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Biomedical subjects

S C Misra

Publications and source records attributed to S C Misra.

At least 19 recordsLinked to original sources

Spectrum of ulcerative colitis in north India.

We analyzed retrospectively the characteristics of 87 patients with ulcerative colitis seen in a tertiary care center in north India. Ulcerative colitis was diagnosed on the basis of clinical features, sigmoidoscopy, rectal biopsy, and exclusion of microbiological causes of colitis. Severe clinical disease was seen in 53 (60%) patients that correlated with extensive colonic involvement (p < 0.001), severe changes on sigmoidoscopy (p < 0.001) and histology (p < 0.001), erythrocyte sedimentation rate (ESR) of > 30 mm for the first hour, and serum albumin of < 3 g/dl (p < 0.001). Remission of the disease was maintained on sulfasalazine in 18 (20.7%) patients, whereas 47 (54%) required steroids. Proctocolectomy with ileoanal anastomosis was done in 22 (25.3%) patients in whom there was poor response to medical treatment. Postoperative complications were seen in seven (31.8%) patients, and death occurred in four (18.1%) patients. Ulcerative colitis thus commonly presents as severe disease, with the majority of patients requiring surgery due to poor response to medical therapy. This pattern of disease as seen in an academic referral hospital in north India is virtually indistinguishable from that seen in similar centers in the West. However, in our setting, proctocolectomy and ileoanal anastomosis is cost-effective in patients unresponsive to, or unable to afford, drug treatment.

Adult

A non-Newtonian fluid model for blood flow through arteries under stenotic conditions.

This paper presents an analytical study on the behaviour of blood flow through an arterial segment having a mild stenosis. The artery has been treated as a thin-walled initially stressed orthotropic non-linear viscoelastic cylindrical tube filled with a non-Newtonian fluid representing blood. The analysis is restricted to propagation of small-amplitude harmonic waves, generated due to blood flow whose wave length is large compared to the radius of the arterial segment. For the equations of motion of the arterial wall consideration is made of a pair of appropriate equations derived by using suitable constitutive relations and the principle of superimposition of a small additional deformation on a state of known finite deformation. It has been shown through numerical computations of the resulting analytical expressions that the resistance to flow and the wall shear increase as the size of the stenosis increases. A quantitative analysis is also made for the frequency variation of the flow rate at different locations of the artery, as well as of the phase velocities and transmission per wavelength.

Arterial Occlusive Diseases

Omeprazole versus famotidine in the healing and relapse of duodenal ulcer.

Sixty patients with symptomatic duodenal ulcer were randomized to receive either omeprazole (20 mg each morning) or famotidine (40 mg at night time) for 2-4 weeks in a double-blind parallel group clinical trial. Healing rates were higher with omeprazole in comparison with famotidine after 2 weeks (77% vs. 40%, P < 0.001) and 4 weeks (93% vs. 80%, P = 0.2) of treatment. Assessment of daily diary cards completed by all patients revealed that omeprazole rapidly relieved ulcer-related day pain and nocturnal pain in comparison to famotidine. Treatment with omeprazole for 2 weeks was also associated with lower cumulative antacid intake (P < 0.05) and reduced absenteeism from work. Helicobacter pylori infection was present in all patients and remained unaffected by treatment with either of the drugs. None of the drugs produced any significant adverse effects. During 6 months follow-up of all the patients after ulcer healing (without maintenance therapy), ulcer relapse was seen in 40% of omeprazole- and 37% of famotidine-treated patients (P > 0.1). The duration of ulcer-free period following initial healing of ulcer was also similar in both the groups (median time: 22 weeks for omeprazole, 21 weeks for famotidine). We conclude that omeprazole is superior to famotidine in rapidly healing duodenal ulcers and achieving more rapid pain relief, but does not influence subsequent ulcer relapse.

Absenteeism

Prospective controlled study of post-transfusion hepatitis after cardiac surgery in a large referral hospital in India.

We studied the risk of post-transfusion hepatitis (PTH) in recipients of blood collected from voluntary donors screened for HBsAg. Two hundred and fifty patients without any previous history of liver disease or transfusion were followed up for 12 months subsequent to cardiac surgery. Thirty-five of them had closed-heart surgery without receiving transfusion and served as controls. The remaining 215 patients received single-point transfusions (mean 4 +/- 2.4 units). None of the controls and 15 (6.9%) blood recipients developed PTH. Three (20%) patients had hepatitis-B-virus-induced hepatitis while the remainder (80%) had non A, non B (NANB) hepatitis. The number of units of blood transfused and surrogate markers for development of PTH (donor alanine aminotransferase, anti-HBc and anti-HBs antibody) were not associated with the occurrence of PTH (p greater than 0.05). Nine (60%) of the 15 patients developing PTH were asymptomatic. All the patients recovered from the PTH, except one who died of fulminant hepatitis. At the end of 1 year of follow-up, none of the patients had evidence of chronic hepatitis. Only three (25%) of the patients with NANB-PTH developed anti-hepatitis C virus (HCV) antibody during the follow-up. We conclude that the incidence of PTH in India is similar to other parts of the world and NANB virus was the major cause of the PTH. The absence of chronicity and lack of seroconversion to anti-HCV antibody in the majority of the patients after 1 year of follow-up may suggest the possibility of a NANB virus other than HCV as the major cause of PTH in India.

Adolescent

High prevalence & heterogenicity of thalassaemias in Orissa.

High incidence of alpha thalassaemias (estimated from detection of Hb Bart's from cord blood), Hb constant spring (CS) and high A2 beta thalassaemia trait (estimated from normal adult subjects) were detected in 12.6, 15 and 8 per cent people of coastal Orissa (with less than 5% tribal population) respectively. Quantitation of Hb Bart's suggest that the alpha thalassaemia could be any of the genotypes such as, -alpha/alpha alpha, -alpha/-alpha, --/alpha alpha and alpha alpha/alpha alpha cs. Both heterozygotes and homozygotes for Hb CS were identified.

Fetal Blood

Hyponatremia in elderly hospital in-patients.

In a prospective study hyponatremia was observed in 30 per cent of 100 elderly hospital in-patients, the serum sodium ranging from 106 to 129 mmol/l. In 67 per cent of the subjects symptoms were absent or non-specific, and the remainder had symptoms of altered sensorium without any focal neurological deficit. Hyponatremia was iatrogenic in 30 per cent, while 17 per cent had an underlying bacterial chest infection. Removal of the cause rapidly reversed hyponatremia and the relevant symptoms. It is stressed that early detection and reversal of this abnormality would significantly limit morbidity in the elderly.

Aged

Hepatoblastoma.

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Adult