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Biomedical subjects

C M Pathak

Publications and source records attributed to C M Pathak.

15 recordsLinked to original sources

Thyroid functions in lithium-treated psychiatric patients: a cross-sectional study.

In the present cross-sectional study, thyroid functions (viz. thyroid radioiodine uptake [RAIU] and serum T3, T4, and thyroid-stimulating hormone [TSH]) were evaluated in 24 healthy controls and 132 outdoor affective disorder patients. Eleven of these patients were to receive lithium (Li) and the remaining 121 patients were at different stages of Li treatment ranging from 0.7 to 240 mo. RAIU was found to increase significantly throughout the Li therapy and was associated with the corresponding rise in TSH levels. In totality, Li treatment induced subclinical hypothyroidism in 51/132 (39%) of patients. However, 8/51 patients who belonged to known iodine-deficient belt had abnormally high TSH (range 15.2-76.0 microIU/mL), low T4 (5.3+/-2.5 microg/dL), and normal T3 and at least 4 of these 8 patients were clinically hypothyroid. T4 levels declined significantly (p < 0.05) with Li treatment ranging from 61 to 240 mo as compared to the corresponding values in the pre-Li group. The T3/T4 ratio was found to be significantly higher with Li treatment ranging from 0.7 to 6 mo in comparison with the pre-Li group and this value returned to base levels after long-term Li therapy. High T3 and T4 were observed in 13% and 12% of the patients, respectively, as compared to the corresponding control values.

Adolescent

[14C]-urea breath test to confirm eradication of Helicobacter pylori.

BACKGROUND: Treatment for Helicobacter pylori reduces ulcer recurrence. Eradication rates of the organism vary with different drug regimens from 30% to 90%. There is a need to identify patients who have failed treatment. [14C]-Urea breath test (UBT) is non-invasive, sensitive, safe and highly reliable test for diagnosis of H. pylori infection. As there is a paucity of reports on the utility of [14C]-UBT in confirming H. pylori eradication, this study was undertaken. METHODS: Thirty-eight patients (age 34 +/- 17 years, range 16-84 years, 27 men) with upper gastrointestinal symptoms underwent upper gastrointestinal endoscopy. Baseline H. pylori infection was diagnosed by identification of the organism on antral biopsies and positive rapid urease test (RUT). After 1 month of completion of treatment, repeat RUT and histological examination of antral endoscopic biopsies were performed. Eradication of H. pylori was defined as absence of the organism on histology, and negative RUT. The [14C]-UBT was performed using 185 kBq [14C]-urea dissolved in 300 mL water. Breath samples were collected once before ingestion of [14C]-urea, and subsequently at 5 and 15 min. Results were expressed as 14CO2/mmol CO2 exhaled as per cent of administered urea. RESULTS: Endoscopy revealed antral gastritis (n = 14), duodenal ulcer (n = 8), duodenitis (n = 2), oesophagitis (n = 1), antral gastritis and duodenal ulcer (n = 3), antral gastritis and duodenitis (n = 7) and normal upper gastrointestinal endoscopy (n = 3). All the 20 patients who were negative for H. pylori on RUT and histology, tested negative for H. pylori on [14C]-UBT. However, of 18 patients shown to have H. pylori infection on RUT and histology, 16 were positive for H. pylori on [14C]-UBT. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of [14C]-UBT were 100, 89, 91, 100 and 95% respectively. CONCLUSIONS: The [14C]-UBT is a reliable indicator of H. pylori eradication after treatment. It can obviate the need for antral biopsies to confirm eradication of H. pylori after completion of treatment.

Adult

Changes in rat alveolar macrophageal antioxidant defense and reactive oxygen species release by high dietary vitamin E.

For the past decade there has been emphasis on the immunomodulatory effects of vitamin E apart from its established role as a free radical scavenger. In alveolar macrophages (AMs), the role of vitamin E supplementation has not yet been investigated sufficiently. In the present study we have evaluated the effects of high vitamin E (DL-alpha-tocopheryl acetate, alpha-TA) supplementation for 10 d on rat-alveolar macrophageal antioxidant defense and reactive oxygen species (ROS) release. There was an increase in plasma vitamin E content from 5.22 +/- 1.30, at 50 mg to 12.23 +/- 1.06 and 22.32 +/- 2.02 micrograms/mL at 250 and 1,250 mg alpha-TA/kg dietary supplementation. Alveolar macrophage-vitamin E content enhanced by 56 to 75% at 250 and 1,250 mg alpha-TA diet as compared with control diet. Superoxide dismutase activity decreased and catalase and glutathione peroxidase activities increased significantly in AMs of 250 and 1,250 mg alpha-TA diet-fed rats. Reduced glutathione, total glutathione, and glutathione-S-transferase activity in AMs did not change significantly at any of the high doses of alpha-TA supplementation. On stimulation of AMs by phorbol-12-myristate-13-acetate (PMA), there was 2.8- and 3.5-fold enhancement in superoxide (O2-.) and H2O2 production, respectively, at 50 mg alpha-TA dose. But this increase by PMA could not take place in AMs from animals supplemented with 250 and 1,250 mg alpha-TA. It may therefore be concluded that high alpha-TA supplementation in diet may equip the AMs with a stronger defense against oxygen-free radical mediated damage to them.

Albuminuria

Evaluation of 14C-urinary excretion and its comparison with 14CO2 in breath after 14C-urea administration in Helicobacter pylori infection.

OBJECTIVES: 1) to estimate levels of 14C-urinary excretion in Helicobacter pylori-infected and noninfected patients after 14C-urea ingestion, 2) to compare 14C-urinary excretion and 14CO2 breath results with biopsy findings, and 3) to find out correlation between 14C-urinary excretion with 14CO2 breath results, if any. METHODS: Twenty-four-hour 14C-urinary excretion was measured in 26 patients of non-ulcer dyspepsia after oral administration of 5 microCi 14C-urea to each patient. One-mmol CO2 breath samples at baseline, 2, 5, 15, and 45 min were collected and 14C content measured. Four gastric biopsies were obtained endoscopically from each patient for histology, culture, Gram staining, and rapid urease test. RESULTS: 14C-urinary excretion in H. pylori-positive patients was 27.38 +/- 13.35% (mean +/- SD) as compared to 67.05 +/- 14.19% in H. pylori-negative patients. Five-, 15-, and 45-min 14CO2 breath values in H. pylori-positive cases were 0.07 +/- 0.041%, 0.063 +/- 0.041%, and 0.028 +/- 0.017% of administered 14C-urea/mmol CO2 exhaled, respectively, which were significantly higher (p < 0.001) from their corresponding values in negative cases. The 14C-urinary excretion data, when compared with biopsies results, discriminated well in 17 of the 18 H. pylori-positive cases, resulting in sensitivity of 94.4%, specificity 100%, and diagnostic accuracy 96.1%, whereas 15 min 14CO2 breath results were 100% accurate. Strong negative correlation between 14C-urinary excretions and 15 min 14CO2 breath was obtained (r = -0.717, p < 0.001). CONCLUSIONS: Measurement of 14C in 24-h urine and in 15-min breath sample may be employed as a cross confirmatory reliable technique for the detection of viable H. pylori colonization.

Adult

Serum gentamicin levels in traumatic paraplegics following intramuscular administration in non-paralyzed limbs.

Intramuscular administration of gentamicin in the paralyzed limb of subjects with spinal cord injury resulted in decreased maximum serum concentration, increased time to maximum serum concentration and decreased absorption rate constant. An investigation was, therefore, undertaken to study the serum gentamicin levels in paraplegics when it is administered intramuscularly in the non-paralyzed limb. Group 1 consisted of six male bed-ridden traumatic paraplegics with complete lesion at the level of T12-L1 and group 2 consisted of six healthy male adults. Following intramuscular administration of gentamicin (1.5 mg/kg) in deltoid muscle, blood samples were taken at 15, 30, 45, 60, 90 and 120 min for determination of serum gentamicin levels by solid-phase radioimmunoassay. Serum gentamicin levels at 15 min after drug administration were 2.2 +/- 0.78 micrograms/ml in group 1 and 4.81 +/- 0.94 micrograms/ml in group 2 (p less than 0.001); at 30 min, serum levels were 3.45 +/- 0.75 micrograms/ml in group 1 and 5.0 +/- 0.48 micrograms/ml in group 2 (p less than 0.01); at 45 min, serum gentamicin levels were 3.3 +/- 0.51 micrograms/ml in group 1 and 4.63 +/- 1.24 micrograms/ml in group 2 (p less than 0.05). There was no significant difference in serum gentamicin levels at 60, 90 and 120 min between the two groups. The maximum serum concentration was 3.8 +/- 0.56 micrograms/ml in group 1 and 5.43 +/- 0.94 micrograms/ml in group 2 (p less than 0.01). The area under the curves in groups 1 and 2 was 315 +/- 41.1 and 451.25 +/- 88.3, respectively (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Normal limits of 14C-urea breath test.

BACKGROUND/AIMS: 14C-urea breath test has been widely used for diagnosis of Helicobacter pylori (H. pylori) infection. There is no general agreement on the cutoff values for determination of H. pylori negative subjects. We studied baseline values in subjects who were proved to be H. pylori negative and calculated the cutoff value of normalcy. A comparison of this test with other tests for diagnosis of H. pylori infection was also done. PATIENTS AND METHODS: 12 patients (mean age 34 +/- 14, range 22-65 years; 8 men) of non-ulcer dyspepsia were studied, who were proved to be H. pylori negative by rapid urease test, Gram's staining, histopathology and culture of gastric mucosal biopsies obtained four each from the antrum, body and fundus of the stomach. The controls included 12 patients (mean age 40 +/- 13, range 22-65 years, 9 men), who were positive for H. pylori on culture or combination of rapid urease test and histopathology or rapid urease test and Gram's stain. 14C-urea breath test was performed using 5 uCi of 14C-urea dissolved in 300 ml of water. Breath samples were collected once before ingestion of 14C urea and subsequently at 5, 15 and 30 minutes after ingestion and 14C-contents in the breath samples measured. Results were expressed as 14 CO2/mmol CO2 exhaled as percent of administered urea. RESULTS: The mean +/- SD 14-C value in H. pylori negative vs H. pylori positive patients at 5 minutes, 15 minutes and 30 minutes were found to be 0.003 +/- 0.003 vs 0.064 +/- 0.042 (p < 0.001), 0.002 +/- 0.001 vs 0.056 +/- 0.039 (p < 0.001) and 0.001 +/- 0.002 vs 0.041 +/- 0.026 (p < 0.001) respectively. The mean values of 14C-urea breath test were significantly lower in H. pylori negative patients as compared to H. pylori positive patients. Using receiver operating characteristic (ROC) analysis of the data, the cutoff values obtained were 0.01, 0.007 and 0.009 at 5 minutes, 15 minutes and 30 minutes respectively. CONCLUSIONS: 14C-urea breath test levels at 5, 15 and 30 minutes intervals are significantly lower in H. pylori negative patients as compared to H. pylori positive patients. This test has high sensitivity and specificity in detecting H. pylori infection.

Adult