Biomedical subjects
Publications and source records attributed to S Yadav.
Primary gastric lymphoma is an extremely uncommon entity in children, and diffuse large-cell-type lymphoma in this age group is still rarer. An 11-year-old boy with primary gastric lymphoma who responded to CHOP regime is reported.
This prospective randomized controlled study was conducted on 105 cases of pregnancy hypertension and 100 normotensive mothers in third trimester of pregnancy. The aim of the study was to determine the association between the elevated levels of maternal serum beta-hCG (MS-beta-hCG) with type and severity of hypertension and adverse pregnancy outcomes in these patients. Elevated levels were noted in 48.6% cases of pregnancy hypertension compared to controls, where the levels were elevated in 2% cases (P < 0.001). Elevated levels were more commonly seen in proteinuric pregnancy induced hypertension (32.4%) and also when the hypertension was severe (30.4%). The results of this study establish a strong association of elevated MS-beta-hCG levels with pregnancy hypertension and poor pregnancy outcomes in these patients.
A case controlled prospective study of 250 cases of hypertension complicating pregnancy (study group) and 400 normal pregnant women (control group) was carried out to determine the effect of hypertension on maternal and foetal outcome. Pregnancy induced hypertension was present in 96% cases and chronic hypertension in 4% cases. Preterm delivery (28.8% versus 3%), labour induction rate (52.8% versus 3.25%), caesarean section rate (14.8% versus 3.5%), stillbirth rate (4.8% versus 0.25%) and overall perinatal mortality rate (14.8% versus 1%) were higher in study group compared to controls. In study group (40%) babies required special nursery care compared to controls (6.75%). From these results it can be concluded that maternal hypertension is associated with adverse pregnancy outcome.
Any change in risk behavior related to acquisition of human immunodeficiency virus (HIV) infection is likely to reduce simultaneously the risk for other agents transmitted through identical routes. A study carried out in the city of Delhi, India on the load of transfusion associated infections among multitransfused (MT) children in relation to mandatory screening of HIV infection in donated blood indicated unchanged prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV) and hepatitis D virus (HDV) infections among the group of MT children transfused after the implementation of mandatory screening of HIV infections in blood banks, i.e. post-implementation period (prevalence of HBV, HCV and HDV being 32.8%, 31.3% and 1.6% respectively) compared to a group of MT children transfused over a similar duration before the implementation of mandatory screening i.e. pre-implementation period (prevalence of HBV, HCV and HDV being 28.1%, 26.6% and 1.6% respectively). However, reduction could be recorded in the prevalence of IgM and IgG classes of antibodies to both CMV and HSV-2 infections among MT children receiving transfusion during the post-implementation period (prevalence of 3.1% and 37.1% for CMV IgM and CMV IgG respectively; prevalence of 3.1% and 25% for HSV-2 IgM and HSV-2 IgG, respectively) compared to the group of MT children transfused in the pre-implementation period (prevalence of 15.6% and 56.3% for CMV IgM and CMV IgG respectively; prevalence of 18.8% and 45.2% for HSV-2 IgM and HSV-2 IgG, respectively). These reductions were statistically significant (p values < 0.02 and < 0.05 for CMV IgM and CMV IgG; p values < 0.01 and < 0.02 for HSV-2 IgM and HSV-2 IgG respectively). These observations were in accordance with the recorded reduction in the prevalence of CMV and HSV-2 infections and unaltered prevalence of HBV, HCV and HDV infections in the group of donors donating blood during the post-implementation period compared to those donating in the pre-implementation period. Study of epidemiological risk factors among blood donors showed a change in behavior towards safer sex practice with only 13.0% of donors in the post-implementation period having history of sex with one or more female commercial sex workers during their donation periods compared to 41.5% of donors in the pre-implementation period having similar history (p < 0.001). However no change could be recorded in the proportion of donors donating at frequency higher than the permissible guidelines among the two groups. The present study points out nosocomial transmission as well as limitations in the existing guidelines for screening of infectious agents in blood banks as possible incriminating factors towards acquisition of hepatitis virus infections in blood donors as well as in MT children.
We have studied the denaturation of metmyoglobin at pH 6.0 and 25 degrees C by urea and guanidine hydrochloride (GdnHCl) which are known to unfold the protein to the same extent. It has been observed that estimates of protein stability (delta G0N-U) from urea-induced and GdnHCl-induced denaturations do not agree with one another; the linear extrapolation method gave delta G0N-U values of 7.59 +/- 0.33 and 5.35 +/- 0.10 kcal mol-1 for urea and GdnHCl denaturations, respectively. Measurements of the effect of the addition of KCl in the concentration range 0.1-1.0 M to urea denaturation have suggested that this disagreement is not due to the nonionic and ionic characters of urea and GdnHCl, respectively. The functional dependence of the free energy change of unfolding (delta GN-U) on [denaturant], the molar concentration of the denaturant, has been investigated for understanding the cause(s) of the disagreement between the two estimates of delta G0N-U of metmyoglobin. For this purpose, we have studied the GdnHCl-induced denaturation of the protein in the presence of different urea concentrations at pH 6.0 and 25 degrees C and vice versa. These measurements yield delta GN-U values in the full concentration range [Ahmad et al. (1994) J. Biochem. 115, 322-327], and these results provide strong evidence that the delta GN-U dependence on [urea] is linear (linear free energy model of denaturation) and the relation between delta GN-U and [GdnHCl] is curved (binding model of denaturation). It has been observed that the extrapolated value of delta GN-U in urea using the linear free energy model becomes identical to the extrapolated value of delta GN-U in GdnHCl using the binding model.
Obstructive carotid artery disease is responsible for 60% of strokes in the United States and is the third major cause of death. Stent-supported carotid artery angioplasty has the potential to prevent stroke in thousands of patients and offers a number of potential advantages over surgical revascularization (carotid endarterectomy). Results of the prospective observational study at the University of Alabama at Birmingham indicate that carotid stent-supported angioplasty is safe and probably effective in reducing stroke in patients with high-risk cerebrovascular disease. Technical success was achieved in 99% of 146 procedures; 210 stents were placed in 152 vessels, with only 1 instance of stent thrombosis. The rate of major in-hospital complications was unexpectedly low-only 1 death and 2 major strokes. Seven patients suffered minor strokes, but only 2 were left with minor weakness. When compared with a projected complication rate of 6% had these patients undergone carotid endarterectomy, stenting resulted in fewer major events. At 6-month follow-up, 69 of 74 patients were evaluated by angiography or ultrasound, which detected 8 cases of stent deformation and a restenosis rate of < 5%. Because of these instances of stent deformation, use of the Palmaz (biliary) stent was discontinued. Although 1 patient had a transient ischemic attack, no strokes occurred during follow-up. To date, carotid stenting is an investigational procedure. Cardiovascular interventionalists, industry, and the FDA are encouraged to validate this approach through clinical testing. However, improvements in technique, devices, and adjunctive therapies are needed before the method can be tested in randomized trials.
This study suggests a procedure by which binding of denaturants could be detected without any additional information other than that provided in the denaturation profiles of proteins. Two predominantly alpha-proteins, namely ferricytochrome c and metmyoglobin were denatured by guanidine hydrochloride (GdnHCl) in the presence of low fixed concentrations of salts at 25 degrees C and transition between native and denatured states was followed by absorbance measurements in the visible region (500-350 nm). The raw data were converted into transition curves from which Cm, the midpoint of GdnHCl-induced transition, and deltaGapp, the free energy changes on denaturation, were calculated assuming a two-state mechanism, and values of deltaGapp at zero concentration of the denaturant were estimated. It has been observed (1) that chlorides of Na, K, Cs, and Rb do not affect the native conformation of proteins, (2) that GdnHCl-induced denaturations of proteins in presence and absence of sodium bromide, sodium perchlorate and salts of lithium and calcium are reversible, (3) that optical properties of the GdnHCl-denatured state of proteins remain unchanged in presence of the second denaturant, (4) Cm decreases with an increase in the denaturant concentration, and (5) that except for GdnHCl there exist one or more binding sites on the native proteins for the denaturants.
BACKGROUND: It is not known why melanocytic nevi (MN) become dysmorphic (atypical) in patients with the atypical mole syndrome (AMS). A complex origin for acquired MN has been postulated. Genetic predisposition, solar radiation, and/or the formation of a sun-induced circulating mitogenic factor may contribute to the formation of MN. OBJECTIVE: This study was undertaken to help elucidate the pathogenesis of atypical MN in patients with AMS. METHODS: The number of common and atypical MN was determined for a defined sun-protected area on the buttocks in 150 patients with AMS (cases) and 150 control subjects without AMS. Patients and control subjects were matched for age and sex and were classified into risk groups for the development of malignant melanoma according to the Rigel classification. RESULTS: MN on the buttocks were found in 23% of patients with AMS and 9% of control subjects (p < 0.003). In patients versus control subjects the mean number (1.3 vs 1.2, respectively) and mean diameter (5.7 vs 5.9 mm, respectively) of MN on the buttocks did not differ significantly. The MN in both patients and control subjects were not atypical clinically. The odds ratio for having AMS if MN were present on the buttocks was calculated to be 1.56 (95% confidence interval, 1.25 to 1.95). CONCLUSION: Although the patients were 2.6 times more likely to have MN on their buttocks than the control subjects, clinically the MN did not differ significantly in number or appearance from those found on the buttocks of control subjects. It is hypothesized that the formation of some atypical MN requires direct solar radiation for their phenotypic expression.
This study was conducted on 160 females of childbearing age and 40 girls of prefertility age group. The rubella immunity status was analysed according to their age, social class, geographical distribution and previous obstetric history. History of previous rubella infection was obtained in 12% cases only. The over all incidence of rubella immunity was found to be 55%. There was a gradual increase in the immunity status, with peak incidence of 66% between 30 to 34 years of age. Females of low socioeconomic status showed higher incidence of immunity (63%) compared to social class I (40%). Rubella immunity was higher in urban female population (57%), where-as only 49% of rural females were immune to rubella virus infection. The immunity status of women with previous BOH was higher (61%) as compared to those with normal obstetric performance (54.6%). From the above observations, it was concluded that a substantial number of women enter child bearing without immunity to rubella. A simple HAI test for rubella antibody (IgG) can be a good pointer to pick up susceptible female population and the seronegative females should be immunised against rubella before they contemplate pregnancy.
Denaturations of ribonuclease A, lysozyme, and cytochrome c by guanidine hydrochloride (GdnHCl), urea, and GdnHCl-urea mixture were studied at constant temperature and pH to assess the functional dependence of denaturational free energy change (delta GD) on denaturant concentration over an extended GdnHCl concentration range. Conventional analysis of GdnHCl-induced transition curve exhibits a linear plot of delta GD versus [GdnHCl] in the transition zone. To extend delta GD measurements beyond this narrow concentration range, GdnHCl-induced unfolding was measured in the presence of different concentrations of urea. delta GD values from these measurements were corrected for the effect of urea on the free energy change using the appropriate relation. The corrected delta GD data were mapped onto the delta GD versus [GdnHCl] plot. For each protein, the dependence of free energy change on denaturation was found to be linear over the full GdnHCl concentration.
A number of factors, including age, sex and atopic status have been reported to influence levels of serum IgE. Serum samples were obtained from 350 (173 males, 177 females) non allergic normal Indian children of 0-15 years of age. Mean serum IgE value was 65.8 +/- 4.0 IU/ml being significantly higher in males (75.0 +/- 2.7 IU/ml) as compared to females (56.6 +/- 3.0 IU/ml). The levels were found to increase with age irrespective of sex.
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BACKGROUND AND DESIGN: There is an increased risk of developing cutaneous malignant melanomas (MMs) in patients with classic atypical-mole syndrome (AMS). This study compares the incidence of newly diagnosed MMs in patients with classic AMS (cases) with the incidence of newly diagnosed MMs developing in a population without classic AMS (control patients). The charts of 287 white patients with AMS and 831 white patients without AMS were reviewed for the occurrence of newly diagnosed invasive MMs during follow-up. Both cases and control patients were followed up regularly by total-body cutaneous examinations. The cumulative 10-year risk for developing newly diagnosed invasive MMs was calculated (life-table method) for each cohort. RESULTS: Of the 287 AMS cases, 10 developed a newly diagnosed invasive MM, resulting in a 10-year cumulative risk of 10.7%. Of the 831 control patients, two developed a newly diagnosed invasive MM, resulting in a 10-year cumulative risk of 0.62%. CONCLUSION: Patients with classic AMS, regardless of the presence of a personal and/or family history of MM, are at significantly increased risk of developing invasive MMs compared with control patients.
Selenium has been shown to be a cancer preventive agent. A few studies have shown that increased selenium level is associated with decreased cancer incidence and decreased cancer mortality. The present study was carried out to find out the relationship of selenium level with site, extent of disease, recurrence of disease, histopathological diagnosis, anaemia and serum protein level of cancer patients. Plasma selenium level were studied in 100 patients and mean selenium level of 75.35 ng/ml in cancer patients was significantly less than control values (116.99 ng/ml) in normal healthy individuals (P < 0.003). The strongest association of plasma selenium level and cancer was found in cancer breast (70.50 ng/ml) and gastrointestinal tract (73.05 ng/ml) cancer. Selenium level decreased with the progress of disease and recurrence of disease. No significant association between histopathological diagnosis and selenium level was observed. Anaemia and hypoproteinemia was also not found to be related with selenium level.
BACKGROUND: There is an increased risk of new basal cell carcinomas (BCCs) developing in a person who has had a BCC. OBJECTIVE: This study attempts to define the magnitude of this increased risk. METHODS: The charts of 260 white patients with a histologically proven BCC were reviewed for the occurrence of new BCCs. The cumulative 5-year incidence (modified life-table method) for new BCCs developing in these patients was compared with the 5-year incidence in the general white population of the United States. RESULTS: Of the 260 patients, new BCCs developed in 137 within an average of 38.3 months, a 5-year cumulative rate of one or more new BCCs of 45.2%. The yearly risk for new BCCs developing in the study population remained high during the 5-year interval. In the general white population of the United States, the maximal 5-year incidence was calculated to be 5% (p < 0.005, chi-square test). CONCLUSION: Patients with a history of BCC require life-long follow-up because of the high probability of new BCCs developing.
A total of 74 multitransfused (MT) children of beta thalassaemia major were analysed for prevalent viral markers transmitted through transfusion. A higher incidence of serological markers for Hepatitis B virus (HBV), cytomegalovirus (CMV) could be observed in the group of MT children compared to control group. There was a significant trend (chi 2 = 33.4; P < 0.001) in the increase in prevalence of viral markers along with the increase in the number of transfusions. MT children receiving more than 50 transfusions were found to have evidence for at least one or multiple viral infections transmitted through blood. Children receiving more than 50 transfusions were characterized by marked alteration of T3, T8, and B cells while T4/T8 ratio was found to be significantly decreased (P < 0.001) only in the group of children receiving more than 100 transfusions. Relative assessment of the alteration of lymphocyte subsets in various groups of viral infection showed that cases with CMV IgM to have more marked influence on the alteration of T8 cells, T4/T8 ratio, and B cells compared to other groups of viral infections. Reassessment of the lymphocyte subset profile in MT children in the light of CMV IgM positive cases revealed that in children receiving more than 50 transfusions significant alterations of lymphocyte subjects were influenced by the presence of CMV IgM positive cases in these groups. Our study points out that the correlation between the alteration of lymphocyte subset profile and number of transfusion in MT children need to be reassessed in the light of acute CMV infection in the form of CMV IgM.
Dermoscopy (epiluminescence microscopy) is an in vivo technique that enables the clinician to visualize a variety of structures in pigmented cutaneous lesions that are not discernible by naked-eye examination. To identify the histologic correlates of these structures, a series of 71 pigmented neoplasms was documented photographically with and without dermoscopy. These lesions then underwent total excision and careful step-sectioning so that the resulting histologic slides could be correlated with the dermoscopic photographs. The histologic correlates of the pigment network, brown globules, black dots, blotches, hypopigmented areas, white areas, grey-blue areas, and whitish veil are identified. The structures seen under dermoscopy have specific histologic correlates. Understanding these histopathologic correlates will allow clinicians to better evaluate the dermoscopic features of pigmented lesions.