PubMed Health⌕ Search

Biomedical subjects

N K Misra

Publications and source records attributed to N K Misra.

At least 19 recordsLinked to original sources
PubMed2005

Reversal of subclinical adrenal insufficiency through antituberculosis treatment in TB patients: a longitudinal follow up.

BACKGROUND & OBJECTIVE: Subclinical adrenal insufficiency has been shown to occur in patients with tuberculosis. Whether this insufficiency can be reversed with therapy and on long-term follow up, is not known. We studied the effect of antituberculosis treatment (ATT) with respect to reversal of the adrenal insufficiency, as assessed by response to standard dose adrenocorticotropin (ACTH) stimulation test in TB patients. METHODS: One hundred and five HIV-negative tuberculosis patients were studied. Of these, 72 patients had pulmonary and 33 had extrapulmonary forms of the disease. Baseline (pre-treatment) standard-dose ACTH stimulation test was done on all the subjects, following which, they were put on standard antituberculosis therapy, depending on the type of disease and were followed up for a period of 30 months. ACTH stimulation tests were performed at follow up, every 6 months. RESULTS: Baseline (pre-treatment) standard-dose ACTH stimulation test revealed an impaired response in 52 of 105 patients (49.5%). At 6 months, the percentage of responders had increased to 71 per cent with a gradual increasing trend noted thereafter. At 24 months, 31 of the 32 patients (97%) who were followed up demonstrated a normal response to ACTH stimulation. The percentage of responders was comparable in both pulmonary [21 of 22 patients (95%)] and extrapulmonary TB [10 of 10 patients (100%)] groups at follow up. INTERPRETATION & CONCLUSION: Our study shows that nearly half of patients with active tuberculosis had a subclinical adrenal insufficiency indicated by an impaired response to ACTH stimulation test. This insufficiency reverse with therapy in most patients on long-term follow up.

Adrenal Insufficiency↗
PubMed1997

Unilateral meningeal thickening: a rare presentation of tuberculous meningitis.

A rare case of tuberculous meningitis (TBM) causing unilateral thickening of meninges, is described here. The 50 year old male is presented with hemicranial headache and unilateral multiple cranial nerve involvement without any long tract signs. Magnetic resonance imaging (MRI) scan including enhanced studies showed a hemicranial thickening of the meninges. Biopsy of the meninges revealed tuberculosis. The patient improved gradually on antitubercular treatment (ATT). Follow-up at 6 months revealed significant improvement in neurological status. Though tuberculous involvement of the central nervous system (CNS) is very common in India, hemicranial meningeal involvement has never been reported.

Antitubercular Agents↗
PubMed1995

Ruptured intracranial aneurysm complicating pregnancy.

Three cases of ruptured intracranial aneurysm during pregnancy are presented. Rupture occurred near term in all three cases. Simultaneous elective cesarean section and clipping of the aneurysm was performed in two cases. Successful maternal and perinatal outcome was achieved in all three patients. The diagnosis and management of the cases are described and discussed.

Aneurysm, Ruptured↗
PubMed1994

Albendazole in single CT ring lesions in epilepsy.

Single, small, enhancing lesions that often resolve spontaneously are frequent findings on CTs of Indian patients with seizures. Based on ELISA and biopsy data, the majority of these lesions are probably cysticercosis. To determine if these patients should be treated with albendazole, we performed a double-blind, randomized, placebo-controlled study involving 75 patients with seizures and the appropriate CT abnormality without neurologic abnormality on examination. Patients were randomized to albendazole (15 mg/kg/d) and placebo for 1 week, and we obtained serial CTs at the end of 1 week, 1 month, and 3 months. All patients completed a 3-month follow-up and none had systemic evidence of tuberculosis or cysticercosis. The lesions varied in size from 3 mm to 2.1 cm, with an average size of 1.18 cm. Serum ELISA for cysticercosis was positive in 30 and CSF ELISA was positive in 20 of 45 patients. Forty patients received albendazole and 35 received placebo. At the end of 3 months, a total of 68 patients showed resolution. Thirty-five of 40 patients who received albendazole showed resolution, as opposed to 33 of 35 patients on placebo. We conclude that albendazole therapy was not beneficial.

Adolescent↗
PubMed1992

Parapharyngeal neurofibromas.

This paper is a retrospective study of 15 patients with parapharyngeal neurofibromas operated over a six year period. No patient presented with a neurological deficit. CT scans revealed a well encapsulated moderately enhancing mass in ten cases. The tumour was removed by a transcervical approach in ten cases while in five a cervical-transpharyngeal route with mandibulotomy was used; in three of the latter group the tumour was retropharyngeal. In two cases a recurrence was successfully excised. It was realized that a mandibulotomy was required when the internal carotid was displaced medially, or if the tumour extended to the base of skull or when its vertical diameter exceeded 8 cm.

Adolescent↗
PubMed1990

Giant subdural empyema in an infant. Sonographic observations.

A giant subdural empyema was found to be the cause of a large head in a two month old female child referred for cranial sonography. The sonographic features of the subdural empyema as illustrated by this case are: (1) The presence of an extra-axial space occupying lesion with mass effect. (2) Its fluid nature with mobile echogenic debris within. (3) Its large extent from frontal to occipital region, and (4) Its thick medial echogenic wall. A total of 250 ml of pus was evacuated from the empyema and the child was doing well on follow up at four months of age.

Empyema, Subdural↗
PubMed1990

Schwannoma of the oculomotor nerve.

A case is described of oculomotor nerve sheath tumour presenting with signs and symptoms of a posterior fossa space occupying lesion with minimal involvement of the IIIrd nerve.

Adult↗
PubMed1989

False-negative IV-DSA in external jugular phlebectasia.

We report a patient with external jugular phlebectasia in whom we performed intravenous digital subtraction angiography but failed to demonstrate the lesion. Direct injection of contrast into the lesion is the preferred method of radiological demonstration.

Adult↗
PubMed1988

Common bile duct obstruction by portal cavernoma.

Obstructive jaundice occurring in a patient with portal hypertension is a rare association. In this report, a 24-year-old patient is described who had biliary obstruction due to a portal cavernoma compressing the common bile duct and in whom surgical decompression of the portal system resulted in relief of the biliary obstruction, thus proving that the dilated portal vein collaterals were compressing the biliary tract and producing jaundice. Although biliary obstruction due to a portal cavernoma has been described earlier, this is, to the best of our knowledge, the first case described in which improvement followed shunt surgery.

Adult↗
PubMed1988

Giant cell tumour of the temporosphenoidal region.

A case of giant cell tumour of the temporo-sphenoidal region and superior part of infratemporal fossa is presented along with a brief review of the literature. The tumour mass was removed by curettage using a Weber-Fergusson incision with transection of the zygoma. There was no recurrence at three-year follow up.

Adult↗
PubMed1986

Inflammatory lesions of the basal ganglia and thalamus: review of twenty-one cases.

We report a series of 21 patients with basal ganglia and thalamic granulomas or abscesses treated over 7 years. Among them, 15 were tubercular, 5 were pyogenic, and 1 was fungal. Pyogenic abscesses, usually hematogenous, also occurred secondary to osteomyelitis of the skull and chronic otitis media. The fungal abscess developed in a nonimmunocompromised patient with no intercurrent malignancy. Evidence of tuberculosis elsewhere in the body was detected in only 7 patients with tuberculomas. The computed tomographic (CT) image morphology characterizing an abscess or a tuberculoma was present in all except 2 patients with tuberculomas. The fungal abscess resembled a malignant glioma. The only hospital mortality occurred in a deeply unconscious patient with a thalamic pyogenic abscess. A 12-month or longer follow-up in 16 patients showed that 3 continued to be handicapped neurologically, and 2 died 13 and 16 months later, respectively. We conclude that inflammatory lesions at these sites are not uncommon and that CT scans are diagnostic in the great majority. Doubtful diagnosis merits stereotactic aspiration or biopsy of the lesion. Satisfactory results follow adequate medical therapy.

Adolescent↗
PubMed1985

Some observations on the macula of pesticide workers.

To study the retinal changes in occupationally exposed pesticide workers, 79 subjects exposed to an organophosphate, fenthion, and 18 exposed to an organochlorine pesticide DDT [1,1,1-trichloro-2,2-bis(p-chlorophenyl) ethane], were subjected to a detailed study, including history taking, physical examination and ophthalmic evaluation. Fluorescein angiography was performed in selected cases. Serum cholinesterase level in 22 workers and serum DDT residue in 17 workers of the respective groups were also estimated. Fifteen workers (19%), who were exposed to fenthion had macular changes (P less than 0.01). The macular lesions were characterized by perifoveal irregularity of pigmentation and areas of hypopigmentation of 1/8-1/3 disc diameter. Mean age of the subjects having macular involvement was 30.6 years and mean duration of exposure 7.9 years. The symptoms reported by them were diminution of vision (8), dislike for bright light, flash of light, black dots in front of the eyes (2 each) and visual blurring (1). Paracentral scotoma and constriction of peripheral field were present in three workers each. Fluorescein angiography suggested pigment epithelium defect. Other causes of macular involvement in these workers were excluded; a possible role of pesticides in the genesis of these macular changes is suggested.

Adolescent↗
PubMed1973

Neurones in the dorsal horn of the rat responding to scrotal skin temperature changes.

1. Micro-electrode recordings have been made from single neurones in the dorsal horn of male rats anaesthetized with urethane. Scrotal temperature was altered within the range 13-43 degrees C by means of a thermode. The mean firing rate of neurones was correlated with step and ramp changes of temperature.2. In the region where the scrotal nerve enters the cord, 47% of the neurones were responsive to scrotal temperature: half were excited by warming and half by cooling. Most of these thermally responding units were not affected when the scrotal skin was touched and only one-fifth responded to both modalities.3. Both the ;warm' and ;cold' groups of neurones showed responses to step changes of temperature which were classified as dynamic plus static, dynamic only or static only. Comparison of these responses with those published for the scrotal thermoreceptors showed that the incoming thermal information was being processed in the dorsal horn.4. Histological examination of the cord showed that recording sites were in laminae I to V of the dorsal horn.

Animals↗
PubMed1973

Neurones in the ventrobasal complex of the rat thalamus responding to scrotal skin temperature changes.

1. In rats the scrotal temperature was raised or lowered with a water-perfused thermode while micro-electrode recordings were made of unit activity in the ventrobasal complex of the thalamus. The electrodes were aimed at the region where evoked responses had been found by electrical stimulation of the scrotum. Recording sites were marked by iontophoresis of dye from the micro-electrode.2. Changes in firing rate of thalamic neurones were only found in the scrotal temperature range of 31-40 degrees C. Within this range, 72% of the 123 cells tested were excited or suppressed by skin warming. At temperatures above or below this range, activity was not affected. Most of the cells responded just to temperature and only 7% were also excited by touch.3. Raising temperature in the range 31-40 degrees C caused 82% of the thermally responding cells to increase their firing rate and 18% to decrease their rate. Individual neurones showed a sudden and maintained change in their activity for scrotal temperature increases of only 2, 1 or even 0.5 degrees C. Mean firing rates changed by factors of about 8 or more with these temperature increases and further warming did not change the rate. These step-like changes in firing rate were found at different points over the whole skin temperature range of 31-40 degrees C, but most were between 33 and 38 degrees C.4. For a given neurone the step-like change in activity occurred once its critical temperature was reached, irrespective of whether this was achieved by a step increase of skin temperature over 1-2 sec or by a slow ramp increase lasting several minutes.5. It is not possible to say whether the skin warm receptors, cold receptors or both were responsible for these thalamic responses, but the results do show that incoming thermal information is considerably processed when it reaches the thalamic level.

Animals↗