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Biomedical subjects

S N Mehta

Publications and source records attributed to S N Mehta.

51 records · Page 3Linked to original sources
PubMed1989

Effect of dietary zinc and copper on peripheral blood plasma cholesterol, testosterone and histomorphology of testes in rats.

Total plasma cholesterol (mg/dl) significantly (P less than 0.01) decreased from 70.8 to 54.01 as the dietary Cu levels increased from 2.5 to 5 ppm at 12 pm Zn concentrations in male weanling rats. A similar trend was observed in the blood peripheral testosterone concentration at 12 ppm Zn and 2.5 ppm Cu. Histological examination of testes revealed smaller seminiferous tubules with atrophy of germinal epithelium. Also a marked loss of spermatogenic cells was observed in Zn and Cu deficient rats.

Animals↗
PubMed1989

Significance of transplant perfusion index in the diagnosis of acute rejection in live related renal allograft recipients.

The study was undertaken to assess the usefulness of transplant perfusion index (TPI) in the differential diagnosis of renal allograft dysfunction with special reference to acute rejection. It was observed that the TPI has a sensitivity of 100 per cent and specificity of 98.1 per cent in the diagnosis of acute rejection. It was also observed that the serial values of TPI provided valuable clues and guide in the management of transplant dysfunction and helped in the immediate and long term follow-up of patients with renal allografts.

Adult↗
PubMed1989

Incidence of reflux nephropathy (RN) in ESRD and effect of nephrectomy in RN on blood pressure and haematocrit following renal transplantation.

One hundred and fifty cases of end stage renal disease (ESRD) on pretransplant workup showed vesicoureteric reflux (VUR) in 21 (14%). Of these, 15 were primary reflux nephropathy (PRN) whereas 6 were secondary VUR. All patients in PRN group showed grade III to IV reflux while secondary VUR ranged between grade I to II. In the PRN group 38.5% had severe, 23% moderate and 23% mild hypertension; 53.3% were nonoliguric and 46.7% were oliguric. Mean plasma renin activity (PRA) was 6.6 and 2.85 ng/ml/hr in PRN and secondary VUR groups respectively. All cases of PRN and 2 from secondary VUR underwent nephrectomy and a month later renal transplantation. Following surgery blood pressure normalised without therapy in 50% and another 50% required lesser drugs in comparison to age matched non nephrectomised controls who showed hypertension in 100% cases, 60% requiring 3 to 4 drugs combination (p less than 0.05). Risk of low haematocrit in nephrectomised patients was insignificant.

Acute Kidney Injury↗
PubMed1979

Urological complications in 119 consecutive renal transplants.

One hundred and nine patients undergoing 119 transplants have been followed up from 8 months to 9 years. Urological complications occurred in 16 transplants, an incidence of 13.4%. Ureteroneocystostomy was performed primarily in all cases; in 98 by the conventional Politano-Leadbetter technique with 9 (9.2%) urological complications and in 32 by an extravesical technique with 7 (21.8%) urological complications. One patient died as a result of ureteric obstruction, without operation. In 3 patients with lower ureteric obstruction, transurethral ureteric meatotomy was successful in 2 cases and resulted in no change in renal function in the third. Two patients with urinary fistulae were managed successfully by continuous drainage with indwelling urethral catheters. The remaining 10 patients required 12 open surgical procedures for relief of ureteric obstruction, with improvement in function in 7 patients.

Follow-Up Studies↗
PubMedDate not supplied

Renal vein injury during percutaneous transluminal renal angioplasty in nonspecific aortoarteritis.

Percutaneous transluminal renal angioplasty of a right renal artery stenosis in a patient with nonspecific arteritis (Takayasu's arteritis) was performed for the treatment of renovascular hypertension and led to ipsilateral renal vein perforation and massive retroperitoneal bleeding. The mechanism of injury and its relationship to nonspecific arteritis remains obscure. Awareness of this potentially lethal complication is essential because early diagnosis is mandatory for definitive management.

Adolescent↗
PubMedDate not supplied

Evolving management of mild-to-moderate gallstone pancreatitis.

The objective of this study was to describe recent trends in the management of mild-to-moderate gallstone pancreatitis and assess patient outcomes. Acute gallstone pancreatitis has traditionally been managed with open cholecystectomy and intraoperative cholangiography during the initial hospitalization. The popularization of endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy has made a reassessment necessary. Two consecutive time periods were retrospectively analyzed: prior to laparoscopic cholecystectomy (prelaparoscopic era [PLE]) and after the diffusion of laparoscopic cholecystectomy (laparoscopic cholectomy era [LCE]). There were 35 patients in the PLE group and 58 in the LCE group. LCE patients waited 37.1 +/- 63 days from admission until cholecystectomy, compared to 9.8 +/- 14.8 days in the PLE group (P = 0.04). Biliary-pancreatic complications occurred in 24% of LCE patients and only 6% of PLE patients (P = 0.05), nearly always while they were awaiting cholecystectomy (P = 0.009). Patients in either time period who underwent cholecystectomy with intraoperative cholangiography developed less pancreatic-biliary complications than those who underwent ERCP prior to cholecystectomy, with or without sphincterotomy. Delaying the interval from pancreatitis to laparoscopic cholecystectomy beyond historical values is associated with a greater risk of recurrent biliary-pancreatic complications, which are not prevented by the use of ERCP. Early cholecys tectomy with intraoperative ductal evaluation is still the approach of choice.

Acute Disease↗
PubMedDate not supplied

Functional assessment of immune markers of graft rejection: a comprehensive study in live-related donor renal transplantation.

A better understanding of the immunobiological processes and predictors of graft rejection holds promise for the development of potential therapeutic strategies and also individualization of immunosuppression. The objective of this study is to analyze the clinical relevance of immune parameters such as antidonor antihuman leukocyte antigen (anti-HLA) antibodies, monitoring of cytokines and their receptors on the graft outcome following live-related donor renal transplantation. Flow cytometry-based methods were used to detect antidonor antibodies (flow cytometry crossmatch, FCXM) and intracellular cytokines. Enzyme-linked immunosorbent assay (ELISA) methods were employed to detect anti-HLA class I and class II antibodies and quantitative serum-soluble interleukin-2 receptor (sIL-2R) levels. The data revealed that patients with HLA class I-specific IgG antibody experienced higher acute rejection (AR) episodes at 1 yr in comparison to the antibody negative group (82% vs. 56%, p = 0.01). On the contrary, donor-specific class II antibodies (B+) did not have any influence on the graft survival. However, 15 recipients having both T- and B-cell antidonor antibodies (T+B+) had significantly poor graft survival (60%) as compared to the antibody-negative group (T-B-, 82%, p = 0.05). Additionally, patients having non-donor but HLA-specific antibodies (FCXM-/ELISA+) had poor graft survival as compared to the antibody-negative group (64% vs. 88%, p < 0.05). Further, patients undergoing AR episodes had significantly higher expression of IFN-gamma-producing T cells (19.16 +/- 7.4% median 17.50) as compared to their pre-transplant levels (5.68 +/- 1.63%, Median 5.20) and the non-rejecter group (5.97 +/- 4.39%, median 4.3, p = 0.0004). Similarly sIL-2 was significantly increased in AR episodes during the first month of transplantation (292 +/- 131.5 pmol/L) as compared to those with well-functioning grafts (p = 0.01) and healthy controls (p = 0.001). Evaluation of antidonor antibodies by flow cytometry is found to be relatively more sensitive and a better predictor of graft outcome. Further monitoring of cytokine expression profile of primed peripheral T-helper cells and quantitative analysis of sIL-2R offer additional valuable diagnostic and prognostic tools for follow-up of transplant subjects and a better alternative for functional assessment of immunosuppression.

Antibodies↗
PubMedDate not supplied

Prospective randomized control trial of isoniazid chemoprophylaxis during renal replacement therapy.

BACKGROUND: Infectious diseases remain among the major morbid events in patients with end-stage renal disease (ESRD) on renal replacement therapy (RRT). In developing countries, tuberculosis (TB) has been found to occur more frequently in these patients than in the general population. Efficacy of isoniazid (INH) chemoprophylaxis has been seen in other situations, such as human immunodeficiency virus infection. However, studies on INH prophylaxis in ESRD patients on RRT are limited. METHODS: In this prospective randomized controlled trial, from April 2000 to June 2001, a total of 109 ESRD patients registered for renal transplant and accepted for maintenance hemodialysis in our hospital were included and followed up until June 2004 to assess the role of INH prophylaxis in preventing development of TB. At the time of acceptance for hemodialysis, 54 patients were assigned to receive daily INH for 1 year and 55 patients were assigned to the control group. Primary outcome was development of TB. Secondary outcome was INH hepatotoxicity. To evaluate the effect of INH prophylaxis on the development of TB, a Kaplan-Meier survival estimate was used to plot TB-free survival curve and log-rank test was used for comparison. RESULTS: Overall, TB was diagnosed in 27 patients during RRT, with an incidence of 24.8%. TB developed in 9 (16.7%) patients in the INH group and in 18 (32.7%) patients in the control group. There was a significantly lower incidence of TB in the INH group as compared with the control group. The risk ratio of INH vs. control group for development of TB was 0.40 (95% confidence index [CI], 0.17-0.92; P=0.032). In the INH group 27 (50%) patients and in the control group 17 (30.9%) patients developed some hepatic dysfunction. However, significant hepatitis that required discontinuation of INH developed in only 9 (16.7%) patients in the INH group. Furthermore, significant hepatitis also developed in 6 (10.9%) patients in the control group. The majority of patients with significant hepatitis in both groups (INH as well as control) were subsequently found to be positive for hepatitis B and/or hepatitis C viral infection. Mild hepatitis (which did not require discontinuation of INH) was seen in 18 (33.3%) patients in the INH group and 11 (20%) patients in the control group. Viral hepatitis infection was not found in any of the milder cases of hepatitis in either group. CONCLUSION: This study shows significant efficacy of INH chemoprophylaxis during RRT in preventing development of TB, when the INH was started during dialysis itself. INH chemoprophylaxis was safe and well tolerated in the majority of patients. However, mild hepatic dysfunction was common, both in the treatment as well as in the control group. As the incidence of viral hepatitis overall was high in our patients on RRT, it is difficult to identify INH-induced hepatitis in this clinical setting.

Adolescent↗
PubMedDate not supplied

Outcome of patients with pre-existing hepatitis B virus infection following renal transplant.

Twenty four patients who were HBsAg positive prior to renal transplantation were studied with respect to their hepatic and renal outcome. The kidneys in all patients were obtained from living related donors. The standard immunosuppressive therapy consisted of azathioprine and prednisolone. Post-renal transplant follow-up varied from 32-86 months (mean 55 +/- 9). Renal functions, liver functions, HBsAg and HBsAb status was closely monitored during follow-up. One patient developed acute hepatitis four months after transplantation; this resolved in 10 weeks. Four patients showed transient elevations of liver enzymes. The results of liver biopsy in 16 cases revealed, normal histology (8), virus in hepatocytes (5), and acute hepatitis (3). None of the patients had evidence of chronic liver disease. Two patients died due to chronic rejection/chronic renal failure and two patients died due to septicaemia. Five living patients have mild to moderate chronic rejection. It was concluded that pre-existing HBsAg carrier state in transplant patients had no deteriorating effect on the liver. The mortality was related to chronic rejection and septicaemia.

Adult↗
PubMedDate not supplied

The quality of life in successful live-related renal allograft recipients in India.

BACKGROUND: The high cost of maintenance of haemodialysis makes most patients in India and elsewhere opt for a renal transplant. The degree of rehabilitation can best be assessed by evaluating the quality of life in successful recipients. METHODS: We studied vocational rehabilitation, social relations, sexual and married life, psychological status and life satisfaction in 51 successful live-related renal allograft recipients using Schwab's depressive scale, Bigot's life satisfaction index and the Kamofsky physical scale. RESULTS: Eight-four per cent of our patients had returned to their original jobs. Ninety-eight per cent of patients had a Kamofsky scale of 90-100 and 81% were leading a normal married life. Ninety-four per cent of them led an active social life. CONCLUSION: Successful live-related renal transplantation is associated with a good quality of life and should be the treatment of choice for patients with end-stage renal disease.

Adolescent↗