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Biomedical subjects

A Jaiswal

Publications and source records attributed to A Jaiswal.

16 recordsLinked to original sources

Deep vein thrombosis after total hip and knee arthroplasty in Indian patients.

BACKGROUND: Deep vein thrombosis (DVT) is one of the most common complications of total hip (THA) and total knee arthroplasty (TKA). Though the reported incidence of DVT is very high, that of proximal DVT is low and that of fatal thromboembolism is very low. Hence the issue of prophylaxis for DVT remains controversial. The incidence of DVT is based on various studies in European and American populations. The Asian population is genetically and socially quite different from American and European populations, and the incidence of DVT can be quite different. Therefore a prospective study was initiated at our centre to determine incidence of DVT after THA and TKA in Indian patients. METHODS: A prospective study was conducted on 60 hips in 45 patients and 46 knees in 26 patients who underwent THA and TKA respectively, without any known risk factors for thromboembolic disease. DVT was studied by preoperative and postoperative serial colour Doppler ultrasonography. No prophylaxis was given to any of the patients. RESULTS: DVT was found in two patients who had undergone THA. No case of DVT was detected in any patient who had undergone TKA. CONCLUSION: These results suggest that the incidence of DVT in Indian patients is very low and is not comparable with American and European populations. It is therefore not cost effective to advise prophylaxis in Indian patients undergoing THA/TKA who have no known risk factors for DVT.

Aged↗

Layer-by-layer self-assembly of Prussian blue colloids.

The adsorption of Prussian blue (PB) colloids within layers of polyelectrolytes has been achieved by a reiterative immersion-rinse approach. Multilayer assemblies consisting of alternate layers of these components have been prepared by the layer-by-layer (LbL) self-assembly technique. Both processes have been carefully monitored by cyclic voltammetry and infrared and UV-visible spectroscopy. Linear increase in the IR and UV-visible light absorbance with the number of deposited layers indicates that well-organized lamellar systems have been elaborated. Size and distribution of Prussian blue nanoparticles in these systems have been investigated by AFM. The effect of the molar concentration of the PB dipping solution on the adsorption process and the distribution of the PB colloids has also been described. Finally, magnetic properties of these assemblies have been studied by low-temperature ESR measurements. Indeed, this new approach of hybrid LbL films opens the way to a new class of nanostructured lamellar compounds.

Adsorption↗

Adherence to tuberculosis treatment: lessons from the urban setting of Delhi, India.

The Revised National Tuberculosis Control Programme (RNTCP), which incorporated the WHO DOTS strategy was introduced in India in the mid-1990s. An operational research project was conducted between 1996 and 1998 to assess the needs and perspectives of patients and providers in two chest clinics in Delhi, Moti Nagar and Nehru Nagar, during the introduction of the new strategy. This paper reports on the findings of the project, concentrating on information collected from 40 in-depth interviews with patient defaulters and from non-participant observations in clinics and directly observed treatment centres. In Moti Nagar chest clinic, 117 of 1786 (6.5%) patients and 195 of 1890 (10%) patients in Nehru Nagar left care before their treatment was complete. It was argued that the reasons for default stem from a poor correlation between patient and programme needs and priorities, and from particular characteristics of the disease and its treatment. Patient needs that were not met by the health system included convenient clinic timings, arrangements for the provision for treatment in the event of a family emergency and provision for complicated cases like alcoholics. The problems facing the provider were poor interpersonal communication with the health staff, lack of attention and support at the clinic, difficulty for patients to re-enter the system if they missed treatment and, in certain areas, long distances to the clinic. Problems related to diseases were inability of the staff to deal with drug side-effects, and patients' conception of equating well-being with cure. Simple, practical measures could improve the provision of tuberculosis (TB) treatment: more flexible hours, allowances for poor patients to reach the clinics and training health care staff for respectful communication and monitoring drug side-effects. The findings indicate a need to rethink the label of 'defaulter' often given to the patients. The important areas for future operational research is also highlighted.

Adolescent↗

TB control, poverty, and vulnerability in Delhi, India.

The Revised National Tuberculosis Control Programme (RNTCP), based on the World Health Organization's DOTS strategy,* was introduced in India in the mid-1990s. This paper reports the findings from operational research studies in two pilot sites in New Delhi from 1996 to 1998. A variety of operational research methods were used, including semi-structured interviews, focus group discussions, non-participant observations and collection of data from the tuberculosis registers. The cure rates for the clinics were 71 and 75% with a default rate of 6 and 11%, respectively. An important finding was that health workers screened patients to determine their ability to conform to the direct observation of treatment element of the RNTCP. If the health worker was confident that the patient would comply and/or be easy to trace in the community in the event of 'default', they were provided with short-course treatment under the RNTCP. Other patients, largely those who were in absolute poverty, socially marginalized, itinerant labourers, poorly integrated in the city, were put on standard tuberculosis (TB) treatment as for the previous National TB Programme. The programme was evidently excluding the most vulnerable from the best available care. These findings demonstrate the potential dangers of target-driven programmes where there is an absence of support to both frontline health workers and patients. The paper also highlights the importance of operations research in helping to identify problems within TB programmes.

Antitubercular Agents↗

SHV-7, a novel cefotaxime-hydrolyzing beta-lactamase, identified in Escherichia coli isolates from hospitalized nursing home patients.

Four ceftazidime-resistant Escherichia coli strains were isolated from elderly nursing home patients in a New York hospital during 1993. Strains MCQ-2, MCQ-3, and MCQ-4 were determined to be identical by pulsed-field gel electrophoresis and plasmid profiles, whereas strain MCQ-1 was unique. Strain MCQ-1 was determined to produce a TEM-10 beta-lactamase. Strains MCQ-2, MCQ-3, and MCQ-4 were also noted to be resistant to cefotaxime. These three strains produced two beta-lactamases with pIs of 5.4 (TEM-1) and 7.6. beta-Lactamase assays revealed that the pI 7.6 enzyme hydrolyzed cefotaxime faster (at a relative hydrolysis rate of 30% compared with that of benzylpenicillin) than either ceftazidime or aztreonam (relative hydrolysis rates of 13 and 3.3%, respectively). Nucleotide sequencing of the gene encoding the pI 7.6 beta-lactamase from strain MCQ-3 revealed a blaSHV-type gene differing from the gene encoding SHV-1 at four nucleotides which resulted in amino acid substitutions: phenylalanine for isoleucine at position 8, serine for arginine at position 43, serine for glycine at position 238, and lysine for glutamate at position 240. This novel SHV-type extended-spectrum beta-lactamase is designated SHV-7.

Amino Acid Sequence↗

In vivo effect of cyanate on serum and eye lens in rat.

Supplementation of cyanate in rats caused a significant decrease in serum GSH and increase in calcium and phosphate level both in serum and lens. Consequently, these changes led to induce acidosis uremia in serum and hypercalcemia and hyperphosphatemia in lens which may be possible causing factor for cataract.

Acidosis↗

Angiotensin converting enzyme in the testis and epididymis of mammals.

Angiotensin converting enzyme (ACE) activity has been reported in testis and epididymis of seven different animal species. Among all the species, the mouse testis and epididymis showed the highest converting enzyme activity followed by rat testis and epididymis. The lowest activity was detected in buffalo testis and rabbit epididymis. Most of the testicular enzyme was found concentrated in the 107,00 X g sediment while the epididymal enzyme was equally distributed between sediment and supernatant. ACE levels of different regions of the rat testis and epididymis was analyzed. The gradient of ACE was found increasing from caput to cauda. A major fraction of testicular and epididymal ACE activity was found in their respective fluid. ACE appeared only in mature rats, rabbits and mice testis and epididymis. Sexually stimulated rabbits showed significant ACE increase in the testis. In vitro characterization studies were conducted.

Animals↗

A thyroid tubercular abscess and bilateral symmetrical hilar lymphadenopathy: a rare association.

An 18-year-old boy presented with a rare association of a thyroid tubercular abscess and bilateral symmetrical hilar lymphadenopathy. He was put on a Category I regimen with standard short course daily chemotherapy of four anti-tubercular drugs under the National Tuberculosis Programme. After a six-month of anti-tubercular treatment (ATT), the boy showed clinical and bacteriological improvement. The thyroid scan with Technetium 99 (Tc 99) and the chest skiagram also became normal.

Abscess↗

Clindamycin in the treatment of anaerobic lung abscess.

A case of anaerobic lung abscess who had treatment failure after 4 weeks of supervised parenteral penicillin and oral metronidazole is described. Anaerobic pathogens resistant to one or the other of the above drugs were isolated. The patient had a striking clinical response to subsequent therapy with oral clindamycin. Failure of therapy should alert physicians to the possibility of infection with resistant anaerobic pathogens and in such situations, clindamycin is considered as an effective alternative.

Adult↗

Amoebic liver abscess rupturing into the chest: ultrasonographic appearance.

Two cases of amoebic liver abscess perforating into chest are reported. Both patients were males in their twenties. They presented with right upper quadrant pain in abdomen in one case and right lower chest pain in second case. Ultrasonography demonstrated hypoechoic liver abscess in superior subdiaphragmatic part of the right lobe of liver, with communication through a hole in the diaphragm into the thoracic cavity in both the cases. Both these cases were diagnosed as cases of amoebic liver abscess perforated into chest on the basis of ultrasonographic findings and both of them showed good response to specific antiamoebic therapy.

Adult↗