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Biomedical subjects

A H Rajput

Publications and source records attributed to A H Rajput.

At least 73 records · Page 4Linked to original sources
PubMed1987

A case-control study of smoking habits, dementia, and other illnesses in idiopathic Parkinson's disease.

From 1967 to 1979, 118 incident cases of idiopathic Parkinson's disease (IPD) and 236 age- and sex-matched controls from Rochester, MN, were identified. Medical records on patients and controls for 40 years preceding the diagnosis of IPD were reviewed. The relative risk (RR) for ever-smoked and IPD was not significantly different from unity (RR = 0.7, 95% confidence interval = 0.4 to 1.2). The mean age at diagnosis of IPD was significantly younger (p = 0.007) in the ever-smokers (68.8 years) compared with never-smokers (73.8 years), although this needs to be interpreted cautiously. It is concluded that smoking had no effect on the development of IPD. Within 5 years after the index date, a new diagnosis of dementia was made more often in cases than in controls (p = 0.01). Relative risk of IPD significantly increased when prior diagnosis of psychoneurosis and psychosomatic illness had been made.

Adolescent↗
PubMed1987

Regional distribution of metals in human brain.

Progress in understanding the role of metals in diseases of the nervous system has been hampered to a large extent by a lack of normal metal concentration values in the human brain. Since several metals interact metabolically, concurrent metal levels are essential for clinical correlation. We are reporting a simultaneous analysis of 24 metals in 4 different areas of 9 human brains. Our data on previously studied metals are comparable to the past observations. Therefore, we suggest the values of all metals reported here should be regarded as "normal" for ages 58-78 years.

Aged↗
PubMed1986

Multiple sclerosis presenting as isolated oculomotor nerve palsy.

A 23-year old woman came to the emergency room with an isolated oculomotor nerve palsy (including pupillary dilatation) of rapid onset. Investigations and history revealed no cause. The subsequent course of events indicated a diagnosis of multiple sclerosis. While the third nerve has been shown to be involved during the course of multiple sclerosis, this is the first report of a case presenting as an isolated oculomotor nerve paralysis.

Adult↗
PubMed1986

Early onset Parkinson's disease in Saskatchewan--environmental considerations for etiology.

The cause of idiopathic Parkinson's Disease (PD) is not known but it is believed to be related to some environmental agent(s). Given a long preclinical interval and onset of symptomatology around age 60 years, it becomes impossible to identify and analyze all prior environmental factors satisfactorily. To circumvent these difficulties we evaluated the childhood environment in those PD patients whose symptoms began at age 40 years or earlier. Twenty-one such cases were born and raised in the province of Saskatchewan. Nineteen of these 21 patients spent the first 15 years of life exclusively in rural Saskatchewan. Detailed population analysis indicates a strong predisposition to early onset idiopathic Parkinson's Disease (EPD) in those raised in rural areas (p = 0.0154). All but one case utilized exclusively well water for the first 15 years of life--a trait significantly different from that expected in the provincial population. It is concluded that rural Saskatchewan environments contribute to EPD and that well water used in childhood should be considered as a potential vehicle for the etiological agent.

Age Factors↗
PubMed1985

Parkinsonism as a manifestation of brain tumor.

Neoplasm is an uncommon cause of the parkinsonian syndrome. We are presenting three cases of intracranial tumors whose major manifestations included parkinsonism. Surgical treatment resulted in control of the extrapyramidal symptoms in two of our patients. Because no curative treatment is available for the vast majority of parkinsonian patients, early detection of an underlying neoplasm may offer a most rewarding outcome. Unilaterality of the symptoms, overwhelming dementia, or suspicion of a mass should lead to the performance of computed tomography.

Aged↗
PubMed1985

Cyanide-induced parkinsonism: a clinicopathologic report.

An 18-year-old man ingested 975 to 1,300 mg of potassium cyanide in a suicide attempt. He was treated and survived the poisoning episode, but then had severe parkinsonian syndrome, characterized primarily by akinesia and rigidity. He died 19 months after the drug overdose. At autopsy, major destructive changes were found in the globus pallidus and putamen, whereas the melanin-containing zone of substantia nigra was intact. This is the first clinicopathologic report of parkinsonism as a result of cyanide poisoning.

Adolescent↗
PubMed1984

Cerebellar norepinephrine in patients with Parkinson's disease and control subjects.

Norepinephrine was measured in postmortem cerebellar cortex of 22 non-neurological control subjects and nine patients with Parkinson's disease, using the high-performance liquid chromatography method with amperometric detection. In all control subjects, substantial amounts of norepinephrine was found in cerebellar cortex. There was a moderate negative correlation between age of control subjects and cerebellar norepinephrine concentration. In the patients with Parkinson's disease, the cerebellar cortical norepinephrine levels were significantly below normal. This is in accord with previously reported reduced norepinephrine levels in locus ceruleus and other regions of the parkinsonian brain. Although the main symptoms of Parkinson's disease are primarily caused by disturbed basal ganglia (dopamine) function, cerebellar dysfunction related to norepinephrine may contribute to some abnormalities of motor performance in this disorder.

Aged↗
PubMed1984

Epidemiology of parkinsonism: incidence, classification, and mortality.

An epidemiological study of parkinsonism over a 13-year period (1967 through 1979) is presented, updating previous reports on incidence and trend in the population of Rochester, Minnesota. The overall average annual incidence of parkinsonism per 100,000 population was 20.5, adjusted to the 1970 total United States population, which is virtually unchanged from previous observations. Incidences calculated for each calendar year (1967 through 1979) revealed no remarkable change following the 1976 swine flu vaccination program. There was no sex difference and the peak incidence occurred between ages 75 and 84 years. Idiopathic Parkinson's disease was the most common variant (86%), followed by drug-induced parkinsonism (7%). There were no new cases of postencephalitic parkinsonism diagnosed during the study period. Relative frequency of other types of Parkinson's disease as identified by practicing neurologists is presented. For each case two age- and sex-matched controls were selected from the Rochester population. The survival rates in the controls were comparable to the general population of the west north central region of the United States. The mortalities in the patients were significantly higher (p = 0.001) than the controls and were unchanged from previous rates reported from the same community. In the 69 (50%) patients treated with levodopa, the mortality was comparable to that in controls. The favorable outcome in these cases is attributed to bias resulting from selection of healthier patients for treatment.

Adult↗
PubMed1984

Epidemiology of Parkinson's disease.

Epidemiology of parkinsonism for 13 years (1967 to 1979) in Rochester, Minnesota is evaluated. For each patient, two age- and sex-matched controls with comparable medical follow-up (mean 40 years before diagnosis) were selected from the same community. Smoking habits, dementia, acute and chronic illnesses and mortality patterns in the two groups are compared. The annual incidence rate was 20.5/100,000, which is virtually unchanged from previous reports on Rochester population. Cigarette smoking habits of cases and the controls before the index date were not significantly different. Prior to diagnosis of Parkinson's disease, dementia was diagnosed significantly more frequently among the patients than the controls (P = 0.048). After diagnosis of parkinsonism dementia emerged nearly three times more frequently in patients than among the controls. Mortality rate in the entire parkinsonian population was similar to that reported from the same community between 1935 and 1966. Only 50% of the patients were treated with levodopa. Among those treated with levodopa the mortality rate was comparable to their controls. Because there were no definite criteria for administering levodopa therapy, higher frequency of dementia and prolonged survival in those treated with this drug could be attributed to the bias of case selection for treatment.

Adult↗
PubMed1984

Essential tremor in Rochester, Minnesota: a 45-year study.

A 45-year (1935-79) retrospective study of essential tremor based on original medical records on residents of Rochester, Minnesota, is presented. The age and sex adjusted incidence for the most recent 15 year period was 23.7 per 100 000 for US white population. The prevalence rate, age and sex adjusted to 1970 US white population on January 1, 1979 was estimated at 305.6 per 100 000. Survival after diagnosis of essential tremor is comparable to age and sex matched population of West North Central United States. Mean age at diagnosis was 58 (range 2-96) years. Age adjusted annual incidence rate was not different in males (18.3/100 000) and females (17.1/100 000). Functional handicap was reported by four (1.5%) of the 266 incidence cases in school, 13 (5%) cases at work and five cases (2%) retired prematurely. Excessive use of alcohol was noted in 16% and 6% were diagnosed as alcoholic. Torticollis was diagnosed in 3% cases and an additional diagnosis of Parkinson's disease after the index date was made in 2% of incidence cases. Subsequent emergence of Parkinsonism was regarded as incidental. Diagnosis of hypertension was made at some time in 30% of incidence cases during the period (mean 37 years) for which the medical records were available. Risk of hypertension after onset of essential tremor in the cases was not different from that in a control group.

Adolescent↗
PubMed1984

Chronic low-dose levodopa therapy in Parkinson's disease: an argument for delaying levodopa therapy.

Levodopa is the most useful drug for treatment of Parkinson's disease today. But after continued use for several years, the effectiveness declines, and the undesirable side effects become more frequent, leading to unsatisfactory control. Once the treatment failure emerges, further management is difficult and often unsuccessful. One alternative for preventing side effects and treatment failure is to use a low dose. We are reporting our 12-year experience on uninterrupted treatment with levodopa, 3 grams (approximate) daily. The improvement was comparable with the best reports on higher dosage, and the side effects were significantly less frequent. The frequency of dyskinesia and on-off phenomena showed a strong correlation with duration of treatment. Psychiatric side effects were more common on treatment, but frequency of dementia did not correlate with duration of therapy. Improvement reached a peak after 6 months and remained statistically significant for 3.5 years. By the end of 5 years, the disability profile in the group was similar to that prior to levodopa treatment. So far, there is no satisfactory method for preventing treatment failure. From our observations, low dosage of levodopa is a desirable alternative, but not the answer to therapeutic failure. We recommend that levodopa use be delayed until the patient has a functional and/or psychological handicap that cannot be satisfactorily controlled with less potent antiparkinsonian agents.

Humans↗
PubMed1984

Epidemiological survey of dementia in parkinsonism and control population.

In a 13-year (1967-1979) survey of Rochester, Minnesota residents, 138 new cases of parkinsonism were recognized. For each case, 2 age- and sex-matched residents from the community were identified who attended the same medical facility as the patient did. Original medical records for 40 years preceding the diagnosis and control selection were reviewed on all patients and controls. Diagnosis of dementia was made three times more frequently in patients than in the controls, but the age at diagnosis was similar in the two groups. Those cases where neither of the three matched individuals had dementia at the time of initial recognition of parkinsonism were further followed. Dementia emerged significantly more frequently in patients than in controls. The subgroup of patients treated with levodopa had higher frequency of dementia than the controls. It is concluded that dementia is significantly more common in parkinsonian patients than in a comparable population. Dementia is believed to be either an integral part of the disease process or these patients are prone to some other illness that produces dementia. Our data conclusively show that dementia is not a reflection of old age. Higher incidence of dementia in levodopa-treated cases may be due to case-selection artifact or an as yet unrecognized effect of levodopa.

Age Factors↗
PubMed1983

Amantadine-dyazide interaction.

To document an interaction between amantadine hydrochloride and Dyazide that had apparently produced amantadine toxicity, a patient was given amantadine alone for 1 week, followed by amantadine plus Dyazide for another week, under controlled conditions. A diuretic effect was observed after Dyazide was added to the regimen, but the urine amantadine excretion fell, and the drug's plasma concentration increased. It was concluded that one or both of the components of Dyazide (hydrochlorothiazide and triamterene) reduce the clearance of amantadine and can produce higher plasma concentrations and toxic effects.

Amantadine↗