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Biomedical subjects

B S Anand

Publications and source records attributed to B S Anand.

At least 37 records · Page 2Linked to original sources
PubMed1996

Low point prevalence of peptic ulcer in normal individuals with Helicobacter pylori infection.

OBJECTIVE: A recent study from Italy reported a high prevalence of ulcer disease in asymptomatic Helicobacter pylori infection. Such results are at variance with previous endoscopy screening studies. Our study was performed to obtain data on ulcer prevalence in normal H. pylori-infected subjects in the United States. METHODS: One hundred and ninety healthy individuals of either gender, over the age of 18, were studied. After completion of a detailed questionnaire and a urea breath test for H. pylori status, endoscopy was performed. Ulcer was defined as a mucosal ulceration > 5 mm in diameter and with apparent depth. RESULTS: There were 108 (57%) women and 82 (43%) men. The mean (+/-SD) age was 38.9 (+/-10.7) yr, range 21-79 yr. Careful history obtained after enrollment revealed presence of dyspeptic symptoms in 35 subjects (18%); the remaining 155 individuals were completely symptom-free. Infection with H. pylori was present in 102 subjects (54%). The infection rate was highest in Hispanics (70%), followed by African-Americans (58%), Caucasians (38%), and Asians (17%). The prevalence increased with age. Only two (1%) of 190 subjects, both with H.pylori infection, had peptic ulcer. In the H. pylori-infected group, the prevalence of peptic ulcer was 2%. CONCLUSION: In the United States, significant unrecognized and asymptomatic gastroduodenal disease is uncommon in H. pylori-infected individuals. These findings do not support the need for a mass screening program for H. pylori infection or for the use of antimicrobial treatment of asymptomatic subjects with this infection.

Adult↗
PubMed1996

Current status of transjugular intrahepatic portosystemic shunt (TIPS).

TIPS is the creation of an intrahepatic shunt between the portal and hepatic veins. The primary indications for TIPS are unresponsive acute variceal bleeding; bleeding from gastric varices, ectopic varices and portal gastropathy; and variceal bleeding in patients awaiting liver transplantation. Preliminary reports suggest that TIPS may be useful in other conditions such as resistant ascites, cirrhotic hydrothrorax and hepatorenal syndrome. TIPS has also been successfully placed in a proportion of patients with Budd-Chiari syndrome and portal vein thrombosis. The immediate post-procedure complication rate is low, considering the serious underlying illness of patients undergoing TIPS. However, the main concern in the long-term is stent stenosis or occlusion. Within one year, nearly 50% of patients develop stent dysfunction and a significant proportion of these patients suffer from recurrent variceal bleeding. At present, no clear solution has been found to this problem. It is hoped that stents made of material which is less thrombogenic and which provokes a less exuberant host tissue response may become available. Until then, TIPS should be reserved for complications which are unresponsive to standard therapy and in patients where surgery is considered hazardous.

Esophageal and Gastric Varices↗
PubMed1995

Helicobacter pylori infection does not reduce the viscosity of human gastric mucus gel.

The mechanism by which Helicobacter pylori undermines host defence mechanisms is unclear. Several in vitro studies using soluble mucins have suggested that H pylori may compromise mucus function. Gastric mucus gel was obtained from 13 H pylori infected patients; six untreated subjects and seven after eradication of the infection. Gastric mucus is a non-Newtonian substance in that its viscosity changes with changing rates of shear, requiring mucus viscosity to be measured in a rotational cone-plate microviscometer. Viscosity was measured at shear rates varying from 1.15 s-1 to 46 s-1. The gastric mucus viscosity was significantly higher in patients infected with H pylori compared with mucus gel obtained after eradication of the infection. The results of our study suggest that the previous studies using in vitro methods involving soluble mucins or its components may have lead to erroneous conclusions about the in vivo interactions of H pylori and gastric mucus gel. The present findings argue against the hypothesis that degradation of gastric mucus by H pylori is important in the pathogenesis of peptic ulcer.

Female↗
PubMed1994

Use of micro samples of finger prick blood dried on filter paper for a quick and simple dipstick dot-EIA for diagnosis of amebic liver abscess (ALA).

Filter paper was used as a support to absorb micro samples of finger prick blood for detection of antibodies to Entamoeba histolytica (causative organism of amebiasis) by a rapid dipstick dot-EIA technique; 8 microliters of blood was sufficient to saturate discs (diameter 6 mm) of Whatman paper No. 3. Conditions of elution of blood from the discs were optimized and the best results were obtained when 0.4 ml of buffer was used for elution for 30 minutes at room temperature. The filter paper technique is extremely useful for field use and for diagnosis of amebic liver abscess on a large scale since it does not involve centrifugation of blood and use of sterile vials because blood dried on paper can be stored in polythene bags at room temperature for up to 3 months and for a week at 42 degrees C without significant loss of antibody activity, thereby eliminating the need of refrigeration of samples for storage or transportation to a reference laboratory. Elution of blood from different discs of the same patient was found to be highly reproducible without appreciable loss of sensitivity or specificity. Twenty-four confirmed ALA, 29 non-ALA, and 25 apparently normal healthy controls, with no previous history of amebiasis, were tested. Sensitivity and specificity of the test was found to be 96% and 92%, respectively.

Animals↗
PubMed1994

Comparative assessment of phenolphthalein and phenolphthalein glucuronide: is phenolphthalein glucuronide a better laxative?

BACKGROUND: Phenolphthalein is widely used as a safe and effective laxative. After oral administration, phenolphthalein is absorbed in the small bowel and is conjugated in the liver to phenolphthalein glucuronide which passes into the colon where it is deconjugated and the active compound, phenolphthalein, is released. Since phenolphthalein glucuronide does not undergo enterohepatic circulation it should theoretically have a more rapid onset of action and a lower threshold dose for laxation. The present study was designed to examine this issue. METHODS: Ten normal healthy subjects volunteered for the study. All subjects were administered placebo, phenolphthalein (at doses of 15, 30, 45, 60, 75 and 90 mg) or phenolphthalein glucuronide (at equivalent doses of 24, 48, 72, 96, 120 and 144 mg) in a random order. Stool weight, the frequency and consistency of stools, and the development of symptoms were recorded at 12-h intervals for 84 h. RESULTS: There was a significant increase in the mean stool weight obtained within the first 24 h of administration of a 30 mg dose of phenolphthalein and its glucuronide equivalent compared to the values obtained with placebo. A further increase in the dose did not improve the therapeutic response. There was no difference between phenolphthalein and phenolphthalein glucuronide with respect to the rapidity of action, the threshold dose, effectiveness of laxation, or the frequency of adverse effects. CONCLUSIONS: The therapeutic response and side effect profile of the different doses favoured 30 mg phenolphthalein as the optimum laxative dose. Although theoretically superior, phenolphthalein glucuronide was not found to be a more effective laxative compared to phenolphthalein in normal subjects.

Cathartics↗
PubMed1994

Pancreatic secretion in man: effect of fasting, drugs, pancreatic enzymes, and somatostatin.

The inhibitory effect of different drugs on pancreatic secretions was assessed in a patient with a posttraumatic pancreatic-cutaneous fistula. The various drugs examined were: pancreatic enzymes, cimetidine, verapamil, propantheline, acetazolamide, and somatostatin analog octreotide. Only fasting and octreotide reduced pancreatic secretion. The optimum dose of octreotide was 50 micrograms bid given subcutaneously; increasing the dose up to 100 micrograms tid had no additional benefit. A stable pancreatic-cutaneous fistula is an excellent model to assess the effect of different therapeutic measures on pancreatic secretion.

Acetazolamide↗
PubMed1994

Diagnosis of intestinal tuberculosis by polymerase chain reaction on endoscopic biopsy specimens.

It is often difficult to establish the diagnosis of intestinal tuberculosis because of close similarities with other conditions, in particular, Crohn's disease. In the present study, we used the polymerase chain reaction (PCR) assay on endoscopic biopsy specimens obtained from a patient with chronic diarrhea. Positive hybridization was obtained with the Mycobacterium tuberculosis probe and the patient was treated with anti-tuberculous drugs with complete resolution of the endoscopic abnormalities. This study demonstrates that polymerase chain reaction assay can be used on endoscopic biopsy specimens to diagnose intestinal tuberculosis.

Adult↗
PubMed1993

Entamoeba histolytica cyst passers. Clinical profile and spontaneous eradication of infection.

The present study was carried out to examine whether Entamoeba histolytica cyst passers suffer from any parasite-related bowel symptoms and to assess the frequency of spontaneous eradication of this infection. The study was carried out in two parts. In part I, stool samples were collected at random from 3536 individuals living in rural communities around Delhi. E. histolytica was isolated by the culture technique in 345 (9.7%) subjects. There was no increase in the prevalence rate of bowel symptoms in the culture-positive compared to the culture-negative subjects. One hundred twenty-four (36%) of the culture-positive subjects agreed to take part in a longitudinal study; the subjects were left untreated and clinical assessment and stool examinations were carried out at three-month intervals. One hundred eighteen (95.2%) subjects had eradicated their parasite spontaneously at the end of one year; none developed any features of invasive amebiasis. Part II of the study was carried out on 625 patients attending our Gastroenterology Clinic. Positive cultures of E. histolytica were obtained from 99 (15.2%) patients. Again, there was no increase in the prevalence rate of bowel complaints in the culture-positive compared to the culture-negative subjects. Moreover, histological appearances of the rectal biopsy specimens were not significantly different between the two groups. Twenty-eight (28.2%) patients agreed to the longitudinal study and all eradicated the parasite spontaneously within five months; none developed any evidence of invasive amebiasis.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Pathogenesis of peptic ulcer in rheumatoid arthritis.

To assess the pathogenesis of the gastro-duodenal mucosal lesions in rheumatoid arthritis, 36 patients, consisting of 23 (group I) receiving non-steroidal anti-inflammatory drugs (NSAIDs) and 13 (group II) on alternative forms of treatment, were examined by fibreoptic upper gastrointestinal endoscopy. Ten (43%) of 23 patients receiving NSAIDs showed mucosal damage in the form of erosions or a definite ulcer crater, compared to only one (8%) of 13 in group II (p less than 0.05). There was no correlation between the duration of illness and the incidence of mucosal lesions. These findings indicate that the high incidence of gastroduodenal mucosal abnormalities seen in rheumatoid arthritis is related to the use of NSAIDs and not to the underlying disease process.

Adult↗
PubMed1991

Pyoderma gangrenosum in ulcerative colitis.

We present a patient with pyoderma gangrenosum, a rare complication of ulcerative colitis. The patient's disease was limited to the distal colon, was clinically mild and responded quickly to treatment, and yet it was associated with pyoderma gangrenosum and arthritis, complications generally associated with more severe and extensive ulcerative colitis.

Abdominal Muscles↗
PubMed1991

Separate pancreatic and biliary ductal openings in alcoholic chronic pancreatitis.

Endoscopic retrograde cholangiopancreatograms of 49 patients with chronic pancreatitis (alcohol related 18; idiopathic 31) were assessed retrospectively. Thirteen (72%) of 18 patients with alcohol-related chronic pancreatitis had separate openings of the common bile duct and the main pancreatic duct into the duodenum. This was significantly more frequent (p less than 0.01) than in previously studied controls (37%). Although this finding was seen more frequently in patients with alcohol related chronic pancreatitis than in those with idiopathic chronic pancreatitis (14 of 31, 45%), the difference was not statistically significant. It is concluded that alcohol-related chronic pancreatitis, but not idiopathic chronic pancreatitis, is associated with the presence of separate openings of the common bile duct and main pancreatic duct into the duodenum.

Adolescent↗
PubMed1990

Development of carcinoma in chronic calcific pancreatitis.

Development of carcinomas of the pancreas over an underlying chronic pancreatitis is a rare event. Diminution of pancreatic calcification, following the development of carcinoma, has been previously reported only once. We report another such case.

Calcinosis↗
PubMed1990

Aspirin concurrently administered with ranitidine does not delay healing of duodenal ulcer.

Sixty-nine patients with endoscopically diagnosed duodenal ulcer were randomised to either Group I or Group II. Group I patients (n = 35) received tablet ranitidine 150 mg twice daily along with tablet aspirin 600 mg three times a day while Group II patients received only tablet ranitidine 150 mg twice daily. Eight patients (four in each group) dropped out of the trial but were included in the final analysis as failure of treatment. At the end of four weeks 51.4% ulcers healed in Group I compared to 58.8% in Group II. The difference between the two groups was not significant. There was also no statistical difference in the time required for relief of pain, number of patients relieved of pain and the complication rate. It is concluded that aspirin concurrently administered with ranitidine is safe and does not delay the healing of uncomplicated duodenal ulcers.

Adult↗