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Biomedical subjects

M Tandon

Publications and source records attributed to M Tandon.

At least 19 recordsLinked to original sources
PubMed2006

Ketamine for treatment of catheter related bladder discomfort: a prospective, randomized, placebo controlled and double blind study.

BACKGROUND: Intraoperative urinary catheterization might cause postoperative catheter related bladder discomfort (CRBD). We evaluated the efficacy of ketamine as a treatment modality for CRBD. METHODS: Fifty-four, ASA physical status I and II, male and female adult patients, having CRBD after elective percutaneous nephrolithotomy were randomized into two equal groups of 27 each. In the postoperative period, patients who complained of CRBD received medication depending upon group allocation. Group 1 (Control) received placebo, Group II (Ketamine) received i.v. ketamine 250 microg kg(-1). After induction of anaesthesia patients were catheterized with a 16 Fr Foley's catheter and the balloon was inflated with 10 ml distilled water. Grading of CRBD was done as none, mild, moderate and severe by a blinded observer at 0, 1, 2 and 6 h after operation. RESULTS: Ketamine reduced the incidence of CRBD (P<0.001) at 2 and 6 h along with reduction in severity (P<0.05) at 1 h compared with control. Higher incidence of mild sedation was observed in the ketamine group (P<0.05) which was not associated with any untoward effects. Operative time and intraoperative fentanyl requirement were similar in both the groups. CONCLUSION: I.V. ketamine (250 microg kg(-1)) is an effective treatment for reducing the incidence and severity of postoperative CRBD.

Adult↗
PubMed2006

Comparison of efficacy of oxybutynin and tolterodine for prevention of catheter related bladder discomfort: a prospective, randomized, placebo-controlled, double-blind study.

BACKGROUND: Bladder discomfort related to intraoperative catheterization of urinary bladder is a distressing symptom and more so in patients awakening from anaesthesia. These symptoms are similar to symptoms of overactive bladder. Muscarinic receptor antagonists have been reported to be effective in the treatment of overactive bladder. This study was therefore undertaken to evaluate the efficacy of oxybutynin and tolterodine in preventing catheter related bladder discomfort. METHODS: Two hundred and thirty-four consecutive adult patients, ASA I and II, of either sex, undergoing elective percutaneous nephrolithotomy surgery requiring urinary bladder catheterization were randomized into three equal groups of 78 each. Group C (control) received placebo, Group O (oxybutynin) received oxybutynin 5 mg and Group T (tolterodine) received tolterodine 2 mg orally 1 h before surgery. After induction of anaesthesia patients were catheterized with a 16 Fr Foley's catheter and the balloon was inflated with 10 ml distilled water. The bladder discomfort was assessed at 0, 1, 2 and 6 h after patient's arrival in the post-anaesthesia care unit. Severity of bladder discomfort was graded as mild, moderate and severe. RESULTS: Incidence of bladder discomfort observed in the control group was higher, i.e. 58% (45/78), compared with oxybutynin and tolterodine groups where it was 35% (28/78) and 33% (26/78), respectively (P<0.05). Significant reduction in the severity of bladder discomfort was also observed after oxybutynin and tolterodine therapy compared with control (P<0.05). CONCLUSION: Pretreatment with either oxybutynin or tolterodine reduces the incidence and severity of catheter related bladder discomfort.

Adult↗
PubMed2006

Magnetic loop basket: a "two-in-one" instrument.

BACKGROUND AND STUDY AIMS: Ingested coins are the most common foreign bodies encountered in the upper gastrointestinal tract in India and if they remain in the stomach for more than 5 days they need to be removed. Ferromagnetic retrieval instruments only work if the coins are ferromagnetic; and it is difficult to maneuver a loop basket in the fundus of the stomach. A magnetic loop basket was designed in an effort to overcome these difficulties and we assessed its feasibility, safety, and effectiveness in the removal of coins from the fundus of the stomach. PATIENTS AND METHODS: Twenty patients with a history of ingested coins were scheduled for removal of the coins using the magnetic loop basket. The time taken, complications, and failure rates were recorded. RESULTS: Twelve ferromagnetic coins were removed in a mean time of 60 seconds (range 30 - 90 seconds) and eight non-ferromagnetic coins were removed in a mean time of 150 seconds (range 90 - 180 seconds) without any failures or complications. CONCLUSION: The magnetic loop basket is a safe, effective, and quick method for removing both ferromagnetic and non-ferromagnetic metallic coins.

Equipment Design↗
PubMed2005

Evaluation of capsaicin ointment at the Korean hand acupressure point K-D2 for prevention of postoperative nausea and vomiting.

The K-D2 point is the Korean hand acupressure point in Koryo Hand Therapy for prevention of postoperative nausea and vomiting. We evaluated the efficacy of capsaicin ointment at the K-D2 point in 186 patients undergoing laparoscopic cholecystectomy in a randomised, prospective, double-blind and placebo-controlled study. Patients were randomised to have either placebo ointment or capsaicin ointment applied to the K-D2 point of both hands 1 h before surgery under standardised anaesthesia. The ointment was removed 8 h later. Postoperative nausea and vomiting was evaluated 6 and 24 h following surgery. The incidence of postoperative nausea and vomiting was lower in the capsaicin group, with an absolute risk reduction (ARR) of 21%, a relative risk reduction (RRR) of 50% and a number-needed-to-treat (NNT) of 5 at 0-6 h (p = 0.001), and an ARR of 11%, a RRR of 85% and a NNT of 9 at 6-24 h (p = 0.003). The need for rescue anti-emetic treatment was also lower at 0-6 h (3 (3%) vs 11 (12%); p = 0.04) and at 6-24 h (5 (5%) vs 0; p = 0.02).

Acupuncture Points↗
PubMed2004

Effect of insulin hypoglycemic stress on nociceptive responses to mu- and kappa-opioid receptor agonists at LH-surge in female rats.

In a randomized, prospective, controlled and crossover study, the effects of insulin hypoglycemic stress on nociceptive responses to mu- and kappa-opioid receptor directed drugs during steroid-induced preovulatory LH-surge were seen in ovariectomized female rats. Ovariectomized rats were equally distributed in two groups of 10. In group 1 rats, LH-surge was induced by sequential treatment with estradiol benzoate 7.5 micro g/rat s.c. and progesterone 5 mg/rat s.c., whereas in group 2 rats, vehicles of estradiol benzoate and progesterone were given in a sequential manner. A third group consisted of sham-operated rats, which received no treatment. Rats were exposed to insulin-induced hypoglycemic stress 1 h before the peak of LH-surge. Antinociceptive responses of morphine, buprenorphine and pentazocine were observed at peak LH-surge during hypoglycemic stress. Increased nociceptive responses to noxious stimulus and decreased percent maximal possible effect for morphine, buprenorphine and pentazocine at LH-surge were significantly (p < 0.01) reversed during insulin hypoglycemic stress. There was a significant (p < 0.01) decrease in the ED(50) values of morphine, buprenorphine and pentazocine during hypoglycemic stress. The present study indicates that insulin hypoglycemic stress is responsible for increased antinociceptive activities of morphine, buprenorphine and pentazocine and decreased sensitivity to noxious stimulus in ovariectomized rats with or without steroid-induced LH-surge.

Analgesics, Opioid↗
PubMed2004

Serum albumin-adjusted phenytoin levels: an approach for predicting drug efficacy in patients with epilepsy, suitable for developing countries.

INTRODUCTION: The antiepileptic drug phenytoin has a high degree of plasma protein binding. Therefore, total phenytoin levels in plasma are misleading indicators of clinical efficacy. This study was designed to investigate whether serum albumin-adjusted phenytoin levels in Indian patients with epilepsy predict clinical outcome better than total phenytoin levels. PATIENTS AND METHODS: Fifty patients with epilepsy were included in the study and were followed-up for a period of 6 months. Serum albumin levels were estimated spectrophotometrically using the bromocresol green dye method, and serum phenytoin levels were estimated using high pressure liquid chromatography. Values were expressed as mean +/- SEM. Corrected phenytoin levels were calculated using the Sheiner-Tozer equation. Corrected phenytoin levels = Measured total phenytoin(micromol/l) [(albumin g/1 x 0.9)+ 0.1] 40. RESULTS: At Visit 1, mean serum albumin levels were 44.1 +/- 1.1 micromol/l and mean serum phenytoin levels were 33.9 +/- 2.8 g/l. After correction of the total phenytoin levels using the Sheiner-Tozer equation, 30% of the patients shifted to a different category. The follow-up visits showed similar results. Throughout the study, the corrected phenytoin levels were better indicators of clinical outcome than the total levels. In 23% of patients there was a significant difference between total and corrected phenytoin levels. CONCLUSION: In patients with serum albumin levels in the hyper- and hypoalbuminemic range, corrected phenytoin levels were better indicators of clinical outcome. In developing countries like India, where estimation of free drug levels is expensive and suitable equipment is not available in most centers, serum albumin-adjusted levels can be used by pharmacologists to predict response and thus assist in clinical decision-making.

Adolescent↗
PubMed2003

Evaluation of antiepileptic activity of aspirin in combination with newer antiepileptic lamotrigine in mice.

Neurotransmitters such as GABA, glutamate and prostaglandins mediate synaptic transmission and their modulation may play a role in the generation of seizures. Numerous studies implicate prostaglandins as potential modulators of seizure activity. This study was designed to assess the antiepileptic activity of aspirin and to investigate the potentiation of its activity in combination with a subconvulsive dose of lamotrigine. Graded doses of aspirin and lamotrigine were used in pentylenetetrazole (PTZ) and maximal electroshock (MES) seizure models in mice. To study the interaction of aspirin and lamotrigine, ED(25) doses of aspirin (250 mg/kg) and lamotrigine (1.5 mg/kg) were used in the two seizure models. Aspirin dose-dependently decreased the incidence of seizures in the PTZ-model mice but did not show any effect in MES-model mice. ED(25) doses of aspirin and lamotrigine showed 100% protection of the PTZ seizure model. Aspirin alone in doses of 400 and 800 mg/kg and in combination decreased mortality in the PTZ model. Aspirin showed a significant anticonvulsant effect in PTZ seizure mode. Potentiation of the anticonvulsant effect of lamotrigine with aspirin was shown in the PTZ model, indicating that prostaglandins could play an important role in this seizure model.

Animals↗
PubMed2002

Genomic diversity at 15 fluorescent labeled short tandem repeat loci in few important populations of State of Uttar Pradesh, India.

Genomic diversity at 15 short tandem repeat loci is studied in four major endogamous populations of Uttar Pradesh (UP), India. The studied populations included Thakur, Khatri, Kurmi and Jat; all of whom belong to Hindi speaking linguistic group of UP State of India. All the STR loci of Powerplex 16 System have been found highly significant in showing genomic diversity among the addressed populations. Homozygosity test values for all the 15 loci in studied population range between 0.053 and 0.999, following Hardy-Weinberg equilibrium. Distribution of allele pattern at fluorescent labeled 13 tetranucleotide repeat loci and two pentanucleotide repeat loci of Powerplex 16 System portrays that these markers are highly polymorphic, and thus, suitable in human identity testing and human genetic studies.

Gene Frequency↗
PubMed2002

Pattern of use of complementary/alternative medicine (CAM) in epileptic patients in a tertiary care hospital in India.

PURPOSE: Many patients use complementary/alternative medicine (CAM) for their health problems especially where long-term treatment is required. Epilepsy is the most prevalent neurological disorder requiring long-term treatment and compliance. The purpose of the study was to establish the pattern of use of CAM in epileptic patients. METHODS: 1000 patients with seizure disorder visiting the Neurology outpatient department were interviewed regarding use of complementary/alternative medicine (CAM) in the past. The pattern of use, persons who recommended CAM and the reasons for trying these therapies and sequence of seeking them was noted in these patients. RESULTS: Overall 32% of patients had used CAM. Ayurvedic medicine was used most frequently, either alone (43%) or in combination (38%) with other CAM therapies followed by homeopathy (12.5%). Use of CAM was seen among all age groups and at all levels of education and was most frequent in the rural population (67%). Influence of family and friends (50%) was the most common reason for trying these therapies. Most patients (57%) sought CAM providers first before seeking the services of a medical doctor in our study. CONCLUSION: As more and more patients use CAM, physicians should ask their patients whether they use these therapies and should discuss these practices with their patients in order to safeguard their health.

Adolescent↗
PubMed2002

Microwave-assisted (radio)halogenation of nitroimidazole-based hypoxia markers.

Microwave-assisted radiohalogenation for the production of short-lived radiopharmaceuticals has now been applied to the synthesis and radiolabelling of azomycin nucleosides. (Radio)halogens were incorporated either by nucleophilic substitution of a leaving group or by halogen-halogen exchange, in the synthesis of IAZA, IAZP and FAZA. A comparison of conventional labelling and microwave-assisted labelling procedures reflects a clear advantage of the microwave technique.

Biomarkers↗
PubMed2001

Endoscopic ultrasound in idiopathic acute pancreatitis.

OBJECTIVE: The aim of this study was to determine the utility of endoscopic ultrasound (EUS) in patients with unexplained acute pancreatitis, and whether endoscopic retrograde cholangiopancreatography (ERCP) is subsequently needed. METHODS: Subjects who underwent EUS for assessment of idiopathic acute pancreatitis were identified, their medical records were reviewed, and they were contacted for a follow-up telephone interview. EUS diagnosis was compared with the final diagnosis and outcome. RESULTS: EUS revealed a cause of pancreatitis in 21 of the 31 subjects (68%), including microlithiasis in five (16%), chronic pancreatitis in 14 (45%), pancreas divisum in two (6.5%), pancreatic cancer in one (3.2%), and was not diagnostic in 10 (32%). During a mean follow-up period of 16 months, diagnosis changed in four subjects (13%), and nine subjects (29%) had ERCP because of persistent symptoms or recurrent pancreatitis. CONCLUSION: EUS, a less invasive test than ERCP, demonstrated an etiology in two-thirds of patients with idiopathic acute pancreatitis. Most patients did not require ERCP during the follow-up period. EUS can be an alternative to ERCP in patients with unexplained acute pancreatitis.

Acute Disease↗
PubMed2000

Design and synthesis of novel thiazole-containing cross-linked polyamides related to the antiviral antibiotic distamycin.

A family of naturally occurring oligopeptides includes netropsin, distamycin, anthelvencin, kikumycin B, amidinomycin, and norformycin. Netropsin (I) and distamycin (II) express their biological activities by targeting specific sequences of chemical functionalities in the minor groove of DNA. Both netropsin and distamycin can be regarded as polyamide chains in which each alpha-carbon has been replaced by a five-membered pyrrole ring. The repeat distance in such an augmented polyamide chain is almost the same as the distance from one base pair to the next along the floor of a minor groove within beta-DNA. In this paper we report the synthesis of 16-21 cross-linked polyamides containing a thiazole heterocyclic ring bearing the active functionalites NH(2), NHCHO, or H. 16 and 17 were synthesized by DCC and HOBt catalyzed reaction of 5 with 14 and 15, while the formylation products 18 and 19 were obtained by coupling the formylated 4-methyl-thiazolated acid 6 with 14 and 15. The deaminated compounds 20 and 21 were obtained by the coupling of 5-trichloroacetyl-4-methylthiazole 7 synthesized from 4-methylthiazole. All the six cross-linked polyamides 16-21 were tested for their DNA gyrase inhibition. The studies have shown these polyamides have better sequence recognition and a greater percentage of inhibition than the corresponding monomers. The compound 17 shows complete inhibition of gyrase at 0.5 microM concentration as compared to the naturally occurring distamycin at 1.0 microM.

Antiviral Agents↗
PubMed2000

Assessment of iodine deficiency disorders using the 30 cluster approach in district Kangra, Himachal Pradesh, India.

Iodine deficiency is an important public health problem in Himachal Pradesh. District Kangra is a known iodine deficiency endemic area. A survey conducted in 1956 reported a goitre prevalence of 55 per cent in the district. A more recent pilot study (1994) in four blocks of the district reported the total goitre rate (TGR) as 7 per cent. A continued prevalence of goitre in more than 5 per cent of school-aged children was found in pilot study, in spite of the distribution of iodised salt. The present study was conducted to assess the prevalence of iodine deficiency disorders (IDD) and to estimate the iodine content of salt consumed by the population in district Kangra. The '30 cluster' sampling methodology and indicators for assessment of IDD, as recommended by the joint WHO/UNICEF/ICCIDD consultation, were utilized for the survey. A confidence level of 95 per cent, a relative precision of 10 per cent and a design effect of three were taken into account for calculation of the sample size. A total of 23,348 school children in the age group 6-11 years were included in the study. The total goitre prevalence rate was found to be 12.1 per cent. The median urinary iodine excretion of the children studied was found to the 15.00 mcg/dl. About 12.7 per cent of families consumed salt with an iodine content of less than 15 ppm. The results of the present study indicated that the population of district Kangra is in a transition phase from iodine deficient to iodine sufficient nutrition and that there is a need for further strengthening of the system of monitoring the quality of iodised salt made available to the population to eliminate IDD from the Kangra Valley.

Age Distribution↗