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Biomedical subjects

V Patil

Publications and source records attributed to V Patil.

16 recordsLinked to original sources
PubMed2006

The burden and determinants of reproductive tract infections in India: a population based study of women in Goa, India.

BACKGROUND/OBJECTIVE: Reproductive tract infections (RTI) present major health, social, and economic problems in developing countries. Our objective was to describe the prevalence and risk factors of RTIs in a population based sample of women aged 18-45 years. METHOD: 2494 women of 3000 randomly selected from the population defined by a primary health centre catchment area consented to participate. Participants were interviewed regarding complaints and risk factors. Laboratory specimens were collected for the diagnosis of RTIs. Analyses of risk factors were carried out separately for the outcomes of sexually transmitted infections: chlamydia, gonorrhoea, trichomoniasis; and endogenous infections: bacterial vaginosis (BV) and candida. RESULTS: Endogenous infections were relatively common (BV 17.8%; candida 8.5%), and sexually transmitted infections (STI) were infrequent (4.2%). Factors indicative of poverty and marginalisation were associated with STIs and BV. Gender disadvantage, particularly spousal violence, was associated with BV, while concern about a husband's extramarital relationships, an indicator of sexual risk, was associated with STI. Husband's discharge was strongly associated with STI, and a non-white vaginal discharge was associated with both STI and BV. Condom use and oral contraceptive use were associated with a reduced risk of BV. CONCLUSIONS: Most of the population burden of RTIs is attributed to endogenous infections. Socioeconomic deprivation and gender disadvantage are associated with raised risk for BV, while the risk factors for STIs indicated that disadvantaged women were likely to be infected by their husbands.

Adolescent↗
PubMed2003

Does neostigmine increase gastric emptying in the critically ill?--results of a pilot study.

OBJECTIVE: Based on the successful use of neostigmine for the treatment of acute colonic pseudo-obstruction, we hypothesised that neostigmine would increase gastric emptying and improve tolerance to enteral feeding in the critically ill patient. METHODS: Eleven patients intolerant of enteral feeds due to high gastric aspirates, were randomised to receive a 'study infusion' consisting of either neostigmine (0.4 mg/hr) or 0.9% saline. If, after 12 hours the patient was deemed intolerant of the nasogastric feed, the rate of the 'study infusion' was doubled. Those who remained intolerant after 24 hours of the 'study infusion' were 'crossed-over' and continued on the other infusion for a further 24 hours. Gastric emptying was assessed in each group before and after the infusion by measuring the hourly rates of feed "absorption" [(delivery rate + returned aspirates) - total aspirates] and paracetamol absorption using the area under a time-concentration curve at 120 minutes (AUC120). Differences within and between groups were analysed using Students t test and one-way analysis of variance. RESULTS: Six patients received neostigmine first and 5 received the placebo first. Four of the 6 patients receiving the neostigmine first compared with all of those receiving placebo first required to be 'crossed-over' to the other infusion. While the hourly rates of feed "absorption" were greater for patients receiving neostigmine than for placebo, these differences did not achieve statistical significance. The mean paracetamol AUC120 for all patients who received neostigmine was 3996 mg/min/L while that for placebo was 1929 mg/min/L (p = 0.21). CONCLUSIONS: These data suggest that while neostigmine may have a positive effect on gastric emptying and enteral feed absorption in critically ill patients, the results did not reach statistical significance and an adequately powered study will be required to confirm this effect.

Journal Article↗
PubMed2002

Training course in local anaesthesia of the airway and fibreoptic intubation using course delegates as subjects.

BACKGROUND: We describe a practical method of training anaesthetists in the technique of awake fibreoptic intubation. This is performed on a training course using the delegates as subjects. METHODS: The first 15 subjects underwent cardiovascular monitoring during airway fibreoptic endoscopy performed by other course members. They were subsequently interrogated by use of a questionnaire. RESULTS: Evidence from questionnaires suggests this method of instruction is acceptable in this self-selected group of individuals. Gagging was the commonest unpleasant side-effect of airway endoscopy, although only one delegate rated this as uncomfortable. Fifty-four per cent of subjects found the procedure slightly painful; 46% reported no pain at all. Overall, the procedure was rated as acceptable by 85% of subjects and enjoyable by 15% of subjects. No delegate found endoscopy or intubation distressing. Cardiovascular monitoring revealed pulse rate and arterial pressure changes of less than 25% of baseline values. Paraesthesia developed in one individual and nasal bleeding in two cases, neither of which was clinically significant and did not interfere with endoscopy. CONCLUSIONS: The use of course delegates as subjects for training was acceptable to anaesthetists and is associated with a low level of discomfort and morbidity.

Adult↗
PubMed2001

5,7-Dihydroxytryptamine: regional brain concentrations following intraventricular administration to rats.

The concentrations of 5,7-dihydroxytryptamine (5,7-DHT) and serotonin (5-HT) were measured in brainstem, hypothalamus and cerebral cortex 0, 2, 6, 12, and 24 hours following the bilateral, lateral ventricular injection of 5,7-DHT (100 microg/each ventricle) into adult male rats. At 6 hours, 5,7-DHT levels had decreased 99% from 0 hr values in all brain regions. Thereafter, 5,7-DHT levels continued to decline in cortex, but not in hypothalamus or brainstem; at 24 hr, but not 48 hr, 5,7-DHT peaks were still measurable in each brain region examined. Serotonin levels in all three regions also fell markedly by 2-6 hours after 5,7-DHT administration. At 24 hours, hypothalamus and brainstem 5HT levels had declined >70% and cerebral cortex approximately 50% below control values. The relevance of these findings to the protective action of monoamine reuptake blockers is discussed.

5,7-Dihydroxytryptamine↗
PubMed2001

Expression profiles of endometrial leukemia inhibitory factor, transforming growth factor beta2 (TGFbeta2), and TGFbeta2 receptor in infertile bonnet monkeys.

The expression profiles of leukemia inhibitory factor (LIF), transforming growth factor beta2 (TGFbeta2), and transforming growth factor beta2 receptor (TGFbeta2R) were analyzed during the peri-implantation period in regularly menstruating, fertile bonnet monkeys and in animals in which endometrial nonreceptivity was induced by administering an antiprogestin, onapristone. Based on our previous experiences, a dose of 2.5 or 5 mg of onapristone was administered s.c. every third day during the menstrual cycle, because these dosages impair endometrial development without upsetting the normal gonadal endocrine profiles. Endometrial biopsy specimens were collected during the proliferative phase (estradiol levels about 200 pg/ml, n = 5) and peri-implantation period (Day 8 after midcycle peak in estradiol levels, n = 5) from normal ovulatory animals and during the peri-implantation period from onapristone-treated animals (n = 10). The biopsy specimens were processed to determine the expression patterns of LIF, TGFbeta2, and TGFbeta2R by immunohistochemical and reverse transcription-polymerase chain reaction (RT-PCR) methods. Levels of both protein and mRNA for LIF, TGFbeta2, and TGFbeta2R (analyzed by immunohistochemistry and RT-PCR, respectively) were greater in the endometrial samples collected during the peri-implantation period compared to samples collected during the proliferative phase in control animals. Treatment with either of the two doses (2.5 or 5 mg) of onapristone caused a significant (P < 0.05) down-regulation in the expression of LIF in the peri-implantation endometria. The endometrial expressions of TGFbeta2 and TGFbeta2R mRNAs were reduced significantly in animals treated with 5 mg of onapristone, but not in those treated with the lower dose. However, immunoreactive TGFbeta2 and TGFbeta2R proteins were significantly (P < 0.05) down-regulated in the endometrial samples from both the 2.5- and 5-mg-treated groups. The alterations observed in the expression patterns of LIF, TGFbeta2, and TGFbeta2R were specific, because the expression levels of epidermal growth factor receptor remained unaffected in the endometria from the treated groups. The present study demonstrates derangement in the expression profiles of LIF, TGFbeta2, and TGFbeta2R during the peri-implantation period in infertile bonnet monkeys. It may be hypothesized that TGFbeta2 function is one of the early steps in the regulation of the progesterone-driven cascade of events leading to endometrial receptivity, and that any aberration in this step may adversely affect the subsequent molecular events (i.e., expression of LIF). These data also suggest that potential aberrations in the functional network of locally produced cytokines and growth factors even may occur in an endometrium exposed to the optimal peripheral hormonal levels.

Animals↗
PubMedDate not supplied

Endometrial contraception: modulation of molecular determinants of uterine receptivity.

Modulation of endometrial receptivity is a promising approach for fertility regulation since it allows a contraceptive to act specifically at the endometrium. This was corroborated by our previous observations that treatment with low doses of a pure progesterone antagonist (PA, antiprogestin), onapristone (ZK 98299), in bonnet monkeys inhibited fertility by selectively retarding endometrial development, without affecting the hypophyseal-hypothalamic function. In the present study, further investigations, undertaken to analyze the molecular repertoire of a nonreceptive primate endometrium, determined expression of: steroid hormone receptors, i.e. progesterone receptor (PR) and estrogen receptor (ER); cytokines, i.e. leukemia inhibitory factor (LIF): transforming growth factor beta (TGFbeta) and its receptor (TGFbetaR); and cell adhesion molecules, i.e. integrins (alpha(v)beta(3), alpha(1)beta(1)). These studies were conducted during the different phases of the normal menstrual cycle and following treatment with different doses of onapristone (2.5 mg, 5 mg, or 10 mg every third day for one cycle) in bonnet monkeys. The molecules were analysed collectively to explore the possibility of a correlation between expression of these markers and endometrial receptivity and to investigate whether there exists a regulatory link between expression of these molecules under in vivo conditions. Three types of expression patterns of endometrial factors were observed during the peri-implantation period following onapristone treatment: 1) LIF, alpha(v)beta(3), and alpha(1)beta(1) showed significant (P < 0.02) down regulation in glandular epithelium of endometria in animals treated with all three doses of onapristone as compared to the control group. This was indicative of their critical role in the progesterone-driven cascade leading to implantation. 2) PR, TGFbeta, and TGFbetaR remained unaffected in the endometria from 2.5 mg treated animals and showed down regulation in animals treated with 5 and 10 mg onapristone as compared to the control group, thereby suggesting that the expression of these markers may not truely reflect endometrial receptivity per se. However, their facilitatory role in preparing the endometrium for implantation can not be ruled out since continued perturbation in the expression of these molecules may affect endometrial growth, remodelling, and differentiation, which in turn may render the endometrium nonreceptive; 3) ER remained unaltered in endometria of animals rendered infertile with 2.5, 5, and 10 mg onapristone. This observation indirectly suggests that onapristone-induced endometrial changes are mediated via some specific mechanisms. The present study clearly demonstrates that endometrial non-receptivity induced at low doses of onapristone is associated with changes in the expression pattern of specific molecular markers. However, no direct correlation was observed between in vivo expression of TGFbeta, LIF, and integrins, thereby lending support to the concept that there exists redundancy or multiple pathways which regulate implantation events.

Animals↗
PubMedDate not supplied

Development and validation of risk scoring system for prediction of cancer cervix.

A Hospital based group matched case-control study was conducted to devise a risk scoring system for the prediction of cancer cervix at the Gynecology Clinic, Government Medical College Hospital, Nagpur, India. The study consisted of 230 cases of cancer cervix (histopathologically confirmed) and equal number of controls, group matched for age. The risk factors considered were Illiteracy, long duration of married life (>25 years), Early Menarche (<13 years), marital status (widow, separated, divorcee), multiparity (> 3), h/o abortion, h/o tobacco use, h/o passive smoking, poor genital hygiene, (grade III & IV) and low socioeconomic status. Statistical Analysis included unconditional multiple logistic regression analysis Receiver Operating Characteristic (ROC) curve analysis. The overall predictive accuracy was calculated by Wilcoxon statistic as an equivalent of area under ROC curve. Five risk factors, illiteracy, poor genital hygiene, long duration of married life, multiparity and early menarche were identified to be significantly associated with cancer cervix. These factors were given statistical weights of 13, 10, 7, 5 and 5 respectively. A total score of 21 was found to be the best cut off for prediction and the overall predictive accuracy of the risk scoring system was calculated to be 0.74(0.67 - 0.81). In case of consistent further validation using other data sets this additive risk scoring system can be used for reducing the cost of universal screening by subjecting only high-risk subjects to laboratory screening procedure (Pap smear) in population setting.

Case-Control Studies↗
PubMedDate not supplied

Adenosine deaminase activity in leprosy.

Serum adenosine deaminase (ADA) was studied in 60 patients of different types of leprosy and 50 healthy control subjects. ADA levels in patients with tuberculoid (50.50 +/- 5.22 U/L), borderline (41.14 +/- 3.89 U/L) and lepromatous leprosy (30.10 +/- .03 U/L) were higher than that in controls (17.84 +/- 2.78 U/L), thus correlating with the immunological status of patients. Patients with lepra reaction showed decreased ADA levels and higher grade of lepromin test positivity was associated with increased ADA activity.

Adenosine Deaminase↗