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Biomedical subjects

G Bhatia

Publications and source records attributed to G Bhatia.

At least 19 recordsLinked to original sources
PubMed1998

Public health interventions to encourage TB class A/B1/B2 immigrants to present for TB screening.

From 1985 to 1995 the proportion of all Santa Clara County, California (SCC), tuberculosis (TB) cases among recent immigrants climbed 73% (137 to 237). In SCC the efficient and cost-effective means encouraging TB Class A/B1/B2 immigrants (TBIMs) to present for TB screening and the prevalence of active TB among them were never investigated. We studied all TBIMs entering SCC from October 1, 1995 to June 30, 1996, notified to SCC by the CDC's Division of Quarantine (DQ). Encouraging TBIMs to seek TB screening, we sent letters to them promptly on the DQ notification, followed sequentially by phone calls and home visits. We determined the outcome of screening and its cost. We screened 314 of 323 (97.2%) TBIMs including 79 of 323 TBIMs who presented prior to interventions, 213 of 314 (87.3%) who responded to letters, 17 (7%) to phone calls, and 5 (2%) to home visits. Of 283 TBIMs screened 16 (5.7%) had active TB. To locate one TBIM cost $9.90 by letter, $43.25 by phone, and $129.88 by home visit. Locating one TB case cost $175.88 by letter, $696.26 by phone call. The prevalence of active TB in TBIMs is high. Our interventions resulted in low-cost TB screening and high-yield identification of active TB cases. We recommended that health departments develop a system for encouraging TBIMs to present for prompt TB screening.

California↗
PubMed1997

Echinococcus.

Echinococcosis (hydatid disease) is a zoonotic infection of human beings caused by the postlarval metacestode stage of the dog tapeworm, Echinococcus. Hydatid disease is more frequently the result of infection by Echinococcus granulosus and E. multilocularis species, which are more widely prevalent geographically than E. vogeli and E. oligarthus. The epidemiology, biology, and host-parasite relationships of echinococcal infection are discussed, and the clinical consequences of human infection are reviewed with particular emphasis on the pulmonary manifestations of the disease. The utility of serological and radiological techniques in diagnosis and management are reviewed. The efficacy of medical therapy and its relationship to the role of surgical intervention in the management of unilocular (cystic) and multilocular (alveolar) hydatid disease is discussed. Finally, the successes and failures of public health programs to control this zoonosis are noted.

Animals↗
PubMed1996

The voluntary community health movement in India: a strengths, weaknesses, opportunities, and threats (SWOT) analysis.

There has been a prolific growth of voluntary organizations in India since independence in 1947. One of the major areas of this growth has been in the field of community health. The purpose of this article is to historically trace the voluntary movement in community health in India, analyze the current status, and predict future trends of voluntary efforts. A review of the literature in the form of a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis was the method of this study. Some of the key trends which emerged as the priority areas for progress and for strengthening voluntary organizations in the future were enhancing linkages between health and development; building upon collective force; greater utilization of participatory training; establishing egalitarian and effectual linkages for decision making at the international level; developing self-reliant community-based models; and the need for attaining holistic empowerment at individual, organizational, and community levels through "duty consciousness" as opposed to merely asking for rights.

Community Health Services↗
PubMed1996

Management of the obstetric patient with tuberculosis.

Tuberculosis in obstetric patients presents a challenging nursing problem to facilities caring for populations at high risk: the economically disadvantaged, minorities, the foreign-born, and patients with human immunodeficiency virus. Coordination of public health, outpatient, and inpatient services is essential for obtaining the desired outcome of a healthy family unit with a minimum of interruption of the attachment process. This article presents issues related to nursing care and medical management of tuberculosis in the perinatal period.

Adult↗
PubMed1995

Assessment of mass properties of human head using various three-dimensional imaging modalities.

Better methods are needed to analyse personal protective devices, such as helmets or facemasks, before they are used in practice. Software tools to quantify three-dimensional craniofacial mass properties are developed to improve our understanding of craniofacial impact biomechanics, supplement existing knowledge of osseous structure and provide a comprehensive description of human head morphology. The application of state-of-the-art imaging systems, solid modelling and other software tools are studied to determine the associated errors in mass property estimation by spiral computed tomography, three-dimensional magnetic resonance and optical surface scanning using phantoms and cadaver head studies. Volume, centre of gravity and principal moments of inertia are determined from solid mathematical models for each scanning modality. Landmark-based registration is used to register scans of the same object obtained from the three imaging modalities to a common reference co-ordinate system. Physically and analytically determined mass properties are used as the standard for truth. Although this comparative study does not lend itself to statistical analysis owing to the small sample size, results indicate that any of the three imaging modalities can be used to predict mass properties within the uncertainty of existing methods. Applying these techniques in vivo is practical and feasible.

Cephalometry↗
PubMed1995

Anthropometric optical surface imaging system repeatability, precision, and validation.

Disciplines using human body surface dimensions require accurate, repeatable measurements. This study presents a design for the analysis of repeatability, precision, and validation of a new anthropometric device. This model enables estimation of the proportion of the total variation attributable to each level of data collection. This model is applied to an analysis of repeatability, precision, and validation of the Cencit Imaging System, a new optical surface scanner. Twenty-seven facial landmarks were marked on 10 men and 10 women at two measurement sessions. Two images were scanned during each session, and each image was digitized twice. The Cencit Imaging System results were compared with a previously validated digitizer. The Cencit Imaging System was found to produce accurate, highly repeatable images. Much of the error in this study is attributable to human error in marking landmarks on the subjects. The new imaging system will prove useful in a variety of anthropometric applications.

Anthropometry↗
PubMed1995

Validation of spiral CT and optical surface scanning for lower limb stump volumetry.

Spiral X-ray Computed Tomography (SXCT), Optical Surface Scanning (OSS), and hydrostatic weighing methods were used to measure stump volume of trans-tibial amputees. The precision and accuracy of these methods were assessed in a validation study. A repeated measures analysis of variance statistical design was employed that required each participant to be measured (scanned) twice at each of two separate measurement sessions. For OSS and SXCT, each scan was segmented twice to determine intra-observer error. Plaster cast replicas of subject stumps were formed by certified prosthetists to serve as a reference standard. Accuracy (bias) of SXCT and OSS was determined by comparison to volumetry by hydrostatic weighing. Ten trans-tibial amputees were recruited for this study and nine completed both sessions. Plaster replica measurement precision error relative to the mean was found to be less than 1% for all modalities. The precision was slightly inferior on subjects, 1.1% and 2.2% error for hydrostatic weighting and OSS respectively, due to patient instability during measurement, but was better with SXCT where the subjects' stumps were stabilized during scan acquisition. The OSS and SXCT methods offer advantages over hydrostatic weighing and other volumetry methods since the volume data are represented digitally and can be analyzed in multiple ways. SXCT enables study of the stump and its internal tissues with the prosthesis in place. It was found that SXCT is comparable to hydrostatic weighing in both precision and accuracy. While OSS had a high precision and reproducibility, it was found to have an associated bias.

Adult↗
PubMed1994

Quantification of facial surface change using a structured light scanner.

Three-dimensional surface changes that accompany facial surgical procedures were measured noninvasively and evaluated quantitatively. An optical three-dimensional surface scanner with 360-degree surface coverage of a subject's head and a subsecond data acquisition was used. The scanner employs six pairs of "white light" pattern projectors and digital TV cameras. A noncontact optical method to quantify facial surface morphology and objectively assess change resulting from reconstructive or cosmetic plastic surgery has been developed. This quantification technique was implemented and tested with the three-dimensional range scanner. This technique defines the entire surface of the head and face, as opposed to the conventional manual method of measuring surface points or facial landmarks. The method allows facial volume change assessment. The method was tested by repeatedly scanning a volunteer who was injected subcutaneously with known volumes of anesthetic solution. The measured and injected volumes were compared and showed little difference.

Computer Graphics↗
PubMed1993

Quantitative three-dimensional assessment of face-lift with an optical facial surface scanner.

Three-dimensional computed tomographic scan images of facial deformities provide information that has been useful in planning and evaluating therapy. However, the benefits of computed tomographic imaging in cosmetic plastic surgery are often insufficient to justify exposing the patient to radiation. This report describes application of an optical, noncontact, three-dimensional surface digitizer with subsecond scanning time for 360-degree examination of the human head. The resultant three-dimensional surface data are suitable for computer graphics display and manipulation, and for noncontact skin surface measurement. The scanner provides accurate and complete coverage of complex facial surfaces. This system was applied to digitization of the human head in the planning and evaluation of facial plastic surgery. The results indicate that the resulting image is accurate enough to detect subtle dimensional changes resulting from surgery, including postoperative edema and surface changes due to face-lift. This type of scanning can assist in a number of tasks performed by plastic surgeons, including collecting anthropomorphic measurements, preoperative and postoperative assessment, volume monitoring, customizing of implants, and interactive planning.

Algorithms↗
PubMed1993

Rural health care.

A critical shortage of primary care physicians exists in many rural areas of the United States. Similarly, rural residents are often far from hospitals. These situations have sparked the development of far-reaching programs designed by the federal government and private foundations, along with medical schools, state and local government, physicians, and local volunteers.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1992

Prevalence of measles antibodies in adults with HIV infection: possible risk factors of measles seronegativity.

OBJECTIVES: To determine the prevalence of measles (rubeola) immunity in a group of HIV-1-infected adults and to examine predictors of measles seronegativity in this population. SETTING: County hospital outpatient clinic and public-health department early HIV intervention clinic. PATIENTS: A total of 262 HIV-infected adults presenting to outpatient clinics between September 1990 and January 1991. INTERVENTIONS: Patients were screened for the presence of measles immunoglobulin G antibody, as measured by an enzyme-linked immunosorbent assay (ELISA). Pertinent clinical and immunologic information was recorded. Univariate and multivariate analyses were performed to identify possible risk factors for measles seronegativity. MAIN OUTCOME MEASURE: Measles seronegativity, as defined by a lack of detectable antibody (ELISA predicted index value < 1.0). RESULTS: Thirteen (5%) patients lacked serologic evidence of immunity. Risk factors for measles seronegativity included year of birth in 1957 or later, Caucasian (non-Hispanic) race and oral hairy leukoplakia. Factors associated with progressive HIV disease (other than hairy leukoplakia) were not associated with a lack of existing immunity. CONCLUSIONS: A high prevalence (95%) of measles antibody was found in this large group of HIV-infected adults. Young, white individuals born in 1957 or later were at the greatest risk for measles seronegativity, but declining immunity due to progressive HIV infection did not appear to be associated with a lack of antibody. Self-reported histories of measles infection or immunization were not reliable predictors of measles immunity.

AIDS-Related Opportunistic Infections↗
PubMed1992

The Indian langur: preliminary report of a new nonhuman primate host for visceral leishmaniasis.

Described are the susceptibility of the Indian langur (Presbytis entellus) to Leishmania donovani and the consequent haematological and serum biochemical changes. The host response to antileishmanial chemotherapy and the immunological profile were also examined. Each langur was inoculated intravenously with 1 x 10(8) amastigotes; a spleen biopsy carried out on day 35 post-infection (p.i.) revealed 10-13 L. donovani bodies per 500 cell nuclei, which reached a maximum of 130-195 at death (day 105-110 p.i.). The infected monkeys lost body weight, developed severe anaemia, lymphocytosis, hyperproteinaemia, hypergammaglobulinaemia, hypoalbuminaemia and an increase in the level of alkaline phosphatase and alanine aminotransferase (AAT). Treatment with sodium stibogluconate (60 mg Sb5+ per kg body weight intramuscularly for 10 days) reduced the number of spleen parasites (0-1 amastigotes per 500 cell nuclei) but after the therapy the parasites appeared in the skin, which had previously been free of infection. Relapse occurred on day 30 post-treatment (10-24 amastigotes per 500 cell nuclei) and the parasites were resistant to repeat intensive therapy (120 mg Sb5+ per kg per day x 30 days). The stibogluconate treatment caused a proportionate reduction in the haematological and biochemical parameters to normal values except for alkaline phosphatase and AAT, which remained elevated. The level of IgG antibodies, which rose during the infection, rapidly fell to the pretreatment value following the first therapeutic schedule and then increased a second time coinciding with relapse. Our findings suggest that langurs could serve as acceptable models for human visceral leishmaniasis.

Animals↗
PubMed1991

Effects of purine nucleoside analogues with a cyclobutane ring and erythromycin A oxime derivatives on duck hepatitis B virus replication in vivo and in cell culture and HIV-1 in cell culture.

The effects on duck hepatitis B virus (DHBV) replication of specific analogues of two classes of chemical compounds not previously tested against hepadnaviruses are described. One is erythromycin A-9-methyloxime (EMO) and other oxime derivatives of erythromycin A, and the other is purine nucleoside analogues (cyclobut A and cyclobut G) with cyclobutane rings. Viral replication was assessed by measuring serum levels of DHBV DNA in infected ducklings and DHBV DNA in infected primary duck hepatocyte cultures. Administration of EMO 15 mg/kg of body weight IM to infected ducklings resulted in a rapid fall in DHBV DNA levels during therapy and a return to pretreatment levels after EMO administration was stopped. There was local toxicity at injection sites with muscle necrosis in some animals. When 100 mg/kg EMO was administered by gastric tube no such viral response was observed. The difference in virus response to EMO 15mg/kg IM and 100 mg/kg by gastric tube was not due to failure to achieve comparable blood and tissue levels of EMO administered by the different routes. The results suggest an indirect effect dependent on IM injection of EMO rather than a direct antiviral effect of the compound. Administration of cyclobut G or cyclobut A at 70 mg/kg IM led to a rapid reduction of DHBV DNA to undetectable levels in serum, and in only 1 of 4 animals did DHBV DNA became detectable again within 10 days after stopping the drug.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenine↗
PubMed1989

Pharmacokinetics of rifabutin.

We investigated the pharmacokinetics of rifabutin in 15 male patients as part of a phase I trial of the treatment of early symptomatic human immunodeficiency virus infection. Six or more patients were studied at each of four different oral dosage levels: 300, 600, 900, and 1,200 mg/day. Twelve studies were also conducted with tracer doses of intravenous radiolabeled [14C]rifabutin. Blood and urine samples were collected for at least 72 h after the first (day 1) and last (day 28) doses of rifabutin and analyzed by high-pressure liquid chromatography. The plasma concentration data were best described by a two-compartment open model with a terminal half-life of 36 h. Rifabutin was rapidly absorbed, reaching a peak concentration about 2 to 3 h after an oral dose. Peak and trough concentrations for the 1,200-mg dose were 907 and 194 ng/ml, respectively. Total body clearance was 10 to 18 liters/h. Oral bioavailability was 12 to 20%. The drug was moderately bound to plasma proteins with a free fraction of 29 +/- 2% (mean +/- standard deviation). About 10% of an administered intravenous dose of rifabutin is excreted into the urine unchanged. Renal clearance was 1.5 +/- 0.2 liters/h. The volume of distribution was large (8 to 9 liters/kg), suggesting extensive distribution into the tissues. The area under the curve for the last dose was smaller than that of the first dose, suggesting possible induction of drug-metabolizing enzymes.

AIDS-Related Complex↗
PubMed1984

Pancreatic cystadenocarcinoma associated with strongyloides.

A 60-year-old woman presented with a mass in the left upper abdominal quadrant. Noninvasive studies showed a cystic structure arising from the pancreas. Pathologic studies of the tumor revealed pancreatic cystadenocarcinoma; the fluid contained Strongyloides larvae. There was no evidence of disseminated Strongyloides or immunosuppression. Results of stool examinations were also negative for Strongyloides. Were these larvae the etiologic agent for the carcinoma? Other parasitic infestations have been associated with carcinoma. This is the first reported association between Strongyloides and cystadenocarcinoma.

Cystadenocarcinoma↗