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Biomedical subjects

V Bhat

Publications and source records attributed to V Bhat.

14 recordsLinked to original sources

Parkinson's disease. Diagnosis and the initiation of therapy.

Parkinson's disease (PD) is the most common cause of parkinsonism. Parkinsonism is characterized by resting tremor, bradykinesia, rigidity and gait impairment. There is no specific diagnostic test for PD and it is important for clinicians to understand the clinical signs which help to distinguish PD from parkinsonism. It is equally important to be aware of the clinical signs which can be an indication that the diagnosis is not PD. These so-called Parkinson-plus syndromes include progressive supranuclear palsy (PSP), multiple systems atrophy (MSA), corticobasal degeneration (CBD), vascular parkinsonism (VP) and parkinsonism with dementia (Lewy body dementia, LBD). The differential diagnosis of parkinsonism will be discussed. Initiating pharmacologic therapy for PD must take into consideration the degree of dysfunction the patient is experiencing, the question of neuroprotection, the degree of motor response required, and the potential complications of long-term treatment. Neuropro-tective trials of coenzyme Q10 (CoQ), vitamin C, vitamin E, monoamine oxidase B inhibitors (MAO-I) and dopamine agonists do not support the use of any of these drugs for a neuroprotective effect. There is recent supportive evidence that levodopa may have a neuroprotective effect. Either dopamine agonists or levodopa may be initiated. Dopamine agonists are associated with fewer motor fluctuations and dyskinesias, while levodopa is associated with better motor performance. Initiation of therapy should be tailored to individual patients with the emphasis on symptom control, with the hope that new approaches to treatment of PD (including neuroprotection) will be forthcoming.

Antioxidants↗

Genetic transformation of Dichanthium annulatum (Forssk)--an apomictic tropical forage grass.

Eleven Dichanthium annulatum (Forssk) plants were regenerated from embryogenic callus co-transformed with two plasmids encoding either the hygromycin phosphotransferase gene (hph) or the beta-glucuronidase (GUS) gene (uidA). Analysis of these putative transformants showed that three plants were transformed with the hph gene, showed the presence of the hph transcript and expressed hygromycin resistance after transfer to soil. Two of these also contained the uidA gene but did not express GUS and were shown to be the same transformation event. All three of the transformants set seed. Hygromycin resistance varied from 68-100% in the progeny of the three transformants. Transgene transmission appeared to have been mainly through apomixis.

Blotting, Southern↗

Particle-inflow-gun-mediated genetic transformation of buffel grass (Cenchrus ciliaris L.): optimizing biological and physical parameters.

The present study was conducted to optimize various biological and physical parameters for developing an efficient and reproducible gene transfer method for genetic transformation of buffel grass. Transformation was carried out using a helium-driven particle inflow gun (PIG). Embryogenic calli produced from mature seeds of buffel grass cv. CC-119 were separately bombarded with four plasmids, containing Actin (pAct1DX), Ubiquitin (pAHC-25; pAHC-27) and CaMV-35S (pCaMVGUS) promoters, coated on tungsten and gold particles. The efficiency of transformation was monitored through transient GUS expression. Different parameters, viz., the type of promoter, type and size of microcarrier, helium gas pressure, distance and time of bombardment, were standardized for delivering DNA into embryogenic calli. Bombardment with plasmid DNA carrying the actin promoter coated on 1.6 micro gold particles, at a helium pressure of 4 bars, a distance of 10 cm for 10 micro sec and 28 mm Hg vacuum in the chamber, produced the best result in transient GUS expression. The Actin promoter was found to be more efficient in driving expression of the GUS gene in buffel grass, followed by Ubiquitin and CaMV-35S promoters. Lower helium pressure was found to be sub-optimal, while higher pressure produced a smaller number of blue spots, probably due to excessive damage to the cells. Maximum of 385 blue spots was observed with gold particles of 1.6 micro size, whereas only 213 blue spots were recorded for tungsten particles of 1.0 micro size. The optimized parameters can be employed for genetic transformation of buffel grass with genes of agronomic importance.

Journal Article↗

Plasminogen did not affect lung function in surfactant-treated preterm lambs.

Preterm infants with respiratory distress syndrome develop fibrin-rich hyaline membranes within the alveoli and have depressed fibrinolytic activity, which is thought to be due to a relative deficiency of plasminogen. Local fibrin deposition inhibits surfactant function and amplifies inflammation. We hypothesized that plasminogen administration to surfactant-treated preterm lambs would prevent fibrin-rich hyaline membrane formation, resulting in the amelioration of lung pathology and improved lung function. We randomly treated preterm lambs (gestational age 127-129 days) with either 16 mg of lysine-plasminogen (n = 10) or saline (n = 10), and ventilated them for 5 h. There were no significant differences in physiologic measurements of lung function (ventilation efficiency index, oxygenation index, dynamic compliance, quasi-static pressure volume curve), measures of lung injury (alveolar wash protein content and (125)I-albumin recovery) or surfactant pool size. The degree and extent of bronchiolar erosion and hyaline membrane formation were similar in the two groups. Plasminogen administration did not improve lung function or prevent hyaline membrane formation in surfactant-treated lambs.

Animals↗

Pharmacological characterization of guanidinoethyldisulphide (GED), a novel inhibitor of nitric oxide synthase with selectivity towards the inducible isoform.

1. Guanidines, amidines, S-alkylisothioureas, and recently, mercaptoalkylguanidines have been described as inhibitors of the generation of nitric oxide (NO) from L-arginine by NO synthases (NOS). We have recently demonstrated that guanidinoethyldisulphide (GED), formed from the dimerisation of mercaptoethylguanidine (MEG), is a novel inhibitor of nitric oxide synthases. Here we describe the pharmacological properties of GED on purified NOS isoforms, various cultured cell types, vascular ring preparations, and in endotoxin shock. 2. GED potently inhibited NOS activity of purified inducible NOS (iNOS), endothelial NOS (ecNOS), and brain NOS (bNOS) enzymes with Ki values of 4.3, 18 and 25 microM, respectively. Thus, GED has a 4 fold selectivity for iNOS over ecNOS at the enzyme level. The inhibitory effect of GED on ecNOS and iNOS was competitive vs. L-arginine and non-competitive vs. tetrahydrobiopterin. 3. Murine J774 macrophages, rat aortic smooth muscle cells, murine lung epithelial cells, and human intestinal DLD-1 cells were stimulated with appropriate mixtures of pro-inflammatory cytokines or bacterial lipopolysaccharide to express iNOS. In these cells, GED potently inhibited nitrite formation (EC50 values: 11, 9, 1 and 30 microM, respectively). This suggests that uptake of GED may be cell type and species-dependent. The inhibitory effect of GED on nitrite production was independent of whether GED was given together with immunostimulation or 6 h afterwards, indicating that GED does not interfere with the process of iNOS induction. 4. GED caused relaxations in the precontracted vascular ring preparations (EC50: 20 microM). Part of this relaxation was endothelium-dependent, but was not blocked by methylene blue (100 microM), an inhibitor of soluble guanylyl cyclase. In precontracted rings, GED enhanced the acetylcholine-induced, endothelium-dependent relaxations at 10 microM and caused a slight inhibition of the relaxations at 100 microM. The vascular studies demonstrate that the inhibitory potency of GED on ecNOS in the ring preparations is considerably lower than its potency against iNOS in the cultured cells. These data suggest that the selectivity of GED towards iNOS may lie, in part, at the enzyme level, as well as differential uptake by cells expressing the various isoforms of NOS. 5. In a rat model of endotoxin shock in vivo, administration of GED, at 3 mg kg-1 bolus followed by 10 mg kg-1 h-1 infusion, starting at 90 min after bacterial lipopolysaccharide (LPS, 15 mg kg-1, i.v.), prevented the delayed fall in mean arterial blood pressure, prevented the development of the vascular hyporeactivity to noradrenaline of the thoracic aorta ex vivo and protected against the impairment of the endothelium-dependent relaxations associated with this model of endotoxaemia. The same bolus and infusion of the inhibitor did not alter blood pressure or ex vivo vascular reactivity in normal animals over 90 min. 6. Administration of GED (10 mg kg-1, i.p.) given at 2 h after LPS (120 mg kg-1, i.p.) and every 6 h thereafter caused a significant improvement in the survival rate in a lethal model of endotoxin shock in mice between 12 and 42 h. 7. In conclusion, we found that GED is a competitive inhibitor of iNOS activity. Its selectivity towards iNOS may lie both at the enzyme level and at the level of cell uptake. GED has beneficial effects in models of endotoxin shock that are driven by iNOS. GED or its derivatives may be useful tools in the experimental therapy of inflammatory conditions associated with NO overproduction due to iNOS expression.

Animals↗

Experience in laparoscopic hysterectomy: analysis of three hundred cases.

A personal experience with 300 cases of laparoscopic hysterectomy was analysed and its merits and demerits were discussed. The demographic features, indications, feasibility, complications, operating time, blood loss, hospital stay, cost effectiveness and its outcome were reviewed. The indications were uterine fibroid (40%), adenomyosis, dysfunctional uterine bleeding and pelvic inflammatory disease (36%), fibroid uterus with endometriosis (17.5%), postmenopausal bleeding (3%), ovarian neoplasm (2.1%) and fibroid uterus with ovarian cyst (1.4%). Two uterine malignancies and one case of potentially malignant ovarian neoplasm, were also encountered in our series. Assessibility score of above 20 was present in 55%. Haemorrhage was prevented intraoperatively by securing the large pedicles with electrocoagulation as well as large titanium clips (LT-400). Retrograde ureteric catheterisation was not necessary. Overall morbidity was present only in 10.62%. Intraoperative bladder injury was encountered in 1%, urinary fistula in 0.66%, primary and secondary haemorrhage in 0.33% respectively, and minor febrile morbidity in 4.66%. Conversion to conventional abdominal hysterectomy occurred in 0.66% of the cases. The average operating time was 141.99 +/- 31.678 min, the estimated blood loss was 237.07 +/- 76.76 ml and average hospitalisation was 3.37 +/- 0.66 days. The cost of laparoscopic hysterectomy was found similar to abdominal hysterectomy. Higher operating fee, operating theatre and anaesthesia charges did not affect the overall cost of laparoscopic hysterectomy because of shorter hospital stay. It is concluded that laparoscopic hysterectomy has definite role in gynaecological surgery.

Adult↗

Cry of an intern.

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Accreditation↗

Influence of parental literacy and socio-economic status on infant mortality.

The influence of parental literacy and socio-economic status (SES) on infant mortality rate (IMR) was studied. This report is only a part of much larger community-based prospective study conducted to determine the factors influencing infant mortality in Dakshina Kannada district of Karnataka, by the Department of Community Medicine, Kasturba Medical College, Manipal, with the financial assistance form IDRC, Canada. A total of 12,857 livebirths during the period of October 1, 1991, to September 30, 1992, where registered and followed up for one year. There were 391 infant deaths which gives an IMR of 30.4 per 1,000 livebirths. Univariate analysis and subsequent stepwise multiple logistic regression analysis revealed that, literacy and SES have a very significant role in reducing IMR.

Cause of Death↗

Nerve injuries due to obstetric trauma.

The incidence of nerve injuries among 32,637 deliveries over a period of ten years was 1.81/1000. Brachial plexus injury (1/1000) and facial nerve injury (0.74/1000) accounted for 98% of nerve injuries. Both the right and left side were involved equally. Bilateral nerve injury was not seen. Lack of antenatal care, macrosomia, abnormal presentations, and operative vaginal deliveries significantly increased the risk of nerve injuries. These babies had significantly higher incidence of meconium stained liquor and intrapartum asphyxia. Parity of the mother, gestational age and sex of the baby did not have significant role in the causation of nerve injuries. Injuries to brachial plexus and facial nerve were seen even in babies born by caesarean section, when it was performed for obstructed labour caused by cephalo-pelvic disproportion and abnormal presentations. Three babies with injuries expired and forty-three could be followed up for varying periods. None of the babies had residual defects. Detection of cephalopelvic disproportion and abnormal lie in the third trimester and their appropriate management would decrease the incidence of obstetric palsies to a significant extent.

Birth Injuries↗