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Biomedical subjects

S Sagar

Publications and source records attributed to S Sagar.

At least 37 records · Page 2Linked to original sources
PubMed1994

Ocular changes in Takayasu's arteritis in India.

Twenty-seven patients (ages 13-55 years) with Takayasu's arteritis (TA) underwent a detailed ophthalmological examination which included a history of visual symptoms, recording of visual acuity, slit-lamp examination, examination of retina (direct fundoscopy and rapid sequence fluorescein angiography) and estimation of retinal haemodynamics. Arterial hypertension was the commonest (77%) presentation of TA. Sixty-six percent of the patients had one or more ocular change. Sixteen (33%) of the 54 eyes tested had Takayasu's retinopathy (TR), 20 eyes (37%) had hypertensive retinopathy (HR) and the retina was normal (NR) in 18 eyes (33%). Two patients with advanced TR had bilateral cataract. The arm-to-retina circulation time in eyes with TR (16.4 +/- 2.66 seconds) was prolonged as compared to the eyes with HR (10.9 +/- 1.63 seconds, P < 0.01) and NR (9.6 +/- 2.37 seconds, P < 0.01). The arteriovenous filling time in eyes with TR was also significantly prolonged. The intraocular pressure (mmHg) in eyes with TR (9.3 +/- 3.6) was lower (P < 0.001) than that in eyes with HR (14.4 +/- 4.1 mmHg) and NR (14.2 +/- 2.6). Central retinal artery pressure recorded in 8 eyes with TR was less than 35 mmHg in spite of the systemic hypertension. The retinal haemodynamics suggest that the carotid artery involvement leading to diminished retinal blood flow is the pathogenetic mechanism of TR.

Adolescent↗
PubMed1993

Non convulsive spike-wave discharges do not induce Fos in cerebro-cortical neurons.

Immunohistochemical localisation of Fos was used as a marker of neuronal activity to demonstrate neurons active during non-convulsive spike-wave epilepsy. Fos-positive neurons in cortex and several subcortical areas were counted. In undisturbed animals. Fos counts were not related to spike-wave in any region. With the electroencephalographic (EEG) recording procedure. Fos induction occurred in all regions, even after habituation. However, in central cortex, counts were found to be inversely related to spike-wave duration. This suggests that neuronal activity is not increased during spike-wave and that the central cortex in these animals is less responsive to arousal than in non-epileptic animals.

Animals↗
PubMed1993

Is a hypertensive always a hypertensive?

Forty two patients of uncomplicated essential hypertension with well controlled and stable blood pressure for the last six months have been followed up for 2 years after withdrawal of therapy. Drug therapy was reinstituted if they became hypertensive again. Thirty four (89.9%) and 33 patients remained normotensive at 4 and 8 weeks respectively. At the end of 6 months, 26 (61.9%) patients were drug free, 9 (21.4%) were back on therapy and 7 (16.5%) were lost to follow up. At the end of one year, 18 (42.8%) were drug free, 14 (33.3%) were on drugs and 10 (23.8%) had dropped out. At the end of 2 years, the figures were 14 (drug free), 15 (on drugs) and 13 (drop-outs). No cardiovascular or any other complication was recorded during the period. These observations suggest that there may be a subgroup of mild or moderate hypertensives in whom it may be possible to withdraw therapy under observation. However, there is a risk of substantial drop out rate possibly under a false sense of security. Considering the large number of hypertensives in our country and the world over, its economic and therapeutic implications are obvious.

Adolescent↗
PubMed1992

Oxygen free radicals in essential hypertension.

Membrane abnormalities in essential hypertensives (EH) are well known. The respiratory burst enzyme, NADPH oxidase is located in the cell membrane of the neutrophil (PMNLs) and its activity is important in generation of oxygen derived free radical (OFR). Recently OFR have been implicated in vascular changes in variety of conditions. An attempt was made to delineate the status of OFR and antioxidants in EH. Ten, age and sex-matched, healthy controls (GpI) and 26 untreated EH (Gp IIA mild-8, Gp IIB Moderate-8, Gp IIC Severe-10) were studied. After clinical examination and basic laboratory evaluation of subjects, neutrophils isolated from their blood were studied. Chemiluminescence (CL) emitted by PMNLs after stimulation was measured (counts/min) in a luminometer and was taken as measure of OFR production and thereby of NADPH oxidase activity. The levels of antioxidants, superoxide dismutase (SOD) and reduced glutathione (GSH), were also estimated. Chemiluminescence was increased significantly (p less than 0.01) in Gp IIC (243.04 +/- 24.9 x 10(3) counts per minute) as compared to Gp IIA (2.80 +/- 1.87), Gp IIB (34.54 +/- 30.24) and Gp I (0.52 +/- 0.15) and SOD was reduced significantly (p less than 0.05) in all EH (Gp IIA 3.9 +/- 0.3 units per mg protein, Gp IIB 3.5 +/- 0.3 and Gp IIC 3.12 +/- 0.3) as compared to controls (4.1 +/- 0.2). Similarly GSH was reduced (p less than 0.05) in EH (Gp IIA 11.2 +/- 1.7 mg per gm protein, Gp IIB 8.5 +/- 1.1 and Gp IIC 6.6 +/- 0.3) as compared to Gp I (13.5 +/- 2.5).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Takayasu arteritis in India.

Takayasu arteritis is the commonest cause of renovascular hypertension in India. The clinical and radiological features, complications and course of 83 patients (51 females, 32 males) seen during the period from 1972-1990 are described in this study. The age of the patients ranged from 5 to 53 years with the mean +/- SD of 26.9 +/- 9.7. Hypertension (n = 50) and the related symptom of headache (n = 40), dyspnea (n = 24), and giddiness (n = 20) were common at presentation. Twelve patients were in congestive cardiac failure. The symptoms of activity with fever and arthralgia were present in only 16% contrary to reports from Japan and Mexico. Abnormal arterial pulses and bruit over abdominal (37%) or extra abdominal great arteries (25%) were useful clinical clues to suspect Takayasu arteritis. Rapid sequence intravenous urography was a sensitive screening procedure and predicted correctly the presence of renovascular disease in 80% of the patients. The diagnosis was confirmed on aortography in 72. In the rest, the clinical features and autopsy findings confirmed the same. The four patterns of the disease based on the anatomical extent of involvement were recognised. These were: type I (n = 8) with involvement of aortic arch and its branches, type II (n = 25) descending thoracic and abdominal aorta type III (n = 46) combination of I and II and type IV (n = 4) pulmonary artery in addition to any of the above.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Immunopathogenesis of Takayasu arteritis.

Takayasu arteritis is a common cause of renovascular hypertension in India. Sensitization to infective agents, particularly mycobacterium tuberculosis or autoimmune disturbances have been incriminated in its pathogenesis. Twenty patients of Takayasu arteritis along with groups of normal individuals, patients of essential hypertension, autoimmune disorders, tuberculosis, and healthy tuberculin reactors were studied. Besides detailed immunological profiles including LE cell phenomenon, serum complement C3 levels, antibodies to single (SS) and double stranded (DS) DNA, rheumatoid factor, lymphocyte subsets, blast transformation to antigens including, phytohemagglutinin, PPD, pokeweed, and purified human aortal antigen (PHAA) were examined. Soluble protein from human aorta was fractionated into 9 peaks by DEASE-52 and Sephadex G-75 chromatography, and 25 micrograms of major protein fraction-II was used for blast transformation study. Blast transformation by PHAA was higher in Takayasu arteritis as compared to all other groups (P < 0.05). Blast transformation to PPD showed wide variation in all the groups, and was significantly higher only in tuberculin reactors as compared to controls. These observations support aortal sensitization to PHAA playing a role in pathogenesis of Takayasu arteritis and do not relate tuberculosis to Takayasu arteritis, at least immunologically. In addition, the ratio of CD-4 positive to CD-8 positive lymphocytes changing in favor of the former and the concomitant increase in B lymphocytes favor the presence of autoimmune disturbances in Takayasu arteritis.

Adolescent↗
PubMed1992

Ca2+ transport in unstimulated platelets of essential hypertensives and their blood relatives.

OBJECTIVE: Intracellular free Ca2+ concentration has been shown to be elevated in platelets from essential hypertensive patients. This study was designed to characterize Ca2+ homeostasis in platelets of essential hypertensives. DESIGN: A double-blind study was carried out. Untreated and treated (propranolol therapy) essential hypertensives were studied in comparison with normotensive control subjects. First-degree blood relatives of essential hypertensives were also studied. The various procedures used in the study were already standardized and well-established methods. METHOD: For Ca2+ uptake and efflux studies, 45Ca was used. For intracellular free Ca2+ concentration studies the fluorescent Ca2+ chelator dye fura-2/acetoxymethyl ester (fura-2/AM) was used. RESULTS: The uptake of 45Ca by unstimulated platelets of untreated essential hypertensives and their relatives was significantly higher than for controls. However, essential hypertensives treated with a beta-blocker drug showed no significant difference in Ca2+ uptake compared with controls. A significantly decreased Ca2+ efflux was observed in essential hypertensives (both untreated and treated) compared with controls. Relatives also showed a depressed Ca2+ efflux compared with controls. CONCLUSIONS: It appears that the elevated intracellular free Ca2+ concentration levels in platelets (also observed by us) may be due to both an enhanced uptake into, and decreased efflux of Ca2+ from, the cell. Beta-blocker therapy may help to normalize the elevated intracellular free Ca2+ concentration levels observed in essential hypertensives. Relatives exhibit a state predisposed towards the development of hypertension.

Adolescent↗
PubMed1992

Prolonged undiagnosed fever in northern India.

A prospective study for five years along with a retrospective analysis of all patients admitted over 10 years with the diagnosis of prolonged undiagnosed fever was carried out in a referral hospital of North India to determine the specific disorders responsible for it. One hundred and fifty patients (80 prospective and 70 retrospective) were included in the study. Infections, especially tuberculosis, was the most dominant cause (50%), followed by lymphoreticular and haematological disorders (21.32%), collagen vascular disorders and neoplasms (8.67%) each. Miscellaneous causes were responsible in 6.67% and in 4.67% the cause of fever remained undiagnosed.

Academies and Institutes↗
PubMed1991

Blood pressure in schoolchildren in northwest India.

Blood pressure was determined among 2,453 schoolchildren aged between 7 and 16 years in the northwest Indian town of Chandigarh to establish the norms. The percentiles were calculated for each age group in both sexes. Both systolic and diastolic blood pressure had a positive correlation with age, weight, height, and body surface area (r = 0.112-0.178, p less than 0.01). There was no difference in the systolic and diastolic pressures of boys compared with girls of corresponding age. The upper limits of normal (90th percentile) systolic/diastolic pressure were 113/74, 119/76, and 126/79 in children aged 7-9 years, children aged 10-12 years, and adolescents aged 13-16 years, respectively. The lower limits of hypertension (95th percentile) for systolic/diastolic pressure were 119/80, 124/81, and 132/82 in each of these groups, respectively. The 99th percentile values indicative of severe hypertension for systolic/diastolic pressure in these groups were 128/88, 135/88, and 149/89, respectively. The 90th percentile of height and weight shown in the percentile table should be taken into consideration whenever blood pressure exceeds the 90th percentile for age and sex while planning the management of an individual.

Adolescent↗
PubMed1991

Proteinuria in essential hypertension.

Proteinuria was estimated using modified biuret method in 100 consecutive essential hypertensives of both sexes with mean age of 40 +/- 0.9 (18-50 yr) attending hypertension clinic. Proteinuria (mg/1.73 M2/24 h) in 60 mild hypertensives ranged from 45.4 to 493.0 with 9 (15%) patients having abnormal proteinuria (greater than 250 mg). In 26 moderate hypertensives proteinuria ranged from 96-1010; 7 (27%) had abnormal proteinuria. The proteinuria in 14 severe accelerated, malignant hypertensives ranged from 146.5-6132.6 with 10 (71%) having abnormal proteinuria. Duration of hypertension had no correlation with the amount of proteinuria. The amount of proteinuria was much higher (P less than 0.001) in patients with renal insufficiency (1322.5 +/- 586.4) and in patients with grades III and IV hypertensive retinopathy. LVH on ECG also correlated positively with proteinuria. The group with abnormal proteinuria had more patients with LVH (42.3% vs 12.2%), severe hypertensive retinopathy (30.8% vs 4.1%) and renal insufficiency (34.6% vs 0%) as compared to patients without elevated proteinuria.

Adolescent↗
PubMed1990

Comparative evaluation of cefotaxime and cephamandole in the prevention of post-operative infective complications following emergency abdominal surgery.

In previous published work we described 57 patients undergoing emergency abdominal surgery, prospectively randomised to receive either cefotaxime or cephamandole as a single-antibiotic, three-dose, peri-operative prophylaxis against post-operative infective complications. This earlier work suggested that cefotaxime might be more effective than cephamandole in preventing wound sepsis in emergency abdominal surgery. We describe here our findings in a further 63 patients undergoing emergency abdominal surgery who were similarly allocated into either a cefotaxime or cephamandole antibiotic group. Infective complications occurred in 12/32 (37 per cent) of the cefotaxime group and 15/31 (48 per cent) of the cephamandole group. Wound infections occurred in 5/32 (16 per cent) of the cefotaxime group and 9/31 (29 per cent) of the cephamandole group. The organisms cultured and their sensitivities are discussed in detail. The total of 120 patients studied in the two series showed wound infection to occur in 13 per cent of the 62 patients receiving cefotaxime and 30 per cent of the 58 patients receiving cephamandole. This difference reaches statistical significance (p less than 0.05). Possible mechanisms to explain this finding are discussed. Again we found the regime of 4 g of cefotaxime given peri-operatively to be a simple, safe and effective single agent as prophylaxis for emergency abdominal surgery.

Abdomen↗
PubMed1985

Spectrum of renovascular hypertension in the young in north India: a hospital based study on occurrence and clinical features.

Occurrence of renovascular hypertension and its etiology is described in this work as seen in north India. Out of 2395 young hypertensives admitted for evaluation during the years 1978-1983, 91 patients (3.8%) were found to be having renovascular hypertension. In all patients suspected diagnosis of RVH was confirmed by the angiography of aorta and main vessels. Idiopathic aortoarteritis, diagnosed in 54 patients (59.4%) was the commonest cause of renovascular hypertension. In this group renal arterial involvement was found to be bilateral in 26 patients. Twenty-eight patients had isolated renal artery stenosis of unknown etiology. Six had fibromuscular dysplasia, 2 had polyarteritis and one had renal artery aneurysm. Twenty-three patients underwent surgery which included autotransplantation, arterial by-pass and nephrectomy with improved blood pressure control in 15. It is concluded that aortoarteritis seems to be the major cause of renovascular hypertension in the young in this part of the world.

Adolescent↗