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Biomedical subjects

S Parikh

Publications and source records attributed to S Parikh.

17 recordsLinked to original sources
PubMed1992

Increased intestinal permeability: implications for thoracoabdominal aneurysm repair.

Coagulopathy and massive bleeding plays a major role in the mortality of thoraco-abdominal aneurysm repair. Increasing supraceliac aortic cross-clamp time from 0 to 90 minutes increases the degree of disseminated intravascular coagulation, which occurs as a result of occlusion and reperfusion of the superior mesenteric artery. The purpose of this study was to investigate the mechanism of the superior mesenteric artery reperfusion disseminated intravascular coagulation. Twenty dogs were divided into four groups: cross-clamp time of 30 minutes; cross-clamp time of 60 minutes; cross-clamp time of 90 minutes; and control. Permeability was determined by lactulose/mannitol absorption. The venous effluent was sampled for endotoxin, potassium, bacteria, and pH every hour and urine was collected for six hours. Lactulose absorption was significantly higher in all of the experimental groups. There was increased permeability in the 60 and 90 minute groups which correlated significantly with time. Venous endotoxin, potassium, and blood cultures for bacteria did not change significantly. The pH was significantly lower every hour for six hours in the 90 minute group. These data suggest that intestinal permeability is increased with supraceliac aortic clamping and can be kept to a minimum for clamp times of under one hour.

Animals↗
PubMed1992

Pheochromocytoma and pregnancy: report of three cases.

Three cases of pheochromocytoma associated with pregnancy are reported. Two patients had adrenal pheochromocytoma coexistent with normal pregnancy and one patient had a bladder pheochromocytoma coexistent with molar pregnancy (gestational trophoblastic disease). The diagnosis was made antenatally in the two normal pregnancy patients, both underwent planned tumor resection, one at mid-trimester, complicated by postoperative miscarriage, while the other had tumor resection during cesarean section at term. Bladder pheochromocytoma, preoperatively mistaken for invasive trophoblastic tumor, was resected at the time of planned abdominal hysterectomy for molar pregnancy, pheochromocytoma was recognized only after microscopic study of the resected bladder tumor. The three patients survived with no evidence of disease.

Adrenal Gland Neoplasms↗
PubMed1991

Molecular cytogenetics of alpha satellite DNA from chromosome 12: fluorescence in situ hybridization and description of DNA and array length polymorphisms.

A 340-bp EcoRI fragment of alpha satellite DNA from human chromosome 12 has been isolated and used in molecular cytogenetic and genetic studies. The clone, pSP12-1, detects tandemly repeated 1.4-kb repeat units at the centromeric region of chromosome 12. By fluorescence in situ hybridization, biotinylated pSP12-1 is highly specific for chromosome 12 and has been used to confirm an i(12p) in a case of Pallister-Killian syndrome, both in metaphase spreads and in interphase nuclei. A dominant DNA polymorphism for the centromeric D12Z3 locus is detected with the enzyme TaqI. In addition, a high frequency of D12Z3 array length polymorphisms can be detected using pulsed-field gel electrophoresis. The D12Z3 array has been measured by pulsed-field gel electrophoresis to span approximately 2,250-4,300 kb at the centromeric region of chromosome 12.

Centromere↗
PubMed1991

Echinococcal infestation of the spine in North America.

Taenia echinococcal infestation, a parasitic disease rarely seen in the United States, occurred in a 62-year-old man. Bone is involved in about 1% of all cases, and of these cases, the spine is involved in about 50%. Preoperative identification is difficult because of lack of characteristic radiographic features. Successful management is also problematic because of the difficulty of preoperative diagnosis, the invasive nature of the bony involvement, and the variable anaphylactic reaction to the cyst fluid antigen. The diagnosis must be entertained in the differential diagnosis of benign spinal neoplasms especially when dealing with patients from endemic areas.

Echinococcosis↗
PubMed1989

Night backache in pregnancy. Hypothetical pathophysiological mechanisms.

One hundred women responded to a questionnaire dealing with night backache during pregnancy. All the women were in the second half of their pregnancy. Sixty seven per cent of the women reported discomfort and/or backache during the night. We hypothesize that hypervolemia combined with obstruction of the inferior vena cava, caused by the enlarging uterus, is the underlying pathomechanism leading to night backache. Patients with inadequate venous collateral circulation may develop excessive pressure within the venous system, the vertebral bodies and overdistension of venous channels distal to the occluded zone. These changes may lead to hypoxemia, metabolic disturbances, irritation of unmyelinated nerves and result in night backache.

Back Pain↗
PubMed1989

The shoulder abduction relief sign in cervical radiculopathy.

A patient with C6 cervical radiculopathy reported that sustained shoulder abduction significantly diminished this upper extremity pain. The patient was instructed to adopt this position for prolonged periods during rest and at work. Pain relief was temporary and lasted as long as the arm was in abduction. Relief of pain, induced by arm abduction, may be observed in cervical radiculopathy in which the lower cervical roots are involved. Reduced tension at the nerve root is the probable underlying mechanism that leads to pain relief. Shoulder abduction can be used not only as a diagnostic sign but also may be incorporated in the conservative management of patients suffering from cervical radiculopathy affecting the lower cervical roots.

Humans↗
PubMed1989

Dermatitis-sympathetic dysfunction in carpal tunnel syndrome. A case report.

A 52-year-old woman complained of numbness affecting the thumb, index, and middle fingers of both hands. The patient was managed with night splints with partial relief of symptoms. As a house cleaner, the patient was routinely exposed to water and detergents. About a year later, the patient developed contact dermatitis in the fingertips innervated by the median nerves. Electromyographic studies confirmed the presence of bilateral carpal tunnel syndrome. The temperature of all the fingertips was measured. The median innervated fingertips were warmer than those innervated by the ulnar nerves. The median sympathetic fibers may be compromized by compression in the carpal tunnel. This caused vasodilation, increased finger temperature, and lack of sweating in the median innervated fingers. Due to regular exposure to water and detergents, the susceptible dry fingertips developed contact dermatitis. The patient was managed conservatively, and the rash and numbness disappeared.

Carpal Tunnel Syndrome↗
PubMed1986

Spine fractures in ankylosing spondylitis.

Patients with ankylosing spondylitis are susceptible to spine fracture, usually in the cervical spine. Less frequently, the thoracic and lumbar spine is affected. The fracture line may involve anterior and posterior elements. Frequently, it extends through the entire width of the spine. As a result the fracture tends to be unstable and may cause neurologic damage. Prompt immobilization and reduction of the dislocated spine followed by stabilization may prevent neurologic damage. We report a 45-year-old man who fell and sustained a fracture dislocation of L2 vertebra. The patient was operated and stabilized with Harrington rods. A deep wound infection developed, which did not respond to antibiotic therapy and led to removal of the rods. In spite of bed immobilization with a body jacket the fracture remained unstable and dislocated. As a result the patient sustained severe neurologic damage. Many fractures in patients with ankylosing spondylitis occur following minor trauma. We feel that a very important aspect of ankylosing spondylitis management is prevention of these fractures. Alerting patients of their spine fragility and teaching then how to evade situations leading to spinal trauma may help in avoiding this situation.

Fractures, Bone↗
PubMed1979

A visual index of thyroid function.

A visual index of thyroid uptake (VITU) is introduced as a qualitative measure of thyroid trapping. This index is determined from the 20-minute 99mTc-pertechnetate scan by visually comparing the relative tracer uptake between the thyroid and salivary glands. Three categories are defined: low, normal and elevated. The VITU correctly identified the functional status of the thyroid in 94% of 123 patients studied and agreed with the 24-hour radioiodine uptake (RAIU) in 89%. The VITU is a very simple but highly accurate, reliable and reproducible test. It was primarily designed to complement other tests of thyroid function by contributing qualitative information about the thyroidal trapping mechanism, but it can also be useful in confirming blood tests of thyroid function in cases in which one would prefer to avoid 131I administration for RAIU studies.

Diagnostic Errors↗
PubMed1977

Popliteal aneurysms.

A review of 64 popliteal aneurysms in 43 patients treated over a 14-year period revealed that thrombotic occlusion with ischemia and threatened limb loss was the most frequent complication (68%). Ten major amputations (23%) were necessary, four of which were the primary operations soon after admission. No limb loss occurred after operation in 11 patients with asymptomatic aneurysms. Direct revascularization was successful in 29 limbs (83%). Popliteal aneurysms should be resected, preferably in the asymptomatic stage, unless medical contraindications exist. Once thrombosis occurs, limb loss becomes a threatening likelihood.

Adult↗
PubMed1975

Carotid endarterectomy utilizing the exclusion clamp.

Carotid endarterectomy is useful in the treatment of the uncomplicated pre-stroke patient. Use of the exclusion clamp makes possible a short period of carotid occlusion without the use of either internal or external shunts. Forty-two patients were operated on using this technic.

Adult↗
PubMedDate not supplied

Results of coronary artery surgery in young adults.

To study the results of bypass surgery in young adults, 221 patients undergoing myocardial revascularisation aged 40 or less (1979-1989) were reviewed. The study included 200 men and 21 women. Mean age was 36.2 years. Risk factors were essentially cigarette smoking (69.6%) and hyperlipidaemia (52%). One-hundred and eighteen patients (53.4%) had a history of previous myocardial infarction (MI) and 16 were operated on after an episode of preinfarction angina. One-hundred and twenty-nine patients had three-vessel disease, 59 had double-vessel disease and 33 single-vessel disease. Twenty-three had left main stem coronary artery lesions. Four-hundred and forty-six saphenous vein grafts and 79 internal mammary artery grafts were performed, an average of 2.3 grafts per patient. Operative mortality was 2.7% (6 patients). Deaths were caused in 4 cases by MI. Twelve patients (5.5%) had a non fatal perioperative MI. One-hundred and ninety-nine patients were followed up for a mean of 7.4 years (4838 patients-years). Seventeen late deaths occurred. Six were from cardiac causes. Overall survival was 84% at 9 years. Five patients underwent cardiac reoperation at a mean interval of 6.4 years after the primary procedure. Eighty-five% of patients were free of angina and 11.5% were in an improved condition. In conclusion, coronary revascularisation can be performed at a reduced risk in younger patients. Long-term prognosis seems similar to that of the overall group of patients undergoing bypass surgery.

Adult↗