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Biomedical subjects

R Kashyap

Publications and source records attributed to R Kashyap.

At least 109 records · Page 6Linked to original sources
PubMed1995

Efficacy of standard ten millicurie dose of radio-iodine in management of autonomously functioning toxic thyroid nodules.

Therapeutic effect of radio-iodine treatment on thyroid patients with autonomously functioning toxic thyroid nodule was evaluated. Fifty one patients were given a standard dose of 10 mci of radioiodine (I-131) and were followed up for 2-3 years. The failure rate (relapse after 10 mci of radioiodine) of this regime was 10%. It was found that the nodules less than or equal to 3 cms. in size were completely cured after a dose of 10 mic. of radio-iodine therapy, over a follow up period of next 6 months. Patients having nodules larger than 3 cms. relapsed after first dose of 10 mci of radio-iodine, but were cured completely after the second dose of 10 mci of radio-iodine therapy. Tri-iodothyronine (T3) and thyroxine (T4) values were both found to be high before giving treatment in all the cases. Only one case developed hypothyroidism after radioiodine therapy.

Female↗
PubMed1994

Differentiation of malignant and degenerative bone lesions using dexamethasone interventional 3- and 24-hour bone scintigraphy.

Seventy-seven adult patients with suspected skeletal metastases were divided into two groups. In group A (n = 30), following intravenous administration of 20 mCi (740 MBq) of technetium-99m methylene diphosphonate (99mTc-MDP), 3- and 24-h scintigraphy of bone lesions was performed. The 24/3 h lesion to bone background radiouptake ratio (RUR) was calculated for each lesion. In group B (n = 47), the same procedure was followed with dexamethasone intervention (10 mg in 24 h) following the 3-h acquisition. In group A, after determination of the critical point, malignant and degenerative bone lesions could be separated with a sensitivity, specificity and accuracy of 0.76, 0.72 and 0.73, respectively. The mean RUR of the malignant lesions was 1.20 +/- 0.23, and that of the benign lesions, 0.95 +/- 0.15. In group B cases, significantly increased sensitivity, specificity and accuracy of 0.87, 0.94 and 0.92, respectively, were found (P < 0.001). The mean RUR of the malignant lesions was 1.48 +/- 0.34, and that of degenerative lesions, 0.88 +/- 0.19. Dexamethasone interventional bone scintigraphy seems to be a new cost-effective method for differentiating malignant from degenerative bone lesions using the RUR.

Bone Diseases↗
PubMed1994

Assessment of location-specific human exposure to dichloro-diphenyl trichloroethane and benzenehexachloride in Gujarat state, India.

On the basis of the use of insecticides in agriculture and vector control programmes, two locations were selected in Gujarat state, India. In location 1 the insecticides are used in both agriculture and vector control programmes while in location 2 they are used only in agriculture. Raw food commodities, water, soil and blood samples were collected from the people residing in these locations, and analysed for total dichloro-diphenyl trichloroethane and total benzenehexachloride residues. Residue levels were significantly lower in location 2 than in location 1.

Adult↗
PubMed1994

A simplified kit for instant preparation of technetium-99m human immunoglobulin-G for imaging inflammatory foci.

A kit consisting of reduced human immunoglobulins G (hIgG), methylene diphosphonate, stannous chloride and ascorbic acid has been developed to instantly produce technetium-labelled hIgG of greater than 97% purity and suitable for inflammation foci scintigraphy in patients. The shelf life of the kit when stored at 4-7 degrees C was at least 3 months. 99mTc-hIgG prepared from the kit, when incubated at 37 degrees C for 24 h in physiological saline and human serum was found to degrade by only 7.8 and 4.3%, respectively, thereby indicating high stability of the labelled product. Competitive RIA data did not exhibit loss of immunoreactivity of the hIgG due to its reduction. Blood clearance of the radiopharmaceutical in rabbits exhibited a monophasic exponential pattern. Biodistribution in mice showed uptake by liver (4.93%), kidneys (3.07%) and intestines (2.12%) at 4 h which was reduced to 1.99, 2.18 and 1.93%, respectively at 24 h. Radiolabelled hIgG prepared from the kit was found to be quite satisfactory for inflammation scintigraphy in human patients.

Animals↗
PubMed1994

A novel method for labelling human immunoglobulin-G with 99Tcm suitable for inflammation scintigraphy.

An amount of 1.0 mg human immunoglobulin G (hIgG) treated with ascorbic acid at a molar ratio of 1:5000 for 16 h at 4-7 degrees C was mixed with 250 micrograms GHA and 5 micrograms stannous chloride dihydrate in normal saline. Radiolabelling of hIgG (> 98%) was achieved instantly when mixed with 99Tcm-pertechnetate. The preparation was sufficiently stable in serum at 37 degrees C. The competitive binding assay and gel electrophoresis of the native and reduced hIgG did not show any measurable loss in immunoreactivity and intactness due to its reduction. There was no significant decrease in the radiolabel of labelled hIgG when incubated with diethylenetriaminepentaacetate (DTPA) (50-fold), in contrast with about 9% loss of the radiolabel by treating it with a similar concentration of cysteine. Blood clearance of labelled hIgG in rabbits was biphasic with about 78 min and 8 h as T1/2 of the fast and slow phases. Biodistribution of the radiotracer in mice at 4 h showed its uptake by liver (10.2%), kidneys (5.39%), intestines (7.33%) and muscles (3.9%), which altered to 5.63, 3.20, 4.03 and 6.73%, respectively, at 24 h. The radiotracer was excreted through both renal and hepatobiliary routes. High accumulation of the radiolabelled hIgG in inflammatory lesions of the patients confirmed the clinical usefulness of the method developed.

Animals↗
PubMed1993

24 hour/3 hour radio-uptake technique for differentiating degenerative and malignant bony lesions in bone scanning.

Differentiating bony metastases from degenerative lesions is of great importance to the oncologist. Routine bone scanning using technetium-99m methylene diphosphonate is the investigation of choice for detecting bony lesions, but its specificity is low. Using the difference in radio-uptake behaviour of metastatic and degenerative lesions as the criterion, a 24/3 h radio-uptake, lesion to non-lesion ratio was used to separate out the two types of lesions. Radio-uptake ratio (RUR) distribution curves of malignant and degenerative lesions were found to be significantly different (P < 0.001). Taking 1.12 as the critical point, RUR of malignant lesions was found to be more than the critical point, and that of degenerative lesions was found to be less than the critical point. Sensitivity, specificity and accuracy were found to be 68%, 80% and 74%, respectively.

Bone Diseases↗
PubMed1993

Evaluation of radionuclide gastroesophagography as a suitable screening test for detection of gastroesophageal reflux.

Thirty cases of recurrent pulmonary infection and ten control cases underwent radionuclide gastroesophagography endoscopy, histopathology and barium esophagography to evaluate the clinical efficacy of scintigraphic technique in, detection of gastroesophageal reflux. After ingesting 500 micro curie of Tc-Sulphur colloid mixed in milk, patients esophageal activity was monitored using the gamma camera for forty-five minutes continuously. By using histopathology as standard of comparison, the sensitivity and specificity of radionuclide esophagography was 78.54 and 81.25%, respectively. Because of its physiologic nature, low radiation exposure and convenience, radionuclide esophagography is recommended as a suitable screening test for detecting gastroesophageal reflux where available.

Barium Sulfate↗
PubMed1992

Evaluation of a DMSA kit for instant preparation of 99mTc(V)-DMSA for tumour and metastasis scintigraphy.

A kit has been developed to instantly prepare 99mTc(V)-DMSA. The freeze-dried kit consisting of DMSA, stannous chloride and ascorbic acid in appropriate proportions, produces quality 99mTc(V)-DMSA when mixed with 0.2 mL of 3.5% NaHCO3 solution and 2-4 mL of (99mTc)pertechnetate. The radiopharmaceutical characterized by chromatography with ITLC-SG in 0.9% saline and horizontal paper electrophoresis in 50 mM vernol buffer, pH 8.6, at a potential gradient of 15 V/cm showed a different mobility with respect to 99mTc(III)-DMSA, a known agent for kidney imaging. The new agent exhibited less plasma protein binding compared to that of 99mTc(III)-DMSA. Biodistribution of the pentavalent DMSA in mouse demonstrated greater uptake in bone and muscle and lower uptake in liver and kidney with respect to trivalent DMSA. The soft tissue tumour specificity and its suitability for tumour scintigraphy was apparent from the scintigrams of mammary carcinoma in a C3H Jax mouse and medullary carcinoma in a patient. Brain metastatic lesions were also visible in a breast carcinoma patient after administering him with the agent.

Animals↗
PubMed1992

Tc-99m(V) DMSA imaging. A new approach to studying metastases from breast carcinoma.

Combined Tc-99m MDP skeletal imaging and Tc-99m(V) DMSA whole body scans to detect metastases were performed during the follow-up of 30 patients who underwent surgery for breast carcinoma. Eight patients had normal Tc-99m MDP and Tc-99m(V) DMSA scans and were declared free of metastatic disease, further confirmed by no change in symptomatology over a 1-year follow-up period. Twenty-two patients had positive Tc-99m MDP scans with varied skeletal involvement. Tc-99m(V) DMSA scans showed matched areas of increased radiotracer concentration in bony metastases in 20 of these patients. Tc-99m(V) DMSA concentration was not seen in traumatic vertebral collapse or in coexistent osteoarthritic disease in vertebral metastatic involvement. Interestingly, Tc-99m(V) DMSA showed increased concentration in brain and liver metastases. Pentavalent Tc-99m(V) DMSA appears useful for detecting skeletal and soft-tissue metastases in breast carcinoma, and can improve the specificity of Tc-99m MDP bone scans in screening for bone metastases.

Adult↗
PubMed1991

Evaluation of functional parameters and left ventricular size by radionuclide ventriculography (RNV) in myocardial infarction patients.

Functional parameters like left ventricular ejection fraction (LVEF), peak ejection rate (PER), peak filling rate (PFR), regional wall motion and left ventricular size index were evaluated in 68 patients with myocardial infarction and in 50 normal subjects, by radionuclide ventriculography (RNV). Patients were divided into four groups (I to IV) according to increasing left ventricular size and the parameters were evaluated in each group. LVEF proved to be the most sensitive parameter of overall left ventricular performance. PFR decreased significantly from group I to group III but not from group III to group IV, suggesting that in extreme degrees of left ventricular enlargement some compensatory mechanism acts to prevent a greater fall in left ventricular compliance. LV size and performance were least affected in inferior wall myocardial infarction. LVEF was however a better predictor of LV size than the site of the myocardial infarction.

Adult↗
PubMed1989

Non-invasive evaluation of global ventricular functions in coronary artery disease by exercise radionuclide angiocardiography.

Rest and exercise radionuclide angiocardiographic measurement of left ventricular functions were obtained in 12 normal subjects (group I) and 42 patients with well documented coronary artery disease (group II). Additionally thirty-five patients had an exercise tread mill test. Resting left ventricular ejection fraction less than 50% provided the greatest diagnostic information. Exercise was induced by supine bicycle exercise ergometer. In group II 32 patients of coronary artery disease with normal global ventricular function at rest, new regions of dysfunction developed during exercise and global ejection fraction fell by 8 to 15 percent while in group I there was an increase in LVEF and no areas of any ventricular wall motion abnormalities were detected. Exercise radionuclide angiocardiography is a useful non invasive technique which permits accurate assessment of the presence and functional severity of coronary artery disease.

Adult↗
PubMedDate not supplied

Immunoglobulin therapy in immunohematological disorders.

Over the last few decades many biological factors have been discovered. Among these immunoglobulins are currently being used for large number of indications. Initially it was used for primary and secondary immunodeficiency states. Subsequently, intravenous immunoglobulins are being used for variety of immunohematological, autoimmune, and immunopathological disorders. In the present communication besides it basic structure, pharmacology and immunoregulation, its use in various hematological disorders is being reviewed. Currently, it is the preferred treatment for conditions such as immune mediated thrombocytopenic purpura, neutropenia, and autoimmune hemolytic anemia.

Autoimmune Diseases↗
PubMedDate not supplied

Management of idiopathic thrombocytopenic purpura.

Idiopathic thrombocytopenic purpura is not an uncommon bleeding disorder with a prevalence of 40-80 per million children per year. Over the last six decades, the subject of ITP has attracted the attention of pediatricians and hematologists. It is one of the subjects which has many controversies because of its unpredictable course heralded by remission relapses, and chronicity with mortality in less than 1% of cases. In the present review only the controversies in the management of acute and chronic ITP have been reviewed as it interests most pediatricians. Management of intracranial hemorrhage (ICH), severe gastrointestinal hemorrhage and menorrhagia continues to still remain a challenge in spite of newer therapies.

Adolescent↗