Biomedical subjects
Publications and source records attributed to B Mishra.
A case of ovale malaria in a child from Delhi is reported. Urban malaria ecotypes caused by P. ovale has never been seen before. Characteristic morphological features of the parasite in stained blood film confirmed its identification.
Microalbuminuria is associated with an increased risk of cardiac death. We assessed whether urinary albumin excretion is related to abnormalities of the QT interval independently of myocardial ischemia. Thirty-four patients with type 1 diabetes who were free from ischemic heart disease on the basis of normal stress electrocardiography and echocardiography were studied. Maximal QT interval and dispersion were significantly greater in the group with microalbuminuria (n=17) compared to controls (n=17) with normal urinary albumin excretion (394 [26.1] vs. 373.8 [27.8] ms; P=.044 and 62.4 [21.8] vs. 42.7[11.6] arbitrary units; P=.009). Autonomic function was similar between the groups. Urinary albumin excretion correlated positively with QT dispersion (P=.023). These data suggest that in type 1 diabetic patients, QT abnormalities can occur independently of autonomic dysfunction or myocardial ischemia and may be related to the processes which increase urinary albumin leakage.
The objective of our study was to prepare and evaluate osmotic matrix (OM) tablets of diclofenac sodium (DS). In vitro studies were done on USPXXIV dissolution apparatus II in different release medium. Surface characteristics of coating films and osmotic contribution of OM tablets also were studied. In vivo evaluation was carried out in 6 healthy human volunteers using HPLC method to assay plasma samples, and the results were compared with the performance of fabricated matrix and two commercial tablets of DS. Through in vitro drug release kinetics, using regression coefficient analysis and Peppas equation, different pharmacokinetic parameters and relative bioavailability were determined. OM tablets were found to provide more prolonged and controlled therapeutic plasma DS levels and also showed improved bioavailability in comparison to fabricated matrix and commercial tablets studied.
Bioadhesive sodium alginate microspheres of Metoprolol tartrate (MT) for intranasal systemic delivery were prepared to avoid the first-pass effect, as an alternative therapy to injection, and to obtain improved therapeutic efficacy in the treatment of hypertension and angina pectoris. The microspheres (Ms) were prepared using emulsification--cross-linking method. The formulation variables were drug loading, polymer concentration, cross-linking agent concentration, and cross-linking time. The Ms were evaluated for characteristics, like particle size, incorporation efficiency, swelling ability, in vitro bioadhesion, in vitro drug release, and in vivo pharmacodynamic performance in rabbits against isoprenaline-induced tachycardia. Treatment of in vitro data to different kinetic equations indicated matrix-diffusion controlled drug delivery from sodium alginate Ms. Polymer concentration, cross-linking agent concentration, and cross-linking time influenced the drug release profiles significantly. In vivo studies indicated significantly improved therapeutic efficacy of MT from Ms with sustained and controlled inhibition of isoprenaline-induced tachycardia as compared with oral and nasal administration of drug solution.
Treatment of severe Pseudomonas infections often calls for multidrug therapy. Combinations of aminoglycosides, beta-lactams and/or quinolones are generally administered, the effect of which may be additive, synergistic or indifferent. The present in vitro study was designed to find out the exact outcome of the postantibiotic effect (PAE). The minimal inhibitory concentrations and the PAE of three antibiotics (amikacin, ceftazidime and ciprofloxacin) were determined both singly and in combination. Ceftazidime alone exhibited a negative PAE but a synergistic effect was observed for the combination of ceftazidime with amikacin. The combination of ceftazidime with ciprofloxacin and ciprofloxacin with amikacin however gave an indifferent PAE. This synergistic PAE of amikacin with ceftazidime has a significant effect on designing optimal dosage regimens.
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The syndrome of increasing angina leading to myocardial infarction was first recognised in the 1930s and the term unstable angina coined in 1971 by Fowler. Since then the importance of acute coronary syndromes as a presentation of ischaemic heart disease has been fully recognised. Recently several new pharmacological agents have been developed for the treatment of these syndromes. We aim to review the current treatments available for unstable angina and give a practical guide to its management.
Ex vivo embryonic liver explant culture is a novel and attractive approach to obtain abundant hepatic and hematopoietic stem cells. Gene therapy of autologous hepatic and hematopoietic stem cells represents an alternative therapeutic approach to liver transplantation for genetic and metabolic disorders. In this study we characterize the growth and differentiation of hepatic stem cells utilizing embryonic liver cultures. Day 9.5 liver buds are microdissected and cultured under specific conditions. Modulation of growth conditions by addition of hepatocyte growth factor, Flt-3 ligand, and stem cell factor leads to enrichment of hepatic progenitor cells in embryonic liver explants. Under these conditions, we also demonstrate the role of a novel marker PRAJA-1 to identify hepatic stem cells and transitional hepatocytes. Utilization of dexamethasone enhanced pseudolobule formation with increased hepatocytic and biliary differentiation. Transforming growth factor-beta leads to enrichment of biliary cells in the culture. Gut formation is enhanced in the presence of interleukin-3 and blood formation by increasing the mesodermal tissue in these cultures. We also show increased retroviral-mediated expression of the green fluorescent protein expression in the expanded hepatic and hematopoietic stem cells under different culture conditions. Thus, the embryonic liver explant culture is an attractive source for hepatic progenitors and is a possible step towards generating nontumorigenic immortalized hepatocytes with possible transplantation applications.
Sub acute sclerosing pan-encephalitis (SSPE) is a slowly progressive inflammatory disorder of the central nervous system. A decline in frequency has been noticed in most of the developed countries, whereas it continues to be high in developing countries. Though a number of studies have been carried out, the exact trend of SSPE is still not clear. Hence the present study was carried out to analyze the trend of SSPE over the past ten years in and around Chandigarh. A total of 205 patients with clinical features suggestive of SSPE were enrolled for the study during Jan'92 to Dec. 2001. Measles specific antibodies were detected in blood and CSF by HAI method. 114 patients were found to be positive for measles specific HAI antibody with a male preponderance. The number of SSPE cases were found to be more during the period 1992-95 in comparison to the next 6 years (p < 0.05). The high incidence of SSPE in our country could be due to improper vaccine coverage, poor cold chain maintenance or circulation of atypical measles virus strain.
Three cases of leprosy who showed evidence of calcification of nerve trunks on radiological examination are reported. Two of these had calcified ulnar nerve at elbow and in one lateral popliteal nerve was calcified at the knee level.
A comparison has been made of the characteristics of dermal granulomas of tuberculoid and lepromatous leprosy by culturing them in vitro. The granulomas were derived from lesions of untreated patients and their effect was assessed on the morphology and function of lymphocytes derived from peripheral blood of normal individuals. The concentration of proteins released in the supernatants was similar in both the type of granulomas. However, the supernatants from the lepromatous granulomas markedly diminished the viability of lymphocytes when compared with supernatants derived from the tuberculoid granulomas. The supernatants from both the tuberculoid and lepromatous granulomas, contained soluble factors which depressed the 14C-leucine and 3H-thymidine incorporation by lymphocytes. The depression in 3H-thymidine uptake was more pronounced with the supernatants from the lepromatous granulomas while the diminution of 14C-leucine incorporation was more marked with supernatants from the tuberculoid granulomas. The supernatants did not show any migratory inhibitory activity in vitro. When the cells from the granulomas were dispersed and cultured in vitro, only very low concentration of proteins was detectable.
Total population survey covering 28055 persons living in 34 villages of eastern Rajasthan was carried out. Out of 28055 persons 20276 (72.27%) were actually examined and 218 cases of leprosy were detected. Prevalence of leprosy was found to be 10.75/1000, which is very high and contrary to earlier observations regarding leprosy prevalence in Rajasthan. Leprosy problem in Rajasthan has been discussed.
Eight out of 30 cases of Borderline Lepromatous and Lepromatous Leprosy suffering with chronic recurrent lepra reactions failed to respond to clofazimine therapy. Three of the eight were steroid dependent. All the eight patients are doing well after weaning off the clofazimine. Lymphadenitis in post clofazimine reactional status was presenting feature in present retrospective study.
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An attempt has been made to definite the levels of "protective sensibility" in terms of perception thresholds to monofilament nylon induced touch/pressure stimuli. Certain problems were observed while interpreting the observations. There appears to be a range of threshold values instead of a clear cut-off point. We suggest that a monofilament nylon stimulus two times the normal threshold value for that patient be taken as cut-off point. This will make the observations of Birke and Sims (1986) and Hammond and Klenerman (1987) reasonable without having any need to exclude the cases who defy the boundaries laid by them. Since the genesis of plantar ulcer is multifactorial, it appears logical to include all patients who have a certain degree of hypoaesthesia, for special ulcer care program. The likely problems while using monofilament nylons in the field and their possible solutions have also been outlined.
Trichuris vulpis was identified in two children from urban slums. Both of them had nonspecific abdominal pain and one had episodes of diarrhea. Clinical recovery was good after treatment with mebendazole.