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Biomedical subjects

R Handa

Publications and source records attributed to R Handa.

At least 55 records · Page 3Linked to original sources
PubMed1999

Validity of tourniquet test in dengue haemorrhagic fever.

OBJECTIVE: Dengue haemorrhagic fever (DHF), a public problem in most of the tropical countries of South-East Asia, is diagnosed on the basis of demonstrating an increased capillary permeability and thrombocytopenia with concurrent haemoconcentration. Tourniquet test has been recommended as the initial screening procedure of patients with suspected DHF, particularly grade I DHF. The objective of the present study was to study the value of this test as an indicator of haemorrhagic tendencies in patients of DHF. METHODS: One hundred and ten adult patients hospitalized with DHF during outbreak of DHF in 1996 in north India were prospectively studied. The diagnosis of DHF was considered on the basis of haemoconcentration > 20%, evidence of transudation, or presence of shock along with thrombocytopenia. A tourniquet test was conducted in these cases in the standard method. RESULTS: Of the 110 patients of DHF studied, 62 patients (56.4%) had bleeding but tourniquet test was positive in only half of these patients. Forty eight patients (43.6%) did not have any bleeding and the tourniquet test was positive in only 27% cases. CONCLUSIONS: The tourniquet test was positive in only 39.1% of all DHF cases. It is concluded that a negative tourniquet test may not be sufficient to exclude a diagnosis of DHF in a febrile patient. This necessitates the need for the re-defining the clinical criteria for the diagnosis of DHF, particularly grade I DHF.

Adolescent↗
PubMed1999

Pictorial CME.

Explore the source record for details and available documents.

Acne Vulgaris↗
PubMed1998

Cardiac involvement in Dengue Haemorrhagic Fever.

We studied 17 consecutive patients of Dengue Haemorrhagic Fever/Dengue Shock Syndrome (DHF/DSS) to assess cardiac function by radionuclide ventriculography, echocardiography and electrocardiography (ECG) during the epidemic of Dengue virus type-2 (DEN-2) in Delhi, India (1996). Case definitions laid down by the WHO were followed. Fourteen patients were seropositive for Dengue infection. In radionuclide ventriculography study, the mean left-ventricular ejection fraction was 41.69 (5.04% (range 33-49%) and 7 patients had an ejection fraction less than 40%, global hypokinesia was detected in 12 (70.59%) patients. In echocardiography, the mean ejection fraction was 47.06 (3.8%). Eight patients had Dengue Shock Syndrome and the mean ejection fraction was 39.63% (4.97% in radionuclide ventriculography, out of which 5 patients had an ejection fraction below 40%. To find out the nature of myocardial involvement, 99m Tc-pyrophosphate imaging was done in 4 patients and it was discontinued further because no myocardial necrosis was detected in those patients. Five patients had ST and T changes in the electrocardiogram, radionuclide ventriculography and echocardiography revealed no abnormalities after 3 weeks of follow up and the ejection fraction was more than 50% in all cases. Global hypokinesia also improved and ECG changes reverted back to normal within 3 weeks. Acute reversible cardiac insult may be noticed in Dengue Haemorrhagic Fever/Dengue Shock Syndrome and could be responsible for hypotension/shock seen in some of these patients. Further studies are required to establish the pathogenic mechanisms of cardiac dysfunction in patients with Dengue Haemorrhagic Fever/Dengue Shock Syndrome.

Adolescent↗
PubMed1998

Fibromyalgia in Indian patients with SLE.

One hundred and fifty-eight patients with SLE were prospectively studied at a tertiary referral centre in India to ascertain the prevalence and clinical profile of fibromyalgia (FM) in Indian patients with lupus. An attempt was made to determine whether socio-demographic factors or disease characteristics differ in SLE patients with and without FM. Only 13 patients (8.2%) in our cohort were found to have fibromyalgia. Their clinical profiles were similar to that reported in other series. Corticosteroid withdrawal or dose reduction was the probable precipitating factor in nearly one-third of our patients. Age, sex, marital status, educational level, disease duration, disease activity and the organ involvement in patients with SLE and FM were comparable to those in patients not having FM. Fibromyalgia appears to be distinctly uncommon in Indian patients with lupus. A strong family support system, the virtual lack of disability benefits and/or racial variations in pain threshold could be the likely factors responsible for the low prevalence of the disease observed in Indian patients with SLE.

Adolescent↗
PubMed1998

Brucellosis in north India: results of a prospective study.

Human brucellosis is a significant public health problem in India, the magnitude of which is not known. Paucity of clinico-epidemiologic data hampers control strategies. We prospectively studied 121 cases of fever of unknown origin (FUO) and 50 occupationally exposed individuals. Four patients with FUO had acute brucellosis (3.3%) while 8 (6.6%) had serological evidence of previous brucella infection. Seven of the 50 (14%) asymptomatic, 'at risk' individuals screened were seropositive for brucella. Persistence of the animal reservoir of infection, low physician awareness, poor availability of diagnostic facilities, and the non existence of regional data bases contribute towards the perpetuation of this zoonosis in India, while it has been eradicated from most developed countries.

Adult↗
PubMed1997

Protein interactions in the herpes simplex virus type 1 VP16-induced complex: VP16 peptide inhibition and mutational analysis of host cell factor requirements.

The herpes simplex virus VP16 protein functions as a potent transcriptional activator and targets DNA sites with the consensus TAATGARAT present in all the viral immediate-early gene promoters. To do so, VP16 directs assembly of a multiprotein complex involving two cellular proteins, host cell factor (HCF) and the Oct-1 DNA-binding transcription factor. To investigate the importance of specific protein-protein interactions to formation of this VP16-induced complex (VIC), we used oligopeptides to prevent VIC assembly. Linear and cyclic peptides corresponding to a region of VP16 previously implicated in complex formation were potent inhibitors of VIC assembly. To further characterize the protein interactions involved, we cloned a human cDNA encoding the minimal VP16 interaction domain of HCF, containing amino acids 1 to 380 [HCF (1-380)]. The REHAYS-based peptides active in preventing VIC assembly were found to specifically block binding of VP16 to HCF (1-380), without affecting VP16-Oct-1 binding. The inhibitory activity of these VP16 peptides was strictly sequence specific for the EHAY residues. Site-directed mutagenesis of the HCF (1-380) domain revealed residues E102 and K105 to be critical determinants in support of VIC formation. Alteration of a single residue in HCF, K105, was shown to virtually abolish complex assembly. Interestingly however, none of the HCF mutants that were impaired in their ability to support complex formation exhibited defects in direct VP16 binding, supporting loss of function at a higher order in complex assembly.

Amino Acid Sequence↗