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Biomedical subjects

A Agarwal

Publications and source records attributed to A Agarwal.

At least 235 records · Page 13Linked to original sources
PubMed1998

A comparative evaluation of pharmacokinetics of conventional and slow-release carbamazepine formulation in newly treated patients of epilepsy: a random evaluation.

Study was conducted to compare the pharmacokinetic profile of conventional and slow-release carbamazepine formulations in Indian epileptic patients. Twenty consecutive untreated patients of partial seizures were randomly assigned to receive either conventional carbamazepine (200 mg thrice a day) or slow-release carbamazepine formulation (200 mg thrice a day), 10 patients in each group. The serum carbamazepine concentrations were measured on 10th day and 20th day of treatment. The blood samples were collected before the morning dose. In the conventional treatment group five patients experienced side effects as compared to two in the slow-release group. On 10th day mean serum carbamazepine levels were significantly higher in conventional group (8.27 +/- 1.39 micrograms/ml) in comparison to slow release group (4.28 +/- 3.89 micrograms/ml). The difference was statistically significant (p < 0.05). On 20th day carbamazepine levels fell significantly in conventional group only (8.27 +/- 1.39 micrograms/ml to 5.76 +/- 2.32 micrograms/ml, p < 0.05). At this stage the difference in mean carbamazepine levels of two groups became insignificant (p < 0.05). In conclusion, controlled release formulations provide more steady serum concentrations of carbamazepine along with better tolerability.

Adolescent↗
PubMed1998

Angiotensin converting enzyme inhibitors and cough--a north Indian study.

Cough is an important side effect of Angiotensin Converting Enzyme Inhibitor (ACEI) therapy. The incidence of cough was investigated in a prospective 8 week study in 250 hypertensive patients receiving ACEI alone or in combination with other agents. Enalapril (5-20 mg/day), Lisinopril (5-20 mg/day), Captopril (25-75 mg/day) or Ramipril (5-15 mg/day) was prescribed to patients, who were followed up at weekly visits. Cough developed in 73 of the 250 patients i.e. an incidence of 29.2%. Females had a higher incidence of cough as compared to males--37.9% versus 15.5% (p < 0.001) and there was no significant difference in the cough incidence in the various age groups. A dry, non-productive cough developed in all patients within 4 weeks of ACEI initiation. Increased nocturnal intensity of cough was reported by 79.4% patients. Cough incidence was 34.4%, 24.3% and 18.1% in patients on Enalapril, Ramipril and Lisinopril, respectively. Cough was not dose related and was not related to smoking. There was no statistically significant difference among patients on ACEI alone or in combination with beta blockers, calcium channel blockers or diuretics. Of the 18 patients with ACEI induced cough who received Indomethacin, 50 mg bid, 8 reported complete cure and cough was reduced in intensity in the remaining ten.

Adult↗
PubMed1998

Partial obstruction, not antisperm antibodies, causing infertility after vasovasostomy.

PURPOSE: We determined whether men who may have partial obstruction and antisperm antibodies after vasovasostomy can be distinguished from other infertile men with antisperm antibodies only, and whether repeat microsurgical reversal is beneficial in such patients. MATERIALS AND METHODS: A total of 412 patients underwent indirect immunobead testing for antisperm antibodies at our laboratory from December 1991 through July 1996. Of 95 patients with an assay greater than 20% binding 49 had normal partners and were grouped by history of vasovasostomy (20), varicocele (9), cryptorchidism (8) and epididymo-orchitis (12). Semen analysis characteristics and antisperm antibody binding variables were compared across histories. Pregnancy rates were compared between patients treated surgically for partial obstruction and those treated for antisperm antibodies. Mean followup was 33.8 months. RESULTS: Compared to the other 3 groups, men with a history of vasectomy and reversal had significantly lower sperm concentration (p = 0.002), poorer motility (p < 0.001), lower overall binding on the indirect immunobead assay (p < 0.001) and lower IgA binding (p = 0.008). The clinical diagnosis of partial obstruction was based on a sense of epididymal fullness by palpation, as well as the aforementioned semen parameters. Of the 20 patients with a history of vasectomy and reversal 14 were diagnosed with partial obstruction and underwent repeat microsurgical reversal and 6 with a history of vasovasostomy but no evidence of obstruction received no further therapy and never established pregnancies. The remaining 29 patients underwent sperm washing and assisted reproduction. Of 14 patients 7 (50%) established pregnancies after repeat reversal compared to only 5 of 29 patients (17.2%) treated with assisted reproduction (P = 0.025). CONCLUSIONS: Antisperm antibodies are not a significant factor in persistently infertile post-reversal cases with the aforementioned criteria. Repeat reversal appears to be the most successful treatment option in this setting.

Adult↗
PubMed1998

Investigation of fertilizing capacity of cryopreserved spermatozoa from patients with cancer.

PURPOSE: There are few published reports concerning fertilization and pregnancy outcomes achieved with cryopreserved spermatozoa from cancer patients. Controversy exists regarding the value of sperm banking for these patients before therapy, whether the spermatozoa are viable after long-term storage and whether they can fertilize the ovum. We assess fertilization and pregnancy outcomes achieved with cryopreserved spermatozoa from cancer patients using assisted reproductive techniques. MATERIALS AND METHODS: We studied 10 cancer patients who transferred cryopreserved semen specimens from our sperm bank to outside in vitro fertilization programs for assisted reproductive technique. Of these patients 5 had Hodgkin's disease, 2 testicular cancer, 1 leukemia and 2 prostate cancer. The length of specimen storage ranged from 14 to 135 months (median 49, interquartile range 24 and 82). RESULTS: The median pre-freeze motility was 44% (interquartile range 36 and 55%) and the median total sperm count was 31.1 x 10(6) (interquartile range 6.3 and 53.9 x 10(6)). At 24 hours after banking the median post-thaw motility was 11% (interquartile range 6 and 35%) and the median total sperm count was 6.6 x 10(6) (1.2 and 17.1 x 10(6)). A total of 18 cycles of assisted reproductive technique were performed among 10 couples with an overall pregnancy rate of 50% per couple, with 2 deliveries, 1 ongoing pregnancy and 2 miscarriages. The pregnancy rate per cycle of in vitro fertilization and intracytoplasmic sperm injection was 36.4% with an implantation rate of 13%. CONCLUSIONS: These results indicate that poor quality cryopreserved spermatozoa from cancer patients, irrespective of the length of storage, may provide successful results with the latest micromanipulative techniques such as intracytoplasmic sperm injection.

Adolescent↗
PubMed1997

Defective induction but normal activation and function of p53 in mouse cells lacking poly-ADP-ribose polymerase.

Poly-ADP-ribose polymerase (PARP) and p53 are both induced by DNA damage and each has been proposed to mediate the normal cellular response to damage. We find that embryo fibroblasts from PARP-null mice have a approximately twofold lower basal level of p53 and that the induction of p53 in response to DNA damage or nucleotide depletion is more than twofold less than in normal mouse cells. These factors combine to decrease the induced level of the p53 protein in PARP-deficient cells by 4-5-fold, compared to normal cells. However, there is virtually no decrease in the induction of p53 activity in PARP-deficient cells, as assayed with a p53-responsive promoter. Furthermore, cells lacking PARP arrest normally in G1 after DNA damage, in contrast to cells lacking p53, where this checkpoint is absent. Other p53-dependent properties, such as the mitotic spindle checkpoint and permissivity for gene amplification, are also normal in PARP-deficient cells. We conclude that the induced level of the p53 protein is governed by a combination of PARP-dependent and PARP-independent pathways and that the activation of p53 is largely PARP-independent. The results are consistent with a model in which the regulation of gene expression by p53 involves both increases in the amount of the protein and activation of p53 as a transcription factor.

Animals↗
PubMed1997

B cell responses to a peptide epitope: III. Differential T helper cell thresholds in recruitment of B cell fine specificities.

Th cell requirements in the individual stages comprising a murine humoral response to a synthetic peptide were examined. Induction of a T-dependent IgM response was readily achieved in the presence of unprimed or low numbers of Ag-primed T cells. In contrast, class switch to the IgG isotype of Abs demanded a markedly elevated frequency of primed T cells and occurred concomitantly with B cell differentiation into an membrane-bound IgG+ memory population. These results indicated that induction and progression of a T-dependent humoral IgG response were comprised of a single rate-limiting step represented by that involving Ab isotype switch. Subsequent studies established that this also represented the principal step where antibody-purifying mechanisms operate. This was enforced by imposing a threshold barrier for Th cell recruitment by early Ag-activated B cells to enable class switch and consequent retention as the response progresses. The quantum of this threshold, however, was not invariant, but, rather, was described as a balance between the affinity of B cell receptor for Ag and the frequency of Ag-specific Th cells.

Adjuvants, Immunologic↗
PubMed1997

Multiple mechanisms of N-phosphonacetyl-L-aspartate resistance in human cell lines: carbamyl-P synthetase/aspartate transcarbamylase/dihydro-orotase gene amplification is frequent only when chromosome 2 is rearranged.

Rodent cells resistant to N-phosphonacetyl-L-aspartate (PALA) invariably contain amplified carbamyl-P synthetase/aspartate transcarbamylase/dihydro-orotase (CAD) genes, usually in widely spaced tandem arrays present as extensions of the same chromosome arm that carries a single copy of CAD in normal cells. In contrast, amplification of CAD is very infrequent in several human tumor cell lines. Cell lines with minimal chromosomal rearrangement and with unrearranged copies of chromosome 2 rarely develop intrachromosomal amplifications of CAD. These cells frequently become resistant to PALA through a mechanism that increases the aspartate transcarbamylase activity with no increase in CAD copy number, or they obtain one extra copy of CAD by forming an isochromosome 2p or by retaining an extra copy of chromosome 2. In cells with multiple chromosomal aberrations and rearranged copies of chromosome 2, amplification of CAD as tandem arrays from rearranged chromosomes is the most frequent mechanism of PALA resistance. All of these different mechanisms of PALA resistance are blocked in normal human fibroblasts.

Aspartate Carbamoyltransferase↗
PubMed1997

Reasons for rejecting potential donors from a sperm bank program.

PURPOSE: Recruiting donors to a sperm bank program is difficult and slow because of high dropout rates and high rejection rates. The profile of successful and unsuccessful donors was determined at our sperm bank. METHODS: A total of 199 men was screened from 1986 to 1994 in the anonymous sperm bank donor programs; 174 (87%) men dropped out or did not meet minimum guidelines. The study included 25 accepted donors and 20 rejected men (of 52 rejected donors, only 20 donors who came for two consecutive semen analyses were selected). Sperm quality variables and demographic data were compared between the groups. RESULTS: Accepted donors had significantly better semen quality in motility, velocity, linearity, and ALH than did rejected donors (P < 0.01). More rejected donors than accepted donors were single (P < 0.01). A higher percentage of accepted donors consumed caffeine (P < 0.001), and they were more likely to have college degrees (P < 0.03). CONCLUSIONS: These results indicate that loss of interest and poor semen quality were the major reasons for rejection of donors in our anonymous donor sperm bank program.

Adolescent↗
PubMed1997

Improved motile sperm recovery by a hyperosmotic Percoll gradient.

PURPOSE: Our purpose was to investigate whether a new, relatively hyperosmotic Percoll gradient, Enhance-S, can improve total motile sperm recovery rates compared with the commonly used Percoll gradient Perception. METHODS: Semen specimens from each of 17 donors were divided into two equal aliquots. One part was washed using Percoll Perception, while the other was prepared using Percoll Enhance-S. RESULTS: Compared to the unwashed specimen, sperm motion characteristics (motility and velocity) improved significantly after Percoll separation using either the Perception or the Enhance-S gradient. There was no difference in motility or velocity in spermatozoa recovered after wash with either of the two preparations. However, the total motile sperm recovery was significantly higher using the Percoll Enhance-S gradient than with the Percoll Perception gradient (P < 0.0024). CONCLUSION: The new Percoll Enhance-S gradient provides significantly more total motile sperm than the Percoll Perception gradient.

Centrifugation, Density Gradient↗
PubMed1997

Segment III cholangiojejunostomy for carcinoma of the gallbladder.

Jaundice in patients of advanced carcinoma of the gallbladder requires palliation for the distressing symptoms of pruritus and cholangitis. Intrahepatic segment III duct cholangiojejunostomy is a means for alleviating the obstruction with malignant porta block. The authors reviewed their experience with this procedure in 48 patients of carcinoma of the gallbladder. All patients had jaundice; pruritus was present in 44 (92%) and cholangitis in 14 (29%). The level of obstruction was determined preoperatively by percutaneous transhepatic cholangiography. In 32 patients the block was below the level of the bifurcation of the right and left ducts, and 16 patients had a block involving the confluence, isolating the two lobes of the liver. Following segment III cholangiojejunostomy, pruritus was relieved in all and cholangitis in 86% of patients. At the end of 6 weeks a significant fall in serum bilirubin and alkaline phosphatase levels was seen with both types of hilar obstruction. Varying degrees of pain relief was also noted in 75% of patients. Segment III biliary bypass is an effective, one-time, reliable means of palliation for carcinoma of the gallbladder with hilar obstruction. Its efficacy appears to depend on the duration and depth of the jaundice and on the anatomy of the biliary ductal system in the left hemiliver rather than on the type of hilar obstruction.

Adult↗
PubMed1997

Factors associated with the quality before freezing and after thawing of sperm obtained by microsurgical epididymal aspiration.

OBJECTIVE: To identify whether the cause, site of ductal obstruction, and characteristics of fluid aspirates are associated with the cryosurvival and fertility after thawing of sperm obtained during reconstruction of the excurrent ducts with microsurgical epididymal sperm aspiration, vasal sperm aspiration, or both. DESIGN: Prospective study. SETTING: Andrology center at a tertiary care institution. PATIENT(S): Men undergoing reconstruction of the excurrent duct and sperm aspiration (n = 42) or microsurgical epididymal sperm aspiration (n = 11). INTERVENTION(S): Sperm were tested for an association with the cause and site of obstruction. Fertilization and pregnancy rates after sperm aspiration and intracytoplasmic sperm injection (ICSI) were evaluated for fresh and frozen aspirates. MAIN OUTCOME MEASURE(S): Motile sperm count and percentage motility after thawing. RESULT(S): The motile sperm count before freezing was significantly higher in the caput epididymis than in the corpus. The motile sperm count before freezing was related inversely to the distance from the caput where the sperm were aspirated. Sperm from clear and opaque fluid aspirates had better percent motility than those from cloudy and creamy fluid aspirates. High fertilization and pregnancy rates were achieved using both fresh and frozen epididymal sperm. CONCLUSION(S): None of the factors studied was associated with cryosurvival of aspirated epididymal or vasal spermatozoa. Because motility is low after thawing, these specimens are best used with ICSI.

Adult↗