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Biomedical subjects

A Goel

Publications and source records attributed to A Goel.

At least 37 records · Page 2Linked to original sources
PubMed1990

Whither short-course chemotherapy for tuberculous meningitis?

Short-course chemotherapy is well established for the treatment of pulmonary tuberculosis but not for extrapulmonary disease. We present a series of 35 cases in which chemotherapy for tuberculous meningitis was given for a period of less than 2 years. Short-term therapy was associated with recrudescence of tuberculous meningitis and, in some cases, with the development of deep cerebral infarcts and permanent neurological deficits. We think short-term chemotherapy for tuberculosis of the central nervous system is inadequate.

Antitubercular Agents↗
PubMed1990

Clinical and roentgenological profiles and etiological correlations of encysted pleural effusions.

One hundred and thirty-six cases of encysted pleural effusions were studied and investigated to reach an etiological diagnosis. The clinical profile of encysted pleural effusions differed little from that of free pleural effusions. Of the four sites of encystments seen (costoparietal, interlobar, subpulmonic, and mediastinal), costoparietal effusions were the commonest and resulted most often from infections. Interlobar encystments came next in frequency and most often resulted from congestive cardiac failure. Of the various causes of encysted pleural effusions, tuberculosis was the commonest, followed by pyogenic infection and congestive cardiac failure, in this order. Conventional radiographic techniques were adequate in diagnosing most cases of encysted pleural effusions.

Adolescent↗
PubMed1990

Intracranial ectopic pituitary tumour.

Pituitary tumours originating primarily from sites other than the sella turcica are rare. A case of an ectopic pituitary tumour in the region of the lesser wing of the sphenoid is reported. The patient presented with signs and symptoms of a progressive increase in intracranial pressure. CT scan appearances resembled those of a sphenoid wing meningioma. The vascular lesion was partially excised. Histology showed it to be a pituitary tumour.

Adenoma, Chromophobe↗
PubMed1989

Review of a liver transplantation programme.

Liver transplantation is now a routine operation in specialist centres. The author reviews the programme of a pioneering unit in Pittsburgh, USA, which he observed during an elective.

Graft Rejection↗
PubMed1989

Cerebellopontine angle epidermoid cysts: a report on 30 cases.

Thirty cases of cerebellopontine angle epidermoid cysts treated over a period of 20 years are reviewed with regard to their clinical features, the pathophysiology of their symptoms and their management. The predominating symptoms were related to the 7th and 8th cranial nerves and headaches. The signs and symptoms were present for an average period of 4 months. It was not always possible to determine if the signs and symptoms were due to local involvement by the epidermoid, increased intracranial pressure, or both. Diagnostic procedures evolved from angiography and ventriculography to non-invasive computed tomography and MRI. The posterior cranial fossa approach was used in 27 cases. Total excision of the epidermoid was the aim and was carried out in five (18%) patients but concern regarding the preservation of nearby important neurovascular structures forced partial removal in 22 patients. To minimise reformation, the residual epidermoid was carefully coagulated with the aid of the operating microscope and bipolar cautery without damaging surrounding neurovascular structures.

Adolescent↗
PubMed1988

Bacteriocin (klebocin) typing of clinical isolates of Klebsiella pneumoniae.

Three-hundred-forty-two clinical isolates of Klebsiella pneumoniae were subjected to bacteriocin (klebocin) typing using six standard klebocin-producer strains (153-158). The overall typability was 72.8 per cent. The predominant klebocin types found were 244 (14.3 per cent), 313 (13.7 per cent) and 113 (7.6 per cent). Klebocin types 314 and 111 each contributed 5.2 per cent to the total number of isolates. No significant correlation was observed between the source of isolation and the klebocin type.

Antibiosis↗
PubMed1988

Transposable element-mediated enhancement of gene expression in Saccharomyces cerevisiae involves sequence-specific binding of a trans-acting factor.

In our studies on the regulation of adjacent-gene expression by Ty sequences, we demonstrated that a single-base-pair change (T-A----C-G) in the epsilon sequence of Ty917-derived elements is primarily responsible for enhancement of beta-galactosidase expression from lacZ fusion plasmids. Using an electrophoretic gel mobility assay, we showed that the same base pair transition is required for binding of a trans-acting factor, TyBF, from crude cell extracts in vitro. We identified the site of TyBF binding and determined the guanine nucleotide contact sites required for TyBF interaction. We propose that TyBF binding to cis-acting Ty2 sequences activates adjacent-gene transcription.

Base Sequence↗
PubMed1985

Variation in the relationship between serum and saliva lithium levels.

This study has been carried out to find out the reasons for the wide variations observed in the correlation between serum and saliva lithium levels. Serum/saliva lithium levels were monitored in 10 individuals on 6 occasions. The correlation coefficient (r) varied within individuals from 0.19 to 0.91 (p less than 0.025) whereas when all the individuals were considered simultaneously, it was 0.59 (p less than 0.005). It was concluded that prediction of serum lithium levels from salivary lithium levels would only be possible in those individuals showing good correlation. The variability in this correlation could be mainly due to inter-individual variations in the particular sample of individuals studied.

Humans↗
PubMedDate not supplied

A study of bronchial reactivity in relation to baseline pulmonary functions in patients with chronic obstructive lung disease.

Baseline bronchial reactivity was studied in 36 patients with chronic obstructive lung disease (COLD) and 20 normal healthy controls using the inhalational histamine challenge test. Using a cut off PD20 dose of 0.195 mg of histamine, 83.3% patients of COLD demonstrated bronchial hyper-reactivity. Presence of bronchial reactivity correlated significantly with the baseline FEV1, FEF25-75 and the ratio FEV1/FVC (p = 0.0019, 0.00001 and 0.008) respectively. Thus, bronchial reactivity in subjects with COLD correlates most significantly with the maximum mid-expiratory flow rate (FEF25-75).

Bronchial Hyperreactivity↗
PubMedDate not supplied

Evaluation of unguided transbronchial biopsy in the diagnosis of pulmonary disease--its safety and efficacy as an out-patient procedure.

Sixty-five patients underwent unguided fiberoptic transbronchial biopsy on an out-patient basis. Satisfactory material for histopathological examination was obtained in 55 patients. A reasonably definite pathological diagnosis could be established in 51 patients. The commonest diagnosis arrived at was that of interstitial fibrosis. Complications were observed in 4 (6.2%) patients. Fiberoptic transbronchial biopsy is, therefore, a safe and efficacious out-patient technique for establishing a pathological diagnosis in patients with infiltrative, diffuse or localized pulmonary disease.

Ambulatory Care↗
PubMedDate not supplied

Clinical implications of acute cerebrospinal fluid changes following iophendylate myelography.

Clinical features and serial cerebrospinal fluid (CSF) samples of 50 patients who underwent myelography with iophendylate were studied. Forty two patients (84%) developed one or more features suggestive of meningism lasting for 2-4 days. There was significant rise in the average (mean) CSF counts from 9.81 in the premyelogram sample to 532.6 at the end of 24 hours (p less than 0.001). Both neutrophil and lymphocyte (p less than 000) count increased. At the end of one week, there was significant decrease of total cells in the CSF to 204 (p less than 0.001). Both, neutrophils and lymphocytes decreased. There was significant rise in total proteins in the 24 hours sample, but the fall at one week was not significant statistically. The sugar and chloride values did not change significantly. All CSF samples were negative for bacterial cultures. In conclusion, a significant proportion of the patients undergoing iophendylate myelography develop clinical features suggestive of meningeal irritation and change in the CSF fractions suggestive of meningitis: however these changes are transient and do not warrant institution of chemotherapy or steroids.

Cerebrospinal Fluid↗
PubMedDate not supplied

Role of corticosteroids in the management of chronic obstructive lung disease: factors predicting response.

A double-blind crossover trial of prednisolone was conducted in 70 patients of chronic obstructive lung disease (COLD). Emphysema dominated the clinical picture in 38, rest being chronic bronchitis with varying degrees of air trapping. None of the patients had clinical asthma. All the patients had obtained maximal benefit from an optimal dose of bronchodilators prior to entering the study. Prednisolone in a dose of 0.8 mg/kg was prescribed in a double blind crossover manner with identical appearing placebo tablets. Patients were evaluated on a weekly basis for an objective as well as a subjective response and side effects of therapy. Thirty-four patients demonstrated a statistically significant improvement in pulmonary functions. In 20 others only subjective response was observed. A good objective response was predicted by a pre-study variability in FEV1, disease duration of less than 10 years and a history of smoking less than 50 pack years.

Bronchitis↗
PubMedDate not supplied

Role of serial pleural biopsies in the diagnosis of pleural effusions.

One hundred fifty-five cases of pleural effusion underwent a percutaneous pleural biopsy by the Cope needle. In the face of an inconclusive result in the first attempt, biopsy was repeated for upto three times. Diagnostic yields of biopsy in tuberculous and malignant effusion were 93.5 per cent and 66.7 per cent, respectively. When combined with pleural fluid cytology, a definite diagnosis of malignancy could be established in 80.95 per cent cases. Serial pleural biopsies significantly increased the diagnostic yield.

Biopsy, Needle↗