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Biomedical subjects

M Sahu

Publications and source records attributed to M Sahu.

10 recordsLinked to original sources

Noninvasive management of Indian visceral leishmaniasis: clinical application of diagnosis by K39 antigen strip testing at a kala-azar referral unit.

Firm diagnosis of visceral leishmaniasis (kala-azar) requires organ aspiration and microscopic examination of tissue specimens. To determine the usefulness of noninvasive diagnosis by strip test detection of anti-K39 immunoglobulin (Ig) G antibody in blood specimens obtained by fingerstick, 143 Indian patients with suspected kala-azar (fever, splenomegaly, anemia) were studied. Of 120 strip test-positive subjects (subjects with presumed kala-azar [group A]), amphotericin B treatment induced clinical cure in 119. Of 23 strip test-negative subjects (subjects presumed to have other diseases [group B]), 16 had other disorders diagnosed at entry, 4 responded to empiric antimalarial therapy, 2 were proven to have kala-azar, and 1 died elsewhere after undergoing splenic aspiration. Six months after treatment ended, all 120 patients in group A and the 18 assessable patients in group B were healthy. In a region in India where visceral infection is prevalent, strip test detection of anti-K39 IgG is a clinically promising diagnostic guide in persons with suspected kala-azar.

Adolescent↗

Immunochromatographic strip-test detection of anti-K39 antibody in Indian visceral leishmaniasis.

Stored sera from 429 Indian subjects were assayed to extend the analysis of the accuracy of immunochromatographic strip-test detection of anti-K39 antibody in the non-invasive diagnosis of visceral leishmaniasis (VL). All 225 samples from patients with proven Leishmania infection tested positive [estimated sensitivity = 100%; 95% confidence interval (CI)=98%-100%]. Sera from 99 of the 100 symptomatic patients with other diseases were non-reactive (estimated specificity = 99%; CI = 94%-100%). However, samples from 13 of the 104 apparently healthy controls showed positive strip-test results (estimated specificity = 88%; CI = 79%-93%), yielding an overall specificity of 93% (190/204; CI = 88%-96%). If applied in a practical clinical setting (on symptomatic patients in whom active VL is suspected and other common infections have been excluded), strip testing of serum for anti-K39 antibody should be both sensitive and specific for diagnosing VL in India.

Adolescent↗

Hormonal effects on skin aging.

With aging, there is a decrease in the level of hormones, such as estrogen, testosterone, dehydroepiandrosterone sulfate, and growth hormone. The effect of this decrease on the skin has been poorly documented, although more data are available for estrogen than for other hormones. This article reviews the effect of decreasing hormone levels on the skin and the possible cutaneous benefits of hormone replacement therapy.

Dehydroepiandrosterone↗

Femoral artery pressures are more reliable than radial artery pressures on initiation of cardiopulmonary bypass.

OBJECTIVE: To compare radial and femoral artery perfusion pressure during initiation and various stages of cardiopulmonary bypass (CPB). DESIGN: Prospective study. SETTING: The cardiac center of a tertiary referral teaching institute. PARTICIPANTS: Sixty consecutive patients of all ages undergoing a variety of cardiac operations. INTERVENTIONS: Radial and femoral arterial pressures were measured in all patients on the same transducer, from the beginning to end of CPB. MEASUREMENTS AND MAIN RESULTS: Mean perfusion pressures on CPB measured at the femoral artery at 1, 5, 10, and 15 minutes of CPB were 38.4+/-3.6, 46.2+/-3.1, 49.7+/-3.9, and 52.8+/-4.1 mmHg and were significantly greater than the corresponding radial artery pressures (29.9+/-4.1, 35.3+/-6.1, 40.9+/-4.8, and 41.8+/-5.3 mmHg) (p < 0.001). At 30 minutes and 60 minutes of CPB, femoral artery pressures are higher (60.3+/-8.8 mmHg and 66.4+/-8.2 mmHg) compared with radial artery pressures (54.7+/-6.9 mmHg and 59.6+/-6.1 mmHg), but the difference is less significant (p < 0.05). On conclusion of CPB, mean femoral artery pressures (70.9+/-6.7 mmHg) are greater than mean radial artery pressures (67.6+/-8.1 mmHg) (NS). CONCLUSIONS: Although radial artery pressures are more commonly monitored during cardiac surgery, femoral artery perfusion pressures are more reliable during the initial part of CPB, and routine monitoring of femoral artery pressures may prevent vasoconstrictor use on initiation of CPB.

Adolescent↗

Medical ethics.

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Ethics, Medical↗

Serous fluid leakage following modified Blalock-Taussig operation using PTFE grafts.

BACKGROUND: Serous fluid leakage is an unusual but often devastating complication following the placement of a modified Blalock-Taussig shunt using a polytetrafluoroethylene graft. METHOD AND RESULTS: Between September 1994 and September 1999, out of 268 patients undergoing a modified Blalock-Taussig shunt using polytetrafluoroethylene grafts, 10 developed massive pleural effusion or seroma due to a leak from the surface of the shunt. The age of the patients ranged from 9 days to 7 years. There were 7 males and 3 females. Nine patients presented with respiratory distress between 2 and 12 weeks of shunt surgery and one presented with sudden cardiac arrest. The shunt was patent in all the patients. Initial management was conservative. i.e. by pharmacological means and tube thoracostomy. Reoperation was undertaken in 9 patients when conservative treatment failed. All patients survived except one who had a cardiac arrest before any intervention could be carried out. CONCLUSIONS: Patients with serous effusion have significant morbidity and mortality and often require reoperation. The initial management remains conservative but, if unsuccessful, re-exploration can be undertaken as it proved to be uniformly successful in our experience.

Child↗