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Biomedical subjects

B S Das

Publications and source records attributed to B S Das.

At least 19 recordsLinked to original sources

Altered plasma lipid pattern in falciparum malaria.

Plasma levels of HDL, LDL, total cholesterol and triglycerides were measured in 60 patients with falciparum malaria (37 severe cases and 23 mild) and in 83 healthy individuals, to study malaria-induced changes in plasma lipids. Triglyceride levels were lower in the patients than in the controls but the difference was significant only for those with severe malaria (P < 0.001). In contrast, the levels of all the other plasma lipids were significantly higher (P < 0.001) in those with severe malaria than in those with mild malaria, and in the mild malaria cases compared with the controls. Initially LDL cholesterol was estimated by the Friedwald formula, but this gave negative values in a few cases of severe malaria. Plasma lipoproteins were therefore also measured by nephelometry; the estimated levels of S particles, corresponding to LDL, were then found to be lower in all malaria cases than in the controls (P < 0.001) but never negative. Interestingly, levels of L particles in the patients with severe malaria were significantly elevated compared with the other patients and controls (P < 0.001), indicating impaired metabolism of chylomicrons. Plasma albumin, considered a negative acute phase protein (i.e. its level decreases as a consequence of the acute phase response), was reduced significantly and was directly correlated to HDL cholesterol levels (r = 0.715 and r = 0.895, respectively) in both mild and severe malaria. Follow-up of 22 of the severe malaria cases three weeks after treatment indicated that, while triglycerides had returned to similar levels to those in the controls, total cholesterol levels were still elevated and could give misleading results if lipid profiles were used, immediately after malaria infection, to assess an individual's risk of developing atherosclerosis.

Cholesterol

Hepatic changes in P. falciparum malaria.

Liver function tests were performed in 165 hospitalized patients suffering from P. falciparum malaria with complications. Serum bilirubin was found increased in 33 patients, and 22 of them had unconjugated hyperbilirubinaemia. Serum alanine aminotransferase was increased in 5 patients, but only to mild to moderate levels. Serum alkaline phosphatase was increased in 11 patients, gamma-glutamyl transpeptidase in 3 patients. Serum total protein and albumin were significantly decreased but these were considered more as indicator of acute phase response. Liver cell necrosis was observed in one patient, and oedema and mononuclear cell infiltration in two patients. Though hepatomegaly and mild elevation of enzymes can be observed in a significant proportion of patients, involvement of liver leading to acute hepatitis or liver cell necrosis is a relatively uncommon complication in P. falciparum malaria.

Adolescent

Influence of serum albumin & total protein on fructosamine measurement.

To assess the effect of serum albumin and total protein on the fructosamine level 57 hypoalbuminaemic patients (serum albumin less than 30 g/1), of whom 44 were nondiabetics and 13 were diabetics, were studied. Fructosamine levels of hypoalbuminaemic diabetics was increased only marginally in comparison to healthy controls (P greater than 0.05) whereas in 122 other normalbuminaemic diabetics, the level was found to be significantly higher (P less than 0.001). In control subjects, the correlation between fructosamine and serum albumin (r = 0.69, P less than 0.001) was better than that of total protein (r = 0.42, P less than 0.01) whereas in hypoalbuminaemic patients the pattern was reversed (r = 0.51 and 0.59 respectively), indicating substantial contribution by the globulins. A working formula suggesting approximate contribution of each gram of albumin and globulin in healthy subjects was calculated. It is inferred that the use of serum fructosamine for assessment of glycaemic status could be misleading in patients with lower albumin values. Calculating serum fructosamine values from serum albumin alone in these patients is likely to be inaccurate, as it ignores the contribution of globulins which can be substantial in certain disease conditions. A gross idea regarding the glycaemic status can be obtained by comparing actual and calculated values of fructosamine from the formula.

Analysis of Variance

Incidence of hypoglycaemia in children with severe Plasmodium falciparum malaria around Rourkela, Orissa state.

To determine the incidence of hypoglycaemia in children suffering from severe falciparum malaria, 23 patients from Rourkela (Orissa), were investigated. Plasma glucose and immunoreactive insulin were estimated before and at hourly intervals during quinine infusion. No child had hypoglycaemia at the time of admission. Correlation between parasite count and prequinine plasma glucose was not significant. In the period of quinine infusion, 20 patients showed fall in plasma glucose during all the three hours (P less than 0.05, P less than 0.01, P less than 0.01 at the end of 1st, 2nd, and 3rd h respectively) but the decrease to hypoglycaemic level (plasma glucose less than or equal to 40 mg/dl) was observed in only one child. Concomitant increase in plasma insulin was noticed in 18 of these patients. Decrease in plasma glucose and increase in plasma insulin was found to correlate well (r-0.78, P less than 0.001). Hypoglycaemia was found to be an infrequent complication of severe falciparum malaria in children from the area studied. Though decrease in plasma glucose was observed after quinine infusion, it was less severe and did not reach the hypoglycaemic level.

Blood Glucose

Homozygous familial hypercholesterolaemia. Report of three cases.

Homozygous familial hypercholesterolaemia is a rare disorder encountered in one in a million in the general population. Case reports of three patients from two families are presented. A 25 year male presented with extensive myocardial infarction and had a fatal outcome. His younger brother (14 years), as also a 12 year girl from another family with multiple planar xanthomata and tuberose xanthomata, are presented.

Adolescent

Exophytic gliomas of the spinal cord.

Intradural extramedullary glial tumours of the spinal cord are rare. We report for such tumours arising from the dorsal cord. Myelography and operative findings were almost similar to that of an intradural neurofibroma. Surgical removal had resulted in rewarding neurological recovery. One of them had a recurrence after six years and was re-explored. Anterolateral attachment near the root entry zone suggests its origin probably from the spinal cord with an exophytic growth.

Adult

Prognosis in traumatic intraventricular haemorrhage.

Traumatic intraventricular haemorrhage (TVH) is rare. The clinical profile and prognosis in 16 patients with traumatic intraventricular haemorrhage after blunt head injury are evaluated. Majority of the patients (94%) had low Glasgow coma score (less than 8) on admission and none had a lucid interval. CT showed haematoma adjacent to the foramen of Monroe in 5 patients and localised to the frontal horn or the body of the lateral ventricle in six. The mortality was 62.5% in this subgroup of patients with head injury. Our findings are compared to those of previous reports in the literature. The poor prognosis of cases with TVH reflects the severity of trauma and general brain damage and is probably not related only to the intraventricular bleeding.

Adolescent

Mesencephalic haematoma, successful surgical evacuation. Case report.

A case of mesencephalic haematoma is reported. Emergency surgical evacuation of haematoma was done. The patient improved and has done well for five years. Subtemporal and infratentorial supracerebellar approaches have been used earlier to remove mesencephalic haematoma. It is possible to remove caudal midbrain haematoma via a IVth ventricular approach causing minimal damage.

Brain Neoplasms

Increased plasma lipid peroxidation in riboflavin-deficient, malaria-infected children.

Plasma lipid peroxides were measured as malonyldialdehyde (MDA) by the thiobarbituric acid (TBA) method in 75 children suffering from Plasmodium falciparum malaria. Their riboflavin status was assessed by measuring erythrocyte glutathione reductase activation coefficients (EGRACs), and values greater than 1.40 were regarded as indicating biochemical deficiency. Plasma MDA was higher (p less than 0.001) in patients than in control subjects; the concentrations were 3.65 +/- 0.70 and 1.77 +/- 0.45 mumol/L (means +/- SD), respectively. The riboflavin-deficient group had higher plasma MDA values (3.98 +/- 0.70 mumol/L) than did the nondeficient group (3.30 +/- 0.68 mumol/L, p less than 0.001). Plasma MDA concentrations correlated with EGRACs (r = 0.46, p less than 0.01) in the patients. It is proposed that riboflavin deficiency restricts regeneration of reduced glutathione making the parasitized erythrocytes more vulnerable to destructive lipid peroxidation and increasing plasma lipid hydroperoxides.

Animals

Recurrences in meningioma after surgery.

123 cases of meningioma operated upon between 1975 and 1984 were reviewed. There were 13 cases of symptomatic tumour recurrence and 15 cases of tumour progression. Both, recurrence and progression of the tumour were seen twice as often in males. They were not related to any particular age group or site of origin. Recurrence was more common in the angioblastic type of meningioma. In the majority, progression of the tumour was seen within two years of the initial operation, while recurrence of the tumour was distributed evenly over time.

Adolescent

Prognosis in traumatic basal ganglia haematoma.

Twenty two patients with traumatic basal ganglia haematoma were studied. The mean Glasgow Coma Score on admission was 7. 17 patients had sustained high acceleration/deceleration injuries. The location and size of haematoma did not correlate with prognosis. Outcome was poor in 7 patients, while 8 patients died.

Adolescent

Intramedullary cysticercosis.

We are reporting two cases of intramedullary cysticercus cysts. Both patients presented with a clinical picture of progressive cord compression. One of them also had bilateral radicular pain. In the female patient the symptoms became exaggerated during her two consecutive pregnancies which is a rare and interesting observation. Excision of cyst resulted in significant improvement in both the patients.

Adult

Progressive unilateral hydrocephalus in adults.

Unilateral dilatation of the lateral ventricle in adults is rare. We report 2 cases of unilateral hydrocephalus with obstruction at the foramen of Monro. Both patients presented with symptoms of raised intracranial pressure.

Adult

Paraganglioma of the orbit with extension to the middle cranial fossa: case report.

Intraorbital paragangliomas are rare. A case of intraorbital paraganglioma with extension to the middle cranial fossa is reported. Progressive throbbing, hemicranial headaches, unilateral proptosis, and visual failure are the presenting symptoms. The computed tomographic and operative findings suggested a meningioma. Surgical removal of the tumor resulted in total relief of symptoms and recovery of vision. The pathogenesis and pathological findings are discussed.

Adult

Calvarial tuberculosis: a report of two cases.

Two cases of calvarial tuberculosis associated with neurological involvement are presented. The radiological features and therapeutic management are discussed and the literature is reviewed.

Child