Changing patterns of treatment for chronic anal fissure.
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Anal Canal↗
Biomedical subjects
N Kumar
Publications and source records attributed to N Kumar.
Effect of 'Mentat' on the pharmacokinetics of single and multiple doses o phenytoin in rabbits.
The effect of 'Mentat', a herbal preparation, was studied on pharmacokinetics of single and multiple doses of phenytoin in rabbits. No significant effect was found after single oral dose of 'Mentat' on single dose kinetics of phenytoin. However, 'Mentat' administration for 7 days increased the steady state kinetic parameters. Peak plasma phenytoin concentration, area under the implasma concentration and elimination half life were significantly increased and t-max was significantly reduced, indicating the suppression of phenytoin metabolism by 'Mentat'.
Animals↗
Aspiration cytology of renal cell carcinoma in an adolescent girl.
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Adolescent↗
Complications of intra- and peri-articular steroid injections.
A prospective study was conducted to investigate the possible complications associated with intra- and peri-articular steroid injections. Data are presented on 1147 injections performed on 672 patients out of a total of 688 consecutive patients attending an orthopaedic outpatient setting. It was found to be a safe procedure, with a very low complication rate, if performed while taking adequate precautions. This should encourage general practitioners to offer these injections in their surgeries.
Adolescent↗
Role of computed tomography in spinal trauma.
Twenty patients admitted for spinal trauma were studied with computed tomography (CT) scan. All the patients had initial routine plain radiographs in the anteroposterior and lateral views. Ten patients sustained injury due to fall from height, 7 suffered road side accident, 2 had injury due to fall of weight on back and one suffered due to slip on floor. Twelve patients had injury at multiple levels. Twenty-four vertebral bodies were involved in 20 patients, 10 had fracture of posterior elements only. Neurological deficit occurred in 16 patients. CT scan provided more information than plain radiography, which missed vertebral body fracture in 2 out of 24 instances and spinal canal compromise in 7 out of 12 patients. CT scan detected posterior element injuries better and in greater detail in all cases.
Adolescent↗
Medullary thyroid carcinoma with melanin production--a case report.
Melanin production in medullary thyroid carcinomas is rare. The present case illustrates melanin and other atypical features of medullary carcinoma of the thyroid in a fifty year old female. The diagnosis was suggested on the cytomorphological features seen on fine needle aspiration cytology smears. On histo-pathological examination the tumor was extensively pigmented with frequent mitosis. Amyloid was conspicuously scarce. Confirmation of diagnosis was done by immunohistochemical positivity for calcitonin and HMB-45 on tissue sections. The case is being presented in view of its rarity and distinct immunoreactivity. Review of literature is done and the implications of such dual positivity in the histogenesis and divergent phenotype of this tumor are discussed.
Antigens, Neoplasm↗
Lack of pharmacokinetic interaction between grapefruit juice and phenytoin in healthy male volunteers and epileptic patients.
The present study was undertaken to determine the effects of grapefruit juice (GFJ) on the oral bioavailability of phenytoin (DPH). Ten healthy male volunteers received a single dose of 300 mg of DPH orally with 300 ml of water or fresh GFJ in a randomized crossover fashion. In both instances, blood sampling was done at 0, 0.5, 1, 2, 4, 6, 9, 12, 24, 48, 72, 96 and 120 h. The study was also carried out in 10 epileptic patients with uncontrolled seizures even after 3 to 4 weeks regular therapy of DPH (100 mg three times a day). Blood samples were drawn at 0, 1, 2, 3, 4, 5, 6 and 8 h after DPH with 300 ml of water or fresh GFJ. No significant difference was observed in any of the pharmacokinetic parameters like Cmax, Cmin, Tmax, t1/2a, t1/2e and AUC of DPH after GFJ administration as compared to control values in healthy volunteers and epileptic patients. It is concluded that GFJ does not affect the oral bioavailability of DPH.
Adult↗
Functional role for the c-Abl tyrosine kinase in meiosis I.
The c-Abl tyrosine kinase is activated by ionizing radiation and certain other DNA-damaging agents. The DNA-dependent protein kinase (DNA-PK) and the ataxia telangiectasia mutated (ATM) gene product, effectors in the DNA damage response, contribute to the induction of c-Abl activity. The present study demonstrates that c-Abl is expressed in mouse and rat testes, and predominantly in pachytene spermatocytes of meiosis I. The results also demonstrate that c-Abl interacts directly with meiotic chromosomes. In concert with a requirement for c-Abl at the pachytene stage, we show that, in contrast to wild-type mice, testes from Abl-/- mice exhibit defects in spermatogenesis. These findings provide the first demonstration that c-Abl plays a functional role in meiosis.
Animals↗
Diagnostic challenge of lobular carcinoma on aspiration cytology.
Lobular carcinomas are among the most difficult to type correctly on aspiration cytology. The inherent cytologic traits such as small size and bland appearance of cells in scanty aspirates may lead to false-negative diagnoses. Due to the low incidence of this form of breast carcinoma, there are few studies solely on lobular carcinoma, and the cytomorphologic features are not well defined. To delineate the cytomorphologic features and to assess their utility in correctly typing an aspirate as lobular carcinoma, we undertook a retrospective review of fine-needle aspirates from 31 cases of lobular carcinoma. The cytologic features of monomorphic cells, with scant cytoplasm, central vesicular nuclei, and inconspicuous nucleoli were found most helpful in correct typing of the cases. Intracytoplasmic vacuoles, nuclear grooves, and "Indian-file" arrangement of cells were corroborating features. We postulate that a combination of cytologic features makes the diagnostic delineation of lobular carcinomas possible on aspiration cytology.
Biopsy, Needle↗
Patient survival after tertiary liver transplantation.
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Adolescent↗
Effect of grapefruit juice on carbamazepine bioavailability in patients with epilepsy.
OBJECTIVE: To examine the effect of grapefruit juice on the bioavailability of carbamazepine in patients with epilepsy. METHODS: This was a randomized crossover study consisting of 2 phases. Ten patients with epilepsy who had received therapy with 200 mg carbamazepine 3 times a day for the previous 3 to 4 weeks participated. They were given either grapefruit juice or 300 mL water at 8 am along with 200 mg carbamazepine. Each treatment was separated by 2 days; subjects continued to receive carbamazepine therapy during the 2-day period. On both occasions, blood samples were collected at different time intervals between 0 to 8 hours. Carbamazepine levels were estimated by reversed-phase HPLC technique. RESULTS: Compared with water, grapefruit significantly increased the steady peak concentration (6.55 versus 9.20 microgram/mL), trough concentration (4.51 versus 6.28 microgram/mL), and area under the plasma concentration-time curve (43.99 versus 61.95 micrograms.h/mL) of carbamazepine. No significant effect was found in the time to reach peak plasma concentration. CONCLUSION: Grapefruit juice increases the bioavailability of carbamazepine by inhibiting CYP3A4 enzymes in gut wall and in the liver.
Adult↗
Inhibition of the growth and development of asexual and sexual stages of drug-sensitive and resistant strains of the human malaria parasite Plasmodium falciparum by Neem (Azadirachta indica) fractions.
Neem (Azadirachta indica) has been shown to possess anti-malarial activity. In this study we systematically evaluated extracts of neem seeds and purified fractions further enriched in polar or non-polar constituents for their effect on in vitro growth and development of asexual and sexual stages of the human malaria parasite Plasmodium falciparum. Use of synchronized stages of parasites suggested trophozoites/schizonts as the susceptible target stages to various neem extracts. In addition, all the maturation stages of gametocytes were also killed by various neem fractions tested. The anti-plasmodial effect of neem components was also observed on parasites previously shown to be resistant to other anti-malarial drugs, i.e. chloroquine and pyrimethamine suggesting a different mode of action. Neem seed fractions are thus active not only against the parasite stages that cause the clinical infection but also against the stages responsible for continued malaria transmission.
Animals↗
Estrogenic and progestational activity of 7alpha-methyl-19-nortestosterone, a synthetic androgen.
Synthetic androgens exhibit estrogenic/antiestrogenic and progestational activities in addition to their androgenic effects. To investigate the pharmacological action of the synthetic androgen, 7alpha-methyl-19-nortestosterone (MENT), we examined its action in female rodents. The criteria employed for estrogenic/antiestrogenic effects were, uterine weight increase, vaginal cornification, induction of progesterone receptors (PR) synthesis and stimulation of peroxidase activity in the uteri of ovariectomized rats and mice. MENT increased uterine weight in a dose dependent manner, but did not cause vaginal cornification or stimulate PR synthesis in the uterus. The uterotropic activity of MENT was 200-fold lower than that of estradiol. Estrogen receptor (ER) bound [3H]-E2 was displaced by E2 and MENT with ED50 values of 70 pg and 250 ng, respectively, a 3,500 fold difference in their binding affinity. The low binding of MENT to ER, in contrast to its relatively high uterotropic action, suggested that receptors other than ER may be involved in its action on the uterus. The progestational activity of MENT in immature rabbits using the McPhail index assay was comparable to that of progesterone. Binding affinities of MENT and progesterone to PR were also comparable. However, the action of MENT on the uterus does not seem to be a progestational effect since mifepristone, an antiprogestin, had no effect on MENT-induced uterine growth. Specific androgen receptors (AR) in uterine cytosol were demonstrated. The involvement of AR in MENT action was confirmed by using an antiandrogen (flutamide) and an antiestrogen (ICI-182) in ovariectomized mice. Although MENT did not block the uterotropic effect of E2, it inhibited the E2-induced cornification of vaginal epithelium, induction of uterine PR synthesis and increase in uterine peroxidase activity in ovariectomized rats. The antiestrogenic effect of MENT was also blocked by flutamide. These results suggest that the uterotropic and antiestrogenic effects of androgens are mediated via AR. It is concluded that the increase in uterine weight caused by MENT is attributable to its anabolic effects.
Animals↗
Human herpes virus 8 (Kaposi's sarcoma herpesvirus).
Human herpes virus 8 (HHV-8) is a recently discovered herpesvirus related to Herpesvirus saimiri and Epstein-Barr virus (EBV). It has been assigned to the Rhadinovirus genus (gamma-2 herpesvirus) on the basis of its genomic sequence and structure. HHV-8 is the first member of this genus known to infect humans and it is now evident that it is the likely cause of Kaposi's sarcoma (KS). The virus is present in endothelial and spindle cells of KS, and in HIV disease the presence of HHV-8 in peripheral blood, and/or serum IgG antibodies to HHV-8, predicts the development of AIDS-related KS. HHV-8 can also infect CD19 + B cells and is of aetiological significance in the development of body cavity B cell lymphomas of AIDS. Of note, the translation products of viral open reading frames (ORFs) reveal HHV-8 to be a molecular pirate, capable of producing homologues of several human gene products that may result in alterations in cell cycle arrest, inhibit apoptosis and cell-mediated immune responses, and thus provide the potential for tumour production.
Genitalia, Male↗
Premorbid hair growth over the trunk and severity of alcohol-related liver disease.
It is unclear why only a minority (<15%) of alcoholics develop liver disease. No predisposing host factor other than gender (women are more susceptible than men) has been identified. The present study was carried out to examine the association of another host factor, hair growth over the trunk, and alcoholic liver disease. Forty-four chronic alcohol abusers were categorized into group I (scanty hair growth) and group II (profuse hair growth) based on premorbid hair distribution over the trunk. The results of laboratory tests, liver histology, and incidence of portal hypertension were compared between the two groups. There were 21 patients in group I and 23 in group II. The mean (+/- SD) daily alcohol consumption was greater in group II (230 +/- 146 g) vs group I patients (152 +/- 56 g; P < 0.05), as was the duration of alcohol abuse (17.3 +/- 7.4 vs 11.9 +/- 4.9 years; P < 0.01). Despite lower alcohol consumption, liver tests showed greater derangement in group I compared to group II patients. At histology, severe forms of liver damage were seen more frequently in group I vs group II patients (P < 0.001). Our results indicate a close association between the premorbid truncal hair growth and severity of alcoholic liver disease. These findings provide an easily recognizable clinical sign identifying individuals at increased risk of developing alcohol-related liver damage.
Adult↗
AFB staining in cytodiagnosis of tuberculosis without classical features: a comparison of Ziehl-Neelsen and fluorescent methods.
Fine needle aspirates (FNA) were obtained from lymph node and other sites in 250 suspected cases of tuberculosis. Twenty-four cases proved to be non-tubercular on FNA smears and served as negative controls. Of the smears obtained from the remaining 226 cases, 233 were classified into five groups based on cytomorphological features, i.e. presence of necrosis and granulomas, necrosis alone or acute inflammatory exudate (AIE) with or without granuloma. Cases with AIE alone formed the largest group (n = 123). Staining for AFB was done by Ziehl-Neelsen (ZN) and fluorescent methods in all 250 cases. A correlation of AFB positivity and its semiquantitative scoring (1+ to 3+) with the cytomorphological spectrum was done. Overall AFB positivity by ZN staining was 33.5% and by fluorescent staining 45.4%. When the two methods were combined, AFB positivity was 58.7%. Fluorescent staining was superior to the ZN stain in the presence of a low bacterial load as seen in smears with diagnostic cytomorphological features of tuberculosis. In problem areas like AIE alone or with occasional granulomas, AFB positivity by ZN staining is nearly as good as the fluorescent method, because the bacterial load is high.
Adolescent↗
Characterization of tubular adenoma of breast--diagnostic problem in fine needle aspirates (FNAs).
FNA smears from six histologically documented cases of tubular adenoma of breast were critically analysed and compared with 10 histologically confirmed cases of fibroadenoma (five pericanalicular and five intracanalicular). Initially a cytological diagnosis of tubular adenoma was rendered only in one case. On review, two cases could be characterized as tubular adenoma, while the findings were suggestive in two others. The features helpful in diagnosis of tubular adenoma were the presence of benign ductal cells as three-dimensional cohesive balls and tubular structures in highly cellular smears. Stroma was conspicuously scanty or absent. Myoepithelial cells were present along with sheets of ductal cells as well as bipolar naked nuclei. Confusion with fibroadenoma occurred in two cases due to presence of a stag-horn pattern of ductal cells.
Adenoma↗
Evidence for epitope-specific thymus-independent response against a repeat sequence in a protein antigen.
We have studied the immunogenicity of a recombinant heat-shock protein-related stress protein of 70,000 MW (Pfhsp) of the human malaria parasite Plasmodium falciparum in H-2 congenic and non-congenic strains of inbred and outbred mice. Most mice of different genetic backgrounds produced antibodies to Pfhsp, indicating a lack of any apparent genetic restriction of immune response. A peptide corresponding to the GGMP repeat sequence in the C-terminal region of Pfhsp was recognized by more than 75% of sera from immunized mice. The GGMP repeat epitope-specific antibodies were largely of the IgM isotype, especially in all seven inbred strains of mice tested. The lack of significant boosting of the immune response, a predominantly IgM isotype of antibodies and generation of antibody responses in athymic nude mice suggest a thymus-independent response against the GGMP repeat epitope in the Pfhsp molecule.
Animals↗