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Biomedical subjects

T Abraham

Publications and source records attributed to T Abraham.

34 records · Page 2Linked to original sources
PubMed1987

Predicting enteric fever without bacteriological culture results.

We used Bayes' theorem to calculate the probability of enteric fever in 260 patients presenting with undiagnosed fever, without recourse to blood or stool culture results. These individuals were divided into 110 patients with enteric fever (63 culture positive, 47 culture negative) and 150 patients with other causes of fever. Comparison of the frequencies of occurrence of 19 clinical and laboratory events, said to be helpful in the diagnosis of enteric fever, in the two groups revealed that only 8 events were significantly more frequent in enteric fever. These were: a positive Widal test at a screening dilution of 1:40; a peak temperature greater than = 39 degrees C; previous treatment for the fever; a white blood cell count less than 9 X 10(6)/litre; a polymorphonuclear leucocyte count less than 3.5 X 10(6)/litre; splenomegaly; fever duration greater than 7 d; and hepatomegaly. When the probability of enteric fever was determined prospectively in 110 patients, using only 6 of these discriminating events, the probability of patients with a positive prediction having enteric fever (diagnostic specificity) was 0.80 (95% confidence interval: 0.68 to 0.91) and the probability of those with a negative prediction not having enteric fever (diagnostic sensitivity) was 0.92 (0.85 to 0.99). Using all 19 events did not alter the diagnostic specificity or diagnostic sensitivity. This study shows that a small number of clinical and laboratory features can objectively discriminate enteric fever from other causes of fever in the majority of patients. Calculating the probability of enteric fever can aid in diagnosis, when culturing for salmonella is either unavailable or is negative.

Bayes Theorem↗
PubMed1987

Immunology of premalignant and malignant conditions of the oral cavity. II. Circulating immune complexes.

Quantitation of circulating immune complexes (CIC) levels was established in patients with oral cancer and oral precancerous lesions. The levels were compared with that in normal controls and chronic chewers of betel quid with no signs of any disease. Both patients with oral cancer and oral precancerous lesions had elevated CIC when compared to both the control groups. The most interesting observations were (a) the CIC levels in the chewing controls were significantly raised when compared to normal controls; and (b) the CIC levels in the patients with premalignant lesions were elevated almost to the same levels as in the oral cancer patients.

Antigen-Antibody Complex↗
PubMed1987

Pathomechanics of congenital and acquired hallux varus: a clinical and anatomical study.

Hallux varus was observed in 69 feet among patients from a rural Indian population. This included three types of congenital hallux varus. The congenital "primary" type was the commonest and was not associated with any other foot deformity. Among the acquired forms was idiopathic hallux varus of middle age, which developed spontaneously in unshod persons and progressed gradually. Hallux varus following chronic arthritis was part of a consistent pattern of foot deformities in which the first ray collapsed in a zig-zag manner in two planes. Although the development of hallux varus is often due to intrinsic muscle imbalance, hallux varus secondary to chronic arthritis seems to occur as a result of both intrinsic and extrinsic muscle imbalance associated with midtarsal and subtalar arthritis. Muscular factors contribute to progression of the deformity also. No anatomical basis for a racial predilection for the deformity was noted. Failure to use footwear could account for the higher incidence of hallux varus in India.

Adolescent↗
PubMed1987

Lymphocyte populations in premalignant lesions and cancer of the oral cavity.

A comparison of the absolute numbers of leukocytes, proportions, and absolute numbers of various lymphocyte populations in patients with precancerous lesions and cancer of the oral cavity along with normal controls was carried out. Total leukocytes and lymphocytes showed reduction in their numbers in the patient group. B lymphocytes showed a significant increase in both its proportion and numbers in premalignant lesions while such an increase was not evident in oral cancer. Reduced T cell proportion and absolute number was noticed in both patient groups. Profound alteration was noticed in the circulating TG and TM populations of lymphocytes. TG cells were significantly increased in both patient groups. The TM population, on the other hand, showed drastic reduction in its numbers. These findings point towards an impairment of the immune response in the precancerous as well as the malignant stage of the disease.

Adult↗
PubMed1986

Diagnosing enteric fever: a reappraisal.

The diagnostic value of 19 clinical and laboratory events was assessed in 150 enteric fever cases. A logistic regression analysis revealed only 8 predicitive variables for the presence or absence of enteric fever. These were, in order of importance, the white blood cell count, the S. typhi H agglutinin titre, body temperature, the S. typhi O agglutinin titre, the S. paratyphi A H agglutinin titre, the S. paratyphi B H agglutinin titre, age and the fever pattern. This study showed that objective variables like the Widal titres were useful in predicting enteric fever, whilst symptoms such as abdominal pain were unhelpful. Use of all 8 variables to calculate the probability of enteric fever might provide an accurate method of diagnosing or confirming enteric fever when culture results are unavailable or negative.

Adult↗
PubMed1983

Effect of metoprolol on cardiac and pulmonary function in chronic obstructive pulmonary disease.

We evaluated the effects of oral metoprolol, 200 mg daily, on cardiac and pulmonary function in 6 patients with chronic reversible airways obstruction and no cardiac dysfunction. The patients were clinically stable. In all patients, baseline forced expiratory volume in 1 second (FEV1) was less than 60% predicted, and increased at least 15% after isoproterenol inhalation. Resting control first pass right and left ventricular radionuclide ejection fractions were normal or only slightly depressed. Compared to placebo, metoprolol did not significantly affect FEV1 or forced vital capacity. Metoprolol did not significantly alter left or right ventricular ejection fraction, measured by first pass radionuclide technique. On patient experienced increased dyspnea on metoprolol, which was not accompanied by changes in clinical exam, spirometry, or ejection fraction. We conclude that metoprolol may be safely administered to a subset of stable patients with chronic reactive airways disease.

Adult↗
PubMed1977

Limits to conceptual rule-learing by schizophrenic patients.

Two studies of conceptual rule-learning by 36 hospitalized psychiatric patients revealed that (a) while all were clinically diagnosed as schizophrenic, they differed widely in their ability to discover abstract rules; (b) the Whitaker Index of Schizophrenic Thinking (WIST) strongly predicted the patients' ability to learn and to apply a conceptual rule; and (c) regardless of severity of conceptual impairment, the patients were unaffected by modest levels of externally generated irrelevant information as presented through the modality of vision. Deficits in abstractive ability, when they exist, are believed to be due to a schizophrenic patient's inability to prevent task-irrelevant information that originates in long-term memory from spilling into and despoiling the operations of working memory.

Adult↗