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Biomedical subjects

G Garewal

Publications and source records attributed to G Garewal.

At least 37 records · Page 2Linked to original sources
PubMed1995

Aplastic anaemia versus hypocellular myelodysplastic syndrome.

It is important to differentiate non-dyplastic aplastic anaemia from hypocellular myelodysplastic syndrome (MDS). Four patients presenting with hypocellular bone marrow and different evolution patterns are being described. Certain morphological features and variable hypocellularity were found to be useful indices for this purpose.

Adolescent↗
PubMed1995

Morphology of spleen in steroid resistant idiopathic thrombocytopenic purpuras.

Twenty spleens of steroid resistant cases of idiopathic thrombocytopenic purpuras were studied by light and electron microscopy. Weights of the spleen were within normal range and were unremarkable grossly. On light microscopy reactive lymphoid follicles were seen in the five of the cases. Prominent and dirty looking sinusal histiocytes contain phagocytosed materials. Prominence of plasma cells were seen in the red pulp and also in the marginal zone. The three cases which failed to respond to splenectomy did not show any morphological variation from the others who had responded.

Adolescent↗
PubMed1994

The molecular basis of beta thalassaemia in Punjabi and Maharashtran Indians includes a multilocus aetiology involving triplicated alpha-globin loci.

We have analysed 201 beta-thalassaemia (beta-thal) genes from natives of the Punjab (156) and Maharashtra states of India and found the causative mutation in 200 of them. The most common beta-globin gene mutations differed significantly between these two groups and between these groups and Indian immigrants in the U.S.A. and the U.K. In the Punjabi Indians the IVS-1, nt 1 (G-T) mutation accounted for nearly one-quarter of beta-thal genes, whereas it was 5% or less in the other groups. Likewise, the cap + 1 mutation was much more prevalent in the Punjabis, whereas the nonsense codon 15 allele had a higher frequency in the Maharashtrans of the Bombay region. The common IVS-1, nt5 allele had a frequency of 60% of beta-thal genes in the Maharastrans, 35% in North American immigrants, and only 23% in the Punjabis. Two-thirds of all beta-thal genes in Punjab were found in the merchant caste (Khatri-Arora), whereas the menial caste (Shudra) was highly represented among those with beta-thal genes in Maharashtra. Two novel beta-globin alleles were each found once; a frameshift codon 55 (+A) in Maharashtrans and a frameshift codons 47-48 (+ATCT) in Punjabis. Of three Punjabi patients with beta-thal intermedia in whom only a single severe beta-globin gene mutation was found, two had six alpha-globin genes (homozygosity for a triplicated alpha-globin locus) instead of the normal alpha-globin gene number of four. Thus, these two individuals had a multilocus aetiology of beta-thal and their parents have the unusual recurrence risk of 1 in 8 for conceiving a third with beta-thal intermedia. Since 15% of 126 alpha-globin clusters studies in Punjabis contained either single (10%) or triplicated (5%) alpha-globin genes, the alpha-globin gene number is a frequent modifier of the phenotype of beta-thal in this ethnic group.

Alleles↗
PubMed1993

Acute intravascular haemolysis in glucose-6-phosphate dehydrogenase deficiency.

Thirty-five children with G6PD deficiency, who presented with acute intravascular haemolysis, were evaluated to define its aetiology, clinical features and ultimate outcome. All were boys with ages ranging from 6 months to 12 years. Pallor of abrupt onset and passage of cola-coloured urine were universal presenting symptoms. Incriminating factors responsible for haemolysis include hepatitis (7), malaria (4), bacterial sepsis (3) and drug intake (24), with more than one predisposing condition existing in some children. Marked elevations in serum bilirubin, coinciding with intravascular haemolysis, was a feature in all the seven children with hepatitis. Azotaemia was noted in 20 patients, of whom 14 did not have oliguria. All four children with malaria presented with protracted renal failure. Therapy focused on maintaining a high urine output in those without oliguria. A total of 15 peritoneal dialyses and five haemodialyses were required in six patients with acute renal failure, all of whom were oliguric. Supportive therapy consisted of blood transfusions and treatment of the predisposing diseases. Thirty-two children recovered completely while three died, the cause of death being severe anaemia and congestive cardiac failure, malaria with oliguric renal failure and hepatic encephalopathy, respectively.

Acute Disease↗
PubMed1993

Neutropenic enterocolitis and cecal perforation in acute lymphatic leukemia.

A ten year old boy who died of the consequences of an infrequent gastrointestinal complication, whilst on induction chemotherapy for acute lymphatic leukemia, is being reported. Recent trends in the diagnosis and management of typhilitis or neutropenic enterocolitis have been reviewed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1992

Routine hematological values in term newborns.

Routine hematological parameters were investigated in 240 term normal neonates, 40 neonates in the first week of life and 49 infants between 3 and 6 months of age. Term normal neonates were selected on the basis of well defined criteria. Cord blood Hb values of 16.2 +/- 1.5 g/dl compared well with some of the recent Indian studies and Caucasian figures. Cord blood hemoglobin was lower in the presence of low maternal hemoglobin and in newborns delivered by Cesarean section. A wide variation existed in the total and differential leucocyte counts, thus limiting the clinical utility of white cell counts in the newborn period. Platelet counts were within the adult normal range.

Blood Cell Count↗
PubMed1991

A clinico-pathological study of six cases of hairy cell leukaemia.

Clinicopathological findings of six cases of Hairy cell leukaemia are presented. All the patients were males, the age ranged between 32-57 years. Complications of anaemia and neutropenia were common modes of presentation. Hepatomegaly and splenomegaly were present in all the cases whereas only 2 patients had lymphadenopathy. Severe pancytopenia was detected in 3 cases and circulating hairy cells were present in all the cases. Trephine biopsy done in all six patients was found to be diagnostic. Tartrate resistant acid phosphatase was detected in the hairy cells of 2 cases.

Adult↗
PubMed1991

Clinico-hematological characteristics in patients with kala azar. A study from north-west India.

Clinico-hematological features were analysed in 23 patients with kala azar. Fever and hepatosplenomegaly were the main presenting features. All patients were moderate to severely anemic (Hb 4.3-8.1 g/dl), 17 were leucopenic and 15 were thrombocytopenic. Bone marrow showed moderate to severe megaloblastosis in 11 cases, an increased number of plasma cells in 20 and megakaryocytic hyperplasia with abnormal morphology in 19 patients. Megakaryocyte numbers per smear were significantly increased (p = 0.01) in thrombocytopenic patients as compared to patients with normal platelet counts. Spleen size, Hb level, platelet count and number of plasma cells in the bone marrow were related to parasite load. In general the degree of parasitisation, spleen size and duration of illness correlated with some of the main hematological features. Thus splenic sequestration and ineffective hematopoiesis appear to be the main etiopathogenetic factors in the emergence of bone marrow changes and peripheral cytopenias.

Adolescent↗
PubMed1990

Danazol therapy in immune thrombocytopenic purpura.

Nine children with chronic refractory immune thrombocytopenic purpura and moderate to severe episodes of bleeding were treated with Danazol in an attempt to increase their platelet counts and improve clinical hemostasis. Only one patient experienced an excellent response while a good response was obtained in another. Cessation of bleeding episodes was observed in two other children with only marginal increases in platelet counts. Four of the nine patients failed to show any clinical or hematological improvement. The drug was well tolerated but its efficacy in childhood ITP needs further evaluation.

Child↗