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Biomedical subjects

Rajeev Jain

Publications and source records attributed to Rajeev Jain.

At least 19 recordsLinked to original sources
PubMed2007

In vivo fluorescein staining of SI-30NB silicone intraocular lens.

We report a case of a 48-year-old pseudophakic woman who presented 3 weeks after Heidelberg retinal angiography using intravenous sodium fluorescein 2%. Bilateral retinal vasculitis with severe retinal ischemia and extensive capillary dropouts had been diagnosed. Anterior segment examination revealed green staining on the silicone optic of the 3-piece SI-30NB intraocular lens (IOL) (AMO), with no cell or flare in the aqueous humor. The anterior and posterior capsules were not stained. The patient did not report dark vision, double vision, or altered color vision. The anterior and posterior IOL surfaces demonstrated an autofluorescence at the time of fundus photography, which persisted to the 6-week examination although there were no symptoms. This is suggestive of deposits of sodium fluorescein on the IOL surface following angiography.

Female↗
PubMed2006

Removal of Reactofix Navy Blue 2 GFN from aqueous solutions using adsorption techniques.

The wheat husk, an agricultural by-product, has been activated and used as an adsorbent for the adsorption of Reactofix Navy Blue 2 GFN from aqueous solution. In this work, adsorption of Reactofix Navy Blue 2 GFN on wheat husk and charcoal has been studied by using batch studies. The equilibrium adsorption level was determined to be a function of the solution pH, adsorbent dosage, dye concentration and contact time. The equilibrium adsorption capacities of wheat husk and charcoal for dye removal were obtained using Freundlich and Langmuir isotherms. Thermodynamic parameters such as the free energies, enthalpies and entropies of adsorption were also evaluated. Adsorption process is considered suitable for removing color, COD from waste water.

Journal Article↗
PubMed2006

Removal of Reactofix golden yellow 3 RFN from aqueous solution using wheat husk--An agricultural waste.

The wheat husk, an agricultural by-product, has been activated and used as an adsorbent for the adsorption of Reactofix golden yellow 3 RFN from aqueous solution. In this work, adsorption of Reactofix golden yellow 3 RFN on wheat husk and charcoal has been studied by using batch studies. The equibrium adsorption level was determined to be a function of the solution pH, adsorbent dosage, dye concentration and contact time. The equilibrium adsorption capacities of wheat husk and charcoal for dye removal were obtained using Freundlich and Langmuir isotherms. Thermodynamic parameters such as the free energies, enthalpies and entropies of adsorption were also evaluated. Adsorption process is considered suitable for removing color, COD from wastewater.

Adsorption↗
PubMed2006

Adsorption of Safranin-T from wastewater using waste materials- activated carbon and activated rice husks.

Textile effluents are major industrial polluters because of high color content, about 15% unfixed dyes and salts. The present paper is aimed to investigate and develop cheap adsorption methods for color removal from wastewater using waste materials activated carbon and activated rice husk-as adsorbents. The method was employed for the removal of Safranin-T and the influence of various factors such as adsorbent dose, adsorbate concentration, particle size, temperature, contact time, and pH was studied. The adsorption of the dye over both the adsorbents was found to follow Langmuir and Freundlich adsorption isotherm models. Based on these models, different useful thermodynamic parameters have been evaluated for both the adsorption processes. The adsorption of Safranin-T over activated carbon and activated rice husks follows first-order kinetics and the rate constants for the adsorption processes decrease with increase in temperature.

Adsorption↗
PubMed2006

Correlation between retinal nerve fiber layer thickness and central corneal thickness in patients with ocular hypertension: an optical coherence tomography study.

PURPOSE: To correlate the retinal nerve fiber layer (RNFL) thickness and optic nerve head (ONH) parameters measured by optical coherence tomography (OCT) with central corneal thickness (CCT) measurements in patients with ocular hypertension (OHT). DESIGN: Observational cross-sectional study. METHODS: setting: Tertiary care referral teaching institute. study population: Fifty-one eyes of 51 patients with OHT and 35 eyes of 35 normal subjects. Both groups were stratified into thin (CCT < or =555 microm) and thick (CCT >555 microm) cornea subsets. Ocular hypertensives were further stratified by CCT into < or =555 microm, 556 to 588 microm, and >588 microm subsets. observation procedure: RNFL thickness (average, superior average, and inferior average) and ONH parameters were measured by OCT. CCT was measured by ultrasonic pachymetry. main outcome measures: Correlation between CCT and OCT measurements of RNFL and ONH parameters. RESULTS: In the OHT group, CCT correlated significantly with all three RNFL measurements (Pearson's coefficient r = 0.412, 0.484, and 0.380, respectively) but with only four ONH parameters (cup-to-disk area ratio, cup area, rim area, and horizontally integrated rim width; r = -0.459, -0.283, 0.421, and 0.436, respectively). The RNFL in ocular hypertensives with CCT < or =555 microm was significantly thinner than in those with thick corneas (analysis of variance, post hoc Bonferroni comparisons, P < .001). RNFL thickness of normal subjects and ocular hypertensives with CCT >555 microm were similar. CONCLUSIONS: Ocular hypertensives with CCT < or =555 microm may represent patients who have either very early undetected glaucoma or an inherent structural predisposition to glaucomatous damage. This may in part explain the higher risk of these patients for progression to glaucoma.

Adult↗
PubMed2006

Acute bacterial cholangitis.

Acute bacterial cholangitis refers to a bacterial infection of the biliary tract. Choledocholithiasis is the most common cause of biliary obstruction, with Escherichia coli, Klebsiella spp, and Enterococcus spp the most frequent biliary pathogens isolated in patients with cholangitis. Clinical presentation varies from mild illness to septic shock. The diagnosis of cholangitis is clinical and is supported by laboratory and radiographic findings. Initial treatment is supportive and includes antibiotics to cover the typical pathogens, but definitive treatment requires biliary drainage. Endoscopic retrograde cholangiopancreatography (ERCP) is the preferred technique to achieve biliary decompression with placement of an internal or nasobiliary stent. In cases in which ERCP is unsuccessful or technically not feasible, percutaneous transhepatic biliary drainage (PTBD) is preferred over surgery, which carries significant morbidity and mortality. In order to prevent post-ERCP cholangitis, prophylactic antibiotics are recommended in patients undergoing ERCP for known or suspected biliary obstruction.

Journal Article↗
PubMed2006

Role of scheimpflug imaging in traumatic intralenticular foreign body.

PURPOSE: The role of Pentacam Scheimpflug imaging in evaluation of penetrating eye injury and intralenticular foreign body (ILFB). DESIGN: Interventional case report. METHODS: A 35-year-old male presented to our clinical practice with penetrating eye injury and endophthalmitis. Scheimpflug imaging helped localize the intralenticular foreign body (ILFB). It confirmed the posterior capsule to be intact. He underwent phacoemulsification, foreign body removal, and intraocular lens (IOL) implant. Postoperatively, IOL was imaged with Pentacam Scheimpflug imaging. RESULTS: Scheimpflug imaging allowed us to confirm the presence and exact location of ILFB and its relation to the intact posterior capsule as well as the postoperative IOL positioning. This helped in better planning of management of traumatic cataract with ILFB. CONCLUSIONS: Pentacam is a potential tool for accurate localization of foreign bodies lodged in the lens and provides an objective basis for better patient counseling and surgical planning.

Adult↗
PubMed2006

Scheimpflug imaging in late Capsular Bag Distention syndrome after phacoemulsification.

PURPOSE: To describe two cases of late Capsular Bag Distention syndrome (CBDS) and posterior capsular opacification (PCO) as documented on Pentacam. DESIGN: Case series. METHODS: A 55-year-old male and a 72-year-old female presented three years after phacoemulsification and intraocular lens (IOL) implantation with a complaint of decreased vision. Scheimpflug imaging was done using Pentacam. Patients underwent Nd:YAG capsulotomy for PCO, and postcapsulotomy capsular bag dynamics were imaged on Pentacam. RESULTS: Three years after phacoemulsification, patients presented with blurred vision and posterior bowing of opacified posterior capsule. Anterior capsular opening was apparently sealed by lens optic, and space between IOL and opacified posterior capsule was filled with turbid fluid. Nd:YAG laser capsulotomy was done. All findings, including collapse of distended bag, were precisely documented on Scheimpflug images. CONCLUSIONS: Pentacam Scheimpflug imaging is a useful technique to diagnose and document the presence and progress of CBDS and PCO.

Aged↗
PubMed2006

CT bronchoscopy in the diagnosis of Williams-Campbell syndrome.

Williams-Campbell syndrome, a rare disorder, is characterized by a congenital deficiency of cartilage, typically involving the fourth to the sixth order bronchi, and resulting in expiratory airway collapse and bronchiectasis. The authors report a patient with Williams-Campbell syndrome with type II respiratory failure due to extensive cystic bronchiectasis and secondary emphysema. CT of the thorax showed the affected bronchi had characteristic ballooning on inspiration and collapse on expiration. Three-dimensional images of the tracheobronchial tree were constructed from a volume of data acquired by thin-slice CT scanning. Apart from confirming expiratory collapse of the affected bronchi, these images revealed an absence of the cartilage ring impressions in the bronchial wall, extending bilaterally from the mainstem down to subsegmental bronchi, suggesting cartilage deficiency.

Adolescent↗
PubMed2006

Systemic non-Hodgkin's lymphoma masquerading as Vogt-Koyanagi-Harada disease in an HIV-positive patient.

A 29-year-old man presented with decreased visual acuity in both eyes secondary to exudative retinal detachment resembling Vogt-Koyanagi-Harada disease. Although fluorescein angiographic pictures supported the clinical findings, there was no choroidal thickening evident with ultrasonography. In 3 days he developed increased disc oedema with peripapillary haemorrhages in both eyes. Further evaluation revealed HIV-positive status and a systemic non-Hodgkin's lymphoma. The patient responded favourably to the treatment for systemic non-Hodgkin's lymphoma confirming our diagnosis of intraocular metastasis. In bilateral exudative detachment, an absence of choroidal thickening on ultrasonography and the presence of peripapillary haemorrhages should prompt a systemic evaluation for causes other than Vogt-Koyanagi-Harada disease, especially in HIV-positive patients.

Adult↗
PubMed2006

Pontobulbar palsy and neurosensory deafness (Brown-Vialetto-van Laere syndrome) with hyperintense brainstem nuclei on magnetic resonance imaging: new finding in three siblings.

Three siblings (one boy and two girls) with Brown-Vialetto-van Laere syndrome are reported. A peculiar feature of onset with hearing loss in a patient with multiple cranial nerve palsies and a positive family history suggests this diagnosis. In our family, an autosomal recessive mode of inheritance was seen. In addition, we observed that early onset was associated with rapid deterioration and death. Optic nerve involvement and hyperintensity of the brainstem nuclei on magnetic resonance imaging (MRI) are two new features described in this report.

Adolescent↗
PubMed2006

Pattern of childhood epilepsies with neuronal migrational disorders in Oman.

Neuronal migrational disorders form a significant cause of psychomotor delay and intractable epilepsy in children. Pediatric neurology services are available at Sultan Qaboos University Hospital, Muscat, Oman, which is a tertiary care hospital for the whole country. The children undergoing evaluation for developmental delay and epilepsy formed the subjects of the study. Data were analyzed from children found to have neuronal migrational disorders on imaging (computed tomography [CT] or magnetic resonance imaging [MRI]). There were 40 cases of neuronal migrational disorders. Corpus callosum agenesis and lissencephaly or pachygyria formed the major group. There were 22 cases of corpus callosum agenesis, 12 of lissencephaly or pachygyria, 2 of schizencephaly, and 1 each of polymicrogyria, holoprosencephaly, hydranecephaly, and hemimegalencephaly. Nineteen of these 40 (47.5%) cases of neuronal migrational disorders had epilepsy. The break-down was 8 of 22 cases of corpus callosum agenesis (36%), 7 of 12 (58.3%) cases of lissencephaly or pachygyria, and 1 each of polymicrogyria, hydranencephaly, and hemimegalencephaly. The family history of developmental delay, similar to the index case, was present in two children with lissencephaly. However, the brain imaging did not reveal the abnormality. The types of seizures were infantile spasms in five, tonic-clonic in nine, myoclonic in two, partial in one, and mixed in five. Nineteen of 40 cases of neuronal migrational disorders had epilepsy. Only 2 of 19 (10.5%) with epilepsy had good seizure control. This raises the possibility of more and more surgical intervention in the management of such cases. Neuronal migrational disorders are related to exogenous and genetic factors from the 6th to 26th weeks of gestation. Molecular and genetic research is defining the mechanism of these disorders. This could help in early diagnosis, prevention, and eventual gene therapy in such conditions.

Agenesis of Corpus Callosum↗
PubMed2006

Long-term safety of pioglitazone versus glyburide in patients with recently diagnosed type 2 diabetes mellitus.

STUDY OBJECTIVE: To evaluate the long-term safety and efficacy of glyburide versus pioglitazone in patients with a recent diagnosis of type 2 diabetes mellitus. DESIGN: Prospective, randomized, multicenter, double-blind trial with a 16-week titration period and a 40-week maintenance period. SETTING: Sixty-five investigative sites in the United States and Puerto Rico. PATIENTS: Five hundred two subjects with a recent diagnosis of type 2 diabetes that was unsuccessfully treated with diet and exercise were randomly assigned to study treatment. Of the 251 patients in each treatment group, 128 (51.0%) glyburide-treated patients and 134 (53.4%) pioglitazone-treated patients completed the study. INTERVENTIONS: Dosages of randomly assigned glyburide and pioglitazone were titrated every 4 weeks for 16 weeks in 5-mg/day and 15-mg/day increments, respectively, until a fasting plasma glucose level between 69 and 141 mg/dl was achieved. The optimized regimen was maintained during the subsequent 40-week double-blind phase. MEASUREMENTS AND MAIN RESULTS: At week 56, glyburide and pioglitazone improved glucose control comparably (change in hemoglobin A(1c) -2.02% and -2.07%, respectively, p=0.669). Withdrawal due to lack of efficacy or adverse events occurred more frequently with glyburide (20.8%) than pioglitazone (12.8%, p<0.032). Significantly higher percentages of glyburide- than pioglitazone-treated patients had a hypoglycemic (24.3% vs 4.4%, p=0.0001) or cardiac (8.8% vs 4.4%, p=0.0478) event. Edema (4.8% vs 7.9%, p=0.1443) and weight gain (4.4% vs 4.0%, p=0.8238) did not differ significantly between the glyburide and pioglitazone groups. Only a few patients discontinued study drug because of weight gain (one glyburide, one pioglitazone), edema (one pioglitazone), or a cardiac event (two glyburide). CONCLUSION: With long-term treatment, both glyburide and pioglitazone resulted in comparable glycemic control; however, pioglitazone was associated with less hypoglycemia and fewer withdrawals due to lack of efficacy or adverse events.

Adolescent↗
PubMed2006

Evaluation of the anterior chamber angle in Asian Indian eyes by ultrasound biomicroscopy and gonioscopy.

PURPOSE: To compare the ultrasound biomicroscopic measurement of the anterior chamber angle in Asian Indian eyes, with the angle width estimated by gonioscopy. MATERIALS AND METHODS PARTICIPANTS: Patients with open and closed angles attending a glaucoma clinic were recruited for the study. OBSERVATION PROCEDURES: Temporal quadrants of the angles of patients were categorized by gonioscopy as Grade 0 to Grade 4, using Shaffer's classification. These angles were quantified by ultrasound biomicroscopy (UBM) using the following biometric characteristics: Angle opening distance at 250 micro (AOD 250) and 500 micro (AOD 500) from the scleral spur and trabecular meshwork-ciliary process distance (TCPD). The angles were further segregated as "narrow angles" (Schaffer's Grade 2 or less) and "open angles" (Schaffer's Grade 3 and 4). MAIN OUTCOME MEASURES: The UBM measurements were computed in each case and analyzed in relation to the gonioscopic angle evaluation. RESULTS: One hundred and sixty three eyes of 163 patients were analyzed. One hundred and six eyes had "narrow angles" and 57 eyes had "open angles" on gonioscopy. There was a significant difference among the mean UBM measurements of each angle grade estimated by gonioscopy (P < 0.001). The Pearson correlation coefficient between all UBM parameters and gonioscopy grades was significant at the 0.01 level. The mean AOD 250, AOD 500 and TCPD in narrow angles were 58+/-49 micro, 102+/-84 micro and 653+/-124 respectively, while it was 176+/-47 micro, 291+/-62 micro and 883+/-94 micro in eyes with open angles (P < 0.001) respectively. CONCLUSIONS: The angle width estimated by gonioscopy correlated significantly with the angle dimensions measured by UBM. Gonioscopy, though a subjective test, is a reliable method for estimation of the angle width.

Anterior Chamber↗
PubMed2005

Acute Acalculous Cholecystitis.

Acute acalculous cholecystitis is defined as acute inflammation of the gallbladder in the absence of gallstones. Patients are usually critically ill with atherosclerotic heart disease, recent trauma, burn injury, surgery, or hemodynamic instability. The presentation of acute acalculous cholecystitis may be insidious, characterized by unexplained fever, leukocytosis, hyperamylasemia, or abnormal aminotransferases, and patients often lack right upper quadrant tenderness. Diagnostic evaluation includes ultrasonography, computerized tomography, and cholescintigraphy. Given the high mortality of untreated disease, definitive treatment consists of cholecystectomy or, in poor surgical candidates, cholecystostomy. Endoscopic therapy with nasobiliary drainage and lavage is an effective treatment option in patients unable to tolerate surgery or cholecystostomy.

Journal Article↗
PubMed2005

The phenotypic spectrum of baraitser-winter syndrome: a new case and review of literature.

The syndrome of iris coloboma, ptosis, hypertelorism, and mental retardation (Online Mendelian Inheritance in Man -- OMIM # 243310), also known as the Baraitser-Winter syndrome, originally was described in a brother and sister and in an unrelated girl in 1988. Six additional individuals with a similar phenotype have been reported in the world literature. Microphthalmos, microcornea, and brain malformations were added to the phenotypic spectrum of this syndrome in 1995. We report a child who presented with the aforementioned findings. Eye examination revealed bilateral microphthalmos and typical iris, optic nerve, and choroidal colobomas. Magnetic resonance imaging of the brain demonstrated pachygyria and cortical atrophy.

Blepharoptosis↗