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Biomedical subjects

Ajay Kumar

Publications and source records attributed to Ajay Kumar.

At least 37 records · Page 2Linked to original sources
PubMed2006

Management of postsurgical recurrence of hepatocellular carcinoma with rhenium 188-HDD labeled iodized oil.

Surgical resection with partial hepatectomy is the treatment of choice in patients with hepatocellular carcinoma (HCC). However, after recurrence, which is common, such patients have limited therapeutic options. In the present report, transarterial radionuclide therapy (TART) with rhenium 188 HDD-labeled Lipiodol was used to treat a patient with postsurgical recurrence of HCC. The patient tolerated therapy well and the lesions were completely ablated with a single dose of 188Re; the patient is free of disease for 14 months. TART with 188Re-HDD Lipiodol appears to be a promising new therapy in case of HCC recurrence after partial hepatectomy and requires further investigation.

Adult↗
PubMed2006

Detection of antibodies against Mycobacterium leprae culture filtrate protein-10 in leprosy patients.

The prevalence of IgG antibodies against Mycobacterium leprae recombinant culture filtrate protein-10 (rCFP-10) was investigated in serum samples from 56 leprosy patients, 15 tuberculosis (TB) patients, 14 other skin-diseased patients and 20 healthy subjects. On classifying the patients into bacterial index (BI)-positive and BI-negative groups, the assay showed 83.3 % (15/18) sensitivity for detection of BI-positive leprosy patients. On the other hand, the sensitivity for detection of BI-negative patients was 18.4 % (7/38). None of the 15 TB patients and 14 other skin-diseased patients was positive; however, only one out of 20 healthy individuals was positive, indicating that antibody response to culture filtrate protein-10 (CFP-10) was highly specific (98.0 %; 48/49). Statistically, the performance of the CFP-10-based assay was found to be comparable (P>0.05) with that of an anti-phenolic glycolipid-I (PGL-I) antibody-detecting assay. Thus, M. leprae CFP-10 is potentially a specific antigen for measuring antibody response in BI-positive leprosy patients. Being a secreted antigen, CFP-10 may act as a marker for the viability of M. leprae inside the host, and hence its serological potential is worth exploring for application in monitoring the response of patients with BI-positive leprosy (a highly infectious form) during the course of chemotherapy. When comparing the bacteriological and serological results, an agreement of 82.1 % showed that seropositivity to M. leprae CFP-10 corresponded well with bacteriological criteria. Hence, CFP-10 seems to be a suitable antigen for classification of leprosy patients into BI-positive and BI-negative groups.

Ambulatory Care Facilities↗
PubMed2006

Personal recognition using hand shape and texture.

This paper proposes a new bimodal biometric system using feature-level fusion of hand shape and palm texture. The proposed combination is of significance since both the palmprint and hand-shape images are proposed to be extracted from the single hand image acquired from a digital camera. Several new hand-shape features that can be used to represent the hand shape and improve the performance are investigated. The new approach for palmprint recognition using discrete cosine transform coefficients, which can be directly obtained from the camera hardware, is demonstrated. None of the prior work on hand-shape or palmprint recognition has given any attention on the critical issue of feature selection. Our experimental results demonstrate that while majority of palmprint or hand-shape features are useful in predicting the subjects identity, only a small subset of these features are necessary in practice for building an accurate model for identification. The comparison and combination of proposed features is evaluated on the diverse classification schemes; naive Bayes (normal, estimated, multinomial), decision trees (C4.5, LMT), k-NN, SVM, and FFN. Although more work remains to be done, our results to date indicate that the combination of selected hand-shape and palmprint features constitutes a promising addition to the biometrics-based personal recognition systems.

Algorithms↗
PubMed2006

Breast lump as a presentation of a hydatid disease.

Hydatid disease is a lesion caused by larval form of Echinococcus granulosus and is seen endemically in sheep-rearing countries. Humans are intermediate hosts of this organism. The liver is the first filter that stops about 75% of the embryos and the lungs filter another 10%, leaving only 15% to develop into cysts in other organs of the body.

Adult↗
PubMed2006

Wound infection after metronidazole infiltration.

In state-run hospitals in India, pre-existing malnutrition and anaemia with late presentation, septicaemia and gross peritoneal contamination lead to a very high wound infection rate despite the use of systemic antibiotics. We studied the wound infection rate of subcutaneous infiltration of metronidazole (group B) versus irrigation with saline (group A) in patients undergoing exploratory laprotomy for perforation peritonitis with pyoperitoneum. The study included 30 patients in group A and 30 in group B. In group A 66.6% of the patients developed wound infection, whereas in group B 26.6% only developed wound infection. This difference is found to be statistically significant at a level of P < 0.01. There was no local complication attributable to infiltration of metronidazole in group B. Thus, we concluded that local infiltration of metronidazole at the incision is a safe and effective measure to control wound infection in cases of perforation peritonitis with pyoperitoneum.

Adult↗
PubMed2006

Pregnancy and rheumatoid arthritis.

Pregnancy in most cases, is associated with remission of rheumatoid arthritis (RA), but a quarter of patients continue to have active disease or even worsening of the disease and most patients who improve, relapse in the postpartum period. The pathophysiology of this improvement in disease activity during pregnancy remains unknown, but hormonal, cell-mediated immunological and humoral immunological changes during pregnancy, have been proposed responsible for this. Most of the pregnant women with RA have an uneventful course, with no significant complications. In general, no significant increase in maternal or fetal morbidity seems to be attributable to RA. Patients with RA do not have decreased fertility. A majority of patients with RA may go in remission and anti-rheumatic treatment may not be required as soon as women become pregnant. But other patients who continue with the disease activity require treatment. The preferred disease-modifying agents during pregnancy are sulfasalazine and hydroxychloroquine. Azathioprine and cyclosporine can be used if the benefits outweigh the risks. Paracetamol and low dose prednisone are preferred and considered safe, both for mother and fetus. Methotrexate and lefunomide are contraindicated and must be prophylactically withdrawn before a planned pregnancy. Biologics generally should be stopped when pregnancy is discovered. An overall rational approach is highly warranted to treat RA during pregnancy.

Anti-Inflammatory Agents↗
PubMed2005

High-dose radioiodine treatment for differentiated thyroid carcinoma is not associated with change in female fertility or any genetic risk to the offspring.

BACKGROUND: We tried to evaluate the female fertility and genetic risk to the offspring from the exposure to high-dose (131)I by assessing the pregnancy outcomes and health status of the children of female patients with differentiated thyroid cancer who had received therapeutic doses of (131)I. MATERIALS AND METHODS: From 1967 to 2002, a total of 1,282 women had been treated with (131)I. Of these patients, 692 (54%) were in the reproductive age group (18-45 years). Forty women had a total of 50 pregnancies after high-dose (131)I. Age at presentation ranged from 16 to 36 years (mean, 23 +/- 4 years). Histopathology was papillary thyroid cancer in 32 cases and follicular thyroid cancer in 8 cases. RESULTS: Single high-dose therapy was given in 30 cases, 2 doses were given in 7 cases, 3 doses were given in 2 cases, and four doses were given in 1 case in which lung metastases had occurred. In 37 patients (92%), disease was successfully ablated before pregnancy. Ovarian absorbed-radiation dose calculated by the MIRD method ranged from 3.5 to 60 cGy (mean, 12 +/- 11 cGy). The interval between (131)I therapy and pregnancy varied from 7 to 120 months (37.4 +/- 28.2 months). Three spontaneous abortions occurred in 2 women. Forty-seven babies (20 females and 27 males) were born. Forty-four babies were healthy with normal birth weight and normal developmental milestones. Twenty women delivered their first baby after (131)I therapy. The youngest child in our series is 11 months of age, and the oldest is 8.5 years of age. CONCLUSIONS: Female fertility is not affected by high-dose radioiodine treatment, and the therapy does not appear to be associated with any genetic risks to the offspring.

Abortion, Spontaneous↗
PubMed2005

Effect of iopanoic acid on radioiodine therapy of hyperthyroidism: long-term outcome of a randomized controlled trial.

CONTEXT: Telepaque [iopanoic acid (IA)] is believed to rapidly ameliorate hyperthyroidism; however, it may preclude subsequent 131I therapy, possibly delaying it for several months. OBJECTIVE: Our objective was to see how early patients, made euthyroid with Telepaque, can be treated with 131I and to compare their short- and long-term outcome with patients treated with 131I, after making them euthyroid with carbimazole and beta-blockers. DESIGN: We conducted a randomized controlled trial. SETTING AND PATIENTS: We studied 200 hyperthyroid patients at a tertiary care teaching institute. INTERVENTIONS: The IA group received Telepaque, 500 mg/d orally, for 7 d and then no medication for 1 wk followed by 131I therapy if radioiodine neck uptake had recovered. The control group received 30-40 mg oral carbimazole daily until patients became euthyroid followed by 131I. MAIN OUTCOME: After 1 wk of Telepaque therapy and 6 wk of carbimazole, almost all patients became clinically and biochemically euthyroid, and 86 and 94% of patients were ready for 131I therapy after 1 and 2 wk off Telepaque, respectively. The cure rate, defined as euthyroid plus hypothyroid, after the first dose of 131I in controls and the IA group was 80 and 76.2%, respectively (P = 0.54). Thirty-two percent among controls and 25% in the IA group became hypothyroid within 1 yr (P = 0.33); thereafter, the annual rate of hypothyroidism was about 2% in both groups. After a mean follow-up duration of 11 yr, 58% of patients in the control group and 51% in the IA group were hypothyroid. CONCLUSIONS: Telepaque rapidly ameliorates hyperthyroidism without jeopardizing the subsequent radioiodine therapy, and the outcome of radioiodine therapy in this subset of patients is in no way different compared with those prepared by carbimazole.

Adult↗
PubMed2005

Kruppel-like factor 2 as a novel mediator of statin effects in endothelial cells.

BACKGROUND: Although 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) are known to modulate endothelial function, the transcriptional mechanisms underlying these effects are incompletely understood. We hypothesized that Lung-Kruppel-like factor (LKLF/KLF2), a novel and potent regulator of endothelial gene expression, may mediate the downstream effects of statins. Here we report that statin-induced expression of endothelial NO synthase (eNOS) and thrombomodulin is KLF2 dependent. METHODS AND RESULTS: KLF2 mRNA was induced by treatment with multiple statins in a concentration-dependent manner. Multiple lines of evidence suggest that this induction is dependent on inhibition of the Rho pathway and requires de novo transcription. Furthermore, promoter deletion and mutational analyses suggest that mevastatin induced KLF2 promoter activity through a single myocyte enhancer factor binding site. Finally, small-interfering RNA-mediated knockdown of KLF2 strongly attenuated the ability of mevastatin to increase eNOS and thrombomodulin accumulation in endothelial cells. CONCLUSIONS: Taken together, these observations indicate that statin-dependent induction of eNOS and thrombomodulin requires KLF2 and thereby provides a novel molecular target for modulating endothelial function in vascular disease.

5' Untranslated Regions↗
PubMed2005

Kruppel-like factor 2 (KLF2) regulates endothelial thrombotic function.

The vascular endothelium maintains blood fluidity by inhibiting blood coagulation, inhibiting platelet aggregation, and promoting fibrinolysis. Endothelial cells lose these nonthrombogenic properties on exposure to proinflammatory stimuli. We recently identified the Kruppel-like factor KLF2 as a novel regulator of endothelial proinflammatory activation. Here it is found that KLF2 differentially regulates key factors involved in maintaining an antithrombotic endothelial surface. Overexpression of KLF2 strongly induced thrombomodulin (TM) and endothelial nitric oxide synthase (eNOS) expression and reduced plasminogen activator inhibitor-1 (PAI-1) expression. Furthermore, overexpression of KLF2 inhibited the cytokine-mediated induction of tissue factor (TF). In contrast, siRNA mediated knockdown of KLF2 reduced antithrombotic gene expression while inducing the expression of pro-coagulant factors. The functional importance of KLF2 was verified by in vitro clotting assays. By comparison to control infected cells, KLF2 overexpression increased blood clotting time as well as flow rates under basal and inflammatory conditions. In contrast, siRNA-mediated knockdown of KLF2 reduced blood clotting time and flow rates. These observations identify KLF2 as a novel transcriptional regulator of endothelial thrombotic function. The full text of this article is available online at http://circres.ahajournals.org.

Animals↗
PubMed2005

Gene networks in hexaploid wheat: interacting quantitative trait loci for grain protein content.

In hexaploid wheat, single-locus and two-locus quantitative trait loci (QTL) analyses for grain protein content (GPC) were conducted using two different mapping populations (PI and PII). Main effect QTLs (M-QTLs), epistatic QTLs (E-QTLs) and QTL x environment interactions (QE, QQE) were detected using two-locus analyses in both the populations. Only a few QTLs were common in both the analyses, and the QTLs and the interactions detected in the two populations differed, suggesting the superiority of two-locus analysis and the need for using several mapping populations for QTL analysis. A sizable proportion of genetic variation for GPC was due to interactions (28.59% and 54.03%), rather than to M-QTL effects (7.24% and 7.22%), which are the only genetic effects often detected in the majority of QTL studies. Even E-QTLs made a marginal contribution to genetic variation (2.68% and 6.04%), thus suggesting that the major part of genetic variation is due to changes in gene networks rather than the presence or absence of specific genes. This is in sharp contrast to the genetic dissection of pre-harvest sprouting tolerance conducted by us earlier, where interaction effects were not substantial, suggesting that the nature of genetic variation also depends on the nature of the trait.

Plant Proteins↗
PubMed2005

Investigation of induction of air due to ultrasound source in the sonochemical reactors.

A detailed investigation into the phenomena of induction of air using a novel arrangement of the ultrasonic horn (tip is located just above the liquid surface) has been made with the quantification of the extent of induction in terms of the air entrainment rate and the gas-liquid mass transfer coefficient for the transfer of air into the system. The measurement of air entrainment rate was found to be quite difficult and hence focus was kept on the quantification in terms of the gas-liquid mass transfer coefficient. The effect of ultrasonic power dissipation and type of the liquid medium (water, sodium chloride and sodium laruyl sulphate [surfactant] solution) on the mass transfer coefficient has been studied and correlations have been developed for the prediction of the same. Comparison with the mechanically agitated surface aerators has enabled us to understand the controlling mechanism in the induction and subsequent distribution of the air i.e. turbulence or convective motion. The present work should open an entirely new field of research in the area of design of sonochemical gas-liquid reactors operating possibly as a combination of gas-inducing reactors and cavitational reactors.

Journal Article↗
PubMed2005

Tumor necrosis factor alpha-mediated reduction of KLF2 is due to inhibition of MEF2 by NF-kappaB and histone deacetylases.

Activation of the endothelium by inflammatory cytokines is a key event in the pathogenesis of vascular disease states. Proinflammatory cytokines repress the expression of KLF2, a recently identified transcriptional inhibitor of the cytokine-mediated activation of endothelial cells. In this study the molecular basis for the cytokine-mediated inhibition of KLF2 is elucidated. Tumor necrosis factor alpha (TNF-alpha) potently inhibited KLF2 expression. This effect was completely abrogated by a constitutively active form of IkappaBalpha, as well as treatment with trichostatin A, implicating a role for the NF-kappaB pathway and histone deacetylases. Overexpression studies coupled with observations with p50/p65 null cells support an essential role for p65. A combination of promoter deletion and mutational analyses, chromatin immunoprecipitation assays, and co-immunoprecipitation studies indicates that p65 and histone deacetylases 4 cooperate to inhibit the ability of MEF2 factors to induce the KLF2 promoter. These studies identify a novel mechanism by which TNF-alpha can inhibit endothelial gene expression. Furthermore, the inhibition of MEF2 function by p65 and HDAC4 has implications for other cellular systems where these factors are operative.

Cells, Cultured↗
PubMed2005

Effect of oil massage on growth and neurobehavior in very low birth weight preterm neonates.

OBJECTIVE: To study the effect of oil massage on growth and neurobehavior in preterm babies less than 1500 g. DESIGN: Randomized Controlled Trial. SETTING: Tertiary level neonatal unit of a teaching hospital. SUBJECTS: Neonates with birth weight <1500 grams, gestation >37 weeks, receiving enteral feeds of at least 100 mL/kg/day and less than 10 days of age. OUTCOME VARIABLES: Primary-Weight gain 28 days after enrolment. Secondary-Neonatal neurobehavior, change in other anthropometry and serum triglycerides. METHODS: Eligible neonates were randomized to one of the three groups (a) massage with oil (b) massage without oil and (c) no massage. Weight, length, head circumference and triceps skin fold thickness were measured in the three groups at regular intervals. Serum triglyceride levels were measured at enrolment and at completion. Neurobehavior using Brazeltons Neonatal Behavior Assessment Scale (NBAS) was assessed at enrolment and after 10 days of intervention. RESULTS: Weight gain in the oil massage group (365.8 +/- 165.2g) was higher compared to the only massage group (290.0 +/- 150.2g) and no massage group (285.0 +/- 170.4g). This difference and the difference in other anthropometric parameters was not statistically significant. Serum triglycerides and neonatal neurobehavior were comparable in the three groups. CONCLUSION: Oil application may have a potential to improve weight gain among preterm very low birth weight neonates.

Female↗