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Biomedical subjects

A Manoharan

Publications and source records attributed to A Manoharan.

At least 55 records · Page 3Linked to original sources
PubMed1997

Low-dose combination chemotherapy for acute myeloid leukemia in elderly patients: a novel approach.

Eighteen patients aged 60-84 years with acute myeloid leukemia were treated with low-dose combination chemotherapy comprising cytarabine, etoposide, and mitozantrone or 6-thioguanine; seven of these patients had a pre-existing myelodysplastic syndrome. Nine patients achieved a complete remission, and five had a partial remission. The duration of survival in these 14 responding patients has ranged from 2+ to 19+ months. Myelotoxicity occurred regularly, with time to recovery (neutrophils > or =0.5 x 10(9)/L, platelets > or =50 x 10(9)/L) from nadir being 10-14 days in 12 of the 14 patients. This novel approach with an overall response rate of 78% appears to be a simple and effective form of therapy for elderly patients.

Acute Disease↗
PubMed1997

Biochemical, histomorphometric and densitometric changes in patients with multiple myeloma: effects of glucocorticoid therapy and disease activity.

It is unknown whether bone changes which can occur in multiple myeloma (MM) are due to cytokine-induced osteoclastic bone resorption from a clone of abnormal plasma cells or high-dose glucocorticoid therapy. We studied 25 MM patients treated for 1-12 years with combination chemotherapy, subdivided into two groups. Group 1 consisted of 12 patients with stage I and II myeloma and group 2 consisted of 13 patients with stage III MM. Their serum biochemistry, tetracycline-labelled bone histomorphometry and bone densitometry were compared to age- and sex-matched controls. Patients with MM demonstrated increased indices of bone resorption (P < 0.001 versus controls) and, to a lesser extent, increased indices of bone formation (P < 0.01 versus controls). No patient had evidence of a mineralization defect. Lumbar spine, femoral neck and total body bone mineral density measurements (BMD) were significantly lower in group 2 compared with group 1 (P < 0.05). Following 12 months of therapy, lumbar spine BMD decreased by 6.6% (95% CI, 2.7% to -9.3%) and femoral neck BMD decreased by 9.5% (95% CI, -3.2% to -15.9%). In a stepwise regression analysis, cumulative prednisolone dosage (B Coef. = -0.39; P = 0.03) and plasma cell infiltrate (B Coef. = -0.08; P = 0.05) were the most important predictors of lumbar spine bone loss, whereas serum paraprotein (B Coef.= -0.35; P = 0.02) and plasma cell infiltrate (B Coef. = -0.20; P = 0.04) were the most important predictors of femoral neck bone loss. We conclude that MM is characterized by high bone turnover with osteoblast-osteoclast uncoupling. Both disease activity and high-dose glucocorticoid therapy may be responsible for the ongoing bone loss seen with MM.

Absorptiometry, Photon↗
PubMed1997

Methysergide-induced retroperitoneal fibrosis: successful outcome and two new laboratory features.

A 25-year-old woman sought medical attention because of iliocaval manifestations of retroperitoneal fibrosis while she was taking methysergide. Laboratory studies yielded substantially increased serum procollagen III levels and anticardiolipin antibodies accompanied with anti-beta(2) glycoprotein I, findings not previously described with this disorder. Clinical and laboratory manifestations resolved after cessation of methysergide therapy.

Adult↗
PubMed1997

Trend of Wuchereria bancrofti infection in Pondicherry urban agglomeration after the withdrawal of a five year vector control programme.

A study was undertaken to investigate the changes in the prevalence of bancroftian filariasis after six years of withdrawal of a five year (1981-85) vector control programme in Pondicherry and the results are presented in this paper. Though there was a drastic increase in the intensity of transmission of filariasis after the withdrawal of vector control operations in 1986, the prevalence of microfilaria (mf rate) of the population declined from 6.35% in 1986 to 4.80% in 1992 (P < 0.05). However, there was an appreciable increase in the mf rate and intensity in the children (0.5 year) born after the withdrawal of the control operations. The overall loss rate of infection was much higher than the gain rate. Many people found to be microfilaraemic six years before, became amicrofilaraemic now. The overall reduction in mf rate, higher loss rate of infection and microfilaraemic people turning amicrofilaraemic indicate that chemotherapy, which has been intensified during the last five years under the National Filaria Control Programme (NFCP), was playing a major role in reducing the infection. However, implementation of mass chemotherapy with annual single dose of DEC (6 mg/kg), combined with vector control may yield better results in further reducing the mf rate as the current approach of detection for treatment may become increasingly difficult with gradual fall in endemicity level. Mass chemotherapy will provide an opportunity to further reduce the mf rate and eliminate filariasis within a few years from Pondicherry urban agglomeration. The increase in the incidence of infection in children, born after the withdrawal of the vector control programme clearly indicates that transmission is continuing and if immediate action is not undertaken it would be difficult to sustain the gains.

Adolescent↗
PubMed1996

Utility of catalytic models in the estimation of incidence and prevalence of malaria in a hyperendemic situation.

Simple catalytic models were used for estimating the true incidence of malaria in hyperendemic villages of Koraput District in Orissa State where Plasmodium falciparum is predominant. The hill top villages recorded a slide positive rate of 45.68. The daily rate of inoculation among infants was estimated to be 0.00781. The inoculation rate was so high that the recovery from one infection was compensated by the subsequent infection and hence the prevalence continued to increase with age. The model adequately represents the observed data for infants but could not be used for estimating the true prevalence in the adult population without incorporating other factors like immunity and superinfection.

Adult↗
PubMed1995

Frequency distribution of Wuchereria bancrofti infection in the vector host in relation to human host: evidence for density dependence.

This paper uses detailed entomological data from Pondicherry to compare the microfilaria distribution in vector with that of human and also to examine the evidence for the operation of density dependence on parasite transmission. Analysis showed that the distribution in vector is similar to that in human. The expected distribution derived from the fit of a zero-truncated negative binomial to the human data, closely reflected the observed microfilaria distribution in the vector. This implies that a relatively large proportion of observed microfilaria negatives in the vector population may be true zeros, as observed in human, arising from the biting on true negatives (as yet uninfected, with unmated female worms or immune) in humans, rather than attributable to the blood sampling process. Further it was found that both the prevalence of infection and the degree of parasite aggregation in the vector population falls significantly with parasite stage, implying the operation of density dependence, perhaps via parasite-induced vector mortality.

Animals↗
PubMed1995

Evans' syndrome, myelofibrosis and systemic lupus erythematosus: role of procollagens in myelofibrosis.

We describe an 18 yr old female with systemic lupus erythematosus presenting with Evans' syndrome (autoimmune hemolytic anemia and immune thrombocytopenia) and dense myelofibrosis. Her clinical course and response to treatment were monitored with regular blood counts, serial measurements of serum procollagen I and III and periodic bone marrow examinations. This report brings to 9 the number of well-documented cases of systemic lupus erythematosis and myelofibrosis in the literature; we discuss the pathogenesis and management of patients with this apparently rare disorder, with particular reference to the role of serum procollagen measurements as markers of myelofibrosis.

Adolescent↗
PubMed1994

Auto-immune haemolytic anaemia in ulcerative colitis.

We report 2 patients with auto-immune haemolytic anaemia (AIHA) complicating ulcerative colitis (UC), each with a hitherto undescribed feature. In the 1st case, direct antiglobulin test showed red cells coated with complement only, and the 2nd case was successfully treated with danazol. These 2 patients bring to 40 the number of cases of AIHA associated with UC. A review of the clinical details suggests that the patients may be divided into two distinct groups. In the first (4/40), AIHA seems to occur as an auto-immune event independent of the activity of UC; in the second group (36/40), AIHA is apparently dependent on active colitis, i.e. control of colitis is crucial to control haemolysis.

Adult↗
PubMed1994

Rates of acquisition and loss of Wuchereria bancrofti infection in Culex quinquefasciatus.

Rates of acquisition and loss of parasitic infection in the vector host of Wuchereria bancrofti were estimated using a new method. The age of parasitic infections was estimated from the abdominal condition, determined on the basis of Sella's stages of blood digestion and ovary development, and parity of the vector host and larval stages of the parasite. A negative exponential relationship between age and number of W. bancrofti infections provided estimated daily losses of 25.3% and 33.2% of the initial infection from the resting and biting populations, respectively, of the mosquito Culex quinquefasciatus. The rates per day of acquisition of infection estimated from resting and biting female Cx. quinquefasciatus were found to be 9.6% and 8.6%, respectively. The mean minimum developmental time for W. bancrofti infective larvae estimated from the natural resting and biting populations were 8.9 +/- 1.41 (+/- SEM) and 8.33 +/- 0.85 days, respectively, which was somewhat less than the duration observed under laboratory conditions. Comparisons of the estimates (mean age, rates of acquisition, and loss of infections) based on the resting and biting data suggest that the rates are independent of the method of collecting mosquitoes.

Animals↗
PubMed1993

Pure red cell aplasia of pregnancy: a distinct clinical entity.

We describe a 31-year-old patient with pure red cell aplasia of pregnancy, successfully managed with regular blood transfusions. In vitro studies showed specific inhibition of day 14 erythroid colonies (BFU-E) using serum and purified immunoglobulin G (IgG) obtained from the patient at diagnosis (before blood transfusion). The inhibition of BFU-E disappeared when haematological remission occurred 3 weeks after delivery and she remains clinically well with a normal haemoglobin 4 years later.

Adult↗
PubMed1993

Spatial and temporal variations in prevalence, intensity and aggregation of microfilaria in the human host.

The prevalence, intensity and the frequency distribution of microfilaria (mf) of Wuchereria bancrofti in the human blood and their variation in time (pre-vector control, control and post control periods) and space have been examined. The prevalence and intensity showed significant variation between time and different areas of urban Pondicherry. The significant reduction in the prevalence and intensity of microfilaremia in the areas of high endemicity indicated that the effect of vector control was well marked in these areas. The distribution of microfilaria in human population was adequately described by the truncated negative binomial prior to interruption of transmission, and the dispersion parameter 'k' of the negative binomial varied between 0.17 and 0.68. A change in the distribution was observed after the 5 years of vector control, during which the transmission was completely interrupted. The increased 'k' values suggest that the distribution of mf is influenced by the degree of exposure to infection. Therefore, comparison of changes in the parameter 'k' can be considered as an additional tool for evaluating the control operations aimed at interrupting the transmission.

Animals↗