Two patients with portal vein thrombosis from lupus anticoagulant.
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Adult↗
Biomedical subjects
V Ahuja
Publications and source records attributed to V Ahuja.
Evaluation of primary pulmonary carcinoid tumors using FDG PET.
OBJECTIVE: The purpose of this study was to determine the spectrum of positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) findings in patients who have primary pulmonary carcinoid tumors. CONCLUSION: On FDG PET imaging, pulmonary carcinoid tumors usually have lower FDG uptake than expected for malignant tumors. Biopsy or close radiologic follow-up is therefore recommended for solitary pulmonary nodules that are clinically suspected of being carcinoid tumors and that do not show increased metabolic activity on FDG PET images.
Adult↗
A case-control investigation on cancer of the ovary in Bangalore, India.
Cancer of the ovary is the sixth leading cancer among females in Bangalore, and is a leading site of cancer in other population-based cancer registries in India. A case-control investigation was conducted utilizing the data from the population-based cancer registry in Bangalore. In addition to the core patient information, certain other details pertaining to consumption of tobacco, reproductive and obstetric factors and those related to the practice of family planning, including the method adopted, were available with the registry, for the period 1982-1985. Identical information was also available for patients residing in the registry area who did not have cancer. Ninety-seven cases of ovarian cancer in ever-married women were age-matched with 194 controls from the same area who showed no evidence of cancer. The risk of ovarian cancer was not influenced by tobacco habits, alcohol consumption, diet or the various reproductive factors. However, tubectomy as a method of family planning appeared to reduce the risk of development of ovarian cancer. This reduction in risk was not influenced by parity or age of the woman at the time of birth of the first child.
Case-Control Studies↗
Identification of two subpopulations of rat monocytes expressing disparate molecular forms and quantities of CD43.
Expression of CD43 (leukosialin, sialophorin) by rat blood monocytes was analyzed by flow cytometric, microscopic, and biochemical techniques. Monocytes were identified cytometrically using a combination of light-scatter parameters and binding of the anti-monocyte/macrophage monoclonal antibody (mAb) OX-41. Two-color flow cytometry studies with W3/13 and HIS 17, two anti-CD43 mAb that react with different antigenic epitopes, revealed two subpopulations of monocytes expressing disparate levels of CD43 (referred to hereafter as hi-CD43 MO and lo-CD43 MO). In three-color flow cytometry studies, hi-CD43 MO were found to express higher levels of CD4 than lo-CD43 MO; in contrast, lo-CD43 MO bound higher levels of RP-3, a mAb raised against rat neutrophils. Hi- and lo-CD43 MO expressed comparable amounts of CD14, CD45, and intercellular adhesion molecule-1 (CD54); hi-CD43 MO expressed somewhat more lymphocyte function-associated antigen-1 alpha chain (CD11a) and CD18 than their lo-CD43 MO counterparts. A minority of cells in both subpopulations expressed class II histocompatibility antigens. Hi- and lo-CD43 MO isolated by fluorescence-activated cell sorting had features typical of monocytes as assessed by light and electron microscopy. In Western blotting experiments, lo-CD43 MO and elicited peritoneal macrophages were found to express a less heavily sialylated form of CD43 than hi-CD43 MO.
Animals↗
An ascending non-obstructive model for chronic pyelonephritis in BALB/c mice.
Chronic pyelonephritis was successfully produced in female BALB/c mice with Escherichia coli after introduction of the bacterial inoculum by the ascending route. E. coli strain 31-B, a nalidixic acid-resistant derivative of strain TN675 expressing type-1 pili, and E. coli strain BH-5, a mutant of 31-B, not expressing type-1 pili, were used in the model. Both the strains were able to induce chronic renal inflammation in the experimental animals. Whereas the initial colonisation was greater with strain 31-B, its non-pilate mutant BH-5 caused a significantly greater inflammatory response and also caused renal scarring observable 5 months after the infection.
Animals↗
Differential expression of CD43 (leukosialin, sialophorin) by mononuclear phagocyte populations.
CD43 is a hematopoietic cell antigen whose distribution includes T lymphocytes, plasma cells, neutrophils, and platelets. Although it has been detected on peripheral blood monocytes, its expression by other mononuclear phagocytes has not been well documented. Possible changes in monocyte/macrophage CD43 expression in response to inflammation are also poorly defined. To examine these questions, the expression of CD43 by rat peripheral blood monocytes and both resident and elicited peritoneal macrophages was examined. By flow cytometry with two anti-CD43 monoclonal antibodies, blood monocytes were found to express large amounts of surface CD43, whereas surface CD43 expression by resident peritoneal macrophages was negligible. Peritoneal macrophage populations elicited by intraperitoneal injection of thioglycollate were uniformly positive for surface CD43, although the level of expression was lower than that found on monocytes. By labeling resident macrophages with a fluorescent tracer dye, this phenotypic shift was found to reflect an influx of CD43-positive elicited macrophages coupled with a disappearance of CD43-negative resident cells. Evidence from both flow cytometry and Western blotting studies suggests that the CD43 expressed by elicited peritoneal macrophages is less heavily sialylated than that expressed by blood monocytes. These findings, coupled with recent evidence that CD43 influences cellular adhesion, indicate that differential expression of CD43 may play a role in monocyte/macrophage trafficking.
Animals↗
Management of amebic liver abscess.
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Antiprotozoal Agents↗
Double blind controlled trial of effect of cisapride on gastric emptying in diabetics.
AIMS: Diabetic gastroparesis is a common complication seen in 20-50% of patients due to autonomic neuropathy involving vagal supply. Cisapride, a specific gastrointestinal cholinomimetic agent may thus be effective. METHODS: Fifty-one diabetic patients (age 12-65 years) of disease duration > 5 years were assessed for symptomatic gastroparesis, other diabetic complications and glycemic control. Gastric emptying time (GET) was estimated using a solid meal method (99mTc labeled rice based idli) and patients randomized to receive either cisapride or placebo for a period of 2 weeks. Cisapride was administered in a dose of 10 mg TID. GET and symptom scores were reassessed on the therapy after 2 weeks. RESULTS: Twenty nine of 51 (56.8%) patients had gastroparesis. Mean GET in the gastroparesis group was 141 +/- 66 minutes compared to 24.53 +/- 10 minutes in the non gastroparesis group (p < 0.01). GET decreased by 72% amongst the patients who received cisapride compared to 23% in the placebo group (p < 0.001). Symptom scores also improved in the cisapride group; no adverse effects were noted. CONCLUSIONS: Cisapride improves the symptom score and the solid gastric emptying time in patients suffering from diabetic gastroparesis.
Adolescent↗
Aetiological spectrum of obstructive jaundice and diagnostic ability of ultrasonography: a clinician's perspective.
BACKGROUND: A vast array of invasive and non invasive diagnostic tests are available to diagnose and establish the etiology of surgical obstructive jaundice (SOJ). Invasive tests may cause cholangitis and imaging techniques like computed tomography(CT) scan and MRI are expensive. The aim of the present study was to test ultrasonography as the primary investigation in patients with SOJ and to elucidate the aetiological spectrum of obstructive jaundice as seen at a tertiary referral center. METHODS: 429 patients diagnosed as having obstructive jaundice on the basis of either CT, endoscopic retrograde cholangiopancreatography(ERCP), fine needle aspiration cytology(FNAC) or surgery underwent real time sonography over a 10 year period from May 1988 to Dec 1997. The diagnostic accuracy of ultrasonography for SOJ was established. RESULTS: Sonography correctly established the presence of obstructive jaundice in 380 of 429 patients. Of 429 patients (mean age 62.5 +/- 34.2 yrs, 229 males and 194 females) the sensitivity of ultrasound to correctly diagnose and establish the site of etiology of obstruction was 94% with a specificity of 96%. Malignant SOJ was much more common than benign causes (75.3% Vs. 24.7%). Carcinoma (Ca) of the gallbladder (28.7%) was the commonest aetiology followed by Ca pancreas (26.5%), choledocholithiasis (12.4%), cholangio Ca (10.8%) benign stricture (10.8%) and ampullary Ca (9.8%). A total of 167 subjects (44%) had high block while 213 (56%) had low block. Block at the porta hepatis was due to gallbladder Ca in 91% of patients. Ca pancreas was the cause of lower end block in 76% of patients. CONCLUSION: SOJ, as seen in this large series of patients was most often due to malignant cause and gallbladder Ca was the commonest cause in North Indian patients. The clinician should utilize the ability of the ultrasound to diagnose the presence of obstructive jaundice and its location.
Adult↗
Evaluation of endoscopy-based diagnostic methods for the detection of Helicobacter pylori.
BACKGROUND: Helicobacter pylori is an etiological factor in duodenal ulcer. Few studies have objectively assessed the accuracy of diagnostic methods for the detection of H. pylori. METHODS: The sensitivity and specificity of histology, touch smear, rapid urease test (RUT) and brush cytology of endoscopic antral biopsy from patients with duodenal ulcer were compared. Forty-nine patients were evaluated before, and 34 after, eradication therapy. Each time, sampling was done for all 4 tests. The infection status for each sample was established by a positive concordance of results of three of four tests. RESULTS: The highest degree of agreement was between RUT and cytology (kappa = 0.69). Brush cytology (100%) followed by RUT (94.5%) were the most sensitive tests. Histology had the highest specificity (89.3%). A combination of RUT or brush cytology with histology had the maximum chance of detecting H. pylori. As single tests, brush cytology and touch smear had high diagnostic accuracies with a Youdin J value of 1.79 and 1.78, respectively. CONCLUSION: The best method for diagnosis of H. pylori is a combination of the rapid urease test or brush cytology with histology. Brush cytology or touch smear are diagnostic tests of choice if a single test is desired.
Adult↗
Reprocessing of endoscopes requires guardians.
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Body Fluids↗
Prevalence of Helicobacter pylori infection by 13C-urea breath test in conference delegates.
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Adult↗
A peptide inhibitor of HIV-1 protease using alpha, beta- dehydro residues: a structure based computer model.
HIV-1 encodes an aspartic protease, an enzyme crucial to viral maturation and infectivity. It is responsible for the cleavage of various protein precursors into viral proteins. Inhibition of this enzyme prevents the formation of mature, infective viral particles and therefore, it is a potential target for therapeutic intervention following infection. Several drugs that inhibit the action of this enzyme have been discovered. These include peptidomimetic inhibitors such as ABT-538 and saquinavir, and structure based inhibitors such as indinavir and nelfinavir. Several of these have been tested in human clinical trials and have demonstrated significant reduction in viral load. However, most of them have been found to be of limited clinical utility because of their poor pharmacological properties and also because the viral protease becomes rapidly resistant to these drugs on account of mutations in the enzyme. One way to overcome these limitations is to design an inhibitor that interacts mainly with the conserved residues of HIV-1 protease. By a rational drug design approach based on the high resolution X-ray crystal structure of the HIV-1 protease with--MVT 101 (a substrate based inhibitor) and the specific design principles of peptides containing dehydro-Alanine (delta Ala) derived from our earlier studies, we have designed a tetrapeptide with the sequence: NH2-Thr-delta Ala-delta Ala-Gln-COOH. Energy minimization and molecular modelling of the interaction of the designed tetrapeptide with the inhibitor binding site indicate that the inhibitor is in an extended conformation and makes excessive contacts with the viral enzyme at the interface between the protein subunits. The designed inhibitor has 33% of its interaction with the conserved region of HIV-1 protease which is of the same order as that of MVT 101 with the enzyme.
HIV Protease Inhibitors↗
Randomized trial of a quadruple-drug regimen and a triple-drug regimen for eradication of Helicobacter pylori: long-term follow-up study.
BACKGROUND: In developing countries, H. pylori eradication rates are suboptimal. A quadruple-drug regimen may improve on the eradication rate achieved with triple-drug regimen. METHODS: 64 consecutive patients with active duodenal ulcer associated with H. pylori infection were randomized to receive either a one-week triple-drug regimen (lansoprazole, clarithromycin, secnidazole) or a one-week quadruple-drug regimen (lansoprazole, amoxycillin, colloidal bismuth subcitrate, secnidazole). H. pylori eradication and ulcer healing were assessed 4 weeks after completion of therapy. Patients were followed up at 24 weeks and 52 weeks for H. pylori recurrence. RESULTS: Both the regimens eradicated H. pylori in 75% (95% CI 0.6-0.9) of patients. The ulcer-healing rate with the triple-drug regimen was 97% (95% CI 0.91-1.0) and 91% (95% CI 0.91-1.0) with the quadruple-drug regimen. No ulcer or H. pylori recurrence occurred in patients eradicated with the triple-drug regimen, whereas 8.3% of patients eradicated with the quadruple-drug regimen had ulcer as well as H. pylori recurrence during the 52-week follow up. CONCLUSION: Triple-drug regimen achieves similar eradication rates as quadruple-drug regimen in H. pylori infection.
2-Pyridinylmethylsulfinylbenzimidazoles↗
Symptom score does not correlate with gastritis grade and Helicobacter pylori infection in non ulcer dyspepsia.
BACKGROUND: Non ulcer dyspepsia (NUD) is being postulated as one of the gastroduodenal manifestations of H. pylori infection. H. pylori infection may result in clinical symptoms as well as histological changes in NUD. AIM: To compare clinical symptom score and histological changes in H. pylori (Hp) positive and negative untreated NUD patients. METHODS: Forty six patients with dyspeptic symptoms and normal upper GI endoscopic examinations were included in this study. During endoscopy 2 biopsies each were taken from the antrum and body of the stomach. These biopsies were used for rapid urease test (RUT) and histological examination. Patients were diagnosed to have Hp infection if either of two tests were positive. There were two groups of patients: Hp positive and Hp negative NUD patients. Clinical scoring using Glasgow dyspepsia score (Max. 20) and histological analysis, using Sydney system (Max score 11) was done and compared for both the groups of patients. Clinical scoring, RUT and histological scoring were blinded to each other. RESULTS: H. pylori was present in 29(63%) of the 46 patients. Mean clinical score for H. pylori positive patient was 10.9 while for Hp negative patient was 11.4. Total histological score for Hp positive and Hp negative patients was 3.37 Vs 1.76 (antrum) and 3.68 Vs 1.29(body) (p < .001), respectively. The only histological change found to be statistically significant between Hp positive and Hp negative patients was presence of lymphoid follicles (p < .05). CONCLUSION: Clinical scoring does not correlate with the presence of H pylori or histological severity. In NUD patients positive for H. pylori, there is a significant increase in the severity of gastritis both in the antrum and the body.
Adult↗
Radiofrequency ablation: a new therapeutic modality for the management of hepatocellular cancer.
We report two patients of hepatocellular cancer who recently underwent radiofrequency ablation at our center. Both underwent successful ablation of the tumour requiring 1-2 sessions of upto 15 minutes. There were no post procedure complications. One of the patients had developed another lesion after 10 months of follow up and underwent another session of RFA, while the second patient is doing well after one year of the procedure.
Carcinoma, Hepatocellular↗