Search PubMed⌕ Search

Biomedical subjects

M Tripathi

Publications and source records attributed to M Tripathi.

At least 19 recordsLinked to original sources
PubMed2006

Association of CYP2D6 100 C > T and 2850 C > T polymorphisms with generalized tonic clonic seizures among Indians.

Multiple avenues of research have provided evidence for the role of genetic and environmental factors in epilepsy. Previous studies indicated an association of debrisoquine hydroxylase (CYP2D6) with susceptibility to epilepsy. In this study, association of CYP2D6 100C > T and 2850C > T polymorphisms with generalized tonic clonic seizures (GTCS) among Indians has been analysed using case-control approach. A significant association of 2850C > T (P = 0.015) has been observed. Comparison between phenytoin toxic and others among patients showed no association of these polymorphisms with phenytoin toxicity.

Adult↗
PubMed2006

Anchoring of the internal jugular vein with a pilot needle to facilitate its puncture with a wide bore needle: a randomised, prospective, clinical study.

In this prospective, randomised study, consented adult patients of both genders were divided into two groups. In group 1 (n = 79) patients, during internal jugular vein cannulation, the pilot needle was removed before the wide bore needle (18G) puncture. In group 2 (n = 78) patients, the internal jugular vein was anchored by leaving the pilot needle in place during wide bore needle puncture. In demographically similar groups, the first attempt success rate improved from 64% in group 1 to 81% in group 2 (p < 0.05). Internal jugular vein puncture was more frequently detected at the entry of the needle with anchoring (group 2: 78%) than without (group 1: 53%); p < 0.05. Ultrasonography of a further 30 internal jugular vein punctures in each group demonstrated that the anchoring manoeuvre (group 2b) significantly (p < 0.05) prevented an indenting effect of the puncture needle, with a higher vertical to horizontal diameter ratio of the internal jugular vein when there was anchoring (0.97; SD 0.004) than without pilot needle anchoring (0.65; SD 0.008). In conclusion, when using surface landmarks, anchoring of the internal jugular vein with the pilot needle facilitated its puncture.

Adult↗
PubMed2006

Expression of CD34 as a novel marker for glioneuronal lesions associated with chronic intractable epilepsy.

The spectrum of glioneuronal lesions underlying intractable epilepsies includes malformative pathologies like focal cortical dysplasia (FCD); and neoplastic lesions like gangliogliomas (GG) and dysembryoplastic neuroepithelial tumours (DNT). These may occur either singly or as dual lesions, having simultaneous presence of both elements. Currently, the relationship between the malformative and neoplastic glioneuronal lesions is poorly understood. Recently, CD34, a stem cell marker transiently expressed during early neurulation, has been identified in these tumours. This study was undertaken to (i) evaluate the role of CD34 as a diagnostic marker for glioneuronal lesions of epilepsy, namely, GG, DNT and FCD, and (ii) attempt to define the relationship among these lesions, using CD34 as a marker. Tissues resected from 47 patients with intractable epilepsy due to glioneuronal lesions (GG, FCD, DNT) were studied. These were evaluated for CD34 expression, using immunohistochemistry. Dysplastic or atypically differentiated neural precursors which could not be identified on routine haematoxylin and eosin (H&E) staining were highlighted by CD34 immunostaining. The pattern of immunostaining was diffuse in GGs, unlike FCDs, wherein cells were present singly or in small clusters. However, cases of DNT and control tissue were largely CD34-immunonegative. Based on these findings, we propose a possible common origin of GG and FCD, from a bipotent precursor that undergoes abnormal glioneuronal development, while DNTs possibly have a different origin. The CD34-immunoreactive cells represent dysplastic or undifferentiated neural precursors, which may signify a valuable marker for the diagnostic evaluation of neoplastic and/or malformative pathologies in patients with intractable epilepsy.

Adolescent↗
PubMed2005

Adenosine deaminase and 5'nucleotidase activities in peripheral blood T cells of multiple sclerosis patients.

Multiple sclerosis (MS) is one of the most common causes of neurological disability in young and middle-aged adults and is thought to be mediated by autoreactive T cells. Activities of adenosine deaminase (ADA) and 5'(nucleotidase (5'NT), which are involved in the differentiation and maturation of the lymphoid system, were measured in peripheral blood T cells from 21 MS patients and in 23 age and sex matched healthy controls to determine whether an association existed between these enzyme abnormalities and cellular immune functions. ADA and 5'NT activities were found significantly decreased in MS patients (P < .001 and P < .01 respectively) when compared with controls. Low levels of ADA and 5'NT activities were found irrespective of whether patients had relapsing-remitting or chronic progressive MS. These findings suggest that low levels of these enzyme activities in T cells may be related to the persistent abnormalities in T cell function in the clinical course of MS.

5'-Nucleotidase↗
PubMed2005

Clinical evaluation of the "T-Dagger": a new bedside percutaneous dilational tracheostomy device.

A number of percutaneous dilational tracheostomy devices are now available for clinical use. Recently, a new percutaneous dilational tracheostomy device, the "T-Dagger" (Criticure Invasives, India), has been introduced for rapid bedside percutaneous tracheostomy. In a prospective preliminary study, we have performed percutaneous dilational tracheostomy (PDT) using the T-Dagger in 20 adult ventilated patients in order to evaluate the safety and efficacy of the new device. The T-Dagger facilitated bedside PDT in about 3 min with no untoward incidents. There was no significant bleeding, pneumothorax, pneumomediastinum, tracheal wall injuries or difficulty in ventilation in any of the patients. We conclude that the T-Dagger shows early promise in bedside percutaneous dilational tracheostomy. However, controlled studies are required in a larger patient population before it can be recommended for routine use.

Adult↗
PubMed2005

Unidirectional whole body turning: a new lateralising sign in complex partial seizures.

BACKGROUND: The lateralising significance of unidirectional whole body turning in patients with complex partial seizures (CPS) arising from the temporal lobe was evaluated. METHODS: A total of 330 patients undergoing long term video-EEG study were included. "Unidirectional whole body turning" was defined as rotation of the trunk, head, and limbs by >90 degrees and lasting >10 s. EEG correlates, MRI, and SPECT findings were compared and outcome after surgery was noted for patients with follow up data for >1 year. RESULTS: Unidirectional whole body turning was observed in 13 patients with a mean age of 18+/-8 years. Concordance of the side of whole body turning with the EEG focus and MRI findings was observed in 11 of the 13 patients (84.7%) and in 26 of 28 seizures (92.8%). The six patients who underwent temporal lobectomy or resection of lesion, opposite to the direction of body turning, had good seizure outcome. CONCLUSION: Unidirectional whole body turning is a new lateralising sign in temporal lobe CPS with good predictive value for epileptogenic focus contralateral to the direction of turning.

Adolescent↗
PubMed2005

Diagnosis of ectopic gastric mucosa using 99Tcm-pertechnetate: spectrum of scintigraphic findings.

We highlight the spectrum of scintigraphic findings likely to be encountered in patients with ectopic gastric mucosa with illustrative cases for each such finding. 11 children (aged 4 months to 120 months, all males) underwent (99)Tc(m)-pertechnetate scintigraphic evaluation for ectopic gastric mucosa. Functioning ectopic gastric mucosa was detected in Meckel's diverticulae in three patients, in small bowel duplications in four, in a gastric duplication in one, and in intrathoracic foregut duplication cysts in three. Ectopic functioning gastric mucosa in Meckel's diverticulum, and gastric duplication is visualized simultaneously with the stomach while in intestinal duplications tracer activity can be visualized in the dynamic sequence and even before gastric tracer visualization. In the three patients with intrathoracic duplication cysts, the functioning ectopic gastric mucosa was evident only in the delayed (99)Tc(m)-pertechnetate images, much later than the visualization of stomach activity. Therefore, acquisition of delayed images are useful when the initial images are equivocal or negative in children with intrathoracic foregut duplication cysts. In addition, we suggest a hypothesis of a possible mechanism for the uptake of pertechnetate in ectopic gastric mucosa in some patients with intrathoracic forget duplication cysts. In conclusion, a variety of scintigraphic patterns may be found in patients with ectopic gastric mucosa undergoing (99)Tc(m)-pertechnetate scintigraphy depending upon the location and size of the ectopic tissue.

Child↗
PubMed2005

Angiotensin converting enzyme gene polymorphism in Indian children with steroid sensitive nephrotic syndrome.

CONTEXT: Nephrotic syndrome is one of the commonest renal problem encountered in children. It is difficult to predict at onset, the clinical course in terms of steroid responsiveness or resistance. Angiotensin converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism has been studied as a predictor of clinical course in common multi-factorial diseases including focal segmental glomerulosclerosis. There is no study available from our country till date to find out any correlation of the steroid response in idiopathic nephrotic syndrome and ACE gene polymorphism. AIM: To study distribution and correlation of ACE gene I/D polymorphism in idiopathic steroid sensitive nephrotic syndrome. SETTINGS & DESIGN: Case-control retrospective study. SUBJECTS & METHODS: We studied ACE gene polymorphism in 90 consecutive patients (82% males, 18% females) with steroid sensitive idiopathic nephrotic syndrome and 300 normal controls (NC). STATISTICAL ANALYSIS: Chi-square test and Fisher's exact test (for cases with insufficient expected cell frequencies). RESULTS: The mean age of onset was 5.3 +/- 4 years. Steroid sensitive (SS) patients showed II (SS-48%, NC-26%) genotype was more frequent than normal controls (p=0.002). There was no significant difference in genotype frequencies among steroid SS subgroups. CONCLUSIONS: In our study II genotype was more frequent in steroid sensitive nephrotic syndrome children in comparison to normal controls. Further functional studies with large number of children are required to investigate the role of II genotype in steroid sensitive nephrotic syndrome. Comparison of the genotypic frequency with steroid resistant patients may provide information, which might be useful in clinical practice.

Child, Preschool↗
PubMed2004

Seizures among families of Indian probands with different epileptic syndromes.

OBJECTIVES: To investigate the contribution of hereditary factors in the causation of different epilepsy syndromes. MATERIAL AND METHODS: Occurrence of seizures among first- and second-degree relatives of 5628 Indian probands with epilepsy, and 3357 probands with non-epilepsy neurological disorders (who acted as control population) was documented. Syndromic concordance between epilepsy probands and affected relatives was investigated. RESULTS: Twenty percent epilepsy probands (1129) had affected relatives. Relatives of epilepsy probands were more often affected compared with relatives of non-epilepsy probands (OR: 3.4). Probands with some epilepsy syndromes more often had a positive family history. Relatives of younger probands were at greater risk of having epilepsy. Sibs were more often affected compared with other first- and second-degree relatives (OR: 1.3 and 4.6). Sibs having generalized epilepsies and syndromes and febrile convulsions (FC) were at greater odds of syndromic concordance with probands compared with second-degree relatives. Sibs and second-degree relatives having idiopathic/cryptogenic epilepsy had greater odds for concordance compared with those with symptomatic epilepsies. CONCLUSIONS: One-fifth of probands with all types of epileptic syndromes have family history of seizures. Familial risk of epilepsy correlated with the epilepsy syndrome among probands and their age at presentation. Risk of relatives being affected varied as a function of the relation with probands. Concordance of epilepsy syndromes varied both as a function of the epilepsy syndrome and relation with the probands.

Adolescent↗
PubMed2004

Comparative evaluation of Tc-99m-heat-denatured RBC and Tc-99m-anti-D IgG opsonized RBC spleen planar and SPECT scintigraphy in the detection of accessory spleen in postsplenectomy patients with chronic idiopathic thrombocytopenic purpura.

OBJECTIVE: Radionuclide imaging specific for functioning splenic tissue is considered the method of choice to detect an accessory spleen in patients of chronic idiopathic thrombocytopenia purpura (ITP), who present with relapse after splenectomy. Radioimmunospleen scintigraphy with Tc-99m-labeled autologous RBC opsonized with anti-D IgG (RIS) is claimed to be more sensitive and specific than Tc-99m heat-denatured RBC spleen scintigraphy (HDRS) in the detection of an accessory spleen. We compared the efficacy of RIS with HDRBC for the detection of accessory spleens METHODS: A total of 45 patients (male:female = 17:28, age range: 6-58 years) who presented with relapse of ITP after splenectomy underwent scintigraphy with both methods. An average of 3 years had passed since surgery. All patients were imaged by a dual-head gamma camera with high-resolution collimators; planar static images and SPECT of abdomen were acquired. RESULTS: Accessory spleens were detected in 31% (14 of 45) of patients, 6 had 1 each and 8 had more than 1 (including 1 patient who had 13 accessory spleens). Both methods were concordant in all the patients. There was no difference in the scintigraphic picture (planar and SPECT) or in the size and number of accessory spleens detected. CONCLUSION: Tc-99m-labeled anti-D IgG opsonized autologous RBC spleen scintigraphy provides no additional diagnostic information over heat-denatured RBC spleen scintigraphy. Heat-denatured RBC scintigraphy thus remains the procedure of choice in the detection of accessory spleens.

Adolescent↗
PubMed2003

A study of nonepileptic seizures in an Indian population.

OBJECTIVE: The goal of this study was to evaluate the background and the clinical profile of nonepileptic seizures (NESs) confirmed by short-term video encephalography (ST-VEEG) recording in an Indian population. METHODS: Seventy-one patients with NESs were enrolled. A complete history was taken and the recorded event was reviewed to define the ictal events. Patients were divided into two groups, Group 1 with a paucity of movements and Group 2 with an excess of movement, and results were analyzed. RESULTS: The mean age was 22.9 (9.6); there were 15 males (21.1%) and 56 females (78.9%). Twenty-four patients (33.8%) were receiving antiepileptic drugs. The majority of the patients (42, 59.1%) were students. All patients were amnesic for the event and were unresponsive during the event. The other characteristics were similar events in 98.6%, hyperventilation in 58 (81.7%). Forty-two patients (59.2%) were in Group 1 and 29 patients (40.8%) were in Group 2. CONCLUSION: NES is a disease of the young and can affect the student or professional. A wrong diagnosis can result in inappropriate treatment. Awareness of this entity is critical to ensuring prompt diagnosis and early intervention.

Adult↗
PubMed2003

Phenotypic analysis of juvenile myoclonic epilepsy in Indian families.

OBJECTIVES: Phenotypic analysis of juvenile myoclonic epilepsy (JME) is presented to document the variations in disease expression. MATERIAL AND METHODS: Information on seizure type and frequency, seizure precipitating factors, electro-encephalographic (EEG) data, response to antiepileptic drugs (AEDs) and family history was collected on 500 Indian probands and 61 relatives with JME. RESULTS: The overall clinical features, EEG characteristics, and familial occurrence were similar to other reports. JME probands and relatives having absences (56 of 561, 10%), those with only myoclonic jerks (MJ) or MJ with one generalized tonic clonic seizure (GTCS) in remission without treatment (five of 561, 1%) and those who required valproic acid (VPA) and another AED for seizure control (19 of 561, 3%) are examples of differential disease expression within JME. Seizures among those having photoparoxysmal response (PPR) on EEG responded very well to VPA alone while those with all three seizure types (MJ, GTCS and absences) were poor responders. CONCLUSIONS: Recognition of clinical 'subtypes' among JME could have therapeutic implications and help improve JME phenotypic characterization for molecular studies.

Adolescent↗
PubMed2003

Seizure worsening with topiramate amongst Indians with refractory epilepsy.

In a prospective open label add-on study on 95 patients (age 1-63 years, mean 17.76 +/- 13.83 years) with seizures refractory to conventional antiepileptic drugs (AEDs) and other new AEDs, the addition of Topiramate (TPM) resulted in seizure worsening in 18 patients (19%) necessitating drug withdrawal over an average follow-up period of 4.94 +/- 1.69 months. Patients who had seizure worsening were older (P = 0.02), were more likely to have had a history of status epilepticus in the past (P = 0.03), were on three conventional AEDs (P = 0.027) or had tried one of the other new AEDs in the past with poor response (P = 0.04). Seven of 18 patients who had seizure worsening with TPM (7.4%) experienced initial seizure worsening, probably representing the subgroup with 'true' seizure worsening whilst 11 (11.6%) had initial improvement followed by 'apparent' seizure worsening. Initial seizure worsening was noted to be significantly more in females when compared with males who worsened after initial improvement (P = 0.05).

Adolescent↗
PubMed2003

Genetics in epilepsy: transcultural perspectives.

In the last two decades there have been many significant advances with regard to the genetics of human epilepsies. Knowledge of the mutations responsible for inherited human epilepsies not only will help in a better diagnosis and understanding of the mechanisms involved in epileptogenesis and their inheritance, but also will result in the development of better and safer antiepileptic drugs, discovery of novel therapeutic modalities, improved genetic counseling, and perhaps even prevention of epilepsies. The overall impact of these genetic discoveries across different populations and cultures will perhaps be beneficial to improving the lives of the millions affected by these diverse but common brain disorders.

Culture↗
PubMed2003

Radionuclide scintigraphy in the evaluation of gastro-oesophageal reflux in post-operative oesophageal atresia and tracheo-oesophageal fistula patients.

Gastro-oesophageal reflux (GOR) is a major cause of morbidity in children who undergo surgical repair for oesophageal atresia with tracheo-oesophageal fistula (OA/TOF). We performed a retrospective analysis to determine the incidence of GOR on radionuclide scintigraphy in symptomatic and asymptomatic OA/TOF patients in the first post-operative year. A total of 124 patients (74 males, 50 females), with a mean age of 3.5 months (range, 20 days to 12 months), were studied. Of these 124 patients, 67 were symptomatic and 57 were asymptomatic. On radionuclide scintigraphy, 73 patients (48 symptomatic and 25 asymptomatic) had reflux. Of the 48 symptomatic patients with scintigraphic studies positive for reflux, 79.2% (38) had proximal reflux and 20.8% (10) had distal reflux, whereas, of the 57 asymptomatic patients, 48% (12) had proximal reflux and 52% (13) had distal reflux. There was a significantly higher incidence of GOR in symptomatic children than in asymptomatic children (P<0.01). In particular, there was a significantly higher incidence of proximal GOR in symptomatic children than in asymptomatic children (P<0.001). In conclusion, the severity and incidence of GOR were significantly higher in symptomatic than asymptomatic OA/TOF patients in their first post-operative year. Scintigraphic evidence of proximal reflux correlates with the presence of symptomatic GOR.

Dilatation↗
PubMed2003

Fenestration of the posterior communicating artery.

A 21-year-old male presented with sudden onset of right-sided third nerve paresis. Angiogram showed a fenestrated posterior communication artery on the right side and no other vascular anomalies. There was no other lesion that could suggest a cause for the third nerve weakness. Fenestration of the posterior communicating artery has not been reported till date. The case is discussed and the literature on the subject is reviewed.

Adult↗
PubMed2003

Restless legs syndrome: diagnosis and treatment.

AIM: To describe clinical, biochemical and electrophysiological profile in Indian patients with Restless Legs Syndrome. MATERIAL AND METHODS: A total of 84 patients with sleep disorders were evaluated. Eight patients were diagnosed to have RLS. All underwent series of hematological, biochemical investigations and electrophysiological studies. Severity was assessed before and after specific treatment RESULTS: Eight patients presenting with clinical features of RLS formed the study group. The mean age was 51.6 +/- 13.8 years. The male : female ratio was 7:1. Six cases were primary and two were of secondary type of RLS. Seven patients reported significant improvement in symptoms after treatment CONCLUSION: RLS can be diagnosed purely on clinical criteria; and appropriate treatment results in significant relief. Thus, the recognition of this entity is essential.

Adult↗