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Biomedical subjects

S K Mathur

Publications and source records attributed to S K Mathur.

At least 19 recordsLinked to original sources

Mannose-resistant haemagglutination by Campylobacter jejuni--a preliminary communication.

Ten strains of C. jejuni each isolated respectively from patients with diarrhoea and from chicken intestine (10 strains from each source) were examined for presumptive colonization factor(s) by measuring their cell surface hydrophobicity and haemagglutination. None of the strains expressed cell surface hydrophobicity. However, 14 strains (7 from either source) showed variable haemagglutination pattern with human, sheep and rabbit erythrocytes in the presence of 0.5 per cent D-mannose. Thus, mannose resistant haemagglutinin(s) may be involved in the colonization of intestinal mucosal surfaces by C. jejuni.

Animals

Cholescintigraphic detection of biliary leaks.

We report four cases in whom post-traumatic or post-surgical biliary leak was detected using dynamic 99mtechnetium-iminodiacetic acid (IDA) cholescintigraphy. This technique is a non-invasive, safe, simple and sensitive method of documenting the presence, location and extent of biliary leaks. Further, it can be repeated and hence, is useful in evaluating the response to treatment. Surgery is indicated when a moderate extravasation of labeled bile suggests that the leak is the chief pathway of bile drainage, with relatively little bile entering the intestine.

Adult

Resistant coagulase negative staphylococci from clinical samples.

Antibiotic susceptibility testing against 17 antibiotics was done on 96 strains of various species of coagulase negative staphylococci by Stokes method. Hundred per cent sensitivity was found against vancomycin and cefotaxime and about 90 per cent against ciprofloxacin, clavulanate potentiated amoxycillin, cloxacillin and clindamycin. Strains showed highest resistance against cotrimoxazole (77.08%) and tetracycline (64.59%). Clavulanate potentiated amoxycillin was found to be highly active against penicillin, ampicillin and amoxycillin resistant organisms. The results highlight the importance of antibiotic resistance typing among coagulase negative staphylococci species which are increasingly being reported from serious clinical infections making empiric therapy and selection of antibiotics difficult in these infections.

Anti-Bacterial Agents

Endoscopic and radiological appraisal of gastric varices.

Of 104 patients with portal hypertension who were subjected to oesophageal variceal sclerotherapy, gastric varices were seen in 81 (78 per cent) at endoscopy and 69 (74 per cent) at splenoportography. In 50 (48 per cent) patients gastric varices were seen at the initial endoscopic examination and in 31 they developed during follow-up at intervals varying from 1 to 56 weeks. Gastric varices were seen significantly more often along the lesser curvature than in the gastric fundus and the left gastric vein was the main feeding vessel in 75 per cent of cases. Varices bled in nine of 81 patients and bleeding was seen significantly more often from fundal varices (30 per cent) than from lesser curve varices (5 per cent) (P less than 0.02). The incidence of gastric varices is high, and contrary to popular belief they are more often located along the lesser curvature of the stomach than in the gastric fundus.

Adolescent

Pneumatic dilatation in achalasia cardia results and follow-up.

Pneumatic dilatation is one of the more recent methods in the management of achalasia cardia. Fifty dilatations were done in 42 patients with achalasia cardia over 5 years. There was a significant decrease in the maximum diameter of the oesophagus and a significant increase in diameter in the narrowed lower oesophageal segment in all the patients. Of the patients studied, 95.23% were relieved of their symptoms after only one to two sessions. There were no immediate complications. Out of the 38 patients on long term follow up, 8 (21.05%) had recurrence of symptoms. On repeat dilatations, 4 (50%) of them had good response. Late complication like reflux oesophagitis was observed in only 1 patient over a median follow up period of 22 months. It was thus concluded that pneumatic dilatation is a safe, simple and effective procedure in managing patients with achalasia cardia.

Adult

Potassium induced insulin release from isolated islet of Langerhans of albino rats.

The secretory effect of Potassium (K+) on endocrine pancreas was studied using collagenase digested isolated islets of Langerhans. Isolated islets of Langerhans incubated in KRB containing 5 15, 30 and 45 mM, quantity of additional K ions caused the release of insulin from beta-cells (significant release of insulin, P less than 0.01, at 15, 30 and 45 mM K+ in presence of 2.8 mM glucose and at 30 mM K in presence of 16.7 mM glucose). But lysosomal AP and CB enzymes did not record proportionate change. Thus a definite stimulation in the release of insulin without significant change in AP and CB were seen.

Animals

Endoscopic removal of retained bile duct calculi via T-tube tract.

A simple and safe technique for removal of retained bile duct calculi using a flexible fibreoptic choledochoscope and rigid nephroscope via the T-tube tract has been described. The technique allowed removal of large impacted calculi under direct vision without damage to the bile duct.

Endoscopy

Comparative trial of three different schedules for endoscopic esophageal variceal sclerotherapy.

We analyzed our experience in 125 patients with variceal bleeding to compare the efficacy and complications of various schedules of endoscopic variceal sclerotherapy. The schedules for the first three injections were as follows: (A) 3-5 ml of aqueous phenol injected at intervals of three weeks (Group I, n = 28), one week (Group II, n = 30) and three days (Group IIIa, n = 33), and (B) 2-3 ml of phenol at each site at intervals of 3 days (Group IIIb, n = 34). Subsequent injections were given at four week intervals for all groups. Varices could be obliterated significantly earlier (p less than 0.001) in patients injected at 3-day intervals (mean +/- SD 9.12 +/- 5.95 weeks) as compared with those injected at 1-week (13.50 +/- 10.28 weeks) and 3-week (20.55 +/- 7.77 weeks) intervals. The rebleeding rate was not significantly less in the 3-day interval group (Group IIIa--16.66% and Group IIIb--17.64%) as compared with the 1-week (23.3%) and 3-week (28.5%) groups. However the mortality due to rebleed was significantly less (p less than 0.05) in patients injected at 3-day interval (nil), as compared with those injected at 1-week (13.3%) and 3-week (10.7%) intervals. Mucosal ulcerations and stricture formation were observed significantly (p less than 0.001) more frequently in patients undergoing sclerotherapy at 3-day intervals (Group IIIa--51.5% and 18.18%) with 3-5 ml of phenol as compared with those injected similar volume at 1-week (16.66% and 3.3%) and 3-week (7.1% and 3.5%) intervals respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Morphological changes in esophagus following endoscopic sclerotherapy with 3% aqueous phenol.

Autopsy studies have shown that a majority of sclerosants presently used for endoscopic variceal sclerotherapy achieve their end result by a process of necrotizing inflammation of the esophageal wall followed by fibrosis and thrombosis, rather than bland thrombosis of varices. We have been using 3% phenol in water for variceal sclerotherapy and found it to be an effective sclerosant. To study the effect of this sclerosant on varices and the esophageal wall, autopsies were performed in 15 patients who died following sclerotherapy. Histopathological examination of sections from the esophagus showed (a) fresh thrombus in the varices immediately following injection, (b) intimal damage with medial sclerosis and superficial mucosal ulceration after one week, (c) organisation and recanalization with marked medial sclerosis at 3-4 weeks, and (d) complete obliteration of varices after 6-12 weeks. None of the patients was found to have esophageal necrosis, perforation or mediastinitis. Thus, 3% aqueous phenol appears to be an effective and safe sclerosant for variceal sclerotherapy.

Esophageal and Gastric Varices

An unusual case of endogenous aspergillus endophthalmitis.

Endogenous aspergillus endophthalmitis is not a common entity. So far, about 25 cases have been reported in the world literature, and to the best of our-knowledge, the crystalline lens was invaded by the fungus in none of the cases, as seen in the present case. This unusual feature, coupled with the rarity of the condition in general, made it worth reporting.

Anterior Chamber

Nerve injuries in neonates.

A clinical study of 40 cases of nerve injuries in neonates with one-year follow-up is presented. The total incidence of such injuries was 1.50%. Thirty-three cases sustained nerve injury due to obstetrical trauma and in 7 cases it was due to postnatal trauma like intragluteal injection and tight splintage. Almost in all cases there was history of prolonged or obstructed labour. Upper limb nerve injuries were commonest followed by facial palsy. Twenty-three cases (76%) showed complete recovery while 17% had partial and 7% no recovery at all. Hence nerve injuries are not uncommon in neonates. If managed properly the recovery is good. Intragluteal injection in the neonatal period should not be recommended.

Arm

Prognostic markers in upper gastrointestinal hemorrhage.

This study was undertaken to ascertain whether clinical and endoscopic factors can predict the outcome in patients with acute upper gastrointestinal hemorrhage. A total of 185 patients admitted with hematemesis over a 4-year period were studied. Clinical evidence of shock and hepatocellular dysfunction and hemoglobin level were noted on admission. Endoscopy was performed within 48 hours of admission to look for the site and number of lesions, and stigmata of hemorrhage. On analysis, age, clinical evidence of shock, hepatic dysfunction and hemoglobin less than 8.0 g/dl (80 g/L) were found to be significant in prediction of risk of further hemorrhage. Similarly age, past history of jaundice, previous bleeding episodes and clinical evidence of hepatic dysfunction were statistically significant predictors of mortality. Bleeding from varices and peptic ulcer was associated with a worse prognosis than acute mucosal lesions. It is concluded that clinical and endoscopic factors can be used to identify a group of patients at high risk of further hemorrhage and mortality.

Adolescent

Anti-secretagogue effect of lithium on isolated rat islets of Langerhans.

Administration of lithium carbonate solution (50 mg/kg, po, twice daily) to Charles Foster male albino rats for 45 consecutive days caused an intolerance to oral glucose. Inhibition in (pro)insulin biosynthesis followed by a significant fall in immunoreactive insulin release was seen in islets isolated from identically treated rats. As the activities of acid phosphatase and cathepsin B were unaltered, it is possible that the anti-secretagogue effect is sequential to inhibition of (pro)insulin biosynthesis by lithium.

Animals