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Biomedical subjects

N Shah

Publications and source records attributed to N Shah.

At least 37 records · Page 2Linked to original sources
PubMed2004

Radiation related morbidities and their impact on quality of life in head and neck cancer patients receiving radical radiotherapy.

Although 50-70% of head and neck cancer patients in India receive radiotherapy (RT), radiation-related acute and late morbidities and their impact on quality of life (QOL) are infrequently reported. Acute and late radiation morbidities and QOL were assessed in a prospective longitudinal study of 45 patients with head and neck cancers receiving radical RT to a dose of 7000 cGy in conventional fractionation. Grade II acute morbidities experienced by the largest percent of the sample during the course of RT pertained to the mucosa (66.4%), salivary gland (84%), and oesophagus (53%). These morbidities led to an increase in the symptom scores of appetite loss (76.46), fatigue (65.75) and pain (44.77). This increase in the symptom scores consequently led to a significant decline in physical, social and emotional functioning as well as global health status score during the course of RT (p < 0.001). Scores improved after 1 month of RT but did not reach the pre-RT value. Future studies may consider correlating QOL assessment to significant patient and disease related parameters such as performance status, weight loss, stage and site of disease.

Adult↗
PubMed2004

Zimmermann-Laband syndrome with bilateral developmental cataract - a new association?

An unusual case of Zimmermann-Laband syndrome in a young male child with an unreported association of bilateral developmental cataract is presented. The pathognomonic triad of gingival fibromatosis, aplastic or hypoplastic distal phalanges with absent nails, and enlargement of soft tissues of the face were obvious, besides the known moderate learning disability and mild hearing loss. The case is discussed in the light of relevant literature. To the best of our knowledge, this is the first report of early developmental cataracts in association with the Zimmermann-Laband syndrome. Besides detection and timely recognition of the syndrome to allow adequate dental care, ophthalmic screening at periodic intervals is merited to improve the overall quality of life for these patients.

Abnormalities, Multiple↗
PubMed2004

Edentulousness, denture wear and denture needs of Indian elderly--a community-based study.

India has a large geriatric population (60+ years) of 77 millions, comprising 7.7% of its total population. One of the major handicaps in the elderly is loss of teeth, affecting their mastication, dietary intake and nutritional status. The present study was planned to assess the level of edentulousness, denture wearing and denture needs of the elderly in the community and to study the correlation between oral health parameters and socio-demographic variables, diet and body mass index (BMI). A total of 1240 (716 urban and 524 rural) elderly people were studied. It was found that 60% were dissatisfied with their function of mastication because of loss of teeth and lack of dentures. The level of edentulousness was found to be high, more so in rural than in urban people and more so in advancing age, with no significant difference between male and females. The striking finding of this study was the very low level of denture wearing. Only <50% of those needing complete dentures and <13% of those needing partial dentures were wearing dentures. The denture needs of the rural elderly were higher than those of the urban elderly. Vegetarians had a higher level of edentulousness compared with non-vegetarians. The BMI was not correlated with level of edentulousness.

Age Distribution↗
PubMed2004

Amiodarone-induced peri-oral photosensitivity.

We describe a 70-year-old Caucasian man with recurrent history of blistering of peri-oral skin during summer months. Following the diagnosis of a phototoxic reaction to Amiodarone, this was discontinued and an alternative drug to control his cardiac arrhythmia was prescribed. His peri-oral lesions rapidly resolved, and there has been no further recurrence. A brief review on photosensitivity and the underlying mechanisms are discussed.

Aged↗
PubMed2004

Recalcitrant osteomyelitis following tooth extraction in a case of malignant osteopetrosis.

Malignant osteopetrosis generally begins in utero and often results in stillbirth. Besides, failure to thrive, increased bone fragility resulting in frequent fractures and recurrent bone infections are the other characteristic features. Infections after tooth extraction and fracture of the sclerotic bone following mild trauma are serious complications, as these ordinarily common problems are very difficult to treat in such patients. Poor bone vascularisation and reduced local defences prolong the defensive response. A rare case of malignant osteopetrosis in a 19-year-old girl, who presented with the complication of osteomyelitis of the mandible following tooth extraction, is presented. The case is of interest for two reasons: it is very rare for a case of malignant osteopetrosis to survive until adulthood and to be aware of the potential dental and oral complications of the disorder.

Adult↗
PubMed2004

A comprehensive analysis of DgN(CT) coefficients for pendant-geometry cone-beam breast computed tomography.

The use of a computed tomography (CT) scanner specifically designed for breast imaging has been proposed by several investigators. In this study, the radiation dose due to breast CT was evaluated using Monte Carlo techniques over a range of parameters pertinent to the cone-beam pendant geometry thought to be most appropriate. Monte Carlo dose computations were validated by comparison with physical measurements made on a prototype breast CT scanner under development in our laboratory. The Monte Carlo results were then used to study the influence of cone angle, the use of a beam flattening ("bow-tie") filter, glandular fraction, breast length and source-to-isocenter distance. These parameters were studied over a range of breast diameters from 10 to 18 cm, and for both monoenergetic (8-140 keV by 1 keV intervals) and polyenergetic x-ray beams (30-100 kVp by 5 kVp intervals. Half value layer at 80 kVp = 5.3 mm Al). A parameter referring to the normalized glandular dose in CT (DgN(CT)) was defined which is the ratio of the glandular dose in the breast to the air kerma at isocenter. There was no significant difference (p = 0.743) between physically measured and Monte Carlo derived results. Fan angle, source-to-isocenter distance, and breast length have relatively small influences on the radiation dose in breast CT. Glandular fraction (0% versus 100%) for 10 cm breasts at 80 kVp had approximately a 10% effect on DgN(CT), and a 20% effect was observed for an 18 cm breast diameter. The use of a bow-tie filter had the potential to reduce breast dose by approximately 40%. X-ray beam energy and breast diameter had significant influence on the DgN(CT) parameters, with higher DgN(CT) values for higher energy beams and smaller breast diameters. DgN(CT) values (mGy/mGy) at 80 kVp ranged from 0.95 for an 8 cm diam 50% glandular breast to 0.78 for an 18 cm 50% glandular breast. The results of this investigation should be useful for those interested computing the glandular breast dose for geometries relevant to dedicated breast CT.

Breast↗
PubMed2004

Pathology of astrovirus associated diarrhoea in a paediatric bone marrow transplant recipient.

Human astrovirus infection often causes outbreaks of self limiting diarrhoea, but may also infect patients who are immunodeficient or immunocompromised. Although there are previous publications relating to various aspects of astroviruses, there is a minimal amount of literature on the histopathological features of gastrointestinal astrovirus infection in humans. We report the histopathological findings, including immunohistochemical and electron microscopic features, of astrovirus infection in a bone marrow transplant recipient aged 4 years with diarrhoea. The appearance of a small intestinal biopsy did not suggest graft versus host disease, but demonstrated villous blunting, irregularity of surface epithelial cells, and an increase in lamina propria inflammatory cell density. Immunohistochemical staining with a murine astrovirus group specific monoclonal antibody demonstrated progressively more extensive staining in the duodenal and jejunal biopsies, predominantly restricted to the luminal surface and cytoplasm of surface epithelial cells, most marked at the villus tips. Electron microscopic examination demonstrated viral particles within the cytoplasm of enterocytes, focally forming paracrystalline arrays.

Astroviridae Infections↗
PubMed2003

Uterine sarcoma: twenty-seven years of experience.

PURPOSE: A correlation of treatment for uterine sarcoma with outcome, prognostic importance of pathology, and clinical parameters. PATIENTS AND METHODS: One hundred forty-one patients (median age: 56 years, range: 19-85 years) with a histologically verified uterine sarcoma were identified from a database compiled at the Royal Marsden Hospital and the University of Florence between 1974 and 2001. Seventy-two patients had leiomyosarcoma, 42 had mixed müllerian tumors, 22 had endometrial stromal sarcoma, 1 hemangiopericytoma, 1 rhabdomyosarcoma, and 3 patients had unspecified sarcoma. According to FIGO classification, Stage I, II, III, and IV tumors were identified in 71, 13, 31, and 26 patients, respectively. RESULTS: At the time of analysis, 73.7% of patients were dead, and 26.3% were alive with a median survival of 2 years from initial diagnosis. Univariate analysis for cause-specific survival demonstrated statistical significance for histology (p = 0.02), grade (p = 0.003), stage (p = 0.007), and age (p = 0.02). Multivariate analysis demonstrated significant prognostic values for stage (p = 0.02) and histology (p = 0.05) only. Postoperative radiotherapy with a total dose higher than 50 Gy seems to be significant (p = 0.001) in reducing local recurrence. CONCLUSIONS: Our data favor treatment for Stages I, II, and III of uterine sarcoma with radical surgery plus radical dose irradiation comprising both external beam radiotherapy and brachytherapy.

Adult↗
PubMed2003

Dissipative dynamics of an extended magnetic nanostructure: spin necklace in a metallic environment.

We study theoretically the dynamics of an "xxz" spin necklace coupled to a conduction electron sea, a model system for a nanostructure in a dissipative environment. We extract the long-time behavior via a mapping to a multichannel Coulomb gas problem followed by a scaling analysis. The strong quantum fluctuations of the necklace cause a nontrivial dependence of couplings on system size which we extract via an analysis involving the "boundary condition changing operator," and confirm via a detailed numerical evaluation of one case.

Journal Article↗
PubMed2003

Gender issues and oral health in elderly Indians.

OBJECTIVES: Gender disparity in health and diseases is increasingly being recognised. Therefore, it was decided to investigate gender differences in the elderly subjects (60+years) from a community-based study. The study was undertaken to evaluate the oral health status and treatment needs of urban and rural elderly and to study the impact of socio-demographic variables on them. STUDY DESIGN: An urban area in South Delhi and its adjoining four villages was selected. A modified WHO-Oral Health Survey proforma and Rup-Nagpal's scale were used to record oral health and socio-demographic data respectively. In addition, diet pattern (vegetarian/non-vegetarian) and body mass index (BMI) were also recorded. Chi square test and p values were calculated for each of the studied parameters. RESULTS: There were significant differences for socio-economic status, literacy level, marital and family status between elderly men and women (p<0.0001). A higher percentage of elderly women were vegetarian and overweight than elderly men (p<0.01). However, there were few differences found in the prevalence of dental caries, periodontal diseases and edentulousness between male and female elderly (p>0.01). The only difference found was in the evidence of previous dental treatment received. Elderly men had a higher percentage of filled teeth and denture wear compared to elderly women (p<0.01). CONCLUSIONS: Women's oral health is significantly influenced by social, economic and psychological factors.

Aged↗
PubMed2003

Surgical and patient reported outcomes of 'clam' augmentation ileocystoplasty in spinal cord injured patients.

OBJECTIVE: To study the outcomes and effectiveness of 'clam' augmentation ileocystoplasty in the treatment of suprasacral spinal cord injured patients with detrusor hyperreflexia refractory to pharmacological and other conservative therapy. METHODS: A retrospective review of spinal injured patients who had undergone 'clam' augmentation ileocystoplasty was performed, followed by a specifically designed questionnaire/telephone interview to assess patient satisfaction and other issues from this specific group of patients with suprasacral spinal cord lesions. 32 patients were followed up for a mean of 6.0 +/- 3.6 years. RESULTS: Complete continence was found in all patients. There was a significant improvement in bladder capacity from a mean 143 +/- 81 ml pre-operatively to 589 +/- 188 ml post-operatively, and the maximum detrusor pressure fell from a mean of 108 +/- 43 cm H(2)O to 19 +/- 15 cm H(2)O. Pre-operative vesico-ureteric reflux resolved completely in 4 out of 5 patients and improved from grade IV to grade II in one, illustrating the need for achieving low bladder pressures rather than the performance of an anti-reflux procedure at the time of cystoplasty. The use of the questionnaire, designed to evaluate this subset of patients after augmentation cystoplasty, highlighted the high levels of satisfaction with the operation in this group of patients with 96.2% of patients reporting an improvement in quality of life parameters. CONCLUSION: Using an appropriate questionnaire we have found high satisfaction rates, in addition to successful surgical outcomes, in spinal cord injured patients following augmentation cystoplasty. We recommend using this questionnaire as part of the work-up and ongoing assessment of spinal injured patients undergoing 'clam' augmentation ileocystoplasty.

Adolescent↗
PubMed2003

B-cell development in the presence of the MLL/AF4 oncoprotein proceeds in the absence of HOX A7 and HOX A9 expression.

Infant acute lymphoblastic leukemia (ALL) is frequently characterized by the t(4;11)(q21;q23) cytogenetic abnormality encoding the MLL/AF4 oncogene, increased HOX gene expression and a pro-B/monocytoid phenotype. We have previously established a novel MLL/AF4-positive cell line, B-lineage 3 (BLIN-3), which retains several features of normal B-lineage development (functional Ig gene rearrangement and apoptotic sensitivity to stromal cell withdrawal) not generally observed in infant ALL. We now use microarray analysis to identify patterns of gene expression in BLIN-3 that may modulate MLL/AF4 oncogenesis and contribute to the retention of normal B-lineage developmental characteristics. Comparison of 6815 expressed genes in BLIN-3 with published microarray data on leukemic blasts from t(4;11) patients indicated that BLIN-3 was unique in lacking the expression of certain HOX-A cluster genes. These results were validated by RT-PCR showing no expression of HOX A7 or HOX A9 in BLIN-3. A HOX C8 promoter reporter was active in BLIN-3, indicating that lack of HOX gene expression in BLIN-3 was not due to a nonfunctional MLL/AF4. Our results suggest that B-lineage development can proceed in t(4;11) leukemic blasts in the absence of HOX-A gene expression.

B-Lymphocytes↗
PubMed2003

Modulation of endothelial cell inflammatory integrins and stress markers with rh-factor VIIa in patients with advanced chronic hepatitis C.

Individuals with chronic hepatitis C (CHC) progress to cirrhosis and hepatic cancer. Individuals with advanced CHC are coagulopathic and can manifest fibrinolysis. The coagulopathy is a consequence of hepatocytic dysfunction. The fibrinolysis represents a response to local endothelial cell injury, and is of a low-grade. Based upon this hypothesis, the effect of the infusion of recombinant human factor VIIa (rh-FVIIa) on endothelial cell inflammatory integrins and measures of endothelial stress were determined in 17 individuals with advanced CHC. Immediately prior to the infusion of rh-FVIIa, the plasma levels of tissue factor (TF), Thrombomodulin (TM), human soluble ICAM-1 (hs-ICAM-1), human soluble VCAM-1 (hs-VCAM-1), human soluble L-Selectin (hs-L-Selectin), the prothrombin time and the activated partial thromboplastin time were determined. The same parameters were assayed at 5, 10, 30, 120, 240 and 360 min after infusion. TF and TM levels were very high at baseline consistent with a vascular endothelial stress response. Similarly hs-ICAM-1, hs-VCAM-1 as well as L-Selectin levels were increased. Thirty minutes after the infusion, a marked reduction in ICAM-1 and VCAM-1 and to a lesser degree L-Selectin levels was observed. This reduction persisted for 360 min. No change in measures of fibrinolysis [plasminogen activator inhibitor-1 (PAI-1), total tissue factor pathway inhibitor (t-TFPI), activated tissue factor pathway inhibitor (TFPIa), d-dimers (DD), FSP and fibrinogen levels] occurred. In addition, no change in plasma Annexin-V was observed. Based upon these data it can be concluded that: (1) rh-FVIIa corrects the coagulopathy seen in advanced CHC; (2) reduces endothelial cell injury and/or stress as evidenced by the TF, TM, hs-ICAM-1 and hs-VCAM-1 levels in plasma; (3) these changes in coagulation occurred without inducing a propagated vascular thrombosis.

Adult↗
PubMed2003

Urethral catheter: a pain in the neck!

Long-term urinary catheterization is well recognized in the literature as being associated with significant morbidity and mortality. We present a rare and previously unreported complication of a cervical spine abscess resulting from methicillin-resistant Staphylococcus aureus septicaemia originating from the urinary tract in a patient with a urinary catheter.

Abscess↗