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Biomedical subjects

A Sinha

Publications and source records attributed to A Sinha.

At least 37 records · Page 2Linked to original sources
PubMed2005

A case of gestational diabetes arising following treatment with glucocorticosteroids for pemphigoid gestationis.

A case of pemphigoid gestationis, a rare autoimmune disease unique to pregnancy, is described. To control the skin lesions systemic corticosteroids were required. The patient developed gestational diabetes mellitus. The pregnancy continued to 37 weeks and a live male infant was delivered. There was no evidence of macroscopic changes in the placenta. The skin lesions resolved in the postpartum period.

Adult↗
PubMed2005

Spontaneous regression of subungual keratoacanthoma with reossification of underlying distal lytic phalynx.

A 45-year-old man presented with a rapidly enlarging keratotic lesion of the distal subungual right middle finger. An X-ray of the digit revealed a well-defined cup-shaped lytic lesion of the phalynx underlying the subungual nodule. The lesion resolved spontaneously with reossification of the underlying bony defect. The clinical history and X-ray is consistent with a diagnosis of spontaneously resolving subungual keratoacanthoma.

Fingers↗
PubMed2004

Sustaining better diabetes care in remote indigenous Australian communities.

PROBLEM: Inhabitants of Torres Strait Islands have the highest prevalence of diabetes in Australia and many preventable complications. In 1999, a one year randomised cluster trial showed improved diabetes care processes and reduced admissions to hospital when local indigenous health workers used registers, recall and reminder systems, and basic diabetes care plans, supported by a specialist outreach service. This study looked at whether those improvements were sustained two years after the end of the trial. DESIGN: Three year follow up clinical audit of 21 primary health care centres, and review of admissions to hospital in the previous 12 months. BACKGROUND AND SETTING: Remote indigenous communities in far north east Australia, population about 9600, including 921 people with diabetes. KEY MEASURES FOR IMPROVEMENT: Number of people on registers, care processes (regular measures of weight, blood pressure, haemoglobin A1c, urinary protein concentration, and concentrations of serum lipids and creatinine), appropriate clinical interventions (drug treatment and vaccinations), and intermediate patient outcome measures (weight, blood pressure, and glycaemic control). Admissions to hospital. STRATEGIES FOR CHANGE: Audit and feedback to clinicians and managers; provision of clinical guidelines and a clear management structure; workshops and training. EFFECTS OF CHANGE: The number of people on registers increased from 555 in 1999 to 921 in 2002. Most care processes and clinical interventions improved. The proportion of people with good glycaemic control (haemoglobin A1c 7%) increased from 18% to 25% in line with increased use of insulin (from 7% to 16%). The proportion of those with well controlled hypertension (< 140/90) increased from 40% to 64%. The proportion admitted to hospital with a diabetes related condition fell from 25% to 20%. Mean weight increased from 87 kg to 91 kg. LESSONS LEARNT: In remote settings, appropriate management structures and clinical support for people with diabetes can lead to improvements in care processes, control of blood pressure, and preventable complications that result in admission to hospital. Control of weight and glycaemia are more difficult and requires more active community engagement. Priorities now include increasing the availability and affordability of good food, achieving weight loss, and increasing appropriate use of hypoglycaemic agents, including insulin.

Adult↗
PubMed2003

The "tamponade test" in the management of massive postpartum hemorrhage.

OBJECTIVE: Massive postpartum hemorrhage is a major cause of pregnancy-related death in the United States. To date there is no diagnostic test to identify those women with intractable hemorrhage who will need surgery. Delay in making this decision can be catastrophic. The successful use of the inflated stomach balloon of a Sengstaken-Blakemore tube as a therapy for obstetric hemorrhage has been reported previously. Using the insertion of the Sengstaken-Blakemore tube as a diagnostic test has not been reported. An inflated Sengstaken-Blakemore balloon catheter creates tamponade and identifies those who will or will not need surgery. This is the basis for the "tamponade test." We evaluated the tamponade test in the management of women with massive postpartum hemorrhage. METHODS: In this prospective study, 16 cases of intractable postpartum hemorrhage were managed by the tamponade test. All 16 women had persistent bleeding despite the maximal and optimal application of conservative measures. Their condition deteriorated, such that surgical intervention was considered mandatory. It was at this predefined end point that the tamponade test was applied. RESULTS: Fourteen (87.5%) had a positive tamponade test result and therefore did not require surgery. Two (12.5%) had a negative test result and underwent laparotomy. CONCLUSION: This diagnostic test rapidly identifies those patients with postpartum hemorrhage who will require a laparotomy. Even when results are positive, life-threatening hemorrhage is arrested and time is also allowed to correct any consumptive coagulopathy.

Adult↗
PubMed2003

The effect of long-term atmospheric CO2 enrichment on the intrinsic water-use efficiency of sour orange trees.

Every two months of 1992, as well as on three occasions in 1994-1995, we obtained leaf samples together with samples of surrounding air from eight well-watered and fertilized sour orange (Citrus aurantium L.) trees that were growing out-of-doors at Phoenix, Arizona, USA. These trees had been planted in the ground as small seedlings in July of 1987 and enclosed in pairs by four clear-plastic-wall open-top chambers of which two have been continuously maintained since November of that year at a CO2 concentration of 400 micromol mol(-1) and two have been maintained at 700 micromol mol(-1). In September 2000, we also extracted north-south and east-west oriented wood cores that passed through the center of each tree's trunk at a height of 45 cm above the ground. Stable-carbon isotope ratios (13C/12C) derived from these leaf, wood and air samples were used to evaluate each tree's intrinsic water-use efficiency (iWUE). The grand-average result was an 80% increase in this important plant parameter in response to the 300 micromol mol(-1) increase in atmospheric CO2 concentration employed in the study. This increase in sour orange tree iWUE is identical to the long-term CO2-induced increase in the trees' production of wood and fruit biomass, which suggests there could be little to no change in total water-use per unit land area for this species as the air's CO2 content continues to rise. It is also identical to the increase in the mean iWUE reported for 23 groups of naturally occurring trees scattered across western North America that was caused by the historical rise in the air's CO2 content that occurred between 1800 and 1985.

Atmosphere↗
PubMed2003

Aphallia.

Explore the source record for details and available documents.

Decision Making↗
PubMed2002

"Thresholdless" hysteresis-free switching as an apparent phenomenon of surface stabilized ferroelectric liquid crystal cells.

The thresholdless, hysteresis-free V-shape electro-optical switching in surface-stabilized ferroelectric liquid crystals, observed usually with a triangular voltage form, has been shown to be rather an apparent and not a real effect. Strictly speaking, it is observed only at one characteristic frequency f(i) and is accompanied by an inversion of the electro-optical hysteresis direction from the normal to the abnormal one. The switching of the director in a liquid crystal layer at f(i), in reality, has a threshold and a normal hysteresis. Even the optical transmittance shows a hysteresis at f(i) when it is plotted as a function of the voltage on the liquid crystal layer and not as a function of the total voltage on the liquid crystal cell which always includes the inner insulating layers. Due to these layers, a voltage divider is formed which includes the capacitance of the insulating layers and the dynamic impedance (capacitance and resistance) of the ferroelectric liquid crystal layer. The new explanation has been confirmed by experiments with different ferroelectric liquid crystal cells combined with external resistors and capacitors and by measurements of a strong dependence of f(i) on the liquid crystal resistance which was varied over three orders of magnitude. A theoretical analysis of the problem has also been made using certain approximations for material parameters and the space dependence of the sine form of the electric field in the liquid crystal layer. The conclusions are qualitatively consistent with the experimental results. Finally, the dynamic problem has been solved numerically by taking into account of all the relevant parameters (in the absence of flow and irregularities in the cell plane) and the obtained results are in excellent correspondence with the experiment. This has been demonstrated for sets of material and cell parameters providing the best V-shape performance.

Journal Article↗
PubMed2002

Mediastinal enteric duplication cyst containing aberrant pancreas.

OBJECTIVE: The purpose of the study is to report a unique association of clinical and pathological findings in a neonate. Foregut enteric duplication cysts--rare developmental anomalies that are associated with midline vertebral fusion anomalies. METHODS: We had a neonate with foregut duplication cyst who presented at birth with respiratory distress. The child also had associated communicating hydrocephalus. The patient underwent excision of the duplication cyst along with a ventriculo-peritoneal shunt. RESULT: The excised specimen revealed a duplication cyst lined by aberrant pancreatic tissue. CONCLUSION: The present case demonstrates histologically the presence of both pancreatic and gastric tissue.

Choristoma↗