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Biomedical subjects

V Shukla

Publications and source records attributed to V Shukla.

At least 19 recordsLinked to original sources
PubMed2006

A missing denture's misadventure!

We report a late onset, benign, tracheoesophageal fistula in a 51-year-old man, due to an accidentally swallowed denture. In view of the extensive peri-esophageal sepsis and fibrosis, he was managed by a subtotal esophagectomy and a cervical esophagogastric anastomosis. The tracheal defect was closed with the help of an intercostal muscle flap. This report also highlights the difficulty in identifying swallowed prosthetic dental material radiologically, when no metallic component is present. This fact was also responsible for the delay in diagnosis, eventually leading to the rare complication of a tracheoesophageal fistula.

Anastomosis, Surgical↗
PubMed2006

The significance of post-traumatic amnesia as a risk factor in the development of olfactory dysfunction following head injury.

OBJECTIVE: To test the following hypothesis in the assessment of head injury PATIENTS: only patients with 5 min or more of post-traumatic amnesia (PTA) are at risk of acute olfactory dysfunction (OD). METHODS: This was a retrospective comparative study of olfactory status in head injury patients seen at a head injury clinic at Glasgow Royal Infirmary from 1985 to 2003. Of 828 clinic attenders, 101 had acute OD. These subjects were compared with a randomly selected control group of 102 patients with head injury but normal olfactory function. The main outcome measure was a significant likelihood of patients with PTA lasting for 5 or more minutes having acute OD compared with those with PTA of less than 5 min. RESULTS: The likelihood of patients with a PTA of 5 min or more having acute OD compared to those with PTA of less than 5 min is clinically significant with an odds ratio of 9.6 (p<0.01). CONCLUSION: Examination of patients with 5 min or more of PTA should include a simple test of sense of smell. Patients with impaired smell sensation should be aware of their condition prior to discharge from hospital. In addition, the need for a CT brain scan and appropriate follow up should be considered.

Acute Disease↗
PubMed2003

Systemic absorption of FD&C blue dye associated with patient mortality.

The addition of FD&C blue dye to enteral feeds is a common practice in hospitals to detect aspiration. However, the degree of systemic absorption and safety of this dye in critically ill patients has not been studied. A patient with sepsis who died after systemic absorption of FD&C blue dye No1 is described.

Benzenesulfonates↗
PubMed2003

Amelioration of B16F10 melanoma cells induced oxidative stress in DBA/2 mice by pentoxifylline.

The constantly produced small amounts of reactive oxygen species (ROS) are reduced by anti-oxidant enzymes and cellular scavengers. The oxidative stress developed by defect in ROS clearance can result in cell injury and may lead to carcinogenesis. Pentoxifylline is a methylxanthine derivative with rheologic and membrane modifier property. We have examined whether Pentoxifylline (PTX) ameliorates oxidative stress produced in subcutaneously injected mice with B16F10 melanoma cells. Treatment of mice with PTX significantly reduced oxidative stress and attenuated the altered changes of reduced glutathione and lipid peroxides. Our findings provide an experimental basis for using PTX to attenuate oxidative stress induced by B16F10 melanoma cells in liver and lung of DBA/2 mice.

Animals↗
PubMed2001

Lead poisoning in Indian silver refiners.

The refining of silver from old silver ornaments, articles and jeweller's waste by smelting these with lead scraps for the fabrication of new jewellery is an important small scale industry in India. The present survey and clinical investigations have shown that 31 out of 50 silver refiners with a mean blood lead level of 32.84+/-1.78 microg/dl (range 20.3-64.9), decrease in blood delta-aminolevulinic acid dehydratase (ALAD) activity and thiamine (as pyruvate) level and an enhanced urinary excretion of ALA as compared to control, were suffering from lead poisoning. Most of these workers have shown anaemia, abdominal colic, blue lining of gum and muscular wasting indicative of lead toxicity. Twenty-four workers with relatively high blood lead levels were equally divided into two groups and given either vitamin B1 (75 mg, once a day) or vitamin C (250 mg. twice a day) for 1 month. The treatment with both the vitamins significantly lowered the blood lead levels and reduced blood thiamine and copper deficiency. In addition, vitamin C was also effective in reversing the inhibition of blood ALAD activity while the effect of vitamin B1 on its activity was marginal. The daily intake of vitamin B1 and vitamin C may prevent the accumulation of lead and reduce its toxic effects particularly in those regularly exposed to lead.

Adolescent↗
PubMed2000

Fungal morphology and fragmentation behavior in a fed-batch Aspergillus oryzae fermentation at the production scale.

It is well known that high-viscosity fermentation broth can lead to mixing and oxygen mass transfer limitations. The seemingly obvious solution for this problem is to increase agitation intensity. In some processes, this has been shown to damage mycelia, affect morphology, and decrease product expression. However, in other processes increased agitation shows no effect on productivity. While a number of studies discuss morphology and fragmentation at the laboratory and pilot scale, there are relatively few publications available for production-scale fungal fermentations. The goal of this study was to assess morphology and fragmentation behavior in large-scale, fed-batch, fungal fermentations used for the production of protein. To accomplish this, a recombinant strain of Aspergillus oryzae was grown in 80 m(3) fermentors at two different gassed, impeller power-levels (one 50% greater than the other). Impeller power is reported as energy dissipation/circulation function (EDCF) and was found to have average values of 29.3 +/- 1.0 and 22.0 +/- 0.3 kW m(-3) s(-1) at high and low power levels, respectively. In all batches, biomass concentration profiles were similar and specific growth rate was < 0.03 h(-1). Morphological data show hyphal fragmentation occurred by both shaving-off of external clump hyphae and breakage of free hyphae. The fragmentation rate constant (k(frag)), determined using a first-order model, was 5.90 and 5.80 h(-1) for high and low power batches, respectively. At the end of each batch, clumps accounted for only 25% of fungal biomass, most of which existed as small, sparsely branched, free hyphal elements. In all batches, fragmentation was found to dominate fungal growth and branching. We speculate that this behavior was due to slow growth of the culture during this fed-batch process.

Aspergillus oryzae↗
PubMed2000

Repair of isolated multiple muscular ventricular septal defects: the septal obliteration technique.

BACKGROUND: Isolated multiple ventricular septal defects (mVSDs) remain a surgical challenge. The dilemma of whether to perform a complete repair ultimately rests with the surgeon, who must decide if all significant septal defects can be located. Avoidance of a pulmonary arterial band (as part of a two-stage repair) will negate the need for future pulmonary arterial reconstruction and will reduce the incidence of late right ventricular diastolic dysfunction. METHODS: We performed a retrospective analysis of hospital and echocardiographic data of eight children who underwent a septal obliteration technique (SOT) as part of their correction of mVSDs (with and without coarctation of the aorta). RESULTS: Eight children with a mean age of 10.5 months (range 1.5 to 36 months), and weight of 6.2 kg (range 2.1 to 13.5 kg), respectively, underwent correction of mVSDs. All had a single, large, perimembranous defect, additional VSDs within the muscular trabecular septum (juxtaposed to the moderator band), and apical mVSDs. All VSDs were repaired via the right atrium, with avoidance of either a right or left ventriculotomy. The posterior and apical defects were excluded from the right ventricular cavity with a pericardial patch (SOT). The follow-up period remains limited to a mean of 20.9 months (8 to 39 months). Two children repaired with SOT had previous pulmonary artery bands (neonatal coarctation repair). All children were successfully discharged home with a mean postoperative Qp:Qs of 1.09:1. One pacemaker was required, but this child has since reverted back to normal sinus rythm. CONCLUSIONS: Our initial experience using the SOT in the treatment of apical VSDs as a component of isolated mVSDs has been rewarding. All children are currently alive, in normal sinus rhythm, and have no residual significant left-to-right shunts.

Cardiac Surgical Procedures↗
PubMed2000

Single coronary artery and complete transposition of the great arteries: a technical challenge resolved?

BACKGROUND: The origin of the coronary arteries from a single aortic sinus remains a rare congenital anomaly, once regarded as having little clinical significance. Contemporary surgical practice, however, frequently demands precise coronary reimplantation. In this article we emphasize a prophylactic surgical technique found especially helpful in the repair of D-transposition of the great arteries (D-TGA)/single coronary artery. METHODS: We reviewed the institutional cardiac registry. RESULTS: Since 1985, 398 neonates with D-TGA were repaired with the arterial switch procedure. A mortality rate of 38% was encountered in "simple" D-TGA (n = 174)/single coronary (2.9% left facing sinus (IRLCx), 7.5% right facing sinus (IIRLCx)) and 41% in neonates with D-TGA (n = 224)/single coronary (3.6% IRLCx, 12% IIRLCx). During the past 3.5 years the surgical mortality rate of neonates (n = 6) treated with origin of the coronary arteries from a single aortic sinus has dropped to 0%. CONCLUSIONS: The surgical repair of D-TGA/single coronary artery continues to trouble surgeons. The implantation of a well-mobilized coronary "button" into a previously anastomosed neoaorta remains a key prophylactic technique in the achievement of good technical results.

Cardiac Surgical Procedures↗
PubMed2000

Synthesis and evaluation of novel bioconjugates as antiviral agents.

Novel lipid (mannito-stearate) antiviral nucleoside and oligonucleotide conjugates were prepared with improved lipophilic and membrane associating properties of drugs. Potential advantages of these liponucleotide prodrugs are lower toxicity, increased cellular uptake, nuclease resistivity and antiviral activity. Oligonucleotide conjugate complementary to a unique segment of viral genome may selectively disrupt the processes dependent on the segment by hybridisation.

Anti-HIV Agents↗
PubMed1999

Direct neonatal ventriculo-arterial connections (REV): early results and future implications.

BACKGROUND: Is the time-honored supposition correct that insertion of a competent prosthetic conduit or homograft is necessary to achieve right ventricular (RV) to pulmonary artery continuity in neonates? A direct ventriculo-arterial connection, or réparation à l'étage ventriculaire (REV), has been successfully used to achieve RV to pulmonary artery continuity in neonates without mortality or major morbidity. Acute RV function is preserved even in the face of free pulmonary insufficiency, but scrupulous preservation of pulmonary artery patency (unobstructed pathway) must be achieved. METHODS: We retrospectively reviewed the cases of 6 neonates who underwent direct ventriculo-arterial connection to achieve RV to pulmonary artery continuity during open heart procedures in the last 3 years. RESULTS: The 6 neonates had a mean age of 12.3 days (range, 2 days to 6 weeks) and a mean weight of 3.2 kg (range, 2.7 to 3.6 kg) at operation. Two of them had a diagnosis of aortic atresia + ventricular septal defect and successfully achieved an in-series circulation. Two had pulmonary atresia + ventricular septal defect and 2, double-outlet right ventricle + transposition of the great arteries + ventricular septal defect + pulmonary atresia. Follow-up is a mean of 16 months (range, 6 to 22 months). Surgical reintervention was required in 3 neonates and resulted in excellent hemodynamics in 2 of them. In the other patient, who had bilateral long-segment branch pulmonary artery hypoplasia, stents were placed without hemodynamic benefit. All children are currently alive with preserved RV function even in the presence of free pulmonary insufficiency. CONCLUSIONS: Although the creation of a direct ventriculo-arterial connection has routinely been used for children older than 1 year with satisfactory initial results, its application in neonate is very limited. Why have neonates been denied this viable alternative? Perhaps the answer involves legitimate concerns about the consequent free pulmonary insufficiency and the presumed acute RV diastolic dysfunction.

Double Outlet Right Ventricle↗
PubMed1996

Early repair of postinfarction ventricular septal defect with gelatin-resorcin-formol biological glue.

BACKGROUND: Early surgical repair of postinfarction ventricular septal defect has improved early mortality rate. Mortality remains high in patients presenting within 1 week of infarction, or when rupture has occurred in the inferior part of the septum. METHODS: We describe a surgical technique for repair of postinfarction ventricular septal defect that involves no infarctectomy: continuous suturing of a bovine pericardial patch to healthy myocardium around the infarcted area and use of gelatin-resorcin-formol biological glue as a sealant between the patch and the interventricular septum. RESULTS: We have used this technique successfully in 3 consecutive patients in whom repair was performed within 1 week of myocardial infarction. The rupture of the interventricular septum was located anteriorly in 2 patients and inferiorly in the other. They all made an uneventful recovery, and at follow-up there was no evidence of residual shunt. CONCLUSIONS: This technique can be a useful adjunct to the surgical management of this difficult group of patients.

Aged↗
PubMed1994

Salmonellosis complicating aortic aneurysms.

We present our experience with two cases of salmonella infected aortic aneurysms. The treatment of salmonella infected aortic aneurysms has been associated with a high mortality, primarily due to the rapidity with which the post-infective complications of salmonellosis develop. Early diagnosis, adequate anti-microbial therapy and improved vascular surgical methods have resulted in a better prognosis for salmonella infected aortic aneurysms.

Aneurysm, Infected↗
PubMed1993

The right-ear advantage in schizophrenia.

Schizophrenics, patients with affective disorder and normal controls were tested on a verbal dichotic listening task at three time periods, 0-2, 4-6 and 14-16 weeks. Schizophrenics had non-significant ear difference during the acute state of illness (0-2 weeks) and the normal right-ear advantage emerged when acuteness subsided (14-16 weeks).

Adult↗