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Biomedical subjects

R Madhok

Publications and source records attributed to R Madhok.

At least 145 records · Page 8Linked to original sources
PubMed1992

Sex and the risk of HIV infection: the role of alcohol.

To investigate sexual behaviour under the influence of alcohol and the relationship between drinking habits and unsafe sex we carried out a postal and interview survey of 2174 students in the North East of England. Drinking habits were classified as non, light, medium and heavy, and cross-tabulated against sexual and other risk taking behaviour. Response rates of 74% and 77% were obtained in the postal and interview surveys respectively. In the postal survey, heavier drinkers were more likely to have unsafe sex such as casual sex without a condom, and sex with someone know to have many partners. Respondents associated alcohol with sexual risk taking; because of drinking too much, in the last year, 19% had not taken contraceptive precautions during sex. The interview survey largely confirmed postal survey results. There are three possible explanations of the association between drinking habits and unsafe sex: alcohol might disinhibit safer sex; young risk-takers may also drink more; or, drinking might be associated with unsafe sex by coincidence because sexual encounters often begin in licensed premises. Drinking habits should therefore be a priority issue for future HIV/AIDS related research, policy debate, and health education endeavour.

Adult↗
PubMed1992

Prospective trial comparing the use of sulphasalazine and auranofin as second line drugs in patients with rheumatoid arthritis.

Two hundred patients with rheumatoid arthritis were studied in a prospective open trial comparing treatment with sulphasalazine and auranofin in patients with active disease over 12 months. The two drugs improved many parameters of disease activity at 12, 24, and 48 weeks. At 12 weeks, the group treated with sulphasalazine had a lower platelet count (Mann-Whitney U test), erythrocyte sedimentation rate, and articular index, with a greater decrease in erythrocyte sedimentation rate (Students t test) and C reactive protein between 0 and 12 weeks. There were no significant differences between sulphasalazine and auranofin treatment after 24 and 48 weeks. Life table analysis showed no significant differences in the rate of side effects which caused treatment to be stopped. Sulphasalazine works more rapidly, may be a more effective disease modifying antirheumatic drug, and is as well tolerated as auranofin.

Adult↗
PubMed1992

Increased interleukin 6 concentrations in the absence and presence of HIV-1 infection in haemophilia.

AIMS: To measure IL-6 concentrations in asymptomatic HIV-1 antibody positive and negative haemophilic patients and to correlate these with IgG concentrations and CD4 positive cell numbers. METHODS: IL-6 concentrations were measured by bioassay in stored serum from a prospective cohort of haemophilic patients in whom immunoglobulins and T cell subsets had been determined. Values of IL-6 and immunoglobulins were also correlated with severity of liver disease. RESULTS: IL-6 concentrations were raised in haemophilic patients independent of HIV-1 antibody status. In HIV-1 antibody positive patients there was no correlation between IL-6 concentrations and CD4 positive cell numbers, but there was a correlation with IgG (r = 0.4; p = 0.05). In HIV-1 antibody negative patients there were no significant correlations. CONCLUSIONS: Haemophilic patients have increased IL-6 concentrations; in HIV-1 positive patients this is independent of the decline in CD4 cell count. The raised concentrations do not correlate with the clinical severity of liver disease.

Adult↗
PubMed1992

Quality of hospital service: a study comparing 'Asian' and 'non-Asian' patients in Middlesbrough.

To compare 'Asian' and 'non-Asian' patients' experience of and satisfaction with non-clinical aspects of their hospital care, and to evaluate the effect of subsequent provision of 'Asian' food, we undertook interview surveys of recently discharged adult patients in Middlesbrough. Fifty-two 'Asians' and 52 'non-Asians' matched for sex, age, specialty of admission and hospital reported similar experiences in regard to the amount of information received, the presence of medical students during examination, and satisfaction with privacy and visiting arrangements. The main differences between the groups related to the receipt of written information in the patients' first language, 'Asian' patients' inability to communicate because of lack of English and their dissatisfaction with existing interpreting arrangements, 'Asian' women's attitudes to examination by male doctors, and provision of and satisfaction with hospital food. For example, 47 (90 per cent) 'Asians' and 14 (27 per cent) 'non-Asians' required a special diet but 19 per cent and 86 per cent, respectively, received it; and 'Asians' were less satisfied with the food overall. Despite being disadvantaged 'Asian' patients seldom complained. Following the provision of 'Asian' food, 'Asian' patients reported satisfaction levels comparable with those of 'non-Asians'. Equitable health care provision for ethnic minorities requires a level of service comparable with that enjoyed by the majority community. Written information in minority languages, professional interpreters, examination of female patients by women doctors and culturally suitable food were confirmed as priority needs. Staff training and community education may ensure successful implementation of policy on health care of ethnic minorities. Finally, the quality of non-clinical care in hospital needs to be raised for all groups of patients.

Adolescent↗
PubMed1991

Tattoos.

Explore the source record for details and available documents.

Choice Behavior↗
PubMed1991

Enteroscopic diagnosis of small bowel ulceration in patients receiving non-steroidal anti-inflammatory drugs.

15 patients with rheumatoid arthritis who were receiving non-steroidal anti-inflammatory drugs (NSAIDs) and who had chronic occult gastrointestinal bleeding underwent extended small bowel examination with a Sonde enteroscope. 7 patients (47%) were found to have jejunal or ileal ulceration. Small bowel enteroscopy may be a valuable technique for the investigation of undiagnosed gastrointestinal bleeding.

Adult↗
PubMed1991

B cell dysfunction in haemophilia in the absence and presence of HIV-1 infection.

56 haemophiliacs selected on the basis of HIV-1 antibody status, liver disease grade and mean annual dose of clotting factor concentrate used were studied. Spontaneous and stimulated IgG and IgM production in vitro were measured. HIV-1 infection was associated with increased spontaneous immunoglobulin production and an impaired response to pokeweed mitogen and Staph Aureus protein A. Implying a shift in the proportions of partially and fully activated B cells. In the absence of HIV-1 infection there was a shift to a greater proportion of partially activated B cells in patients with severe liver disease. The remainder had in vitro immunoglobulin production comparable to controls. B cell abnormalities occur early in the course of HIV-1 infection. Liver disease and not clotting factor concentrate treatment cause B cell abnormalities in the absence of HIV-1 infection in haemophilia.

Adolescent↗
PubMed1991

Evening primrose oil in patients with rheumatoid arthritis and side-effects of non-steroidal anti-inflammatory drugs.

Forty patients with rheumatoid arthritis and upper gastrointestinal lesions due to non-steroidal anti-inflammatory drugs entered a prospective 6-month double-blind placebo controlled study of dietary supplementation with gamma-linolenic acid 540 mg/day. Nineteen patients received active therapy (as evening primrose oil 6 g/day) and 21 received placebo (olive oil 6 g/day). No patient stopped non-steroidal anti-inflammatory therapy but three patients in each group reduced their dose. Other results showed a significant reduction in morning stiffness with gamma-linolenic acid at 3 months and reduction in pain and articular index at 6 months with olive oil. Whilst gamma-linolenic acid may produce mild improvement in rheumatoid arthritis, olive oil may itself have hitherto unrecognized benefits.

Adolescent↗
PubMed1991

T cell sensitization to factor VIII in haemophilia A?

Previous studies have indicated that factor VIII concentrates have a direct inhibitory effect on the proliferation of peripheral blood mononuclear cells (PBMC) obtained from normal volunteers. We have studied the effects of an intermediate and high purity factor VIII concentrate on haemophiliac PBMC. Intermediate purity factor VIII concentrate inhibited PBMC proliferation, the high purity factor VIII concentrate had no effect. The high purity factor VIII concentrate increased production of the lymphokine interleukin 2, suggesting the presence of a clone of T cells sensitized to factor VIII.

Albumins↗
PubMed1991

A double blind, randomised, multicentre comparison of two doses of intravenous iloprost in the treatment of Raynaud's phenomenon secondary to connective tissue diseases.

OBJECTIVE: To compare low (0.5 ng/kg/min) and standard dose (2 ng/kg/min) iloprost (a stable carbacyclin analogue of prostacyclin) in patients with Raynaud's phenomenon secondary to connective tissue disorders. DESIGN: Double blind, random allocation, three six hour infusions on consecutive days. Follow up period eight weeks. SETTING: Rheumatology units, five teaching hospitals. PATIENTS: 55 Patients with Raynaud's phenomenon (greater than seven attacks per week), 32 secondary to well documented classical progressive systemic sclerosis (American Rheumatism Association criteria), 11 CREST syndrome, 5 mixed connective tissue disease, 1 rheumatoid arthritis, 1 Sjögren's syndrome, 1 childhood dermatomyositis, and 4 abnormal nailfold capillaroscopy and antibody profiles but no definite diagnosis. INTERVENTIONS: All other treatment for Raynaud's phenomenon was discontinued two weeks before entry. 28 Patients were randomly allocated to receive the low dose, 27 the standard dose. Differing dilutions allowed infusion rates to be started at 10 ml/h with increments of 10 ml/h every 15 minutes until infusion rates reached 0.5 ng/kg/min and 2 ng/kg/min respectively. MAIN OUTCOME MEASURE(s)--Reduction in frequency, duration, and severity of attacks of Raynaud's phenomenon. Assessment of ulcer and ischaemic lesion healing. RESULTS: Both dosage regimens were equally effective in reducing severity, frequency, and duration of Raynaud's attacks. Ulcer healing occurred to similar degree in both treatment groups (standard dose 44%, low dose 39%). Low dose was associated with significantly fewer side effects. CONCLUSIONS: Both dosage regimens reduce severity of Raynaud's phenomenon and encourage ulcer healing. Low dose was associated with fewer side effects and was better tolerated by the patients.

Adult↗