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Biomedical subjects

R Handa

Publications and source records attributed to R Handa.

At least 37 records · Page 2Linked to original sources
PubMed1999

Dengue haemorrhagic fever in adults: a prospective study of 110 cases.

One hundred and ten adult patients hospitalized with dengue haemorrhagic fever (DHF) during the recent outbreak in North India were prospectively studied. Of these, 48 (43.6%) were grade I, 40 (36.4%) grade II, 10 (9.1%) grade III and 12 (10.9%) grade IV DHF. Dengue shock syndrome (DSS) was seen in 22 (20%) patients. Fever, headache, myalgias and arthralgias were the common symptoms seen in 100%, 80.9%, 76.2% and 52.3% patients, respectively. Spontaneous bleeding was seen in 62 patients (56.4%) with mucocutaneous bleeding being the most common (46 patients). Gastrointestinal bleeding was seen in 38 (34.5%) patients. In as many as 40 patients, the haemorrhagic manifestations occurred after the fever had come down. Fifty-five patients (50%) required platelet transfusions. Twelve patients died, giving a mortality rate of 10.9% in the present study. Prompt recognition and supportive treatment can be lifesaving.

Adult↗
PubMed1999

Poncet's disease in a north Indian hospital.

Although the entity of tuberculous rheumatism or Poncet's disease has sometimes been the subject of debate, it has been reported infrequently in the English literature. We discuss here seven patients (5 women, 2 men; age 18-48 years) who presented primarily with polyarthritis and fever and developed pulmonary, pleural or nodal tuberculosis later in the course of disease. Rheumatoid arthritis, collagen vascular diseases and other common causes of polyarthritis were ruled out by appropriate investigations. Polyarthritis resolved in all the patients after the institution of antitubercular treatment and did not recur, thus providing a therapeutic confirmation of the clinical diagnosis.

Adolescent↗
PubMed1999

A prospective study of Lyme arthritis in north India.

Twenty seven patients presenting with mono/oligoarticular disease of unknown etiology were prospectively screened for Lyme arthritis. In addition, 12 healthy blood bank donors, 25 individuals with rheumatoid arthritis (disease controls), and 20 deer handlers and veterinarians were also screened for IgG antibodies to Borrelia burgdorferi. Only one patient tested borderline positive for antibodies to B. burgdorferi (more likely false positive). None of the healthy subjects, disease controls or occupationally exposed individuals exhibited serological evidence of exposure to B. burgdorferi. Screening for Lyme disease may not be warranted while investigating mono/oligoarthritides of unknown etiology in this part of the country.

Enzyme-Linked Immunosorbent Assay↗
PubMed1999

Estimation & significance of serum & synovial fluid malondialdehyde levels in rheumatoid arthritis.

Serum and synovial fluid (SF) levels of malondialdehyde (MDA), a marker of free radical induced lipid peroxidation, were estimated in patients of rheumatoid arthritis (RA) and compared with healthy controls and patients of osteoarthritis (OA). While serum MDA levels were similar in healthy controls (0.24 +/- 0.10 nmol/ml) and OA (0.28 +/- 0.11 nmol/ml), the serum levels in RA (0.47 +/- 0.19 nmol/ml) were significantly higher as compared to both healthy controls and OA patients; and correlated with synovial fluid (SF) MDA levels. No difference was observed in SF-MDA levels in RA (0.17 +/- 0.07 nmol/ml) and OA (0.16 +/- 0.09). MDA levels did not correlate with markers of disease activity in RA like joint counts, duration of morning stiffness, erythrocyte sedimentation rate etc. Increased serum MDA levels in RA suggest the role of free radicals in the pathogenesis of this inflammatory arthropathy and support the need for further studies assessing the therapeutic role of free radical scavengers in RA.

Arthritis, Rheumatoid↗
PubMed1999

Validity of tourniquet test in dengue haemorrhagic fever.

OBJECTIVE: Dengue haemorrhagic fever (DHF), a public problem in most of the tropical countries of South-East Asia, is diagnosed on the basis of demonstrating an increased capillary permeability and thrombocytopenia with concurrent haemoconcentration. Tourniquet test has been recommended as the initial screening procedure of patients with suspected DHF, particularly grade I DHF. The objective of the present study was to study the value of this test as an indicator of haemorrhagic tendencies in patients of DHF. METHODS: One hundred and ten adult patients hospitalized with DHF during outbreak of DHF in 1996 in north India were prospectively studied. The diagnosis of DHF was considered on the basis of haemoconcentration > 20%, evidence of transudation, or presence of shock along with thrombocytopenia. A tourniquet test was conducted in these cases in the standard method. RESULTS: Of the 110 patients of DHF studied, 62 patients (56.4%) had bleeding but tourniquet test was positive in only half of these patients. Forty eight patients (43.6%) did not have any bleeding and the tourniquet test was positive in only 27% cases. CONCLUSIONS: The tourniquet test was positive in only 39.1% of all DHF cases. It is concluded that a negative tourniquet test may not be sufficient to exclude a diagnosis of DHF in a febrile patient. This necessitates the need for the re-defining the clinical criteria for the diagnosis of DHF, particularly grade I DHF.

Adolescent↗
PubMed1999

Pictorial CME.

Explore the source record for details and available documents.

Acne Vulgaris↗
PubMed1998

Cardiac involvement in Dengue Haemorrhagic Fever.

We studied 17 consecutive patients of Dengue Haemorrhagic Fever/Dengue Shock Syndrome (DHF/DSS) to assess cardiac function by radionuclide ventriculography, echocardiography and electrocardiography (ECG) during the epidemic of Dengue virus type-2 (DEN-2) in Delhi, India (1996). Case definitions laid down by the WHO were followed. Fourteen patients were seropositive for Dengue infection. In radionuclide ventriculography study, the mean left-ventricular ejection fraction was 41.69 (5.04% (range 33-49%) and 7 patients had an ejection fraction less than 40%, global hypokinesia was detected in 12 (70.59%) patients. In echocardiography, the mean ejection fraction was 47.06 (3.8%). Eight patients had Dengue Shock Syndrome and the mean ejection fraction was 39.63% (4.97% in radionuclide ventriculography, out of which 5 patients had an ejection fraction below 40%. To find out the nature of myocardial involvement, 99m Tc-pyrophosphate imaging was done in 4 patients and it was discontinued further because no myocardial necrosis was detected in those patients. Five patients had ST and T changes in the electrocardiogram, radionuclide ventriculography and echocardiography revealed no abnormalities after 3 weeks of follow up and the ejection fraction was more than 50% in all cases. Global hypokinesia also improved and ECG changes reverted back to normal within 3 weeks. Acute reversible cardiac insult may be noticed in Dengue Haemorrhagic Fever/Dengue Shock Syndrome and could be responsible for hypotension/shock seen in some of these patients. Further studies are required to establish the pathogenic mechanisms of cardiac dysfunction in patients with Dengue Haemorrhagic Fever/Dengue Shock Syndrome.

Adolescent↗
PubMed1998

Fibromyalgia in Indian patients with SLE.

One hundred and fifty-eight patients with SLE were prospectively studied at a tertiary referral centre in India to ascertain the prevalence and clinical profile of fibromyalgia (FM) in Indian patients with lupus. An attempt was made to determine whether socio-demographic factors or disease characteristics differ in SLE patients with and without FM. Only 13 patients (8.2%) in our cohort were found to have fibromyalgia. Their clinical profiles were similar to that reported in other series. Corticosteroid withdrawal or dose reduction was the probable precipitating factor in nearly one-third of our patients. Age, sex, marital status, educational level, disease duration, disease activity and the organ involvement in patients with SLE and FM were comparable to those in patients not having FM. Fibromyalgia appears to be distinctly uncommon in Indian patients with lupus. A strong family support system, the virtual lack of disability benefits and/or racial variations in pain threshold could be the likely factors responsible for the low prevalence of the disease observed in Indian patients with SLE.

Adolescent↗