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Biomedical subjects

A Goyal

Publications and source records attributed to A Goyal.

At least 37 records · Page 2Linked to original sources
PubMed2004

Efficacy and acceptabilty of oral-transmucosal midazolam as a conscious sedation agent in pre-school children.

The purpose of the present study was to test the efficacy of oral-transmucosal route of administration of midazolam in young potentially un-cooperative children. A sample of 40 children up to 4 years of age with ASA I status were randomly divided into experimental and control groups of 20 each. The children in experimental group received 0.5-mg/kg-body weight midazolam mixed in strawberry syrup via the oral-transmucosal route and those in control group were given the same syrup diluted with normal saline. A class II amalgam restoration was performed and routine behavior management techniques were employed in both groups. It was found that the number of procedures successfully completed and sedation produced 15 minutes after test solution administration was significantly greater in the experimental group compared to the control group. The total treatment time was also much lesser in the experimental group children. There was no significant difference in the acceptability of the test solutions in the children of the two groups.

Administration, Oral↗
PubMed2003

Haematoma as a late complication after breast reconstruction with implant.

We report a patient who, 3 1/2 years after mastectomy and breast reconstruction using a Becker implant, developed haematoma around the implant. We believe this is the first description of late haematoma formation in association with tissue expander (Becker implant), the differential diagnosis of which includes infection, recurrent cancer and implant rupture.

Breast Diseases↗
PubMed2003

Iatrogenic injury to the breast bud causing breast hypoplasia.

A 14-year-old girl with iatrogenic breast asymmetry is reported. She had multiple operations to the left anterior chest wall in the neonatal period for diaphragmatic hernia that resulted in multiple scars, which damaged the left breast bud. A better thoracotomy incision avoiding the breast bud could prevent later breast hypoplasia.

Adolescent↗
PubMed2003

Endoscopic third ventriculostomy in obstructed hydrocephalus.

Forty-three ETV were performed in 46 patients of obstructive hydrocephalus. Study was divided into two groups. Group 1 was with 29 children of less than two years age. Group 2 had seventeen patients of more than 2 years, adolescent and adults. Group 1 had 70% clinical and 63% radiological improvement whereas Group 2 showed 100% clinical and 73% radiological improvement. ETV failed in relieving the symptoms of hydrocephalus in eight patients. They were eventually benefited with VP Shunt. There was one postoperative death, which was not related to the procedure. ETV is an important alternative to VP Shunt in relieving hydrocephalus due to obstruction in CSF pathway.

Adolescent↗
PubMed2003

Glioblastoma of the cerebellum. A report of 3 cases.

Glioblastoma (GBM) is one of the commonest intra cranial tumors. Infratentorial GBM is, however, a rare entity. We report 3 cases of histologically proven posterior fossa GBM. The clinical presentation was of a rapidly growing posterior fossa mass. The diagnosis was made only on histological examination. The radiological features are non-specific and the clinical course same as GBM elsewhere. We describe their clinical presentation, radiological and pathological features and a review of describe the literature.

Adolescent↗
PubMed2003

Subdural hemorrhage associated with falcine meningioma.

A case of falcine meningioma associated with acute subdural hemorrhage is reported. The possible mechanisms of hemorrhage in the case are discussed. We believe that an early recognition and surgery can prevent neurological deterioration.

Aged↗
PubMed2002

The S. cerevisiae Mag1 3-methyladenine DNA glycosylase modulates susceptibility to homologous recombination.

DNA glycosylases, such as the Mag1 3-methyladenine (3MeA) DNA glycosylase, initiate the base excision repair (BER) pathway by removing damaged bases to create abasic apurinic/apyrimidinic (AP) sites that are subsequently repaired by downstream BER enzymes. Although unrepaired base damage may be mutagenic or recombinogenic, BER intermediates (e.g. AP sites and strand breaks) may also be problematic. To investigate the molecular basis for methylation-induced homologous recombination events in Saccharomyces cerevisiae, spontaneous and methylation-induced recombination were studied in strains with varied MAG1 expression levels. We show that cells lacking Mag1 have increased susceptibility to methylation-induced recombination, and that disruption of nucleotide excision repair (NER; rad4) in mag1 cells increases cellular susceptibility to these events. Furthermore, expression of Escherichia coli Tag 3MeA DNA glycosylase suppresses recombination events, providing strong evidence that unrepaired 3MeA lesions induce recombination. Disruption of REV3 (required for polymerase zeta (Pol zeta)) in mag1 rad4 cells causes increased susceptibility to methylation-induced toxicity and recombination, suggesting that Pol zeta can replicate past 3MeAs. However, at subtoxic levels of methylation damage, disruption of REV3 suppresses methylation-induced recombination, indicating that the effects of Pol zeta on recombination are highly dose-dependent. We also show that overproduction of Mag1 can increase the levels of spontaneous recombination, presumably due to increased levels of BER intermediates. However, additional APN1 endonuclease expression or disruption of REV3 does not affect MAG1-induced recombination, suggesting that downstream BER intermediates (e.g. single strand breaks) are responsible for MAG1-induced recombination, rather than uncleaved AP sites. Thus, too little Mag1 sensitizes cells to methylation-induced recombination, while too much Mag1 can put cells at risk of recombination induced by single strand breaks formed during BER.

Apurinic Acid↗
PubMed2002

Atmospheric dust loads and their elemental composition at a background site in India.

Air particulate samples collected during 1995-96 at a background site situated on the east coast of Thar Desert in Rajsthan State of India were analysed for atmospheric dust loads (Suspended Particulate Matter) and elemental composition. The values of SPM ranged from 9 microg M(-3) to 97 microg M(-3) with an average of 43 microg M(-3) except a few episodic values, which were 3 to 5 times higher than the average during summer months. The results for elemental composition of the particulate samples showed that the concentrations of anthropogenic toxic trace elements viz. Br, Cr, Pb, Sb, Se and Zn are lower by a factor of 2 to 10 as compared to urban areas. The high enrichment factors for anthropogenic elements viz. Br, Pb, Sb and Zn show an input from coal/wood fuel burning and vehicular pollution at the sampling site. The depletion of Si in SPM samples shows long distance transport of dust to the sampling site.

Air Pollutants↗
PubMed2002

Spinal epidural cavernous haemangioma: a case report and review of literature.

STUDY DESIGN: A case report of purely epidural cavernous haemangioma with MRI appearance and pathological features. OBJECTIVE: To present a rare case of extradural mass with differential diagnosis. SETTING: Delhi, India. METHOD: A 55-year-old man presented with progressive weakness and diminished sensation in both lower limbs. MRI demonstrated a pure extradural mass with no bony invasion. Histopathology of the lesion revealed a typical cavernous haemangioma. RESULT: The patient showed significant improvement after surgery. CONCLUSION: Radiological presentation could be confusing in a purely epidural cavernous haemangioma. Awareness of the characteristics of the lesion will facilitate diagnosis and treatment of the lesion.

Central Nervous System Neoplasms↗
PubMed2002

Retrospective review and long-term follow-up of radical cystectomy in a developing country.

OBJECTIVE: To retrospectively review the clinical data from patients undergoing radical cystectomy for bladder cancer, and to analyse the complications and survival rates associated with this operation in a developing country. PATIENTS AND METHODS: The study comprised 105 patients who underwent radical cystectomy from 1986 to 1993. Data were collected from retrospective reviews of hospital and physician's office records, and by contact with the patients. Metastatic status was evaluated before surgery and tumours staged using the Tumour-Nodes-Metastasis classification. The indication for surgery was histologically confirmed muscle invasion after transurethral resection biopsy, or endoscopically uncontrollable superficial disease. The data were analysed to assess the perioperative complications and long-term survival, with 5-year survival rates determined using Kaplan-Meier survival curves. RESULTS: The complication rate was 27.6%; most of the complications were managed conservatively with good results and re-operation was required in only two patients. There were two deaths (1.9%) at 15-45 days after surgery, but none during surgery. Patients were divided into node-negative and node-positive groups for analysis and 5-year survival rates determined; for node-negative organ-confined disease (< or =pT3A) the survival was 68% and for nonorgan-confined disease (> or =pT3B) 25%. The 5-year survival rate in the presence of nodal metastases was 13% for N1 and none for N2 disease. Six patients developed urethral recurrence, detected on follow-up urethral-wash cytology. Five of these patients underwent urethrectomy, and four of the six survived for 5 years. Pelvic recurrence occurred in five patients (4.7%), none of whom survived for 5 years. CONCLUSION: Radical cystectomy and pelvic lymph node dissection remains the mainstay of treatment in muscle-invasive bladder cancer. This is a relatively safe procedure with minimal morbidity and mortality; 68% of the present patients with organ-confined disease survived 5 years and 12 patients were alive at 10 years, indicating the effectiveness of this operation in selected cases. However, < 29% of patients with nonorgan-confined and nodal metastatic disease survived 5 years, thereby implying the need for more effective adjuvant therapy in these patients. Radical cystectomy is a viable option in developing countries, with 5-year survival rates comparable with most large published series.

Adult↗
PubMed2002

Incidence of phenytoin induced gingival overgrowth in epileptic children: a six month evaluation.

Thirty children aged 8-13 years with epileptic disorders and receiving mono-drug therapy with Phenytoin, were selected from the Departments of Pediatrics and Neurology of PGIMER, Chandigarh to evaluate the development of gingival overgrowth induced by phenytoin over a period of six months. These children were evaluated at baseline at three monthly intervals for a period of six months for plaque (Silness and Loe, 1964), gingivitis (Loe and Silness, 1963) and probing depth of the gingival sulcus. Gingival overgrowth was noted as and when it developed using modified version of Harris and Ewalt Index, 1942. No attempt was made to modify the childrens' prevailing oral habits. The results indicated that gingival overgrowth in 57% of the children was in the mesio-distal dimension of the gingival papillae and occurred within six months of initiation of therapy with Phenytoin.

Adolescent↗
PubMed2001

Allosteric behaviour of 1:5 hybrids of mutant subunits of Clostridium symbiosum glutamate dehydrogenase differing in their amino acid specificity.

Hybrid hexamers were made by refolding mixtures of two mutant forms of clostridial glutamate dehydrogenase. Mutant Cys320Ser (C320S) has a similar activity to the wild-type enzyme, but is unreactive with Ellman's reagent, 5,5'-dithiobis(2-nitrobenzoate) (DTNB). The triple mutant Lys89Leu/Ala163Gly/Ser380Ala (K89L/A163G/S380A), active with norleucine but not glutamate, is inactivated by DTNB, since the amino acid residue at position 320 is a cysteine residue. The chosen ratio favoured 1:5 hybrids of the triple mutant and C320S. The renatured mixture was treated with DTNB and separated on an NAD(+)-agarose column to which only C320S subunits bind tightly. Fractions were monitored for glutamate and norleucine activity and for releasable thionitrobenzoate to establish subunit stoichiometry. A fraction highly enriched in the 1:5 hybrid was identified. Homohexamers (C320S with 40 mM glutamate and 1 mM NAD(+) at pH 8.8, or K89L/A163G/S380A with 70 mM norleucine and 1 mM NAD(+) at pH 8.5) showed allosteric activation; succinate activated C320S approx. 50-fold (EC(50)=70 mM, h=2.4), and glutarate gave approx. 30-fold activation (EC(50)=35 mM, h=2.3). For the triple mutant, corresponding values were 80 mM and 2.2 for succinate, and 75 mM and 1.7 for glutarate, but maximal activation was only about 2-fold. In the 1:5 hybrid, with only one norleucine-active subunit per hexamer, responses to glutarate and succinate were still co-operative, and activation was more extensive than in the triple mutant homohexamer. A single norleucine-active subunit can thus respond co-operatively to a substrate analogue at the other five inactive sites. On the other hand, similar hyperbolic dependence on the norleucine concentration for the hybrid and the triple mutant homohexamer reflected the inability of C320S subunits to bind norleucine. With glutamate at pH 8.8, an h value of 3.6 was obtained for the 1:5 hybrid, in contrast with an h value of 5.2 for the C320S homohexamer. The "foreign" subunit evidently impedes inter-subunit communication to some extent.

Chromatography, Affinity↗
PubMed2001

(99m)Tc antigranulocyte monoclonal antibody imaging for the detection and assessment of inflammatory bowel disease newly diagnosed by colonoscopy in children.

OBJECTIVE: This prospective study evaluated a (99m)Tc antigranulocyte monoclonal antibody Fab' imaging agent (Sulesomab) in children with inflammatory bowel disease (IBD) newly diagnosed by colonoscopy. MATERIALS AND METHODS: Ten children (4 boys, 6 girls; mean age 14 years) with newly diagnosed Crohn's disease (n = 6) or ulcerative colitis (n = 4) were studied. Colonoscopy was performed in all of these patients. Within 24 h after colonoscopy, they underwent scintigraphy with (99m)Tc-Sulesomab. Abdominal/pelvic images were acquired at 30 min (planar) and 2-4 h (planar and SPECT) after injection of Sulesomab. Eighty bowel segments were evaluated semi-quantitatively by the investigators, using these three sets of images. The Pediatric Disease Activity (PDA) was correlated with the erythrocyte sedimentation rate (ESR), white blood cell (WBC) count, albumin, Kirschner's score, the Sulesomab bowel segment with maximum uptake, and the sum of Sulesomab score in each segment. RESULTS: The median PDA score was 26 (range 12.5-40). Three children had normal ESR and six normal WBC counts. All patients had at least one positive mucosal biopsy for IBD. While using the Kirschner's scale, the maximal severity of colonoscopy findings was graded as none (n = 2), mild (n = 4), moderate (n = 3), or severe (n = 1). Of the 59 segments evaluated with endoscopy, 35 were found to be endoscopically abnormal. The planar images identified 17 of these abnormal segments and the SPECT images 20. Nine of these ten children had abnormal bowel uptake by scintigraphy. Thus, the sensitivity of Sulesomab per patient was 90 % and per bowel segment 57 %. The correlation coefficient between the scintigraphic score for the segment with the Sulesomab maximum activity and the PDA was 0.3 (P = 0.41). CONCLUSION: In pediatric IBD assessment, planar imaging with Sulesomab did not prove very sensitive in detecting inflammation in each bowel segment. However, SPECT detected the presence of inflammation in the majority of patients. A trial comparing (99m)Tc-HmPAO-WBC with Sulesomab in a large number of patients is required.

Antibodies, Monoclonal↗
PubMed2001

Current practices in left-sided colonic emergencies: a survey of US gastrointestinal surgeons.

BACKGROUND: The paradigms in the surgical management of obstruction and perforation of the left colon - once considered absolute contraindications to primary resection and anastomosis - are changing. The aim of this survey was to poll American Gastrointestinal surgeons on their current approach to left colonic emergencies. METHODS: A questionnaire was sent to 500 US-based surgeons, randomly selected members from the membership list of the Society for Surgery of the Alimentary Tract. It surveyed the surgeons on how they would approach 'good-risk' and 'poor-risk' patients with left colonic obstruction or perforation. RESULTS: 215 (43%) surgeons responded to the questionnaire; 180 fully completed questionnaires (36%) were analyzed. Sigmoid obstruction: 96 responders (53%) selected a one-stage procedure in 'good-risk' patients; 78 preferred sigmoid resection with (n = 46) or without (n = 32) 'on-table' colonic lavage and 18 opted for a subtotal colectomy and ileo-rectal anastomosis. Most (94%) responders preferred a staged procedure in 'high-risk' patients: a Hartmann resection (n = 120) or a transverse colostomy (n = 46). Sigmoid diverticular perforation: only one third of the responders recommended a one-stage procedure in 'good-risk' patients: 58 would perform a sigmoidectomy with (n = 19) or without (n = 39) 'on-table' colonic lavage; only two opted for subtotal colectomy with ileo-rectal anastomosis. In 'high-risk' patients most surgeons opted for a Hartmann's (88%) procedure or a diverting colostomy (7%). CONCLUSIONS: This survey suggests that a half and one-third of the responders would perform a one-stage resection and anastomosis in 'good-risk' patients with left colonic obstruction and perforation, respectively. In 'poor-risk' patients most responders would still opt for a staged procedure.

Anastomosis, Surgical↗