 2-8% of the mononuclear cells.

B-Lymphocytes↗
PubMed2001

Evolution of proto-neutron stars with quarks.

Neutrino fluxes from proto-neutron stars with and without quarks are studied. Observable differences become apparent after 10-20 s of evolution. Sufficiently massive stars containing negatively charged, strongly interacting, particles collapse to black holes during the first minute of evolution. Since the neutrino flux vanishes when a black hole forms, this is the most obvious signal that quarks (or other types of strange matter) have appeared. The metastability time scales for stars with quarks are intermediate between those containing hyperons and kaon condensates.

Journal Article↗
PubMed2001

Heart rate recovery: validation and methodologic issues.

OBJECTIVES: The goal of this study was to validate the prognostic value of the drop in heart rate (HR) after exercise, compare it to other test responses, evaluate its diagnostic value and clarify some of the methodologic issues surrounding its use. BACKGROUND: Studies have highlighted the value of a new prognostic feature of the treadmill test-rate of recovery of HR after exercise. These studies have had differing as well as controversial results and did not consider diagnostic test characteristics. METHODS: All patients were referred for evaluation of chest pain at two university-affiliated Veterans Affairs Medical Centers who underwent treadmill tests and coronary angiography between 1987 and 1999 as predicted after a mean seven years of follow-up. All-cause mortality was the end point for follow-up, and coronary angiography was the diagnostic gold standard. RESULTS: There were 2,193 male patients who had treadmill tests and coronary angiography. Heart rate recovery at 2 min after exercise outperformed other time points in prediction of death; a decrease of <22 beats/min had a hazard ratio of 2.6 (2.4 to 2.8 95% confidence interval). This new measurement was ranked similarly to traditional variables including age and metabolic equivalents but failed to have diagnostic power for discriminating those who had angiographic disease. CONCLUSIONS: Heart rate at 1 or 2 min of recovery has been validated as a prognostic measurement and should be recorded as part of all treadmill tests. This new measurement does not replace, but is supplemental to, established scores.

Adult↗
PubMed2001

Diagnostic exercise tests on 4000 consecutive men.

OBJECTIVE: Our purpose was to report the prevalence of abnormal treadmill test responses and their association with mortality in a large consecutive series of patients referred for standard diagnostic exercise tests, with testing performed and reported in a standardized fashion. BACKGROUND: Exercise testing is widely performed, but an analysis of responses has not been presented for a large number of consecutive tests performed on patients referred for diagnosis of cardiac disease. METHODS: All patients referred for evaluation at 2 university-affiliated Veterans Affairs Medical Centers who underwent exercise treadmill tests for clinical indications between 1987 and 2000 were determined to be dead or alive according to the Social Security Death Index after a mean 5.9-year follow-up. Patients with established heart disease (ie, prior coronary bypass surgery, myocardial infarction, or congestive heart failure) were excluded from analyses. Clinical and exercise test variables were collected prospectively according to standard definitions; testing and data management were performed in a standardized fashion with a computer-assisted protocol. All-cause mortality was used as the end point for follow-up. Standard survival analysis was performed, including Kaplan-Meier curves and a Cox hazard model. RESULTS: After the exclusions, 3974 men (mean age 57.5 +/- 11 years) had standard diagnostic exercise testing over the study period with a mean of 5.9 (+/-3.7) years of follow-up (64% of all tested). There were no complications of testing in this clinically referred population, 82% of whom were referred for chest pain, risk factors, or signs and symptoms of ischemic heart disease. Five hundred forty-nine (14%) had a history of typical angina. Indications for testing were in accordance with published guidelines. A total of 545 died, yielding an annual mortality rate of 1.8%. The Cox hazard model chose the following variables in rank order as independently associated with time to death: change in rate pressure product, age greater than 65 years, METs less than 5, and electrocardiographic left ventricular hypertrophy. A score based on these variables classified patients into low-, medium-, and high-risk groups. The high-risk group with a score greater than 3 has a hazard ratio of 4 (95% confidence interval 3.82-4.27) and an annual mortality rate of 4%. CONCLUSION: This comprehensive analysis provides rates of various abnormal responses that can be expected in men referred for diagnostic exercise testing at typical Veterans Administration Medical Centers. Four simple variables combined as a score predict all-cause mortality after clinical decisions for therapy are prescribed.

Aged↗
PubMed2001

Endothelial function in patients with chronic heart failure.

Congestive heart failure is characteristically associated with systemic vasoconstriction and impaired vasodilatory capacity, leading to decreased peripheral perfusion. Factors identified as possible causes of reduced vasodilatory capacity include activation of the sympathetic nervous system and the renin-angiotensin system, vascular stiffness due to increased sodium and fluid retention, and structural vascular changes. More recently, the role of the endothelium as a mediator of vasoregulation and tissue perfusion has been recognized.

Endothelium, Vascular↗
PubMed2001

Jaundice and hepatocellular damage associated with nevirapine therapy.

OBJECTIVE: Nevirapine is a nonnucleoside reverse transcription inhibitor that is used as part of highly active antiretroviral therapeutic combinations. Nevirapine has been associated with a skin rash in 32 to 48% of patients. Recent reports indicate that hepatic toxicity also occurs. METHODS: We describe four instances of reversible hepatocellular damage associated with the use of nevirapine in patients with HIV infection. Two of the four patients were also coinfected with the hepatitis C virus. RESULTS: Evidence of malaise, skin rash, and icteric hepatitis with pruritus occurred 4-6 wk after the beginning of nevirapine therapy. No evidence of metabolic acidosis was present in any of our patients. In all cases, liver test results declined to normal or near normal levels, and pruritus disappeared 4-6 wk after discontinuation of the medication. No patient was rechallenged with the drug. CONCLUSION: Nevirapine can be associated with icteric hepatitis, which appears to be reversible after withdrawal of the drug.

Adult↗
PubMed2001

Macrophages are increased in cervical epithelium of women with cervicitis.

BACKGROUND: Sexually transmitted diseases (STIs) are major causes of morbidity in women. The mechanisms involved in establishment of genital mucosal infection are poorly defined. OBJECTIVE: To investigate changes in cervical epithelial (CE) CD45+ cell subpopulations in women with microscopic evidence of cervicitis (n=9) and those without (n=12). METHODS: CE samples were obtained using cytobrush including matched venous blood. CE and peripheral blood (PB) mononuclear cells were analysed by flow cytometry for CD3+, CD4+, CD8+, CD14+,CD19+, and HLA-DR+ expression. RESULTS: Women with cervicitis had increased CE macrophages compared with those without (p<0.05). MHC class II+ cells were predominant in all cervical samples. Considerably fewer B lymphocytes were found in cervical samples in both groups of women. No changes were observed in cervical T lymphocyte subsets. However, a relative CD8+ lymphocytosis in PB was noted in women with cervicitis. CONCLUSION: The increased numbers of CE macrophages in women with cervicitis may have important implications for pathogenesis of STIs including human immunodeficiency virus infection.

Adult↗
PubMed2001

Clinical and exercise test predictors of all-cause mortality: results from > 6,000 consecutive referred male patients.

OBJECTIVE: To report the prevalence of abnormal treadmill test responses and their association with mortality in a large consecutive series of patients referred for standard exercise tests, with testing performed and reported in a standardized fashion. BACKGROUND: Exercise testing is widely performed, but few databases exist of large numbers of consecutive tests performed on patients referred for routine clinical purposes using standardized methods. Even fewer of the available databases have information regarding all-cause mortality as an outcome. METHODS: All patients referred for evaluation at two university-affiliated Veterans Affairs medical centers who underwent exercise treadmill testing for clinical indications between 1987 and 2000 were determined to be dead or alive using the Social Security death index after a mean 6.2 years (median, 7 years) of follow-up. Clinical and exercise test variables were collected prospectively according to standard definitions; testing and data management were performed in a standardized fashion using a computer-assisted protocol. All-cause mortality was utilized as the end point for follow-up. Standard survival analysis was performed, including Kaplan-Meier curves and a Cox hazard model. RESULTS: There were 6,213 male patients (mean +/- SD age, 59 +/- 11 years) who underwent standard exercise ECG treadmill testing over the study period with a mean follow-up duration of 6.2 +/- 3.7 years. There were no complications of testing in this clinically referred population, 78% of whom were referred for chest pain, or risk factors or signs or symptoms of ischemic heart disease. Overlapping thirds had typical angina or history of myocardial infarction (MI). Five hundred seventy-nine patients had prior coronary artery bypass surgery, and 522 patients had a history of congestive heart failure (CHF). Indications for testing were in accordance with published guidelines. Twenty percent died over the follow-up period, for an average annual mortality rate of 2.6%. Cox hazard function chose the following variables in rank order as independently and significantly associated with time to death: exercise capacity (metabolic equivalents < 5, age > 65 years, history of CHF, and history of MI. A score based on these variables (summing up the four variables [if yes = 1 point]) classified patients into low-risk, medium-risk, and high-risk groups. The high-risk group (score > or = 3) has a hazard ratio of 5.0 (95% confidence interval, 4.7 to 5.3) and a 5-year mortality rate of 31%. CONCLUSION: This comprehensive analysis provides rates of various abnormal responses that can be expected in patients referred for exercise testing at a typical medical center. Four simple variables combined as a score powerfully stratified patients according to prognosis.

Aged↗
PubMed2000

Prospects of detecting baryon and quark superfluidity from cooling neutron stars

Baryon and quark superfluidity in the cooling of neutron stars are investigated. Future observations will allow us to constrain combinations of the neutron or Lambda-hyperon pairing gaps and the star's mass. However, in a hybrid star with a mixed phase of hadrons and quarks, quark gaps larger than a few tenths of an MeV render quark matter virtually invisible for cooling. If the quark gap is smaller, quark superfluidity could be important, but its effects will be nearly impossible to distinguish from those of other baryonic constituents.

Journal Article↗
PubMed2000

Familial infantile myaesthenia.

We report a family of two brothers with familial infantile myaesthenia which is an autosomal recessive congenital myaesthenic syndrome. It is a presynaptic neuro muscular junction disorder, responsive to treatment and has got good prognosis.

Adolescent↗
PubMed1999

Subnormal retinal oxygenation response precedes diabetic-like retinopathy.

PURPOSE: Determining which patients are at risk for the development of diabetic retinopathy is expected to greatly improve existing prevention and treatment options. In this study, using an animal model of diabetic retinopathy, the hypothesis was tested that magnetic resonance imaging (MRI) and a carbogen inhalation challenge provides important diagnostic information regarding the risk of developing diabetic retinopathy. METHODS: MRI was used to measure noninvasively the change in oxygen tension along the entire inner retina (i.e., from superior ora serrata to inferior ora serrata) during a carbogen (95% O2/5% CO2) inhalation challenge (IOVS 1996;37:2089). Two animal groups were examined by this MRI method at two time points: (1) rats fed either normal rat chow (n = 20) or a 50% galactose diet (n = 20) for 3.5 months (i.e., before the appearance of extensive retinal lesions) or (2) rats fed either normal rat chow (n = 3) for 15 months or a 30% galactose diet (n = 4) for 15 to 18 months (i.e., when lesions are present). Retinal biochemical and morphometric measurements were also obtained. RESULTS: After 3.5 months of galactosemia, before the appearance of extensive retinal morphologic lesions, a significant (P < 0.05) reduction in the panretinal oxygenation response was observed in the galactosemic group compared with its age-matched control. These galactose-fed animals also displayed a significantly (P < 0.05) larger oxygenation response in the inferior hemiretina than in the superior hemiretina. After 15 to 18 months of galactosemia, during the period when lesions are present, the panretinal oxygenation response remained significantly (P < 0.05) lower in the galactose-fed animals than in their age-matched controls. In contrast to the 3.5-month results, the oxygenation response in galactosemic animals at 15 to 18 months was significantly (P < 0.05) larger in the superior than in the inferior hemiretina. Hemiretinal oxygenation responses were not different in normal controls at either duration. CONCLUSIONS: MRI measurement of the retinal oxygenation response to a carbogen challenge appears to be a powerful new and noninvasive approach that may be useful for assessing aspects of pathophysiology underlying the development of diabetic retinopathy in galactosemic rats. These results support our working hypothesis and suggest that further research into the diagnostic potential of this MRI approach for predicting the development of diabetic retinopathy is warranted.

Animals↗
PubMed1998

Crossed aphasia leading to pure word deafness.

We report a case of crossed aphasia following a vascular insult of the right hemisphere in a middle aged dextral man with subsequent evolution to pure word deafness. Development of pure word deafness during recovery from crossed Wernickes aphasia is an extremely rare clinical entity. Probably this is the first Indian report of this entity.

Aphasia↗