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Biomedical subjects

I Kaur

Publications and source records attributed to I Kaur.

At least 19 recordsLinked to original sources
PubMed2006

Superior ex vivo cord blood expansion following co-culture with bone marrow-derived mesenchymal stem cells.

One factor limiting the therapeutic efficacy of cord blood (CB) hematopoietic progenitor cell (HPC) transplantation is the low cell dose of the graft. This is associated with an increased incidence of delayed or failed engraftment. Cell dose can be increased and the efficacy of CB transplantation potentially improved, by ex vivo CB expansion before transplantation. Two ex vivo CB expansion techniques were compared: (1) CD133+ selection followed by ex vivo liquid culture and (2) co-culture of unmanipulated CB with bone-marrow-derived mesenchymal stem cells (MSCs). Ex vivo culture was performed in medium supplemented with granulocyte colony-stimulating factor, stem cell factor and either thrombopoietin or megakaryocyte growth and differentiation factor. Expansion was followed by measuring total nucleated cell (TNC), CD133+ and CD34+ cell, colony-forming unit and cobblestone area-forming cell output. When compared to liquid culture, CB-MSC co-culture (i) required less cell manipulation resulting in less initial HPC loss and (ii) markedly improved TNC and HPC output. CB-MSC co-culture therefore holds promise for improving engraftment kinetics in CB transplant recipients.

AC133 Antigen↗
PubMed2006

Effect of topical calcipotriol, betamethasone dipropionate and their combination in the treatment of localized vitiligo.

BACKGROUND: Treatment of vitiligo is a challenge. Steroids are known to be effective but are associated with serious adverse effects. Many uncontrolled studies have shown calcipotriol to be a promising therapeutic modality in vitiligo. OBJECTIVE: To conduct a randomized trial to evaluate the effect of topical calcipotriol ointment (0.005%) and betamethasone dipropionate (0.05%) cream, given alone or in combination, in treatment of localized vitiligo. METHODS: Forty-nine patients with vitiligo affecting 5% of their skin were recruited. Patients were randomized into three groups. Group I patients were treated with betamethasone dipropionate (0.05%) cream twice daily. Group II patients were treated with calcipotriol ointment (0.005%) twice daily, and group III with betamethasone dipropionate (0.05%) in the morning and calcipotriol (0.005%) in the evening. RESULTS: Forty-five patients completed the study period of 3 months with 15 patients in each group. No patient achieved excellent (> 75%) pigmentation. Marked (50% to 75%) repigmentation was observed in 2 (13.3%), 1 (6.7%) and 4 (26.7%) patients in groups I, II and III, respectively. Moderate (25-50%) repigmentation was observed in 7 (46.7%), 5 (33.3%) and 7 (46.7%) patients in groups I, II and III, respectively. Patients with < 25% pigmentation were termed as minimal pigmentation or no response. The mean time for initial pigmentation to appear was 9.04 +/- 2.0 weeks in group I, 10.18 +/- 1.6 weeks in group II and 5.17 +/- 2.4 weeks in group III (P < 0.01). The acquired pigmentation in the lesions was more stable in group III as compared with patients in groups II and I (P < 0.01). Side-effects in the form of atrophy and lesional burning sensations were more common in group I when compared with groups II and III (P < 0.05). CONCLUSION: Combined therapy appeared to give a significantly faster onset of repigmentation along with better stability of the achieved pigmentation and with lesser number of side-effects.

Administration, Cutaneous↗
PubMed2006

Simple and economical method for speciation and resistotyping of clinically significant coagulase negative staphylococci.

An attempt was made to speciate 102 clinically significant isolates of coagulase negative staphylococci (CoNS) by a practical scheme adapted from various references. This scheme utilizes slide and tube coagulase test, urease test ornithine decarboxylase, novobiocin susceptibility and aerobic acid from mannose for assigning species group. Inclusion of one or two additional tests in a species group could identify the isolates to species level. Ninety eight (97%) isolates were conveniently identified as S. epidermidis (41%), S. saprophyticus (16.6%), S. haemolyticus (14.7%), S. hominis (14.7%), S. lugdunensis (4.9%), S. schleiferi (1.9%) and S. capitis (1.9%). Only four isolates were not identified to the species level, two of which were probably S. capitis subspecies ureolyticus / S. warneri / S. simulans . Antibiotic susceptibility testing showed maximum resistance to ampicillin (89%) followed by cefotaxime (59%) with no resistance to vancomycin. The increasing recognition of pathogenic potential of CoNS and emergence of drug resistance amongst them denotes the need to adopt simple laboratory procedures to identify and understand the diversity of staphylococci isolated from clinical material.

Bacteriological Techniques↗
PubMed2004

Single-dose fluconazole versus itraconazole in pityriasis versicolor.

BACKGROUND: The new antifungal triazoles itraconazole and fluconazole have revolutionized the treatment of pityriasis versicolor. Both drugs have shown promising results in different dose schedules. OBJECTIVE: To compare the efficacy and safety of single oral dose treatment with fluconazole versus itraconazole in patients with pityriasis versicolor. METHODS: A total of 40 patients with pityriasis versicolor were allocated randomly to group A and group B. A single dose of fluconazole (400 mg) or itraconazole (400 mg) was given orally to group A or group B patients, respectively. Patients were assessed mycologically by KOH and culture. Culture was done from lesional and perilesional skin to quantify growth and to observe the effect of these drugs and the persistence/reappearance of the fungus in relation to relapse at 2 and 8 weeks. Relapse was defined as reappearance or worsening of clinical signs and symptoms or positive KOH/culture after initial improvement. RESULTS: Thirteen (65%) patients in the fluconazole group and 4 (20%) patients in the itraconazole group became culture negative at the end of 8 weeks. Relapse was found to be higher in the itraconazole group compared to the fluconazole group (60 vs. 35%). A direct correlation was found between the relapse rate and positivity of perilesional skin for Malassezia furfur. CONCLUSION: In the same dosing, fluconazole was found to be more effective than itraconazole; however, both drugs were found to be safe.

Administration, Oral↗
PubMed2003

Changing trends in bacteriology of burns in the burns unit, Delhi, India.

A retrospective study of bacterial isolates from the wounds of patients admitted to burns unit, was undertaken at Guru Tegh Bahadur Hospital, University College of Medical Sciences, Delhi, India, over a period of 5 years between July 1997 and April 2002. The study compared the results obtained with the previous 5 years data (June 1993-June 1997) from the same unit to determine the changing patterns and emerging trends of bacterial isolates and their antimicrobial susceptibilities. Pseudomonas species (31%) and Staphylococcus aureus (22%) were the most common pathogens followed by Klebsiella species (19%). Multi-drug resistant (MDR) Acinetobacter species (9%) have emerged as an important nosocomial pathogen in our burn unit. Most of the gram-negative isolates obtained were found to be multi-drug resistant and 61% of the tested isolates were extended spectrum beta-lactamase (ESBL) producers. Concomitant resistance to penicillin and aminoglycosides was observed in 61% of Enterococcus fecalis isolates. When compared with the results of previous 5 years (June 1993-June 1997) Pseudomonas spp. was still the commonest pathogen in the burns unit. However, isolation of this organism and other gram-negative organisms has decreased in comparison to previous years. The incidence of antimicrobial resistance has markedly increased over the past years resulting in limitation of therapeutic options.

Burn Units↗
PubMed2002

A randomised controlled trial of the effect of anticipation of a blood test on blood pressure.

Blood pressure is affected by situational anxiety, such as the white coat effect. We hypothesised that blood pressure would also be affected by anticipation of a blood test. Volunteer subjects were recruited on the campus of Birmingham University. Subjects were randomly assigned to intervention and control groups. After a period of rest, three seated blood pressure measurements were taken at 1-min intervals using an electronic sphygmomanometer. Between the second and third measurements subjects in the intervention group were told that a blood test would be carried out after the last measurement. No blood test was carried out. Three blood pressure measurements were made in all 213 randomised subjects. Analysis was by intention-to-treat. In the control group mean systolic and diastolic blood pressure fell in successive measurements. Between the second and third measurements mean systolic blood pressure fell by 1.4 mm Hg in the control group and rose by 2.6 mm Hg in the intervention group (difference 4.0 mm Hg, P < 0.0001). A rise in diastolic blood pressure between the second and third measurements did not reach statistical significance. It was concluded that anticipation of a blood test affects measured systolic blood pressure in volunteers. The practice of taking blood tests at the same time as measuring blood pressure may potentially bias estimations of blood pressure.

Adolescent↗
PubMed2002

Mucocutaneous adverse effects of hydroxyurea: a prospective study of 30 psoriasis patients.

Hydroxyurea is an anti-tumour agent most commonly used to treat chronic myeloproliferative disorders in doses up to 4 g per day. Dermatological adverse effects reported so far have been observed predominantly in these patients. As we are treating selected psoriasis patients with low dose hydroxyurea we attempted to define the spectrum and chronology of dermatological adverse effects in this group of patients prospectively. Of the 29 evaluable patients, 19 (65.5%) developed a mucocutaneous adverse reaction after a mean duration of 6.4 weeks of treatment. Pigmentation of nails, skin or mucosa was the most common observation and was seen in 17 (58.6%) patients. Other less common findings were xerosis, diffuse alopecia, oedema of the legs, oral ulcers and actinic psoriasis. Adverse effects subsided in 11 (57.9%) patients during a mean follow up of 18 weeks. Three hitherto unreported side-effects - scleral pigmentation, acquired ichthyosis and pigmentation of lunula of the nails - were noted. This first study of dermatological adverse effects of hydroxyurea therapy on Asian psoriatic patients reveals several new findings. Pigmentation of skin, nails and mucosa appears to be very common and occurs early. Serious dermatological side-effects probably do not occur with low dose (up to 1.5 g per day) hydroxyurea in patients with psoriasis.

Adult↗
PubMed2002

Psychiatric morbidity in vitiligo: prevalence and correlates in India.

BACKGROUND: Vitiligo, a common pigmentary disorder, is recognized to be associated with a high psychiatric morbidity, yet compared to other dermatological disorders like leprosy, psoriasis, etc., it has not been subjected to detailed evaluation of its psychological consequences. The data from the developing countries on this aspect in particular is meager. METHODS: One hundred and thirteen cases with vitiligo were evaluated along with 55 healthy controls comparable for sociodemographic profile and matched on attitude to appearance scale. Clinical details, impact of illness, associated dysfunction and psychological morbidity were additionally assessed. RESULTS: Twenty-eight patients with vitiligo were found to have psychiatric morbidity, a clinic prevalence rate of 25% (95% confidence interval 20.3-29.3%). The majority of the cases had a diagnosis of adjustment disorder. Psychiatric morbidity was significantly correlated with dysfunction arising out of illness. CONCLUSIONS: Vitiligo is associated with high psychiatric morbidity. There is a need to develop cross-cultural database on psychosocial aspects and psychiatric morbidity associated with vitiligo.

Adjustment Disorders↗
PubMed2002

Lack of effect of dimethylsulphoxide in cutaneous amyloidosis.

OBJECTIVE: To evaluate dimethylsulphoxide (DMSO) as a topical therapeutic agent for the treatment of two major variants of primary, localized, cutaneous amyloidosis -- macular amyloidosis (MA) and papular/lichen amyloidosis (LA) -- using a monocentric, open, prospective trial. METHODS: A total of 25 patients with histopathologically proven cutaneous amyloidosis - MA, LA and BA (biphasic amyloidosis) (13 MA, seven LA, five BA) were requested to undertake a once daily application of either 50% or 100% DMSO for 12 weeks. Progress was regularly assessed with a scoring system for pruritus, pigmentation and papules. RESULTS: In 17 (68%) cases, the scores for pruritus decreased but never completely disappeared in any of the patients. Lightening of the pigmentation was noted in only six (24%) cases and the scores for the papules were decreased in only two out of 12 (16.6%) patients. Post-treatment skin biopsies did not reveal a reduction/disappearance of the amyloid deposits. In the follow-up period, the relapse rate was 100%. CONCLUSION: DMSO does not have an anti-pruritic effect or amyloid-dissolving properties. As the results are partial and transient, it is concluded that DMSO is not a satisfactory treatment for cutaneous amyloidosis.

Adolescent↗
PubMed2002

Fabric-staining properties and washability of a novel liposomal dithranol formulation.

AIM: To test the staining potential of a novel liposomal dithranol gel on different types of fabrics and compare it with the only commercially available dithranol preparation in India, Derobin. METHODS: Pure cotton, pure polyester and four blends of the two fabrics were tested for staining and washability. RESULTS: Both products showed the least staining and spreading on pure cotton with progressively worse stains as the proportion of polyester in the fabric increased. When compared with each other the liposomal dithranol gel showed markedly lighter staining than Derobin on all fabrics. It also washed off completely with water whereas the Derobin stains could not be washed off, even with detergent. CONCLUSION: The liposomal gel due to its superior staining properties may potentially increase the acceptability of dithranol amongst psoriasis patients.

Administration, Topical↗
PubMed2001

Silver(I) ion-selective membrane based on Schiff base-p-tert-butylcalix[4]arene.

A PVC membrane electrode for silver(I) ion based on Schiff base-p-tert-butylcalix[4]arene is reported. The electrode works well over a wide range of concentration (1.0 x 10(-5)-1.0 x 10(-1) mol dm-3) with a Nernstian slope of 59.7 mV per decade. The electrode shows a fast response time of 20 s and operates in the pH range 1.0-5.6. The sensor can be used for more than 6 months without any divergence in the potential. The selectivity of the electrode was studied and it was found that the electrode exhibits good selectivity for silver ion over some alkali, alkaline earth and transition metal ions. The silver ion-selective electrode was used as an indicator electrode for the potentiometric titration of silver ion in solution using a standard solution of sodium chloride; a sharp potential change occurs at the end-point. The applicability of the sensor to silver(I) ion measurement in water samples spiked with silver nitrate is illustrated.

Journal Article↗
PubMed2001

Safety and efficacy of glycolic acid facial peel in Indian women with melasma.

BACKGROUND: Melasma is a common disorder of facial hyperpigmentation. Many modalities of treatment are available, but none is satisfactory. MATERIALS AND METHODS: Twenty-five nonpregnant female patients with a minimum melasma area and severity index (MASI) of 15 were recruited in the study. After a detailed history and clinical examination under natural light and Wood's light, MASI was calculated and color photographs were taken of all patients. Patients were advised to carry out a prepeel program of daily application of topical sunscreens (sun protection factor-15, SPF-15) and 10% glycolic acid lotion at night for 2 weeks. Patients were then treated with 50% glycolic acid facial peel once per month for three consecutive months. At regular intervals and at the end of the follow-up period (3 months) after the last peel, the degree of improvement in pigmentation was assessed by remeasuring MASI. Side-effects, if any, were also recorded. The data obtained were statistically analyzed using Student's paired t-test and Spearman rank correlation coefficient test. RESULTS: Improvement in melasma (reduction in MASI) was observed in 91% of patients (P < 0.01). Patients with epidermal-type melasma demonstrated a better response to treatment than those with mixed-type melasma (P < 0.05). CONCLUSIONS: The prepeel program followed by 50% glycolic acid facial peel once per month for three consecutive months proved to be an effective treatment modality in Indian patients without any significant side-effects.

Adult↗
PubMed2001

Childhood cutaneous tuberculosis: a study over 25 years from northern India.

AIMS: We undertook this study to analyse the pattern of childhood cutaneous tuberculosis prevailing in northern India over the past 25 years and to highlight differences from and similarities to adult tuberculosis. MATERIALS AND METHODS: Clinical records of children with cutaneous tuberculosis who attended the Nehru Hospital attached to the Postgraduate Institute of Medical Education and Research, Chandigarh, India, between January 1975 to December 1999 were analysed. RESULTS: Four hundred and two patients with cutaneous tuberculosis were examined during the 25-year period of observation. These patients formed 0.1% of the total dermatology outpatients. Seventy-five (18.7%) of these 402 cases were children (</= 16 years). There were 32 (42.7%) boys and 43 (57.3%) girls with a boy : girl ratio of 0.74 : 1. The majority of the children, 41 (54.7%) were in the 10-14 years age group. There was no significant boy or girl preponderance in any group other than in scrofuloderma (SFD), where girls significantly outnumbered boys at all ages. Of the various patterns of cutaneous tuberculosis seen, 40 (53.3%) had SFD, 30 (40.0%) had lupus vulgaris (LV), 3 (4.0%) had tuberculosis verrucosa cutis (TVC), 1 (1.3%) child each had tuberculids and tubercular gumma. No child had a tubercular chancre or acute miliary cutaneous tuberculosis. The neck was the commonest site afflicted with SFD and the face was the commonest site affected with LV. No child had generalized lymphadenopathy. Eighteen (60.0%) of the 30 children with LV had regional lymphadenopathy of which 15 (83.3%) had localized disease and 3 (16.7%) had disseminated disease. Of the 16 children with systemic organ involvement, 12 (75.0%) had regional lymphadenopathy. Of the 62 children in whom the data regarding vaccination status was available, 31 (50.0%) had been vaccinated and 31 (50.0%) had not. Among the vaccinated group no child had disseminated disease. Three (9.7%) children in the nonvaccinated group had disseminated disease. Information regarding Mantoux reactivity was available in 71 (94.7%) children, 61 (86.0%) with localized disease and 10 (14.1%) with disseminated disease. Of the 61 children with localized disease, 56 (91.8%) were Mantoux positive and of the 10 children with disseminated disease, only 5 (50.0%) were Mantoux positive (> 10 mm). Histopathologic reports were available for evaluation in all 75 children. Out of 30 cases of LV, 24 (80%) showed classical tuberculous histology. In contrast, out of 40 cases with SFD, only 19 (47.5%) showed classical histology. Classical tuberculous histology was noted in all 3 (100%) cases of TVC and 1 (100%) case each with tuberculids and gumma. Tubercle bacilli could be demonstrated in 4/30 (13.3%) cases with LV and 9/40 (22.5%) cases with SFD. Systemic involvement was seen in 16 (21.3%) children, of whom 3 (18.8%) had LV and 13 (81.3%) SFD. The lungs were the most common organs involved in 8 (50.0%) children followed by bone(s) in 4 (25.0%), abdomen in 2 (12.5%), and both lung and bone in 1 (6.3%) child. In contrast to adults, girls outnumbered boys in the childhood series; SFD was a common form of presentation in contrast to LV and TVC, tuberculous gumma and tuberculids were noted less often. In both children and adults, Mantoux reactivity did not correlate with the extent of the disease; patients with disseminated disease were found to be less often vaccinated with BCG and regional lymphadenopathy was noted more often in patients with disseminated disease. CONCLUSIONS: In the whole spectrum of cutaneous tuberculosis, there is a proportion of patients with dissemination (systemic involvement) who are of great epidemiological significance as they require a change in the standard therapeutic regimens recommended for cutaneous tuberculosis.

Adolescent↗
PubMed2001

Rediscovering hydroxyurea: its role in recalcitrant psoriasis.

BACKGROUND: There is an acute paucity of second-line systemic agents for the treatment of extensive chronic plaque psoriasis (CPP). Recent studies using hydroxyurea in patients with HIV infection and sickle cell anemia have rekindled interest in this old drug and have provided more data regarding safety and dosage. OBJECTIVE: We wanted to test the efficacy and tolerability of hydroxyurea in patients with extensive CPP who had to discontinue first-line oral agents for any reason. METHODS: The study was a prospective nonrandomized series. Thirty-one patients, including 26 with prior history of systemic antipsoriatic therapy were given hydroxyurea 1-1.5 g per day for a median duration of 36 weeks. They were followed up for a mean period of 36.1 +/- 13.8 weeks. RESULTS: Almost 75% of the patients showed an adequate response (35% reduction in Psoriasis Area and Severity Index at or before 8 weeks) with over half showing more than 70% reduction in PASI score. All adverse effects were mild and reversible and none of the patients required cessation of therapy. CONCLUSION: Hydroxyurea is an effective, very safe but relatively slower acting alternative for patients with extensive CPP over the short-to-medium term.

Adult↗