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Biomedical subjects

J R Kamat

Publications and source records attributed to J R Kamat.

At least 19 recordsLinked to original sources

Immunological response to two hepatitis B vaccines administered in two different schedules.

OBJECTIVES: To evaluate the antibody response to a plasma derived hepatitis B vaccine containing pre-S and S antigens and a recombinant vaccine containing only S antigen and compare the two vaccines in 0, 1, 2 and 0, 1, 6, schedules METHODS: One hundred fifty nine healthy infants were randomized to receive the vaccines in two different schedules. Anti HBs titers were estimated prior to the vaccination and then one-month following the second and third doses. RESULTS: Both the vaccines produced a high rate of seroconversion and seroprotection. The antibody response was similar with both the vaccines and the 0, 1, 6, schedule induced a significantly higher antibody level than the 0, 1, 2, schedule. CONCLUSION: 0, 1, 6 schedule produces a higher antibody level than 0, 1, 2 schedule though both the schedules have good seroconversion and seroprotection rates with both the vaccines.

Drug Administration Schedule↗

Necrotizing myelitis in an immunocompetent child: a case report with review of literature.

A few cases of necrotizing myelitis have been reported in adults since its first description in 1973. No case has been described in the pediatric age group. A 12-year-old boy, who presented with acute flaccid paraplegia, loss of sphincter control and sensory loss showed features suggestive of necrotizing myelitis on magnetic resonance imaging. Investigations carried out could not reveal a specific etiological or pre-disposing factor. No clinical improvement occurred despite the therapy.

Child↗

Infantile tremor syndrome and zinc deficiency.

Infantile tremor syndrome is characterized by coarse tremors, mental and physical retardation, light colored brown hair, skin pigmentation and anemia. Amongst the theories proposed for the etilogy of the disorder, the nutritional theory is most accepted. In this case report, we have presented a fourteen-month-old male child with ITS and documented zinc deficiency. Though most of the previous workers have proposed vitamin-B12 deficiency as the etimology for ITS, our report suggests that zinc deficiency could also have a causative role.

Humans↗

An unusual case of biliary atresia.

Intrahepatic biliary cysts are rarely seen in the patients with biliary atresia. We describe a ten-month-old child with biliary atresia in whom the abdominal imaging studies (ultrasonography, computed tomographic scan and magnetic resonance cholangiopancreatography) revealed multiple intrahepatic biliary cysts ('bile lakes'). The child also had intrapulmonary shunting of blood due to pulmonary arteriovenous fistulae, which were demonstrated on contrast-enhanced echocardiography. Both these findings, 'bile lakes' and pulmonary arteriovenous fistulae occur rarely in biliary atresia.

Abdomen↗

Glanzmann's thrombasthenia.

Glanzmann's thrombasthenia (GT) is an uncommon cause of bleeding in children. We diagnosed two siblings as having GT on the basis of flow cytometric studies. Both had cutaneous bleedings and epistaxis since early childhood. Hematological investigations revealed prolonged bleeding time and a normal platelet count. Both the patients had absence of aggregation of platelets with the agonist adenosine diphosphate. Absence of the GPIIb/IIIa receptor was confirmed by flow cytometry. A short review of the disorder is presented.

Child, Preschool↗

Pulmonary arteriovenous malformations.

Pulmonary arteriovenous malformations rarely present in childhood. Two cases are presented in this report. Both the cases presented clinically with cyanosis and clubbing without a cardiac murmur. The second case had cerebral abscess in addition. Both the cases underwent a contrast-enhanced echocardiography which suggested the presence of pulmonary arteriovenous malformations. The first case also underwent 99mTc radionuclide scan and pulmonary angiography. The cases are being reported for their characteristic clinical features and for emphasizing the role of non-invasive modalities like contrast-enhanced echocardiography and radionuclide scan in reaching the diagnosis.

Angiography↗

Thyroiditis as a presenting feature of mumps.

Thyroiditis complicating mumps is rare and occurs 1 week after the parotitis. A 9-year-old boy with a history of contact with a case of mumps presented with thyroid swelling. Thyroid scan showed a diffusely reduced uptake. The aspiration cytology showed lymphocytic thyroiditis. Thyroid function tests were normal and antithyroid antibodies were absent. Parotitis occurred 12 days after the onset of thyroiditis.

Child↗

Rheumatic fever in children.

Rheumatic fever (RF) and rheumatic heart disease (RHD) are major public health problems in developing countries. A prospective study carried out in a large general hospital showed that carditis was the predominant feature in first attack and also the recurrence of RF but that recurrence was associated with more severe manifestations. Echocardiography picked up cases of subclinical carditis. Presence of congestive cardiac failure in association with carditis always led to chronic RHD. Recurrence occurred only when patient defaulted penicillin prophylaxis. The overall recurrence rate was 0.026 per patient.

Child↗

Kawasaki disease.

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Anti-Inflammatory Agents, Non-Steroidal↗

Prevalence of antibodies to polioviruses & enteroviruses excreted by healthy children in Bombay.

A total of 132 healthy children between the ages one month and 12 yr were surveyed to determine the prevalence of antibodies to the three poliovirus serotypes. Among infants up to six months of age, 73.2, 85.4 and 56.1 per cent had antibodies to poliovirus types 1, 2 and 3, respectively. In children of age groups 7 months to 3 yr and above 3 yr, antibody prevalence to the three poliovirus serotypes was 90.2, 86.9 and 57.4, and 83.3, 96.7 and 76.7 per cent, respectively. Immunization coverage with three doses of OPV exceeded 85 per cent in children above 7 months of age. Low seroprevalence to type 3 poliovirus in the children was conspicuous. Of the 80 faecal samples studied from these children, 24 (30%) were positive for virus. Among these isolates, 16 were poliovirus type 1 and three type 2. Intratypic differentiation revealed that 15 of the 16 poliovirus type 1 isolates were of wild origin. Two out of the three poliovirus type 2 isolates were of oral poliovaccine origin. Our data indicate that in spite of good vaccination coverage wild poliovirus type 1 circulation was endemic in Bombay and; that a large number of children were susceptible to poliovirus type 3 infections.

Antibodies, Viral↗

Elevated levels of IgG specific antimyosin antibodies in acute rheumatic fever (ARF): differential profiles of antibodies to myosin and soluble myocardial antigens in ARF, acute glomerulonephritis and group A streptococcal pharyngitis.

Group A streptococcus is the common etiologic agent associated with group A streptococcal pharyngitis (SAP) and its sequelae: acute rheumatic fever (ARF) and acute glomerulonephritis (AGN). However, hyperresponsiveness to cardiac antigens stemming from the shared antigenic determinants with streptococcal antigens is believed to play a role only in the pathogenesis of ARF. A Profile of IgM and IgG immune responses to soluble myocardial antigen (SMA) and myosin was evaluated in ARF, AGN and SAP. A modified ELISA measuring the area under curve (AUC) for quantitation of antibodies to SMA and rabbit muscle myosin was employed. Proteins in the SMA were resolved by SDS-PAGE. Immune responses to a major protein band of congruent to 205 kD, corresponding to the molecular weight of the heavy chain of cardiac myosin was also evaluated. In the ARF group while a significant elevation of both IgM and IgG anti-SMA antibody levels was observed, only antibodies of IgG isotype were elevated against rabbit muscle myosin and 205 kD protein of human cardiac tissue in comparison with normal controls, AGN and SAP groups. There was a significant positive correlation of antibodies against skeletal muscle myosin with antibodies against 205 kD protein of human cardiac tissue for both IgM and IgG specificities in ARF alone. The incidence of positive sera (values greater than mean + 2SD of control values) for IgM and IgG anti-SMA and antimyosin antibodies was higher in ARF than in AGN and SAP. None of the AGN and SAP sera had elevated levels of antibodies against SMA whereas low incidence of positive sera for antimyosin antibodies was observed in these groups. Although group A streptococcus etiology is associated with ARF, AGN and SAP, differential profiles of immune responses to cardiac antigens is observed in these diseases. Elevated IgG specific response to myosin and 205 kD cardiac protein was demonstrated in ARF and not in other groups with a similar etiology. It may be worthwhile, therefore to explore the possibility of using this as an additional parameter in diagnosis of ARF.

Acute Disease↗