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Biomedical subjects

N Agarwal

Publications and source records attributed to N Agarwal.

At least 73 records · Page 4Linked to original sources
PubMed1999

Contraceptive status and sexual behavior in women over 35 years of age in India.

The aim of this paper is to survey the current contraception use and analyze the sexual patterns in women above 35 years of age in India. Five hundred women, of whom 250 were at least 35 years old and 250 were less than 35 years old (control group) were interviewed with the help of a prepared questionnaire. A permanent surgical method of contraception had been accepted by 40.4% of women > or = 35 years old versus 16.8% of women < 35 years old. Of various temporary methods, an intrauterine device (IUD) was used by 5.2% and 22.8% oral contraceptive pills (OCs) by 1.2% and 9.6%, and natural methods by 6.4% and 3.2%, in women > or = 35 years and < 35 years, respectively. No contraception was used by 25.6% women > or = 35 years. A history of medical termination was given by 67.18% of non-contraceptive users vs. 27.41% of contraceptive users in women > or = 35 years. Coital frequency was noted at 4.32 times/month in women > or = 35 years but 7.2 times/month in women <35 years. Among contraceptive users > or = 35 years, coital frequency was 4.9 times/month compared with 3.9 times/month in non-contraceptive users. There is a high acceptance of irreversible sterilization and a high abortion rate in women > or = 35 years. Use of contraceptives was linked with increased sexual activity and a decreased abortion rate.

Abortion, Induced↗
PubMed1999

Early abortion by mifepristone (RU 486) followed by vaginal gel (meteneprost) versus oral (misoprostol) prostaglandin.

The present study was conducted to compare the therapeutic regimens of low-dose mifepristone (200 mg) plus vaginal meteneprost versus oral misoprostol in terms of efficacy and safety for medical termination of early pregnancy. A randomized clinical trial was conducted by the Department of Obstetrics and Gynecology at the All India Institute of Medical Sciences, New Delhi. A total of 101 subjects were enrolled within 56 days of amenorrhea. A single dose of 200 mg of mifepristone (RU 486) was given and, 48 hr later, prostaglandin was administered as either 5 mg of 9 methylene PGE2 vaginal gel, meteneprost (classified as group I) or 600 microg of oral PGE1 derivative misoprostol (classified as group II). In group I, 50 subjects and in group II, 51 subjects were treated with the respective schedule. The success rate with mifepristone + misoprostol (group II) was 88.63% which was significantly higher than that with mifepristone + meteneprost (group I) which was 82% (p < 0.05). The average duration of bleeding in cases with complete abortion was 8.95+/-5.67 and 9.77+/-6.51 in group I and II, respectively. There were no serious side-effects. Only one subject in group I (2%) required blood transfusion for heavy bleeding. This study indicated that oral prostaglandin after a low dose of mifepristone (200 mg) could be developed into an effective method to terminate early pregnancy. Oral administration of both drugs would be a more convenient, feasible, private and acceptable regimen.

16,16-Dimethylprostaglandin E2↗
PubMed1999

Fatality Analysis Reporting System demonstrates association between trauma system initiatives and decreasing death rates.

BACKGROUND: Trauma registries frequently do not include the deaths of patients who do not get to trauma centers (TCs). Thus, complementary methods of monitoring the impact of trauma system initiatives should be considered. The objective of this study is to use National Highway Safety Traffic Administration's Fatality Analysis Reporting System (FARS) and New York State Department of Motor Vehicles data and to study the impact of state and regional initiatives over a 10-year period in the seven-county Hudson Valley New York (HV) region with one regional TC in Westchester County (WC) and to assess its face validity. METHODS: FARS data for the United States (US), New York State (NY), the HV region, and WC were analyzed from 1987 to 1996. Trauma system initiatives included the following. Statewide: (1) TC standards (1989), (2) TC designation and funding (1990), (3) State Trauma Advisory Committee (1991), (4) BLS triage protocol and trauma registry (1993), and (5) quality improvement site surveys (1994). Regional: (1) one regional and two area TCs (1990), (2) helicopter services (1992 and 1994), (3) two additional area TCs, and (4) E 911 in all three counties (1995). The results were presented to the New York State Trauma Advisory Committee. RESULTS: Although nationally motor vehicle crash deaths/100,000 persons have plateaued since 1991, trauma system initiatives have been temporally associated with death rates continuing to diminish in New York, the HV, and WC. From 1987 to 1996, the HV death rate dropped from 17.00 to 9.45, a 44% drop; and the WC rate dropped from 12.51 to 7.05, a 44% drop compared with United States death rate drop of 16% (p < 0.005). The percentage of seriously injured trauma patients going to the trauma centers increased from 53% in 1990 to 72% in 1995 (p < 0.001). The STAC felt that the data reflected in part effects of New York State trauma system initiatives. CONCLUSION: The drops in motor vehicle crash death rates may reflect injury prevention as well as trauma system initiatives. Thus, although FARS and New York State Department of Motor Vehicles data cannot establish cause and effect relationships, it can monitor the aggregated impact of multiple initiatives. Taken together with increasing percentages of seriously injured trauma patients going to trauma centers and comparisons with national FARS data, the association of decreasing deaths with the implementation of a trauma system seems to have face validity.

Accidents, Traffic↗
PubMed1999

Human Müller cells express VEGF183, a novel spliced variant of vascular endothelial growth factor.

PURPOSE: Vascular endothelial growth factor (VEGF) is a potent angiogenic factor expressed as multiple RNA transcripts due to alternative splicing. During an investigation of the expression of VEGF mRNA in human Müller cells cultured under hypoxic conditions, a cDNA species was isolated whose size was incompatible with known VEGF transcripts. This study was performed to determine the nucleotide sequence of the candidate VEGF species and examine the effects of hypoxia on its expression. METHODS: Cultured human Müller cells were exposed to normoxic (20% O2, 5% CO2, 75% N2) or hypoxic (2% O2, 5% CO2, 93% N2) conditions at 37 degrees C for 4 hours and processed for reverse transcription-polymerase chain reaction (RT-PCR), molecular cloning, Southern hybridization, nucleotide sequencing, semiquantitative RT-PCR, and ribonuclease protection assay. RESULTS: The nucleotide sequence of the novel VEGF species isolated from human Müller cells had a short exon 6-encoded sequence without 18-bp nucleotides immediately upstream of the exon 7-encoded sequence in VEGF189. The 18-bp deletion (corresponding to the six amino acids Tyr-Lys-Ser-Trp-Ser-Val) was compatible with a polypeptide containing 183 amino acids (VEGF183). Although VEGF183 mRNA was found in all tissues studied, its expression seemed to be higher than that of VEGF 189 in the brain and spleen; lower in the kidney, retina, skeletal muscle, and liver; and at similar level in the heart. Exposure to hypoxic conditions for 4 hours promoted increased levels of VEGF mRNA including that of VEGF183. CONCLUSIONS: The expression of the novel isoform VEGF 183 in human Müller cells, its variable tissue expression, and its modulation by hypoxia may provide another pathway for VEGF induction of angiogenesis in the retina.

Alternative Splicing↗
PubMed1999

Tuberculosis: a rare cause of splenic abscess.

Splenic abscess is a rare condition associated with septicemic conditions. Splenic abscess due to tuberculosis is still rarer, mostly diagnosed in immuno-compromised hosts. A case of tubercular splenic abscess without any underlying disease is reported.

Abscess↗
PubMed1999

Mortality trends in falciparum malaria--effect of gender difference and pregnancy.

Falciparum malaria in pregnancy is a significant health problem in India. Pregnant women constitute an important high risk group for malaria infection which may cause abortions, stillbirths, intra-uterine growth retardation (IUGR) and premature labour. In this hospital based study on 602 admitted patients of falciparum malaria which included 314 males, 243 non-pregnant females and 45 pregnant females, there was significantly increased mortality rate in females (18.4%) in comparison to males (7.64%, p < 0.001). The mortality rate was highly significant in pregnant females (37.77%) in comparison to non-pregnant females (14.81%) and males (7.64%; p < 0.001). Severe anaemia with Hb < 5 gm% was observed more commonly in pregnant patients (20.0%) in comparison to non-pregnant patients (4.11%). Incidence of malaria infection was more in primi gravida and second gravida. Pregnancy related complications in the form of preterm live births, intra-uterine death (IUD), still births and abortions were more in primi parous than multiparous patients. As the pregnancy is associated with increased incidence and adverse outcome of P.falciparum malaria infection, chemoprophylaxis should be made an integral part of antenatal care along with antianaemia therapy to reduce the risk of serious maternal and fetal complications.

Adult↗
PubMed1999

Screening for Chlamydial infection in women attending STD clinic by polymerase chain reaction, ELISA and cell cytology.

Thirty five female patients with endocervicitis attending STD clinic were studied for the presence of Chlamydial infection by Polymerase Chain Reaction (PCR), Enzyme Immunoassay (EIA) and Cell Cytology. PCR was found to be positive in 54.2% of patients, Enzyme-Linked Immunosorbent Assay (ELISA) in 25.7% of patients, but cell cytology revealed the presence of inclusion bodies only in 3% of the cases, thereby showing that polymerase chain reaction is a better method for detection of Chlamydia trachomatis than EIA and cell cytology.

Adult↗
PubMed1998

Importance of blood glucose level at the time of admission in severe and complicated malaria.

A prospective study of blood glucose level at the time of admission was done on 532 cases of severe and complicated malaria admitted in classified malaria ward at PBM Hospital, Bikaner. Eleven patients had blood glucose level < 40 mg% (< 2.2 mmol/L) and all were unconscious with diagnosis of cerebral malaria. Four patients became conscious with i.v. infusion of 25% dextrose only without receiving any specific antimalarial treatment. Recognition of these patients of "falciparum malaria with hypoglycaemia" by blood glucose estimation at the time of admission can significantly affect the ultimate outcome. The mortality trend was more in patients having blood glucose level < 40 mg% (< 2.2 mmol/L) in comparison to group of patients having blood glucose level between 41 to 60 mg% (2.2 to 3.3 mmol/L) and was least in those having blood glucose level > 60 mg% (> 3.3 mmol/L).

Adult↗
PubMed1998

Prevalence and determinants of central obesity and age-specific waist:hip ratio of people in five cities: the Indian Women's Health Study.

OBJECTIVE: To study the prevalence of central obesity and age-specific waist:hip ratio of urban women from five Indian cities. DESIGN AND SETTING: Cross-sectional surveys were conducted in 6-12 urban streets in different parts of India using similar methods of sample selection and criteria of diagnosis. SUBJECTS AND METHODS: We randomly selected 3212 women, aged 25-64 years, from Moradabad (n = 902), Trivandrum (n = 760), Calcutta (n = 365), Nagpur (n = 405), and Bombay (n = 780). Evaluation was by a questionnaire administered by a physician and a dietician, a physical examination, and anthropometric measurements. RESULTS: The overall prevalence of central obesity among the total number of women was 55.0%, with the highest prevalence in Calcutta (62.2%) and the lowest in Bombay (47.4%). Waist:hip ratio was 0.85 +/- 0.13 (mean +/- SD) with the highest ratio for women in Calcutta (0.87 +/- 0.12) and the lowest for women in Moradabad (0.84 +/- 0.16). After pooling of data from all five cities, multivariate logistic regression analysis showed that, regardless of age, body mass index (> 23 kg/m2; odds ratio 1.12), sedentary lifestyle (odds ratio 2.51), and family history of obesity (odds ratio 2.15) were strongly associated with central obesity. Excess intake of fat was weakly associated with central obesity but age was not a risk factor for central obesity, although the prevalence was highest among those aged over 55 years in Moradabad, Calcutta, and Nagpur. CONCLUSIONS: The overall prevalence of central obesity among the urban women of India has increased, more so in Calcutta and Trivandrum. Body mass index, sedentary lifestyle, and family history of excess intake of fat were significant risk factors for central obesity.

Adult↗
PubMed1998

Comparison of magnified chemiluminescent examination with incandescent light examination and colposcopy for detection of cervical neoplasia.

Magnified Chemiluminescent Examination (MCE) or speculoscopy is a new visual method for detection of cervical neoplasia. It utilizes low magnification and a special "blue-white" chemiluminescent light. The study includes 125 women with unhealthy cervix who were subjected to magnified examination with projected incandescent light (PIL) and chemiluminescent light (MCE). This was followed by colposcopy and directed biopsy from acetowhite areas. Of all 125 subjects, 20 patients showed cervical neoplasia of varying degree on histopathology. MCE could detect 18/20 neoplasias while PIL detected 11/20 cases. Sensitivity of MCE (90%) was significantly superior (P < 0.05) to PIL (55%) in detecting cervical neoplasia. Colposcopy, as compared to MCE, is better than speculoscopy as it facilitates grading of lesions due to higher magnification but antecedent MCE detected the acetowhitening in majority of patients (32/43). However, tendency to "overall" acetowhite lesions was significantly less during MCE when compared with colposcopy. Thus, MCE is a new diagnostic tool which is better than routine incandescent light examination and correlates well with colposcopy.

Adult↗
PubMed1997

Possible involvement of Bcl-2 pathway in retinoid X receptor alpha-induced apoptosis of HL-60 cells.

Retinoids induce granulocytic differentiation and subsequent apoptosis in human myeloid (HL-60) leukemia cells. Differentiation is induced due to activation of retinoic acid receptors (RARs) whereas, activation of retinoid X receptors (RXRs) seems to be essential for driving these cells into apoptosis. In order to understand the mechanism of RXR induced apoptosis, we used a variant HL-60 cell line (HL-60R) with a transdominant negative mutation. The retroviral vector-mediated gene transfer was used to introduce the functional RARs or RXR alpha into HL-60R cells. We studied the effect of receptor-selective retinoid treatment on the expression of Bcl-2 and Bax oncogenes by reverse-transcription polymerase chain reaction (RT-PCR) and immunoblot analysis in RARs and RXR alpha transfected HL-60 cells. Our results show that activation of RXR alpha results in apoptosis via down-modulation of Bcl-2 mRNA as well as its gene product expression with no change in Bax mRNA expression.

Alitretinoin↗
PubMed1997

Human papillomavirus-16 E6/E7 transfected retinal cell line expresses the Müller cell phenotype.

The introduction of viral transforming genes into mammalian cells has been used in establishing cultures of unlimited lifespan. Although Müller cells, the predominant glial cells in the mammalian retina, have been isolated using a variety of techniques, most of these cultures have limited capacity for cell division and are often contaminated by other cell types especially astrocytes, endothelial cells and microglial cells. We have established pure cultures of retinal cells which express Müller cell characteristics and exhibit unlimited growth in vitro. We now report the techniques involved in the propagation and characterization of these cultures. Mixed retinal cultures isolated from dystrophic rat retinas were infected with defective retroviruses coding for human papillomavirus (HPV) type 16 E6 and E7 proteins. The disabled viral constructs also contained the neomycin gene allowing selection of the cultures using Geneticin, a neomycin analogue. Pure cultures were then obtained from Geneticin-selected populations by limiting end-dilution techniques. The expression of the HPV-16 E6/E7 genes in the transfected cell line was established using an HPV-16 E6/E7 PCR product to probe Northern blots. Cloned cells were found to be highly reactive for Müller cell markers including S-100, carbonic anhydrase-C, cellular retinaldehyde binding protein, and glial fibrillary acidic protein but not for glutamine synthetase. Ultrastructural studies showed stacks of cells with long elaborate processes, short microvilli, coated pits, cytoplasmic filaments, abundant perinuclear rough endoplasmic reticulum, and smooth endoplasmic reticulum extending to the cell processes. Growth patterns of late passage cells (> 50 passages) showed a lag phase of 48 hr followed by exponential growth extending past visual confluence at day 5. Since the cultures have undergone more than 240 population doublings, they can be characterized as a continuous cell line with unlimited lifespan. The HPV-16 E6/E7 transfected Müller cell line may prove useful in studies requiring abundant and pure cultures of Müller cells.

Animals↗
PubMed1997

Combination of antisense oligonucleotide and low-dose chemotherapy in hematological malignancies.

Current conventional chemotherapy for the treatment of hematological malignancies, although quite effective, has associated toxicities to normal tissue and organs, which is still a major dose limiting factor. In addition, high dose chemotherapy followed by autologous stem cell transplantation is limited by tumor cell contamination in the stem cell harvest. The use of conventional chemotherapy alone to purge these tumor cell contaminants is known to damage normal hematopoietic progenitor cells, resulting in delayed engraftment. The combination of antisense oligodeoxynucleotides (ODN) and low doses of chemotherapy offer a potential regiment which may lower the doses of conventional therapeutics required to effectively combat disease, thus lowering cytotoxicity experienced by normal cells. Transient downregulation of genes by ODN treatment, which are involved in the transformation or perpetuation of the cancerous disease state, can remove the growth and survival advantages exploited by tumor cells. Many groups are currently investigating this combination and have produced intriguing results. This review article discusses the current research investigating the combination of antisense ODN therapy with conventional chemotherapy in the treatment of hematological malignancies. Although further improvements in this strategy are required, the results thus far support a future for this strategy in clinical management of hematological malignancy.

Antineoplastic Combined Chemotherapy Protocols↗