Biomedical subjects
R Aggarwal
Publications and source records attributed to R Aggarwal.
Incidence of congenital heart disease among hospital live births in India.
Ten thousand nine hundred and sixty four consecutive live births weighing more than 500 g and more than 28 weeks of gestation were subjected to a thorough clinical examination within 24 h of birth. Those suspected of having congenital heart disease (CHD) were followed up every 4-6 weeks for a period of 6 to 18 months (mean 9.75 months). Forty three of 10,964 infants had CHD, i.e., 3.9/1000 live births. Incidence of CHD was higher in pre-terms as compared to full term live births (22.69 vs 2.36/1000 live births). Diagnosis was confirmed by echocardiography including 2D, Doppler and color flow imaging. Twenty eight per cent of the infants with CHD had other associated somatic anomalies, Down's syndrome being the commonest (9.3%). Patent ductus arteriosus (41.9%) and ventricular septal defects (VSD) (34.9%), were the commonest lesions with an incidence of 1.6 and 1.4/1000 live births, respectively. Incidence of PDA was higher probably because of larger number of pre-term deliveries. During follow up of 6-18 months, 34.9% of the infants with CHD died. The diagnosis of CHD was confirmed at autopsy in 20% of the deaths.
Role of infectious agents in exacerbations of ulcerative colitis in India. A study of Clostridium difficile.
Fifty patients with idiopathic ulcerative colitis--25 with acute exacerbation of the disease (Group I) and 25 in quiescent phase (Group II)--were studied. None of the patients had a history of recent exposure to antimicrobial drugs or hospitalization. Evidence of infection with protozoal and bacterial agents and/or presence of Clostridium difficile toxin was demonstrated in eight (32%) patients in group I and one (4%) patient in group II (group I vs. group II, p < 0.05; chi 2 test with Yate's correction). In five of the six patients with demonstrable Clostridium difficile toxin in the stool, one patient with Entamoeba trophozoites, and another with Salmonella infection, the exacerbation responded clinically and endoscopically to specific antimicrobial therapy. Another two patients who had Entamoeba histolytica cysts in the stool had no change in their clinical status with metronidazole. We conclude that infectious agents are responsible for some of the exacerbations in patients of ulcerative colitis in a tropical country like India, where careful microbiologic examination is in order in every acute exacerbation of this disease. This contrasts with the findings in developed countries.
Evaluation of phenolic glycolipid-I (PGL-I) antibody as a multidrug therapy (MDT) monitor.
Since phenolic glycolipid-I (PGL-I) is an unequivocal marker for Mycobacterium leprae, this antigen has been a good candidate for the serodiagnosis and monitoring of the effectiveness of leprosy chemotherapy. The present study, a continuation of an earlier report, was undertaken to estimate PGL-I antibody titers in 40 leprosy patients 3 and 6 months after starting MDT. All the leprosy groups showed significant declines in anti PGL-I reactivity after 6 months. There was a good correlation between bacteriological indices (BI) and anti PGL-I antibody levels. Thus, PGL-I based serology may be useful in monitoring the response to multidrug therapy.
Conjunctival amyloidosis: is it related to trachoma?
Due to presence of trachoma in a large percentage of cases of conjunctival amyloidosis, trachoma has been blamed for causing secondary localized amyloidosis. However, there is no study to demonstrate evidence of amyloidosis in tarsoconjunctival specimens of trachomatous lids. 50 eyes of 35 patients having trachomatous eyelids with thickened tarsal plate, trichiasis and entropion had a tarsoconjunctival biopsy (3 mm x 20 mm) from the upper lid. Histopathological examination using Haematoxylin--eosin and congo red stains failed to reveal evidence of amyloid deposition in any of the biopsies. This is the first histopathological study of amyloidosis in trachomatous patients. Our study rules out the long-standing concept of trachoma having causal relationship with conjunctival amyloidosis. It is concluded that conjunctival amyloidosis occurring in trachomatous lids should be considered as primary localized amyloidosis.
Infection associated hemophagocytic syndrome.
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Communication at scientific meetings: in support of posters.
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A comparison of citations in the Indian Journal of Gastroenterology with other journals.
OBJECTIVE: Comparison of citing pattern of the Indian Journal of Gastroenterology (IJG) with that of three general gastroenterology journals included in the Science Citation Index (SCI). METHODS: Citations in articles published in the IJG in the year 1988 were analyzed; data for three control journals [American Journal of Gastroenterology (AJG), Hepatogastroenterology (HGE) and Italian Journal of Gastroenterology (ItJG)] were obtained from the SCI Journal Citation Reports for the year 1988. MAIN OUTCOME MEASURES: Yearwise distribution of citations and citing half-life; aggregate of citation scores [percentage of citations from a journal ximpact factor (IF) of that journal] for five journals most frequently cited by each of the journals; and, proportion of citations from three most cited general medical journals and three most cited gastroenterology journals as ranked by IF. RESULTS: Percentage of citations for all years from 1979 to 1988 in the IJG were lower than in the three control journals, and citing half-life longer (9.0 yr vs 6.0, 6.4, 6.9 yr for the three control journals). While aggregate citation score of IJG for the five journals most frequently cited in it was lower than that of two control journals (178.7 vs 205.4, 140.7 and 201.5 for AJG, HGE and ItJG respectively), total citations in the IJG from three most cited general medical journals (8.8 vs 9.4, 6.1 and 9.2 for AJG, HGE and ItJG respectively) and from three most cited gastroenterology journals (16.3 vs 16.0, 15.0 and 14.1 for AJG, HGE and ItJG respectively) were comparable with the control journals; this was related to lower number of citations from the journals with the highest IF in both general medicine and gastroenterology. CONCLUSIONS: Citations in IJG were older than those in the three control journals and tended to be from journals with lower IF. To improve the citation pattern of the IJG, authors contributing to it need to keep up with recent literature in high quality journals and to cite more recent citations.
Evaluation of impact factor of the Indian Journal of Gastroenterology.
OBJECTIVE: a) To determine the impact factor (IF) of the Indian Journal of Gastroenterology (IJG) for the years 1987 to 1990. b) To compare the IF of the IJG with those of other gastroenterology journals. METHODS: For each year (1987 to 1990), the number of citations received in that particular year in the journals included in the Science Citation Index (SCI) phi by items published in the IJG in the previous two years was determined by manual searching of SCI. Similarly, self citations in the IJG of articles published in the IJG were determined manually from the back volumes of the journal. IF was calculated from these data. RESULTS: The IF of IJG for the years 1987, 1988, 1989 and 1990 was 0.087, 0.092, 0.098 and 0.192 respectively. The impact factor of IJG for 1990 compared quite poorly with that of other gastroenterology journals. CONCLUSIONS: The IF of IJG, though low, has shown a progressive improvement with time. Publication of better articles in the IJG should lead to improvement in its IF.
Pulmonary abnormalities in liver disease.
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Halothane-induced fulminant hepatic failure.
Fulminant hepatic failure developed in the early post-operative period in a patient after third exposure to halothane. Exclusion of other causes of post-operative jaundice and temporal relationship of jaundice to anesthesia suggested halothane as the etiologic agent for the submassive necrosis, which was documented at postmortem liver biopsy.
Faecal excretion of hepatitis E virus.
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Intestinal lymphangiectasia: evaluation by CT and scintigraphy.
Intestinal lymphangiectasia caused severe diarrhea and generalized edema in a 40-year-old man. The diagnosis was established by clinical, laboratory, and duodenal biopsy findings. The abnormalities detected on computed tomography (CT) and scintigraphy using 99mTc human serum albumin are herein described and pertinent literature is briefly reviewed.
Effect of age and sex on hepatic intraacinar enzyme profile.
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Novel monoclonal antibodies to cyclosporine A: characterization and epitope mapping with cyclosporine analogs and cyclophilin.
Monoclonal antibodies to cyclosporine A (Cs), a potent immunosuppressant, were generated in BALB/c mice using a novel antigen prepared by linking Cs to a protein carrier via a photoactive cross-linking reagent, 4-benzoylbenzoic acid (BBa). Twenty-two monoclonal anti-Cs antibodies were generated, using Cs-BBa-bovine serum albumin (Cs-BBa-BSA) as the immunogen. They were characterized with respect to affinity by Scatchard analysis of a radioimmunoassay (RIA), and with respect to specificity by an ELISA in which a series of singly substituted Cs derivatives were examined as inhibitors. McAb affinities ranged from 5 x 10(-8) M to 2 x 10(-10) M. Based on ELISA inhibition data with Cs analogs, and on the binding to two Cs-BSA conjugates in which opposite sides of the Cs molecule are exposed, the antibodies fell into five epitope recognition groups. Binding to Cs was also studied by ELISA in competition with cyclophilin (CyP), a Cs-binding protein whose epitope specificity has been well characterized. Competition by CyP was found to correlate with antibody specificity, not with affinity, i.e. CyP competed best with antibodies having specificities most similar to that of CyP. Epitope mapping can, therefore, be accomplished in a system in which two different species of binding proteins compete for the same antigen. This type of characterization may be useful in identifying antibodies whose combining sites mimic those of a receptor.
Efficacy of topical antiseptics on staphylococcal colonization of neonates.
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Significance of antibodies to phenolic glycolipid-I in leprosy diagnosis.
A gelatin particle agglutination assay for the detection of anti PGL-I antibodies in 40 clinically diagnosed and variously classified groups of leprosy cases revealed elevated PGL-I antibody titers in 85% of cases. In contrast, the slit-skin smear examination was positive in only 30% of cases. It was further observed that, out of 28 cases with Bacteriological Index (B.I.) zero, 22 cases (78.5%) had significant levels of PGL-I antibodies. There was no case in which the slit skin smear was positive and the PGL-I antibody titer was not significant. The elevated titers of PGL-I antibody better correlated (84%) with histopathological findings than did B.I. Thus it was concluded that estimation of PGL-I antibody titer is a better supplement to clinical diagnosis than B.I. Significant levels of PGL-I antibody were seen in 85% of cases who had no earlier chemotherapy or were treated for less than 2 months. Similar findings were observed in 12 patients who were on MDT for more than 5 months but for less than 2 years. In order to determine the significance of anti PGL-I antibodies in monitoring the response of patients to chemotherapy, a longer follow up with a greater number of cases should be contemplated.
Effect of anthelmintics on phosphatases in Ascaridia galli.
In vitro addition of the drugs tetramisole (TMS) and levamisole (LMS) caused an inhibition of the specific activities of acid phosphatase and Mg(++)-dependent adenosine triphosphatase. The inhibition was non-competitive in nature. No significant inhibition was caused by TMS in the activity of glucose-6-phosphatase, but LMS inhibited the enzyme in a non-competitive manner. The activity of alkaline phosphatase was, however, increased in the presence of both TMS and LMS.