Biomedical subjects

A Sahai

Publications and source records attributed to A Sahai.

78 records · Page 5Linked to original sources

PubMedDate not supplied

Cyclic nucleotide metabolism in solid tumor tissues.

The examination of the regulation of the system of 3'-5' cyclic nucleotide monophosphates has only begun in cancer tissues. In human cancers, these studies are notably non-existent. However, in animal cancers, especially the Morris hepatomas, enough data has been gathered that, while risky, certain trends seem to begin to appear. Cyclic AMP is constant or lowered, while cyclic GMP is elevated in the fast growing hepatomas. Regulation of adenylate cyclase by protein hormones is reduced, while regulation by epinephrine may be increased. Binding of glucagon is decreased in the fast growing hepatomas. Guanylate cyclase, while being predominantly cytoplasmic in the normal liver, is predominantly membrane bound in the tumors. The liver enzyme is also readily stimulated by several chemical carcinogens. The cyclic GMP phosphodiesterases are decreased in these tumors; while the cAMP phosphodiesterases are increased. Although the cyclic nucleotide dependent protein kinases (histone as substrate) are altered in the hepatomas, observations of unique cyclic nucleotide binding proteins or cAMP independent protein kinases in cancer tissues may be of even greater significance for the development of or the maintenance of the neoplastic state of cells.

3',5'-Cyclic-AMP Phosphodiesterases↗

PubMedDate not supplied

Effects of intrapartum zidovudine therapy on fetal heart rate parameters in women with human immunodeficiency virus infection.

OBJECTIVE: To determine the effects of intrapartum maternal administration of zidovudine on fetal heart rate (FHR) parameters in women infected with the human immunodeficiency virus (HIV). METHODS: Term HIV-infected women who delivered at our institution (1995-1998) were identified by medical records coding. Sixty minutes of FHR tracing prior to zidovudine administration and 60 min of FHR tracing 2 h after initiation of therapy were reviewed by 3 perinatologists blinded to patient status. Data were compared with paired t tests; p < 0.05 was considered significant. Inter- and intra-observer FHR interpretation variation were calculated. RESULTS: Ten patients met study criteria. Their demographic data included: Maternal age 26.5 +/- 6.5 years, gestational age 38.9 +/- 1.3 weeks, median parity 2 (range 0-3). Eighty percent were African American. There were no significant differences in FHR parameters after intravenous zidovudine therapy (pretreatment versus 2 h after treatment) with respect to FHR baseline (p = 0.2), FHR variability (p = 0.3), or the number of accelerations (p = 0.1). There was also no difference in the number of variable (moderate or severe), early, or prolonged decelerations following zidovudine infusion. CONCLUSION: Two hours of continuous intrapartum intravenous infusion of zidovudine does not alter any parameter of the FHR in the laboring HIV-infected gravida.

Adult↗

PubMedDate not supplied

Handgrip strength and endurance as a predictor of postoperative morbidity in surgical patients: can it serve as a simple bedside test?

Postoperative morbidity is related to preoperative nutritional status. Current methods of assessing this are cumbersome, lack sufficient accuracy to completely separate all those at risk from others, and require a laboratory backup. This study was done to evaluate handgrip manometry, a simple bedside test as an indicator of preoperative nutritional status to predict risk of postoperative complications. Normal values for maximal grip strength and endurance times were established in 496 controls. Similar values were recorded in 100 patients undergoing elective surgery preoperatively. Postoperative variables studied included complication rate and hospital stay. The efficacy of four parameters, serum albumin, clinical nutritional score based on subjective global assessment, maximal grip strength (MGS), and grip endurance time, in predicting complications were studied. It was found that age and presence of co-morbidity increased risk of complications. Of the four predictive parameters studied, it was found that MGS is better than serum albumin. Clinical scoring was superior to MGS in predicting risk of complications. MGS is a simple bedside test, which can be easily performed. It can be used as a complimentary test to clinical scoring in identifying patients at risk of complications after surgery. Patients with abnormal MGS require urgent preoperative correction to reduce the risk of complications.

Adolescent↗

PubMedDate not supplied

Effect of indoor air pollution on the respiratory system of women using different fuels for cooking in an urban slum of Pondicherry.

BACKGROUND: Some of the highest exposures to air pollutants in developing countries occur inside homes where biofuels are used for daily cooking. Inhalation of these pollutants may cause deleterious effects on health. We studied the effects of exposure to indoor air pollution from the use of cooking fuels on lung functions and respiratory symptoms in women aged 15-60 years. METHODS: The study was conducted in Kuruchikuppam, an urban slum in Pondicherry. The study participants were 105 women using biofuels, 105 using kerosene and 105 using liquid petroleum gas (LPG), selected from among 1117 women aged 15-60 years, by a stratified random sampling technique. These women were interviewed at home to collect information about exposure to fuel smoke and presence of respiratory symptoms. Lung functions were assessed by measuring forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and peak expiratory flow rate (PEFR). Occurrence of respiratory symptoms over six months was noted by making monthly follow up visits. RESULTS: Women using biofuels experienced more respiratory symptoms (23%) than those using kerosene (13%;p > 0.05) or LPG (8%; p < 0.05). Lung functions-FVC, FEV1, FEV1% and PEFR-were significantly lower in biofuel users compared with both kerosene (p < 0.01) and LPG users (p < 0.001). Lung functions in kerosene users also were significantly poorer when compared with LPG users (p < 0.01). Predicted pulmonary functions using multiple regression equations, derived from the data set of the present study, indicated that women using biofuels were more liable to have reduced pulmonary functions than women using kerosene or LPG. CONCLUSION: Women exposed to biofuel smoke suffer more from respiratory illnesses and have decreased pulmonary functions compared with women exposed to kerosene or LPG smoke. To reduce pollutant exposures we recommend the use of smokeless chullas or cleaner fuels such as charcoal, biogas and kerosene.

Adolescent↗

PubMedDate not supplied

Truncal vagotomy and gastrojejunostomy for chronic duodenal ulcer in India.

BACKGROUND: Insufficient information is available on long term results of truncal vagotomy and gastrojejunostomy since most previous series have relied on functional grading using the Visick scale which possibly both overdiagnoses and underdiagnoses complications. We used endoscopy to assess the results following truncal vagotomy and gastrojejunostomy as well as functional grading and compared them with published results of highly selective vagotomy. METHODS: Two hundred patients were reviewed (5-11 years after truncal vagotomy and gastrojejunostomy) by clinical examination and endoscopy. Completeness of vagotomy was assessed by estimation of the postprandial alkaline tide in the urine and gall bladder using ultrasonography. RESULTS: The ulcer recurrence rate was 15 (7%). Nine (60%) of the recurrent ulcers were asymptomatic and detected only on endoscopy. In all patients with recurrence, the urinary alkaline tide estimation revealed an incomplete vagotomy. Dumping was present in 12%, it was troublesome in 4%, occasional episodes of post-vagotomy diarrhoea in 6% (all in Visick grades I or II) and bile vomiting in 17% (affecting the lifestyle in only 5%). Recurrence and other complications were not related to the experience of the operating surgeon or the type of gastroenterostomy. There was no mortality. Overall, satisfactory long term functional results (Visick grades I and II) were found in 8% of patients. CONCLUSIONS: Truncal vagotomy and gastrojejunostomy still remains the best option in the surgical management of chronic duodenal ulcer. Long term results are good with a relatively low incidence of troublesome complications.

Adolescent↗

PubMedDate not supplied

A trial of various regimens of antibiotics in acute appendicitis.

A three year prospective randomised study was undertaken to study the efficacy of three regimens of antimicrobial drug combinations in reducing postoperative wound sepsis in acute appendicitis. Group A--Metronidazole and gentamicin; Group B--Metronidazole and ciprofloxacin; Group C--Metronidazole and cefotaxime. Randomization was done by drawing from a set of sealed envelopes. Antibiotics were started preoperatively once a presumptive diagnosis of appendicitis was made, provided there was no history of prior antibiotic usage. For simple appendicitis (normal or inflamed) two more doses were given postoperatively. For complicated appendicitis, duration of antibiotic treatment was four days postoperatively. All antibiotics were given intravenously to avoid variations in bioavailability. Wound was inspected daily till discharge and at 30 days post operatively or earlier if the patient had symptoms of wound infection. A total of 128 patients completed the study. Eighty nine were simple appendicitis while the rest were complicated. Twenty one developed wound infection. Out of 21, 13 occurred in group A, 5 in group B and 3 in group C. Individually, the difference in infection rates between group A and group C patients with simple appendicitis was statistically significant. Infection rates in all other groups were not statistically different. Cefotaxime and metronidazole combination had the lowest wound infection rate. Hence it is recommended for antibiotic prophylaxis.

Acute Disease↗