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Biomedical subjects

L Pandit

Publications and source records attributed to L Pandit.

11 recordsLinked to original sources
PubMed2001

Epilepsy care in six Indian cities: a multicenter study on management and service.

BACKGROUND: Epilepsy care in developing countries is lagging behind than in the developed countries. Precise data on delivery of neurological services for epilepsy is essential to optimize the medical services for epilepsy care with limited resources. OBJECTIVE: This study was carried out in order to examine the management practices and utilization of various medical services for epilepsy in different parts of India. METHODOLOGY: University centers with epilepsy clinics, one each from six states of India, had participated in this study. Demographic data, clinical details, and data on epilepsy care were collected simultaneously on standard proforma. RESULTS: Data on 285 patients with epilepsy (generalized epilepsy: 49.1%, localization-related epilepsy: 49.9%, others: 1%) were included. Mean age of onset of epilepsy was 14.8+11.1 years. Mean delay in diagnosis was 1.5+/-4 years. Mean distance from place of residence to the consulting neurologist was 70+/-82 km. Medical consultations before referral to epilepsy center included general practitioners (54.1%) and specialists (43.3%). Very few patients received services from clinical psychologist or social worker. Investigations included, EEG (63.2%), CT Scan (36.2%). MRI brain (8.5%) and video EEG (2.1%) were limited to a few. Nearly 75.5% were on monotherapy. Newer Anti-Epileptic Drugs (AEDs) were used only in less than 5% patients. CONCLUSION: The services for epilepsy are urban-based and there is underutilization of services, general practitioners and specialists. Newer AEDs (although expensive) are gradually emerging in Indian market. Facilities for epilepsy surgery, therapeutic drug monitoring and services of clinical psychologist or medical social workers are limited.

Anticonvulsants↗
PubMed2001

Economic burden of epilepsy in India.

PURPOSE: The economic burden due to epilepsy is not adequately examined in developing countries. Cost estimates are very important in health care planning and delivery of services. We have estimated the direct and some of the indirect costs of epilepsy in India. METHODS: Epilepsy centers attached to University hospitals in six states of India participated in this study. Data on clinical characteristics, utilization of medical services, and costs were collected in a standardized format. RESULTS: There were 285 patients (mean age, 22.6 + 12.5 years) drawn from six centers in this study. The annual cost of epilepsy per patient was INR 13,755 (USD, 344). The direct cost was INR 3,725 (USD, 93), and the indirect cost was INR 10,031 (USD, 251). Direct cost included medical consultations (INR 329), laboratory services (INR 271), hospitalization charges (INR 316), and cost of travel to clinics (INR 659). The indirect cost included the cost of lost productivity due to seizures, its complications, or attendance to clinics. There are approximately 5 million people with epilepsy in India. The economic burden due to epilepsy to the nation is to the tune of INR 68.75 billion (USD, 1.7 billion). CONCLUSIONS: The annual economic burden of epilepsy in India is 88.2% of GNP per capita and 0.5% of the GNP.

Adolescent↗
PubMed1998

Acute thyrotoxic neuropathy--Basedow's paraplegia revisited.

A forty seven year old woman with previously undetected goitre, developed thyroid storm in the immediate postoperative period. Forty eight hours after undergoing nephrolithotomy for renal calculus, she was noted to have flaccid areflexic quadriparesis, most marked in the lower limbs. Electrophysiologic studies revealed evidence of an asymmetric, mixed axonal and demyelinating, motor-sensory peripheral neuropathy. Ultrastructure of the sural nerve showed predominant abnormalities in the mitochondria and cytoskeletal elements compatible with thyrotoxicosis. Treatment of thyrotoxicosis coincided with recovery of symptoms. We believe that thyrotoxicosis precipitated an acute polyneuropathy the ultrastructure of which is being described for the first time.

Acute Disease↗
PubMed1997

Postmenopausal vaginal atrophy and atrophic vaginitis.

Menopause is associated with a marked reduction in endogenous estrogen production. Lower levels of circulating blood estrogen have various deleterious effects, including those on the lower urinary tract. The vaginal epithelium becomes atrophied and dry, which can cause vaginal discomfort, itching, and dyspareunia. The epithelium may become inflamed and contribute to urinary symptoms, including frequency, urgency, dysuria, and incontinence. Diminished estrogen effects on periurethral tissues can contribute to pelvic laxity and stress incontinence. Changes in vaginal pH and normal flora may predispose older women to urinary tract infection. Although estrogen replacement therapy can result in maturation of the vaginal epithelium, the optimal form of administration and the dosage regimen for improving symptoms and quality of life of the geriatric female population have not been well studied.

Aged↗
PubMed1996

Gene therapy of metastatic pancreas cancer with intraperitoneal injections of concentrated retroviral herpes simplex thymidine kinase vector supernatant and ganciclovir.

OBJECTIVE: The objective of this study was to determine the efficacy of intraperitoneal (IP) injections of a new concentrated herpes simplex thymidine kinase (HS-tk) retroviral vector and ganciclovir (GCV) for peritoneal metastases from pancreas cancer. SUMMARY BACKGROUND DATA: Metastatic pancreas cancer is fatal. Gene therapy may provide a novel approach for this disease. Gene therapy with adeno- or retroviral-mediated transfer of the HS-tk gene into tumor cells renders the cells susceptible to GCV. Intratumoral or intracavity injections of retroviral vectors have been ineffective in previous studies. METHODS: Pancreatic cancer B x PC3 cells (3 x 10(7)) were injected into the tail of pancreas in nude mice. Mice received IP injections of a concentrated HS-tk vector (5 x 10(7)) cfu/mliters) or a control vector (G1Na) without the tk gene for 10 days and GCV (100 mg/kg) for 14 days. To determine whether the vector would survive in the milieu of the peritoneal cavity, the authors examined the effects of ascitic fluid on the vector. Pancreas cancer cells were transduced in vitro with HS-tk vector in presence of media or ascitic fluid and treated with GCV. RESULTS: Highly significant reductions in the mass of metastatic peritoneal tumor deposits were found in HS-tk-treated group (124 +/- 27 mg; n = 11) compared with G1Na vector controls (910 +/- 168 mg; n = 8; p < 0.0001). Results of polymerase chain reaction analysis demonstrated integration of the vector in the tumors, and on immunohistochemistry, expression of the TK protein was seen in the number of surviving colonies (representing nontransduced cells) were similar in both groups, suggesting that the vector effectively transduced tumor cells bathed in the ascitic fluid. CONCLUSIONS: Results demonstrate that IP administration of concentrated retroviral HS-tk vectors is effective treatment for pancreas cancer metastatic to the peritoneal cavity; furthermore, the vector is active in the presence of ascitic fluid. Intraperitoneal retroviral HS-tk may provide a novel approach to treatment of metastatic pancreas cancer.

Animals↗
PubMed1996

Recurrent myelitis.

Three patients presented with acute complete transverse myelopathy which relapsed several times at the same site. These patients, two women and one man, had two to five attacks spanning three to seven years. All patients underwent detailed investigations including a complete myelogram and serial evoked potential studies. Oligoclonal bands were present in the CSF in one patient. Brain MRI was normal in two patients; MRI of the spinal cord was abnormal and showed cord oedema with multiple areas of hyperintense signals on T2 and proton density weighted scans and hypointense signals on T1 weighted images in areas corresponding to the clinical level, suggesting an inflammatory/demyelinating disorder. These patients may represent a relapsing demyelinating disorder restricted to the spinal cord, distinct from multiple sclerosis.

Adult↗
PubMed1995

Thymomatous myasthenia gravis.

Ten cases of thymoma associated myasthenia were seen in the last 7 years. They constitute 17.2% of all cases of Myasthenia gravis seen during the same period. Five of these patients presented in the third decade, all of them presenting with acute generalised Myasthenia (Osserman stage-III). Two patients presented with tumour related symptoms of chest pain, cough and dyspnea both of them having large, invasive and partially resectable tumours. Five patients underwent complete thymectomy and 3 patients underwent partial resection of tumour. Two patients underwent radiotherapy subsequently. Histologically, mixed lymphoepithelial tumours were common (70%). Tumour recurrence was seen in one patient. Two patients died, one in the post operative period. The surviving 8 patients followed up over 1-8 years remained in partial remission, on maintenance dose of steroids. The special problems related to thymomatous MG and practical approach to management are highlighted.

Acute Disease↗
PubMed1994

Computerised tomography in Tolosa-Hunt syndrome.

Twelve patients who satisfied the clinical criteria of Tolosa-Hunt syndrome (THS), underwent axial computerised tomography (CT) scan of the head. Two patients had abnormalities detected in the cavernous sinus on the affected side which supported the clinical diagnosis. This coupled with steroid responsiveness and long-term asymptomatic follow-up firmly established the diagnosis of THS. We discuss the computerised tomographic findings seen in THS and the relevance of using accurate imaging techniques as the first line of investigation in these cases.

Adult↗
PubMedDate not supplied

Development of systemic immunologic responses against hepatic metastases during gene therapy for peritoneal carcinomatosis with retroviral HS-tk and ganciclovir.

Gene therapy with retroviral mediated gene transfer of the herpes simplex thymidine kinase (HS-tk) gene into a tumor mass confers sensitivity of the tumor cells to ganciclovir (GCV). Tumor-specific immunologic responses may develop following treatment of the primary tumor with retroviral HS-tk and GCV. In the present study we assessed whether GCV treatment of HS-tk transduced colon cancer (TK+) implanted in the peritoneal cavity induced a systemic antitumor response that would inhibit growth of a second wild-type (TK-) tumor implanted in the liver. DHDK12 rat colon cancer cells were transduced in vitro with the retroviral HS-tk vector and established as a permanent cell line (TK+ cells). TK+ or TK- DHDK12 cells (6x10(6) cells) were injected intraperitoneally on day 0 into BD-IX rats. On day 10, TK- cells (3x10(6) cells) were injected into the liver in all the groups. The animals were then treated with GCV (150 mg/kg) for 13 days. TK+ peritoneal tumors underwent significant regression during therapy with GCV (0.05+/-0.004 g; n=7) compared to wild-type (TK-) tumors (2.2+/-0.7g; n=6) (P<0.05). The volume of TK- tumors in the liver was significantly lower in GCV-treated rats with TK+ peritoneal tumors (12.5+/-8.3 mm3) compared to rats with TK- peritoneal tumors (96.7+/-18.1 mm3) (P<0.05). Histology of the liver tumors in the TK+ groups showed a dense monocytic infiltrate with fibrosis and only occasional viable tumor cells. Gene therapy with retroviral HS-tk vectors may provide a novel approach to treatment of gastrointestinal cancer by both direct cytotoxicity and an indirect mechanism that may include enhanced immuno logic responses against disseminated disease.

Animals↗