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Biomedical subjects

R Jha

Publications and source records attributed to R Jha.

17 recordsLinked to original sources
PubMed1999

Conditions in rural Nepal for which depot-medroxyprogesterone acetate initiation is not recommended: implications for community-based service delivery.

The presence of medical conditions that might affect the use of depot-medroxyprogesterone acetate (DMPA) as a contraceptive method was assessed in a rural district in Nepal. A general health survey was conducted in nonpregnant and noncontracepting women aged 15-44 years to determine the presence of any health problems. The survey included a general assessment interview by nonphysicians, followed by formal medical histories and physical exams by female gynecologists. Possible pregnancy (nine cases) and abnormal uterine bleeding (one case) were the only conditions identified in which DMPA should not be used, based on the World Health Organization (WHO) Medical Eligibility Criteria for Contraceptive Use. Five additional cases of cardiovascular problems, in which DMPA initiation is not usually recommended, were also detected. Recently developed checklists based on the WHO criteria for DMPA use would have identified all of these health conditions. This checklist would allow the safe delivery of DMPA at the community health worker level, and increase the availability and accessibility of DMPA in rural Nepal.

Adolescent↗
PubMed1999

Pulmonary infections after kidney transplantation.

OBJECTIVE: To retrospectively analyse the epidemiology, aetiology, temporal profile and outcome of lung infection following kidney transplantation. METHODS: Out of 142 consecutive renal transplant (RT) recipients who underwent live donor transplantation from June, 1990 to May, 1998, 43 (33%) had serious infection requiring hospitalisation of which 27 were pulmonary. All such pneumonia were included for retrospective analysis. All had a minimum follow up of six months (if alive) and were on triple drug immunosuppression. All had detailed and appropriate investigations for definitive diagnosis. RESULTS: The aetiological agents were Gram negative bacterial infection (2), Gram positive bacterial infection (1), nocardia (2), tuberculosis (10), aspergillosis (2), mixed bacterial and fungal infection (4), Pneumocystis (2) and unconfirmed (4). Four patients had pneumonia because of probable nosocomial exposure. Radiologically lobar/segmental pneumonia was observed in five, nodular lesion six, reticulonodular lesion eight, patchy consolidation five and pleural effusion three. Nodular pneumonias were due to aspergillosis or nocardiosis. Four patients developed secondary cavitation. Pulmonary infections were significantly associated with leucopenia (8/27) (p < 0.01) but not with renal dysfunction (creat > 2 mg%), diabetes, old age or additional immunosuppression (p > 0.05). There were 11 deaths. Mortality was related to failure to reach diagnosis (3) and delayed institution of therapy (6 patients). Pneumonia within first six months had a higher mortality (9/16) compared to late pneumonia (2/11). Immunomodulating virus (CMV 4, HEP B 2) was present in six patients of whom four succumbed. CONCLUSION: Pulmonary infection is a common and serious post-transplant infection requiring hospitalisation, is associated with high mortality. Patients with leucopenia are predisposed to these infections. Prophylaxis for Pneumocystis, Nocardia and tuberculosis needs strong consideration to reduce mortality of such infection. Nosocomial exposure risk needs careful consideration in outbreaks of opportunistic infection.

Adult↗
PubMed1996

Jha et al. reply.

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Journal Article↗
PubMed1996

Visceral leishmaniasis in a renal transplant recipient: diagnostic and therapeutic problems.

Visceral leishmaniasis is infrequently reported in renal transplant recipients. A 40-year-old renal transplant recipient developed hepatosplenomegaly and pyrexia of unknown origin 5 months after transplantation. Visceral leishmaniasis was confirmed on bone marrow examination. The usual dose of antiparasitic therapy with stibogluconate sodium failed to eradicate Leishmania donovani. High-dose conventional therapy with stibogluconate sodium for an extended period of time was successful in the treatment of a relapse of leishmaniasis.

Adult↗
PubMed1995

Hydrolysis of the GlcNAc oxazoline: deamidation and acyl rearrangement.

The specific deamidation of 2-acetamido-1,3,4,6-tetra-O-acetyl-alpha-D-glucopyranose is achieved by p-toluenesulfonic acid-promoted hydrolysis of 2-methyl-(3,4,6-tri-O-acetyl-1,2-dideoxy-alpha-D-glucopyrano)-[2,1 -d]-2- oxazoline 2 to give quantitative formation of the 1,3,4,6-tetra-O-acetyl-2-amino-2-deoxy-alpha-D-glucopyranose p-toluenesulfonate (5d). This two-step procedure provides an amino sugar which may be readily acylated to give novel glycoconjugates. Alternatively, base-catalyzed O-1-->N-2 acyl rearrangement of the amino tosylate 5d gives the 2-acetamido-3,4,6-tri-O-acetyl-2-deoxy-D-glucopyranose 4 as a 9:1 mixture of alpha and beta anomers. Thus, hydrolysis of GlcNAc oxazoline 2 gives the amino-ester 5 as the kinetic product and the amido-alcohol 4 as the thermodynamic product.

Acylation↗
PubMed1995

Central pontine myelinolysis following 'slow' correction of hyponatremia.

Two patients with central pontine myelinolysis are described for the peculiar mode of development. Both patients were in chronic renal failure and admitted in a stuporous state due to hyponatremia. Both developed central pontine myelinolysis during the hospital stay following slow and judicious correction of hyponatremia. The role of chronicity of hyponatremia prior to its correction, in the genesis of central pontine myelinolysis, particularly in the patients who have chronic debilitating illness, septicemia or malnutrition, is highlighted.

Adult↗
PubMed1994

Carbon monoxide poisoning: an unusual cause of acute renal failure.

Carbon monoxide poisoning in a family of 3 persons resulted in renal failure with neurological damage in a 40-year-old husband and a fatal neurological injury in 35-year-old wife whereas the newborn child survived without any ill effects. Rhabdomyolysis and myoglobinuria secondary to anoxia was the probable cause of acute renal failure. The recognition of nontraumatic rhabdomyolysis-related acute renal failure is important in preventing fatality if neurological salvage is done at the right time.

Acute Kidney Injury↗
PubMed1993

Acute renal failure in the elderly: experience from a single centre in India.

A total of 139 patients with acute renal failure (ARF) were studied, of which 41 (29.4%) were elderly with mean age of 67.1 years and 98 (70.6%) were younger with mean age of 32.3 years. Surgical causes accounted for 65% of geriatric ARF while medical causes were predominant in the younger patients (55.1%). Amongst the surgical causes, prostate-related problems due to obstruction or following transurethral resection of prostate were seen in 20 patients (74%). Drugs and sepsis were the predominant causes of medical ARF in the geriatric patients (85.7%). Of all the causes of geriatric ARF, which included both medical and surgical, nephrotoxic drugs either alone or in combination with other predisposing factors were the cause in 22 (51%) patients. Haemodialysis was needed in 15 of geriatric (36.6%) and 64 of younger (65.3%) ARF patients. Recovery from ARF, as evidenced by normalization of serum creatinine, was delayed in the elderly as compared to the younger patients (32.0 versus 11.4 days, P < 0.001). Mortality, though higher in the elderly as compared to the younger patients, was not significantly different (9.75% versus 6.1%).

Acute Kidney Injury↗
PubMed1985

Investigation into the value of Papanicolaou stained cervical smears for the diagnosis of chlamydial cervical infection.

Forty five (37%) of 121 female contacts of men with non-gonococcal urethritis or gonorrhoea were chlamydia positive, as judged by isolation or by detecting elementary bodies in smears with a fluorescein labelled chlamydial monoclonal antibody. Only six (13%) of these, however, had Papanicolaou stained smears in which there were inclusion like changes suggestive of chlamydial infection. Furthermore, of 15 patients who had such cytological changes, chlamydiae were detected in only six and the abnormalities were found also in Papanicolaou stained smears from 10 (13%) of the 76 chlamydia negative patients. Modifying the Papanicolaou stained smears by including endocervical material did not increase sensitivity. In addition, destaining and restaining them with the monoclonal antibody was time consuming and the results were unreliable. The staining of cervical smears with Papanicolaou reagent is a technique of low sensitivity and specificity for diagnosing or screening for chlamydial cervical infection and cannot be recommended.

Cervix Mucus↗
PubMed1979

On the solid state of bone.

Photovoltaic effect (infrared and visible light) is observed in bone and its two major components, collagen and apatite, at room temperature. A dimunition in the magnitude of photovoltage is observed after exposure to ultraviolet light in all the cases. The drift mobility of the charge carriers is obtained by measuring I versus V relationships in sandwich samples and relating them to the permittivity of the medium. Lifetime of the injected carriers is measured in the usual way. The data are consistent with the hypothesis that the effects are due to protonic conduction phenomena.

Animals↗
PubMedDate not supplied

Wegener's vasculitis: diagnostic and therapeutic problems.

A case of Wegener's granulomatosis (WG) presenting with pulmonary manifestation which were initially suspected to be due to tuberculosis is being reported. Renal involvement appeared later. He developed complications of antitubercular treatment and of immunosuppression. The difficulties in distinguishing pulmonary manifestation of WG from tuberculosis and other diagnostic and therapeutic problems are discussed.

Antitubercular Agents↗