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S S Uppal

Publications and source records attributed to S S Uppal.

28 records · Page 2Linked to original sources
PubMed1990

Clinical aspects of centipede bite in the Andamans.

Clinical aspects of centipede bite as seen in the Andamans are reported. Centipede bite produces excruciating local pain and burning. Local bleeding is common but transient. Occasionally local infection or necrosis develops. Constitutional upset occurs in a small minority. Centipede bites are never fatal and pain-relief is the cornerstone of treatment.

Adolescent↗
PubMed1987

Soluble antigen fluorescent antibody (SAFA) test is not useful in childhood tuberculosis.

The diagnostic value of the soluble antigen fluorescent antibody (SAFA) test in childhood tuberculosis was studied in 117 children in the age group 0-12 years; 79 cases belonged to the study group, 23 children were non-tuberculous controls and 15 were tuberculin-negative healthy controls. The SAFA test was positive in 35 of 44 children with only pulmonary tuberculous lesions (80%) and in 21 of 35 children with other types of tuberculosis (60%). In the 23 non-tuberculous and 15 healthy controls it was positive in 11 cases (48%) and 7 cases (47%), respectively. The sensitivity, specificity and predictivity of the test were found to be 71%, 53% and 72%, respectively. The diagnostic value of the SAFA test was thus found to be low in childhood tuberculosis, especially in disseminated disease and tuberculous meningitis.

Child↗
PubMedDate not supplied

Analysis of the clinical profile, autoimmune phenomena and T cell subsets (CD4 and CD8) in Takayasu's arteritis: a hospital-based study.

OBJECTIVE: To evaluate clinical and immunological abnormalities in patients with Takayasu's arteritis (TA) from India, with particular reference to autoimmune perturbations and abnormalities in T cell subsets (CD4 and CD8 cells). METHODS: 16 consecutive patients with TA (11 females and 5 males) underwent clinical and laboratory evaluation inclusive of flow cytometric analysis of T cell subsets (CD4 and CD8). A control population of 94 age- and sex-matched blood donors was used to determine the normal T cell subsets. Student's t-test was used to compare the means. RESULTS: The mean age at onset was 23.4 + 2.3 yrs. Common symptoms observed were headache, limb claudication, abdominal pain and visual disturbance/blackout. Common clinical signs observed included reduced arterial pulsations, bruits, and a BP difference > 10 mm Hg in the upper limbs. Systemic hypertension was documented in 12 patients. The mean absolute lymphocyte count in the patients was 2289/mm3. The mean CD4 count and CD4% were 1003 and 41 respectively; the mean CD8 count and CD8% were 755 and 34, respectively; and the mean CD4/8 ratio was 1.41. The patients had statistically significantly higher CD8 but not CD4 T cell values than controls. IgG and IgM immunoglobulin levels were increased. The mean multi-test CMI score in patients using CMI multi-test device of Pasteur Merieux was 14.6 mm. Two patients had an anergic response, 4 a partial response (1-13 mm), and 6 a full response of > 13 mm. Four patients hyper-responded with a score of > 20 mm. ANCA was positive in 2 patients. ANA was positive in 3 patients. IgG anticardiolipin was positive in 12 patients and IgM in 3; overall 12 patients were anticardiolipin positive by ELISA. Anti-beta 2GPI of the IgG variety was found to be positive in 3 patients and IgM in 2 patients; overall 3 patients being positive for the same. Nine of the patients with active disease were started on a combination of moderate dose prednisolone (20-40 mg once daily) along with weekly oral methotrexate (7.5-15.0 mg). Surgical intervention was required in 6 patients. CONCLUSION: This study found an increase in CD8 positive T cell subsets, increased IgG and IgM immunoglobulin levels, and the presence of autoantibodies including ANA, ANCA, anticardiolipin and anti-beta 2GPI antibodies in TA patients. TA may be an autoimmune disorder with T cell aberrations. The relationship with antiphospholipid antibodies and anti-beta 2GPI needs to be explored and confirmed by other larger studies. The strikingly positive responses to tuberculin, as well as the multi-test CMI also indicate exaggerated T cell responses and cell mediated immunity in Takayasu's arteritis. Immunosuppressive therapy was successful in controlling disease activity in the majority, but surgery was needed for irreversible stenotic lesions.

Adult↗
PubMedDate not supplied

Henoch-Schönlein's purpura in adults versus children/adolescents: A comparative study.

OBJECTIVE: To assess the possible differences in etiological and clinical factors between children/adolescents (< or = 20 years) and adults (> 20 years) with Henoch-Schonlein purpura (HSP). METHODS: A retrospective-cum-prospective study of consecutive patients with HSP who presented to our teaching hospital over 5 years. Patients were classified as having HSP according to the criteria proposed by Michel et al and the ACR criteria. RESULTS: 102 patients (43 of all patients being male and 59 female) were classified as having HSP; 20 of the patients were adults (mean age 32.1 +/- 11.7 years) and 82 were children/adolescents (mean age 6.2 +/- 2.6 years). We were unable to identify any precipitating event in 40% of the adults and 37% of the children/adolescents. The frequency of previous drug treatment and of previous upper respiratory tract infection was similar in both groups. At symptom onset, palpable purpura was the chief clinical manifestation in both groups. However, renal involvement, in all its aspects, was more frequent and severe in adults. Adults also had a higher frequency of diarrhoea (with or without occult blood) and leucocytosis, but a lower frequency of thrombocytosis. The frequency of joint manifestations, nausea, vomiting, malena/hematochezia and intussuseption was equal in both groups. Adults required more aggressive therapy, and had a longer hospital stay (10.2 vs. 4.3 days). The outcome was relatively worse in adults, with complete recovery in 18 adults (90%) compared to 81 children/adolescents (98.8%) after a mean +/- SD follow up of 2.8 +/- 1.7 and 2.4 +/- 1.3 years, respectively. CONCLUSION: In adulthood, HSP is a more severe clinical syndrome, with a higher frequency of diarrhoea and renal involvement. Adults also require aggressive treatment more frequently and have a longer hospital stay.

Adult↗