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M Tripathi

Publications and source records attributed to M Tripathi.

At least 37 records · Page 2Linked to original sources
PubMed2003

X-linked lissencephaly in an Indian family.

Neuronal migration disorders are an important differential diagnosis to be considered in the evaluation of intractable epilepsy. Though the underlying causative factors which govern their development are many and varied, genetic factors have been found to be contributory in a few forms of these disorders. An X-linked association with lissencephaly has recently been discovered and there are a few families described till now with this entity.

Cerebral Cortex↗
PubMed2003

Absence of factor V Leiden (G1691A) mutation, FII G20210A allele in coronary artery disease in North India.

BACKGROUND: Interaction between various genetic and environmental factors is associated with coronary artery diseases (CADs). Factor V Leiden mutation (FVL) and FII G20210A polymorphism are two recently described genetic factors with a propensity towards venous thrombosis, however, with a doubtful role in coronary artery disease and myocardial infarction. AIM: Present study was conducted to assess the relationship of both these factors in coronary artery disease in population from North India. SETTING AND DESIGN: Case control study. MATERIAL AND METHODS: Two hundred angiographically proven coronary artery disease patients were studied to examine the association of Factor V Leiden mutation and FII G20210A mutation with coronary artery disease and myocardial infarction. Out of 200 patients, 51 had myocardial infarction. Two hundred controls were selected who were from north India and were also age and sex matched. RESULTS AND CONCLUSIONS: Our results indicate that both these polymorphisms were totally absent in our population, therefore, these variants cannot be considered as independent risk factors or as a predictor for CAD. However, there is a need to confirm the above findings on patients from different populations from different parts of the country as there are reports which show that the incidence of Factor V Leiden varies from 1.3 % to 10%.

Adult↗
PubMed2003

Intrathoracic pulmonary artery catheter allocation in the background of left atrial dilatation.

AIM: The aim of the study was to find out whether dilatation of the left atrium (LA) influences the intra-thoracic distribution of thermodilution pulmonary artery (TPA) catheter in either branch of pulmonary artery and compare the measured cardiac output. METHODS: In this prospective study of 132 consecutive patients in a university hospital setting, LA size and ejection fraction was assessed by echocardiography, in the preoperative period. In 66 patients posted for coronary artery bypass grafting (Group 1), a standard anaesthesia regimen was used and TPA catheter was floated through the right internal jugular. In another 66 patients of long-standing mitral stenosis for mitral valve repair/replacement (Group 2), TPA catheters were similarly floated. Intrathoracic placement of the tip of the TPA catheter into the right or left pulmonary artery (PA) was confirmed on chest X-ray. TPA catheter length to its wedging, intra-arterial pressure, heart rate, PA pressure, pulmonary artery wedge pressure (PAWP) and cardiac output by thermodilution technique were noted. RESULTS: Leftwards TPA catheter placement was significantly (p<0.001) more frequent (71%) in mitral stenosis patients (group 2) than the CABG (group 1), (18%). On regrouping the observations of rightwards placed TPA (Group R) and leftwards placed TPA (Group L), we observed that large LA (> or = 25 mm3/m2) body surface area (BSA) and high PAWP (> or = 20 mmHg) was associated with significantly (p<0.001) higher incidence of leftwards TPA catheters. Positive predictive value of both the factors in combination was significantly higher (96%) than individual factors large LA (81%) and high PAWP (88%). CONCLUSION: In long standing mitral stenosis, left atrium enlargement, with high PAWP and the hypokinesia of left atrium (atrial fibrillation) likely to influence the angulation of left PA with main PA and so the predominant entry of TPA catheter tip in left PA.

Adult↗
PubMed2003

Obstructive sleep apnoea: a case-control study.

INTRODUCTION: Obstructive sleep apnoea (OSA), is characterized by loud snoring and excessive daytime sleepiness. Though the gold standard for diagnosis is overnight polysomnography (PSG), sleep questionnaires have also been used to diagnose this with good predictive value. MATERIAL AND METHODS: A pre-designed proforma with clinical details, symptom-specific questions for diagnosis of OSA, and Epworth Sleepiness Scale (ESS) was administered to 20 patients presenting to the Sleep Disorder Clinic of our hospital and to 40 age and sex-matched relatives (control group). The students 't-test' and chi-square were used as the statistical tests. RESULTS: There were 20 patients with a mean age of 41+/- 8 years, and 40 controls with a mean age of 41 +/- 6 years (P=>0.05). Seven had family history of snoring in the study group and 3 in the control group (P=0.02). Four had met with road traffic accidents in the study group and none in the control group (P=0.001). The body mass index (BMI) was 29.9 (SD 4.4) in the study group and 24.5 (SD3.5) in the controls (P=0.001). The mean ESS was 13.3 +/- 6 in the patients and 4.2+ 4 in the controls (P=0.001). A larger number of patients with OSA had hypertension: 5/20 vs. 3/40 (P=0.01). CONCLUSION: Patients with OSA had significantly higher BMI and ESS score, and were more likely to have hypertension and road traffic accidents. Increased awareness of this entity is essential.

Adult↗
PubMed2002

Prognostic significance of captopril renography for managing congenital unilateral hydronephrosis.

PURPOSE: In this prospective study we evaluated the results of captopril enhanced diuretic renography in patients with congenital unilateral ureteropelvic junction type hydronephrosis. Captopril renography helps to distinguish patients who have renin-angiotensin system activation from those in whom it is not yet activated. Renin-angiotensin system activation heralds the beginning of compensatory vasoactive response in the kidney. Identifying grades of such activation may help in determine the end points of nonoperative management. MATERIALS AND METHODS: We prospectively studied 25 patients with suspected unilateral ureteropelvic junction obstruction treated at our department. A prenatal diagnosis was made in 60% of cases. Patient age was 1 to 144 months (mean 40) and the male-to-female ratio was 4:1. Followup was 6 to 72 months (mean 30). Patient evaluation and analysis included sonography, standard diuretic and captopril renography, glomerular filtration rate, serum creatinine and blood pressure. The indications for surgery were symptoms, differential function below 35%, or a documented decrease of 10% or more during followup. Activation of the renin-angiotensin system was considered positive when split renal function decreased significantly by 5% or more in an obstructed system on a post-captopril study. The results of captopril renography were examined retrospectively in patients who required surgery according to preexisting criteria. RESULTS: Society for Fetal Urology hydronephrosis grade was II to IV in 8, 10 and 7 renal units, respectively. The renin-angiotensin system was activated in 8 of the 25 cases (32%) of unilateral ureteropelvic junction obstruction. In 15 patients there was no change on pre-captopril and post-captopril studies and in 2 split renal function on the obstructed side marginally increased on the post-captopril study. Surgical correction was required in only 6 of the 8 patients with renin-angiotensin system activation. Of those who required surgery hydronephrosis was grades II to IV in 3, 1 and in 2 patients, respectively. CONCLUSIONS: In the current study renin-angiotensin system activation correlated with the need for surgery in 75% of the cases of congenital unilateral ureteropelvic type hydronephrosis. Since captopril serves to identify patients who have renin-angiotensin system activation, it may also be possible to grade this activation. Our preliminary results show that there may be a role for captopril renography for identifying the risk group for surgical intervention.

Captopril↗
PubMed2001

Molecular and clinical correlation in five Indian families with spinocerebellar ataxia 12.

Spinocerebellar ataxia 12 (SCA12) is a recently identified form of autosomal dominant cerebellar ataxia associated with the expansion of an unstable CAG repeat in the 5' untranslated region of the gene PPP2R2B. We analyzed 77 Indian families with autosomal dominant cerebellar ataxia phenotype and confirmed the diagnosis of SCA12 in 5 families, which included a total of 6 patients and 21 family members. The sizes of the expanded alleles ranged from 55 to 69 CAG repeats, and the sizes of the normal alleles ranged from 7 to 31 repeats. We believe our study is the first to demonstrate that SCA12 may not be as rare in some populations as previously thought.

Adult↗
PubMed2001

Stroke in a young man with fibromuscular dysplasia of the cranial vessels with anticardiolipin antibodies: a case report.

A case of fibromuscular dysplasia (FMD), presenting with a non-hemorrhagic infarct is reported. Positivity of anticardiolipin antibodies suggested an immune response. A 40-year-old man presented with sudden onset of stroke, preceded by similar ischemic attacks. Computed tomography (CT) of the brain showed a recent non-hemorrhagic infarct in the left middle cerebral artery (MCA) territory and an old right MCA territory infarct. Serum was positive for anticardiolipin antibodies. These above findings were confirmed at autopsy. A portion of the internal carotid artery and the middle cerebral arteries on both sides revealed features of FMD, with thrombosis. This case suggests an immune mechanism for FMD, hitherto unobserved in the cerebral circulation.

Adult↗
PubMed2001

Anti-inflammatory effect of (+)-pinitol.

In the carrageenin-induced paw oedema in rats, (+)-pinitol (2.5-10 mg/kg, i.p.), isolated from Abies pindrow leaves, showed a significant anti-inflammatory effect, the highest dose being comparable to phenylbutazone (100 mg/kg, i.p.).

Animals↗
PubMed2001

Cyclopeptide alkaloids from Zizyphus jujuba.

A new cyclopeptide alkaloid, jubanine-C (1), together with known alkaloids scutianine-C (4) and zizyphine-A (5), have been isolated from the stem bark of Zizyphus jujuba and identified by spectral analysis.

Alkaloids↗
PubMed2001

The beneficial effect of OST-6 (OsteoCare), a herbomineral formulation, in experimental osteoporosis.

OST-6 (OsteoCare), a herbomineral formulation, was evaluated for its inhibitory effect on the progress of bone loss induced by ovariectomy in rats. Ovariectomized (Ovx) rats were administered with OST-6 at 250 and 500 mg/kg b.wt., orally daily for 90 days. On 91st day, ovariectomized rats showed reduced bone mineral content and increased serum alkaline phosphatase levels, excretion of urinary calcium and pyridinium cross-links levels. Histologically, bone sections revealed narrowed and disappearance of trabeculae and widened medullary spaces. The total numbers of Tartrate-resistant acid phosphatase (TRAP) positive cells were significantly increased both in-vivo and in-vitro methods. OST-6, at a dose of 500 mg/kg, significantly improved bone mineral contents, serum alkaline phosphatase levels, reduced the elevated urinary calcium and pyridinium cross-links excretion, number of TRAP positive cells and reversal of the above mentioned histological features. These results indicate the usefulness of OST-6 in the management of osteoporosis in a natural way through herbal resources.

Amino Acids↗
PubMed2001

Spontaneous decompression of a posterior fossa arachnoid cyst: a case report.

The authors present a case of spontaneous regression of a posterior fossa, supracerebellar arachnoid cyst causing hydrocephalus in a 7-month-old male child. The patient presented with macrocrania, bulging fontanelle and upgaze paresis of the eyes. There was complete improvement of these symptoms on the morning of the day of surgery without any obvious precipitating factors, including trauma. CT scan showed complete resolution of the cyst and hydrocephalus. The child was doing well at 1 year of follow-up. To the best of our knowledge, this is the first case report of spontaneous resolution of a posterior fossa arachnoid cyst.

Arachnoid Cysts↗
PubMed2001

Chasing hyponatraemia: unusual presentation.

Two females, in their sixth decade, presented with recurrent episodes of headache, vertigo, vomiting and altered sensorium. Both patients had persistent hyponatraemia as the only clue. Detailed investigations revealed a pituitary aetiology in both. One patient had a pituitary microadenoma while the other had an empty sella syndrome. The diagnosis and management is discussed and the relevant literature reviewed.

Adenoma↗
PubMed2001

Serum cobalamin levels in dementias.

The present study attempts to find a correlation between low serum B-12 levels and dementias. A total of 178 patients of dementia were seen at the cognitive disorder clinic from 1996 to 1998. Serum B-12 levels were studied in 100 patients. 15 patients (39.5%) of Alzheimer's dementia had reduced B-12 levels, while only 5 patients (13.9%) with vascular dementias and 3 patients (11.5%) with other types of dementias had reduced levels. The incidence of low serum B-12 was statistically significant in the Alzheimer's group when compared with the other groups, individually as well as combined together (p<0.05). The aetiopathogenesis and significance of these findings is discussed and the literature is reviewed.

Aged↗
PubMed2000

Air or nitrous oxide for loss-of-resistance epidural technique?

PURPOSE: To compare the spinal-epidural spread of gas following loss of resistance (LOR) technique for detection of the epidural space using air or nitrous oxide (N2O). METHODS: Comparison of the spread of air and N2O in the epidural space following LOR technique was performed by using Magnetic Resonance Imaging (MRI). Ten adult patients ASA grade I served as their own control in this prospective study. A control MRI (MRI Contr-1) of the dorsolumbar spine was performed. Then, an 18 gauge epidural needle was introduced at the L3-4 intervertebral space using 0.14 ml x kg(-1) N2O for LOR and the MRI (MRI-N2O) was repeated. Forty eight hours later, an MRI scan (Contr-2 MRI) was performed and, subsequently, an 18 gauge epidural needle was introduced, using 0.14 ml x kg(-1) air for LOR followed by an MRI (MRI-Air) scan. The volumetric measurements of gas pockets were done using a formula. RESULTS: Gas bubbles after N2O were few and small compared with larger gas pockets occupying up to three vertebral segments after the use of air for LOR. The volume of air in the epidural space was 2.96+/-0.93 ml compared with 0.35+/-0.32 ml N2O. CONCLUSION: The use of N2O for LOR technique of detecting the epidural space produced very small bubbles detected by MRI compared with the use of air under similar conditions.

Adult↗
PubMed2000

Atypical "tails-up" capnograph due to breach in the sampling tube of side-stream capnometer.

OBJECTIVE: An atypical "tails-up" capnograph pattern was noticed in a patient during the use of an accidentally crushed sampling tube with a slit-like hole. We investigated the mechanics involved in the observed capnograph pattern. METHODS: Forty consenting ASA I patients of both sexes presenting for tonsillectomy were included in this study. After intravenous induction of anaesthesia, intermittent positive pressure ventilation (IPPV) using a mechanical ventilator was maintained for 20 min and the capnograph trace, ETCO2, and inspiratory/expiratory sevoflurane were compared using a breached sampling tube and then an intact sampling tube. Similar comparisons were made during spontaneous breathing. RESULTS: During IPPV, an atypical "tails-up" capnograph was noted using the breached sampling tubing. At similar inspiratory sevoflurane (2.0 +/- 0.03) levels, expiratory levels (0.9 +/- 0.03) were significantly lower when using the breached sampling tube than the intact tube (1.7 +/- 0.03). ETCO2 with the breached sampling tube (26.8 +/- 0.30 mmHg) showed significantly lower values than with the intact sampling tube (37 +/- 0.3). During spontaneous breathing, the capnograph was normal in shape with both sampling tubes, but ETCO2 and both insp./exp. sevoflurane levels were lower with the breached sampling tube. CONCLUSION: During IPPV, pressure in the breathing circuit is lower during exhalation, thus allowing air to enter through the slit-like hole in the sampling tube causing erroneously low ETCO2 and expiratory sevoflurane. With inspiration, positive pressure in the breathing circuit, transmitted to the sampling tube, prevents air admixture and the upsurge in CO2 is displayed giving the capnograph an atypical "tails-up" appearance. During spontaneous breathing, since pressure in the breathing circuit barely becomes positive during exhalation and is negative during inspiration, air mixes with the sampled gas during both phases and so the capnograph shape was normal but with lower values for ETCO2, insp./exp. sevoflurane, and nitrous oxide levels. If undiagnosed, this defect in the sampling tube can lead to significant errors in the measurement of inspired and expired gas concentrations.

Adolescent↗