Circulatory collapse in a 30-year-old amenorrheic woman.
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Adult↗
Biomedical subjects
B Singh
Publications and source records attributed to B Singh.
Salbutamol inhalation for delivery of a retained second twin.
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Adult↗
Treatment of neonatal seizures with carbamazepine.
Carbamazepine has been used in adults and children for over 30 years. In spite of an excellent therapeutic and side-effect profile in older children, it has never been used as a primary anticonvulsant in neonates. This is the first report of the long-term use of carbamazepine in neonates. Ten full-term neonates with two or more seizures due to hypoxic-ischemic encephalopathy were given 10 mg/kg of carbamazepine as a loading dose via nasogastric tube. Twenty-four hours later, the first five patients began a maintenance regimen of 21 mg/kg/daily, and the remaining five patients began a maintenance regimen of 15 mg/kg/daily, all via nasogastric tube. Therapy was continued for 3 to 9 months. Drug levels were monitored every 2 to 4 hours during the first 24 hours, and on days 2, 4, 8, 15, 30, 45, and 60, and monthly thereafter. Absorption of carbamazepine was excellent even in sick neonates. Therapeutic levels were reached in 2 to 4 hours in all patients. Peak levels were achieved in 4 to 16 hours (mean, 9.2 +/- 4.2). Elimination half-life was 24.5 hours. Levels dropped precipitously around 8 to 15 days and thereafter declined slowly over the next 3 months. Seizure control was excellent; only two patients had one seizure each during the first 10 hours. There were no gastrointestinal, hepatic, hematologic, renal, or dermatologic side effects. This preliminary study shows that carbamazepine may be an effective anticonvulsant for neonatal seizures.
Carbamazepine↗
Interleukin-6 expression in cord blood of patients with clinical chorioamnionitis.
The objective of this study was to define whether IL-6 is an early marker of infection in the newborn. To correlate the occurrence of clinical chorioamnionitis with the levels of IL-6 expression in neonates, IL-6 was measured in cord plasma by ELISA and in mononuclear cells by reverse transcriptase-PCR before and after mitogenic stimulation. Eight neonates were included in each of the following four groups: elective cesarean section, uncomplicated normal spontaneous vaginal delivery, delivery after prolonged rupture of amniotic membranes with no evidence of chorioamnionitis, and delivery with evidence of chorioamnionitis. All 32 neonates were clinically well after delivery, and all 16 babies with prolonged rupture of membranes or clinical chorioamnionitis had negative blood cultures. Elevated IL-6 levels were found only in neonates born to mothers with chorioamnionitis (119.7 +/- 33.5 pg/mL versus 2.71 +/- 0.59 pg/mL, p < 0.005). Mononuclear cells from five of these neonates expressed no IL-6 mRNA in vivo despite elevated levels of IL-6 in their cord plasma. Cord blood mononuclear cells from healthy term babies were capable of synthesizing IL-6 in vitro in response to stimulation with bacterial lipopolysaccharide. These results suggest that IL-6 levels in cord plasma increased with clinical chorioamnionitis, despite the lack of evidence of infection in the neonates. Therefore, we conclude that, although a high level of IL-6 may be a good marker of chorioamnionitis, it may not be a specific marker of infection in the newborn.
Chorioamnionitis↗
Epidemiology of inclusion body hepatitis in poultry in northern India from 1990 to 1994.
The epidemiology of inclusion body hepatitis (IBH) was studied in poultry in northern India, from April 1990 to March 1994, to evaluate the various factors responsible for causing and determining the severity of the disease. Broiler chicks and Japanese quail (Coturnix coturnix japonica) were the species examined. The factor observed to be most commonly associated with IBH was the presence of aflatoxins in the feed at higher than permissible levels, i.e. 20 parts per billion. Avian adenovirus-1 was isolated from the livers of affected birds. In the final year of the study, a number of outbreaks of IBH caused heavy mortalities among three to five-week-old broiler chicks, which displayed typical IBH lesions in addition to hydropericardium.
Adenoviridae Infections↗
Endoscopic transthoracoscopic sympathectomy--the Durban experience.
Advances in optics, illumination and video-technology together with refinements in operative technique have made endoscopic transthoracoscopic sympathectomy (ETS) the method of choice for upper thoracic sympathectomy. Palmar hyperhidrosis is by far the main indication for ETS. The procedure is technically easy and well tolerated by patients, and complications are few and minor.
Adolescent↗
Primary gastric tuberculosis. A report of 3 cases.
Gastric tuberculosis is an uncommon clinical entity. Great difficulty is encountered in making the pre-operative diagnosis. Other chronic granulomatous conditions (Crohn's disease, sarcoidosis and isolated granulomatous gastritis) should always be considered. Surgery, with postoperative antituberculosis treatment, remains the main modality for accurate diagnosis and treatment.
Adult↗
Metastatic carcinoma in the neck from an occult primary lesion.
Over an 11-year period, from January 1980 to December 1990, 23 patients with metastatic carcinoma of the neck were admitted to Addington Hospital with an unknown primary lesion. More than 50% of patients presented with disease in the N3 nodal stage. Sixteen patients had squamous cell carcinoma, 6 undifferentiated carcinoma and 1 adenocarcinoma. The diagnoses were made by means of fine-needle aspiration cytology and histological assessment of the neck nodes. Twenty-one patients were treated with radiotherapy and 2 with surgery. The primary tumour became apparent in only 4 (17%) patients, 7, 8, 9, and 12 months respectively after initial presentation. The sites were the base of tongue in 2, the pyriform fossa in 1 and the scalp in the remaining patient. The overall 3-year and 5-year survival rates were 26% and 17% respectively.
Adenocarcinoma↗
Glutathione-glutathione reductase system and lipid peroxidation in Saccharomyces cerevisiae under alcohol stress.
The content of malondialdehyde (MDA) as well as diene conjugates increased in Saccharomyces cerevisiae under alcoholic conditions. These cells had lower content of water soluble antioxidant, i.e., glutathione. Ethanol-treated S. cerevisiae also exhibited lower activity of glutathione reductase (GR). The decrease in reduced glutathione (GSH) content cannot be attributed completely to lower GR activity. Not only the GSH content was lowered, but oxidized glutathione (GSSG) was also less in ethanol-treated yeast cells. The decrease in oxidized glutathione was much more (84%) as compared to that of reduced glutathione (40%).
Ethanol↗
Laparoscopic removal of intra-abdominal foreign body. An unusual case.
Laparoscopic retrieval of an intra-abdominal foreign body is described. This novel use of the laparoscope has not been described before.
Abdomen↗
Effect of diazepam sedation on arterial oxygen saturation during esophagogastroduodenoscopy: a placebo-controlled study.
OBJECTIVE: To determine the effect of sedation using diazepam on hemoglobin oxygen saturation (SpO2) in patients undergoing esophagogastroduodenoscopy (EGD). METHOD: 100 consecutive patients scheduled for EGD were randomly allocated to receive 0.03 mL/Kg of either diazepam (5 mg/mL solution) or normal saline intravenously after topical oropharyngeal anesthesia immediately before the procedure. SpO2 was continuously monitored throughout the procedure by an anesthetist who was unaware of the drug received. RESULTS: Fall in SpO2 exceeding 4% was noted in 78% of patients in the diazepam group and in 38% of patients in the placebo group (p < 0.001). Fall in SpO2 to suboptimal level (89%) was seen in 20% of patients in the diazepam group and in 10% patients in the placebo group (p < 0.001). The duration of suboptimal SpO2 was similar (means +/- SD being 2.47 +/- 0.10 min in diazepam group and 2.86 +/- 0.32 min in placebo group). CONCLUSION: Intravenous diazepam administration before EGD produces a significant fall in SpO2 during the procedure, and so should be avoided; continuous monitoring of SpO2 should be done during EGD.
Adult↗
Are sutured faucial pillars really an advantage in tonsillectomy?
A prospective study was undertaken in 40 patients to determine whether suturing of the faucial pillars has any effect in relieving pain and discomfort associated with tonsillectomy. The first 20 patients (5 adults and 15 children) had tonsillectomy without suturing of the faucial pillars. The next 20 patients (3 adults and 17 children) had the anterior and posterior faucial pillars approximated and sutured with 3.0 chromic catgut. Objective methods of evaluating pain and discomfort were undertaken immediately and 24 hours postoperatively. The pain and discomfort were the same in both groups. Adults experienced more pain than children, in both groups. Complications occurred in 3 patients, all belonging to the sutured group: 2 had palatal haematoma and 1 nasal regurgitation. Approximation of the faucial pillars to cover the raw tonsillar bed after tonsillectomy does not relieve pain. It is disadvantageous in that it produces complications and prolongs the anaesthetic time significantly. Therefore suturing of the faucial pillars is not recommended.
Adolescent↗
Dysphagia secondary to tuberculous lymphadenitis.
Oesophageal tuberculosis is a rare entity often pre-disposed to by caseating tuberculous mediastinal lymphadenopathy (TML). Although widely reported in children, TML is an under appreciated entity in adults; in this article dysphagia in an adult patient caused by TML is described.
Adult↗
Regulation of urokinase-type plasminogen activator expression by the v-mos oncogene.
We undertook a study to determine if the serine-threonine kinase-encoding v-mos oncogene regulated the expression of the urokinase-type plasminogen activator. An expression vector encoding v-mos, but not a kinase-inactive mutant, stimulated urokinase promoter activity in CAT assays employing a squamous cell carcinoma cell line. The induction of urokinase promoter activity by v-mos was mediated, in part, via an increased AP-1 activity since (a) mutation of 2 AP-1 binding sites (at -1967 and -1885), or the co-expression of a transactivation domain-lacking c-jun mutant reduced the induction of the urokinase promoter by v-mos and (b) expression of v-mos increased the activity of a CAT reporter driven by three AP-1 tandem repeats. The stimulation of the urokinase promoter by v-mos was partially countered by co-expression of an ERK1/ERK2-inactivating phosphatase. Western blotting and zymographic analysis indicated that v-mos-transformed NIH3T3 cells (MSV NIH-3T3) secreted more urokinase compared with NIH3T3 cells and this was associated with a higher level of activated ERK1 and ERK2. Expression of a catalytically-inactive MAPKK mutant reduced the activity of a urokinase promoter-driven CAT reporter in the MSV NIH-3T3 cells. In conclusion, the data herein indicate that urokinase expression is regulated by v-mos through a MAPKK-dependent signaling pathway.
3T3 Cells↗
Gonadotropin response to naloxone challenge in female and male psychotic patients: a pilot study.
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Adult↗
Gene expression and peptide localization for epidermal growth factor receptor and its ligands in porcine luteal cells.
The present study was undertaken to determine the expression of the genes for epidermal growth factor receptor (EGF-R), and two of its ligands, epidermal growth factor (EGF) and transforming growth factor-alpha (TGF-alpha) in isolated large (LLC) and small (SLC) porcine luteal cells by reverse transcription-polymerase chain reaction (RT-PCR), and to localize their peptides in whole corpora lutea (CL) as well in isolated LLC and SLC by immunocytochemistry. RT-PCR revealed strong cDNA signals for EGF-R and EGF in both LLC and SLC, and for TGF-alpha in LLC. The signal for TGF-alpha message in SLC was relatively weaker but detectable. Immunocytochemistry revealed intense EGF-R staining in LLC and SLC in both isolated and intact CL preparations. On the other hand, immunoreactive EGF and TGF-alpha appeared to be present only in LLC in intact CL sections, and isolated luteal cell preparations confirmed their presence in LLC and absence in SLC. These results suggest an autocrine/paracrine role for EGF and TGF-alpha in luteal functions.
Animals↗
Synthesis and antibacterial activity of some novel 1-substituted 1,4-dihydro-4-oxo-7-pyridinyl-3-quinolinecarboxylic acids. Potent antistaphylococcal agents.
The palladium-catalyzed coupling of 3- and 4-(trialkylstannyl)pyridines with 7-bromo or 7-chloro 1-substituted 1,4-dihydro-4-oxo-3-quinolinecarboxylates has provided access to the corresponding 1-substituted 1,4-dihydro-4-oxo-7-pyridinyl-3-quinolinecarboxylic acids. The antibacterial activity of these derivatives was studied with the finding that the optimal 1- and 7-position substituents for Gram positive activity are cyclopropyl and 4-(2,6-dimethylpyridinyl), respectively. We find that for the fluorine-substituted derivatives studied, the position of the fluorine on the quinolone nucleus or the number of fluorine atoms does not seem to be important for good Gram positive activity. For 1-cyclopropyl 7-(2,6-dimethyl-4-pyridinyl) derivatives, the 6-fluoro 4a, 8-fluoro 10d, 6,8-difluoro 10b, and 5,6,8-trifluoro 8, all provided equal antibacterial activity against Staphylococcus aureus ATCC 29213. There is also a correlation between the substitution on the 7-(4-pyridinyl) group and the Gram positive activity, particularly for S. aureus, clearly indicating that the 2,6-dimethylpyridinyl group is optimal. The MIC50 value for the most potent agents in this study against S. aureus ATCC 29213 is 0.008 microgram/mL. By comparison, ciprofloxacin and aminopyrrolidine 28 gave values of 0.25 and 0.015 microgram/mL, respectively, against this organism.
Anti-Bacterial Agents↗