Biomedical subjects
L S Arya
Publications and source records attributed to L S Arya.
Intrauterine growth of Afghan babies.
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Neuropsychological abnormalities following CNS prophylaxis in children with acute lymphatic leukemia.
The pattern and prevalence of neuropsychological abnormalities in children receiving combination CNS prophylaxis (2000 rads cranial irradiation and intrathecal methotrexate) during therapy for acute lymphoblastic leukemia (ALL) were studied. Thirty five children (25 boys) in the age group 5-15 years (mean 9.3) with no evidence of CNS leukemia were included and 20 age matched normal siblings served as controls. Neuropsychological parameters of general intelligence (Malin's modification of WISC test); attention and concentration (colour cancellation test); memory (modified PGI memory test) and visuomotor perception (Bender Gestalt test) were evaluated at least 6 months after CNS prophylaxis. Six (17.1%) patients had mean intelligence quotients (IQ) less than 85, while all controls had IQ > 85 (p < 0.05). The mean IQ of the patient population (93.4 +/- 11.9) was significantly lower than the control group (107 +/- 8.4) (p < 0.001). Scores on the colour cancellation test were lower in the patients as compared to controls (148.7 +/- 27.7 versus 184.9 +/- 23.9; p < 0.01). The mean memory quotient in the patient population was also lower than in controls (74.5 +/- 12 versus 93.6 +/- 9.2; p < 0.001). Scores on the Bender-Gestalt test did not show a significant difference. The presence of significant neuropsychological abnormalities in patients of ALL indicates the need for modification of the schedule of CNS prophylaxis. A comprehensive psychometric evaluation at regular intervals is essential for longterm rehabilitation.
Congenital malformations at birth among live-born infants in Afghanistan, a prospective study.
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Birth weight gestational age correlates of neonatal mortality.
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Anthrax in infants and children in Afghanistan.
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Metastatic malignant melanoma in a child.
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Hematological responses to hydroxyurea therapy in multitransfused thalassemic children.
Fifteen multi-transfused thalassemic children between 3-6 years of age (seven boys and eight girls) were administered hydroxyurea for 5 days and three such cycles were repeated at 15 days interval. Rise in hemoglobin levels was observed in 13, 8 and 7 cases, while rise in mean hemoglobin F was seen in 8, 11 and 10 cases following 1st, 2nd and 3rd course of hydroxyurea therapy respectively. Rise in hemoglobin level was associated with transient rise in fetal hemoglobin level. Though the changes in mean hemoglobin levels and hemoglobin F levels were statistically insignificant, a definite trend of rise in hemoglobin and hemoglobin F was observed.
Neutropenic enterocolitis in children with acute lymphoblastic leukemia.
Neutropenic enterocolitis is an acute, life-threatening inflammation of the small and large bowel, often seen in children with malignancies during periods of prolonged or severe neutropenia. During the period 1990-1995, 180 children were treated at the authors' center for acute lymphoblastic leukemia using a standard chemotherapy protocol. Among them, 11 children (6.1%) aged 4 to 12 years, were diagnosed clinically to have neutropenic enterocolitis. Eight had severe neutropenia (absolute neutrophil count < 10(8)/L and 5 had prolonged neutropenia (> 7 days duration). The symptoms included diffuse abdominal pain (10 children), oral mucositis (7), hematochezia (7), diarrhea (6), hematemesis (5), and right lower quadrant tenderness (4). Three children had radiological evidence of free intraperitoneal gas and an additional 3 children were found on surgical exploration to have cecal perforation. Laparotomy was performed on 8 children (73%), 4 of whom survived. Among the 3 children managed conservatively, 1 died awaiting surgical exploration, while the other 2 did well. The overall survival was 55%. The authors recommend an approach to management that respects the heterogeneity of the disease.
Thrombocytopenic purpura following DPT vaccination.
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Rhinocerebral aspergillosis in a child with acute lymphoblastic leukemia.
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Efficacy of induction chemotherapy in retinoblastoma, alone or combined with other adjuvant modalities.
BACKGROUND: There are not much data available on the use of newer antimetabolites as an initial treatment modality in retinoblastoma, or their effect on vitreous seedings and de novo foci, especially in the Indian subcontinent. METHODS: To evaluate the efficacy of newer agents as induction chemotherapy, 34 tumors in 22 eyes of 19 children with bilateral retinoblastoma were treated with 2 cycles of carboplatin, etoposide, vincristine, and cyclophosphamide; each cycle was of 1 month duration. The tumor response was evaluated at 2 months and adjuvant salvage modalities (ie, cryotherapy, laser, and/or external beam radiotherapy) were added as needed. The cycles were continued and ophthalmoscopic and ultrasonographic monitorings were performed to determine further tumor response, tumor height regression, effect on vitreous seeds, and other ocular changes. RESULTS: Mean tumor height at presentation was 4.2 mm, which regressed to 2.61 mm at 6 months (P=0.000). The biggest tumor to respond was 12.5 mm, although smaller multiple tumors regressed better. Adjuvant modalities were used in 28 tumor foci in 16 eyes. A follow up of 6 to 24 months (mean, 12.8+/-6.21 months), showed complete regression in 12/34 tumors, partial regression in 15/34, stable disease in 6/34, and 1 tumor progressed despite all therapy. Results in all 6 eyes with vitreous seeds were most gratifying; at 1 year vitreous seeds disappeared in 4 eyes and showed complete calcification in 2. Fresh new lesions were not seen in any eye with complete response after the first 2 cycles of chemotherapy. Recurrences were nil and complications minor. CONCLUSIONS: The overall tumor response (complete and partial) of more than 80% indicates that chemoreduction is an effective modality alone and combined with adjuvant salvage modalities. The results with our treatment regime, even in cases with advanced intraocular retinoblastoma, are encouraging.