Loose cilium in meibomian gland: mimicking early postoperative endophthalmitis.
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Cilia↗
Biomedical subjects
A K Jain
Publications and source records attributed to A K Jain.
Non-Pseudomonas Gram-negative peritonitis.
Non-Pseudomonas Gram-negative organisms account for over 10% of cases of peritoneal dialysis-associated peritonitis. The key findings from a paper by Szeto et al. are discussed and compared with those from previous publications. This type of peritonitis has a high rate of catheter removal and technique failure. Results may be better with more aggressive antibiotic treatment. Other developments in the field are reviewed.
Enterobacteriaceae Infections↗
The use of immunomodulators as an adjunct to antituberculous chemotherapy in non-responsive patients with osteo-articular tuberculosis.
We studied 51 patients with osteo-articular tuberculosis who were divided into two groups. Group I comprised 31 newly-diagnosed patients who were given first-line antituberculous treatment consisting of isoniazid, rifampicin, ethambutol and pyrazinamide. Group II (non-responders) consisted of 20 patients with a history of clinical non-responsiveness to supervised uninterrupted antituberculous treatment for a minimum of three months or a recurrence of a previous lesion which on clinical observation had healed. No patient in either group was HIV-positive. Group II were treated with an immunomodulation regime of intradermal BCG, oral levamisole and intramuscular diphtheria and tetanus vaccines as an adjunct for eight weeks in addition to antituberculous treatment. We gave antituberculous treatment for a total of 12 to 18 months in both groups and they were followed up for a mean of 30.2 months (24 to 49). A series of 20 healthy blood donors served as a control group.Twenty-nine (93.6%) of the 31 patients in group I and 14 of the 20 (70%) in group II had a clinicoradiological healing response to treatment by five months. The CD4 cell count in both groups was depressed at the time of enrolment, with a greater degree of depression in the group-II patients (686 cells/mm(3) (sd 261) and 545 cells/mm(3) (sd 137), respectively; p < 0.05). After treatment for three months both groups showed significant elevation of the CD4 cell count, reaching a level comparable with the control group. However, the mean CD4 cell count of group II (945 cells/mm(3) (sd 343)) still remained lower than that of group I (1071 cells/mm(3) (sd 290)), but the difference was not significant. Our study has shown encouraging results after immunomodulation and antituberculous treatment in non-responsive patients. The pattern of change in the CD4 cell count in response to treatment may be a reliable clinical indicator.
Adjuvants, Immunologic↗
Enhancement of pulse oximeter plethysmographic waveform in a patient with Takayasu's arteritis.
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Adult↗
Hepatitis E infection with Bell's palsy.
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Adult↗
Wilson's hepatitis: unusual presentation and survival.
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Ceruloplasmin↗
Design and development of multivesicular liposomal depot delivery system for controlled systemic delivery of acyclovir sodium.
The aim of the present study was to design a depot delivery system of acyclovir sodium using multivesicular liposomes (MVLs) to overcome the limitations of conventional therapies and to investigate its in vivo effectiveness for sustained delivery. MVLs of acyclovir were prepared by the reverse phase evaporation method. The loading efficiency of the MVLs (45%-82%) was found to be 3 to 6 times higher than conventional multilamellar vesicles (MLVs). The in vitro release of acyclovir from MVL formulations was found to be in a sustained manner and only 70% of drug was released in 96 hours, whereas conventional MLVs released 80% of drug in 16 hours. Following intradermal administration to Wistar rats, the MVL formulations showed effective plasma concentration for 48 hours compared with MLVs and free drug solution (12-16 hours). C(max) values of MVL formulations were significantly less (8.6-11.4 microg/mL) than MLV and free drug solution (12.5 microg/mL). The AUC(0-48) of the MVL formulations was 1.5- and 3-fold higher compared with conventional liposomes and free drug solution, respectively. Overall, formulations containing phosphatidyl glycerol as negatively charged lipid showed better results. The MVL delivery system as an intradermal depot offers the advantage of a very high loading and controlled release of acyclovir for an extended period of time. The increase in AUC and decrease in C(max) reflects that the MVL formulations could reduce the toxic complications and limitations of conventional iv and oral therapies.
Acyclovir↗
A comparative adsorption study with different industrial wastes as adsorbents for the removal of cationic dyes from water.
Four adsorbents have been prepared from industrial wastes obtained from the steel and fertilizer industries and investigated for their utility to remove cationic dyes. Studies have shown that the adsorbents prepared from blast furnace sludge, dust, and slag have poor porosity and low surface area, resulting in very low efficiency for the adsorption of dyes. On the other hand, carbonaceous adsorbent prepared from carbon slurry waste obtained from the fertilizer industry was found to show good porosity and appreciable surface area and consequently adsorbs dyes to an appreciable extent. The adsorption of two cationic dyes, viz., rhodamine B and Bismark Brown R on carbonaceous adsorbent conforms to Langmuir equation, is a first-order process and pore diffusion controlled. As the adsorption of dyes investigated was appreciable on carbonaceous adsorbent, its efficiency was evaluated by comparing the results with those obtained on a standard activated charcoal sample. It was found that prepared carbonaceous adsorbent exhibits dye removal efficiency that is about 80-90% of that observed with standard activated charcoal samples. Thus, it can be fruitfully used for the removal of dyes and is a suitable alternative to standard activated charcoal in view of its cheaper cost.
Journal Article↗
Evaluation of systems of grading of neurological deficit in tuberculosis of spine.
STUDY DESIGN: Prospective comparative study. OBJECTIVE: To compare the efficacy of the ASIA scoring system and Tuli's classification for assessment of neurological status in a typical case of Pott's paraplegia/tetraplegia and suggest a suitable classification. SETTING: Department of Orthopaedics of University College of Medical Sciences and GTB Hospital, Delhi, India. METHODS: A total of 33 cases of tuberculosis of the spine with paraplegia were evaluated serially for the severity of the neurological deficit by grading systems as suggested by Tuli and ASIA score, during the course of treatment. A total of 111 readings of neurological status were recorded and analysed. RESULTS: Tuli's grading was found to be sensitive for detection of early stage (grade I) of neurological deficit. The rest of the grades (grade II, III, IV) of Tuli's classification have a wide range of sensory-motor deficit and hence are insensitive to early detection of any deterioration/improvement in the neurological status. The ASIA score failed to grade all types of neurological deficit associated with the Pott's spine. The sensory-motor score obtained by the ASIA scale depends on the level of involvement of the spinal cord. The higher the level of the cord damage, the poorer is the score. CONCLUSION: Neither Tuli's grading nor the ASIA scale alone can effectively grade all stages of neurological deficit in tuberculosis of the spine. The neurological deficit in tuberculosis of the spine should be described in stages and each stage should have sensory and motor scoring. A new staging system of Pott's tetraplegia/paraplegia is suggested.
Adolescent↗
Management of chronic hepatitis B with New Livfit in end stage renal disease.
New Livfit (NLF) is a standardized, poly-herbal formulation that has been found useful in the management of hepatitis. The aim of this placebo-controlled study was to evaluate its usefulness against hepatitis B virus in the patients of end stage renal disease (ESRD). Patients were regularly evaluated at 6, 12, 24 and 36 weeks of therapy. With 36 weeks of treatment of NLF, there was rapid clearing of HBV-DNA in a significant number of patients. Significant seroconversion of the other markers of hepatitis B and restoration of the raised levels of ALT and AST was observed. The study suggests the potential usefulness of NLF in the control of HBV infection in the patients of ESRD prior to renal transplant.
Adult↗
Hepatitis C virus-associated keratitis.
AIM: To study the association between chronic hepatitis C virus (HCV) and Mooren's type keratitis. METHOD: A total of 50 patients with chronic HCV were screened for any evidence of corneal ulceration. Detailed ocular examination was conducted by slit-lamp biomicroscopy. Patients with history of trauma to the eye or previous herpetic keratitis were excluded from the study. RESULTS: There were 37 males and 13 females. The age of the patients ranged from 10 to 70 years. There was no evidence of Mooren's ulcer in any of our patients. CONCLUSION: No association between chronic HCV and Mooren's ulcer was found in our study. Screening therefore in such cases is not necessary.
Adolescent↗
Removal of 2-fluoro and 2-iodophenol from aqueous solutions using industrial wastes.
A comparative study of the adsorbents prepared from several industrial wastes for the removal of 2-fluorophenol and 2-iodophenol has been carried out. The results show that maximum adsorption on carbonaceous adsorbent prepared from fertilizer industry waste has been found to be 35.3 and 235.3 mg g(-1) for 2-fluorophenol and 2-iodophenol, respectively. Compared to carbonaceous adsorbent, the other three adsorbents (viz., blast furnace sludge, dust, and slag) adsorb phenols to a much smaller extent. This has been attributed to the carbonaceous adsorbent having a larger porosity and consequently higher surface area. The adsorption of phenols on this adsorbent has been studied as a function of contact time, concentration and temperature. The adsorption has been found to be endothermic, and the data conform to the Langmuir equation. The further analysis of data indicates that adsorption is a first order process and pore diffusion controlled. A comparative study of adsorption results with those obtained on standard activated charcoal sample shows that prepared adsorbent is about 45% as efficient as standard activated charcoal and therefore, can be fruitfully employed for the removal of phenolic pollutants from wastewaters.
Adsorption↗
Effects of glycaemic control on cardiovascular disease in diabetic American Indians: the Strong Heart Study.
AIMS: Diabetes increases the risk of cardiovascular disease (CVD). Only part of this excess risk is explained by diabetes-associated hypertension, obesity, and lipid disorders. Poor glycaemic control may help explain the residual CVD risk. The aim of this study was to determine whether variations in glycaemic control are associated with CVD risk in diabetic individuals. METHODS: We examined longitudinal data from the Strong Heart Study, a population-based study of CVD and its risk factors among American Indians (a population with a high prevalence of diabetes). Diabetes was defined using the 1998 World Health Organization criteria: fasting plasma glucose >/= 126 mg/dl or 2-h plasma glucose >/= 200 mg/dl. American Diabetes Association guidelines for glycaemic control were used: good, A(1c) < 7%; fair, 7-7.9%; and poor, >/= 8%. The analysis was based on data from diabetic individuals with no CVD at baseline. RESULTS: During 9 years of follow-up, 494 of the 2011 diabetic participants developed CVD. Although Cox multivariate regression modelling showed dose-response effects of glycaemic control on overall CVD and coronary heart disease (CHD) incidence, the relationships were weakened when adjusted for confounding variables. Kaplan-Meier analysis, however, showed that diabetic individuals with poor baseline glycaemic control had significantly increased proportions of overall CVD and CHD (P = 0.001) during the 9 years of follow-up, compared with those who had good or fair control. CONCLUSIONS: These findings highlight the importance of risk factors, such as high blood pressure and dyslipidaemia, in increasing CVD risk in those with diabetes.
Aged↗
Extrapleural anterolateral decompression in tuberculosis of the dorsal spine.
We reviewed 64 anterolateral decompressions performed on 63 patients with tuberculosis of the dorsal spine (D1 to L1). The mean age of the patients was 35 years (9 to 73) with no gender preponderance. All patients had severe paraplegia (two cases grade III, 61 cases grade IV). The mean number of vertebral bodies affected was 2.6; the mean pre-treatment kyphosis was 24.8 degrees (7 to 84). An average of 2.9 ribs were removed in the course of 64 procedures. The mean time taken at surgery was 2.45 hours when two ribs were removed and 3.15 hours when three ribs were removed. Twelve patients (19%) showed signs of neurological recovery within seven days, 33 patients (52%) within one month and 12 patients (19%) after two months; but six patients (10%) showed no neurological recovery. Forty patients were followed up for more than two years. In 34 (85%) of these patients there was no significant change in the kyphotic deformity; two patients (5%) showed an increase of more than 20 degrees.
Adolescent↗
Behaviour of the kyphotic angle in spinal tuberculosis.
We followed 70 adult patients with spinal tuberculosis for a minimum of 2 years. Forty patients were treated by ambulant multi-drug chemotherapy (group A), and 30 with neurological complications (group B) were treated by antero-lateral decompression and chemotherapy. We studied the angle of spinal kyphosis as calculated on lateral spinal X-ray by the modified Konstam's method. The angle at final follow-up was compared with the pre-treatment angle. The relationship between the amount of initial vertebral loss, the predicted kyphotic angle and the observed kyphotic angle was analysed. Mean initial vertebral loss, mean pre-treatment angle and mean observed kyphotic angle in group A were 0.77 degrees, 24.3 degrees and 31.75 degrees respectively, with a mean increase in angle of 7.4 degrees. In group B, the readings were 0.67, 25.9 degrees and 26.8 degrees respectively, with a mean increase in angle of 0.9 degrees. Kyphotic deformity continued to progress until 2 years' follow-up. Progression was more pronounced in the non-operative group.
Adolescent↗
Evaluation of serum ferritin in screening for iron deficiency in tuberculosis.
Serum ferritin (SF) values </=10 micro g/l are diagnostic of absent Bone Marrow Iron (BMI) stores and therefore of iron deficiency (ID). However, SF, which may be elevated as a part of acute phase reaction, is an unreliable indicator of BMI stores in the setting of chronic disorders, making it difficult to diagnose ID in these patients. Thus, in chronic disorders (CD) such as tuberculosis, bone marrow examination is the only reliable way to establish ID. This study was done in order to identify levels of SF that would be indicative of absent BMI stores and also to study a combination of hematological and biochemical parameters that would be helpful in raising the predictive power of SF in patients of tuberculosis. Fifty-five tuberculosis patients were studied and classified into Iron Deplete (ID) and Iron Replete (IR) based on BMI. Raising the cut-off values of SF from </=10 micro g/l to </=30 micro g/l diagnosed 88% of ID cases correctly, as compared with 61% when cut-off levels of </=10 micro g/l were used. At cut-off values higher than 30 micro g/l, the sensitivity was markedly reduced. Therefore, raising cut-off levels of SF to </=30 micro g/l was most effective in predicting absent BMI, especially in a population where ID is highly prevalent. Combination of SF </=30 micro g/l with mean corpuscular volume (MCV), erythrocyte sedimentation rate (ESR) and total iron binding capacity (TIBC) did not improve the predictive power of SF further. Also, 89.5% cases could be correctly classified by logistic regression equations using SF with ESR and C- reactive protein (CRP).
Adult↗
Utilization of industrial waste products as adsorbents for the removal of dyes.
A number of low cost adsorbents from steel and fertilizer industries wastes have been prepared and investigated for the removal of anionic dyes such as ethyl orange, metanil yellow and acid blue 113 from aqueous solutions. The results indicate that inorganic wastes, i.e. blast furnace dust, sludge and slag from steel plants are not suitable for the removal of organic materials, whereas a carbonaceous adsorbent prepared from carbon slurry of fertilizer industry was found to adsorb 198, 211 and 219mg/g of ethyl orange, metanil yellow and acid blue 113, respectively. The adsorption of dyes on this adsorbent was studied as a function of contact time, concentration, particle size and temperature by batch method. The adsorption isotherm conformed to Langmuir model and the adsorption was found to be exothermic and physical in nature. Kinetic data conforms to Lagergren's equation with good correlation coefficients varying from 0.9998 to 0.9999 indicating that the adsorption is a first-order process. The adsorption data on carbonaceous adsorbent was compared to a standard activated charcoal sample and it was found that the prepared adsorbent is about 80% as efficient as standard activated charcoal and therefore, can be used as low cost alternative ( approximately 100 US dollars per ton) for colour removal from effluents.
Adsorption↗
Anteversion of the femoral neck in Indian dry femora.
The purpose of this study was to estimate the average angle of femoral neck anteversion in an Indian population. A total of 300 dry femora were classified by standard anatomical norms into male and female types and left-side and right-side types. They were evaluated by the Kingsley Olmsted and parallelograph methods, and the data were statistically analyzed. The average angles of anteversion obtained were 8.1 degrees and 8.3 degrees by the Kingsley Olmsted and parallelograph methods, respectively. The average female-type bone showed about 3 degrees more anteversion than the male-type bone. The average left-sided bone showed about 1.6 degrees more anteversion than the right-sided bone. A statistically significant difference existed between the sexes and the sides. The Kingsley Olmsted and parallelograph methods were found to be comparable with a correlation coefficient of 0.99. Altogether, 42.33%, 57.66%, and 79.00% of bones had readings of 5 degrees -10 degrees, 0 degrees -10 degrees, and 0 degrees -15 degrees, respectively. Thus, femoral neck anteversion has been found to be less in the Indian population than in Western populations.
Bone Wires↗