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Biomedical subjects

N Marwaha

Publications and source records attributed to N Marwaha.

69 records · Page 4Linked to original sources

The liver in siblings of patients with Indian childhood cirrhosis: a light and electron microscopic study.

Liver biopsies from 29 siblings of patients with Indian childhood cirrhosis (ICC) and from two age-matched controls were examined by routine light and transmission electron microscopy. Histochemical stainings for copper and copper-binding protein were also carried out. The mild and non-specific structural alterations that were observed did not differ from those seen in control livers, even though a slight to moderate excess of copper and copper-binding protein was demonstrated in the majority. Aggregates of microtubules seen in some siblings, as well as in control livers, may indicate the preconditions for development of Mallory hyaline. It is possible that these features suggest a susceptibility for the development of ICC but not early disease.

Carrier Proteins↗

Bleeding manifestations in megaloblastic anemia.

Ten children with megaloblastic anemia and a hemorrhagic diathesis are reported. Four of them had life-threatening bleeds necessitating an emergency blood transfusion. Seven had platelet counts of less than 30,000/cu mm, and nine had hemoglobin values of less than or equal to 5.2 g/dl at initial presentation. Deficiency of vitamin B12 was more frequently encountered. Response to therapy was excellent and hemostasis was possible within 12 to 24 hours of initiating treatment.

Anemia, Macrocytic↗

Clinico-hematological profile and natural history of childhood myelodysplastic syndromes.

The clinical and hematological characteristics of ten children with myelodysplastic syndromes diagnosed and followed up over a 3 year period are presented. All of them had anemia and a low platelet count whilst the white blood cell count was variable. Presentation with bilateral proptosis and acute febrile neutrophilic dermatosis (Sweet's syndrome) were unique features observed in one case each. None of these cases could afford specific therapy and thus serve to illustrate the natural history of the disease in pediatric practice.

Adolescent↗

Facial nerve palsy in an infant with hemophilia A.

A 5-month-old infant with hitherto undiagnosed hemophilia A, who developed a unilateral lower motor neurone type of facial palsy, is described. A high-resolution CT scan confirmed the nerve palsy to be a consequence of a hemotympanum. The patient recovered completely in 7-10 days after therapy with factor VIII concentrate.

Facial Nerve↗

Enteral nutrition in surgical patients.

BACKGROUND: Malnutrition is common in patients admitted for surgery and is a major cause of increased morbidity and mortality. Nutritional support has been shown to be of help in reducing complications. Parenteral nutrition and commercially available enteral diets are expensive, so the efficacy of a 'home-brew' enteral diet was studied in such patients. METHODS: Forty malnourished patients, 20 with benign disease and 20 with malignancy, were administered a 'home-brew' enteral diet (1140 calories and 60 g protein per litre) perioperatively for 14 days. They received 2500 to 4000 calories per day according to their requirement. Weight, triceps skinfold thickness, midarm circumference, serum albumin and transferrin, absolute lymphocyte count and creatinine-height index were monitored on days 0, 7 and 14. Nitrogen balance was estimated on alternate days and the results of the two groups were compared. RESULTS: Weight, skinfold thickness and midarm circumference did not change. Serum albumin levels showed a rise in the benign group by day 7, but the rise attained significance in the malignancy group by day 14. A similar pattern was observed in transferrin levels and there was a significant correlation (r = 0.652, p < 0.001) between albumin and transferrin levels. A positive nitrogen balance was attained earlier in the benign group (4.3 v. 5.8 days, p < 0.001). The creatinine-height index showed a rise in both groups by day 7 and a further rise by day 14. Diarrhoea was the commonest complication but was easily controlled with loperamide. The efficacy of the diet was evidenced by the improvement recorded in various objective nutritional parameters and complications were minimal. CONCLUSION: This cost-effective diet may be used for nutritional support with good results in patients in India and other developing countries.

Adolescent↗

Algorithm for recall of HIV reactive Indian blood donors by sequential immunoassays enables selective donor referral for counseling.

BACKGROUND: HIV/AIDS pandemic brought into focus the importance of safe blood donor pool. AIMS: To analyze true seroprevalence of HIV infection in our blood donors and devise an algorithm for donor recall avoiding unnecessary referrals to voluntary counseling and testing centre (VCTC). MATERIALS AND METHODS: 39,784 blood units were screened for anti-HIV 1/2 using ELISA immunoassay (IA-1). Samples which were repeat reactive on IA-1 were further tested using two different immunoassays (IA-2 and IA-3) and Western blot (WB). Based on results of these sequential IAs and WB, an algorithm for recall of true HIV seroreactive blood donors is suggested for countries like India where nucleic acid testing or p24 antigen assays are not mandatory and given the limited resources may not be feasible. RESULTS: The anti-HIV seroreactivity by repeat IA-1, IA-2, IA-3 and WB were 0.16%, 0.11%, 0.098% and 0.07% respectively. Of the 44 IA-1 reactive samples, 95.2% (20/21) of the seroreactive samples by both IA-2 and IA-3 were also WB positive and 100% (6/6) of the non-reactive samples by these IAs were WB negative. IA signal/cutoff ratio was significantly low in biological false reactive donors. WB indeterminate results were largely due to non-specific reactivity to gag protein (p55). CONCLUSIONS: HIV seroreactivity by sequential immunoassays (IA-1, IA-2 and IA-3; comparable to WHO Strategy-III) prior to donor recall results in decreased referral to VCTC as compared to single IA (WHO Strategy-I) being followed currently in India. Moreover, this strategy will repose donor confidence in our blood transfusion services and strengthen voluntary blood donation program.

Adult↗