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Biomedical subjects

D Chowdhury

Publications and source records attributed to D Chowdhury.

40 records · Page 3Linked to original sources

Couple-friendly services in a metropolitan sexually transmitted disease clinic: views of clients and providers.

CONTEXT: Clients making clinic visits related to reproductive health might benefit from participation with their partner. There is little information available, however, on whether either clients themselves or clinic staff would feel comfortable with such a possibility. METHODS: The Multnomah County Health Department Sexually Transmitted Disease Clinic in Portland, Oregon, conducted a survey of 237 new clients in June 1994 to assess clients' and providers' responses to the idea of offering couple visits. RESULTS: Twenty-six percent of female clients and 16% of male clients were accompanied by their partner on their visit to the clinic. Eighty-seven percent of all clients favored the clinic's offering couple visits, 5% opposed the concept and 8% were undecided. Fifty-four percent would have wanted their partner to be with them during their present visit if this choice had been offered, and 62% would want their partner to join them in follow-up couple visits if this were recommended by their provider. Seventy-one percent had already discussed with their partner the reason for their immediate clinic visit, and 88% expected to discuss the visit with their partner afterward. Attitudes toward couple services were similar for male and female clients and did not vary by race or ethnicity. For more than one-fifth of clients, clinic staff reported that they would not recommend couple visits; however, many of these clients reported that they would prefer being accompanied by their partner. CONCLUSIONS: Appropriately designed couple-friendly options are likely to be generally accepted and moderately utilized by clients of varying backgrounds. Clinic staff may be more reluctant to involve clients' partners than the clients are themselves, however.

Adolescent↗

Gastro-duodenal mucosal changes associated with low-dose aspirin therapy: a prospective, endoscopic study.

OBJECTIVES: The association of low-dose aspirin use and gastro-intestinal bleeding is well described. However, the gastroduodenal mucosal changes associated with low-dose aspirin therapy have not been properly evaluated. We undertook a prospective, endoscopic study to evaluate gastro-duodenal mucosal lesions produced by low-dose aspirin. METHODS: Forty-seven patients with non-hemorrhagic cerebral infarct or transient ischemic attacks and normal upper gastrointestinal endoscopy were randomized to receive either enteric-coated (n=25) or plain (n=22) aspirin (150 mg/day). Follow-up endoscopy was done at 2, 4 and 8 weeks; gastro-duodenal mucosal lesions, if present, were scored. Forty-seven patients with hemorrhagic infarct who were not treated with aspirin served as controls. RESULTS: Twenty eight (60%) of 47 patients receiving aspirin had mucosal lesions; stomach alone was the most frequent site (32%), followed by both stomach and duodenum (23%). Frequency of mucosal changes in the stomach at 8 weeks (19%) was significantly lower (p<0.05) than those at 2 weeks (53%) and 4 weeks (55%). Coated (56%) and plain (63.6%) aspirin induced mucosal lesions with similar frequency. CONCLUSION: Administration of low-dose aspirin, either plain or enteric-coated, induces endoscopic gastro-duodenal mucosal lesions in a large majority of patients. The frequency of damage decreased after 8 weeks of therapy.

Adult↗

Vitamin B12 deficiency: a clinical and electrophysiological profile.

OBJECTIVE: The present study was conducted to evaluate the clinical and electrophysiological profile of vitamin B12 deficiency syndrome and whether a correlation exists between the disease process and the various electrophysiological parameters. METHODS: 40 patients with vitamin B12 deficiency neurological syndromes with low serum vitamin B12 and high homocysteine levels were subjected to a detailed motor and sensory nerve conduction studies and pattern reversal VER (P100), SSEP (P37) after stimulation of the posterior tibial nerve and median nerve (N 20) were obtained bilaterally. MR cervical spine was done in all the patients and MR brain in those who presented with neuro-psychiatric symptoms. The patients were followed up at three months, six months and one year after treatment. RESULTS: On the basis of clinico-electrophysiological profile, 31 patients had myeloneuropathy, 5 isolated myelopathy, 4 isolated neuropathy. Four of the patients with myeloneuropathy, had concomitant dementia. MR imaging revealed abnormality in 12.5% of cases. Prolongation of P37 latency was observed in 39 (97.5%) patients, N 20 latency in 22 (55%), and P100 latency in 19 (47.5%) patients. Peripheral neuropathy was seen in 18 patients; optic neuropathy in 8; and combination of peripheral and optic neuropathy in 9 patients. The peripheral neuropathy was axonal in 19, and demyelinating in 6 patients. There was a significant correlation of the duration of the disease with N 20 latency (P < 0.04). Serum vitamin B12 level correlated well with the latencies of P37 (P < 0.005) and sural SNAP (P < 0.006). On treatment, normalization of P100, MRI signal, N 20 and partial recovery of P37 latencies was seen at 6 months, 9 months and one year respectively. CONCLUSION: Differential recovery of central and peripheral syndromes was seen. This correlated with the underlying demyelinating and axonal processes, which was well reflected by the electrophysiological studies, and has an important bearing on the outcome.

Adolescent↗

Intravenous thrombolytic therapy in unstable angina.

One hundred consecutive age and sex-matched patients of 3 different subsets of unstable angina (recent onset angina -65, crescendo angina -20, post-infarct angina-15) were randomized 1:1 after coronary angiography to receive I.V., either 1.5 x 10(6) units of streptokinase (SK) in 200 ml of normal saline or 200 ml of normal saline alone (control) in 1 hour. Repeat angiography was done in those patients having intra-coronary thrombi (37.3%) during the initial angiography. Both groups received optimal doses of heparin followed by warfarin, aspirin and other standard drugs and were followed up for 6 months. Anginal pain subsided significantly in the SK group-41 (82%) vs 25 (50%) (P < 0.005), especially in patients with recent onset angina (92.5% vs 60%, P < 0.005). Incidence of acute myocardial infarction (AMI) was much less in the SKgp (4(8%) vs 17 (34%) (p < 0.05). Four cases of fatal MI and four cases of sudden cardiac death (SCD) occurred in the control group against none in the SKgp. Requirements of mechanical revascularization was significantly less (P < 0.05) in the SK gp. Angiographic evidence of partial or complete clot lysis was noted in 90% of SK gp. vs 4.8% of control (P < 0.01). Echocardiographically assessed LV function improved significantly with SK-therapy in recent onset (P < 0.05) and crescendo angina (P < 0.001) subsets--however, the improvements in post infarct angina subset were not statistically significant. The beneficial outcome with SK therapy was observed in patients irrespective of angiographic evidence of thrombi.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗