A clinical study of Kleine-Levin syndrome with evidence for hypothalamic-pituitary axis dysfunction.
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Adolescent↗
Biomedical subjects
S Malhotra
Publications and source records attributed to S Malhotra.
"Ideal" length of stay after colectomy: whose ideal?
PURPOSE: In response to external pressure to achieve an idealized length of stay after colon resection, a study was designed to define perioperative factors that significantly impact average length of stay (ALOS). METHODS: We retrospectively reviewed the records of 226 patients undergoing open colon resection from 1988 to 1995 to determine the effects of age, type of procedure, nature of the procedure (elective vs. emergency), and postoperative course on ALOS. Statistics were calculated by Student's t-test, chi-squared analysis, and analysis of variance. RESULTS: Average length of stay was 10 (range, 4-34) days, with a significant trend toward lower ALOS in recent years; ALOS in 1988 averaged 11 days, whereas in 1994, ALOS averaged 9 days (r2 = 0.118; P < 0.001). Patients younger than 65 years of age had an ALOS of 9 days vs. 11 days in patients older than 65 years (P = 0.0024). Patients with anastomoses on the right and left side had similar ALOS (8.5 vs. 9.1 days), whereas creation of a stoma was associated with a significantly higher ALOS (12.1 days; P < 0.00001). The need for postoperative nasogastric intubation (14.9 vs. 9.3 days) and the performance of emergency operations (12.2 vs. 6.5 days) were also associated with a significantly higher ALOS (P < 0.00001). CONCLUSIONS: Caution must be exercised in accepting rigid criteria for length of stay for patients undergoing colorectal resections, as uncontrollable clinical variables are involved in defining the "ideal" patient.
Age Factors↗
Anti-invasive activity of alkaloids and polyphenolics in vitro.
Invasiveness, the ability of certain tumour cells to migrate beyond their natural tissue boundaries, often leads to metastasis, and usually determines the fatal outcome of cancer. The need for anti-invasive agents has led us to search for possibly active compounds among alkaloids and polyphenolics. One hundred compounds were screened in an assay based on the confrontation of invasive human MCF-7/6 mammary carcinoma cells with fragments of normal embryonic chick heart in vitro. Anti-invasive activity was frequently found among chalcones having a prenyl group. Six compounds were found to inhibit invasion when added to the culture medium at concentrations as low as 1 microM. For at least three of them the anti-invasive effect could be associated with a cytotoxic effect on the MCF-7/6 cells, but not on the heart tissue. This selective cytotoxicity was substantiated by different methods, such as histology and growth assays (volume measurements, cell counts, MTT and sulforhodamine B assays). The anti-invasive effects of the compounds could neither be ascribed to induction of apoptosis nor to the promotion of cell-cell adhesion. Our data indicate that among the alkaloids and polyphenolics a number of molecules can inhibit growth and invasion of human mammary cancer cells via selective cytotoxicity.
Alkaloids↗
Dietary and nutritional abnormalities in alcoholic liver disease: a comparison with chronic alcoholics without liver disease.
OBJECTIVE: To document the profile and role of malnutrition in alcoholic hepatitis, compared with chronic alcoholics and nonalcoholic chronic liver disease. METHODS: To this end, we studied 67 patients with alcoholic liver disease (ALD) (group I), 52 chronic alcoholics without histological evidence of liver disease (group II), 44 nonalcoholic cirrhotics (group III), and 52 healthy controls (group IV). Alcoholic and nonalcoholic calories were calculated and percentage dietary and nutritional deficiencies computed. Anthropometric indices, nitrogen balance, and immune status of the patients were assessed. RESULTS: Alcohol constituted about 48% of daily caloric intake in patients with ALD. The percentage mean intake of carbohydrate, protein, and energy was decreased in all three study groups compared with controls. The deficiencies were more pronounced in patients with severe than with moderate ALD. These deficiencies were more severe in the group III patients. Whereas body fat stores were maintained in groups I and II, reduction in lean body mass and serum transferrin was significant in patients in groups I and III. In group II patients compared to group I patients, the body mass index (19.9 +/- 4.0 vs. 22.3 +/- 3.4) and triceps skinfold thickness (6.1 +/- 4.8 vs. 10.2 +/- 5.6 mm) were significantly lower. CONCLUSIONS: 1) protein energy malnutrition is common in both alcoholic and nonalcoholic cirrhotics, but is more pronounced in the latter; 2) the degree and profile of malnutrition in chronic alcoholics and in alcoholic cirrhotics are comparable; 3) based on our results, we hypothesize that malnutrition may not play a primary role in the pathogenesis of ALD.
Adult↗
Psychosocial and biological aspects of acute brief psychoses in three developing country sites.
This study explored biological as well as psychosocial contributions to the incidence of acute brief psychoses in three developing country sites. The samples were taken from the five year follow-up data of the International Pilot Study of Schizophrenia sites in Ibadan, Nigeria and Agra, India, and from the Determinants of Outcome of Severe Mental Disorders rural Chandigarh site. Baseline narratives of the cases and controls were reviewed and rated for presence or absence of three exposures: fever, departure from or return to parental village (women), and job distress (men). Results showed an association between fever and acute brief psychosis in all three sites. There was an association between acute brief psychosis and departure from or return to the parental village among women in all sites, and among men, an association between job distress and acute brief psychosis was noted in Ibadan and Agra. These findings suggest that psychosocial and biological factors such as these three exposures merit further research to clarify their roles in the etiology of acute brief psychoses.
Acute Disease↗
Course and outcome of acute non-organic psychotic states in India.
This paper presents an overview of the diagnoses and short-term course of acute psychotic illnesses--affective as well as nonaffective--in a developing country setting. In the Chandigarh Acute Psychosis Study (CAPS) in Northern India, a cohort of 91 cases of acute psychotic illness were assessed for symptoms, diagnosis, and course ratings at multiple intervals over a 12 month period; cases were drawn from a rural and an urban clinic, permitting comparison of patients in these two settings. Non-affective (mainly schizophrenic) patients were found to be the predominant group (51%), followed by manic (26%), and depressive (19%) patients. Overall the acute psychoses had an excellent short-term course and outcome, a result which held across all diagnostic groups and both the rural and urban setting. Rural and urban patients were similar in diagnostic distribution and course of illness. Investigations of such cases can expand our view of the possible manifestations and course of psychotic disorders, and may have implications for diagnosis.
Acute Disease↗
Efficacy of low-dose alpha interferon therapy in HBV-related chronic liver disease in Asian Indians: a randomized controlled trial.
BACKGROUND/AIMS: Interferon therapy has been shown to be effective in Western patients with chronic hepatitis due to hepatitis B viral infection, but not in Asian Chinese. Its efficacy in Asian Indian subjects with chronic HBV infection is not known. METHODS: Forty-one patients with HBV-related chronic liver disease received randomly either: (a) recombinant alpha 2b interferon (n = 20) 3 MIU, subcutaneously, three times a week for 4 months, or (b) no treatment (n = 21). Patients were followed up for 12 months after completion of therapy. RESULTS: In the interferon-treated group, complete response (loss of HBV-DNA and HBeAg) was significantly higher than spontaneous clearance in the control group (50% vs. 4.8% p < 0.05). Seroconversion to anti-HBe was seen in 35% of the treated and 4.8% of the control group (p < 0.05) at 4 months; it was noticeably higher in patients with chronic hepatitis than in those with cirrhosis. In the responders, alanine aminotransferase levels nearly normalized. One year after interferon therapy, HBeAg and HBV-DNA clearance was observed in 65% of patients, with HBsAg clearance in 15%. Reactivation was not seen in any patient. Side-effects were transient and minimal. CONCLUSION: Low-dose recombinant alpha interferon therapy is quite effective and safe in Asian Indians with chronic liver disease due to hepatitis B infection.
Alanine Transaminase↗
Analysis of the murine ecotropic leukemia virus receptor reveals a common biochemical determinant on diverse cell surface receptors that is essential to retrovirus entry.
Two residues, tyrosine 235 and glutamic acid 237, of the ecotropic murine leukemia virus receptor (ATRC1) have been shown to be essential for receptor-mediated virus envelope binding and entry. We performed genetic analyses to examine the biochemical contribution of these residues in a productive virus-receptor interaction. Altered ATRC1 receptors bearing either a phenylalanine, a tryptophan, a histidine, or a methionine at position 235 mediated ecotropic virus entry comparable to that mediated by ATRC1. In contrast, altered ATRC1 receptors bearing alanine, threonine, serine, or proline at position 235 exhibited a 300- to 10,000-fold decrease in receptor capability. Furthermore, substitution of tyrosine or phenylalanine into the corresponding position (242) of the homologous human protein that lacks ecotropic virus receptor capability resulted in acquisition of ecotropic virus receptor function comparable to that of ATRC1. Substitution of a tryptophan or a histidine at that position of the human protein, however, resulted in a much-reduced receptor capability, suggesting a preference for a benzene ring in the hydrophobic side chain. A similar analysis of proteins substituted at position 237 revealed that aspartic acid, but not arginine or lysine, can functionally substitute for glutamic acid 237 in ATRC1 or at the corresponding position in the human protein. These results suggest a requirement for an acidic and a nearby hydrophobic amino acid for efficient ecotropic virus entry. Similar motifs have been identified in the virus binding sites of other retrovirus receptors, suggesting that the initial step of retrovirus entry may be governed by a common mechanism.
3T3 Cells↗
Cavernous hemangioma of the uterus.
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Adolescent↗
Atrioventricular asystole as a manifestation of hiccups.
Sinus pause with atrioventricular asystole can be caused by an excessive vagal response. This case report describes a patient in whom this phenomenon developed after hiccups.
Atrioventricular Node↗
Interactions of thyroid hormone receptor with the human immunodeficiency virus type 1 (HIV-1) long terminal repeat and the HIV-1 Tat transactivator.
Thyroid hormone (T3) receptor (T3R) regulates the human immunodeficiency virus type 1 (HIV-1) long terminal repeat (LTR) by binding to and activating thyroid hormone response elements (TREs) embedded within the viral NF-kappa B and Sp1 motifs. The TREs within the NF-kappa B sites are necessary for activation by T3 in the absence of Tat, while those in the Sp1 motifs function as TREs only when Tat is expressed, suggesting that Tat and T3R interact in the cell. Transactivation of the HIV-1 LTR by T3R alpha and several receptor mutants revealed that the 50-amino-acid N-terminal A/B region of T3R alpha, known to interact with the basal transcription factor TFIIB, is critical for activation of both Tat-dependent and Tat-independent responsive sequences of the LTR. A single amino acid change in the highly conserved tau 1 region in the ligand-binding domain of T3R alpha eliminates Tat-independent but not Tat-dependent activation of the HIV-1 LTR by T3. Ro 5-3335 [7-chloro-5-(2-pyrryl)-3H-1,4-benzodiazepin-2(H)-one], which inhibits Tat-mediated transactivation of HIV-1, also inhibits the functional interaction between Tat and T3R alpha. Binding studies with glutathione-S-transferase fusion proteins and Western (immunoblot) analysis indicate that T3R alpha interacts with Tat through amino acids within the DNA-binding domain of T3R alpha. Mutational analysis revealed that amino acid residues in the basic and C-terminal regions of Tat are required for the binding of Tat to T3R alpha, while the N terminus of Tat is not required. These studies provide functional and physical evidence that stimulation of the HIV-1 LTR by T3 involves an interaction between T3R alpha and Tat. Our results also suggest a model in which multiple domains of T3R alpha interact with Tat and other factors to form transcriptionally important complexes.
Antiviral Agents↗
Delineation of acute and transient psychotic disorders in a developing country setting.
BACKGROUND: We examined whether acute transient psychoses can be distinguished from schizophrenia and the affective disorders. METHOD: We studied 46 cases of nonaffective acute psychosis in the Chandigarh Acute Psychosis Study. With respect to separation from schizophrenia, we examined the distribution of duration of the episode. With respect to separation from affective disorders, we assessed the frequency of affective symptoms. RESULTS: Duration was bimodal, suggesting the presence of two distinct conditions of short and long duration. Affective symptoms were minimal, suggesting that these were not atypical affective syndromes. CONCLUSIONS: Acute transient psychoses conform neither with schizophrenia of brief duration nor with atypical affective psychosis, and thus require separate classification as proposed in the ICD-10.
Acute Disease↗
A novel intermediate filament-associated protein: further characterization of the G.3.5 antigen.
Several novel intermediate filament-associated proteins (IFAPs) have been discovered using hybridoma technology on multiple sclerosis plaque tissue. One of these, designated the G.3.5 antigen, is a desmin-binding IFAP in skeletal and cardiac muscle. It has been suggested that because of sequence similarities to alpha-actinin the G.3.5 antigen is an alpha-actinin-like protein which may cross-link actin and intermediate filaments in the cytoskeleton. In this study, it is reported that (1) the G.3.5 antigen is present in hepatocytes in addition to the previously described astrocytes, skeletal and cardiac myocytes, fibroblasts, and several other non-nervous tissues; (2) in myocytes and hepatocytes, the G.3.5 and alpha-actinins do not co-localize; (3) by transmission electron microscopy the G.3.5 antigen appears to be a rod-shaped dimer similar to alpha-actinin; (4) isolation of the G.3.5 antigen does not simultaneously isolate alpha-actinin; and (5) limited proteolysis of the G.3.5 antigen and alpha-actinin generates dissimilar maps. In binding studies, alpha-actinin cross-links actin but has no effect on desmin; the G.3.5 antigen does not appear to cross-link actin, desmin or mixtures of both under the assay conditions. These results support the hypothesis that the G.3.5 antigen is a novel IFAP related to alpha-actinin, but do not support a role for the antigen as a cross-linker between intermediate filaments and actin.
Actinin↗
Knowledge of asthma among parents of asthmatic children.
The knowledge and attitude towards asthma, of parents, of 85 asthmatic children was assessed using a 17 item questionnaire. Results showed that 34.1% believed asthma to be contagious, 48.2% of the parents hesitated in referring to their child's illness as asthma. Other commonly held beliefs were that asthma is a life long illness (35.3%); food items are important precipitating factors for acute attacks (88.2%); mild exacerbations need to be treated with bronchodilators (6.3%); bronchodilators should be started at home before consulting a physician in case of an acute attack (61.2%); and cure of asthma is possible through modern drugs (30.6%) or through alternative systems of medicine (65%). Ninety one per cent of parents lacked an awareness of the side effects of anti-asthma medication. It is concluded that parental education through improved physician parent communication is necessary for enhancing the quality of care being provided to children with asthma, a fact also highlighted by the International Consensus Report on Management of Asthma.
Adolescent↗
Intellectual functions in childhood malignant disorders.
Our study was designed to compare the intellectual functions in 35 children with lymphoreticular malignancies (ALL or NHL) who had received CNS directed therapy (Group A), with those in 21 patients with solid tumors (Group B). Intellectual assessment was done using the Malin's modification for Indian children of the Wechsler's intelligence scale. Using 5 verbal and performance subscales each, the verbal IQ, performance IQ and full scale IQ were derived. The mean VIQ, PIQ and FIQ were comparable in the two groups with the differences not being statistically significant. However, the dispersion of IQ scores was greater in Group A with a larger number of subjects having scores of < 80. Similarly, the scores obtained in the arithmetic, digit-span, picture completion and block design subscales were lower in Group A. Mean IQ scores were significantly lower in children over the age of 10 years at diagnosis. Sex duration since diagnosis, disease free survival and treatment variables did not affect IQ scores. In conclusion, a cross-sectional evaluation of intellectual functions has revealed only minimal differences in children treated with chemotherapy and CNS directed therapy (ITMTX and RT) in comparison to those treated with chemotherapy alone.
Adolescent↗
Varied psychiatric manifestations of acute intermittent porphyria.
Acute Intermittent Porphyria (AIP) is an autosomal dominant metabolic disorder that has various psychiatric manifestations. This is a report of a case who had six brief psychotic episodes of varying nature within a 2-month period. The psychotic manifestations included catatonic stupor, hypomania, and delirium in different episodes. The management aspects of the case have been highlighted.
Acute Disease↗
A study of P300 in melancholic depression--correlation with psychotic features.
The relationship between delusions and hallucinations (psychotic features) in melancholic depression and auditory P300 was studied. Forty patients with melancholic depression as per DSM-III-R were studied, 20 of whom had hallucinations and/or delusions. The 20 patients of the two groups were individually matched on age, gender, sociodemographic variables, and psychopathology (except for psychotic features). Auditory P300 obtained by the "oddball paradigm" showed that those with hallucinations and/or delusions had a significantly smaller P3 amplitude. Significant correlations between "psychotic features" and P3 amplitude was found. Implications of these findings on research, classification, and management of depression have been outlined.
Acoustic Stimulation↗
A quantitative microbiological study of bacterial vaginosis.
A quantitative microbial study of vaginal secretions from 100 women with bacterial vaginosis (BV) and 50 healthy women matched for age, was undertaken. This was aimed at comparing the bacterial flora colonising the vagina of sexually active asymptomatic women with those with BV and correlating bacterial counts with presence of symptoms. Of the total 475 bacteria isolated anaerobes were predominant among controls and among patients aerobes and anaerobes had equal prevalences. The increased viable counts of all anaerobes (> 10(7) cfu/g) were related with symptoms. Mobiluncus mulieris could be isolated from one patient and Chlamydia trachomatis antigen was absent in all samples tested. Bacteroides, G. vaginalis and Ureaplasma urealyticum were found to be the most commonly occurring group in women with BV. Lactobacillus, and probably Coryneforms have a protective role in health, preventing disease.
Adolescent↗