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Subhash Varma

Publications and source records attributed to Subhash Varma.

22 records · Page 2Linked to original sources

Depression among hospitalised medically ill patients: a two-stage screening study.

BACKGROUND: There is wide variability in prevalence of depression in the physically ill. Moreover, data from the developing world is scarce. METHODS: Consecutive patients between the age 20-60 years and excluding those with malignancies and neurological illnesses, admitted to medical units (N=176), were screened with Beck's Depression Inventory (BDI). Those scoring more than 10 on BDI (N=55) were assessed with the Schedule for Clinical Assessment in Neuropsychiatry (SCAN). Age/sex matched healthy relatives served as controls. RESULTS: Thirty two percent (32%) of patients scored more than 10 on the BDI. None among controls scored more than the cut-off on BDI. Second-stage screening with SCAN on 33 subjects yielded a figure of 17% for depressive syndrome among the physically ill. Depression was mostly of the mild to moderate variety. CONCLUSIONS: High rates of depression were detected among physically ill hospitalised patients. Perhaps, differences in instruments used and population screened accounted for this. CLINICAL IMPLICATIONS: Need for increasing awareness as well as improving methods of detecting depression in physically ill is underscored. LIMITATIONS: a significant number of patients who screened positive on the BDI could not be interviewed with the SCAN for various reasons. Thus figures obtained after second stage screening are likely to be an underestimate.

Adult↗

Flow cytometric characterization of phenotype, DNA indices and p53 gene expression in 55 cases of acute leukemia.

OBJECTIVE: To characterize the phenotype of acute leukemia cases using flow cytometry, to detect mixed lineage cases and to use DNA index determination, including S-phase fraction (SPF) and p53 detection, to find if there was any correlation of SPF and p53 expression with outcome. STUDY DESIGN: Fifty-five cases of acute leukemia were enrolled in this study. A complete hemogram and routine bone marrow examination, including cytochemistry, was done. Mycloperoxidase-negative cases were evaluated on a flow cytometer using monoclonal antibodies. DNA indices were determined by flow cytometry in all cases, and p53 was detected immunohistochemically using the alkaline phosphatase/antialkaline phosphatase technique. RESULTS: Acute myeloblastic leukemia (AML) was diagnosed in 32 cases; acute lymphoblastic leukemia (ALL) was diagnosed in 18 (14 B lineage and 4 T line age). Four cases showed mixed lineage leukemia, and undifferentiated acute leukemia was diagnosed in one case. The mean/range of SPF for these groups were 3.76/0.33-6.91, 6.25/0.15-21.4, 2.89/0.35-10.64, 2.60/0.72-6.94 and 7.34, respectively. Aneuploidy was detected in two cases of B-lineage ALL and tetraploidy in a case of AML-M7, while all others were diploid p53. Was detected in 6 of 55 cases (10.90%). Follow-up was available for 24 patients. Five patients relapsed, and four had B-cell type ALL and were diploid and expressed no p53 gene. SPF% did not show any correlation with outcome. CONCLUSION: These data suggest that within acute leukemia subtypes, there is a wide variation in SPF. SPF does not seem to correlate with outcome. Immunophenotyping is essential to determine the lineage in myeloperoxidase-negative cases. It is perhaps the only way to diagnose mixed lineage leukemia and aberrant expression of markers presently. The p53 gene was detected less frequently. However, more studies are required from different centers with longer follow-up to evaluate prognostic significance.

Adolescent↗