Biomedical subjects
Publications and source records attributed to V Pai.
Chronic cough is a distressing symptom for patients and parents in paediatric practice. Investigations of the child with persistent cough can be simple or complex depending on the underlying cause. There are some unusual reasons for chronic cough, which need to be kept in mind when investigating the cause. A case of a long, floppy uvula causing chronic cough through mechanical irritation of upper airway is reported.
UNLABELLED: Primary non-Hodgkin's lymphoma of the bone is an unusual entity. Twenty-five patients with diffuse large cell lymphoma of the bone were registered at the Tata Memorial Hospital (TMH) from August, 1991, to May, 2002. Pain at the local site and soft tissue swelling were the commonest symptoms. Involvement of the bones in the lower half of the body was more frequent than the bones in the upper half. Osteolytic lesions and an associated soft tissue mass were the common radiological findings. Nineteen patients received CHOP chemotherapy and five received COP chemotherapy. Twenty-three patients received involved field radiotherapy. The overall response to therapy was 96%. On follow-up, two patients had a nodal relapse. One patient died of progressive disease, and one patient died of cryptococcal meningitis. There were no deaths due to treatment-related toxicity. The mean progression free survival was 9.39 yr and the overall survival was 11.66 yr. The median overall survival has not been reached. At last follow-up, 21 patients were being following up at TMH and are free of disease. CONCLUSION: Primary bone lymphoma is a malignancy that is highly curable with a combination of chemotherapy and radiotherapy.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
OBJECTIVE: To evaluate haemodynamic changes in the ophthalmic artery and the retina following carotid endarterectomy and their effect on the pathophysiology of the eye. DESIGN: Prospective study. METHOD: Twenty-two consecutive patients with severe carotid stenosis underwent 23 carotid endarterectomies and one subclavian-carotid bypass. The following measurements were made preoperatively and 3 months after operation; Ophthalmic artery (OA) and retinal arteriole (RA) peak systolic velocity (PSV) and peak diastolic velocity (PDV), macular photostress recovery time, visual acuity, intraocular pressures, colour vision and visual fields testing. RESULT: The RA PSV increased by 50% (p = 0.005) and PDV increased by 22% (p = 0.03). The OA PSV increased by 51% (p = 0.001). Macular photostress testing decreased from 58 s to 42 s (p = 0.001). Visual acuity improved in four and was unchanged in 13 eyes ipsilateral to the endarterectomy which had abnormal preoperative measurements. One patient experienced a dramatic increase in the ipsilateral intraocular pressure associated with visual deterioration. In two patients there was resolution of periorbital pain. CONCLUSION: Our results demonstrate an increase in the PSV of the RA and OA following carotid surgery. There are pathophysiological changes in the eye, which accompany tight stenotic extracranial carotid artery disease and these may be influenced by carotid endarterectomy.
We performed a randomized controlled study of the mortality and morbidity of 49 babies born with thick meconium staining of amniotic fluid. These unasphyxiated babies were consecutively born and were admitted to the intensive care unit for observation as routine. The groups were comparable in regard to sex, birth weight, gestational age, maternal factors like anaemia, toxaemia, antepartum haemorrhage, prolonged rupture of membranes, presentation, and interventions including caesarian section. The control group, comprising 26 babies received only oropharyngeal suction, while the intervention group, comprising 23 babies, underwent oropharyngeal suction followed by tracheal suction. There was no significant difference in the mortality or morbidity in form of evidence of air leak or hypoxic ischaemic encephalopathy.
A total of 42 adults with acute lymphoblastic leukemia were treated with an aggressive induction/consolidation chemotherapy (MCP-841) between June 1986 and December 1991. 32 patients (76.19%) achieved complete remission at the end of induction. There were 9 induction deaths, 6 of them due to infection. All patients received cranial irradiation in the dose of 20 Gy and intrathecal methotrexate for CNS prophylaxis. Twelve patients relapsed, 10 in the bone marrow, one case had isolated CNS relapse and the other relapsed in the bone marrow and CNS. The actuarial overall survival of all patients at the end of 5 years was 41.94%. Patient characteristics including age, sex, FAB morphology, phenotype, WBC count, platelet count and LDH did not influence survival significantly.
To determine the appropriateness of heparin-surface-modified (HSM) lenses in eyes at risk for breakdown of the blood-aqueous barrier, 36 consecutive patients with cataracts associated with chronic recurrent or past uveitis had extracapsular cataract extraction and insertion of an HSM posterior chamber one-piece intraocular lens (IOL). Examinations for implant precipitates (IPs), fibrin membranes, IOL synechias, and visual outcome were done postoperatively. Results show that despite a recurrence of overt uveitis with keratic precipitates in 13 eyes (36.1%), IPs were seen in only six eyes (16.6%) and were generally small and few in number. An acute postoperative fibrin reaction, which is related to blood-aqueous barrier breakdown, occurred in nine eyes. Implant synechias were found in three eyes. We found that HSM provided a cell-free IOL surface in the majority of eyes at high risk for blood-aqueous barrier breakdown and uveitis. Heparin surface modification does not prevent complications but tends to protect the IOL from inflammation changes that might otherwise occur.
Desmosine is an amino acid specific to elastin. Animal studies suggest that urinary desmosine (UD) represents endogenous elastin degradation. Therefore, UD has previously been used to investigate endogenous elastolysis, but was not elevated in subjects with chronic obstructive airways disease (COAD), although accelerated pulmonary elastolysis is thought to contribute to COAD. We have investigated whether this reflects large day-to-day and between-subject variation in UD and whether, in man, dietary desmosine contributes significantly to that in urine. Mean 24-hour UD output (over 5 consecutive days) from 10 asymptomatic subjects (5 males) was higher in males than females (77.4 +/- 9.6 and 40.2 +/- 5.0 nmol/24 hours, respectively; mean +/- SD, P less than .001), but not significantly different when expressed in terms of creatinine (micrograms desmosine/100 mg creatinine: males, 2.5 +/- 0.4; females, 3.1 +/- 0.8; mean +/- SD). The lowest between-subject variation was observed when the mean of 5 days' 24-hour UD values was analyzed on the basis of gender (coefficient of variation [CV], 12.5%); when gender was not considered, the least between-subject variation was found for the mean of 5 days' desmosine/creatinine analysis (CV, 24.5%). Approximately 1% of dietary desmosine (ingested as [3H]elastin and [3H] desmosine) was excreted in the urine within 24 hours, contributing approximately 15% of UD while on a normal diet. Although ingestion of a low elastin diet (less than 1/10 desmosine/24 hours than a normal diet) resulted in lower within-subject variation in 24-hour UD excretion (mean CV decreased from 31.5% to 20.2%), the between-subject CV and UD levels did not alter.(ABSTRACT TRUNCATED AT 250 WORDS)
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The mutagenic activity of several arylamines, alkyl- and arylcarbamates and their corresponding N-hydroxylated derivatives towards Escherichia coli WP2uvrA was investigated using the fluctuation test without a metabolic activation system. None of the parent amines or carbamates were mutagenic while several arylhydroxylamines and N-hydroxycarbamates were direct-acting base-pair substitution mutagens. With the exception of n-hexyl-N-hydroxycarbamate, the mutagenic activity of the N-hydroxycarbamates increased with increase in the length of alkyl substituent. Some arylamines and arylhydroxylamines were further examined, again without a metabolic activation system, using a plate test in conjunction with bacterial strains which detect either base-pair or frameshift mutagens. The arylhydroxylamines were found to cause both base-pair and frameshift mutations but were more active as frameshift mutagens. Possible reasons for the observed mutagenic activity are considered.
This study was done to evaluate the retention of complete cast crowns in teeth with adequate and inadequate crown height and to evaluate the effects of auxiliary retentive features on retention from of complete cast crowns. Thirty-six extracted human maxillary first premolars were obtained. In one group teeth were prepared to a constant height of 3.5 mm and in the second group teeth were prepared to a constant height of 2.5 mm. Each group was further subgrouped into three. In the first subgroup teeth were prepared conventionally, second subgroup proximal grooves were incorporated and in the third subgroup proximal boxes were incorporated. Tensional forces required to dislodge each cemented casting from its preparation was used for comparison of retention quality. These results were then subjected to an analysis of variance (ANOVA). The retention of crown in tooth with adequate crown height were statistically highly significant (P < 0001), compared to inadequate crown height and in boxes compared to grooves and conventional preparation.