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Biomedical subjects

S Talwar

Publications and source records attributed to S Talwar.

17 recordsLinked to original sources

VDRL titres in early syphilis before and after treatment.

OBJECTIVE: To observe the pretreatment VDRL titres in different stages of early syphilis and evaluate the changes in VDRL titre following treatment using different treatment schedules. DESIGN: Retrospective study was carried out by analysing the records of cases of early syphilis treated between 1976 to 1981. SETTING: Armed Forces personnel treated at different service hospitals in India. SUBJECTS: Of 3183 cases of early syphilis treated with different regimens during this period, 1532 were fully followed-up for a period of 30 months. Records of these 1532 cases were analysed. MAIN OUTCOME MEASURES: Assessment of VDRL titres before treatment and during post treatment surveillance period of 30 months. Attainment of non-reactivity of VDRL test in various stages of early syphilis using different treatment schedules was evaluated. RESULTS: Relatively higher titres were observed in secondary syphilis. Following treatment it was observed that VDRL test was still reactive at the end of 6 months in 16.47% of primary, 27.56% of secondary and 18.95% of early latent cases; at the end of 12 months in 11.38% of primary, 17.25% of secondary and 15.79% of early latent cases while at 30 months reactivity was still observed in 6.60% of primary, 8.39% of secondary and 11.58% of early latent cases. CSF was examined in 1173 cases at 6 months, of which one case revealed VDRL reactivity while two cases showed reactivity amongst 1188 CSF examined at 30 months. There has been no significant difference with broad spectrum antibiotics and 2.4 MU benzathine penicillin. Results were better with 4.8 MU benzathine penicillin and procaine penicillin. CONCLUSION: VDRL test appears to be a reliable test for the follow-up of treated patients in early syphilis. Early treatment prevents development of seropositivity in seronegative syphilis while majority of seropositive cases attain seronegativity by 6 months. Higher doses of benzathine penicillin and procaine penicillin accelerate the speed of seroconversion.

Antigens, Bacterial

Neuritic leprosy: epidemiology and therapeutic responsiveness.

We studied epidemiology, progression and therapeutic responsiveness in 62 cases of neuritic leprosy. Numbness was the main presenting symptom. Mononeuritis involving the ulnar nerve, followed by the common peroneal nerve was the commonest presentation. The lepromin test was positive in 34 cases while a slit-skin smear was negative in all cases. We treated 20 of these cases with dapsone monotherapy and 5 cases (25%) developed a skin lesion after an average duration of 3 months' treatment. We treated 42 cases with a combination of dapsone and rifampicin, and 3 cases (7%) developed a skin lesion after an average duration of 2-6 months. The subsequent diagnosis in cases developing skin lesions was borderline--lepromatous in 1 case, borderline-tuberculoid in 4 cases, tuberculoid in 2 cases and indeterminate in 1 case.

Adult

Localized borderline lepromatous leprosy.

A 48-year-old soldier presented with 3 small leprosy lesions localized over the flexor area of the forearm. There was no nerve thickening and clinically the lesions looked like borderline-tuberculoid leprosy. However, these lesions demonstrated a bacteriological index (BI) of 4+ while no acid-fast bacilli (AFB) could be demonstrated from any other site of the body. A lepromin test was negative. Histologically evidence of borderline lepromatous leprosy was conspicuous. The case was diagnosed as localized borderline lepromatous-leprosy and treated with multidrug therapy. After 1 year of treatment, the lesions regressed, a lepromin test was positive (5 mm) and the BI from the lesions fell to 1+.

Forearm

Ultrasonic evaluation of intra-abdominal abscesses.

This study describes the role of ultrasound in the evaluation of abdominal abscesses in children. A total of 41 abscesses were encountered in 36 patients (21 boys and 15 girls). The youngest patient was 1-month-old. Abscesses were localised at various sites (hepatic, renal, perirenal, paracolic, appendicular, pelvic, psoas, subphrenic, parietal), and of varied sonographic patterns (complex, anechoic, hypoechoic and containing uniform low level echoes). Most of them had irregular walls.

Abdomen

Testing of autonomic cardiovascular regulation--methodological considerations.

The different analyses of the results on autonomic nervous function tests were evaluated in 43 male and 32 female diabetic patients and in 24 male and 24 female control subjects, aged 47-67 years, all without any known heart disease. The Valsalva ratio of the first effort did not differ from the mean Valsalva ratio of three efforts. During deep breathing, heart rate variation and max/min R-R interval ratio determined from the first three breathing cycles did not differ from the respective variables calculated from six consecutive breathing cycles. Diastolic blood pressure response to isometric handgrip was greater during the third minute than during the first and the first two minutes. In conclusion, the tests for the evaluation of autonomic nervous function can be simplified without losing their diagnostic value.

Aged

Role of ultrasound in the evaluation of blunt abdominal trauma.

Twenty nine cases of intra abdominal injuries who became stable after initial shock were selected for ultrasound examination. Ultrasound detected intra-abdominal hematomas in 19/29 (65.51%). These cases were managed conservatively. The different types of hematomas encountered were renal, hepatic, splenic, retroperitoneal and parietal.

Abdominal Injuries

Impaired left ventricular systolic function during exercise in middle-aged insulin-dependent and noninsulin-dependent diabetic subjects without clinically evident cardiovascular disease.

Equilibrium radionuclide angiocardiography was performed on 19 men and 17 women with insulin-dependent diabetes mellitus (IDDM) and on 24 men and 15 women with noninsulin-dependent diabetes mellitus (NIDDM) and on 24 male and 24 female control subjects aged 46 to 67 years. All were without clinically evident cardiovascular disease. No significant differences were found in left ventricular (LV) ejection fraction at rest between men with IDDM (56 +/- 1%; mean +/- standard error of the mean) or NIDDM (58 +/- 1%) and control men (58 +/- 1%), whereas LV ejection fraction was higher in women with IDDM (63 +/- 1%; p less than 0.01) and NIDDM (64 +/- 2%; p less than 0.01) than in control women (58 +/- 1%). An abnormal LV ejection fraction response to dynamic exercise (an increase of less than 5% units or a decrease) was observed in 1 control man (4%), in 8 men with IDDM (42%, p less than 0.01) and in 10 men with NIDDM (42%, p less than 0.01). The respective figures were 4 (17%) for control women, 7 (44%, difference not significant) for women with IDDM and 10 (71%, p less than 0.01) for women with NIDDM. Abnormal LV ejection fraction response to exercise in diabetic patients was not related to the metabolic control of diabetes, presence of microangiopathy or abnormalities in the autonomic nervous function. Myocardial perfusion scintigraphy performed in 18 diabetic patients in whom LV ejection fraction decreased during exercise showed a reversible perfusion defect in only 5 (28%).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged

Impairment of diastolic function in middle-aged type 1 (insulin-dependent) and type 2 (non-insulin-dependent) diabetic patients free of cardiovascular disease.

Left ventricular systolic and diastolic function was studied using systolic time intervals and echocardiography in 19 male and 17 female patients with Type 1 (insulin-dependent) diabetes, 24 male and 15 female patients with Type 2 (non-insulin-dependent) diabetes and 24 male and 24 female control subjects. The subjects for the present study were selected from a population based study in which 117 Type 1 and 510 Type 2 diabetic patients and 649 non-diabetic subjects were originally examined. After exclusions, none of the subjects had any evidence of coronary heart disease, hypertension or other diseases known to affect left ventricular function. There were no consistent differences in systolic time intervals or echocardiographic variables of systolic function between patients with Type 1 diabetes and non-diabetic control subjects; but patients with Type 2 diabetes showed an increased fractional shortening. Female patients with Type 2 diabetes showed an increased left ventricular mass not explicable by hypertension. Isovolumic relaxation period was longer in male (86 +/- 3 ms; mean +/- SEM) and female patients (84 +/- 6 ms) with Type 2 diabetes than in male (76 +/- 3 ms; p less than 0.05) and female (71 +/- 3 ms; p less than 0.05) control subjects. Peak diastolic filling rate was lower in female patients with Type 1 diabetes (12.8 +/- 0.8 cm/s, p less than 0.05) and in male (11.5 +/- 0.8 cm/s; p less than 0.01) and female patients (11.5 +/- 0.6 cm/s; p less than 0.001) with Type 2 diabetes as compared to male (14.4 +/- 0.7 cm/s) and female (14.9 +/- 0.5 cm/s) control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Diabetes Mellitus, Type 1

Spina bifida occulta with atrophy of toes.

A case of lumbosacral spina bifida occulta presented with resorption of toes which started at six years of age. Its differential diagnosis with neural leprosy is discussed.

Adult

Aphallia.

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Humans

Thymoma.

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Humans