Biomedical subjects
Publications and source records attributed to R Aggarwal.
Stereotactic radiosurgery was given as a boost in the initial radiation management of five children with localized intracranial ependymoma. Preliminary results in young children with high-risk tumors indicate good local control without excessive neurotoxicity.
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Association of serological markers for various sexually transmitted diseases (STDs) with Human Immunodeficiency Virus type 1 (HIV-1) infection among heterosexually promiscuous blood donors is well recognized. However, possibility of similar association among children receiving transfusion from these donors has not been adequately explored. Study on the association of some STD markers with HIV-1 infection in multitransfused (MT) children showed that both HIV-1 positive and HIV-1 negative groups of children had significantly higher prevalence of hepatitis B virus (HBV) markers, i.e. HBsAg (23 and 30 per cent), anti-HBs (46 and 57 per cent), anti-HBc (18 and 23 per cent), antibodies to cytomegalovirus of IgM class (36 and 37 per cent) and IgG class (72.7 and 70 per cent), IgG antibodies to Herpes Simplex Virus type-2 (23 and 23 per cent) compared to control group. However, seropositivity for HIV-1 infection could not be attributed as a risk factor for any of these markers in the group of MT children. On the contrary, significant association of anti HBc, anti HCV, CMV IgG and antitreponemal antibody with HIV-1 infection could be recorded in the group of blood donors. It appeared that due to low prevalence of HIV-1 infection among blood donors in India, both HIV-1 positive and HIV-1 negative groups of MT children received transfusion from HIV negative donors predominantly resulting in a comparable prevalence of STD markers in both the groups of MT children due to cumulative effect of transfusion from HIV-1 negative donors.
Myocytes from the epicardial border zone (EBZ) of the 5-day infarcted canine heart (IZ) have abnormal transmembrane action potentials, reduced L-type Ca2+ currents (ICa,L) and altered intracellular Ca2+ (Cai) transients compared with those of normal epicardial myocytes (NZ). We hypothesized that altered Cai cycling might be reflected in differences in Cai-dependent outward currents (Ito2). We recorded Ito2 in NZ and IZ using whole cell patch-clamp techniques. Ito2 was defined as the amplitude of the 4-aminopyridine-resistant transient outward current that was blocked by 200 microM 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (DIDS) or DIDS+ ryanodine (2 microM). Ito2 were present in both NZ and IZ, but peak density was significantly reduced in IZ, particularly at positive plateau voltages. Time course of decay of Ito2 was biexponential and similar in NZ and IZ. A given peak ICa,L was usually associated with a smaller peak Ito2 in IZ. These differences were exaggerated when Ito2 and Cai transients were determined in rapidly paced cells. In summary, myocytes surviving in the EBZ of the infarcted heart have Ito2, yet they are reduced in density and can vary, particularly at fast pacing rates.
We report a woman with achalasia cardia who developed dysphagia for the first time during pregnancy. She was initially mistakenly treated elsewhere as hyperemesis gravidarum. The diagnosis and treatment of achalasia during pregnancy is reviewed.
This study investigated the advice given on breastfeeding problems by community health professionals involved with breastfeeding mothers in the Huntingdon area. A questionnaire on 10 common breastfeeding problems was used, and had a significant educational effect on the GP and health visitor groups.
We report a woman with intestinal lymphangiectasia whose symptoms were wrongly attributed to pregnancy; the diagnosis was made in the postpartum period. She also developed alopecia and herpes zoster.
The study describes the value of specific chlamydial IgM antibody detection by indirect immunoperoxidase assay (IPA) for early confirmation of cases of primary infertility and pelvic inflammatory diseases (PID) of chlamydial aetiology. Forty-eight infertile women and forty-six women with acute PID were screened. Seven (14.2%) infertility patients and twenty-one (45.6%) PID patients had positive titers for chlamydia trachomatis. The difference in incidence of antichlamydial antibodies in the study group as compared with control was statistically significant (p < 0.05). These findings suggest that in the absence of tissue culture facilities, detection of specific chlamydial IgM antibody is a sensitive serological marker for specific diagnosis of chlamydial infection.
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The pharmacologic responses of macroscopic L-type calcium channel currents to the dihydropyridine agonist, Bay K 8644, and beta-adrenergic receptor stimulation by isoproterenol were studied in myocytes enzymatically dissociated from the epicardial border zone of the arrhythmic 5-day infarcted canine heart (IZs). Calcium currents were recorded at 36 degrees to 37 degrees C using the whole cell, patch clamp method and elicited by applying step depolarizations from a holding potential of -40 mV to various test potentials for 250-msec duration at 8-second intervals. A Cs+ -rich and 10 mM EGTA-containing pipette solution and a Na+ -and K+ -free external solutions were used to isolate calcium currents from other contaminating currents. During control, peak ICa,L density was found to be significantly less in IZs (4.0 +/- 1.1 pA/pF) than in myocytes dispersed from the epicardium of the normal noninfarcted heart (NZs; 6.5 +/- 1.8 pA/pF). Bay K 8644 (1 micro M) significantly increased peak ICa,L density 3.5-fold above control levels in both NZs (to 22.5 +/- 6.2 pA/pF; n = 7) and IZs (to 12.8 +/- 3.0 pA/pF; n = 5), yet peak ICa,L density in the presence of drug was significantly less in IZs than NZs. The effects of Bay K 8644 on kinetics of current decay and steady-state inactivation relations of peak ICa,L were similar in the two cell types. In contrast, the response of peak L-type current density to isoproterenol (1 micro M) was significantly diminished in IZs compared to NZs regardless of whether Ba2+ or Ca2+ ions carried the current. Thus, these results indicate an altered responsiveness to beta-adrenergic stimulation in cells that survive in the infarcted heart. Furthermore, application of forskolin (1 micro M and 10 micro M) or intracellular cAMP (200 micro M), agents known to act downstream of the beta-receptor, also produced a smaller increase in peak IBa density in IZs versus NZs, suggesting that multiple defects exist in the beta-adrenergic signaling pathway of IZs. In conclusion, these studies illustrate that reduced macroscopic calcium currents of cells in the infarcted heart exhibit an altered pharmacologic profile that has important implications in the development of drugs for the diseased heart.
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BACKGROUND: Colloidal bismuth subcitrate (CBS) causes endoscopic and histological improvement in gastritis and eradication of Helicobacter pylori in patients with non-ulcer dyspepsia (NUD). The effect of sucralfate, a cytoprotective drug, on endoscopic and histologic gastritis and H pylori clearance is not clear. We studied the effect of CBS and sucralfate on these features in patients with NUD. METHODS: Sixty three patients with NUD and H pylori infection were randomized to receive one of the following for four weeks: (i) CBS (240 mg twice daily) (Group 1); (ii) placebo I, similar in size, color and shape to CBS (Group 2); (iii) sucralfate (2.0 g twice daily) (Group 3) and (iv) placebo II, similar to sucralfate (Group 4). Symptoms, endoscopic and histological findings and H pylori status were assessed before and after treatment. RESULTS: Similar symptomatic improvement was observed with each treatment, indicating a placebo effect. Significant endoscopic and histological improvement was observed with CBS only. CBS was better than sucralfate in inducing endoscopic and histological improvement. Clearance rate of H pylori was 46.6% with CBS, 16.6% with its placebo, 33.3% with sucralfate and 13.3% with its placebo. CONCLUSION: CBS is more effective than sucralfate in inducing endoscopic and histologic healing of H pylori-related gastritis among NUD patients.
Immunoproliferative small intestinal disease (IPSID) is a poorly recognized cause of malabsorption syndrome in India. Clinicopathological features of five patients with IPSID seen over a two-year period are described. Our data suggest that IPSID is commonly misdiagnosed as intestinal tuberculosis due to lack of awareness and reluctance to obtain small bowel biopsies. Empirical institution of anti-tubercular chemotherapy not only leads to delayed diagnosis but also possibly alters the natural history of the disease, resulting in an intermediate phase of amelioration followed by a terminal phase of lymphomatous transformation. The disease is therefore usually diagnosed at an advanced stage and hence is associated with a relatively poor outcome.
PURPOSE: The extent to which limbal epithelial stem cell allografts will repopulate the human corneal ocular surface, and the time frame over which such cells survive, are uncertain. We investigated the survival of donor-derived epithelial cells after limbal stem cell allotransplantation in a patient with bilateral limbal stem cell failure by using short tandem-repeat DNA polymorphisms to distinguish donor and recipient cells. METHODS: Epithelial cells were harvested by impression cytology from the grafted eye before and at various times after transplantation. DNA was extracted and amplified by the polymerase chain reaction at an informative locus, D8S264. RESULTS: Cells of donor genotype were present over the grafted areas at the time of surgery but were not detected in the central cornea until 12 weeks postoperatively, indicating that repopulation of the epithelial surface from transplanted limbal stem cells took considerable time. However, by the 20th postoperative week, only recipient-type cells were detected in the grafted eye, despite systemic immunosuppression of the recipient with azathioprine and cyclosporine. CONCLUSIONS: Discrimination between donor and recipient cells on the ocular surface after limbal allotransplantation was possible using genotypic variation at DNA polymorphic sites (microsatellites). Long-term survival of donor cells after limbal transplantation did not occur in this patient. Detection of DNA polymorphisms amplified by the polymerase chain reaction is a simple, rapid, and noninvasive method of following the course of transplanted cells at the ocular surface.
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