Biomedical subjects
P Vaidya
Publications and source records attributed to P Vaidya.
Malignant colo-jejunal fistula--a rare internal fistula.
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Duodenal diverticular haemorrhage in a patient taking NSAID.
We present a 55 years old male with severe anemia with history of pain abdomen for 2 weeks and malena of 10 days duration. He was taking NSAID (Diclofenac sodium). Upper GI endoscopy done twice did not reveal any abnormality. Upper gastrointestinal (UGI) barium series with small bowel follow through revealed a diverticulum on medial wall of second part of duodenum and there was evidence of ulcer in diverticulum. He underwent diverticulectomy. On follow up after 6 months patient was asymptomatic.
Analysis of synaptic quantal depolarizations in smooth muscle using the wavelet transform.
The time-frequency characteristics of synaptic potentials contain valuable information about the process of neurotransmission between nerves and their target organs. For example, at the synapse between autonomic nerves and smooth muscle, two central issues of neurophysiology, i.e., 1) the probability of neurotransmitter release and 2) the quantal behavior of transmission can be deduced from analysis of the rising phases of evoked excitatory junction potentials (eEJP's) recorded from smooth muscle. eEJP rising phases are marked by prominent inflexions, which reflect these features of neuronal activity. Since these inflexions contain time-varying frequency information, we have applied recent techniques of time-frequency analysis based upon wavelet transforms to eEJP's recorded from the guinea-pig vas deferens in vitro. We find that these techniques allow accurate and convenient characterization of neuronal release sites, and that their probability of release falls between 0.001-0.004. We have also analyzed eEJP's recorded in the presence of the chemical 1-heptanol, which reveals quantal depolarizations. These results have helped clarify the nature of the quantal depolarizations that underly eEJP's. The present method offers significant advantages over those previously employed for these tasks, and holds promise as a novel approach to the analysis of synaptic potentials.
Overexpression of different members of the type 1 growth factor receptor family and their association with cell proliferation in periampullary carcinoma.
The expression of epidermal growth factor receptor (EGFR), c-erbB-2, and c-erbB-3 was examined immunohistochemically in 57 cases of periampullary carcinoma. The percentage of Ki-67-positive cells was also examined in the same tissue, to determine the relationship between the expression of the members of the type I growth factor receptor family and cell proliferation. In carcinoma of the head of pancreas, the percentage of cases with overexpression of c-erbB-3 was significantly higher than with overexpression of c-erbB-2 and EGFR. In contrast, in lower bile duct carcinoma and carcinoma of the ampulla of Vater, the percentages of cases with overexpression of c-erbB-2 was greater than with overexpression of other growth factor receptors. A higher percentage of cases with overexpression of c-erbB-3 in pancreatic head carcinoma and overexpression of c-erbB-2 in carcinoma of the ampulla of Vater was found in Ki-67 antigen-positive cases. Moreover, the overexpression of c-erb-3 in pancreatic head carcinoma, c-erb-2 in ampulla of Vater carcinoma, and Ki-67 in both carcinomas was found to be associated with poor patient outcome. These results demonstrate that different members of the type I growth factor receptor family are overexpressed in different carcinomas of the periampullary region.
Combined analysis of expression of c-erbB-2, Ki-67 antigen, and tenascin provides a better prognostic indicator of carcinoma of the papilla of Vater.
Expression of the molecular biological factors (MBFs) c-erbB-2, Ki-67 antigen, and tenascin (TN) was assessed immunohistochemically in specimens from patients who had undergone surgery for carcinoma of the papilla of Vater. The MBFs were then analyzed by histological factors (v, d, panc, n, Stage), which have been demonstrated to be outcome predictors, and by patient outcome. None of the MBFs showed any significant correlation with the histological factors. There were significant differences (p < 0.05) in the expression of c-erbB-2, Ki-67 antigen, and TN between patients who survived >5 years and those who survived <5 years. The patients with greater expression of c-erbB-2, Ki-67 antigen, and TN had a poor prognosis, whereas those with less expression had a good prognosis. They were therefore considered independent predictors of outcome for carcinoma of the papilla of Vater. Combined analysis of both histological factors and MBFs was also performed, with the result that the combined analysis of MBFs yielded a better prediction of outcome in carcinoma of the papilla of Vater than analysis of either one histological factor or MBF.
Detection of Chlamydia trachomatis antigen & Toxoplasma gondii (IgM) & Mycoplasma hominis (IgG) antibodies by ELISA in women with bad obstetric history.
A total of 365 non pregnant women with bad obstetrics history (BOH) were studied with a control group of 100 women who had delivered full term clinically normal infants. The presence of C. trachomatis antigen and T. gondii (IgM) and M. hominis (IgG) antibodies was assessed by ELISA test. C. trachomatis antigen was detected in 28.2 per cent of women with BOH whereas T. gondii and M. hominis specific antibodies were found in 43.83 and 27.1 per cent respectively, these were highly significant (P < 0.001) in comparison with the control group. In case, facilities for culture are not available then detection of antigen and IgM class of antibodies by ELISA can pinpoint current infection.
Obstetric hazards among elderly primigravidae.
Three hundred and seventeen cases of elderly primigravidae were studied from January 1987 to December 1990 at Lokmanya Tilak Municipal General Hospital, Bombay. The aim was to study the complications of pregnancy, complications of labour, perinatal mortality and maternal mortality in an urban, socio-economic backward class of elderly primigravidae and to compare them with younger primigravidae in the same population. The study covered all cases, either booked for hospital confinement or admitted as an emergency case without any prior antenatal care. The incidence of breech was found to be higher in elderly primiparae as compared to younger primiparae. Duration of labour as also operative intervention was found to be more in elderly primigravidae. There was no maternal mortality in this study. The most important feature in relation to infants was the high perinatal mortality in the study group.
Unconventional use of oxytocin.
Various agents are in wide clinical use for the purpose of inducing and or accelerating labour. Undoubtedly, the most widely used is oxytocin. The present study represents the experience in the use of oxytocin in unconventional obstetric cases. The study comprises 300 cases where oxytocin drip was used for the initiation of labour, acceleration of labour and to control postpartum haemorrhage in both unconventional and conventional cases. The results are analysed and compared in both the groups along with the complications. Oxytocin has proved to be so safe, that there is only one contra-indication to its use and that is a grossly contracted pelvis.
Mycoplasma hominis infections in female genital tract & use of immunofluorescence for antibody detection.
A total of 325 women with genital tract infection and 108 healthy controls were screened for the presence of mycoplasmas. Of these, 325 patients, mycoplasmas were recovered in 186. Thirty five isolates were M. hominis and 151 isolates of Ureaplasma urealyticum. The fluorescent-antibody technique (FAT) has been employed for the rapid identification of mycoplasma colonies growing on agar plates. The method was found to be rapid for detection of M. hominis growing on primary isolation plates. The antibody titre of patient's serum was also detected by FAT. Patients' sera were diluted four fold from 1:4 to 1:256 dilutions. In 7 patients fluorescence was seen with 1:16 serum dilution, in 18 with 1:64 dilution and in 3 with 1:256. The immunofluorescence test gave a sensitivity of 96.66 per cent, specificity of 95.0 per cent, with percentage of false negativity and false positivity being 3.45 and 5.0 per cent respectively.
ICMR Task Force Study on hormonal contraception. Biological activity of ethinyl estradiol present in the breast milk.
A study was conducted to compare the biological activity of the estrogenic component of the endogenous steroids in breast milk samples collected during various phases of lactation with those milk samples collected from women who were on estrogen therapy. The estrogenic biological activity in the milk sample was assessed by the immature mouse uterine weight gain assay. Milk samples collected during postpartum period from six different study groups, viz., control colostrum of 1-3 days and 4-6 days, transitional milk (10-20 days) and mature milk (1-3 months) were compared with colostrum and mature milk of women treated with Lynoral (ethinyl estradiol 0.1 mg) three times a day for three days. Estrogenic activity was observed only in animals injected with milk extracts of colostrum samples from both control and Lynoral-treated women; however, they were not significantly different from each other. Therefore it is not the exogenous estrogens, but the endogenous estrogen present in large quantities in the colostrum that is responsible for the biological activity.
Early observations on pulmonary changes and clinical morbidity due to the isocyanate gas leak at Bhopal.
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Massive hydrothorax complicating continuous ambulatory peritoneal dialysis.
2 patients on continuous ambulatory peritoneal dialysis (CAPD) developed massive hydrothorax. Further studies revealed preferential transfer of fluid from peritoneal cavity to pleural space in absence of a direct pleuroperitoneal communication. Hydrothorax resolved in both following a brief interruption in CAPD but recurred in one upon restitution of CAPD. In case of recurrent hydrothorax, pleurodesis or alternate dialytic therapy should be considered.
Coagulation studies in women on combination type of oral contraceptives.
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Oral contraceptives--acceptability and side effects with combination pills.
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Deaths encountered in psychiatric inpatients in a general hospital.
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Testicular feminisation syndrome.
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Blood cardioplegia--a comparative clinical and laboratory study.
A prospective comparative study was undertaken to determine quality of myocardial preservation during open heart surgery by crystalloid and blood cardioplegic solutions. Total 55 consecutive patients were studied. Alternate patients received blood and crystalloid cardioplegia at random. Group I had 30 patients who received crystalloid cardioplegia, and group II, with 25 patients, received blood cardioplegia. The efficacy of two solutions was assessed by serum enzyme estimation of creatinine phosphokinase, M.B. fraction of creatinine phosphokinase and serum glutamate oxalate transferase (CPK, CPK-MB, SGOT), electron microscopic study of Left Ventricular biopsy and clinical assessment of post anoxic cardiac performance. Group II patients had lower serum enzyme levels, lesser microscopic myocardial damage, and better cardiac performance during immediate post-operative period, thus proving superiority of myocardial protection by blood cardioplegia.