Biomedical subjects
Publications and source records attributed to A Kumar.
This short report describes a possible beneficial effect of dapsone in the treatment of chronic unresponsive muco-cutaneous lesions of systemic lupus erythematosus (SLE) without any serious side effects.
Till recently, Wegener's granulomatosis (WG) was considered a rare disease in India. Over the last 5 years we studied 13 proven cases of WG. This paper describes the details of the disease as seen in these patients, and response to corticosteroid and cyclophosphamide therapy, and compares these observations with a Western and an Indian study.
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Ethanol is the major metabolic product of glucose fermentation by the protozoan parasite E. histolytica under the anaerobic conditions found in the lumen of the colon. With the goal of finding new targets for anti-amebic drugs, the E. histolytica NADP(+)-dependent alcohol dehydrogenase gene (EhADH1; EC 1.1.1.2) and an aldehyde dehydrogenase gene (EhALDH1; EC 1.3.2) were cloned. The EhADH1 alcohol dehydrogenase gene encoded -39 kDa protein with 62 and 60% amino acid identities, respectively, with NADP(+)-dependent alcohol dehydrogenases of anaerobic bacteria Thermoanaerobium brockii and Clostridia beijerinckii. In contrast, EhADH1 showed a 15% amino acid identity with the closest human alcohol dehydrogenase. An EhADH1-glutathione-S-transferase fusion protein showed the expected NADP(+)-dependent alcohol dehydrogenase and NADPH-dependent acetaldehyde reductase activities. The enzymatic activities of the EhADH1 fusion protein were inhibited by pyrazole and 4-methyl pyrazole. The E. histolytica aldehyde dehydrogenase EhALDH1 gene encoded a 60 kDa protein, which showed a 36% amino acid identity over a 451 amino acid overlap with the human stomach aldehyde dehydrogenase (ALDH3).
Filaria surveys conducted in some select slum clusters namely Hari Nagar, Yamuna pusht near Vijaya Ghat along the Ring Road and Timarpur in Delhi during 1989, 1991 and 1992 respectively, covering a population of approximately 5000 slum dwellers revealed the presence of bancroftian microfilaria (mf) carriers and disease cases. The mf and disease rates (per cent) in these three slum areas were in the order of 6.3, 2.2, 3.7 and 1.4, 0.5 and 0.1 respectively. The mf density varied from 3.1 to 12.3 per 20 cumm. blood. High ten man hour densities of Culex quinquefasciatus (581) in Yamuna pusht followed by (355) in Timarpur were recorded during entomological investigations. Hari Nagar accounted for least ten man hour density of Cx. quinquefasciatus (160), because collection was made during winter months (November-December). The dissection of Cx. quinquefasciatus did not reveal any human filarial infection except in Yamuna pusht where out of 139 only one Cx. quinquefasciatus was found infective.
To find out the prevalence of antibody of hepatitis C virus (anti-HCV) in patients with chronic liver disease in Bombay, sera from 126 patients (93 men, 33 women; aged 9-70 years, mean 39.7) with chronic liver disease (cirrhosis 103, cirrhosis with hepatocellular carcinoma 3, chronic active hepatitis 20) were tested for HBsAg and anti-HCV antibody. HBsAg positive sera were tested for anti-delta antibody and IgM anti-HBc. All the tests were carried out by ELISA. Of 126 patients, 51 (40.5%) were HBsAg positive, 49 (38.8%) alcoholic and 21 (16.6%) anti-HCV positive. The prevalence of anti-HCV in HBsAg positive, alcoholic and cryptogenic (HBV negative and no alcohol) liver disease patients was 13.7%, 14.7% and 20.5% respectively. Of 21 anti-HCV antibody positive patients, 8 (38%) had received blood transfusions previously. HCV is present in 15-20% of patients with chronic liver disease in Bombay.
The authors compared the performance of an automated biopsy device with a large-bore cutting needle system in ultrasonography-guided native renal biopsy. They retrospectively analysed 52 biopsy specimens from 50 adults with diffuse renal parenchymal disease. Twenty-six consecutive biopsy samples had been obtained manually with a 14-gauge needle (Tru-Cut, Travenol Laboratories, Deerfield, Ill.); a second set of 26 samples had been obtained with a biopsy gun (Bard Biopty, Radiplast, Uppsala, Sweden) fitted with a 14-gauge needle of similar design. The systems were compared in terms of the specimens obtained (the adequacy and the quality of tissue, the number of intact glomeruli and the presence of artifacts) and the incidence of biopsy-related complications. Biopsy specimens obtained with the biopsy gun were judged qualitatively as well as quantitatively superior; they contained an average of 17.6 intact glomeruli, whereas only 11.5 intact glomeruli were retrieved with the needle system. Although the incidence of minor complications was lower after biopsy with the automated gun than after use of the needle system (8% and 15% respectively), two major complications were observed after gun biopsy and none after needle biopsy. The results reported here indicate that for native renal biopsy the Biopty gun delivers a higher-quality tissue core with a lower frequency of minor complications, but not of major complications, than the Tru-Cut needle system.
A total of 130 patients of liver cirrhosis (97 males, 33 females; aged 9-70 yr) of various etiologies were subjected to anti HIV antibodies testing by ELISA and supplementary Western Blot (WB) tests. Eleven patients were positive by ELISA. Of these 11 patients, 5 were WB positive, 4 were WB negative and 2 were indeterminate. Of the 5 WB positive patients none had received blood transfusions and one was a homosexual. These results indicate that HIV infection was present in 3.8 per cent patients of liver cirrhosis. Further studies are required on a large number of patients to recommend HIV testing routinely in cirrhotic patients.
We prospectively evaluated the effectiveness of peribulbar anesthesia in retinal reattachment surgery. Of the 24 patients studied, 2 required retrobulbar supplementation during the latter part of the surgery. Our results show that peribulbar anesthesia can be effectively used for retinal reattachment surgery and probably should be the preferred form of local anesthesia for this surgery, since the eyes involved have a relatively high incidence of axial myopia and posterior staphyloma.
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Of forty multi-transfused thalassemia patients (26 males, 14 females; mean age 8.1 +/- 5.3 years, range 1-35) with no clinical or biochemical evidence of liver disease, HBsAg, anti-hepatitis C virus and anti-human immunodeficiency virus antibodies were present in 18 (45%), 7 (17.5%) and 1 (2.5%) cases respectively. Three of the 18 (16.7%) HBsAg positive patients were anti-delta antibody positive. Our results indicate that more than 50% of multi-transfused thalassemia patients show serological evidence of one or more of hepatitis B, C and D and human immunodeficiency virus infection.
A rare case of solitary intussuscepting capillary hemangioma in the distal ileum with perforation and peritonitis is presented. The diagnosis was made only at surgery for presumed acute intestinal obstruction.
To determine the efficacy and safety of intermittent intravenous pulse cyclophosphamide in patients of severe systemic lupus erythematosus (SLE), 50 patients having severe/refractory lupus nephritis, vasculitis or neuropsychiatric manifestations were treated with 3 weekly pulses of cyclophosphamide for 6 such pulses. This treatment was found to be associated with significant and sustained improvement during a 2 yr follow up with respect to the mean renal activity score, individual renal parameters (proteinuria, erythrocyturia, and serum creatinine levels), focal neurological manifestations, vasculitic lesions, antinuclear antibody titers, complement component C3, anti-dsDNA antibodies levels and ESR. There was a sustained decrease in the overall mean disease activity score, and the mean daily dose of prednisolone (pretreatment 32.62 mg daily to 3.75 mg daily after 24 months). There was a significant decline in the percentage and absolute B cell count after 7, 14 and 21 days of this treatment. Effect on other lymphocyte subsets (CD3+, CD4+ and CD8+) was not marked. Pulse cyclophosphamide could therefore be an effective and less toxic form of treatment in patients with SLE having severe lupus nephritis, focal neurological lesions or vasculitis.
The alterations in the oesophageal epithelium were studied in mice after a single whole-body exposure to 7.5 Gy of Co-60 gamma rays in presence or absence of 2-mercaptopropionyl glycine. The epithelium showed an increase in the thickness which reached a maximum on the third day and then decreased gradually up to seventh day after irradiation in the non-drug treated group. In the 2-mercaptopropionyl glycine treated animals the epithelial thickness remained in the normal range except on the day 7 when it was significantly lower than normal. The total cell population registered a steady decline from one to seven days post-irradiation in both groups, but the number of cells was more in the 2-mercaptopropionyl glycine treated group. The number of pycnotic nuclei showed an inverse relationship to the total cell population, it increased continuously up to seven days in both the protected and non-protected groups. However, pycnotic nuclei were significantly lower in the protected group on days 3, 5 and 7 in non-protected group.
An attempt was made to explore the scope of the bio-antioxidants in the management of symptoms of epidemic dropsy caused by argemone alkaloids, sanguinarine and dihydrosanguinarine. The study was performed on 24 randomly selected epidemic dropsy cases who consumed argemone contaminated mustard oil. On examination the cases revealed characteristic pitting edema over limbs (95.8%) accompanied by tenderness (79.2%) and diffuse erythema (95.8%). Tachycardia was present in 1/3 of the examined cases while elevated jugular venous pressure was seen in over 40% of the cases. In two of the cases, reddish-purplish blotches over lower limbs, not raised and which blanched on pressure, was an unusual feature. Chest X-ray revealed pulmonary congestion in 5 cases. ECG performed in 3 cases with severe breathlessness, showed non-specific ST-T changes most marked in L2,L3, avF and V2-V6 which reversed on recovery. Treatment with a combination of antioxidants, riboflavin and tocopherol showed improvement in pain in lower limbs (75%), edema (83.3%) and erythema (66.6%).
The importance of the R region in basal human immunodeficiency virus type 1 (HIV-1) transcription was addressed by comparing a panel of HIV-1 R region mutants using in vitro and in vivo assays. Using deletion, base substitution mutants, and compensatory mutants, the precise R region sequences essential for basal HIV-1 promoter activity in vitro were mapped to sequences between +17 to +21. Within this regulatory domain, nucleotides +19 and +21 appear to be critical. The effect of these mutations on steady state RNA levels in transfected cells has been analyzed by S1 nuclease protection assay using uniformly labeled probes. Two main conclusions may be drawn from these studies. First, HIV-1 basal transcription is abundant, with the majority of correctly initiated transcripts truncated between sequences +57 to +70. Second, analysis of the compensatory mutants indicates the secondary structure of the nascent R region RNA is not an obligate requirement for the production of the truncated transcripts. Mutations in R region primary sequence that selectively abolish the production of the truncated transcripts in vivo also exhibit reduced promoter activity in vitro. The appearance of high levels of truncated transcripts raise the interesting possibility that-similar to c-myc, c-myb, and c-fos--basal HIV-1 expression is regulated by transcription elongation.