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Biomedical subjects

S Jain

Publications and source records attributed to S Jain.

At least 19 recordsLinked to original sources
PubMed2007

Bilateral posterior dislocation of the crystalline lens after a head injury sustained during a seizure.

This article presents a case of bilateral posterior dislocations of the crystalline lens in a patient with epilepsy who presented with reduced vision and anisocoria 2 weeks after having sustained head injuries during a seizure. The possibility of lens dislocation was raised only at this time, and subsequently confirmed on computed tomography. Such patients may require prompt referral to the ophthalmologist to treat complications such as functional aphakia, uveitis and more seriously pupillary block glaucoma. This case highlights the importance of ocular examination of head injuries to rule out possible ophthalmological pathology.

Emergencies↗
PubMed2006

Major surgical trauma induces proteolysis of insulin-like growth factor binding protein-3 in transgenic mice and is associated with a rapid increase in circulating levels of matrix metalloproteinase-9.

BACKGROUND: The authors previously demonstrated a significant decrease in plasma levels of intact insulin-like growth factor binding protein-3 (IGFBP-3) after major open but not after laparoscopic-assisted surgery in humans. They postulated that this decrease may have an effect on postoperative tumor growth. It also has been shown that plasma levels of matrix metalloproteinase-9 (MMP-9), a protease capable of degrading IGFBP-3, are transiently increased after open colectomy in humans. The authors aimed to develop an animal model that would allow further study of the effect that surgical trauma has on plasma levels IGFBP-3 and MMP-9. In addition, they set out to assess the concentration of MMP-9 in circulating monocytes before and after surgery. METHODS: The 30 mice included in this study were divided into three groups: sham laparotomy, carbon dioxide (CO2) pneumoperitoneum, and anesthesia control. All mice were IGFBP-3 transgenics (overexpressing human IGFBP-3) on a CD1 background. The mice were anesthetized using ketamine and xylazine. Blood was drawn retroorbitally 48 h before the procedure. The duration of the procedure was 30 min. The animals were killed 24 h postoperatively and blood was drawn. Intact IGFBP-3 levels were measured using a combination of Western blot analysis and enzyme-linked immunoassay (ELISA) at the two time points: before and after the operation. Plasma and peripheral blood mononuclear cell levels of MMP-9 were measured at each time point using zymography. Mononuclear cell lysates were used to determine intracellular MMP-9 levels. RESULTS: Plasma levels of intact IGFBP-3 were significantly lower than preoperative levels after sham laparotomy. A mean decrease of 76.6% was noted (p < 0.05). Zymography demonstrated significantly higher plasma MMP-9-related proteolytic activity than observed preoperatively after sham laparotomy (78.5 vs 42.3 Relative Units [RU]; p < 0.05). In the pneumoperitoneum group, no significant decrease was found between the pre- and postoperative levels of intact IGFBP-3. A nonsignificant increase in MMP-9 was noted after CO2 pneumoperitoneum (38 RU preoperatively vs. 46.4 RU postoperatively; p > 0.05). The anesthesia control group did not demonstrate a significant change in either circulating intact IGFBP-3 levels or MMP-9 levels. Mononuclear intracellular levels of MMP-9 were significantly lower after laparotomy than the preoperative levels (3 vs 37 RU). The postprocedure intracellular levels of MMP-9 were not significantly decreased in the pneumoperitoneum or anesthesia control group. CONCLUSION: Plasma levels of intact IGFBP-3, a cell growth regulating factor, were found to be decreased significantly after laparotomy. This decrease was not seen after pneumoperitoneum. Depletion of intact IGFBP-3 after laparotomy correlated with a rapid release of MMP-9 from mononuclear cells and an increase in circulating plasma MMP-9 levels. Matrix metalloproteinase-9 may play an important role in IGFBP-3 proteolysis after surgical trauma. Furthermore, circulating mononuclear cells are one source of MMP-9 after surgery. Finally, the model used reproduces events in humans after surgery, and thus should permit further study on the mechanism of IGFBP-3 proteolysis after surgical trauma.

Animals↗
PubMed2006

Evidence of linkage and association on 18p11.2 for psychosis.

The genetic basis of bipolar disorder (BPD) and schizophrenia (SCZ) has been established through numerous clinical and molecular studies. Although often considered separate nosological entities, evidence now suggests that the two syndromes may share some genetic liability. Recent studies have used a composite phenotype (psychosis) that includes BPD, SCZ, psychosis not otherwise specified, and schizoaffective disorder, to identify shared susceptibility loci. Several chromosomal regions are reported to be shared between these syndromes (18p, 6q, 10p, 13q, 22q). As a part of our endeavor to scan these regions, we report a positive linkage and association finding at 18p11.2 for psychosis. Two-point linkage analysis performed on a series of 52 multiplex pedigrees with 23 polymorphic markers yielded a LOD score of 2.02 at D18S37. An independent set of 159 parent offspring trios was used to confirm this suggestive finding. The TDT analysis yielded support for association between the marker D18S453 and the disease allele (chi2 = 4.829, P < 0.028). This region has been implicated by several studies on BPD [Sjoholt et al. (2004); Mol Psychiatry 9(6):621-629; Washizuka et al. (2004); Biol Psychiatry 56(7):483-489; Pickard et al. (2005); Psychiatr Genet 15(1):37-44], SCZ [Kikuchi et al. (2003); J Med Dent Sci 50(3):225-229; Babovic-Vuksanovic et al. (2004); Am J Med Genet 124(3):318-322] and also as a shared region between the two diseases [Ishiguro et al. (2001); J Neural Transm 108(7):849-854; Reyes et al. (2002); Mol Psychiatry 7(4):337-339; Craddock et al. (2005); J Med Genet 42(3):193-204]. Our findings provide an independent validation of the above reports, and suggest the presence of susceptibility loci for psychoses in this region.

Chromosomes, Human, Pair 18↗
PubMed2006

Septic arthritis of the small joints of the hand.

Twenty-five patients with sepsis of 26 hand joints were treated by urgent debridement, antibiotics and early hand therapy. We reviewed 15 patients (16 joints) in a clinic and three patients by postal questionnaire after a mean follow-up of 54 (range 10-94) months. Of the 26 involved joints, 14 had restricted motion at discharge. Stiffness increased with increase in delay between onset and treatment. At final review, one joint with painful degenerative changes had been fused. Seven patients had regained full movements. The remaining six had some stiffness but, nevertheless, had undergone significant improvement in the ranges of movement. There were two cases with radiological joint degeneration in this group of six patients. Three patients had mild, intermittent pain. No patient had significant disability. While there is significant loss of motion after this joint pathology in the early recovery period, overall motion and function appears to improve over the longer term.

Activities of Daily Living↗
PubMed2006

Association of CYP2D6 100 C > T and 2850 C > T polymorphisms with generalized tonic clonic seizures among Indians.

Multiple avenues of research have provided evidence for the role of genetic and environmental factors in epilepsy. Previous studies indicated an association of debrisoquine hydroxylase (CYP2D6) with susceptibility to epilepsy. In this study, association of CYP2D6 100C > T and 2850C > T polymorphisms with generalized tonic clonic seizures (GTCS) among Indians has been analysed using case-control approach. A significant association of 2850C > T (P = 0.015) has been observed. Comparison between phenytoin toxic and others among patients showed no association of these polymorphisms with phenytoin toxicity.

Adult↗
PubMed2006

Persistence and the random bond Ising model in two dimensions.

We study the zero-temperature persistence phenomenon in the random bond +/-J Ising model on a square lattice via extensive numerical simulations. We find strong evidence for "blocking" regardless of the amount disorder present in the system. The fraction of spins which never flips displays interesting nonmonotonic, double-humped behavior as the concentration of ferromagnetic bonds is varied from zero to one. The peak is identified with the onset of the zero-temperature spin glass transition in the model. The residual persistence is found to decay algebraically and the persistence exponent theta(p) approximately = 0.9 over the range 0.1< or =p< or =0.9. Our results are completely consistent with the result of Gandolfi, Newman, and Stein for infinite systems that this model has "mixed" behavior, namely positive fractions of spins that flip finitely and infinitely often, respectively. [Gandolfi, Newman and Stein, Commun. Math. Phys. 214, 373 (2000).].

Journal Article↗
PubMed2006

Altered plasma matrix metalloproteinase-9/tissue inhibitor of matrix [corrected] metalloproteinase-1 concentration during the early postoperative period in patients with colorectal cancer.

BACKGROUND: The authors have previously demonstrated that insulin-like growth factor binding protein-3 (IGFBP-3) is depleted in plasma for 1 to 3 days after major open surgery (OS), but not after laparoscopic surgery (LS). After surgery, IGFP-3 cleavage occurs rapidly and is likely attributable to altered plasma proteolytic activity. This study aimed to assess plasma proteolysis after both open and closed colorectal resection and, if possible, to identify a protease/protease inhibitor system affected by surgery. METHODS: Plasma from 88 patients with colorectal cancer (stages I-III) who underwent resection was obtained preoperatively (pre-OP) and on postoperative days (POD) 1 to 3. Plasma proteolytic activity was assessed via zymography. On the basis of the results, specific protease and protease inhibitor concentrations were next measured via enzyme-linked immunoassay (ELISA). Statistical analysis was performed using Wilcoxon's test. RESULTS: Early after surgery, zymography showed a predominant band representing a 92-kDa gelatinase corresponding to a proform of matrix metalloproteinase-9 (MMP-9), a protease known to cleave IGFBP-3. In OS patients, the mean concentration of plasma MMP-9 was significantly higher on POD 1 than at pre-OP (p < 0.003). On POD 2 and 3, no differences were noted. In the LS group, the mean levels of MMP-9 before and after surgery were comparable. The levels of a natural MMP-9 inhibitor, tissue inhibitor of metalloproteinase-1 (TIMP-1), also were measured. In the OS group, the level of TIMP-1 was significantly higher on POD 1 (p < 0.0003) and POD 2 (p < 0.01) and 3 (p < 0.01) than at pre-OP. In the LS group, a smaller but significant increase in TIMP-1 levels was found between the pre-OP sample and the POD 1 (p < 0.01) and POD 2 (p < 0.01) samples. No difference was noted on POD 3 (p = 0.1). CONCLUSIONS: Open surgery, but not laparoscopic surgery, is accompanied by a short-lived significant increase in MMP-9 levels, which likely accounts for the decrease in IGFBP-3 levels observed after OS. The transitory nature of MMP-9 imbalance may be attributable to the increase in TIMP-1 levels postoperatively.

Adenocarcinoma↗
PubMed2006

Revisiting reliability of quantified perineal ultrasound: Bland and Altman analysis of a new protocol for the rectangular coordinate method.

AIMS: This study tested the reliability of a new protocol for the rectangular coordinate method of quantifying perineal ultrasound. METHODS: Representative scans of healthy primiparous females were quantified by positioning a pubic bone template, drawn onto an acetate sheet containing x-y axes, over scans, by aligning the x-axis with the pubic bone central axis. Values for x (D(x)) and y (D(y)) located the urethrovesical junction (UVJ) at Rest, and at maximal Valsalva and Kegel. Range of motion (V-K) was calculated. Bland and Altman analysis, correlations, and t-tests determined intra- and inter-rater reliability, and variance due to designation of the pubic bone central axis (template control). RESULTS: Correlations averaged 0.72, 0.70, and 0.92 for intra-rater, inter-rater, and template control experiments. D(x) Rest, D(x) Kegel, and V-K were reliable in all experiments. First and second measures for inter-rater D(y) Rest and D(y) Kegel, and template control D(y) Valsalva were significantly different. Bland and Altman analysis showed D(y) Rest, D(y) Kegel, and D(x) and D(y) Valsalva for both reliability experiments to have limits of agreement (LOA's) large enough to explain >or=50% of the actual value ranges. Template control LOA's explained <or=30% of the actual value ranges. CONCLUSIONS: The reliability of this protocol varied according to the conditions analyzed; accurate reliability assessment of all conditions required Bland and Altman analysis; and the designation of the pubic bone central axis remained a source of variance between investigators. Our results suggest Bland and Altman analysis be used with each study that quantifies perineal ultrasound.

Adult↗
PubMed2006

Drusen classification in bilateral drusen and fellow eye of exudative age-related macular degeneration.

AIM: To assess the value of the modified international classification system in screening high-risk patients with bilateral age-related maculopathy (ARM) from those with lower risk characteristics. METHODS: In total, 164 digital images of 106 patients with either bilateral ARM (group A) or the fellow eyes of unilateral exudative age-related macular degeneration (AMD) (Group B) were included. Patients with no signs of ARM in both eyes or those with bilateral late AMD were excluded. The images were randomised and then graded by two masked ophthalmologists based on the modified International Classification of ARM. RESULTS: The interobserver consistency between the two graders was high with a Kappa value of 0.82 (SE 0.34, P<0.0001). There were no significant differences in the distribution of the stages of ARM between the two subgroups. Stage 3 was the most common stage in each group for both graders followed by stage 2a in the bilateral drusen group. Stages 1a, 2a and 2b were equally the next common stage in the fellow eye of chordial neovascularisation group. CONCLUSION: A screening system based on clinical characteristics would be of value in risk prediction in a clinical setting. Type of Drusen alone, as identified by the modified International grading system, may not be reliably predictive in screening for patients who are at high risk of developing choroidal neovascularisation.

Choroidal Neovascularization↗
PubMed2006

Screening for age-related macular degeneration using nonstereo digital fundus photographs.

UNLABELLED: Age-related macular degeneration (AMD) is a disease with significant visual morbidity and accounts for the majority of blind registrations in the developed world including the UK. Certain forms of neovascular AMD are amenable to treatment but require expeditious referral to a retinal specialist. AIM: To evaluate the possibility of using nonstereo fundus photographs as a low-cost screening tool for neovascular AMD. DESIGN: Retrospective review of patients referred to the macular clinic of a teaching hospital in London. METHODS: A total of 198 randomised digital fundus photographs, without any other clinical information, were presented to two independent ophthalmic interns who graded them into one of the three categories: normal, age-related maculopathy (ARM), or neovascular age-related macular degeneration (AMD) to determine the urgency of referral to clinic. The results were compared with the known diagnosis for each patient and sensitivities and specificities for each diagnostic category calculated. RESULTS: The intraobserver Kappa statistic was 0.75 and 0.91 for grader 1 and 2, respectively. The interobserver Kappa was 0.54. The mean sensitivity and specificity for the identification of ARM was 60.5 and 76.3%, respectively The mean sensitivity and specificity for the identification of AMD was 85.7 and 78.8%, respectively. CONCLUSION: Nonstereo digital fundus photograph is a reasonable screening tool for CNV and may aid in decreasing the visual morbidity it causes by enabling timely referrals and treatment.

Choroidal Neovascularization↗
PubMed2006

Breast cancer in pregnancy.

Breast cancer in pregnancy is rare with an incidence of 1:3,000 to 1:10,000 and is the second most common after cervical cancer. The outlook for such patients is less favourable than that of non- pregnant women probably because the stage of the disease is more advanced when it is discovered and also due to delay in therapy. The need for prompt treatment presents a clinical dilemma of considerable magnitude as there is always a conflict between optimal maternal therapy and the resultant risks imposed on fetal well-being. In the absence of a standardised protocol for management, this review focuses on the issues of diagnosis and treatment of breast cancer in pregnancy. Relevant current literature using Medline search strategy was examined.

Breast Feeding↗
PubMed2006

Madmen and specialists: the clientele and the staff of the Lunatic Asylum, Bangalore.

The history of the asylum has proven to be an invaluable resource for exploring the interface between science, medicine, religion and social and political processes. The definitions of insanity have troubled humans for centuries, as have the methods for treatment. Diverse, and often conflicting, ideological positions are quite common. Documenting the specific histories of the staff and patients of an asylum can thus help us understand the evolution of the physical and the intellectual growth of psychiatry in India. In this endeavour, we have used the records of the Lunatic Asylum, Bangalore (later the All India Institute of Mental Health and subsequently the National Institute of Mental Health and Neurosciences [NIMHANS]) to explore the history of psychiatry in India. The only asylum maintained by a 'Native Kingdom', it exemplifies the dynamics of the growth of mental health services in the country. We trace the changes in administrative control of the Asylum, the changes in medical practice and some aspects of the social history of the region. This article traces the history of psychiatry at one institution, which, at the micro level, is a mirror to the understanding of the historical trends of psychiatric services in India.

Catchment Area, Health↗
PubMed2006

Infection in a neonate caused by Pichia fabianii: importance of molecular identification.

Pichiafabianii, an uncommon yeast species recovered from clinical specimens, was documented as the cause of an infection in a 5-week-old female twin delivered at 25 and 3/7 weeks. She developed respiratory distress syndrome and necrotizing enterocolitis. At the time of the infection, she was febrile, thrombocytopenic, and still was requiring minimal ventilatory support. Blood cultures drawn on two consecutive days were positive for a germ tube negative yeast. Phenotypic methods including carbohydrate fermentations and assimilations (API 20C AUX) did not identify the yeast. Sequencing of D1/D2 domain of the large subunit rDNA was performed in one laboratory and sequencing a subunit of D2 performed in a second laboratory identified the yeast as P. fabianii. The organism was susceptible in vitro to amphotericin B, fluconazole and 5-fluorocytosinc. The patient responded to amphotericin B and removal of her vascular catheter. This case illustrates that there are an increasing number of fungi that may be pathogenic. Phenotypic tests may fail to identify them, emphasizing the need for commercially available, molecular based assays for identification.

Amphotericin B↗
PubMed2006

Microwave-assisted rapid cyclization of lapachol, a main constituent of Heterophragma adenophyllum.

Cyclization reactions of lapachol (1) isolated from Heterophragma adenophyllum have been studied under microwave irradiation under different conditions using alumina (acidic, basic and neutral)/silica gel/montmorillonite (KSF and K-10) as solid support along with neat reaction using 2-3 drops of DMF giving naturally occurring dehydro-alpha-lapachone (2), alpha-lapachone (3), beta-lapachone (4) depending upon the nature of support and irradiation time. A novel naphthoquinone derivative adenophyllone (5) can be synthesized from lapachol using DMF under microwaves.

Bignoniaceae↗