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Biomedical subjects

S N Bhagwati

Publications and source records attributed to S N Bhagwati.

At least 19 recordsLinked to original sources
PubMed2003

Idiopathic hypertrophic cervical pachymeningitis: a case report with 5 year follow up.

Idiopathic hypertrophic pachymeningitis is an extremely rare entity. It usually affects cranial meninges. The spinal form is further uncommon and presents as a chronic progressive disease. We describe a 42 year old female with isolated idiopathic hypertrophic cervical pachymeningitis who had a relapsing remitting course under observation for five years. Laminectomy and immunosuppressive therapy produced temporary and partial relief. The long term course and relevant literature is reviewed.

Adult↗
PubMed1999

Paediatric neurosurgery in India.

In a vast country like India, with children constituting 40% of a total population of 900 million people, the need and scope for paediatric neurosurgery is enormous. Initial organised attempts to focus attention on the need for paediatric neurosurgery as a subspecialty were made in 1983 and 1987, respectively, by holding symposia on infections and tumours in children. However, when the Annual Conference of ISPN was held in Bombay this served as a great impetus to the development of paediatric neurosurgery as a subspecialty in this country. It led to the formation of the Indian Society for Paediatric Neurosurgery in the following year, which now has 90 neurosurgeons in full membership. It has held annual meetings ever since its inception and has held CME programmes with international faculty in 1992, 1994, 1996, 1997 and 1998. Half a dozen neurosurgeons have already devoted themselves mainly to the practice of paediatric neurosurgery. Paediatric neurosurgery is best developed in a large multi-disciplinary paediatric institute. We have been able to establish a neurosurgical service at Jerbai Wadia Hospital for Children, a paediatric institute of repute in Mumbai, and hope to have training programmes and fellowships in the near future for both general and paediatric neurosurgeons, as they will have to continue treating cases of spina bifida and hydrocephalus for several years to come.

Child↗
PubMed1998

Trauma in congenital atlanto-axial dislocation.

Congenital atlanto-axial dislocation (AAD) usually presents with chronically progressive compression of the cervico-medullary junction. However, even a minor trauma can cause acute compression with development of quadruplegia and respiratory impairment. At times these may be transient, or trauma may aggravate the compression and lead to progressive quadriplegia. Of 60 children seen with congenital AAD, in 15 it had been associated with trauma. Nine of these 15 AADs were of the mobile variety, and 6 of the fixed variety with odontoid invagination. In 6 children with mobile and 2 with fixed AAD, trauma led to an acute manifestation with quadriplegia. Three of the children also experienced respiratory distress and needed ventilatory support. All 15 were initially treated with skull traction. Once the condition was stabilised, those with the mobile variety underwent fixation in a reduced position and grafting. One of the children with respiratory distress died within 2 days of admission. In 4 of them, sublaminar wiring between C1 and C2 was carried out, and in 3 others wiring between occiput and base of spinous process of C2 was performed. In 1 case a Hartshill loop was used. Among the children with fixed AAD, reduction of the odontoid invagination was obtained in 2, and they underwent fusion. In 4 cases with unsatisfactory reduction, posterior decompression of the foramen magnum and the fused posterior arch of the atlas was performed. The results depended on the degree of neurological deficit in each child.

Adolescent↗
PubMed1998

Incidence of subarachnoid hemorrhage from aneurysmal rupture in India.

Incidence of subarachnoid hemorrhage from aneurysmal rupture is low in India when compared with that in Western world and Japan. A review of aneurysms seen in eight institutions of the country in 1985 and 1986 has shown a very small incidence of aneurysms. A study of circle of Willis in 1021 consecutive autopsies has also shown only two aneurysms on middle cerebral artery, the incidence being only 0.2%. For last 2-3 years, after an increasing awareness of its entity amongst the physicians and the population, only 300-350 aneurysms were seen in the cities of Bombay and Delhi with a population of 13 and 8 million, respectively.

Adult↗
PubMed1996

Adoptive immunotherapy using lymphokine-activated killer (LAK) cells and interleukin-2 for recurrent malignant primary brain tumors.

Ten patients with recurrent malignant primary brain neoplasms were treated with adoptive immunotherapy using lymphokine-activated killer (LAK) cells and interleukin-2 (IL-2). Nine patients had supratentorial glioma and they received multiple intratumoral instillations of LAK cells through reservoir-catheter system or burrhole. The other patients with disseminated subarachnoid metastases from posterior fossa medulloblastoma received immunotherapy via lumbar subarachnoid route. A partial and transient clinical response was observed in two patients. following the therapy, and a cystic transformation of the essentially solid tumour was noted on the CT scans of these two patients. No significant clinical or radiological response to the treatment was observed in the remaining 8 patients. The results of this preliminary study reveal limitations of the regional intratumoral adoptive immunotherapy using currently available techniques and provide sufficient evidence of its effectiveness to warrant further investigations.

Adolescent↗
PubMed1996

Medical abortion: ethics, laws and religious points of view, A study by the 1994-1995 Ethics and Morals Committee of the ISPN.

Central nervous system malformations are now frequently detected prenatally. Unfortunately, the progress in diagnosis having far outstripped that in therapeutics, the only question to answer is usually whether the pregnancy should be continued or terminated. Pediatric neurosurgeons have to deal with such problems more and more often. They are asked to give an opinion on the prognosis. In many cases the law requires their involvement in the decision about the possibility of a "therapeutic", or more correctly a medical, abortion. The final decision is based on the religious attitutes of the family and the neurosurgeon and on the law of the country in which the medical abortion would be performed. This article reviews the points of view of the main religions and also the laws in different countries. This knowledge may be of some help to neurosurgeons, especially when the religious attitudes of those involved are different or when their final decision is not in accordance with the law of the country.

Abortion, Legal↗
PubMed1994

Transient myocardial dysfunction in a patient with subarachnoid haemorrhage.

We report a patient of subarachnoid haemorrhage who presented with severe left ventricular dysfunction and marked electrocardiographic changes indistinguishable from acute myocardial infarction. Coronary arteriography showed normal anatomy and the ventricular regional wall motion abnormalities recovered spontaneously after 3 weeks. The implications of this association are discussed.

Coronary Angiography↗
PubMed1993

Study of Circle of Willis in 1021 consecutive autopsies: incidence of aneurysms, anatomical variations and atherosclerosis.

Incidence of subarachnoid haemorrhage from aneurysmal rupture is very low in India when compared with that in the Western world and Japan. Either they are not recognised or diagnosed adequately or there may be a true decreased geographical/racial incidence. To have an idea of the true incidence of aneurysms, a study of Circle of Willis with its anatomical variations and incidence of atherosclerosis was carried out in 1021 consecutive autopsies. The incidence of anatomical variations was slightly less than that seen in most of the other studies. Atherosclerosis was seen in 9.2% of the Circles of Willis. There were only two aneurysms, both located at the bifurcation of middle cerebral artery. This incidence of 0.2% is definitely much lower than that seen in other series, thus, suggesting that the incidence of subarachnoid haemorrhage from aneurysmal rupture is likely to be genuinely less in India.

Adult↗
PubMed1990

Lamina terminalis approach for retrochiasmal craniopharyngiomas.

The retrochiasmal location of a tumour and the presence of a prefixed chiasm pose a major difficulty in total excision of craniopharyngiomas. An approach through the lamina terminalis gives direct access to these lesions, which are situated predominantly in the midline. Our experience with total excision of six such tumours exclusively through the lamina terminalis route is presented. Despite a stormy postoperative course due to water and electrolyte imbalance, no mortality resulted and minimal long-term morbidity was observed. Total excision was confirmed in all the cases by postoperative computed tomography scans.

Adolescent↗
PubMed1989

Brain tumours in childhood in Bombay: I: Histopathology showing changing patterns; II: Tissue culture with light and electronmicroscopy, stressing ingestion & degradation of bacteria by glial cells in vitro.

The pathological pattern of 86 brain 'tumours' in childhood during the years 1981-85 (out of a total of 586 for all ages), showed a higher proportion of neoplasms and a much lower of tuberculomas compared to the preceding three decades. A large number of histologically unusual cases was revealed. Through tissue culture of brain tumours we carried out morphological, histochemical and fine structural study of the tumour cells in vitro. The abundant presence of lysosomal acid phosphatase, in outgrowing cells, correlated with the detection of lysosomal dense bodies and vacuoles in araldite sections, by light and electronmicroscopy. In view of the phagocytic propensity of schwann cells for M. leprae as the important factor in leprous neuritis, TC preparations of gliomas, (in addition to acoustic schwannomas and meningiomas), were inoculated with two mycobacteria, M. scrofulaceum and the ICRC bacillus. There was a pronounced intracytoplasmic uptake, i.e. endocytosis, of acid-fast bacilli by the growing cells of these tumours. This was confirmed by electronmicroscopy which showed intact and degrading bacilli in various stages, in such cells of a typical cerebral astrocytoma used as an illustrative case in this paper. Ingestion and Digestion appear to be an inherent property of growing tumour cells in vitro. Fine structural examination of in vitro growth of an unusual subependymal giant cell astrocytoma, not inoculated with bacilli, served as a control. Cells of both tumours showed copious autophagic activity and cytoskeletal features of developing microtubules and filaments.

Adolescent↗
PubMed1989

Treatment of glioma with intratumoral instillation of autologous lymphocytes.

Autologous lymphocytes were instilled into the tumor in a girl 15 years of age who had presented with a recurrent left frontoparietal astrocytoma 1.5 years after surgery, radiation, and chemotherapy. She had remissions for 5 weeks, 5 months, and 20 months after the first, second, and third instillations, respectively. The usefulness of intratumoral instillation of autologous lymphocytes [or preferably lymphokine activated killer (LAK) cells with interleukin-2 is demonstrated in such recurrent astrocytomas.

Adolescent↗
PubMed1986

Use of intrathecal hyaluronidase in the management of tuberculous meningitis with hydrocephalus.

A preliminary study to evaluate the efficacy of intrathecal hyaluronidase was carried out in nine children suffering from tuberculous meningitis with communicating hydrocephalus. This was followed by a randomized trial in which five cases were treated with intrathecal hyaluronidase, while six cases were treated by the insertion of a ventriculoperitoneal shunt. No untoward reaction of any significance was noted. The results were judged in terms of improvement in the sensorium and mentation, in specific neurological deficit (e.g., visual impairment and hemiparesis), and in overall functional performance. Although most of the patients receiving hyaluronidase showed some improvement in the sensorium, only one of the nine preliminary cases and one of the five cases in the randomized trial showed a total recovery of function. Two of the six shunted patients, however, showed complete recovery. Shunt insertion led to further improvement in two of the nine preliminary cases who had failed to respond to treatment with hyaluronidase. This preliminary study shows that intrathecal hyaluronidase does, in most cases, lead to an improvement in the sensorium but does not offer any particular advantage over shunt insertion in terms of regression of specific neurological deficit or overall functional improvement.

Antitubercular Agents↗
PubMed1986

Management of intracranial tuberculoma in children.

Thirty-one patients were studied during a period of 3 years in order to identify features helpful for the diagnosis of tuberculoma. Sixteen had a history of pyrexia, 4 had had contact with cases of tuberculosis, the tuberculin test was positive in 15, the erythrocyte sedimentation rate (ESR) was elevated in 23, and 5 had concomitant tuberculous infections. Three had multiple lesions and 10 showed CT scan features suggestive of tuberculoma. Nineteen patients were successfully treated with drugs alone; seven needed surgery because they failed to respond to drugs clinically or because CT indicated no improvement. One patient proved to have a tumor, having shown an absence of response to drugs; four were operated on without drug trial because they were thought to have a tumor, and 1 needed surgery because of the mass effect of a very large tuberculoma. Infratentorial lesions associated with hydrocephalus were treated with ventriculoperitoneal shunts.

Adolescent↗