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Biomedical subjects

Ravi Kashyap

Publications and source records attributed to Ravi Kashyap.

14 recordsLinked to original sources
PubMed2005

Anti-inflammatory activity of Seabuckthorn (Hippophae rhamnoides) leaves.

Immunomodulatory activity of Seabuckthorn (SBT) leaf extract was evaluated in adjuvant induced arthritis (AIA) rat model. Inflammation was induced by injecting Complete Freund's Adjuvant (CFA) in the right hind paw of rats. SBT extract was administered intraperitoneally to treat the inflammation. The extent of inflammation and treatment response was evaluated by clinical analysis, scintigraphic visualization using technitium-99m-glutathione (Tc99m-GSH) and lymphocyte proliferation. Serial evaluation was carried out on days 1, 7, 14, 21 and 28 after creation of inflammation. The Tc99m-GSH uptake in the inflamed leg was compared with the normal contralateral leg of the same animal. The measurements were done by obtaining scintigraphic images using gamma camera and an online computer. Both qualitative and quantitative evaluation of radiotracer accumulation was considered to evaluate the anti-inflammatory response. The lymphocyte proliferation study revealed cellular immunosuppression during the early phase of the disease. Administration of SBT extract on the same day or 5 days prior to inflammatory insult into the joint, significantly reduced the inflammation as compared to the untreated animals in a dose dependent manner. These observations suggest that the SBT leaf extract has a significant anti-inflammatory activity and has the potential for the treatment of arthritis.

Animals↗
PubMed2004

Endovascular stent implantation for severe pulmonary artery stenosis in aortoarteritis (Takayasu's arteritis).

Symptomatic pulmonary artery stenosis is a relatively uncommon manifestation of aortoarteritis. We describe a patient of aortoarteritis with severe proximal right pulmonary artery stenosis who presented with dyspnea on exertion and central cyanosis. The pulmonary artery stenosis was successfully relieved by percutaneous transluminal balloon angioplasty and implantation of a balloon-expandable stent. This resulted in immediate improvement in oxygen saturation, disappearance of cyanosis, relief of dyspnea, and marked improvement in right lung perfusion as demonstrated by pre- and postangioplasty technetium lung ventilation-perfusion scans. The changes in the pulmonary arterial wall morphology were detected precisely by intravascular ultrasound imaging.

Adult↗
PubMed2004

Unusual widespread metastatic presentation of mixed medullary-follicular thyroid carcinoma.

Mixed medullary-follicular thyroid carcinoma (MMFTC) is a rare tumor with a metastatic behavior that has not been fully appreciated. Scintigraphy and radioiodine entrapment propensity of its metastases remains largely undescribed. The authors present a case of MMFTC with widespread bone and soft-tissue metastases, where every known site of metastases concentrated radioiodine intensely. The patient responded well to radioiodine therapy. The report suggests that the tumor may have a propensity to metastasize to the skeleton, and the metastases retain the ability to accumulate radioiodine.

Adenocarcinoma, Follicular↗
PubMed2004

Differentiation of malignant and benign solitary thyroid nodules using 30- and 120-minute tc-99m MIBI scans.

Technetium-99m methoxy isobutylisonitrate (MIBI) has been found to be taken up by various tumors, including thyroid cancer. We prospectively evaluated 77 patients with cold thyroid solitary nodules on Tc-99m pertechnetate scintigraphy to evaluate the diagnostic value of Tc-99m MIBI scintigraphy. The aim of this study was to find out if thyroid nodules can be characterized on the basis of retention of MIBI and whether preoperative evaluation of malignancy is possible using this method. Single injection, dual-phase (30 and 120 minutes) thyroid scintigraphy using Tc-99m MIBI was performed in all these patients. In the following days and weeks, all patients underwent surgery. Using the 120/30-minute thyroid lesion to background radiouptake ratio (RUR), malignant and benign thyroid nodules could be separated with a sensitivity, specificity, and positive predictive value of 84.4%, 95.45%, and 93.33%, respectively. The mean RUR for malignant thyroid lesions was found to be 1.57+/-0.32, whereas for benign lesions, the ratio was significantly lower, 0.32+/-0.19. In conclusion, fine needle aspiration cytology along with the 120/30 minutes Tc-99m MIBI scintigraphy ratio appears to be useful in the preoperative assessment of solitary thyroid nodules.

Adult↗
PubMed2003

Bronchoesophageal fistula in a neonate: radionuclide study as diagnostic modality.

A neonate with H-type fistula between esophagus and right bronchus is described. He presented with an uncommon symptom of hypersialosis. The fistula was missed both at cinesophagogram and endoscopy, the modalities currently held as investigations of choice for the diagnosis of this entity. Instead it was incidentally picked up by radionuclide study undertaken to rule out dyskinesia or gross gastroesophageal reflux, which demonstrated the tract unequivocally. To the best of our knowledge this modality has not been used earlier for this purpose. The authors feel that although persistence in attempts to demonstrate the tract preoperatively is important, radionuclide study can also be considered as a diagnostic tool in difficult cases.

Bronchial Fistula↗
PubMed2002

Detecting protein losing enteropathy by Tc-99m dextran scintigraphy: a novel experience.

OBJECTIVE: To evaluate protien using enteropathy by Tc-99m dextran scintigraphy. METHODS: Methods for detecting protein loss from the intestine revolve around fecal nitrogen excretion, the clearance of alpha-1 antitrypsin in stools and by endoscopic biopsy. RESULT: The diagnosis of protein-losing enteropathy (PLE) can also be established by a scintigraphic method that is noninvasive, simple and requires no patient preparation or motivation. This diagnostic modality can also delineate the site of protein loss, thereby offering a targeted approach, and if need be, surgery. Radiolabelling of a non-protein, noncolloidal, nonparticulate and biofriendly molecule like dextran with Technetium-99m for imaging enteric protein loss was utilized in imaging eight children with PLE. CONCLUSION: The results were encouraging. The authors advocate the use of this diagnostic tool in identifying patients with PLE, particularly in the pediatric age group.

Child↗
PubMed2002

Diagnosis, characterisation and evaluation of treatment response of frostbite using pertechnetate scintigraphy: a prospective study.

No large prospective study is available on use of a radionuclide method to assess frostbite and its response to conservative treatment. Recently, a large retrospective study using two-phase bone scintigraphy suggested that non-uptake (or low uptake) in frostbite lesions in the blood pool or bone phase had a strong correlation with the subsequent need for amputation. In the present study, we performed early blood pool scintigraphy with technetium-99m pertechnetate in 20 patients (10-180 days after frostbite injury; 71 clinical lesions) referred for a topical treatment protocol for mild to moderately severe frostbite, and in 22 asymptomatic controls. The aims of the study were to define the "normal" microcirculation of the hands and feet, to characterise the appearances of frostbite lesions on scintigraphy and correlate these with the clinical presentation, and to evaluate the usefulness of scintigraphy for assessing the treatment response. Six patients were "fresh", 12 had been undergoing conservative treatment (topical homeopathic) for several weeks and two had permanent fibrotic hand phalanges. Nine patients on treatment underwent serial scintigraphy a total of 22 times. Eleven patients were imaged only once, including the two with permanent fixed defects. Three distinct physiological microcirculation patterns were evident in control hands or feet: right- or left-handedness (seven subjects), subclinical inflammatory foci correlating with callosity or pressure points (36 lesions) and distinctly increased pooling of radiotracer at the thenar or hypothenar region (eight subjects). In frostbite patients, 128 lesions (48 inflammatory, 80 ischaemic) were seen on the scan. This number included all 71 lesions identified clinically, the rest being subclinical. Subclinical frostbite lesion as an entity has not been described previously. Microvasculature of normal muscle groups (in the hands, elbow or feet) was shown on scintigraphy to improve after topical treatment. The treatment resulted in improved or normalised perfusion scan in 25 of 45 ischaemic segments with matching clinical improvement, and reduction or normalisation of uptake in inflammatory lesions (n=30). The data confirm the vasodilator and anti-inflammatory action of the topical preparation, and the sensitivity of the radionuclide method in monitoring treatment response. In contrast to the previous findings that non-uptake on a scan performed 2 or more weeks after exposure correlates with the need for amputation, none of the 80 ischaemic lesions in our series required amputation while 60% showed improvement or normalisation in microvascular blood flow even though they were 10-180 days old. Our findings suggest that moderate to severe frostbite lesion can be classified as having infarcted, ischaemic or hibernating (viable) tissue, similar to the classification employed when using myocardial scintigraphy. Absence of uptake even after the initial 10 days does not necessarily indicate infarction and the need for amputation as many such lesions retain potential for vasodilation and recovery.

Adolescent↗
PubMed2002

Etiology and clinical predictors of intractable epilepsy.

To determine the etiology and clinical predictors of intractable epilepsy, a case-control study comprising 50 patients and 50 control subjects was performed. Patients included children who had more than one seizure per month over at least 6 months. Control subjects included children with epilepsy who had been seizure-free for more than 6 months. Patients were evaluated with special reference to birth history and development. Clinical examination and neurodevelopmental assessment were performed in all the patients. Drug monitoring was performed to exclude pseudointractability. Epilepsy in the study group was caused by perinatal problems (48%) and sequelae of central nervous system infection (24%) and was idiopathic in 20%. In the control group, epilepsy was idiopathic in 72%, a result of calcified granuloma in 22%, and perinatal problems comprised 6% of the subjects. On univariate analysis, strong association was evident between intractable epilepsy and several factors, including age at onset of seizure, remote symptomatic epilepsy, initial seizure type, history of neonatal seizure, high initial seizure frequency, microcephaly, and neurologic impairment. On multivariate analysis, neurologic impairment (odds ratio [OR] 12.25; 95% confidence interval [CI] 3.58-41.89), age at onset of seizure less than 1 year (OR 11.70; 95% CI 2.95-46.43), myoclonic seizure/infantile spasm (OR 10.36; 95% CI 2.39-44.93), and remote symptomatic epilepsy (OR 2.9; 95% CI 1.13-7.43), were independent predictors of intractability.

Anticonvulsants↗
PubMed2002

Association of gastroesophageal reflux disease in young children with persistent respiratory symptoms.

Forty children aged between 3 months and 3 years (median age 14 months) with persistent respiratory symptoms beyond 4 weeks or recurrence of respiratory symptoms were investigated for gastroesophageal reflux (GER). Diagnostic tests included upper gastrointestinal endoscopy, oesophageal biopsy, gastroesophageal scintiscan and 24 h ambulatory oesophageal pH monitoring. GER was detected in 14 (35 per cent) of these patients; which included 38 per cent of the enrolled cases of recurrent bronchopneumonia, 40 per cent cases of reactive airway disease, and 22 per cent cases of persistent cough. Amongst the cases detected to have GER, the age of onset of respiratory symptoms was less than 1 year in 86 per cent of cases (p < 0.01), nocturnal symptoms of cough and wheeze were reported in 78 per cent (p < 0.05), and 86 per cent cases did not present with typical gastrointestinal symptoms (p < 0.01). Family history of asthma was absent in all cases of GER-related reactive airway disease (p < 0.01). Cases detected to have GER were followed for 3-6 months after starting anti-reflux therapy. A significant (p < 0.01) decrease was noticed in the number of further episodes in children with GER-related recurrent bronchopneumonia and reactive airway disease after starting anti-reflux therapy. Improvement was also noticed in nocturnal symptoms and nutritional status after anti-reflux therapy was started. Our results suggest that GER may be one of the possible contributing factors in any child with recurrent and persistent respiratory complaints. Early diagnosis and anti-reflux therapy in cases with GER-related respiratory complaints can result in significant improvement in symptoms.

Child, Preschool↗