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Biomedical subjects

B N Tandon

Publications and source records attributed to B N Tandon.

At least 73 records · Page 4Linked to original sources
PubMed1987

Bedside ultrasonography. A low-cost definitive diagnostic procedure in obstructive jaundice.

We evaluated real-time ultrasonography carried out by gastroenterologists for its diagnostic accuracy in 89 patients with obstructive jaundice. The positive predictive values for the site and nature of the obstruction were 94.3 and 89.9%, respectively. The advanced stage of disease in our patients and the clinical background of the investigators may have contributed to the high diagnostic accuracy of ultrasonography in this study. Nevertheless, we recommend that gastroenterologists themselves perform bedside ultrasonography for a definitive diagnosis in patients with obstructive jaundice. The high degree of precision achieved by ultrasound in our setting makes more expensive investigations unnecessary as routine procedures.

Cholestasis, Extrahepatic↗
PubMed1986

A clinico-radiological reappraisal of intestinal tuberculosis--changing profile?

Intestinal tuberculosis is still common in developing countries. In 186 patients with intestinal tuberculosis, clinical features, radiological findings and complications were carefully recorded and compared with those from earlier studies with a view to study any possible changes after the liberal use of antitubercular drugs. Sixty two percent of the patients in the present series had had prior exposure to antitubercular drugs. The incidence of systemic symptoms like fever and anorexia, alternating diarrhoea and constipation, peritoneal and lymph node involvements and associated pulmonary lesions were less frequently observed. On the other hand, an indolent and complicated course with intestinal obstruction (47%) and lower gastrointestinal bleeding (5.5%) and frequent colonic involvement (19%) often necessitating surgical intervention appeared to have become more frequent than reported in earlier series. Awareness of these changes in the clinical profile of intestinal tuberculosis should be helpful in the diagnosis and management of the condition.

Adult↗
PubMed1986

Serodiagnosis of intestinal tuberculosis by enzyme immunoassay and soluble antigen fluorescent antibody tests using a saline extracted antigen.

The efficacy of enzyme-linked immunosorbent assay (ELISA) and soluble antigen fluorescent antibody (SAFA) tests in the diagnosis of intestinal tuberculosis was compared using saline extracted surface antigen of M. tuberculosis H37Ra. Of the 24 proved cases of intestinal tuberculosis ELISA detected positivity in 92% compared with 83% detected by the SAFA test. The 2 tests showed a strong correlation with each other and yielded a clear cut difference between patients and controls, although there was some degree of overlap.

Enzyme-Linked Immunosorbent Assay↗
PubMed1986

Enzyme linked protein-A: an ELISA for detection of IgG antibodies against Mycobacterium tuberculosis in intestinal tuberculosis.

Enzyme linked protein-A has been used to develop an enzyme-linked immunosorbent assay (ELISA) to detect circulating IgG antibodies to Mycobacterium tuberculosis. The specific binding of protein-A to IgG fractions through Fc receptors, makes the test more specific for detection of total IgG antibodies. The ELISA system has been used for detection of circulating antibodies to M. tuberculosis H37Ra in 22 patients with histologically proven intestinal tuberculosis and 88 healthy controls, in addition to 7 diseased controls. The ELISA has been found to be a sensitive test as it was positive in all 22 patients with intestinal tuberculosis. Its specificity was 85% in Indian controls and 97% in Norwegian controls. The test is easy to perform and may be recommended for the serological diagnosis of intestinal tuberculosis.

Antigens, Bacterial↗
PubMed1986

Acute liver failure. Experience with 145 patients.

Acute liver failure (ALF) is an uncommon but serious disease still carrying a high mortality. This report describes one of the largest series of cases of acute failure, managed on a simple intensive supportive therapeutic regimen. One hundred fifty-eight patients with ALF were admitted to the Rajgarhia Liver Unit of the All-India Institute of Medical Sciences (AIIMS) during the period July 1976 to December 1981. Data from 145 were completed and analyzed for this report. Of the patients, 85.4% were below the age of 40 years. The female-to-male ratio was 1.3:1. Of the 77 women in the reproductive age group, 59.7% were pregnant. All cases of ALF were secondary to viral hepatitis. Cerebral edema, bleeding, infection, and renal failure were seen in 57.2, 57.2, 39.3, and 16.5% of patients, respectively. Overall survival was 28.9% of patients. It was 33% below the age of 40 years and only 4.8% above this age. Pregnancy did not adversely affect the prognosis. Survival was related to grade of coma, being 22.8% for patients in Grade IV coma and 62% for patients in Grade I coma. In fatal cases the immediate complications resulting in death were cerebral edema (63%), bleeding (30%), renal failure (10.6%), and infection (8.7%). Presence of HBsAg, a serum bilirubin of over 20 mg%, and serum sodium less that 119 mEq/liter were indicators of poor prognosis. A simple, intensive, support therapy yielded results comparable to those reported by centers using a variety of complex therapeutic regimens.

Acute Disease↗
PubMed1986

Liver morphology in marmosets infected with epidemic non-A, non-B hepatitis in India.

In this study the morphological changes in the livers of marmosets inoculated with stool extracts from epidemic non-A, non-B hepatitis patients in India were examined. The histologic changes of epidemic non-A, non-B hepatitis in marmosets consisted mainly of round cell infiltration in the portal tracts, spotty liver cell necrosis, sinusoidal lymphocyte infiltration, and Kupffer cell mobilization. By electron microscopy, liver cells from infected marmosets showed cisternal dilation of the endoplasmic reticulum, irregularly-shaped nucleus, and disorganization of the mitochondrial cristae. In some areas interaction of lymphocytes with hepatocytes was observed. Similar observations have been made in type B hepatitis infection, presumably due to liver cell damage mediated by immune mechanisms. The result of our study is also compatible with the interpretation that the liver cell damage in this experimental model may be mediated by immune mechanisms.

Animals↗
PubMed1986

Acute hepatic failure due to Plasmodium falciparum liver injury.

Nine patients with acute liver failure due to Plasmodium falciparum liver injury admitted to the Rajgarhia Liver Unit of the All-India Institute of Medical Sciences during 1982-84 are presented. The liver was palpable in all the patients, and eight had splenomegaly. Investigations revealed mild to moderate abnormality in liver function tests. All were negative for the markers of acute infection due to hepatitis A and B viruses. Blood film examination showed P. falciparum alone in seven and along with P. vivax in the remaining two patients. Liver histology, which was identical in all eight patients where liver biopsy was done, showed centrizonal necrosis and hyperplastic Kupffer cells loaded with malarial pigment. All the patients recovered with specific anti-malarial and supportive treatment. Our observations suggest that malaria due to P. falciparum may present as jaundice and encephalopathy which stimulates acute hepatic failure due to fulminant hepatitis.

Acute Disease↗
PubMed1986

Serodiagnosis of intestinal tuberculosis by the soluble antigen fluorescent antibody test (SAFA test).

The diagnosis of intestinal tuberculosis can only be established by the tissue obtained during surgery or endoscopy. We investigated the role of the soluble antigen fluorescent antibody (SAFA) test with the possibility that it may prove to be a valuable technique for the serodiagnosis of intestinal tuberculosis. The sera of 38 patients and 60 control subjects were studied. Mycobacterial saline extract was used as an antigen in the test. Thirty-two (84%) of 38 patients with intestinal tuberculosis yielded positive values (fluorescence coefficient greater than 3). Among the control subjects a false positive result was observed in only one patient who had eosinophilic enteritis. Patients with intestinal tuberculosis had a significantly higher level of antibodies than patients with non-tuberculous intestinal disease and healthy subjects. These results suggest that this technique may be used for the diagnosis of intestinal tuberculosis and in differentiating it from other non-tuberculous intestinal diseases.

Adolescent↗
PubMed1986

Cell-mediated immunity in amoebic liver abscess.

Cell-mediated immunity studies were carried out in 26 cases of amoebic liver abscess by the leucocyte migration inhibition test and in 23 cases by T-cell counting. The tests were repeated after treatment and clinical recovery in 20 and 18 cases respectively. In addition, the leucocyte migration inhibition test was performed on 20 normal healthy controls and 11 Entamoeba histolytica cyst passers, and T-cell counting was carried out on 18 normal healthy controls and nine E. histolytica passers. The results of the present study show a transient state of immunodepression which may help E. histolytica to evade the defence mechanism of the host, and thereby invade target cells and produce liver abscess. This immune response is reversed after treatment and clinical recovery.

Cell Migration Inhibition↗