Search PubMed⌕ Search

Biomedical subjects

A Agarwal

Publications and source records attributed to A Agarwal.

At least 343 records · Page 19Linked to original sources
PubMed1993

Cervical spine surgery in rheumatoid arthritis: improvement of neurologic deficit after cervical spine fusion.

Ninety of 110 consecutive patients with rheumatoid deformities of the cervical spine surgically treated had associated neurologic deficits. Fifty-five patients had atlantoaxial subluxation. In this group, there were 16 Ranawat Class I patients (normal), 21 Class II (weakness, hyperreflexia, dysesthesia), 13 Class IIIA (paresis and long-tract findings but can ambulate), and five Class IIIB (quadriparesis and inability to ambulate). After C1-C2 stabilization, 94.8% improved at least one class. Twenty-two patients had AAS-SMO (atlanto-axial subluxation and superior migration of the odontoid) only one before surgery was Class I, five Class II, eight Class IIIA, and eight Class IIIB. Seventy-six percent improved at least one class after surgery. Nineteen had isolated subaxial subluxation (SAS). Three were Class I, two Class II, nine Class IIIA, and five were Class IIIB. After surgery, 94% improved at least one class, and all were ambulating. Fourteen had combined AAS-SMO-SAS deformities. There were no Class I patients, only four Class II, four Class IIIA, and six Class IIIB. After surgery, 71% improved. The four deaths that occurred in the immediate postoperative period were Class IIIB. Fifteen patients had worsening or recurrence of their symptoms. Thirteen of these were related to the later development of subaxial subluxation. Neurologic symptoms and recovery were related to severity of the deformity. Those with SMO had greater neurologic deficits and worse results. In general, neurologic recovery is encouraging even in the IIIB patient. Earlier surgery should be done, however, particularly before SMO develops, if possible.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

Effect of proteinuria on renal interstitium: effect of products of nitrogen metabolism.

Tubulointerstitial disease is an invariant finding in proteinuric renal disease regardless of the underlying disease or the compartment in which the disease originates. Such histologic changes are functionally significant in that scores of such injury rather than glomerular histologic injury correlate with decrements in GFR. Proteinuria, the consequence of a loss of glomerular permselectivity incurred by glomerular diseases, also provides an index of renal functional decline. This review provides evidence that proteins leaked into the urinary space may directly or indirectly provoke tubulointerstitial injury, a linkage that may underlie the functional significance of proteinuria and tubulointerstitial disease. This review also highlights two products of nitrogen metabolism, ammonia and nitric oxide, in the pathogenesis of tubulointerstitial disease.

Ammonia↗
PubMed1993

A clinico-hematological profile of hemolytic-uremic syndrome.

Hemolytic uremic syndrome (HUS) is defined as microangiopathic hemolytic anemia, thrombocytopenia and uremia. It is an important cause of acute renal failure (ARF) in children all over the world. The present study was carried out to assess the incidence, clinical presentation, hematological and biochemical profile of children presenting with HUS from 1987 to 1990. Out of the 100 cases who presented with ARF 22 had HUS. A majority of these children were males below 1 year of age, and had a prodromal phase of mainly gastrointestinal manifestations lasting for about a week. Anemia was a constant feature followed by bleeding diathesis, mainly melena and purpura. Neurological manifestations included altered sensorium, irritability, coma, hypertensive encephalopathy and convulsions. Renal problems mainly included oliguria, hypertension, hematuria and edema. Investigations revealed thrombocytopenia and microangiopathic hemolytic anemia in all cases. Evidence of disseminated intravascular coagulation (DIC) was observed in 3 cases as decreased fibrinogen levels, increased fibrinogen degradation products and deranged clotting studies. Blood biochemistry revealed azotemia in all cases, hyponatremia in 5 cases, hypernatremia in 3 cases and hyperkalemia in 12 cases. Stool culture showed the presence of Shigella in 8, E. coli in 6 and Klebsiella in 4 cases. Out of 22 cases of HUS, 15 were treated conservatively; of these 2 died. Both of these deaths were due to DIC 7 children were put on peritoneal dialysis; only 1 child died in this group. Factors affecting the outcome were duration of oliguria, levels of blood urea and presence of encephalopathy.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗
PubMed1993

Clinical and laboratory predictors of invasive diarrhoea in children less than five years old.

Five hundred and thirty-three children < 5 years of age with acute watery diarrhoea were followed for appearance of blood in their stools to evaluate various clinical and laboratory predictors of dysentery. The statistical analysis was performed in two steps. Firstly, clinical and laboratory variables were evaluated as 'predictors' for isolation of invasive bacterial enteropathogens from stool culture. Secondly, all the variables, including isolation of invasive bacterial enteropathogens, were analyzed for predicting bloody diarrhoea. Presence of mucus (sensitivity = 57.4%, specificity = 83.1%, positive predictive value = 24.8%, negative predictive value = 95.3%, p = 0.0000) was the only significant clinical predictor of bloody diarrhoea. Polymorphonuclear leucocytes (PMN) > 10/hpf (sensitivity = 55.3%, specificity = 92.4%, positive predictive value = 41.3%, negative predictive value = 95.5%, p = 0.0000) and red blood cells, regardless of their number, (sensitivity = 78.7%, specificity = 93%, positive predictive value = 52.1%, negative predictive value = 97.8%, p = 0.0000) on light microscopy of fresh stool samples were two significant laboratory findings. Isolation of invasive bacterial enteropathogens was also a significant predictor of bloody diarrhoea (sensitivity = 19.1%, specificity = 89.5%, positive predictive value = 15%, negative predictive value = 92% p = 0.0077) but ranked lower than the other 3 variables. Our results indicated that it is the severity of invasion caused by offending enteropathogens, clinically manifesting as mucoid stools and/or presence of PMN or RBC, which may be a better indicator of the invasive process and subsequent development of dysentery rather than mere isolation of invasive enteropathogens from the stools.

Acute Disease↗
PubMed1993

A prospective study of closure techniques of abdominal incisions in infants and children.

In a prospective study of layered versus mass closure of abdominal incisions in infants and children, 34 cases underwent wound closure by layered and mass closure technique on an alternate basis. All the patients were assessed for their nutritional status and haemoglobin level pre-operatively, and wound complications were compared with respect to closure technique, nutritional status and normal haemoglobin level. Presence of protein energy malnutrition and anaemia did not increase the risk of wound complications with either of the technique.

Abdomen↗
PubMed1993

Jones' fracture.

The Jones' fracture is defined as a transverse fracture of the proximal fifth metatarsal diaphysis within 1.5 cm of the tuberosity. It is classified radiographically as acute, delayed union and nonunion. Some orthopedists also have added a classification of stress fractures. The best form of treatment is based on the presence or absence of medullary sclerosis adjacent to the fracture site. In addition, the prescribed treatment must be adhered to by the patient to prevent increased morbidity associated with this fracture.

Adult↗
PubMed1992

The flax ribosomal RNA-encoding genes are arranged in tandem at a single locus interspersed by 'non-rDNA' sequences.

The ribosomal RNA (rRNA)-encoding genes (rDNA) in flax, estimated to be present in about 2400 copies per diploid nucleus, have been reported as a single homogeneous repeat unit of 8.6 kb. In situ hybridization analysis indicated that these genes were located at a single site on one pair of chromosomes. However, an analysis of a flax variety, CI 1303, has revealed heterogeneity in the intergenic spacer of the rDNA repeat unit. A genetic analysis of rDNA inheritance in two flax lines, Stormont Cirrus and CI 1303, has again supported the observation that there is a single rDNA locus in this plant species. Screening of four different genomic libraries made in methylation-sensitive and -insensitive systems, and the analysis of 40 phage clones, demonstrate a much higher number than that expected of junctions between rDNA and non-rDNA. Direct evidence of rRNA-encoding genes being present in tandem comes from a few phage clones that contain more than two rDNA repeats. The evidence presented here indicates that rDNA, although present at a single locus in tandem arrays, may be interrupted frequently by other non-rDNA sequences, thus giving rise to questions about their organization into long tandem arrays.

Blotting, Southern↗
PubMed1992

Lymphocyte subsets associated with T cell receptor beta-chain gene rearrangement in patients with rheumatoid arthritis and neutropenia.

OBJECTIVE: To determine the incidence of a clonal lymphoid disease in patients with chronic rheumatoid arthritis (RA) and neutropenia. METHODS: Lymphocytes from 23 RA patients with either current neutropenia or a history of this complication were studied. RESULTS: Eight patients had a clonal rearrangement of the T cell receptor beta-chain gene. Phenotypically, they showed a distinctive pattern characterized by an inverted CD4+:CD8+ cell ratio and an increased number and percentage of CD57+/CD8+ and CD3+/DR+ lymphocytes. None had evidence of a lymphoid malignancy. CONCLUSION: Among RA patients with neutropenia, there is a subset who have a subclinical disease resembling T gamma lymphoproliferative disease.

Adult↗
PubMed1992

Characterization of Ca(2+)-ATPase of Setaria cervi (Nematoda: Filarioidea): effect of phenothiazines and anthelmintics.

1. A Mg2+ independent, Ca(2+)-ATPase requiring high concentrations of Ca2+ (5 mM) for the activation, equally distributed in cuticle-muscular-hypodermis, genital organs and gastrointestinal tissues and mainly localized in 10,000 g pellet fraction, was identified in Setaria cervi, a bovine filarial parasite. 2. Filarial enzyme showed Km value of 3.33 mM for ATP as computed from the double reciprocal Lineweaver-Burk plot. 3. The enzyme could be completely solubilized by sonication with about 4-fold increase in specific activity of the enzyme. 4. The enzyme showed about 2-fold activation by the calmodulin fractions isolated from S. cervi and rat brain homogenates. 5. The enzyme was highly sensitive to inhibition with some phenothiazine derivatives. Trifluoperazine was observed to be the most potent inhibitor followed by promethazine and chlorpromazine. 6. Some anthelmintics viz. diethycarbamazine and centperazine were found to be highly potent inhibitors of the enzyme, significant inhibition of filarial Ca(2+)-ATPase was also observed with levamisole and suramine. 7. Studies indicate Ca(2+)-ATPase of S. cervi as a potential chemotherapeutic target.

Animals↗
PubMed1992

Improvement in semen quality and sperm fertilizing ability after filtration through the L4 membrane: comparison of results with swim up technique.

The L4 filtration membrane was used at our laboratory on 30 semen specimens (19 from suspected subfertile patients and 11 from fertile donors) to assess changes in semen quality after routine sperm washing and swim up versus filtration through the L4 membrane. Of these 30 samples 17 (11 suspected subfertile patients and 6 fertile donors) were chosen to evaluate differences in sperm fertilizing ability between the 2 sperm preparation methods. Liquified specimens were analyzed on a Cell Soft semen analyzer. Semen specimens were divided equally, and 1 aliquot was processed by sperm washing and the swim up technique and the other by filtration. In all subjects the results of semen analysis and the hamster-egg penetration test showed significant improvement in sperm quality and fertilizing ability after filtration through the L4 membrane. Sperm motility was 58% after the swim up technique compared to 79% after filtration (p less than 0.0001) and velocity was 47 mu. per second after the swim up method compared to 52 mu. per second after filtration (p less than 0.048). Penetration rate and penetration index also showed a significant increase after filtration over values for the swim up method. Our results demonstrate that sperm filtration through the L4 membrane provides results superior to those of the traditional swim up technique. Due to significant savings in time associated with its use the L4 membrane can be used during sperm processing for intrauterine insemination and in vitro fertilization procedures.

Female↗
PubMed1992

Retinal involvement in Wucheria bancrofti filariasis.

We report the first case of inflammation of the retinal pigment epithelium and retinal vasculities presumably caused by microfilaria of Wucheria bancrofti and discuss its possible pathogenesis. Therapy with diethyl carbamazine citrate resulted in rapid resolution of the inflammation.

Adult↗
PubMed1992

The diagnostic value of CT scan in acute renal cortical necrosis.

We report the characteristic CT scan findings of renal cortical necrosis in a patient of acute renal failure, which was confirmed on renal biopsy. CT scan is a useful, noninvasive investigative modality for an early diagnosis of renal cortical necrosis.

Acute Disease↗
PubMed1992

Acute renal failure in severe hypothermia.

A patient who developed acute renal failure associated with severe hypothermia is reported. Warm peritoneal dialysis was initiated for core rewarming followed by intermittent hemodialysis till he entered the diuretic phase. The factors which led to acute renal failure in this patient included hypovolemia, hypotension, and acute pancreatitis.

Acute Kidney Injury↗
PubMed1992

Efficacy of oral fluconazole in Cryptococcus neoformans infection.

We report a renal allograft recipient who developed disseminated cryptococcosis, which was treated effectively, with oral fluconazole, a new triazole antifungal agent. The patient is doing well on maintenance therapy with fluconazole and immunosuppressive agents.

Administration, Oral↗
PubMed1991

Filtration of spermatozoa through L4 membrane: a new method.

OBJECTIVE: To explore the possibility of using the L4 membrane filtration device for processing of spermatozoa for intrauterine insemination and other assisted reproductive techniques. DESIGN, SETTING, PATIENTS: Semen samples from 15 patients attending an infertility clinic of a tertiary referral institution and from seven fertile donors were used for the study. MAIN OUTCOME MEASURES: The effect of L4 membrane filtration was studied on the following semen parameters: sperm motility, velocity, percentage of normal and abnormal sperm forms, and percentage and concentration of round cells in semen. RESULTS: The statistical analysis of data from both the subfertile patient population and the normal fertile donor group showed similar improvement in semen quality after L4 membrane filtration. Therefore, the results for these two groups were combined for statistical purposes. Our findings demonstrate a significant increase in normal sperm forms and a decrease in abnormal forms after filtration of specimens through the L4 membrane. In all subjects, the mean sperm motility increased from 47% to 77% (P less than 0.0001); velocity increased from 30 to 48 microns/seconds (P less than 0.0001); normal sperm forms increased from 53% to 84% (P less than 0.0001); abnormal forms decreased from 28% to 10% (head defects) (P less than 0.0001); neck defects from 3.5% to 1% (P less than 0.0006); tail defects from 8% to 3.5% (P less than 0.005); and undifferentiated round cells decreased from 6% to less than 1% (P less than 0.002) after filtration. The concentration of round cells counted by the Makler chamber (Sefi Medical, Haifa, Israel) decreased significantly from 6 x 10(6)/mL to 0.2 x 10(6)/mL (P less than 0.0003). Similarly, white blood cell counts measured by the Endtz test also decreased from 3.4 x 10(6)/mL to less than 0.1 x 10(6) (P less than 0.043). CONCLUSION: We conclude that the filtration of the semen specimens through L4 membrane results in a significant improvement in semen parameters and should be considered as an adjunct in sperm processing.

Cell Count↗