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Biomedical subjects

S A Kamat

Publications and source records attributed to S A Kamat.

At least 19 recordsLinked to original sources

Genital tuberculosis--a major pelvic factor causing infertility in Indian women.

OBJECTIVE: To study the effect of tuberculosis, a common infectious disease in the Indian subcontinent, on the female pelvic factor and its subsequent effect on female fertility. DESIGN: Retrospective case studies. SETTING: Department of Infertility Management and Assisted Reproduction, Jaslok Hospital and Research Centre, Bombay, India. PATIENT(S): Three hundred women, between the ages of 25 and 35 years, with tubal factor as a cause of their infertile state. RESULT(S): One hundred seventeen women with a tubal factor were found to have tuberculosis as the cause of tubal blockage. On laparoscopy, 49.5% were found to have simple tubal blockage, 15.3% showed tubo-ovarian masses, and 23.9% had a frozen pelvis. Seventy-five percent complained of menstrual irregularities, thus indicating endometrial involvement; 25.6% of these women underwent an IVF procedure. The pregnancy rate after IVF-ET was 16.6% per transfer. CONCLUSION(S): This study highlights the fact that tuberculosis, a chronic infectious disease, is one of the major etiologic factors of female tubal infertility, especially on the Indian subcontinent.

Adult↗

Computer-assisted semen analysis parameters in men with varicocele: is surgery helpful?

OBJECTIVE: To assess sperm characteristics and fertility before and after varicocelectomy using computer-assisted semen analysis (CASA). DESIGN: Preoperative and postoperative sperm parameters of infertile men with varicocele were analyzed statistically and the outcome of pregnancy was determined. SETTING: Department of Infertility Management and Assisted Reproduction, Jaslok Hospital and Research Centre, Bombay. PATIENTS: Semen samples of 49 men with varicocele-related infertility were analyzed using CASA. INTERVENTIONS: Sperm parameters of 26 men who underwent varicocelectomy were evaluated 3, 6, and 9 months postoperatively. Conception, occurring either naturally or therapeutically, was recorded. MAIN OUTCOME MEASURES: Evaluation of improvement of sperm parameters after surgery. RESULTS: Sperm count, motility parameters, curvilinear velocity, straightline velocity, lateral head displacement, and normal morphology were significantly lower in men with varicocele. Postoperatively, there was significant improvement in count, motility, and normal morphology, with a decrease in proportion of acrosome-deficient heads and tapering forms. After varicocelectomy, 46.2% of the men had normal semen parameters, with the overall pregnancy rate being 50%. CONCLUSIONS: Computer-assisted semen analysis provides the potential for accurate quantitative evaluation of semen in men with varicocele. Varicocelectomy results in improvement in semen quality with pregnancy rates of 50%.

Acrosome↗

Assisted hatching in an in vitro fertilization programme.

Assisted hatching was performed on 37 women (IVF, n = 12; micromanipulation, n = 25), who were at risk of poor implantation after in vitro fertilization and micromanipulation, and who had previous cycles of failed implantation. A total of 292 oocytes was retrieved (7.9 per cycle) of which 90 were subjected to IVF and 202 were micromanipulated. Assisted hatching was performed on day 3 of culture, on six- to eight-cell embryos, by the technique of mechanical partial zona dissection. All the patients undergoing the procedure of assisted hatching had embryos with thick zonae, greater than 15 microns. Assisted hatching was performed on 39 embryos (55.7%) in the IVF group and 104 embryos (77.6%) in the micromanipulation group. The damage rate after hatching was 1.4%. The pregnancy rate per cycle was 50% in the IVF group and 44% in the micromanipulation group, compared with 10% (IVF) and 19.2% (micromanipulation) in the control groups. Assisted hatching, by partial zona dissection, results in significant improvement in pregnancy rates in women more than 38 years of age, who have a thick zona and with previous poor implantation results. This paper reports the first pregnancy in India by the technique of assisted hatching (partial zona dissection).

Adult↗

Serum immunoglobulins in viral hepatitis.

The serum levels of IgA, IgG and IgM were determined by single radial immuno-diffusion technique in 104 male patients of acute viral hepatitis. HBsAg was detected by counterimmuno-electrophoresis (CIEP) and 51% were HBsAg + ve. IgA, IgG and IgM levels were found to be higher than normal levels. Mean IgA and IgG levels were same in HBsAg + ve and HBsAg--ve patients. Mean IgM levels were however, higher in HBsAg--ve patients.

Adolescent↗

Chloramphenicol resistant Salmonella species isolated between 1978 and 1987.

During the ten year study i.e. 1978 to 1987, out of 53,251 cases of suspected enteric fever, S.typhi was isolated from 4005 cases (7%) and S.para typhi 'A' from 1108 cases (2.5%). A total of 52 strains of S. typhi and 4 strains of S.para typhi 'A' were found to be resistant to chloramphenicol. Minimal inhibitory concentration was greater than 256 micrograms/ml of all the strains of S.typhi and S.para typhi 'A'.

Chloramphenicol↗

Comparative study of methods of detection of hepatitis 'B' surface antigen (HBsAg).

The serum samples were collected from 52 patients of acute viral hepatitis and 235 hospital staff from Kasturba Hospital for Infectious Diseases. HBsAg was detected in their sera by counter-immuno-electrophoresis (CIEP), reverse passive hemogglutination (RPHA) and by micro-enzyme-linked-immunosorbent assay (ELISA) technique. Among the patients, HBsAg was detected in 12 cases (23%) by CIEP, in 18 cases (34%) by RPHA and in 23 patients (45%) by ELISA. In the hospital staff, HBsAg was detected in 4 samples (1.7%) by CIEP, in 8 samples (3.5%) by RPHA and in 32 samples (13.5%) by ELISA. Thus ELISA was found to be the most sensitive technique in detecting HBsAg.

Acute Disease↗

Anti-idiotypic humoral and cellular responses to antibody to hepatitis B surface antigen in hepatitis B viral infections.

In order to investigate regulatory significance of humoral and cellular responses to the idiotypic (Id) determinants on the antibody to hepatitis B surface antigen (anti-HBs), they were studied in acute hepatitis B and in chronic HBV infection. The results were compared with humoral and cellular responses of the same patients to hepatitis B surface antigen (HBsAg). In acute hepatitis B, the responses to HBsAg, were delayed until 3-4 weeks after the onset of clinical symptoms. However, the leucocyte migration inhibition (LMI) and the lymphocyte transformation (LTT) responses to affinity purified anti-HBs were found to be evolved very early in the course of acute hepatitis B, though anti-Id antibodies were absent. The majority of chronic HBV carriers showed a poor humoral and cellular response to HBsAg. Ten out of 38 chronic carriers showed anti-Id antibodies which recognized a major cross-reactive idiotype (CRI) on the anti-HBs molecule. Twenty-five out of 38 chronic carriers also showed LMI response to the Id determinants on the anti-HBs. LMI response induced by anti-HBs could be blocked by a specific Balb/c anti-Id antibody which also recognized the CRI. Thus, in both acute and chronic HBV infections, the anti-Id humoral and cellular responses correlated with poor humoral and cellular responses to HBsAg, indicating regulatory significance.

Acute Disease↗

Mechanisms of liver cell damage in acute hepatitis B.

Markers of hepatitis B viral infection and the evolution of immune response to these were compared with serum alanine aminotransferase (ALT) levels in adult male and non-pregnant and pregnant female patients with acute hepatitis B from the time of onset of disease to the seventh week. In the adult male and non-pregnant female patients, the peak ALT levels of about 360 IU/litre, seen at the time of onset, gradually declined during the course of the disease. Significantly, even in the seventh week, the median ALT level was abnormal (80 IU/litre). In contrast, the disease was mild in pregnant patients and the ALT levels declined rapidly, returning to normal by the third week. Markers associated with HBV replication, i.e., serum HBV-DNA and HBeAg, declined early in the course of the disease in both groups. The anti-HBc-IgM and anti-HBe responses were well evolved early in the course of the disease in both groups. HBsAg was present in the serum in large amounts (1-1.5 X 10(4) AU/100 microliter) early in the course of the disease and remained so up to the seventh week. Even the pregnant patients who had recovered clinically by the fourth week continued to have HBsAg in their sera in large amounts in spite of normal ALT levels. LMI and LTT responses to HBsAg, which were practically absent in the first week, gradually increased to a peak during the fourth week and remained elevated up to the seventh week in adult male and non-pregnant female patients. In contrast, LMI response to HBsAg was absent in pregnant patients with acute hepatitis B even up to the fourth week Thus, continued liver cell necrosis after the fourth week, as indicated by raised ALT levels, may be associated with T cell responses to HBsAg.

Acute Disease↗

Virological markers and antibody responses in fulminant viral hepatitis.

Clinical profiles, serological markers, and antibody responses to antigens of hepatitis B virus (HBV) were studied in patients with fulminant viral hepatitis. Whereas hepatitis A and B were found to be uncommon causes (6.9% and 12.2%, respectively), non-A, non-B (NANB) hepatitis was found to be the most common cause of fulminant hepatitis (80.9%). As against this, the incidence of hepatitis B and NANB hepatitis was very similar in nonfulminant acute viral hepatitis in adults (41.2% and 51.9%, respectively). Pregnancy with labour was an important precipitating factor for development of fulminant hepatitis of the NANB type only; 32% of fulminant NANB hepatitis patients were pregnant women and 22.6% had a history of labour preceding hepatic coma. Only 0.8% of nonfulminant NANB hepatitis cases were pregnant women. Another major precipitating factor for the development of the fulminant form of NANB hepatitis was concomitant chronic HBV carrier state. A total of 38.6% of fulminant NANB hepatitis patients were HBV carriers, whereas only 19.2% of nonfulminant acute NANB hepatitis cases were HBV carriers. Sera of 32 chronic HBV carriers with fulminant NANB hepatitis and 10 cases of fulminant hepatitis B were tested for delta antibody, and all were nonreactive. The antibody responses of the fulminant hepatitis B patients to the antigens of HBV were found to be greater compared to those of patients with nonfulminant acute hepatitis B. Antibody responses of chronic HBV carriers with fulminant NANB hepatitis to antigens of HBV were found to be depressed in comparison with those of chronic asymptomatic carriers.

Acute Disease↗

Typhoid: clinical picture and response to chloramphenicol. Prospective study in Bombay (1972).

The clinical picture of 78 cases with proven typhoid and 18 cases with proven paratyphoid A fever is presented. The diagnosis was made by isolating the organisms from the blood. The Widal test could not be used as a diagnostic criterion. By means of chemotherapy with chloramphenicol (initial dose 30-40 mg/kg body weight) defervescence was achieved within an average of 4.5 days. The course of the disease was generally mild; one patient with typhoid fever died. The average hospital stay was 19 days. Four patients of the typhoid fever group were readmitted with a relapse. The laboratory examinations included blood clot culture, phage typing, Widal test, haemoglobin, leucocyte count, transaminases, serum bilirubin, and routine examination and culture of stool and urine. Forty-two patients were infected with intestinal parasites and 25 with Shigella organism. The findings are discussed and compared with findings of similar studies of enteric fever.

Adolescent↗