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Biomedical subjects

M Varma

Publications and source records attributed to M Varma.

At least 37 records · Page 2Linked to original sources

Needle stick injuries among medical students.

Questionnaires were distributed among 200 medical students regarding safety precautions observed while perfonning various invasive procedures during their clinical posting. Only 106 students responded with the completed questionnaire. The most common procedure performed by the students was drawing of blood, with an average frequency of 60.8 per month. Sixty-one per cent of the students reported being injured during the various procedures and only 3 5.5% of them used gloves. Resheathing the needle was responsible for causing injury to 69% of the students, which was significantly higher than injuries occurring while entry into the vein or withdrawing the needle (p<0.05).

Adult↗

Incidence of enteroadherence in diarrhoegenic Escherichia coli in infants in Delhi.

Fifty-six isolates of Escherichia coli including 40 isolates from diarrhoeic infants and 16 from non-diarrhoeic infants were investigated. Twenty-two of the diarrhoeic isolates were typable, the most common serogroup being 086 (33%). None of the non-diarrheic isolates are typable with EPEC antisera with enteropathogenes. Adherence tests with HEp-2 cell line revealed localized adherence in 23%, diffuse adherence in 14% and aggregative adherence in 5.7% of the 35 isolates tested. Aggregative adherence was not observed in any of the EPEC isolates. None of the isolates in the control group exhibited localized or aggregative adherence. However, 25% of these isolates showed diffuse adherence (DA) which was not significantly different from the incidence of DA (34%) in the test group (p > 0.05). The importance of serogrouping and studying adherence pattern of E. coli isolates in establishing their pathogenic potential is thus emphasized.

Bacterial Adhesion↗

Potential strategies for ameliorating early cancer anorexia.

BACKGROUND: Normally the lateral hypothalamic area (LHA) and the ventromedial nucleus (VMN) interact to regulate food intake (FI), the product of meal number (MN) and meal size (MZ), by changes in neurotransmitters, mainly dopamine and serotonin. Change in LHA dopamine influences meal size; while in VMN, decreasing dopamine and increasing serotonin levels influence meal number. Whether this situation exists in early cancer anorexia was tested in a series of studies to examine the role of the hypothalamus in the pathogenesis of early cancer anorexia. MATERIALS AND METHODS: In experiment 1, male Fischer tumor-bearing (TB) rats and weight-matched controls had FI, MN, and MZ measured continuously via a computerized rat eater meter. At onset of anorexia, feeding patterns were measured. In experiment 2, the VMN was temporarily blocked with 0.32 microgram of colchicine in TB rats, while TB controls had an equal volume of intra-VMN saline, and changes in feeding patterns were measured. In experiment 3, changes in VMN dopamine and serotonin were measured via microdialysis at anorexia and after tumor resection. RESULTS: In experiment 1, with the onset of anorexia, food intake decreased significantly in TB rats, initially by a decrease in MN and then by a decrease in both MN and MZ. No change occurred in controls, suggesting that VMN versus LHA played a more significant role in mediation of cancer anorexia. In experiment 2, following VMN block, FI increased significantly in anorectic TB rats, achieved by an almost exclusive increase in MN with minimal change in MZ, thus supporting the role of the VMN in anorexia. In experiment 3, at the onset of anorexia, FI decreased significantly in TB rats versus controls. TB rats had a significant increase in VMN serotonin and a significant decrease in VMN dopamine. After tumor resection, food intake improved and high levels of serotonin normalized with no change in dopamine. CONCLUSION: Serotoninergic and dopaminergic systems are involved in the etiology of cancer anorexia. The changes in food intake are mediated via the VMN by a decrease in meal number.

Animals↗

Lack of influence of hysterectomy on meal size and meal number in Fischer-344 rats.

Based on our previous observation that, when eating the same amount of food per 100 g b.wt., male rats gain five to seven times more weight than females who have an estrous cycle every 4 to 5 days, we questioned whether lower weight gain seen in female rats could be the result of increased energy cost in preparing endometrium for anticipated fertilization. Because the uterus modulates estrogenic effects on other hormone-dependent behaviors, for example, sexual receptivity and lordosis, we performed this study to determine if estrogen-mediated cyclical changes in food intake and feeding pattern occur after hysterectomy. Fifteen female Fischer 344 rats were randomized during the estrous phase to either hysterectomy with ovarian preservation or sham operation. A rat eater meter was used to continuously measure food intake, meal number, and meal size for two estrous cycles before and four cycles after surgery. Both groups showed the estrous phase linked cycling in meal number, meal size, and food intake. No differences existed between the two groups in these indices either before or after surgery. No differences existed between groups in rate of body weight gain after surgery, 0.95 +/- 0.13 g/day in hysterectomized and 0.77 +/- 0.1 g/day in sham-operated rats. We conclude that hysterectomy has no effect on rate of weight gain, food intake, and estrus linked cyclical feeding pattern in Fischer 344 rats.

Animals↗

Effect of operative stress on food intake and feeding pattern in female rats.

Effects of operative stress on food intake, meal size, and meal number were measured in 15 female rats before and after jugular vein catheterization. All rats had 5-d estrous cycles which correlated with cyclical feeding patterns that were most prominent during dark phase eating. In proestrous, meal number peaked (30.3+/-1.32), and meal size reached a nadir (0.33+/-0.02 g) with some corresponding change in food intake (9.8+/-0.38 g). Following operation on day 11, the cyclical variation of food intake, meal number, and meal size with estrous cycle was lost for the first 3 d, as was the diurnal rhythm in food intake. Eight rats recovered their dark phase feeding pattern by day 17 (recovered group), while 7 had not done so even by day 24 (non-recovered group). Food intake decreased to 40% of baseline in the recovered group and to 25% in the non-recovered group on day 11, increasing to 70% by day 14 in both groups and matching preoperative levels by day 17. Similar postoperative decreases were observed in meal number and meal size. Light phase feeding was increased, the ratio of day to night food intake being three times preoperative levels even at day 24. Preoperatively, non-recovered rats were similar to the recovered rats in all feeding indexes and continued to have estrous cycling in vaginal smears postoperatively. In the non-recovered rats, meal size more than doubled and meal number was depressed by 47% of preoperative levels and remained low until the end of the study. We conclude that operative stress disrupted cyclical and diurnal rhythms in food intake. In female rats, meal size is the first index to recover, increasing temporarily to maintain food intake.

Animals↗

Postatrophic hyperplasia of the prostate gland: a detailed analysis of its morphology in needle biopsy specimens.

Postatrophic hyperplasia is a histologic pattern showing atrophic and hyperplastic glands, sometimes with a small acinar configuration. Because distinction from small acinar carcinoma may be challenging, particularly in needle biopsy specimens, we studied 56 needle biopsy specimens containing 68 foci to ascertain the morphologic spectrum of postatrophic hyperplasia. All foci showed a distinct lobular small acinar proliferation with varying proportions of atrophic and hyperplastic glands. Gland size was typically variable, predominantly of small caliber but occasionally of intermediate to larger caliber. Round, oval, elongated, slitlike and stellate glands were seen. The nuclei were generally regular without hyperchromasia, with rare small nucleoli seen in 10 (15%) foci. The cytoplasm was variable, ranging from scant in atrophic glands to moderate or abundant and clear or occasionally eosinophilic in hyperplastic glands. An irregular internal gland contour was noted in glands with features of both atrophy and hyperplasia. Basal cells were apparent by light microscopy in most foci, although their distribution within foci and between foci varied. This finding was confirmed in all 26 cases studied with the high molecular weight cytokeratin immunohistochemical stain (34betaE12). Associated pathology included adenocarcinoma (12%), high-grade prostatic intraepithelial neoplasia (3%), atrophy distinct from foci of postatrophic hyperplasia (55%), and atypical adenomatous hyperplasia (2%). Adjunctive features of cancer were not seen in any of the foci of postatrophic hyperplasia. Familiarity with the histologic features of postatrophic hyperplasia will allow its confident separation from cancer, especially in limited biopsy material.

Aged↗

Use of orchiectomy and testosterone replacement to explore meal number-to-meal size relationship in male rats.

Because food intake is a function of meal number and meal size and because gender-related hormones are involved in feeding regulation, we explored effects of orchiectomy and testosterone replacement on the relationship between meal number and size and changes in resulting feeding patterns in adult male rats, randomized into orchiectomy and sham-operation groups. A rat eater meter measured feeding indexes for 1 wk before and 2 wk after castration and during 8 days of testosterone replacement. Orchiectomy leads to an immediate change in the meal number-to-size relationship, resulting in 1) change in pattern of feeding; 2) a significant decrease in dark-phase meal number; 3) a significant increase in dark-phase meal size, but insufficient to offset decrease in meal number, so total food intake significantly decreased during dark phase; 4) no significant change in light-phase meal number; and 5) an increase in meal size leading to an increased food intake during light phase, which offset decreased food intake in dark cycle and resulted in no net significant change in food intake after orchiectomy. Testosterone replacement acutely reversed effects of orchiectomy on meal number-to-meal size relationship, restoring feeding pattern. Data suggest that androgens immediately influence the meal number-to-meal size relationship. The speed of onset seen after orchiectomy suggests that the influence of testosterone on food intake may also occur partially via a nongenomic effect.

Animals↗

Pharmaceutical care of patients with congestive heart failure: interventions and outcomes.

We evaluated a structured pharmaceutical care program for elderly patients (> 65 yrs) with congestive heart failure (CHF) based on objective measures of disease control, quality of life, and use of health care facilities in a randomized, controlled, longitudinal, prospective clinical trial. The 42 patients in group A received education from a pharmacist on the disease and its treatment, and lifestyle changes that could help control symptoms. Patients also were encouraged to monitor their symptoms and comply with prescribed drug therapy. If necessary, dosage regimens were simplified in liaison with hospital physicians. The 41 control patients (group B) received standard care. The following outcome measures were assessed in all patients at baseline (before the start of the trial) and at 3, 6, 9, and 12 months: 2-minute walk test, blood pressure, body weight, pulse, forced vital capacity, quality of life [disease-specific (Minnesota Living with Heart Failure questionnaire) and generic (SF-36)], knowledge of symptoms and drugs, compliance with therapy, and use of health care facilities (hospital admissions, visits to emergency room, emergency calls). Patients in group A showed improved compliance with drug therapy, which in turn improved their exercise capacity compared with those in group B; education on management of symptoms, lifestyle changes, and dietary recommendations were also of benefit. Group A patients significantly improved knowledge of their drug therapy over the 12-month study and had fewer hospital admissions compared with group B patients. They also had improved outcomes compared with group B, despite the small samples. An extension of this trial to other sites with pooling of results would provide additional evidence of the value of this structured program in elderly patients with CHF.

Aged↗

Effect of formalin fixation and epitope retrieval techniques on antibody 34betaE12 immunostaining of prostatic tissues.

Basal cell-specific, anti-high molecular weight cytokeratin (HMCK) antibody is often used to confirm the diagnosis of prostatic adenocarcinoma, particularly if limited amounts of tissue are available. HMCK is formalin sensitive and requires pretreatment by enzymes or heat if formalin-based fixatives are used. To date, the effect of prolonged formalin fixation on HMCK immunoreactivity has not been systematically studied; this is critical, because the diagnosis of malignancy is based on a negative immunoreaction. In this study, 5 tissue blocks obtained from each of 10 radical prostatectomy specimens were fixed in formalin from 6 hours to 1 month. HMCK immunostaining was performed with monoclonal antibody clone 34betaE12 after pretreatment of the sections by either enzymatic predigestion with pepsin, heat-induced epitope retrieval (HIER) with a microwave, or HIER with a hot plate. For scoring, the staining intensity at 6 hours of formalin fixation was considered as the baseline for that particular antigen retrieval technique. After pepsin predigestion or microwaving, there was progressive loss of HMCK immunoreactivity from 1 week or longer of formalin fixation. HIER with a hot plate yielded consistent results with no decrease in HMCK immunoreactivity with as long as 1 month of formalin fixation. The staining intensity was consistently stronger at all periods of formalin fixation when the hot plate method was used, compared with pepsin predigestion or microwaving. Generally weak HMCK positivity was observed in rare neoplastic cells of 3 of 10 specimens after hot plate HIER but not with pepsin predigestion or microwave antigen retrieval. This sporadic immunostaining of malignant cells was quantitatively and qualitatively distinct from the pattern seen in benign epithelium. We conclude that formalin fixation affects HMCK immunoreactivity over time and might impact its diagnostic usefulness. Efficacies of different antigen unmasking/epitope retrieval techniques vary and must be standardized for individual laboratories.

Antibodies, Monoclonal↗

Incidence of HTLV-I in high-risk population in Delhi.

Human infection due to HTLV-I occurs by transmission of infected T-cells via sexual intercourse, blood transfusion or breastfeeding. The present investigation was carried out to find the incidence of HTLV-I in high risk population and its relationship with syphilis and HIV infection. The study group comprised 124 antenatal cases, 9 patients attending Sexually Transmitted Disease (STD) clinics and 144 blood donors. Passive particle agglutination test was performed on all the test sera for anti HTLV-I antibodies. VDRL and Treponema pallidum haemagglutination tests were carried out on sera from antenatal and STD cases. Sera from blood donors were tested for HIV antibodies by ELISA and confirmed by Western Blot. Anti HTLV-I antibodies were found in 10.6% of the cases studied. There was no association between the presence of anti HTLV-I antibodies and syphilis in expectant mothers and STD cases. However, significant association was found between the former and HIV infection in blood donors.

Adult↗

A randomized double-blind controlled study of nimodipine in acute cerebral ischemic stroke.

A randomized placebo controlled double-blind clinical trial of nimodipine was conducted in 31 patients of acute cerebral infarction. Nimodipine was administered in dosage of 120 mg/day for 28 days. Treatment was begun within 48 hours of ischemic stroke. Diagnosis was confirmed by computed tomographic (CT) scan. Similar number of patients (control) received placebo. Neurological assessment was done at the time of entry into the trial, and after 4 weeks, by using Mathew's scale. After four weeks of treatment with nimodipine or placebo, Mathew's scale score improved significantly (< 0.001) in both groups, but difference in mean score between two groups was insignificant (> 0.05). However, significant difference (< 0.05) was noted in relative change in neurological deficit (mean X-value) of two groups. The nimodipine group had higher value in scores on Mathew's scale. No adverse reaction, was observed in either group. The study suggests a beneficial a effect of nimodipine in acute cerebral ischaemia.

Adult↗

Normalization of plasma factor X levels in amyloidosis after plasma exchange.

Some patients with systemic light chain amyloidosis develop bleeding complications that can be caused by vascular infiltration with amyloid or by alterations of the coagulation or fibrinolytic systems. Factor X deficiency is the most common cause of bleeding manifestations, although deficiencies of other clotting factors, a disruption in the conversion of fibrinogen to fibrin, and circulating heparin-like anticoagulants have also been reported. Deficiency of factor X is a well-recognized cause of bleeding manifestations in patients with light chain amyloidosis. This acquired disorder appears to be secondary to adsorption of factor X to the amyloid fibrils. Previous studies have shown that infusion of plasma into patients with acquired factor X deficiency and amyloidosis induces a transitory improvement of the coagulation tests. However, there is a rapid return to pretransfusion levels. In this manuscript we report the clinical application of plasma exchange in the management of a patient with systemic light chain amyloidosis with acquired factor X deficiency.

Amyloidosis↗

Hypolipidaemic effect of fruit juice of Emblica officinalis in cholesterol-fed rabbits.

The lipid lowering and antiatherosclerotic effects of Emblica officinalis (Amla) fresh juice were evaluated in cholesterol-fed rabbits (rendered hyperlipidaemic by atherogenic diet and cholesterol feeding). E. officinalis fresh juice was administered at a dose of 5 ml/kg body weight per rabbit per day for 60 days. Serum cholesterol, TG, phospholipid and LDL levels were lowered by 82%, 66%, 77% and 90%, respectively. Similarly, the tissue lipid levels showed a significant reduction following E. officinalis juice administration. Aortic plaques were regressed. E. officinalis juice treated rabbits excreted more cholesterol and phospholipids, suggesting that the mode of absorption was affected. E. officinalis juice is an effective hypolipidaemic agent and can be used as a pharmaceutical tool in hyperlipidaemic subjects.

Animals↗

Optimizing bone-graft nasal reconstruction: a study of nasal bone shape and thickness.

Nasal reconstruction may best be carried out with bone grafting in certain cases of loss of structural support. In order to optimize both the aesthetic and functional results of bone-graft nasal reconstruction, we studied the shape and thickness of the normal human nasal bone. Sixty Caucasian skull nasal bones were measured by width throughout their length at three planes of depth. Seventeen Caucasian cadaver nasal bones were examined to determine the thickness of the bone throughout its length at three sagittal planes. The results showed that the nasal bone was widest at the nasofrontal suture (14 mm), narrowest at the nasofrontal angle (10 mm), and then widened again to a maximum width of 12 mm about 9 to 12 mm inferior to the nasofrontal angle. The nasal bone was thickest superiorly at the nasofrontal angle (average 6 mm) and progressively thinned toward the tip. It was 3 to 4 mm thick in the critical area where screws are most commonly placed for fixation (5 to 10 mm inferior to the nasofrontal angle). From these data, three-dimensional models of the normal nasal bone shape were formulated and used in clinical bone-graft cases.

Bone Transplantation↗

Application of the HSEF to assessing radiation risks in the practice of radiation protection.

The primary risk coefficients upon which exposure limits for radiation protection purposes are currently based are derived almost exclusively from cancer-induction data obtained from human populations exposed to radiations of low linear energy transfer. The question of higher linear energy transfer radiations is handled by means of quality factors derived from values for relative biological effectiveness obtained from animal data. However, the advent of microdosimetry has made it possible to establish hit size effectiveness functions from single-cell systems, both in vitro and in vivo. This type of function can substitute completely for the concept of relative biological effectiveness, Q and equivalent dose. A common basis for risk coefficients and the hit size effectiveness function lies in the fact that human cancers are monoclonal and thus single cell in origin. The present communication utilizes this common base as a means of extending the present low-linear energy transfer based risk coefficients to include carcinogenic responses from exposure in radiation fields of any one or mixed qualities, extending from the smallest to the largest linear energy transfers of practical consequence. In doing so, risks from ionizing radiations of any linear energy transfer may be predicted more accurately than at present.

Biophysical Phenomena↗