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Biomedical subjects

P Bajaj

Publications and source records attributed to P Bajaj.

At least 19 recordsLinked to original sources
PubMed2004

Role of parecoxib in pre-emptive analgesia: comparison of the efficacy and safety of pre- and postoperative parecoxib in patients undergoing general surgery.

Management of acute postoperative pain remains sub-optimal despite the availability of multiple analgesics and improved pain management strategies (with nearly 80 % of patients reporting moderate to extreme pain following surgery). To evaluate the role of parecoxib as a pre-emptive analgesic in patients undergoing general surgery, the present study was undertaken. Eighty patients of either sex, aged 18 to 70 years, requiring elective ambulatory general surgery like hernioplasty, appendicectomy, cholecystectomy, etc, were enrolled in this prospective, randomised, assessor-blind, parallel-group, comparative trial. Eligible patients were randomised to receive a single dose of 40 mg of parecoxib IM/IV either 30-45 minutes prior to induction of anesthesia (pre-emptive analgesia) or in the postoperative period when one reported pain or when the effects of anesthesia were worn off (whichever was earlier). The primary measures of efficacy were pain intensity scores measured on a visual analog scale (VAS) and pain relief before and after therapy. Adverse event monitoring, physical examination and changes in laboratory tests, chest x-ray and ECG were used to evaluate safety. A comparison of the pain intensity scores between the two groups revealed that patients treated with parecoxib preoperatively did not complain of pain in the entire postoperative period up to 12 hours. Mild pain (1.05+/-1.36) was reported by patients in this group only at the 24 hours assessment. On the other hand, patients treated with parecoxib in the postoperative period, experienced severe pain at baseline, which declined gradually up to 12 hours. The difference in the pain intensity scores between the two groups was statistically significant at all the time intervals from 0 hour to 24 hours. All the 40 patients (100%) in the pre-operatively treated group reported total pain relief at 12 hours compared to only 22 patients (55%) in the postoperative period. At 24 hours total pain relief was reported by 70% of the patients in the pre-operatively treated group, compared to only 20% (8) patients in the postoperatively treated group. The difference between the two groups was statistically significant in favour of the pre-operatively treated group (p<0.05). Present results suggested that pre-operative administration of parecoxib was more effective than a postoperative use in providing pain relief in postoperative period in patients undergoing elective general surgical procedures. Both the regimens were well tolerated. Based on the above data, it appears that pre-operative dose of parecoxib 40 mg IV/IM is a useful optionfor pre-emptive analgesia in general surgical practice.

Adolescent↗
PubMed2003

Incidental detection of microfilariae in aspirates from Ewing's sarcoma of bone.

Microfilariae have been reported as coincidental findings with various neoplasms. We present a case in which microfilariae were encountered in fine-needle aspiration (FNA) smears from a 10-yr-old boy who presented with a lytic lesion in the diaphysis of the right tibial bone. Stained aspirates from the swelling were composed of a dispersed population of small round cells with scanty to vacuolated cytoplasm. Two sheathed microfilariae with several nuclei and cephalic and caudal clearing were identified. A diagnosis of Ewing's sarcoma with presence of microfilariae of Wuchereria bancrofti was made. The diagnosis of Ewing's sarcoma was confirmed on histopathology.

Animals↗
PubMed2003

Giant cell tumour of talus with osteosarcomatous transformation in a young male: a case report.

A case of osteosarcomatous transformation in a benign giant cell tumour is described. Spontaneous malignant transformation is rare in a giant cell tumour with only 17 cases reported in the literature till date. In addition, a giant cell tumour arising in the bones of the hands and feet is in itself a rarity. In this instance the lesion presented in the talus of the left ankle in a 13 year old male.

Adolescent↗
PubMed2002

Glial choristoma.

Glial choristoma is a developmental malformation of heterotopic central nervous tissue with limited growth potential. It is considered to be one of the very rare choristomatous lesions involving the oral cavity. This report details the morphological characteristics of glial choristoma arising from the palate in a newborn. Bulk of the tissue comprised of mature neuroglial tissue with astrocytes representing developing brain, cystic spaces lined by cuboidal epithelium indicating ependymal layer. Clinical features, associated malformations and histomorphology of this lesion is discussed.

Brain↗
PubMed2001

Pitfalls in the diagnosis of epithelioid sarcoma presenting in an unusual site: a case report.

The cytologic appearance of epithelioid sarcoma in fine-needle aspiration biopsy cytology (FNABC) smears has not been extensively described. We report a case of epithelioid sarcoma in a 55-year-old male who presented with nodular swellings in the abdominal wall and scrotum. The scrotal swelling was subsequently demonstrated to arise from the vas deferens. We highlight the cytomorphologic, immunocytochemical, and histopathologic features of this rare lesion in an unusual site, with particular emphasis on the dilemma encountered in the cytodiagnosis of this lesion.

Abdominal Neoplasms↗
PubMed2001

Intracytoplasmic and intranuclear Reinke's crystals in a testicular Leydig-cell tumor diagnosed by fine-needle aspiration cytology: a case report with review of the literature.

We report on the cytopathologic findings of a Leydig-cell tumor of the testis in a young adult male with no evidence of endocrine dysfunction. The preoperative diagnosis was based on fine-needle aspiration cytology (FNAC) alone, which was subsequently confirmed on histopathology. The present case was of interest on account of the paucity of literature regarding the cytodiagnosis of this lesion. In addition, the finding of intracytoplasmic lipofuscin pigment and several intracytoplasmic as well as intranuclear Reinke's crystals served to clinch the diagnosis on FNA. Therefore, the use of FNAC, especially in the presence of diagnostic Reinke's crystals, may vitiate the need for more invasive biopsy procedures in the preoperative diagnosis of testicular Leydig-cell tumors.

Adult↗
PubMed2001

Mechanomyography and electromyography force relationships during concentric, isometric and eccentric contractions.

The purpose of this study was to investigate systematically if complementary knowledge could be obtained from the recordings of electromyography (EMG) and mechanomyography (MMG) signals. EMG and MMG activities were recorded from the first dorsal interosseous muscle during slow concentric, isometric, and eccentric contraction at 0, 25, 50, 75 and 100% of the maximal voluntary contraction (MVC). The combination of the EMG and MMG recordings during voluntary concentric-isometric-eccentric contraction showed significant different non-linear EMG/force and MMG/force relationships (P<0.001). The EMG root mean square (rms) values increased significantly from 0 to 50% MVC during concentric and isometric contraction and up to 75% MVC during eccentric contraction (P<0.05). The MMG rms values increased significantly from 0 to 50% MVC during concentric contraction (P<0.05). The non-linear relationships depended mainly on the type and the level of contraction together with the angular velocity. Furthermore, the type of contraction, the contraction level, and the angular velocity influenced the electromechanical efficiency evaluated as the MMG to EMG ratio (P<0.05). These results highlight that EMG and MMG provide complementary information about the electrical and mechanical activity of the muscle. Different activation strategies seem to be used during graded isometric and anisometric contraction.

Adult↗
PubMed2001

Post-exercise muscle soreness after eccentric exercise: psychophysical effects and implications on mean arterial pressure.

The aim of the study was to examine the time course of changes in pressure pain threshold (PPT), visual analogue scale (VAS) pain and tenderness scores, McGill Pain Questionnaire (MPQ) descriptors, pain areas, skin temperature and mean arterial pressure (MAP) following intensive eccentric exercise. In 11 healthy male subjects, eccentric exercise of the first dorsal interosseous muscle (FDI) of the right hand with 114% maximum voluntary contraction weight (MVC) was used to induce post-exercise muscle soreness (PEMS) in the right hand, while the left hand served as a control. At 24 h to 48 h all the pain profiles indicated the presence of PEMS in the right hand when compared to before exercise (P<0.05). MPQ and pain area assessments also indicated PEMS immediately after the exercise, while the pain assessment by PPT and tenderness VAS showed insignificant pain immediately after the exercise. Skin temperature measured in the first web space of the hand did not change at any time. MAP was significantly reduced at 48 h. It is concluded that eccentric exercise of a small hand muscle is followed by PEMS and a reduced MAP after 48 h that may suggest a role of central mechanisms in the PEMS, thereby giving further insight into clinical aspects of muscle pain.

Adult↗
PubMed2001

Lichen planopilaris.

P, a 20-year-old laborer displayed initial symptoms of the disease in question when he was 10 years old. Initially he had an asymptomatic progressive loss of hair on the scalp. A couple of years later he had mild to moderate pruritus, and the appearance of slate-blue eruptions on the scalp and elsewhere on the body. This resulted in a complete loss of hair on the vault of the scalp, which led him to seek specialist opinion. Skin surface examination revealed the presence of grayish-blue acuminate follicular papules, disposed singly and in groups (plaques). The pilo-sebaceous orifices were conspicuously obliterated and filled by keratin plugs. Perifollicular erythema was a predominant feature on the scalp. The lesions were present over the scalp, around the neck, chest, back, axillae, groin and legs. Shiny atrophied scalp skin depicting scarring alopecia mimicking male-type baldness was a salient feature. In addition, it was studded with conspicuous acuminate papules in its center (Fig. 1a). The known nonhairy (glabrous) skin had classic lichen planus lesions (Fig. 1b). Hemotoxylin-eosin stained microsections prepared from typical lichen planus (LP) lesions over the abdomen and those of lichen planopilaris (LPP) of the scalp were simultaneously studied. The former revealed changes in the epidermis comprising of hyperkeratosis, increase in thickness of stratum granulosum, hydropic degeneration of the basal cell layer and band-like lympho-histiocytic infiltrate pressing against and invading the epidermis, while the latter revealed uniform atrophy of the epidermis and vacuolization of basal cells. The hair follicles were dilated and were filled with keratin plugs. In addition to fibrosis of the dermis, pigment laden microphages and lympho-histiocytic infiltrate was prominent. The follicles and the sebaceous glands were absent. However, arrectores pilorum and sweat glands were preserved (Fig. 2a,b).

Adult↗
PubMed2001

Sensory changes during the ovulatory phase of the menstrual cycle in healthy women.

This study compared the pain sensitivity in healthy women at the abdomen and lower back (presumed referral areas of menstrual pain), thigh and arm (control areas), in the menstrual, ovulatory, luteal and premenstrual phases of confirmed ovulatory cycles, with that of males. The pressure pain threshold (PPT) and pinch pain threshold (PiPT) was determined by an electronic pressure algometer, heat pain threshold (HPT) by a contact thermode and tactile threshold (TT) with von Frey hairs. The abdominal PPT was significantly lower in females in all menstrual phases as compared to the control sites ( p<0.0007). The abdominal and lower back HPT was significantly lower in females in all menstrual phases compared with control areas, and to the sites in males ( p<0.002). The TT was significantly reduced in females compared with males ( p< 0.013). There was no difference in the PiPT between females and males. In males, the HPT, PPT and TT were not different within any site. During the ovulatory phase, the HPT was significantly reduced at the abdomen and the PPT at the back compared with the menstrual, luteal and premenstrual phases (p<0.0002). There were no within-menstrual phase variations in the PiPT and TT at any site, or for the HPT and PPT at the control areas. The reduced thresholds in menstruating women may be due to the presence of latent uterine algogenic stimuli, and the increased levels of oestrogen and leuteinizing hormone at ovulation may enhance nociception by acting both at the peripheral and central level, resulting in the hypersensitivity changes at the abdomen and lower back areas.

Abdominal Pain↗
PubMed2001

Leiomyosarcoma arising from tunica vaginalis testis: a case report.

Benign and malignant soft tissue tumors of the paratesticular region i.e. those arising from the testicular tunics, epididymis and spermatic cord are uncommon. Of these, leiomyosarcoma arising from the tunica vaginalis is extremely rare. On extensive computerised search, a single case has been reported till date in the literature. We hereby report one such case because of its rarity.

Humans↗