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Biomedical subjects

R Kant

Publications and source records attributed to R Kant.

At least 19 recordsLinked to original sources
PubMed2001

Clozapine impact on clinical outcomes and aggression in severely ill adolescents with childhood-onset schizophrenia.

OBJECTIVE: To evaluate the impact of clozapine on aggressive behaviour and clinical outcomes in children and adolescents with schizophrenia or schizoaffective disorder. METHODS: We reviewed the charts of 6 children and adolescents who were admitted consecutively to a long-term care facility for clinical outcomes, including seclusion and restraints incidents prior to and during clozapine treatment. We also present a representative case history. RESULTS: We noted clinically significant improvements in social interaction and decreases in the number of violent episodes and homicidal or suicidal thoughts. The global assessment of functioning (GAF) scores improved significantly. Weight gain was significant. CONCLUSIONS: These cases illustrate the benefits of clozapine treatment in refractory childhood-onset schizophrenia. Outcomes are similar to those described in adults. Even though open data limit conclusions from this study, it is pertinent that there was a clinically significant improvement in aggressive behaviours. This may be particularly important for improved morale of patients, their families, and treating staff. It may also be helpful in discharge to a less restrictive environment.

Adolescent↗
PubMed1999

Plasticity of axial identity among somites: cranial somites can generate vertebrae without expressing Hox genes appropriate to the trunk.

Classic studies have shown that the presomitic mesoderm is already committed to a specific morphological fate, for example, the ability to generate a rib. Hox gene expression in the paraxial mesoderm has also been shown to be fixed early and not susceptible to modulation by an ectopic environment. This is in contrast to the plasticity of Hox expression in neuroectodermal derivatives. We reexamine here the potential of somites for morphological plasticity by transplanting the cranial (occipital) somites 1-4, that normally produce small contributions to the skull, to the trunk of avian embryos. Surprisingly, the transposed cranial somites are able to form reasonably normal vertebral anlage. In addition, the cranial somitic mesoderm produces intervertebral disks, structures not normally found in the skull. These somites are however unable to generate some elements of the vertebrae, such as the costal process. In contrast to the morphogenetic plasticity of the occipital somites, their characteristic inability to support survival of dorsal root ganglia was not significantly modified by posterior transplantation. Dorsal root ganglia initially developed and then degenerated with the same morphological stages as normally observed. In striking contrast to the plasticity of morphology, we found that all four members of the of the fourth paralogous group of Hox genes that are expressed endogenously at the level of the graft are not upregulated in the caudad-transposed cranial mesoderm. It therefore appears that genes other than those of the Hox family normally expressed at this axial level control the position-specific morphogenesis of ectopic vertebrae formed from cranial somites. In evolutionary terms, the present results imply that occipital somites that were incorporated into the "New Head" retain the ability to develop according to their original morphogenetic fate, into vertebrae.

Animals↗
PubMed1999

Interstitial laser hyperthermia, a new method in the management of fibroadenoma of the breast: A pilot study.

BACKGROUND AND OBJECTIVE: This study attempts to evaluate the effect of interstitial laser hyperthermia in breast fibroadenomas as an outpatient procedure. STUDY DESIGN/MATERIALS AND METHODS: In an uncontrolled prospective study, 27 patients younger than 35 years were subjected to laser phototherapy of their breast fibroadenomas. Under real-time ultrasound monitoring, Nd:YAG laser (1,064 nm wavelength) was used at 2 W for 300 sec (600 J) in a continuous wave mode to produce interstitial hyperthermia. Follow-ups were done at 2, 4, and 8 weeks. Subsequently, excision biopsy of residual lumps was performed. RESULTS: There was significant decrease in clinical and sonographic sizes (P < 0.001). Follow-up ultrasound showed a progressive change of hyperechoic texture, from a heterogeneous to a nearly homogeneous one. There were minimal scars (2-3 mm) and no keloid or abscess formation. CONCLUSION: Interstitial laser hyperthermia is a safe, precise, and minimally invasive outpatient procedure for in situ destruction of breast fibroadenomas.

Adolescent↗
PubMed1999

Safety and efficacy of ECT in patients with head injury: a case series.

Electroconvulsive therapy (ECT) is a safe and effective treatment for certain psychiatric disorders. Eleven patients who had sustained a closed head injury were treated with ECT for their psychiatric symptoms. Eight patients responded to an index course of ECT: 2 were partial responders and became responders during continuation ECT (cECT); 1 patient was a nonresponder. Post-ECT Neurobehavioral Cognitive Status Examination and Mini-Mental State Examination scores showed no significant decline (P > 0.70 and P > 0.89, respectively) from baseline. Eight patients received cECT, without any lasting cognitive side effects. These findings indicate that ECT can be used effectively in patients with a history of closed head injury, without adverse effects on cognitive functioning.

Adult↗
PubMed1998

Cytotoxic effects of 125I-labeled PBZr ligand PK 11195 in prostatic tumor cells: therapeutic implications.

The effect of [125I]PK 11195 was examined in human prostatic tumor cells (DU 145) in culture and compared with Na[125I] and non-radioactive PK 11195. [125I]PK 11195 was clearly cytocidal. The data for dose-related cell survival with [125I]PK 11195 showed a linear relationship. Na[125I] or non-labeled PK 11195 at similar concentrations did not lead to any cell killing. The uptake of [125I]PK 11195 and [3H]PK 11195 in cells was very similar. Fragmentation of DNA measured by agarose gel electrophoresis showed that exposure of DU 145 cells to [1251]PK 11195 for 1, 4 or 24 h caused no fragmentation. These results indicate that nuclear DNA is not the prime binding site for [125I]PK 11195, which is consistent with the presence of specific peripheral benzodiazepine receptors (PBZr) in the mitochondria. The cell killing effect of [125I]PK 11195 suggests the use of PBZr ligand for radiotherapy.

Antineoplastic Agents↗
PubMed1998

Treatment of aggression and irritability after head injury.

Thirteen patients who experienced problems with irritability and aggression following closed head injury (CHI) participated in a non-blind, 8 week open trial and sertraline HCl. Significant reduction in irritability and aggressive outbursts was observed. No significant changes were observed in depressive symptomatology. Results suggest that serotonergic agents may be useful in treating aggression and irritability after head injury. Further placebo-controlled studies using serotonergic agents are indicated.

Adult↗
PubMed1998

Prevalence of apathy following head injury.

Although several studies have examined the demographics of mood disorders and personality changes following closed head injury (CHI), there are no studies that address the prevalence of apathy after CHI. Utilizing standardized evaluation tools, this study examines the prevalence of apathy in 83 consecutive patients seen in a neuropsychiatric clinic. A total of 10.84% had apathy without depression while an equal number were depressed without apathy; another 60% of patients exhibited both apathy and depression. Younger patients were more likely to be apathetic than older patients who were more likely to be depressed and apathetic. Patients with severe injury were more likely to exhibit apathy alone. Family members rated the patients higher on apathy scale. These findings suggest that apathy is a frequent symptom after head injury and may occur either alone or in association with depression.

Adolescent↗
PubMed1998

Species diversity and interspecific associations among mosquitoes in rice agro-ecosystem of Kheda district, Gujarat.

Rice agro-ecosystem of Kheda district in Central Gujarat was inhabited by 14 species of anophelines and 15 species of culicines. Anopheles subpictus and Culex vishnui gr dominated the respective groups. Species diversity in rice fields as well as in associated habitats remained high during non-monsoon (rabi) period. There existed several positive and negative interspecific associations. Malaria vector An. culicifacies showed positive association with An. subpictus, An. annularis, An. pallidus and Cx. quinquefasciatus but was found negatively associated with An. nigerrimus, Cx. vishnui and Cx. tritaeniorhynchus.

Animals↗
PubMed1997

Tc-HMPAO SPECT in persistent post-concussion syndrome after mild head injury: comparison with MRI/CT.

The purposes of this study were: (1) to determine the prevalence of abnormal 99mTc-HMPAO SPECT scans in patients suffering from persistent post-concussive syndrome (PPCS) after mild closed head injury (CHI); (2) to compare SPECT with structural neuroimaging (MRI and CT) in patients with mild CHI; and (3) to investigate correlations between SPECT and clinical data obtained from the patient sample (neuropsychological testing, demographics, psychiatric diagnoses). Forty-three patients were included. SPECT was read as abnormal in 53% of patients and showed a total of 37 lesions while MRI was read as abnormal in 9% and CT scan in only 4.6% of patients after mild CHI. SPECT appears to be more sensitive in detecting cerebral abnormalities after mild CHI, especially in patients with PPCS symptoms, than either CT or MRI. No statistically significant relationship was found between SPECT scan abnormalities and age, past psychiatric history, history of substance abuse, or history of multiple CHI. Education level did not differ between patients with normal and abnormal SPECT. Current neuropsychiatric symptoms did not seem to have any impact on the results of SPECT scan.

Adolescent↗
PubMed1997

Antidepressant efficacy and cardiovascular safety of venlafaxine in young vs old patients with comorbid medical disorders.

OBJECTIVE: To determine whether venlafaxine exerts a differential effect on blood pressure in young versus old depressed patients. METHOD: We compared thirty-four consecutive patients treated with 50-250 mg/day venlafaxine for major depressive disorder or another major mood disorder at our medical college's ambulatory neuropsychiatry program. We obtained baseline and follow-up blood pressure measurements. Each patient also received a baseline and final Clinical Global Impressions (CGI) score; global improvement was determined by consensus of two clinicians. RESULTS: Sixteen nongeriatric patients (age, 13 to 56 years) were compared with eighteen elderly patients (age, 65 to 86 years). Most patients (88%) had serious medical comorbidities or histories. Despite a higher mean daily venlafaxine dosage for patients in the young group, no significant changes in systolic blood pressure were noted in either group. For the older group, we found a non-statistically significant 4.7 mm Hg mean increase in diastolic blood pressure. No patient became hypertensive. We also found a negative correlation between baseline diastolic blood pressure and change in diastolic blood pressure during treatment with venlafaxine. This inverse relationship was statistically significant in the older patients. CONCLUSIONS: Venlafaxine was not associated with significant, sustained changes in blood pressure in any patient receiving dosages of 50-250 mg/day. Minimal changes in diastolic blood pressure were no more likely to occur in older venlafaxine-treated patients than in younger ones. Higher baseline diastolic blood pressure in older patients, but not in younger ones, seemed to protect against diastolic adrenergic blood pressure effects of venlafaxine.

Adolescent↗
PubMed1996

Allelic forms of the knob associated histidine-rich protein gene of Plasmodium falciparum.

The knob associated histidine-rich protein (KAHRP) gene was cloned and sequenced from two Indian isolates of Plasmodium falciparum, Pf3-92 and Pf29-92. These isolates showed major sequence differences in the C-terminal repeat domain of KAHRP. However, the biologically important domains such as spectrin-actin binding region remained highly conserved. The PCR amplification of a variable C-terminal repeat domain from the clinical isolates of P. falciparum, from Rajasthan epidemic, showed the presence of multiple alleles of KAHRP gene. The presence of multiple alleles indicates the existence of several P. falciparum strains in India. This should be taken into account for future malaria control strategies such as molecular therapy and vaccines.

Alleles↗
PubMed1996

Hemiballismus following closed head injury.

Movement disorders are relatively rare after closed head injury (CHI), but when present they can go unrecognized if clinicians are not aware of their occurrence. We are presenting a case of hemiballismus which was not recognized over 3 years and was labelled as malingering or as psychosomatic. The symptoms have responded significantly to pharmacological interventions. The SPECT scan of the brain showed the lesions in the subthalamic areas while MRI, CT scans of brain and EEGs were reported normal. It is concluded that one should be aware of the existence of movement disorders after mild to moderate CHI, and that SPECT scan of the brain should be considered if a patient is symptomatic and other neuroimaging studies prove 'normal'.

Brain↗
PubMed1996

Obsessive-compulsive disorder after closed head injury: review of literature and report of four cases.

An increasing number of recent reports has pointed to the underlying neuropathological substrate for obsessive-compulsive disorder (OCD). Neuropsychological testing may suggest underlying organicity even though the neuroimaging studies and the neurological examination may be normal. Earlier reports are not in agreement about the laterality of deficits. Abnormalities in frontal regions, limbic areas and basal ganglia are noted in functional neuroimaging and neuropsychological studies. In closed head injury the damage tends to be diffuse, and it is not easy to clearly localize deficits or to determine their laterality. In this paper we review the various theories and literature on OCD and organicity, and report on four individuals who developed OCD symptoms after closed head injury. We also discuss their neuroimaging and neuropsychological testing results.

Adolescent↗
PubMed1996

Clinical utility of clozapine in 16 patients with neurological disease.

Patients who develop psychosis or agitated behavior secondary to neurological disorders present a therapeutic dilemma. The authors review clinical efficacy and side effect profiles of clozapine in a cohort of 16 patients with various neurobehavioral disorders. One-third showed a marked decrease in symptoms while on clozapine. However, one-quarter developed an acute confusional state; of these, all had diffuse slowing on their baseline EEG prior to starting the drug.

Adult↗
PubMed1996

Mosquito breeding in relation to aquatic vegetation and some physico-chemical parameters in rice fields of central Gujarat.

Mosquito breeding in relation to aquatic vegetation and certain physico-chemical parameters was studied in rice fields of Kheda district in central Gujarat. A total of 14 anopheline and 15 culicine species were encountered in close association with different types of aquatic vegetation in different proportions. Among anophelines, Anopheles annularis, An. nigerrimus, An. subpictus and An. tessellatus were of general distribution and were found associated with each aquatic vegetation. An. culicifacies showed poor association with most of the aquatic weeds. Maximum number of anophelines were found associated with algae. Culex vishnui sub-group predominated among culicines and showed frequent association with Ceratophyllum, Hydrilla and algae. Physico-chemical parameters also exerted some impact on mosquito larval population.

Agriculture↗
PubMed1996

Socio-economic aspects of malaria in Kheda district, Gujarat.

Study on the socio-cultural factors and economic loss due to malaria in rural and urban areas of Kheda district, Gujarat revealed that factors such as education, profession, income, housing pattern, social groups, water storage and treatment seeking behaviour play an important role in malaria transmission. However, the difference of these components in respect to malaria cases between rural and urban areas were statistically insignificant. Mean monetary loss per malaria episode was found to be more in urban area (Rs. 393.59) as compared to rural (Rs. 157.59). The study also suggests the importance of socio-cultural factors in implementing any community health programme. Health education is needed to make the people aware and health conscious for prevention of disease at their own level.

Adolescent↗