Biomedical subjects

Rajvir Singh

Publications and source records attributed to Rajvir Singh.

36 records · Page 2Linked to original sources

PubMed2005

Comparing glaucomatous optic neuropathy in primary open angle and chronic primary angle closure glaucoma eyes by optical coherence tomography.

PURPOSE: To comparatively evaluate the optic nerve head (ONH) using Optical Coherence Tomography (OCT) in normal subjects, primary open angle glaucoma (POAG) and chronic primary angle closure glaucoma (CPACG) patients. METHODS: A total of 138 normal eyes (138 subjects) and 139 glaucomatous eyes (139 patients), were evaluated in this cross-sectional observational study. The ONH was imaged on OCT using the optic disc scan. Disc area, cup area, rim area, vertical integrated rim area (VIRA), rim volume (horizontal integrated rim volume), average cup/disc ratio, horizontal and vertical cup/disc ratios, and cup volume were evaluated. Additionally, cup depth and slope of the temporal ONH were also measured. These ONH parameters were compared between normal subjects and eyes with early POAG and CPACG. Correlation of mean deviation and corrected pattern standard deviation on full threshold 30-2 perimetry, with measured ONH parameters was carried out amongst the two groups. RESULTS: There was a significant difference in disc area (2.38 +/- 0.5, 2.77 +/- 0.4, 2.62 +/- 0.4 mm(2), p < 0.01), cup area (0.88 +/- 0.6, 1.99 +/- 0.7, 1.60 +/- 0.7 mm(2), p < 0.01), rim area (1.48 +/- 0.4, 0.86 +/- 0.4, 0.96 +/- 0.4 mm(2), p < 0.01), VIRA (1.64 +/- 0.3, 1.23 +/- 0.3, 1.22 +/- 0.4 mm(2), p < 0.01), rim volume (0.34 +/- 0.2, 0.1 +/- 0.1, 0.15 +/- 0.1 mm(3), p < 0.01) and cup/disc ratio (0.36 +/- 0.2, 0.69 +/- 0.1, 0.63 +/- 0.2, p < 0.01) in normal vs POAG vs CPACG eyes respectively. A comparison of ONH parameters between early POAG and early CPACG showed a significant difference in the disc area (2.85 +/- 0.3, 2.57 +/- 0.4 mm(2), p = 0.03), cup area (2 +/- 0.5, 1.34 +/- 0.5 mm(2), p < 0.01), rim area (0.96 +/- 0.4, 1.21 +/- 0.5 mm(2), p = 0.009), rim volume (0.12 +/- 0.1, 0.18 +/- 0.1 mm(3), p < 0.01) and cup/disc ratio (0.67 +/- 0.1, 0.53 +/- 0.2, p < 0.01). The parameters with the highest area under the receiver operator characteristic (AROC) curves for differentiating normal and early POAG eyes were rim volume, 0.89, VIRA, 0.84, and rim area, 0.76. The AROC values (normal vs early CPACG eyes) were 0.75 for rim volume, 0.72 for VIRA, and 0.66 for rim area. CONCLUSION: OCT may serve as a useful diagnostic modality in distinguishing a normal optic disc from a glaucomatous one, even in the early stages of glaucoma. Rim volume, VIRA and rim area can be used to differentiate normal from early glaucoma (both early POAG and CPACG), and most efficiently early POAG eyes. CPACG eyes have smaller discs, a smaller cup, smaller cup/disc ratio, and a larger rim area when compared with eyes with POAG.

Adult↗

PubMed2004

Influence of sweet tasting solutions on opioid withdrawal.

The effect of the ingestion of palatable fluids on the suppression of opioid withdrawals in the opioid-dependent rats was studied. Physical dependence was induced by administration of morphine over a period of 6 days. Withdrawals were precipitated with naloxone (1 mg/kg, s.c.) 4 h after the last morphine injection on the 6th day. Test drugs (10-30% sucrose solution) were given orally for 2 h prior to naloxone-induced withdrawal in 14 h water deprived rats. Somatic signs of withdrawals were scored by using the global Gellert-Holtzman rating scale. Animals pretreated with low doses of sucrose solution (10-15%) did not produce any effect on the global withdrawal scale whereas a significant decrease on the global withdrawal scores was observed at higher doses of sucrose solution (20-30%) as compared to the controls. All the individual behavioral signs of withdrawals were significantly suppressed in a dose-related manner at higher doses of sucrose solutions whereas minimal suppression was observed for facial fasciculation/teeth chattering. These findings provide support that ingestion of high concentrations of sucrose solutions for shorter duration may activate the endogenous opioid system and appears to have an important role in modifying morphine withdrawals.

Analysis of Variance↗

PubMed2004

Prevalence of multiple micronutrient deficiencies amongst pregnant women in a rural area of Haryana.

UNLABELLED: Deficiencies of micronutrients (zinc, iron, folic acid and iodine) during pregnancy are known causes of Low Birth Weight (LBW). Studies have documented status of one or two micronutrients amongst pregnant women (PW). However, no attempt has been made to concurrently assess the prevalence of multiple micronutrient deficiencies and the factors associated with them amongst PW. OBJECTIVE: The present study was undertaken to assess the prevalence of multiple micronutrient deficiencies amongst PW in a rural area. METHODS: A community based cross sectional survey was conducted in six villages of a rural area of district Faridabad in Haryana state, India during November 2000 and October 2001. All PW aged 18 years or more, with pregnancy duration of more than 28 weeks were enrolled. Data were collected on socio-economic status and other demographic parameters. Serum zinc, copper and magnesium levels were estimated by utilizing the Atomic absorption spectrophotometry (AAS); serum ferritin and folate was estimated by Enzyme Linked Immuno Sorbent Assay (ELISA) method and the Radio-Immuno Assay (RIA) method, respectively and serum thyroid stimulating hormone (TSH) level was estimated by the Abbot AxSYM System. Serum zinc, copper, magnesium, ferritin, and folate levels less than 70.0 microg/dl, 80.0 microg/dl, 1.80 mg/dl, 15 ng/ml, and 3 ng/ml, respectively were considered as indicative of deficiency for respective micronutrients. The TSH levels of 4.670 and more indicated iodine deficiency status. Dietary intake of micronutrients was assessed utilizing 1-day 24-hour dietary recall methodology. Food consumption pattern was assessed utilizing the food frequency questionnaire methodology. RESULTS: Nearly 73.5, 2.7, 43.6, 73.4, 26.3, and 6.4 percent PW were deficient in zinc, copper, magnesium, iron, folic acid and iodine, respectively. The highest concurrent prevalence of two, three, four and five micronutrient deficiency was of zinc and iron (54.9%); zinc, magnesium and iron (25.6%); zinc, magnesium, iron and folic acid (9.3%) and zinc, magnesium, iron, folic acid and iodine (0.8%), respectively. No pregnant woman was found to have concomitant deficiencies of all the six micronutrients. Dietary intake data revealed an inadequate nutrient intake. Over 19% PW were consuming less than 50% of the recommended calories. Similarly, 99, 86.2, 75.4, 23.6, 3.9 percent of the PW were consuming less than 50% of the recommended folic acid, zinc, iron, copper, and magnesium. The consumption of food groups rich in micronutrients (pulses, vegetables, fruits, nuts and oil seeds, animal foods) was infrequent. Univariate and Multivariate logistic regression analysis revealed that low dietary intake of nutrients, low frequency of consumption of food groups rich in micronutrients and increased reproductive cycles with short interpregnancy intervals were important factors leading to micronutrient deficiencies. CONCLUSION: There was a high prevalence of micronutrient deficiencies amongst the PW of the area, possibly due to the poor dietary intake of food and low frequency of consumption of food groups rich in micronutrients. The concurrent prevalence of two, three, four and five micronutrient deficiencies were common.

Adolescent↗

PubMed2004

Histopathology and morphometry of radial artery conduits: basic study and clinical application.

BACKGROUND: The purpose of this study was to determine the pathohistology, morphometry, and risk factors for the development of intimal hyperplasia, calcification, and arteriosclerosis in the radial artery and to compare the morphometry of the distal and proximal radial arteries. METHODS: A total of 190 proximal and distal radial artery specimens obtained from patients who underwent myocardial revascularization were exposed to histopathologic and morphometric analysis. The severity of disease was evaluated on the basis of the percentage of luminal narrowing, intimal thickness index, and intima-to-media ratio. RESULTS: Sixty-two proximal (32.6%) and 22 distal (11.5%) radial artery segments were indicated as histologically normal. Morphometric analysis (Z test) revealed a lesser degree of intimal hyperplasia and luminal narrowing in the proximal segments compared with the distal segments (p < 0.001). The incidence of intimal hyperplasia, medial calcification, and arteriosclerosis in the distal radial arteries was 76.3%, 6.3%, and 5.78%, respectively. Using multivariate logistic regression, we have identified three significant predictors for intimal hyperplasia. Expressed as an odds ratio with a 95% confidence interval, these included (i) age greater than 50 years (1.052; 1.000-1.106, p = 0.052), (ii) smoking (14.073; 5.293-37.414, p = 0.000), and (iii) hypertension (2.777; 1.171-6.583, p = 0.020). Factors associated with an increased likelihood of medial calcification and arteriosclerosis included a history of smoking, diabetes, hypercholesterolemia, peripheral arterial disease, and chronic renal failure (p < 0.05). CONCLUSIONS: The great majority of radial artery conduits indicate preexisting intimal hyperplasia mostly affecting the distal portion. Therefore in cases of longer diseased segments of radial arteries, the discarded segments should be the distal end. Care should be taken when selecting radial artery as a conduit in myocardial revascularization, particularly in elderly males, diabetics, smokers, hypertensive patients, and in those with associated peripheral vascular disease.

Adult↗

PubMed2004

Status of serum ferritin and folate levels amongst young women in a rural community of Haryana, India.

A community based cross sectional study was conducted amongst young married non-pregnant women aged 18 years or more from six randomly selected villages in Ballabhgarh block, district Faridabad, Haryana state. Data was collected on socio-demographic profile and obstetric parameters utilizing a pre-tested semi-structured questionnaire. The non-pregnancy status of the women was confirmed by inquiring about the last menstrual period. Serum ferritin and folate levels were assessed utilizing the ELISA and the RIA method, respectively Serum ferritin and folate levels less than 15.0 and 3 ng/ml were considered as indicator of poor iron and folic acid stores, respectively. The dietary intake of iron, folic acid and calories was assessed utilizing the 24-hour dietary recall methodology. Almost 63.8 and 27.7 % of the women had poor serum ferritin and folate levels. The mean dietary intake of iron, folic acid and calories was 14.8+/-7.7 mg, 49.2+/-20.1 microg, and 1564+/-411 kcal, respectively. There was an inadequate intake of food as revealed by their calorie intake that was 83.4% of the recommended dietary allowances. Only 6.9 and 7.8 % of the women were consuming iron and folic acid more than 75.0 % of the recommeded dietary allowances (RDA) Women with dietary intake of calories less than 50.0 % of the RDA had a lower serum ferritin level compared to the women who had a higher calorie intake. It was also revealed that there was a decreasing trend in serum folate levels with poor socio-economic status. Young rural women had poor serum ferritin and folate levels in the community studied, possibly due to poor dietary intake of food and thereby iron and folic acid. Distribution of iron and folic acid tablets may be recommended to young women of reproductive age group.

Adolescent↗

PubMed2004

Significance of splenomegaly in childhood Hodgkin disease.

OBJECTIVES: Spleen involvement in childhood Hodgkin disease (HD) has not been described extensively. The authors' purpose was to study the clinicoradiologic features and prognostic significance of splenomegaly and that of splenic involvement in childhood HD. METHODS: One hundred forty-one children presenting with HD between January 1991 and February 2001 and treated with chemotherapy alone (4 COPP/4 ABVD) were included in the study. Radiotherapy was given in four patients with residual mediastinal disease. Patients were staged clinically and assessed for splenic deposits by computed tomography, ultrasonography, or both. RESULTS: Splenic involvement was seen in 22 children (15.6%). On univariate analysis, spleen deposits were significantly correlated with constitutional symptoms (P = 0.02), splenomegaly on physical examination (P < 0.001), involvement of three or more lymph node areas (P = 0.006), involvement of subdiaphragmatic lymph nodes (P = 0.01), mediastinal involvement (P = 0.001), and bulky disease (P = 0.005). Multivariate analysis retained enlarged spleen, involvement of three or more lymph node areas, and bulky disease as significant risk factors for spleen involvement. Relapse occurred significantly more in children with splenic involvement (P = 0.04) and in those with splenomegaly (P = 0.04). Presence of splenic deposits was an adverse prognostic factor for 5-year event-free survival (67.5% vs. 93.0%, P = 0.01). CONCLUSIONS: Enlarged spleen, involvement of three or more lymph node areas, and bulky disease are predictable risk factors for HD splenic deposits. Splenic involvement on computed tomography scan or ultrasonography is significantly associated with relapse and contributes to a poorer outcome of HD in children treated with chemotherapy alone.

Adolescent↗

PubMed2003

Magnitude of pesticidal contamination in winter vegetables from Hisar, Haryana.

Monitoring of 80 winter vegetable samples during 1997-1998 for pesticidal contamination was carried out on GC-ECD and GC-NPD systems with capillary columns following multiresidue analytical technique. The tested samples were found 100% contaminated with low but measurable amounts of pesticide residues. Among the four major chemical groups, residue levels of organophosphorous insecticides were highest followed by carbamates, synthetic pyrethroids and organochlorines. About 32% of the samples showed contamination with organophosphorous and carbamate insecticides above their respective MRL values. On the basis of observations made in these studies, it is suggested that more extensive monitoring studies covering all vegetable crops from different agro-climatic regions of the state be carried out to know exact level of pesticidal contamination, which may serve as basis for future policy on chemical use.

Chromatography, Gas↗

PubMed2003

Magnitude of zinc deficiency among nulliparous nonpregnant women in a rural community of Haryana State, India.

Zinc deficiency during pregnancy affects the outcome of pregnancy. A high prevalence of zinc deficiency (55.5%) has been reported among pregnant women. It is not known whether pregnancy leads to zinc deficiency due to the increased fetal needs or whether the women are zinc deficient when they become pregnant. No data are available on the zinc status of nulliparous nonpregnant women from India. To assess the magnitude of zinc deficiency among nulliparous nonpregnant women in a rural community of Haryana State, India. A community-based cross-sectional survey was conducted in six villages of a rural area in a district of Haryana State, India. All nulliparous nonpregnant women aged 18 years or over who were willing to participate in the study were enrolled. Each woman was questioned about her age, socioeconomic status, and dietary pattern with the use of a pretested semistructured questionnaire. Blood from the antecubital vein was drawn to assess the serum zinc levels using an atomic absorption spectrophotometer. Serum zinc levels less than 70.0 micrograms/dl were considered to indicate zinc deficiency. The dietary intakes of zinc, protein, and calories were assessed by the 24-hour dietary recall method. Two hundred eighty-eight nulliparous nonpregnant women were enrolled. Forty-one percent had zinc deficiency, and 75.7%, 1.4%, and 7.3% of the women consumed less than 50% of the recommended intake of zinc, protein, and calories, respectively. Women who consumed less than 50% of the recommended intake of calories (1,875 kcal) were at a 4.9 times higher risk of zinc deficiency than women who consumed more than 50% of the recommended intake. A high prevalence of zinc deficiency was found among the nulliparous nonpregnant women in the area studied.

Adolescent↗

PubMed2002

Effects of hemicastration and castration on foam production and its relationship with fertility in male Japanese quail.

Healthy heavy body weight strain of adult male Japanese quail (Coturnix coturnix Japonica) of the same age were used in this study to observe the effect of hemicastration and castration on the frequency of foam discharges from cloacal gland and other related parameters. The quails were housed in individual cages and divided into four groups: control (intact birds), sham-operated control (intact birds with incision), hemicastrated, and castrated groups of birds. Hemicastration and castration were carried out surgically at 10 and 13 weeks of age, respectively. Subsequently, 3 weeks after castration birds were examined for different parameters. Hemicastration caused a significant (P < 0.05) drop in the foam discharge frequency, weight of the foam, and the level of testosterone in the plasma, whereas in castrated group these variables were observed nil or negligible as compared to both of the controls. A suppressive effect of hemicastration was also noticed on the body weight, area of the cloacal gland, as well as percent fertility. Castration induced the drastic regression of the cloacal gland and a significant reduction (P < 0.05) of the body weight was also noted as compared to other groups. Frequencies of foam discharges were twice the number in daytime (06:00-18:00 h) than night, irrespective of the groups. In another study, the effect of characteristics of foam or foam glands on fertility was examined in 77 male birds paired with females. Several characteristics of foam and foam glands were examined for infertility, such as light yellow foam, dark yellow foam, smaller area of foam gland (below 225 mm2), hardness of foam gland and certain unknown factors that contributed 0.23, 0.68, 5.23, 2.27 and 3.64% infertility, respectively. An overall 12.1% birds were found to be infertile. This data indicated that smaller sizes of foam glands might reflect the poorest fertilizing ability of the male birds. From this study, it may be concluded that the cloacal gland may be considered as an external indicator of testicular function of the birds. Characteristics of the cloacal gland or foam or both may be used as a simple and effective tool to predict the fertilizing ability of an individual male in view of the very small semen ejaculate that is very difficult to collect and evaluate for fertility.

Animals↗

PubMed2002

Randomized study comparing 4'-epi-doxorubicin (epirubicin) versus doxorubicin as a part of induction treatment in adult acute lymphoblastic leukemia.

Doxorubicin or daunorubicin are routinely used to induce remission in acute lymphoblastic leukemia (ALL). Efficacy of epirubicin (an analog of doxorubicin), however, has not been adequately evaluated in ALL management. This randomized study was undertaken to compare the relative efficacy of epirubicin vs. doxorubicin as part of induction chemotherapy in adult ALL. Between January 1990 and June 1998, 79 previously untreated adult ALL patients (age 11-55 years, median 20 years) were randomized to receive either doxorubicin (Group A, n = 39) or epirubicin (Group B, n = 40) as a part of induction therapy. Vincristine and prednisolone were common in each group. The induction treatment was followed by identical consolidation and maintenance therapy. The two groups were compared as regards pretherapy clinical and laboratory parameters, dose intensity of therapy, therapeutic efficacy, myelotoxicity, and survival. Epirubicin was as effective as doxorubicin in terms of complete remission rate (80% vs. 78.3%; P = 0.87) and relapse rate (57.1% vs. 51.7%; P = 0.68). Five-year overall survival (30% vs. 30%, P = 0.98) and disease-free survival (40% vs. 39%, P = 0.92) at median follow-up of 68 months was also similar in the two groups. The incidence of Grade 4 myelotoxicity was comparable in the two groups. Patients 20 years of age or less had better CR rates (90% vs. 65%; P = 0.011) and median overall survival (39 vs. 11 months; P = 0.008) compared to those who were older. From this study epirubicin appears as effective as doxorubicin as part of induction therapy for adult ALL. However, the results need to be validated on the basis of immunophenotype and cytogenetic prognostic characterization.

Adolescent↗

PubMed2002

Posterior corneal topographic changes after retreatment LASIK.

PURPOSE: To evaluate posterior corneal topographic changes after retreatment after myopic laser in situ keratomileusis (repeat LASIK). DESIGN: Retrospective nonrandomized comparative self-controlled trial. PARTICIPANTS: Thirty-three eyes of 23 patients who underwent repeat LASIK for residual myopia. INTERVENTION: Retreatments were performed. Slit-scanning corneal topography was performed before and at 1, 3, and 6 months after repeat LASIK. MAIN OUTCOME MEASURES: Posterior corneal topographic changes before and after repeat LASIK were correlated with central corneal pachymetry (preoperatively, before repeat LASIK, after repeat LASIK), residual bed thickness (RBT) and ablation depth (after primary laser in situ keratomileusis (LASIK) and repeat LASIK). On the basis of the amount of posterior corneal elevation after repeat LASIK, the eyes were divided into two groups: group 1 (>66 micro m) and group 2 (< or =66 micro m). Student's t test/Mann-Whitney rank-sum test was used to determine the significant difference of mean level of each variable between the two groups. RESULTS: After primary LASIK, an increase in posterior corneal elevation had significant positive correlation with attempted correction (P = 0.02), ablation depth (P = 0.008), and significant negative correlation with preoperative central pachymetry (P = 0.0003), RBT (P = 0.0003), and postoperative central pachymetry (P = 0.00008). After repeat LASIK, the mean increase in posterior corneal elevation had significant negative correlation with preoperative central pachymetry (P = 0.03). However, its correlation with the ablation depth (P = 0.43) during repeat LASIK and RBT after repeat LASIK (P = 0.11) was statistically insignificant. On multiple linear regression analysis, the attempted correction (P < 0.01) and RBT after primary LASIK (P < 0.001) were two independent significant determinants of an increase in posterior corneal elevation after primary LASIK. However, for increase in posterior corneal elevation after repeat LASIK, preoperative central pachymetry (P < 0.01) and posterior corneal elevation increase after primary LASIK (P < 0.05) were the two significant determinants. Compared with group 2, group 1 had significantly high values of posterior corneal elevation both after primary LASIK (P = 0.0037) and after repeat LASIK (P = 0.0000). This group also had significantly low values of central pachymetry preoperatively (P = 0.0003) and after primary LASIK (P = 0.0001) and repeat LASIK (P = 0.0001) surgeries. The mean RBT after primary LASIK (P = 0.0006) and after repeat LASIK (P = 0.001) was also lower in group 1. CONCLUSIONS: Posterior corneal elevation increases after repeat LASIK. Eyes with an increase in posterior corneal elevation after primary LASIK and with thinner cornea are more predisposed.

Adolescent↗

PubMed2002

Potential of CT-scan based tumor volume as a response indicator in chemotherapy of advanced epithelial ovarian cancer.

BACKGROUND: Response prediction in patients undergoing chemotherapy for ovarian cancer is an important issue, since the cure rate is only about 15-20%. We attempted to develop a semi-empirical model to predict response in individual cases after the first cycle of chemotherapy. MATERIAL/METHODS: This prospective study included 51 cases of advanced ovarian cancer. A method was standardized to estimate ovarian tumor volume accurately from CT scan films. This permits the inclusion of patients who have undergone CT scan elsewhere. Patients underwent 4-6 cycles of chemotherapy and tumor volume was estimated after each cycle. This yielded a tumor regression curve for each patient. RESULTS: Percent reduction in tumor volume after the first chemo-cycle was a significant prognostic factor in multivariate analysis. Depending upon the rate of regression patients could be classified into Fast Regressing FR (n=29) and Moderately Regressing MR (n=16), whereas 6 patients showed Progressive Disease (PD) despite ongoing chemotherapy. The median survivals for the FR, MR and PD groups were 29.3, 18.9 and 8.5 months respectively. We found that 'percent reduction in volume after first chemo-cycle' could categorize a patient as FR/MR/PD correctly in 94.1% of cases. This parameter could also detect 5 out of 6 inherently resistant PD cases, who would otherwise undergo further chemotherapy, since early detection of resistance by clinical monitoring is quite difficult. CONCLUSIONS: An individual patient at risk for shorter survival and with inherent drug resistance can be identified after the first cycle of chemotherapy.

Antineoplastic Agents↗

PubMedDate not supplied

Analgesic efficacy of two doses of intrathecal midazolam with bupivacaine in patients undergoing cesarean delivery.

OBJECTIVES: In this prospective, randomized, double-blind, placebo-controlled study, we investigated the postoperative analgesic efficacy of 2 doses of intrathecal midazolam as an adjunct to bupivacaine for spinal anesthesia. METHODS: Sixty patients undergoing elective cesarean delivery under spinal anesthesia were allocated randomly to 3 groups: group B, 2 mL hyperbaric bupivicaine 0.5%; group BM1, 2 mL bupivacaine plus midazolam 1 mg (preservative free); and group BM2, 2 mL bupivicaine plus midazolam 2 mg. RESULTS: The mean duration of postoperative analgesia (determined by request for rescue medication) was 3.8 +/- 0.5 hours in group B compared with 4.3 +/- 0.7 hours in group BM1 (P = .18), and 6.1 +/- 1.0 hours in group BM2 (P = .001). Supplemental analgesic requirements with diclofenac were significantly less in group BM2 (93 +/- 29 mg) compared with group B (145 +/- 12 mg) and group BM1 (148 +/- 16 mg, P < .001). Time to block regression was longer in group B (182 +/- 30 minutes) compared with group BM1 (152 +/- 32 minutes) and group B (126 +/- 20 minutes) (both P < .001). Arterial pressure, heart rate, oxygen saturation, sedation score, and time to first void were comparable between groups. Group B had a significantly higher incidence of nausea and vomiting than groups BM1 and BM2 (P = .02). No neurologic deficits were observed. CONCLUSIONS: Intrathecal midazolam 2 mg provided a moderate prolongation of postoperative analgesia when used as an adjunct to bupivacaine in patients undergoing cesarean delivery. Intrathecal midazolam, 1 mg and 2 mg, decreased postoperative nausea and vomiting.

Adult↗

PubMedDate not supplied

Outcomes after laser in situ keratomileusis retreatment in high myopes.

PURPOSE: To evaluate the refractive and visual performance after laser in situ keratomileusis (LASIK) retreatment. METHODS: A retrospective study was performed on 33 eyes of 23 patients who underwent LASIK (Bausch & Lomb Technolas 217C) retreatment for residual myopia with or without astigmatism. Parameters evaluated were uncorrected and best spectacle-corrected visual acuity, spherical equivalent refraction, contrast sensitivity, glare acuity, and pachymetry, preoperatively and at 1, 3, and 6 months postoperatively. RESULTS: The mean spherical equivalent refraction before primary LASIK was -9.89 +/- 4.00 D and before retreatment was -2.85 +/- 2.17 D. Although contrast sensitivity and glare acuity decreased significantly after primary LASIK (P<.05), no significant change in these parameters was observed after retreatment. Smaller ablation zones were associated with decreased contrast sensitivity and glare acuity after primary LASIK as well as following retreatment. Contrast sensitivity and glare acuity following primary LASIK were significantly better in eyes with ablation zones > or = 5 mm than those with < 5 mm (P<.05). Eyes in which the ablation zone was the same as that for primary LASIK had significantly better contrast sensitivity than those with different ablation zones (increased or decreased) during retreatment. Attempted refractive correction during primary LASIK and retreatment had a significant negative correlation with contrast sensitivity and glare acuity following primary LASIK as well as retreatment. CONCLUSION: The ablation zones following primary LASIK and retreatment should be > or = 5.00 mm and remain unchanged to improve visual performance.

Adolescent↗

PubMedDate not supplied

Assessing glomerular filtration rate in healthy Indian adults: a comparison of various prediction equations.

BACKGROUND: Accurate measurement of renal function is important for the diagnosis, stratification and management of kidney disease. As the use of recommended filtration markers is limited by cumbersome and costly techniques, renal function is typically estimated by using various specifically derived prediction equations. Most of these equations have been derived from Caucasian patients suffering from varying degrees of chronic kidney disease. This study considers the validity of these equations in an Indian population without known kidney disease. METHODS: One hundred and twenty-two consecutive renal donors who had undergone 99mTc-diethylenetriaminepentaaceticacid (DTPA) glomerular filtration rate (GFR) estimation were enrolled. The predictive capabilities of the Cockcroft and Gault equation for creatinine clearance corrected for body surface area (CG-CrCl), CG-CrCl corrected for GFR (CG-GFR), modification of diet in renal disease (MDRD) 1, MDRD 2 and 24-hr urinary creatinine clearance (urine-CrCl) were evaluated with DTPA GFR as measured GFR. RESULTS: The mean age of the study population was 44.7 yrs with 72.2% being female). The mean measured DTPA GFR was 83.42 ml/min with a range of 61-130 ml/min. The median % absolute difference between the calculated and measured GFR was 19.7, 15.4, 19.3, 20.8 and 25.5, respectively, for CG-CrCl, CG-GFR, MDRD 1, MDRD 2 and urine-CrCl. Pearson's correlation between the measured and estimated GFR varied from 0.09-0.27. The precision as reflected by R2 value was 0.05 for CG-CrCl and CG-GFR, 0.06 for MDRD 1 and MDRD 2 and 0.01 for urine-CrCl. The bias was -14.14, 1.46, 11.89, 17.70 and -2.80 for CG-CrCl, CG-GFR, MDRD 1, MDRD 2 and urine-CrCl, respectively. The accuracy within 30% was 71.3, 85, 86, 76 and 69% for CG-CrCl, CG-GFR, MDRD 1, MDRD 2 and urine-CrCl, respectively. CONCLUSIONS: Our results from a healthy Indian population suggest that of all the predictive equations, MDRD 1 and MDRD 2 were the most precise, MDRD 1 the most accurate and CG-GFR the least biased. However, the poor correlation and error level exhibited by these equations makes them sub-optimal for clinical use.

Adult↗

PubMedDate not supplied

Assessment of risk factors in laryngeal cancer in India: a case-control study.

Cancer of the larynx is fourteenth most common cancer in the world. Limited data are available from India on associations with risk factors and hence the present hospital based matched case-control study was conducted. Three hundred and five laryngeal cancer patients and an equal number of healthy controls matched for their age within 2 years, sex and place of residence constituted the study population. A pre-tested, semi-structured questionnaire was administered to each individual to elicit information on their socio-demographic profile, food habits and risk factors and dietary consumption patterns. Univariate logistic regression analysis and multivariate forward stepwise conditional logistic analysis were performed. In the univariate analysis a lower consumption of roots and tubers green leaf vegetable other vegetables and fruits, and higher consumption of milk, eggs, meat, tea, alcohol , smoking, consumption of betel leaf with tobacco as well as a preference for spicy and fried foods emerged as significant positive variables. After adjusting for education, years of use of alcohol, smoking, chewing of betel leaf with tobacco in the model, low green leafy vegetables and preference for spicy foods were found to be positively related to the risk of laryngeal cancer. There was a significant difference in the dietary consumption patterns of laryngeal cancer patients and controls, indicating a role for nutritional factors in the etiology of laryngeal cancer in the Indian population.

Adult↗

PubMedDate not supplied

Vitamin E-based therapy is effective in ameliorating transaminasemia in nonalcoholic fatty liver disease.

BACKGROUND: Comparative trials of ursodeoxycholic acid (UDCA), vitamin E and weight management programs among patients with nonalcoholic fatty liver disease (NAFLD) are lacking. AIM: To find an effective single agent or combination of agents for management of NAFLD. METHODS: In this retrospective study, consecutive patient with histologically confirmed NAFLD with raised ALT were included. The patients received either weight management (exercise and therapeutic lifestyle changes [TLC] diet with a target to reduce body weight 10% in 6 months) (group I) ; weight management + UDCA (300 mg BID) (group II); or weight management + UDCA + vitamin E (400 mg OD) (group III). Outcome measure was normalization of ALT. RESULTS: 42 patients (18, 12 and 12 in groups I, II and III, respectively) were included between 1996 and 2004. All patients in group III normalized their ALT levels, which was significantly higher than numbers in group I (8/18) and group II (5/12); (p=0.003). Post treatment ALT was significantly lower in group III (28.6 [9.3]) as compared to group I (59.3 [32.2]) and group II (49.0[31.8]); (p=0.01). Type of therapy received was the only factor predictive of ALT normalization. CONCLUSION: Combination regimen containing vitamin E appears to be effective in normalizing ALT among NAFLD patients.

Adolescent↗

PubMedDate not supplied

New method of electrode placement for determination of cardiac output using impedance cardiography.

In thirty eight young healthy adult subjects, cardiac output was determined non-invasively by using two methods of electrode placement viz. vertical (uses silver braided wires in a band shape) and horizontal (conventional stick-on type surface ECG electrodes), using the technique of Impedance Cardiography. The recordings were taken in supine position on the same day in two separate sets with 30.0 min interval between two sets. In each set of recording, five successive recordings, each at an interval of five minutes were taken. The mean values of cardiac out put by two methods were compared. For the set I, the respective values (Mean +/- SD) of cardiac output by horizontal and vertical methods for the each of the five recordings were 4.87 +/- 0.77 and 5.03 +/- 0.64 for the first, 4.87 +/- 0.71 and 4.91 +/- 0.66 for the second, 4.99 +/- 0.67 and 5.00 +/- 0.70 for the third, 4.78 +/- 0.69 and 4.98 +/- 0.61 for the fourth, 4.84 +/- 0.69 and 4.98 +/- 0.62 for the fifth recording in supine position. The respective P values for these pairs for between the group comparisons were 0.33, 0.50, 0.96, 0.17, and 0.36. In addition, to see the repeatability for each method, within the group comparison was done, the P values were 0.71 and 0.91 for the horizontal and vertical methods, respectively. The mean value of cardiac output did not differ significantly between two methods for recordings of set II in supine position. The cardiac output measurement by placing four spot electrodes horizontally, gave consistent result on repeated measurements and their values showed concordance with the cardiac output values obtained by conventional four band electrodes tied around the chest.

Adult↗