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Biomedical subjects

R Bhatia

Publications and source records attributed to R Bhatia.

At least 127 records · Page 7Linked to original sources
PubMed1993

Single umbilical artery: accurate diagnosis?

OBJECTIVE: We sought to evaluate the accuracy of ultrasonographic, obstetric, and neonatal diagnosis of a single umbilical artery. STUDY DESIGN: We studied 17,777 consecutive singleton births from women who had undergone ultrasonographic examination at our hospital. A single umbilical artery was confirmed in 37 cases (0.2%) by two clinical methods or by pathologic assessment. Outcome of neonates with a single umbilical artery was compared with the outcome of neonates with either two or three vessel cords. RESULTS: Ultrasonographic diagnosis had a 65% sensitivity and positive predictive value. Obstetricians and pediatricians failed to diagnose 24% and 16% of the cases, respectively. On average, neonates with a single umbilical artery weighed 320 gm less, were delivered 1 week earlier, and had lower Apgar scores than neonates with three vessel cords (p < 0.01 in each case.) CONCLUSION: Although early gestational age may account for some cases not diagnosed by ultrasonography, there is a little justification for missing the diagnosis after delivery. Greater emphasis on clinical examination of the umbilical cord is needed to identify neonates at risk of associated malformations.

Apgar Score↗
PubMed1993

Transferable colicinogeny in Salmonella bareilly.

Twenty eight (5.6%) of the 500 isolates of S. bareilly studied were found to be colicin producers. Of these 27 (96.4%) were Col V producers. None of these produced aerobactin and 18 (64.3%) were multidrug resistant. Among 23 (85.2%) strains both drug resistance as well as colicinogeny could be transferred by conjugation. This is the first time that the transferable colicinogeny has been demonstrated in S. bareilly.

Colicins↗
PubMed1993

Prevalence of copper resistant salmonellae in India.

Sixty eight of 330 strains of Salmonella belonging to three different serotypes, S. typhi, S. typhimurium and S. bareilly, referred to at the National Salmonella and Escherichia Centre, Central Research Institute, Kasauli, between 1989-1991 were found to be copper resistant. Maximum number of strains (39.1%) were resistant in S. bareilly serotype, followed by S. typhimurium (21.7%) and least in S. typhi (17.4%). Of the 15 States/Union Territories (UTs) from where Salmonella strains were received, copper resistance was observed in strains from 10 States/UTs. This resistance was maximum among the strains from Goa (85.7%).

Copper↗
PubMed1992

Bronchoesophageal fistula of tuberculous origin in a child.

Bronchoesophageal fistulas (BEF) are uncommon in children, the etiology being congenital or acquired. Acquired bronchial perforation of tuberculous origin is common in children with pulmonary tuberculosis but bronchoesophageal perforation secondary to tuberculosis and leading to a fistulous tract formation is rare. To date, there have only been 4 case reports of BEF of tuberculous origin in children. We present yet another case of an acquired BEF of tuberculous origin in a child who presented with a sudden onset of dysphagia and choking sensation.

Bronchial Fistula↗
PubMed1992

Giant lumbosacral nerve sheath tumors.

Cauda equina nerve sheath tumors are usually small, well-encapsulated tumors. Sometimes they may attain very large proportions, cause extensive bony changes, and resemble ependymomas in the cauda equina. They may also infiltrate into adjacent soft tissue planes and retroperitoneal spaces and yet be histologically benign. An awareness of this entity ensures aggressive surgical removal at the time of exploration. Primary neuro-fibrosarcomas or malignant changes in primary nerve sheath tumors of the cauda equina are seen in patients with neurofibromatosis.

Adolescent↗
PubMed1992

Gross and histopathological observations on the effects of therapeutic ultrasound in experimental acute chemical arthritis in calves.

Acute chemical arthritis was induced in right radiocarpal joints of eight cow calves by intraarticular injections of turpentine oil. They were randomly divided into two groups A and B of four calves each. Group A served as control. Group B was given therapeutic ultrasound at 2.0W/cm2 for 7 minutes daily for 7 days starting on day 5. On day 19, all the calves of both the groups were slaughtered. Grossly as well as microscopically, joint tissues of group A calves showed severe inflammatory and degenerative changes. Joint capsule of group B calves showed regeneration of synovial membrane and articular cartilage was normal grossly as well as microscopically.

Acute Disease↗
PubMed1992

Somatosensory and brainstem auditory evoked potential in congenital craniovertebral anomaly; effect of surgical management.

Clinical features and evoked potential recordings were analysed in 32 patients with congenital atlantoaxial dislocation before and after surgery. Seven patients (group 1) had atlantoaxial dislocation, while 22 patients had associated basilar invagination (group 2). In both groups, pyramidal tract signs, posterior column signs, wasting of the upper limbs, and abnormality of somatosensory evoked potentials (SSEP) were similar. Conversely, lower cranial nerve involvement and abnormal brainstem auditory evoked potentials (BAEP) were significantly more in patients with basilar invagination (p less than 0.05). All seven patients in group 1 and 17 patients in group 2 were operated upon. Clinical and electrophysiological deterioration were significant in patients with basilar invagination (group 2), following posterior fixation compared with group 1. Among the patients in group 2, who clinically deteriorated following posterior fixation, seven had transoral excision of odontoid and six of them improved both clinically and electrophysiologically. Two patients in group 2 had odontoid excision before posterior fixation, and in both the evoked potentials improved postoperatively. In group 1 the patient's BAEP remained unaffected following posterior fixation, however, in group 2, eight patients over 53% showed improvement in brainstem function following posterior fixation. This study shows the value of evoked potentials in congenital atlantoaxial dislocation, and rationalizes the surgical procedure in these patients. In patients with basilar invagination, odontoid excision is the preferred first stage procedure.

Atlanto-Axial Joint↗
PubMed1991

Collet-Sicard syndrome resulting from closed head injury: case report.

A 67-year-old man developed paralysis of the right ninth, tenth, eleventh, and twelfth cranial nerves (Collet-Sicard syndrome) after sustaining a closed head injury. Plain x-ray films of the skull revealed two linear fractures of the occipital bone (one of them probably traversing through the right occipital condyle) and a prominent soft-tissue shadow in the region of the nasopharynx, suggestive of a skull base fracture. The patient was managed conservatively. This is the only case of unilateral multiple caudal cranial nerve palsies (IX through XII), seen by us over a 20-year period, from among more than 5,000 moderate to significant head injuries.

Accessory Nerve↗
PubMed1991

Serodiagnosis of Indian kala-azar: evaluation of IFA, ELISA and CIEP tests.

The sensitivity and specificity of three serological tests viz. indirect immunofluorescent antibody test (IFAT), enzyme linked immunosorbent assay (ELISA) and counterimmunoelectrophoresis (CIEP) for the diagnosis of Indian kala-azar were evaluated. Of the 209 patients in whom Leishmania donovani parasite could be demonstrated in bone marrow, 207 (99.04 per cent) could be diagnosed with IFAT, 203 (96.6 per cent) with CIEP and 208 (99.5 per cent) with ELISA. None of these serological tests was positive in 40 healthy individuals and 10 patients each with tuberculosis, toxoplasmosis and malaria. In only one out of 10 patients with malaria ELISA alone gave false positive result. Of the 119 patients who had clinical features simulating kala-azar but were negative for Leishmania donovani in bone marrow and responded to treatment other than that for Indian Kala-azar, IFAT, CIEP and ELISA were false positive in three (2.5 per cent), nil and three (2.5 per cent) cases, respectively. The use of serodiagnostic tests like ELISA for mass screening and CIEP in less well equipped peripheral laboratories is suggested.

Counterimmunoelectrophoresis↗
PubMed1991

Comparison between indirect fluorescent antibody and Weil-Felix tests for detecting antibodies against rickettsia.

Comparative evaluation of indirect fluorescent antibody test (IFAT) and Weil-Felix test (WFT) was carried out for detecting rickettsial antibodies in 102 patients with pyrexia of unknown origin (P.U.O.), 20 brucellosis cases and 20 normal healthy controls (N.H.C.). Of 102 sera of cases with P.U.O., antibodies against rickettsia could be detected in 11 (10.7 per cent) cases by IFAT and in 10 (9.8 per cent) cases by WFT, but amongst these 10 sera, antibodies could be detected only in six by IFAT. All 20 brucella positive sera were negative for rickettsia by IFAT but by WFT in 6 sera antibodies against rickettsia could be detected and 20 N.H.C. sera were negative by both the tests. Thus the advantages of IFAT over WFT in detecting antibodies against rickettsia in terms of sensitivity and specificity make it a more reliable test.

Agglutination Tests↗
PubMed1990

Haemostatic abnormalities in brain tumours.

The coagulation profile of 25 patients with brain tumours was studied preoperatively, intraoperatively and postoperatively. Ten patients had abnormal coagulation status preoperatively. Surgical intervention led to either an alteration of preexisting abnormality or appearance of new coagulation abnormality. Disseminated intravascular coagulation and fibrinolysis occurred with equal frequency in patients with meningiomas and gliomas. The alterations as a result of surgery were transient and compensated rapidly.

Adult↗
PubMed1990

Evaluation of potential early markers of chorioamnionitis associated with preterm premature ruptured membranes.

Optimal expectant management of preterm premature rupture of membranes (PROM) requires the early detection of chorioamnionitis. To date, however, no universally sensitive and specific marker for chorioamnionitis has been identified. Recently, the serial determination of plasma fibronectin, antithrombin, and prekallikrein has been reported to facilitate the early detection of sepsis in critically ill neonates and adult surgical patients. A cross-sectional study was undertaken to determine if plasma levels of these markers change significantly in patients with overt chorioamnionitis following expectant management of preterm PROM. Plasma levels of fibronectin and prekallikrein were not significantly different between the study (30 patients with overt chorioamnionitis following preterm PROM) and control (30 undelivered patients without antenatal complication matched for gestational age) groups. Antithrombin levels were significantly lower in the study group (p less than 0.05), but the magnitude of the difference (102% versus 94%) is not likely to be of clinical significance. We conclude that determination of plasma levels of fibronectin, prekallikrein, and antithrombin is not likely to aid in the early detection of chorioamnionitis in the setting of preterm (PROM).

Antithrombins↗
PubMed1990

Prevalence of toxoplasma antibodies among women with BOH and general population in Delhi.

One thousand and thirty-six serum samples obtained from women with bad obstetric history (BOH) were subjected to detection of toxoplasma antibody by indirect immunofluorescent antibody test (IFAT) using whole promastigotes of Rh strain of Toxoplasma gondii as antigen. Thirtyone (2.99 per cent) samples were found to be positive (titre greater than or equal to 1:64). Of these 31 patients' sera 27 (87.09 per cent) showed rising titre of antibody when second samples were drawn after 4 weeks. Two hundred serum samples from general population were also assayed and only 2 (1 per cent) were found to be having toxoplasma antibodies in titre of 1:64. The observations suggest low prevalence of toxoplasmosis in and around Delhi which is in consonance with the food habits of local people and their infrequent contact/association with cats.

Antibodies, Protozoan↗
PubMed1990

Zoonoses in India.

Intimate and prolong contact between man and animal facilitates the transmission of various communicable diseases between them. These diseases (zoonoses) are more prevalent in developing countries especially in the rural areas. These diseases virtually stunt the economic and social growth also. Lack of authentic data and awareness regarding the occurrence of these diseases and their true impact on public health have acted as major obstacles in instituting adequate and effective control measures. The information available regarding the current status of few important zoonoses in India is being presented in this paper.

Animals↗
PubMed1990

Postpartum rupture of a splenic artery.

Postpartum abdominal apoplexy is a rare obstetric complication that is associated with a very high maternal mortality rate. We report a patient with a low risk pregnancy and spontaneous vaginal delivery, who at 17 h post partum went into shock secondary to rupture of the splenic artery. She recovered following splenectomy and transfusion of 10 units of blood. This is the seventh documented case of splenic artery rupture in the postpartum period. Four of the seven patients survived. The cases are reviewed and the clinical presentation, pathogenesis and treatment are discussed.

Abdominal Pain↗
PubMed1990

A student health HMO as a partnership model within an academic medical center.

The Department of Family Practice, College of Medicine, in partnership with the University of Illinois at Chicago, was responsible for the reorganization of the Student Health Service into a health maintenance organization (HMO), Campus Care. Historically, the two campuses of the University of Illinois at Chicago operated student health as an infirmary model. Reorganization of student health into the Campus Care HMO provided expanded health care services to students, preserved more health care dollars in the university system, and provided a nonincremental increase in the size and responsibility of the Department of Family Practice. One year's experience showed that while the capitation was low compared with standard HMOs, the variable and less frequent use of services by the student population resulted in a fiscally viable operation. Numerous transition difficulties were encountered, including the need for rapid systems conversion within a complex university system, reeducation of students as well as traditional university-based practitioners for operation in a managed care system, and the rapid expansion of a small family practice department. The positive experience of the University of Illinois at Chicago supports the notion that family practice is better suited to providing student health care than other primary care disciplines. Three issues are paramount to success: (1) approval, support, and protection by higher level administration from university territorialism, (2) a core family practice faculty with strong leadership and experience in high-volume clinical activity, and (3) a close examination of financial resources in light of expected utilization.

Academic Medical Centers↗