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Biomedical subjects

D R Patel

Publications and source records attributed to D R Patel.

48 records · Page 3Linked to original sources

T lymphocyte subsets and antilymphocyte antibodies in lupus nephritis.

T lymphocyte subsets were determined in 12 patients with untreated systemic lupus erythematosus (SLE) and in 14 healthy controls. Six out of 8 (75%) patients with lupus nephritis had reduction in the percentage of T helper cells and low helper: suppressor cell ratios compared with controls. None of the 4 patients without nephritis had low ratios. Cold-reactive anti-lymphocyte antibodies cytotoxic to both the helper and the suppressor cells were detected in 7 of the 8 patients who had nephritis. Low T helper: suppressor cell ratio in SLE seems to correlate with the presence of active nephritis.

Adult↗

Smoking and children.

Tobacco use by children and adolescents is a major health threat. A number of carcinogens and other harmful compounds have been identified in tobacco smoke. The major component, nicotine, is highly addictive. In India, approximately 5500 children and adolescents start using tobacco products daily, some as young as 10 years old. The majority of users have first tried tobacco prior to age 18. Children and adolescents are exposed to the harmful effects of nicotine from smoking or second hand smoke from others; and from use of smokeless tobacco. There is increased prevalence of respiratory disease, ear and sinus infections, asthma, oral disease, and many long-term complications such as cardiovascular disease and cancers due to tobacco use. Prevention and treatment strategies include behavioural approaches and pharmacotherapy. There is an increased urgency especially, for countries like India to address the problem of tobacco use by children and adolescents as the tobacco industry faces legal and public opinion obstacles in Western countries like United States. The medical practitioner can play an important role by implementing the preventive and treatment strategies in his or her practice.

Adolescent↗

Substance abuse: a pediatric concern.

Use of alcohol, tobacco, and other drugs is a worldwide problem and affects many children and adolescents. The use of opiates, cannabis, tobacco, and alcohol have been well recognized for centuries in India. Abuse of alcohol is widespread in college campuses. In the United States, in 1997, 54.3% of high-school students had used an illicit drug by the time they entered 12th grade. In India the use of drugs and alcohol within the context of religious beliefs and local traditions has been historically documented. Children & adolescents are exposed to alcohol, cannabis products, and tobacco product. Several risk factors and protective factors have been identified. A screening psychosocial history is the most useful tool to identify non-specific indicators of substance abuse. In India the use of pan masala, and home brewed products containing marijuana and alcohol have special significance. Pan masala is shown to have carcinogenic, genotoxic, and clastogenic properties. The pediatrician can play a vital role in the appropriate recognition and early referral.

Child↗

Medical evaluation of child abuse.

Child abuse is a world-wide problem and has existed in all societies and cultures in various forms since ancient times. Intrafamilial physical and sexual abuse is well recognized in United States and other western countries. In countries like India there is a general lack of sensitivity to the issue among professionals and the lay public alike. The pressing issues of poverty, malnutrition, and infectious diseases take priority on resource allocation. Although some of the methods of child rearing and discipline may be culturally sanctioned and inherent, it does not necessarily mean they are harmless. In this paper the authors present clinical signs and symptoms of physical and sexual abuse which occur in the intrafamilial context and are of direct relevance to the medical practitioner.

Child↗

Eating disorders.

Anorexia nervosa and bulimia nervosa are primarily psychiatric disorders characterized by severe disturbances of eating behaviour. Anorexia nervosa has been well documented in pre-pubertal children. Eating disorders are most prevalent in the Western cultures where food is in abundance and for females attractiveness is equated with thinness. Eating disorders are rare in countries like India. As Western sociocultural ideals become more widespread one may expect to see an increase in number of cases of eating disorders in non-Western societies. Etiological theories suggest a complex interaction among psychological, sociocultural, and biological factors. Patients with anorexia nervosa manifest weight loss, fear of becoming fat, and disturbances in how they experience their body weight and shape. Patients with bulimia nervosa present with recurrent episodes of binge eating and inappropriate methods of weight control such as self-induced vomiting, and abuse of diuretics and laxatives. Major complications of eating disorders include severe fluid and electrolyte disturbances and cardiac arrhythmias. The most common cause of death in anorexia nervosa is suicide. Management requires a team approach in which different professionals work together. Individual and family psychotherapy are effective in patients with anorexia nervosa and cognitive-behavioral therapy is effective in bulimia nervosa. Pharmacotherapy is not universally effective by itself. Patients with eating disorders suffer a chronic course of illness. The pediatrician plays important role in early diagnosis, management of medical complications, and psychological support to the patient and the family.

Adolescent↗

Encopresis.

Encopresis is fecal soiling associated with functional constipation in a child. Constipation and encopresis are common problems in children. Encopresis is most common between ages 3 and 7 years. Infants and pre-school children present with a history of constipation and withholding maneuvers. The school-age child may have constipation and fecal soiling for some time prior to detection. In some children encopresis is associated with enuresis and urinary tract infection. Family education is the essential first step in management, followed by disimpaction of stool and complete evacuation of the rectum. Reaccumulation of stool should be prevented by appropriate use of laxatives and stool softeners. This is followed by a gradual weaning of the laxative regimen and instituting toilet training. Relapses may occur. Up to 50-60% of children achieve acceptable bowel control, free of soiling, within a year.

Age Factors↗