Biomedical subjects
Publications and source records attributed to V Aggarwal.
Indinavir is a protease inhibitor used in the treatment of HIV infected individuals and as post-exposure prophylaxis. Indinavir is associated with various adverse effects including gastrointestinal, a lipodystrophy syndrome and nephrolithiasis. We describe indirect hyperbilirubinemia as an adverse effect of indinavir in a person on post-exposure prophylaxis (PEP).
OBJECTIVE: To study the change in airway reactivity due to presence of acid in lower esophagus and its reversibility by antacid. METHOD: In this double blind study 12 subjects with asthma and gastroesophageal reflux received acid (N/10 hydrochloric acid) and antacid (mixture of magnesium trisilicate and aluminum hydroxide) perfusion in lower esophagus via a nasogastric tube. The four combinations were antacid-antacid (control), antacid-acid, acid-antacid and acid-acid. Airway reactivity (Histamine PD20) was recorded after each perfusion. RESULTS: Histamine PD20 significantly decreased (airway reactivity increased) (p < 0.05) with all three combinations containing acid as compared to control. No significant difference in airway reactivity was observed if the antacid was given before or after the acid. CONCLUSION: Presence of acid in lower esophagus can increase airway reactivity. This effect lasts longer than the presence of acid in esophagus itself.
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A bacterial culture from telephone mouthpiece showed that 47 percent of the instruments carried pathogenic bacteria. Wiping with a disinfectant swab reduced the number of contaminated telephones. But for complete elimination of bacterial contamination changes in design of mouthpiece holes or type of instrument or using a polythene plastic cover over mouthpiece is recommended.
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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.
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A model district action plan for control of Visceral Leishmaniasis a serious public health problem in north-east Bihar was developed in late 1989 and implemented in 1992 in district Vaishali. A two years implementation resulted in decline in cases and deaths due to Visceral Leishmaniasis to the extent of 65.32% and 46.51% respectively in 1993 as compared to 1992 and 41.13% and 44.93% respectively in 1994 as compared to 1993 with an overall decrease of 79.58% in case and 70.54% in deaths in 1994 as compared to 1992. The implementation of action plan not only established declining trends in morbidity and mortality due to Visceral Leishmaniasis in the district but also successfully contained the cases unresponsive to first line treatment with Sodium Stibogluconate by reducing the prevalence of such cases from 12.42% in 1992 to 8.59% in 1994. Various components of the action plan, implementation strategy and consequent impact on disease situation are presented in this paper.
Ultrasonography (US) remains underutilized as a guidance tool for performing fine needle aspiration cytology (FNAC) mainly because of a lack of understanding and experience in this technique. We describe here our experience in performing 346 FNACs. In our opinion, US guided FNACs are highly accurate and safe procedures which can be done on an out-patient basis, with routinely available equipment.
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Immerslund-Grasbeck syndrome is an uncommon disease, characterized by megaloblastic anaemia and persistent proteinuria. A Libyan boy with the characteristic findings is presented. He received intramuscular vitamin B12 injections and there followed a remarkable clinical and haematological improvement.
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Certain repetitive tasks of the anaesthesiologist are studied and modelled for automatic processing. These analyses make it possible for optimal control procedures to be programmed and administered by less trained anaesthesia professionals. A dynamic programming model is developed and validated with real data collected from several hospitals in the Cleveland, Ohio, area. By conjunctively monitoring certain transients in the anaesthesia administration process, the scarce supply of anaesthesiology manpower can be more efficiently deployed.
Cycloheximide, pactamycin and tenuazonic acid inhibit protein synthesis in eukaryotic cells. It is the purpose of these studies to determine whether these agents would be effective in vivo inhibitors of epidermal DNA synthesis. Single I.P. administration of 1.5 mg/kg cycloheximide, 0, 1 or 3 hours prior to a 45 minute pulse of thymidine-3H inhibited epidermal DNA synthesis by 68%, 63% and 88%, respectively. This response was dose related at 3.75 hours after cycloheximide with no effect at 0.375 mg/kg and maximal inhibition at 1.5 mg/kg. Epidermal DNA synthesis was inhibited 18, 29 and 62% at doses of 1.5, 3.0 and 6.0 mg/kg pactamycin administered 3 hours before thymidine-3H. Similarly, at doses of 70 and 140 mg/kg tenuazonic acid, epidermal DNA synthesis was inhibited by 50% and 60%, respectively. These data suggest the possible use of protein synthesis inhibitors in epidermal disorders.
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