Biomedical subjects
M Agrawal
Publications and source records attributed to M Agrawal.
Vancomycin-resistant enterococcal colonization in nonhospitalized HIV-infected patients.
We studied fecal colonization with vancomycin-resistant enterococci (VRE) in 89 HIV-infected nonhospitalized patients ages 24 to 62 years, including 70 (79%) men (including 41 homosexual and 5 bisexual men) and 19 (21%) women. Of the 89 patients, 61 (69%) were black, 25 (28%) Hispanic, and 3 (3%) white; 53 (60%) had history of ongoing or recent antibacterial therapy with trimethoprim/sulfamethoxazole (29), clarithromycin (18), amoxicillin (7), ofloxacin (3), and metronidazole, doxycycline, dicloxacillin, and cephalexin (1 each). VRE were not isolated from any of the patients studied.
Morbidity after neonatal inguinal herniotomy.
Neonatal inguinal herniotomy is recognised by paediatric surgeons to be a potentially difficult procedure. This study reviewed the clinical, operative, and outcome details of 74 infants undergoing herniotomy at less than 44 weeks' gestation with particular reference to the incidence of complications such as recurrent hernia and testicular atrophy. Follow-up information was obtained in 69 patients (93%, mean follow-up, 8.1 months). There were 8 recurrent hernias in 5 patients (2 bilateral recurrences, 1 second recurrence) giving an overall hernia recurrence rate of 8.6%. There was only 1 case of testicular atrophy (secondary to a wound infection and scrotal abscess). Despite the provision of a consultant-led service, the recurrence rate in neonates is much higher than that seen in the paediatric population as a whole. In light of commissioners' current demands for quality standards and managed healthcare, it is important that outcomes in this high-risk group are defined separately from those of other patients undergoing inguinal herniotomy.
Urokinase-type plasminogen activator regulates cranial neural crest cell migration in vitro.
Proper migration and differentiation of neural crest (NC) cells are required for normal development of craniofacial structures, heart and great vessels, sensory and autonomic nervous systems, and other organs with vertebrate embryos. Serine-protease inhibitors reduce NC cell migration in vitro, suggesting the extracellular proteases are important mediators of NC cell migration. While plasminogen activator activity levels are high in NC cells relative to other embryonic tissue, its ability to regulate NC cell migration has not been specifically tested in vivo or in vitro through its ability to convert plasminogen to plasmin. Using a transfilter migration assay, NC cell migration was measured in the presence or absence of plasminogen. Our results showed that plasminogen significantly enhanced NC cell migration. This increase could not be attributed to differences in initial NC cell attachment or cytotoxicity and did not require a chemotactic gradient. The plasminogen-enhanced NC cell migration was blocked by aprotinin (a plasmin inhibitor) and was mimicked by the direct addition of plasmin to the NC cells, indicating that the plasminogen effect was mediated through plasmin generation. Furthermore, anticatalytic-uPA antibody blocked the plasminogen-enhanced NC cell migration showing that NC cell-associated uPA activity was required for this effect. Finally, decreasing NC-uPA activity by treating cells with transforming growth factor-Beta, also blocked the plasminogen-dependent increase in cell migration. These data show that in vitro, NC cell migration is regulated by NC-associated uPA activity suggesting that growth factor-regulation of this activity may play a major role in regulating NC cell migratory capacity in vivo.
Response of two cultivars of Triticum aestivum L. to simulated acid rain.
The present experiment was aimed at assessing the impact of simulated acidic precipitation (SAR) on growth, biomass accumulation and yield of two cultivars of wheat (Triticum aestivum L.), Malviya 206 and 234, varying in cuticular thickness and leaf area. Wheat cultivars were exposed to simulated rain acidified to pH 5.6 (control), 5.0, 4.5, 4.0 and 3.0 from 30 days of age, twice a week for five weeks. The plants received ambient precipitation of unknown acidity, as well as the acid rain treatments. Growth parameters such as shoot height, root length, and leaf area were reduced significantly in treated plants at different growth stages. Above and below-ground biomass also decreased significantly in the plants treated with acidic precipitation. Relative to control, the number of grains per plant and yield per m(2) declined significantly at all SAR treatments. The hypothesis that the variety with thinner cuticle and greater leaf area would be more susceptible to acidic precipitation was not supported by the present study.
Examining the applicability of market forecasting models to new pharmaceutical products.
Developing new products is a complex and risky business, particularly in the pharmaceutical industry. In recent years, several pretest and test market models have been proposed to evaluate the performance of a new product. Although these models have been tested and validated with a wide variety of frequently purchased products, certain unique characteristics of the market for pharmaceutical products render the models subject to modification. This study examines and evaluates the applicability of three types of market forecasting models (Awareness forecasting models, Pre-test market models, and Test market models) in predicting the market potential of new pharmaceutical products.
Leukaemoid reaction in megaloblastic anemia during puerperium.
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Management of alimentary tract duplication in children.
Duplication of the alimentary tract is rare but potentially dangerous. Five of 72 children with alimentary tract duplication treated between 1973 and 1992 died from postoperative complications; a further ten required more than one operation. Ileal duplications were the commonest, occurring in 16 patients (22 per cent). Thoracoabdominal duplications were the most complicated and responsible for much of the overall morbidity and mortality. Surgical complications were related to the size and location of the duplication, communication with the gastrointestinal tract or vertebral canal, presence of heterotopic gastric mucosa and involvement of mesenteric vessels. Complete excision of the duplication should be possible in most cases.
New drug adoption models: a review and assessment of future needs.
New drug products today are the key to survival in the pharmaceutical industry. However, the new product development process in the pharmaceutical industry also happens to be one of the riskiest and most expensive undertakings because of the huge research and development costs involved. Consequently market forecasting of new pharmaceutical products takes on added importance if the formidable investments are to be recovered. New drug adoption models provide the marketer with a means to assess new product potential. Although several adoption models are available in the marketing literature for assessing potential of common consumer goods, the unique characteristics of the prescription drug market makes it necessary to examine the current state of pharmaceutical innovations. The purpose of this study, therefore, is to: (1) review new drug adoption models in the pharmaceutical literature, (2) evaluate the existing models of new drug adoption using the ten criteria for a good model as prescribed by Zaltman and Wallendorf (1983), and (3) provide an overall assessment and a ¿prescription¿ for better forecasting of new drug products.
Identification of medicine.
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Meconium ileus due to extensive intestinal aganglionosis.
Seven full-term infants with aganglionosis extending into the small bowel presented with clinical, radiological, and operative features of meconium ileus. Misdiagnosis resulted in inappropriate treatment. The correct diagnosis was eventually established by rectal suction biopsy, mostly after either recurrent intestinal obstruction or stomal dysfunction, and after cystic fibrosis had been excluded. For two patients, the results of rectal suction biopsies were initially misleading. Two infants died. Extensive intestinal aganglionosis should be considered a rare possibility in all infants with meconium ileus. In such cases, histological examination of the appendix may avoid this potential pitfall.
An indirect immunoperoxidase assay for rapid serodiagnosis of visceral leishmaniasis.
An easy, inexpensive and rapid indirect immunoperoxidase assay for serodiagnosis of Kala-azar (VL) has been tried using whole promastigotes of L. donovani in dried smear form as antigen. A total of 138 sera were tested including sera from parasite positive cases of VL (32), normal controls from endemic (20) and non-endemic (20) areas, cases of tuberculosis (10), leprosy (10), amoebic hepatitis (10), malaria (10) and tropical splenomegaly (26). All the positive control sera were positive in very high dilutions of serum ranging from 1/500 to 1/64,000. None of the sera with other diseases were positive by this method except 3 cases with tropical splenomegaly were positive in low titres. No other cause could be established in these cases for splenomegaly. Sensitivity and specificity of the test were found to be 100 and 95.3% respectively. Predictive values of the negative and positive tests were 100 and 86.5% respectively.
Beliefs about the world and recovery from myocardial infarction.
Seventy male, Hindu Myocardial Infarction (MI) patients were interviewed twice--4 to 5 days after their first heart attack (Time 1) and a month after their first heart attack (Time 2). The patients' beliefs about the world (world beliefs), about the causes of the disease (causal beliefs), and about the factors contributing to their recovery (recovery beliefs) were measured. Each category of beliefs was concerned with three domains: karma, God, and just world (or self). The patients' physical and psychological recovery was evaluated. World and recovery beliefs were intercorrelated, but these beliefs were only weakly correlated with causal beliefs. Furthermore, world beliefs and recovery beliefs were positively associated with recovery from MI at both Time 1 and Time 2. Attribution of causality to God was negatively correlated with medical recovery, perceived recovery, and mood state at Time 2. This trend was in the reverse direction for attribution of causality to self.
Antioxidant potential of specific estrogens on lipid peroxidation.
Coronary heart disease (CHD) is the leading cause of death in postmenopause. Estrogen administration in postmenopause lowers the risk of CHD by 50%. A variety of estrogen preparations are currently used in postmenopausal hormone replacement therapy. It is unknown, however, if structural differences in the estrogen molecule influence the cardioprotective effects of estrogens. In this communication we have shown that equine estrogens (especially equilin) exhibit higher antioxidant potency (as measured by fatty acids and sterols oxidation) when compared to estrone and estradiol-17 beta.
Congenital mesangioproliferative nephrotic syndrome associated with cytomegalovirus infection.
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Cholesterol peroxidation potential as influenced by dietary fat type.
Oxidation of lipoproteins is believed to play a key role in atherogenesis. In this study, influence of two fat vehicles, corn oil (unsaturated) or beef tallow (saturated), on cholesterol induced effects in terms of a) plasma lipoprotein peroxidation and b) aortic accumulation of cholesterol, cholesterol oxide and malonaldehyde was investigated in weanling rabbits. Although the increase in plasma cholesterol induced by cholesterol feeding was similar in both the groups Cu2+ ion induced peroxidation of lipoprotein cholesterol to oxysterols was significantly higher in corn oil group. This difference persisted even at 5 weeks after switching to chow diet. Aortic content of cholesterol and cholesterol oxides was also significantly higher in corn oil group at the end of chow diet period. Aortic accumulation of malonaldehyde (detected by immunocytochemistry) appeared to be greater in corn oil group at the end of the study. These results suggest that fatty acid composition of a given diet during exposure to high dietary cholesterol can influence cholesterol peroxidation to oxysterols and its accumulation in aorta.