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Biomedical subjects

N Shetty

Publications and source records attributed to N Shetty.

47 records · Page 3Linked to original sources

Detection of IgG, IgA, IgM and IgE in antibodies in invasive amoebiasis in endemic areas.

Entamoeba histolytica--specific serum IgG, IgA, IgM and IgE were assayed in cases of amoebiasis in an endemic area. Patient groups consisted of amoebic liver abscess (n = 18), pre abscess hepatic amoebiasis (n = 22) and amoebic colitis (n = 30). Control subjects comprised 26 asymptomatic cyst passers, 13 giardiasis cases, 20 typhoid patients and 24 non amoebic individuals. Serum IgG was assayed by ELISA: using a monoclonal anti IgG beta-galactosidase (IgG beta-gal) conjugate, a polyclonal avidin biotin horse radish peroxidase (AB-HRP) and a polyclonal anti IgG horse radish peroxidase (IgG HRP) conjugate. IgA and IgM were assayed by the beta-gal ELISA and IgE by AB-HRP. Diagnostically significant IgG and IgA while lower IgM and IgE levels were seen in extra intestinal cases. About 40% of suspected pre abscess hepatic amoebiasis cases were confirmed by antibody estimation. All isotype levels in most dysentery cases were in the range of the controls. Inter assay coefficient of variation and assay specificity/sensitivity are also discussed.

Animals↗

Primary pulmonary rhabdomyosarcoma in a child, with a review of literature.

A cyst in the left lower lobe of the lung was removed from a 15-month-old girl and showed evidence suggesting a preexistent congenital cystic adenomatoid malformation; in addition a rhabdomyosarcoma was identified. Primitive mesenchyme and mesenchymal elements also were seen. The origin of the rhabdomyosarcoma is discussed. The findings in the present case are compared with those of all childhood pulmonary rhabdomyosarcomas reported in the literature. This report of a child with a coexistent congenital adenomatoid malformation and a rhabdomyosarcoma is the third of its kind in the literature.

Female↗

Evaluation of faecal preservation and staining methods in the diagnosis of acute amoebiasis and giardiasis.

The use of a faecal preservative and several staining methods, together with formalin ether concentration, were evaluated for the improved diagnosis of intestinal amoebiasis and giardiasis in 1285 patients with diarrhoea or dysentery and from asymptomatic controls. All samples were screened by three wet mount techniques. Thirty eight specimens of diarrhoeal or dysenteric stool were preserved in polyvinyl alcohol (PVA) and stained by trichrome and Spencer and Monroe short iron haematoxylin stain. Thirty nine preserved faecal samples submitted for routine screening were subjected to formalin ether concentration, wet mount examination, and permanent staining. Saline and buffered methylene blue (BMB) mounts were equally good for detection of trophozoite Entamoebae while Giardia trophozoites were detected only by the saline mount. The iodine mount was superior to the other mounts for protozoan cyst detection. The concentration procedure enhanced cyst recovery. Faecal preservation and subsequent staining was superior to wet mount examination for detection of the trophozoite stage and avoided the need for fresh specimens. Both the trichrome and the iron haematoxylin stains were comparable for the detection of cysts and trophozoites of the Entomoebae. Giardia lamblia trophozoites stained better with iron haematoxylin than with the trichrome. Preservation and permanent staining is recommended as the most productive means for the accurate identification of the various protozoan parasites.

Animals↗

Observations on the interpretation of amoebic serology in endemic areas.

Antibody to Entamoeba histolytica antigen was evaluated in cases of proven and suspected intestinal amoebiasis as well as in extra-intestinal cases from an endemic area. Screening methods included the gel diffusion precipitation test (GD), counter immunoelectrophoresis (CIE) and the indirect haemagglutination test (IHA). Control populations consisting of asymptomatic cyst passers, non-amoebic individuals, patients with giardiasis and cases of enteric fever were also screened using the above tests. All (100%) cases of amoebic liver abscess and 75-80% of hepatic amoebiasis without overt abscess formation could be detected by serology, with good correlation between the tests used. However, the interpretation of serology in cases of proven and suspected intestinal amoebiasis posed two main problems. The presence of low antibody levels even in proven cases and the persistence of antibodies due to past infection was found to reduce the diagnostic efficiency of serology for acute intestinal amoebiasis. There was no statistical difference between intestinal cases and controls when comparing either percentage of cases detected or titre of antibody obtained. The results of this study indicate that serology for acute intestinal amoebiasis can be unreliable; however, it is of undoubted value as an adjunct to clinical diagnosis in cases of hepatic amoebiasis.

Animals↗

Subtle hyperthyroidism presenting as suspected hepatobiliary disease.

Three patients, each with a nonspecific clinical history and raised serum alkaline phosphatase levels, were referred for investigation of hepatobiliary disorders. Isoenzyme analysis showed both hepatic and bony isoenzymes to be elevated, and eventually hyperthyroidism was diagnosed in each patient. Hyperthyroidism can be difficult to recognize clinically, and isolated elevation of serum alkaline phosphatase levels may be a useful clue.

Adult↗

Intestinal amoebiasis and giardiasis in southern Indian infants and children.

The role of Entamoeba histolytica and Giardia lamblia as causative agents of paediatric diarrhoea was studied in a southern Indian population. Relationship between infant feeding practices, co-existing malnutrition and the occurrence of intestinal amoebiasis and giardiasis was also examined. The subjects were 361 paediatric patients with acute diarrhoea and 70 hospitalized control children without diarrhoea. Faecal samples from cases and controls were examined for the protozoal pathogens using faecal preservatives, permanent staining and formalin-ether concentration. Bacteriological studies were conducted on 244 of the 361 cases. A high prevalence of invasive amoebiasis was seen in the 0-6 month (12.5%) and 7-12 month (20.3%) age groups. Giardiasis was uncommon under 6 months (2.1%) but occurred in 8-10% of all other age groups. Invasive amoebiasis occurred mainly in children on weaning foods (45.9%) but also [corrected] in exclusively breast-fed children (13.5%). Giardiasis was not seen in exclusively breast-fed infants, but commonly occurred in older children on normal diets. There was no association between amoebiasis or giardiasis and malnutrition.

Age Factors↗

A community genetics approach to population screening in India for mental retardation--a model for developing countries.

Some 0.55 million people living in semi-urban and slum populations were screened for mental retardation by trained primary health centre (PHC) doctors, nurses and community health volunteers (CHVs). The staff were provided with prior training on the detection, prevention and diagnosis of mental retardation, prenatal diagnosis, and reproductive responsibilities. Field visits were employed to confirm diagnosed developmental disabilities, and demographic data incorporating social maps of 14 PHCs were prepared. Cases with high-risk genetic factors detected by PHC staff were referred to the Centre for Research in Mental Retardation (CREMERE) for cytogenetic and metabolic investigations, thus linking the study population and the Referral Centre. A genetic team interacted with the patient and family members for genetic counselling. Mental retardation was confirmed in 511 of the 525 cases reported, reflecting the positive impact of training on the CHVs. Potentially preventable environmental factors, such as birth asphyxia, infections, and low birth weight were identified in 251 cases (49%), 137 (27%) of which had additional genetic factors. Genetic causes were found in 186 (36%) individuals, the most common being Down syndrome. The study illustrates the urgent need for the integration of genetic screening into the public health services in India.

Asphyxia Neonatorum↗

The placebo response in Parkinson's disease. Parkinson Study Group.

Our objective was to study the placebo response in Parkinson's disease (PD). We conducted a literature search in which placebo response was measured in all studies of PD from 1969 to April 1996. Strict criteria were defined to include or exclude published reports in our survey. The Parkinson Study Group database for Deprenyl & Tocopherol Antioxidative Therapy of Parkinsonism (DATATOP) was reviewed and placebo "responders" were compared to placebo "nonresponders" by age, race, religion, level of education, duration of PD, and gender. A significant difference between the efficacy of placebo and that of active drug was reported in 61% (22 of 36) of the articles meeting the required criteria; DATATOP analysis showed no statistically significant epidemiologic differences between 140 placebo responders and 58 placebo nonresponders except in PD effect on current job. Although there is clearly a placebo response in PD patients, our review suggests that the variation in placebo response does not correlate with demographic factors such as age, gender, religion, level of education, or duration of PD.

Female↗