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Biomedical subjects

S Singh

Publications and source records attributed to S Singh.

At least 19 recordsLinked to original sources

Novel environmental toxins: steryl glycosides as a potential etiological factor for age-related neurodegenerative diseases.

Amyotrophic lateral sclerosis-parkinsonism dementia complex (ALS-PDC) is a unique neurodegenerative disease found on the island of Guam. This disease presents as a spectrum of neurological disorders characterized by features of ALS, parkinsonism, dementia, or a combination. The strongest epidemiological link has been to the consumption of the seeds from the cycad plant that purportedly contained a neurotoxin. Mice fed washed cycad flour show signs that mimic ALS-PDC, which include progressive deficits in motor, cognitive, and olfactory functions associated with neuron loss in the spinal cord, nigrostriatal system, cortex, hippocampus, and olfactory bulb. Through a series of chemical extractions of washed cycad flour, we identified steryl glycoside molecules as bioactive molecules that are neurotoxic in culture and in mice. A detailed review of this class of molecule revealed that the molecules are abundant in the environment, particularly in plants and bacteria. Lipid analysis showed that some bacteria that are associated with some forms of neurodegenerative disorders have the capacity to synthesize steryl glycosides. Furthermore, certain steryl glycosides have been found to be a cell stress mediator and may have some immunomodulary effects. We hypothesize that steryl glycosides are putative neurotoxins involved in the etiopathogenesis of several age-related neurodegenerative disorders.

Aging↗

Impaired detoxication of hydrogen sulfide in ulcerative colitis?

Impaired butyrate oxidation and raised counts of sulfate-reducing bacteria in the colon of patients with ulcerative colitis (UC) indicate that the disease may be induced or aggravated by hydrogen sulfide toxicity. We aimed to examine enzymatic removal of H(2)S in erythrocytes and colonic mucosa from controls and patients with UC and Crohn's disease (CD). Rhodanese (RHOD) and thiol methyltransferase (TMT) activities were measured in rectal mucosa and erythrocytes, and plasma thiocyanate was determined. Four groups were analyzed: patients with UC, patients with CD, hospital controls (patients with dyspepsia or IBS), and a group of healthy volunteers. RHOD and TMT activity in rectal biopsies did not differ significantly between controls and patients with UC or CD (n=56). Control levels of RHOD were significantly higher in men than in women (212+/-25 and 132+/-14 nmol/mg/min, respectively; P<0.01). In erythrocytes (n=128) RHOD activity was significantly higher in UC patients than in hospital or volunteer controls (1.15+/-0.12 compared with 0.88+/-0.12 and 0.66+/-0.02 nmol/mg/min; P<0.05 and P<0.02, respectively). TMT activity was also significantly higher in erythrocytes from UC patients and hospital controls than volunteer controls (2.02+/-0.13 pmol/mg/min [P<0.001], 1.51+/-0.21 pmol/mg/min [P<0.05], and 1.17+/-0.18 pmol/mg/min, respectively). We found no evidence of defective enzymic detoxication of sulfide by RHOD or TMT in patients with UC or CD.

Adult↗

Adherence to generic reverse transcriptase inhibitor-based antiretroviral medication at a Tertiary Center in North India.

At least 95% adherence to medications is required for sustained response to antiretroviral therapy (ART). In resource constraint restrained settings it is not possible to use electronic methods to determine adherence. We determined adherence during the previous 4 weeks by the recall method in 200 patients (138 males) receiving generic triple drug reverse transcriptase inhibitor-based antiretroviral medications. They were administered a uniform questionnaire to determine the number of time they forgot or were unable to take their medications and the reasons thereof. One hundred and fifty received two and 50 took three pills daily. One hundred and forty-seven did not miss any dose. Fifty-three (26.5%) missed at least one dose during the preceding 4 weeks. Thirty-one took treatment on and off. Seven missed a dose in the preceding 3 days, nine more between the last 3 and 7 days, and six from 1 to 4 weeks. The major reasons for non-adherence were financial constraints, forgetting to take the medication, drug toxicity, lack of access to the drug, fear of getting immune to the benefit of the drug, and to avoid adverse effects. Non-adherence in 26.5% individuals could be an additional factor that can increase the risk of drug resistance.

Adult↗

Recommendations on the use of exercise testing in clinical practice.

Evidence-based recommendations on the clinical use of cardiopulmonary exercise testing (CPET) in lung and heart disease are presented, with reference to the assessment of exercise intolerance, prognostic assessment and the evaluation of therapeutic interventions (e.g. drugs, supplemental oxygen, exercise training). A commonly used grading system for recommendations in evidence-based guidelines was applied, with the grade of recommendation ranging from A, the highest, to D, the lowest. For symptom-limited incremental exercise, CPET indices, such as peak O(2) uptake (V'O(2)), V'O(2) at lactate threshold, the slope of the ventilation-CO(2) output relationship and the presence of arterial O(2) desaturation, have all been shown to have power in prognostic evaluation. In addition, for assessment of interventions, the tolerable duration of symptom-limited high-intensity constant-load exercise often provides greater sensitivity to discriminate change than the classical incremental test. Field-testing paradigms (e.g. timed and shuttle walking tests) also prove valuable. In turn, these considerations allow the resolution of practical questions that often confront the clinician, such as: 1) "When should an evaluation of exercise intolerance be sought?"; 2) "Which particular form of test should be asked for?"; and 3) "What cluster of variables should be selected when evaluating prognosis for a particular disease or the effect of a particular intervention?"

Exercise Test↗

Peripheral bone mineral density and its predictors in healthy school girls from two different socioeconomic groups in Delhi.

UNLABELLED: Peripheral bone density measurements are scarce and the factors, which predict bone mineral density at these sites, especially in children, are not clearly known. In this study, age, height, weight and alkaline phosphatase had a significant association on peripheral bone mineral density in healthy Indian school girls. INTRODUCTION: Factors that lead to the attainment of peak bone mass at peripheral sites, during period of growth are not clearly known. METHODS: Six-hundred and sixty-four randomly selected 7- to 17-year-old girls from upper and lower socioeconomic status (USES/LSES) schools were assessed clinically and a recording of their height and weight was undertaken. Serum calcium, phosphorus, total alkaline phosphatase (ALP), 25-hydroxyvitamin D (25-OHD) and parathyroid hormone (PTH) were measured in all of them. Bone mineral density (BMD) was measured at the distal forearm (BMDdf) and calcaneum (BMDca) by peripheral dual energy X-ray absorptiometry (pDXA). RESULTS: Girls belonging to the USES were significantly taller (149.7 +/- 12.3 cm vs 144.4 +/- 11.9 cm; P < 0.001) and weighed more (44.3 +/- 12.9 kg vs 35.9 +/- 10.0 kg; P < 0.001) than girls from the LSES. USES girls had a significantly higher mean serum calcium (9.3 +/- 0.7 mg/dl vs 9.2 +/- 0.8 mg/dl; P < 0.05) and significantly lower alkaline phosphatase (316 +/- 166 IU/l vs 423 +/- 228 IU/l; P < 0.01) and iPTH (29.9 +/- 18.4 pg/ml vs 45.7 +/- 64.6 pg/ml; P < 0.01). There was no significant difference in mean serum phosphorus and 25-OHD levels between the two groups. USES subjects had higher BMD at both sites than LSES subjects. BMDdf and BMDca increased with age and tended to plateau by 16 years and 12 years of age respectively in both the groups. Age, height and weight explained approximately 50% of the variability, while biochemical parameters explained approximately 30% of variability in BMD at both the sites. The only biochemical parameter which had a significant association with BMD was ALP at the distal forearm. CONCLUSION: In conclusion, age, nutrition, height and weight are significantly associated with BMD at peripheral sites.

Adolescent↗

Clinical spectrum of chronic renal failure in the elderly: a hospital based study from eastern India.

The aim of this study was to describe the clinical spectrum of chronic renal failure (CRF) in the elderly. The diagnosis of CRF was made using standard clinical criteria. The elderly was defined as person with over 60 years of age. In total, 200 elderly patients with CRF were evaluated between July 2002 and February 2004. Their age (male: 146; female: 54) ranged between 60 and 90 (mean 64.31+/-4.18) years. Diabetic nephropathy was the most common (46%) cause of CRF. Hypertensive nephrosclerosis, chronic interstitial nephritis and obstructive uropathy were responsible for CRF in 18%, 14% and 13% of patients, respectively. We observed chronic glomerulonephritis in 7% of elderly CRF. Urinary tract infection (55.5%), hypovolemia (22.2%), accelerated hypertension (11.1%) and sepsis (11.1%) were responsible for acute exacerbation of renal failure in 36 (18%) patients. Associated co-morbid conditions were noted in 93 (46.5%) patients. They included; coronary artery disease 46 (49.46%), cerebrovascular disease 20 (21.50%), osteoarthritis 13 (13.97%), chronic obstructive pulmonary disease 6 (6.45%), dilated cardiomyopathy 5 (5.37%), and malignancy in 3 (3.22%) patients. Acute dialytic support was required in 164 (82%) cases and remaining 36 (18%) patients received conservative management. Mortality was noted in 25 (12.5%) cases. The coronary artery disease (48%), acute pulmonary edema (20%) and hyperkalemia (12%) were the main causes of death. Subsequent evaluation revealed that 102 (51%) patients had ESRD of which only 3 (2.94%) patients could afford CAPD. A total of 11 (10.7%) patients underwent chronic maintenance hemodialysis for 3-4 months and then discontinue dialysis mainly because of financial constraints. Remaining 88 (86.27 %) patients with ESRD were discharged from hospital after symptomatic improvement with acute dialysis. Thus, diabetic nephropathy related to type-2 diabetes was the commonest cause of CRF in our elderly patients. Chronic renal failure in elderly was associated with a number of co-morbid conditions, which contributed significantly to morbidity and mortality. Acute on chronic renal failure with severe uremic complications were an important cause of hospitalization. The financial constraint was the major limiting factor for the management of elderly ESRD patients.

Aged↗

Anti-filarial activity of novel formulations of albendazole against experimental brugian filariasis.

The study was aimed at developing better orally active albendazole (ALB) formulations. Six formulations (ALB-1 to ALB-6) were prepared and tested against Brugia malayi in Mastomys coucha and jird (Meriones unguiculatus) at 200 mg/kg, orally, for 5 consecutive days. The anti-filarial efficacy was assessed against microfilariae (mf), adult worms and female reproductive potential. Three of the 6 ALB formulations showed greatly improved female worm sterilizing potential (ALB-1: 90%; ALB-3: 63%; ALB-4: 77% of untreated control) in B. malayi - M. coucha model. Sterilization efficacy of ALB-1 was also better than that shown by pure-ALB (P<0.001) or its marketed tablet formulation, Zentel (P<0.01), while that of ALB-4 was better than pure-ALB (P<0.05). The activity of ALB-3, pure-ALB and Zentel was, however, comparable. ALB-1 also showed late microfilaricidal activity with a maximum of 78% fall in microfilarial count. In contrast, neither the pure ALB nor Zentel showed any microfilaricidal activity. In the jird - B. malayi model, ALB-1 and ALB-4 showed marginal sterilizing efficacy whereas pure ALB or Zentel were ineffective. In conclusion the anti-filarial efficacy of ALB-1 was found to be superior to pure-ALB or Zentel.

Albendazole↗

Deglutitive laryngeal closure in stroke patients.

BACKGROUND: Dysphagia has been reported in up to 70% of patients with stroke, predisposing them to aspiration and pneumonia. Despite this, the mechanism for aspiration remains unclear. AIMS: To determine the relationship between bolus flow and laryngeal closure during swallowing in patients with stroke and to examine the sensorimotor mechanisms leading to aspiration. METHODS: Measures of swallowing and bolus flow were taken from digital videofluoroscopic images in 90 patients with stroke and 50 healthy adults, after repeated volitional swallows of controlled volumes of thin liquid. Aspiration was assessed using a validated Penetration-Aspiration Scale. Oral sensation was also measured by electrical stimulation at the faucial pillars. RESULTS: After stroke, laryngeal ascent was delayed (mean (standard deviation (SD)) 0.31 (0.06) s, p<0.001), resulting in prolongation of pharyngeal transit time (1.17 (0.07) s, p<0.001) without a concomitant increase in laryngeal closure duration (0.84 (0.04) s, p = 0.9). The delay in laryngeal elevation correlated with both the severity of aspiration (r = 0.5, p<0.001) and oral sensation (r = 0.5, p<0.001). CONCLUSIONS: After stroke, duration of laryngeal delay and degree of sensory deficit are associated with the severity of aspiration. These findings indicate a role for sensorimotor interactions in control of swallowing and have implications for the assessment and management of dysphagia after stroke.

Adult↗

Interaction of lead with some essential trace metals in the blood of anemic children from Lucknow, India.

BACKGROUND: The effects of lead on the hematological system results in the inhibition of heme synthesis and in anemia. Lead may affect the absorption and metabolism of essential trace metals also. There is little information especially from the northern region of India regarding the relationship between blood lead levels>or=10 microg/dl and anemia in children. We performed a cross-sectional study to evaluate the association of blood lead levels>or=10 microg/dl with anemia, and its effect on hematological system and some essential trace metals in children. METHODS: A total of 75 children aged 1-7 years, 50 anemic (Hb 8 g%), drawn from Lucknow, India and nearby areas were recruited to determine blood levels of lead, iron, zinc, copper, and calcium along with hematological parameters [delta-aminolevulinic acid dehydratase (delta-ALAD) hemoglobin (Hb), hematocrit, and ascorbic acid]. RESULTS: Based on Centre for Disease Control and Prevention's intervention level of blood lead, children were categorized into those with blood lead<10 microg/dl (6.89+/-2.44) (n=19) (GI) and those with blood lead<10 microg/dl (21.86+/-7.58) (n=56) (GII). After adjustment for child's age, sex, and area of residence, children with blood lead levels>or=10 microg/dl were 2.87 (95% CI: 1.60-2.87) times as likely to have anemia as children with blood lead levels<10 microg/dl. The differences of the adjusted mean values of Hb, delta-ALAD, and hematocrit were significantly lower in children from the GII group when compared to children from the GI group (p<0.01, p<0.01, and p<0.05, respectively). Among essential trace metals, adjusted mean levels of blood iron, zinc, and calcium were significantly lower in GII as compared to GI (P<0.05 each). There were significant negative correlations of blood lead levels with delta-ALAD (r=-0.612, p<0.01), hematocrit (r=-0.427, p<0.05), iron (r=-0.552, p<0.05) zinc (r=-0.427, p<0.05), and calcium (r=-0.324, p<0.05). CONCLUSION: Results indicate that elevated blood lead levels (>or=10 microg/dl) in children were significantly associated with risk of anemia and that blood lead levels also influenced the status of essential trace metals. However, results of this study may be limited due to limited sample size but certainly form the basis of a larger sample size study, taking into account all the known potential confounders of anemia in children.

Anemia↗

Systematic review: the effectiveness of hypnotherapy in the management of irritable bowel syndrome.

AIM: To systematically review the literature evaluating hypnotherapy in the management of irritable bowel syndrome (IBS). METHODS: Electronic databases were searched (Cochrane Library, Medline, CINAHL, AMED, Embase, PsycINFO, CISCOM, TRIP and the Social Science Citation index), bibliographic references scanned and main authors contacted. No restrictions were placed on language or publication year. Eligible studies involved adults with IBS using single-component hypnotherapy. All studies, except single case or expert opinion, were sought and all patient-related outcomes eligible. RESULTS: Out of 299 unique references identified, 20 studies (18 trials of which four were randomized, two controlled and 12 uncontrolled) and two case series were eligible. These tended to demonstrate hypnotherapy as being effective in the management of IBS. Numbers of patients included were small. Only one trial scored more than four out of eight on internal validity. CONCLUSION: The published evidence suggests that hypnotherapy is effective in the management of IBS. Over half of the trials (10 of 18) indicated a significant benefit. A randomized placebo-controlled trial of high internal validity is necessary to establish the effectiveness of hypnotherapy in the management of IBS. Until such a trial is undertaken, this form of treatment should be restricted to specialist centres caring for the more severe forms of the disorder.

Adult↗

Frequent requirement of hedgehog signaling in non-small cell lung carcinoma.

Although it had previously been suggested that the hedgehog (HH) pathway might be activated in some lung tumors, the dependence of non-small cell lung carcinomas (NSCLC) for HH activity had not been comprehensively studied. During a screen of a panel of 60 human tumor cell lines with an HH antagonist, we observed that the proliferation of a subset of NSCLC cell lines was inhibited. These NSCLC cell lines express HH, as well as key HH target genes, consistent with them being activated through an autocrine mechanism. Interestingly, we also identified a number of NSCLC cell lines that express high levels of the downstream transcription factor GLI1 and harbor enhanced levels of HH activity, but appear insensitive to known HH antagonists. We hypothesized that the high levels of GLI1 in these cells would function downstream of the HH antagonist target, allowing them to bypass the antagonist-mediated block in proliferation. Consistent with this hypothesis, when the levels of GLI1 are knocked down in such cells, they become sensitive to these inhibitors. We go on to show that a large percentage of primary NSCLC samples express GLI1, consistent with constitutive activation of the HH pathway in these samples. Taken together, these results establish the involvement of the HH signaling pathway in a subset of NSCLCs.

Carcinoma, Non-Small-Cell Lung↗

Heavy metal load of soil, water and vegetables in peri-urban Delhi.

Peri-urban lands are often used for production of vegetables for better market accessibility and higher prices. But most of these lands are contaminated with heavy metals through industrial effluents, sewage and sludge, and vehicular emission. Vegetables grown in such lands, therefore, are likely to be contaminated with heavy metals and unsafe for consumption. Samples of vegetables i.e., spinach (Spinacia oleracea L.) and okra (Abelmoschus esculentus L.); soil and irrigation water were collected from 5 peri-urban sites of New Delhi to monitor their heavy metal loads. While heavy metal load of the soils were below the maximum allowable limit prescribed by the World Health Organization (WHO), it was higher in irrigation water and vegetable samples. The spinach and okra samples showed Zn, Pb and Cd levels higher than the WHO limits. The levels of Cu, however, were at their safe limits. Metal contamination was higher in spinach than in okra. Spatial variability of metal contamination was also observed in the study. Bio-availability of metals present in soil showed a positive relationship with their total content and organic matter content of soil but no relationship was observed with soil pH. Washing of vegetables with clean water was a very effective and easy way of decontaminating the metal pollution as it reduced the contamination by 75 to 100%.

Abelmoschus↗

Decolorization of triphenylmethane dye-bath effluent in an integrated two-stage anaerobic reactor.

In the present study, decolorization of a simulated dye waste containing three different triphenylmethane (TPM) dyes--Magenta, Malachite Green and Crystal Violet, was investigated in a laboratory scale, two-stage anaerobic high-rate reactor. The effect of various parameters (influent dye concentration, hydraulic and co-substrate loading rates) on color and COD removal efficiency of the reactor has been studied. It has been shown that the influent dye concentration had little effect on overall COD and color removal efficiency. More than 99% color removal and 96% COD removal efficiency were maintained even at a dye concentration of 500 mg/l and a dye loading rate of 1000 mg/l day. However, a minimum level of glucose as supplementary carbon source is required to maintain the maximum color removal efficiency and it drops appreciably when no glucose is added to the influent. The study also showed that the acidogenic phase of the reaction plays an important role in decolorization of the TPM dyes. In addition, the two-stage anaerobic reactor was observed to have distinct advantages over the single-stage system, as the drop in color and COD removal efficiency of stage 1 are adequately compensated by stage 2 of the reactor especially under high dye loading rates accompanied by low co-substrate loading and under reduced HRTs.

Bacteria, Anaerobic↗

Risk of conjunctival contamination in total joint arthroplasty.

This study arose from a concern about the transmission of infection through conjunctival contamination during total joint arthroplasty surgery. A prospective analysis of 110 sets of personal face and eye protective equipment (Sterishields) used for 29 total hip arthroplasties (THA) and 26 total knee arthroplasties (TKA) were examined for macroscopic contamination. In additition, a postal questionnaire regarding the perceived risk of eye contamination and current practice of eye protection used during TKA and THA surgery was sent to 1500 Fellows of the British Orthopaedic Association. All Sterishields demonstrated macroscopic contamination with an average of 203 blood and fat spots. The number of these was significantly higher in the lower half of the Sterishields. Of the 834 useable replies, 48% of respondents did not use adequate eye protection routinely. Twenty-eight percent felt that no eye protection was needed, while 45% felt that the eye protection available compromised their vision and so did not use it. One hundred and seven respondents (13%) reported being aware of eye contamination, while 21 (2.5%) respondents were aware of at least one case of conjunctival infection following contamination. This study demonstrates that there is a high risk of conjunctival contamination with fat and blood in major total joint arthroplasty. The reported use of appropriate eye and face protection in the UK has been shown to be low (52%).

Arthroplasty, Replacement, Hip↗

Influence of pressure on the electric-field-induced phase transitions in liquid crystals.

Within the framework of Landau-de-Gennes formulation, we analyse the effect of pressure on electric-field-induced phase transitions in a liquid crystal which shows spontaneously an isotropic-smectic A transition. Inferring from the experimental pressure dependences on the layer spacing in smectic A phase, as well as the nematic-smectic A metastable temperature T*(AN), we incorporated the pressure dependence in the free energy through (the surface energy term) and the coupling between the quadrupolar nematic ordering Q(ij) and the smectic order parameter psi. From the S-T phase diagram, we found that the stability of field-induced nematic phase increases with pressure, whereas the discontinuity of the transition decreases. Also, the region where paranematic phase transits directly to smectic A phase increases with pressure.

Electricity↗

The influence of different management systems and age on intestinal morphology, immune cell numbers and mucin production from goblet cells in post-weaning pigs.

At time of weaning, the immune system in piglets is not fully mature resulting in reduced growth and increased mortality. Early-weaned pigs transported to a segregated early weaning (SEW) facility have enhanced performance and gut development compared to conventional (CONV) pigs which may be due, in part, to decreased pathogen challenge. To gain further insight into SEW enhanced performance and gut development, gut samples from pigs weaned at 19+/-2 days were assessed during the post-weaning (PW) period. The numbers of cells expressing CD2, CD4, CD8, and CD172 (the 74-22-15 (SWC3) antibody is now known to be specific for CD172), MHC class II, and CD25 were quantified using immunohistochemistry. Additionally, samples of duodenum, jejunum, and ileum were evaluated for the production of neutral, acidic, and sulfuric mucins from goblet cells and morphological measurements were also made. No effects due to the management systems alone were observed for any of the parameters. However, there were interactive effects of age/time post-weaning and management system on the immune cells as well as on the mucin secreting goblet cells. There were no differences in gut morphology between SEW and CONV reared pigs.

Age Factors↗