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Biomedical subjects

A K Jain

Publications and source records attributed to A K Jain.

At least 37 records · Page 2Linked to original sources
PubMed2003

Isolated gastric varices: prevalence, clinical relevance and natural history.

BACKGROUND: Isolated ectopic gastric varices (IGV2) are present either in the body or antrum of the stomach or upper duodenum. The prevalence, natural history and clinical significance of these varices has not been adequately described. MATERIALS AND METHODS: Consecutive patients with portal hypertension, prospectively studied and diagnosed to have IGV2, were assessed for their time of appearance - primary (at first presentation) or secondary (after obliteration of oesophageal varices), association with other varices, portal hypertensive gastropathy and any overt bleeding. RESULTS: Fifty-three of the 1128 (4.7%) patients had IGV2. The IGV2 were commonly seen in the antrum (53%), duodenum (32%), or at both sites (11%) and rarely in body and fundus (4%). IGV2 were predominantly (84.9%) secondary in origin, developing after oesophageal variceal obliteration. The median time for emergence of secondary IGV2 was 8.2 months for patients with cirrhosis, 12.8 months for non-cirrhotic portal fibrosis and 10.8 months for extra-hepatic portal vein obstruction. Eight (15%) patients had primary IGV2, 6 of them had underlying portal vein obstruction. Portal gastropathy (p < 0.05) and UGI bleeding were more common in the secondary than in primary IGV2. Bleeding due to IGV2 was seen only in 3 (5.7%) patients during a mean follow-up of 36.3 +/- 12.1 months, and could be successfully managed with endoscopic ligation or obliteration. CONCLUSIONS: Isolated ectopic gastric varices are not uncommon and generally develop following obliteration of main variceal columns. They rarely bleed and often can be managed with endoscopic interventions.

Adult↗
PubMed2003

Enhancement of dissolution and oral bioavailability of gliquidone with hydroxy propyl-beta-cyclodextrin.

The virtual insolubility of gliquidone in water results in poor wettability and dissolution characteristics, which may lead to a variation in bioavailability. To improve these characteristics of gliquidone, binary systems with hydroxypropyl-beta-cyclodextrin (HP-beta-CD) were prepared by classical methods such as physical mixing, kneading, co-evaporation and co-lyophilization. The solid state interaction between the drug and HP-beta-CD was assessed by evaluating the binary systems with X-ray diffraction, differential scanning calorimetry and IR- spectroscopy. The results establish the molecular encapsulation and amorphization of gliquidone. The phase solubility profile of gliquidone in aqueous HP-beta-CD vehicle resulted in an A(L) type curve with a stability constant of 1625 M(-1). The dissolution rate of binary systems was greater than that of pure drug and was significantly higher in the case of co-lyophilized and co-evaporated systems. Upon oral administration, [AUC]-alpha was significantly higher in case of co-lyophilized (2 times) and co-evaporated systems (1.5 times) compared to pure drug suspension while other binary systems showed only a marginal improvement. The study ascertained the utility of HP-beta-CD in enhancing the oral bioavailability of gliquidone, and points towards a strong influence of the preparation method on the physicochemical properties.

2-Hydroxypropyl-beta-cyclodextrin↗
PubMed2003

Ultra-structural observations on the lymphoid organs of the freshwater catfish, Clarias batrachus (Linnaeus).

Light microscopic and ultra-structural studies of the lymphoid tissues such as blood immunocytes, spleen and pronephros of the freshwater catfish, Clarias batrachus, were carried out. The peripheral blood showed nucleated erythrocytes, total leucocytic count (TLC) more than that observed in mammalian blood and leucocytes with morphological appearance similar to the mammalian white blood cells (WBCs). The spleen and pronephros showed presence of numerous lymphocytes, monocytes and nucleated red blood cells (RBCs) along with hemosiderin-containing macrophages. The morphology of lymphoid organs of the catfish has been discussed in light of the evolution of the immune system in this class of vertebrates.

Animals↗
PubMed2002

Methylphenols removal from water by low-cost adsorbents.

A comparative study on the adsorption of methylphenols on adsorbents prepared from several industrial wastes has been carried out. The results show that extent of adsorption on carbonaceous adsorbent prepared from fertilizer industry waste has been found to be 37.3, 40.5, 65.9, and 88.5 mg/g for 2-methylphenol, 4-methylphenol, 2,4-dimethylphenol, and 2,4,6-trimethylphenol, rspectively. As compared to carbonaceous adsorbent, the other three adsorbents viz. blast furnace sludge, dust, and slag adsorb methylphenols to a much smaller extent. This has been accounted for due to the carbonaceous adsorbent having a larger porosity and consequently higher surface area. The adsorption of phenols on this carbonaceous adsorbent as a function of contact time, concentration, and temperature has been studied by the batch method. The adsorption has been found to be endothermic and data conform to the Langmuir equation. The analysis of data indicates that adsorption is a first-order process and pore diffusion-controlled. The efficiency of the carbonaceous adsorbent was assessed by comparing the results with those on a standard activated charcoal sample. It was found that the carbonaceous adsorbent is about 45% as efficient as standard activated charcoal and can therefore be employed for the removal of methylphenols from wastewaters.

Journal Article↗
PubMed2001

Transdermal delivery of naloxone: effect of water, propylene glycol, ethanol and their binary combinations on permeation through rat skin.

The effect of the solvent systems water, ethanol (EtOH), propylene glycol (PG) and their binary combinations was studied on the ex vivo permeation profile of the opioid receptor antagonist, naloxone, through rat skin. Fourier transform-infrared (FT-IR) spectroscopic studies were done to investigate the effect of enhancers on the biophysical properties of the stratum corneum (SC), in order to understand the mechanism of permeation enhancement of naloxone by the solvent systems used. The flux of naloxone was found to increase with increasing concentrations of EtOH, upto 66% in water, and PG upto 50% in water. The maximum flux of 32.85 microg cm(-2) h(-1) was found with 33% PG in EtOH. The FT-IR spectra of SC treated with EtOH showed peak broadening at 2920 cm(-1) at all concentrations of EtOH studied indicating that EtOH increases the translational freedom (mobility) of lipid acyl chains. Theoretical blood levels well above the therapeutic concentration of naloxone can be achieved with the solvent system comprising 33% PG in EtOH and hence, provides flexibility in choice of patch size depending on the addiction status of the patient to be treated.

Administration, Cutaneous↗
PubMed2001

Hemiplegic/monoplegic presentation of cervical spine (C1-C2) tuberculosis.

Tuberculosis of the craniovertebral region is very rare. Neural deficit in this region is reported in between 24% and 64% of cases, and mainly takes the form of quadriparesis. Hemiplegic and monoplegic presentation among this set of patients is rarer. Out of 32 patients treated at our institution between May 1989 and February 2001, only one had hemiplegia, while two had monoplegia. These three cases are discussed. Case 1 involved a 45-year-old woman who presented with hemiplegia following a trivial fall. Plain radiographs and computed tomographic (CT) scans of the skull appeared normal, but CT scans of C1-C2 and the craniovertebral junction revealed destruction of the dens and atlantoaxial subluxation. The patients in cases 2 and 3 had monoplegia. Plain radiographs in both cases showed an increased prevertebral soft tissue shadow in front of C1-C2. CT in case 2 and magnetic resonance imaging (MRI) in case 3 revealed destruction of the arch of C1 and the dens, with subluxation. All three patients were successfully treated with rest, skull traction, anti-tubercular drugs and suitable braces. Case 3 required stabilization. All three patients achieved complete neural recovery. Patients 1, 2 and 3 had 22, 48 and 4 months' follow-up respectively. Patient 3 was subsequently transferred to a neurosurgery ward for stabilization of the occipito-C3 vertebrae. Hemi/monoplegic presentation is extremely rare; no author in the literature is able to give reason for the rarity or the pathomechanics of the condition. We believe that if medullary cervical junctional involvement extends slightly higher (in rare circumstances), with involvement of one of the branches of the vertebral or lower basilar artery, medial medullary syndrome will occur, sparing medial lemniscus and emerging hypoglossal nerve fibres. Thus the pyramids will be involved, causing contralateral hemiparesis, and if the pyramids are selectively involved, it will cause contralateral monoparesis.

Adult↗
PubMed2001

Viral hepatitis during pregnancy.

OBJECTIVE: A great degree of controversy prevails over the existing reports on the severity and outcome of acute viral hepatitis (AVH) during pregnancy. The present study describes the outcome of AVH associated with pregnancy. A correlation was also assessed for gestation period, viral etiology and outcome of AVH. METHOD: The serum samples of 273 females with viral hepatitis (age group 18--23 years) were included in the study. Among them, 127 females were pregnant and 146 were non-pregnant cases (as a control group). The sera were screened for seromarkers of the hepatitis A virus (HAV) through to the hepatitis E virus (HEV) by the latest available generation ELISA kits. Among the 127 pregnant females, 83 were AVH cases, while 44 were fulminant hepatic failure (FHF) cases. Among the 146 non-pregnant females, 129 were AVH and 17 were FHF cases. RESULT: Among the AVH pregnant females, 73 (57.5%) had HEV infection. Fifty-eight percent of the HEV infected pregnant females were associated with FHF. Among non-pregnant females HEV was documented in 67 (46%) cases. HBV infection was observed in 19% and 18% of the pregnant and non-pregnant females, respectively. Twenty percent of the pregnant and 33% of the non-pregnant females remained non-reactive for seromarkers of HAV-HEV. The mortality rate was highest (56%) among HEV infected FHF cases during third trimester of pregnancy. The chi(2) test was applied to check the statistical significance for the differences over the prevalence in various groups. CONCLUSION: In the present study, HEV was found to be the chief etiological agent, associated with higher morbidity and mortality. However, the incidence of HEV in pregnant females was not significantly different from non-pregnant females. The prevalence of HAV, HCV and HDV were very low in the study. An increased incidence of FHF was noted among HEV infected pregnant females, while infection with an agent other than A-E was commonly associated with FHF among non-pregnant females.

Acute Disease↗
PubMed2001

The combination of stricture dilation, endoscopic needle aspiration, and biliary brushings significantly improves diagnostic yield from malignant bile duct strictures.

BACKGROUND: Brush cytology, routinely performed at ERCP to assess malignant-appearing biliary strictures, is limited by relatively low sensitivity and negative predictive value. This study assessed whether the combination of stricture dilation, endoscopic needle aspiration, and biliary brushing improves diagnostic yield. METHODS: In a prospective nonrandomized study, 46 consecutive patients were evaluated with malignant-appearing biliary strictures at ERCP. Twenty-four patients (Group A) underwent standard brush cytology alone and 22 patients (Group B) underwent stricture dilatation to 10F, endoscopic needle aspiration, and subsequent biliary brushing by using the Howell biliary system. The diagnostic yields for both techniques were compared. RESULTS: Of the 46 patients, 34 had proven malignant strictures (14 Group A, 20 Group B). Compared with brushing alone, the combination of stricture dilatation, endoscopic needle aspiration, and subsequent biliary brushing significantly increased both the sensitivity (57% vs. 85%, p < 0.02) and specificity (80% vs. 100%, p < 0.02) of cytology with positive brushings in all patients with pancreatic or gallbladder carcinoma. CONCLUSIONS: The combination of stricture dilation, endoscopic needle aspiration, and biliary brushing significantly improves diagnostic yield for malignant bile duct strictures and may particularly be of benefit for extrinsic strictures caused by pancreatic or gallbladder carcinoma.

Adult↗
PubMed2001

Intracameral amphotericin B: initial experience in severe keratomycosis.

PURPOSE: Fungal keratitis is a significant cause of ocular morbidity in India. The most commonly implicated fungi are Aspergillus spp. Patients often present with hypopyon, which usually contains fungal elements. The treatment is difficult owing to poor intraocular penetration of most available antifungal agents. This study evaluated the results of intracameral injection of amphotericin B in natamycin resistant cases of severe keratomycosis. METHODS: Three patients of culture proven Aspergillus flavus corneal ulcer with hypopyon not responding to topical natamycin 5%, amphotericin B 0.15%, and oral itraconazole were administered intracameral amphotericin B. The first case received 7.5 microg in 0.1 mL followed by two subsequent injections of 10 microg in 0.1 mL each, the second case received two injections of 10 microg in 0.1 mL, and the third patient received a single dose of 10 microg in 0.1 mL. Culture of the aqueous sample also grew A. flavus in all three cases. RESULTS: All three cases responded favorably, with the ulcer and hypopyon clearing completely. There was no clinical evidence of corneal or lenticular toxicity in any patient. CONCLUSIONS: Intracameral amphotericin B may be a useful modality in the treatment of severe keratomycosis not responding to topical natamycin. It ensures adequate drug delivery into the anterior chamber and may be especially useful to avoid surgical intervention in the acute stage of the disease.

Adult↗
PubMed2001

Isolated dislocation of the second metacarpal at both ends.

A dislocation of the second metacarpal at both ends is reported herein for the first time. Six weeks after injuring her right hand in a fall while climbing stairs, a 34-year-old woman visited our clinic with pain, swelling, and deformity of her hand. The radiographs showed a volar dislocation of the head and a dorsal dislocation of the base of the second metacarpal. The probable mechanism of injury was the hyperextension at the metacarpophalangeal joint; this force dislocated the metacarpal head toward the volar plate. Force then further continued along the second metacarpal shaft in the hyperflexed wrist, thus dislocating the base dorsally. We performed an open reduction and K-wire fixation of the second metacarpophalangeal joint and an arthrodesis of the second carpometacarpal joint. At the six-month follow-up, the patient had restricted flexion (0 to 50 degrees) at the second metacarpophalangeal joint, but full range of motion at the interphalangeal joints. The grip strength on the right side was 70% of that measured in the uninvolved hand. Key Words: Dislocation, Second metacarpal.

Accidental Falls↗
PubMed2001

Multifocal skeletal tuberculosis.

Multifocal skeletal tuberculosis is an uncommonly reported entity. The article presents a series of 18 cases encountered in our institution. There clinical characteristics are analysed and compared with available international literature.

Adolescent↗