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Biomedical subjects

S K Mehta

Publications and source records attributed to S K Mehta.

At least 19 recordsLinked to original sources

Hyperaggregation of platelets in intestinal tuberculosis: role of platelets in chronic inflammation.

Eighty-eight percent (38/43) patients of intestinal tuberculosis showed significant hyperaggregation of platelets (P < 0.001). Serum and plasma from 15 patients when incubated with normal platelets caused hyperaggregation. Gel filtered platelets from 2 patients suspended in normal plasma showed hyperaggregation of platelets with arachidonic acid. Tubercular protein had no effect on platelet aggregation. A role of hyperactive platelets in chronic inflammatory response is discussed.

Adolescent

Effect of mild malnutrition on disaccharidase activity and glucose uptake in intestinal brush border vesicles of growing monkeys.

BACKGROUND: The effect of severe malnutrition has been reported by some workers, but there is a paucity of information on milder forms even though 85% of pre-school children show evidence of mild to moderate malnutrition in India. METHODS: Mild to moderate protein energy malnutrition was induced in 12 monkeys, and 12 were kept as controls. After a 30-40% reduction in body weight as compared with their controls, the animals were killed, and brush border membrane vesicles were prepared from three small parts of the small intestine. Purified vesicles were used for the assay of lactase, sucrase, maltase and glucose uptake in vitro. RESULTS: The activity of lactase, sucrase, and maltase, and uptake of (U-14C)-D-glucose was decreased in all three parts of small intestine, and the lactose tolerance test result was also abnormal in the protein energy-malnourished group. On nutritional rehabilitation, the disaccharidase activities recovered completely. CONCLUSION: This study indicates that even mild to moderate malnutrition decreases the digestion and absorption of carbohydrates throughout the small intestine, and it should not be ignored during the developing stage.

Animals

Assessment of optimal dose of lactose for lactose hydrogen breath test in Indian adults.

To evaluate the possibility of using a 12.5 g or 25 g oral dose of lactose for hydrogen breath test for diagnosis of lactose intolerance instead of the usual 50 g dose. 35 patients with non-ulcer dyspepsia and an abnormal 50 g lactose breath hydrogen of more than 20 ppm over the base line were retested using 12.5 g and 25 g lactose. 32 (91.4%) and 15 (42.8%) of these 35 patients had an abnormal hydrogen breath test using 25 g (p = ns compared to 50 g dose) and 12.5 g (p < 0.001) lactose doses respectively. This study reveals that it may be possible to use a 25 g lactose dose instead of a 50 g dose for the lactose hydrogen breath test.

Breath Tests

Effect of protein energy malnutrition on the lipid composition and leucine uptake of small intestinal brush border vesicles of growing rhesus monkeys.

Mild to moderate protein energy malnutrition (PEM) was induced in young developing rhesus monkeys by giving them half of the casein-based synthetic diet which was given to control animals. After a body weight reduction of 30-40%, the PEM animals were sacrificed. The small intestine was removed, flushed with ice-cold saline, everted and divided into equal proximal, middle and distal segments. Brush border membrane vesicles (BBMV) were prepared from all three segments and assayed for marker enzymes, e.g. sucrase and alkaline phosphatase, to assess their purity. Sucrase was found to be purified 23-fold and alkaline phosphatase 12-fold compared to the respective homogenates in all three parts. In PEM animals, uptake of [U-14C]L-leucine into the BBMV was diminished in all three segments and cholesterol and phospholipid levels also decreased significantly. As a result there was an elevation in the molar ratio of cholesterol to phospholipid, and the sphingomyelin: phosphatidylcholine molar ratio also increased. This signified a decrease in lipid fluidity and amino acid uptake in PEM in the small intestine. Histologically, a mild to moderate grade of partial villus atrophy was observed in the intestine. The diminished uptake and lipid fluidity of the membrane and the histological changes returned to their control values after nutritional rehabilitation.

Alkaline Phosphatase

Differential tropism of EB rotavirus (serotype 3) to small intestine of homologous murine model.

The 4-5 days-old NMRI strain infant mice were orally inoculated with EB rotavirus (serotype 3). The intestinal disaccharidases activity was studied separately in three segments of the small intestine i.e. duodenum, jejunum and ileum on day 1 to 7 post inoculation (p.i.). The severity of EB rotavirus infection correlated with a significant decrease of small intestinal lactase, maltase and sucrase on day 3 p.i. The level of maltase after the initial decline increased in all the three segments of small intestine of infected mice. However, the lactase activity remained suppressed for a relatively longer period in ileum of infected mice than in controls. These enzymes began to approach to normal value by day 5 p.i., but in ileum, lactase activity continued to be severely depressed even on day 7 p.i. Rotavirus was consistently detected in intestinal contents by ELISA on days 1 to 7 p.i. The infected mice showed a significant increase in rotavirus (serotype 3)-specific serum IgG and IgM antibody level during the declining (days 5-7 p.i.) phase of infection. Diarrhoea was noted up to day 6 p.i. The protracted suppression of the lactase activity in ileum in comparison to duodenum and jejunum showed a differential tropism of EB rotavirus (serotype 3) strain to the small intestine of homologous murine model.

Animals

Fungal colonization of untreated peptic ulcer.

AIM: To evaluate the relationship between Candida and peptic ulcer. METHODS: One hundred consecutive patients with untreated peptic ulcer (81 with duodenal ulcer and 19 with gastric ulcer) were studied using histopathology, culture and fungal serology. Twenty subjects with non-ulcer dyspepsia were taken as controls. RESULTS: Forty seven patients (47%) with peptic ulcer were colonized by Candida as compared to 3 patients (15%) with non ulcer dyspepsia (p < 0.05). Confluent growth of Candida on culture of gastric aspirate or biopsy from ulcer edge was a more sensitive method for diagnosis of peptic ulcer-associated candidiasis than histological examination. There was no significant difference in the prevalence of Candida isolation in relation to age or sex of the patients, smoking habit and alcoholism. Large ulcers (> 2 cm) were, however, more often colonized by Candida (75%) than smaller ones (43%) (p < 0.05). Candida albicans was the commonest species isolated (60%). Invasive candidiasis was associated with Candida agglutinin titer of 1:128 in 81% of cases. CONCLUSION: Candida colonization rate in peptic ulcer is significantly higher than in non-ulcer dyspepsia.

Adolescent

Distribution of digestive enzymes in gastrointestinal tract of young rhesus monkeys.

The distribution of different mucosal digestive enzymes along the gastrointestinal tract of young rhesus monkeys were studied by biochemical analysis of homogenized specimen from 13 different segments (i.e. stomach-fundus, body, antrum; small intestine-D1, D2, proximal, middle, distal; caecum; colon-ascending, transverse, descending and rectum), obtained from 6 monkeys of approximate age 8-12 months. The activity of all the enzymes was lowest in gastric mucosa rising through duodenum to peak in small intestine and declining towards the large bowel. There was no significant difference in levels of any of the enzymes between different parts of stomach or large bowel. This study suggests that like humans in rhesus monkeys maximum activity of digestive enzymes is present in small intestine and much less in gastric and large bowel mucosa.

Animals

Double pigtail cystogastric stent in the management of pancreatic pseudocyst.

We describe placement of a double pigtail cystogastric stent in 5 patients with pancreatic pseudocyst using real-time ultrasonography and fluoroscopy as guidance techniques. This was done as a two-step procedure. First, a transgastric drainage catheter was placed for a period of six days. All the patients continued to have high drainage output and the cyst size decreased, as seen sonographically. Simultaneous barium meal and sinogram were then done to measure the distance between the posterior gastric wall and the cyst. A polyurethane double pigtail stent of appropriate size was then introduced to achieve cystogastric drainage. The cyst resolved in all the patients by four weeks to six weeks, when the stent was removed endoscopically. There was no recurrence of pseudocyst during follow-up for 6 months to 13 months. None of the patients suffered any complication. Cystogastric drainage using a double pigtail stent is an easy and safe alternative to surgical cystogastrostomy.

Adult

Esophageal strictures following endoscopic variceal sclerotherapy. Antecedents, clinical profile, and management.

We have evaluated 169 patients with portal hypertension receiving endoscopic variceal sclerotherapy in order to assess the predisposing factors, clinical profile, and treatment response of sclerotherapy-induced esophageal strictures. Of the 129 patients included in the final analysis, 20 (15.5%) developed persistent esophageal stricture. No significant difference was found with respect to age, nature of sclerosant (absolute alcohol, ethanolamine oleate, or sodium tetradecyl sulfate), etiology of portal hypertension, Child's class, initial variceal score, or intensity of sclerotherapy schedule between the patients who developed strictures and those who did not. However, female sex (P less than 0.01) and persistent esophageal ulceration (P less than 0.05) did predispose to stricture formation. Sclerotherapy-induced strictures presented with a variable grade of dysphagia, were always solitary, and were localized to the lower end of esophagus. Most of these could be dilated rapidly using Eder-Puestow metal olives (3.15 +/- 0.80 dilatation sessions per patient). Stricture formation did interrupt an effective sclerotherapy program but only temporarily, and successful variceal obliteration could be obtained after stricture dilatation.

Adolescent

Quantitation of immunoglobulin-containing cells in the jejunal lamina propria in tropical sprue.

Ten patients with tropical sprue (TS) and 10 with irritable bowel syndrome (IBS) as controls were studied to characterize the immunocytes in the jejunal mucosa. IgA cells numbered 516,155 +/- 48,715 cells/mm3 in TS and 729,308 +/- 146,011/mm3 in the IBS patients. IgG cell counts were 28,885 +/- 8,081/mm3 in TS and 10,615 +/- 4,100/mm3 in IBS; IgM counts were 170,729 +/- 25,015/mm3 in TS and 169,253 +/- 45,353/mm3 in IBS. A positive correlation was present between IgM-bearing plasma cells and corresponding serum immunoglobulins (r = +0.71; p less than 0.05). No correlation was evident between the different immunocytes (IgA, IgG, and IgM) and the duration of illness, serum albumin, and tests for absorption of fat, B-12, and D-xylose (p greater than 0.05). The gut immunocytes expressed in absolute numbers were higher in our controls and TS patients than reported in Western populations.

Adult

Colorectal carcinoma in Indian patients with idiopathic ulcerative colitis.

In contrast to reports from Western countries, the incidence of colorectal carcinoma among patients with idiopathic ulcerative colitis is considered to be low in the Indian subcontinent. In order to assess the risk of carcinoma in Indian patients, a retrospective analysis of 436 cases of idiopathic ulcerative colitis seen by us over a period of 12 years was carried out. Eight cases of colitis carcinoma (1.8%) were encountered during the study period. Pancolitis was present in six of them while colitis was of limited extent in two cases. The mean duration of colitis prior to development of carcinoma was 12.1 (range 7-25) years. While four of these patients were on our follow-up list and were diagnosed to have carcinoma at the time of a medical or surgical complication, four others first presented to us with a surgical complication of colitis carcinoma. We conclude that colitis carcinoma is not a rare entity among Indian patients with idiopathic ulcerative colitis. We feel that until proved otherwise, patients with idiopathic ulcerative colitis from the Indian subcontinent should not be denied the benefits of a cancer surveillance programme.

Adult

Specific antibodies in serum of patients with hydatidosis recognised by immunoblotting.

Hydatid fluids from sheep, goat, pig and man, after resolution by sodium dodecyl sulphate-polyacrylamide gel electrophoresis under reducing conditions, revealed at least 15 discrete polypeptide bands of 8-116 Kda. By ELISA, sera from all 20 cases of hydatidosis showed anti-hydatid antibody, but so did 11 (73%) of 15 sera samples from cysticercosis patients, eight (67%) of 12 sera from patients with other parasitic infections (amoebic liver abscess or hymenolepiasis) and one (4%) of 25 sera from healthy controls. Antibody to cysticercus antigen was found in 14 (93%) of 15 sera from cysticercosis patients, 17 (85%) of 20 sera from hydatid patients, six (50%) of 12 sera from patients with other parasitic infections and one (4%) of 25 sera from healthy controls. Sera from 17 (85%) of 20 hydatid patients, 11 (73%) of 15 cysticercosis patients and five (42%) of 12 patients with other parasitic infections had antibodies to both hydatid and cysticercus antigens. Sera from 20 surgically confirmed cases of hydatidosis reacted with 12 polypeptides of 8-116 Kda in Western immunoblot with hydatid antigens. Polypeptides of 16, 24, 38, 45 and 58 Kda were recognised by all hydatidosis sera but also by many sera from patients with other infections. However, polypeptides of 8 and 116 Kda were recognised by all hydatidosis sera but not by any sera from patients with cysticercosis, other parasitic infections or viral hepatitis, or from healthy controls. Thus, recognition of 8- and 116-Kda hydatid antigens by a patient's serum appears to be a specific test confirming a clinical diagnosis in an individual case of hydatidosis.

Animals

Optimal number of biopsy specimens in the diagnosis of carcinoma of the oesophagus.

The study evaluated 48 patients with carcinoma of the oesophagus to assess the optimal number of biopsy specimens required to obtain the highest yield. Eight specimens were obtained from each patient and two specimens were placed serially in each of four vials. The first vial provided a positive diagnosis in 95.8% of cases. The addition of two more specimens (second vial) increased the yield to 97.9% and the fifth and sixth specimens increased the positive yield to 100%. There was no statistically significant difference in the yield according to the site and the type of growth.

Adult