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Biomedical subjects

R Nanda

Publications and source records attributed to R Nanda.

At least 55 records · Page 3Linked to original sources
PubMed1988

Response of tuberculous stricture to antituberculous treatment.

Tuberculous infection of the gastrointestinal tract results in a variety of histopathological lesions. Some patients develop intestinal strictures and present with subacute intestinal obstruction. The treatment is controversial and vary from a trial of antituberculous drugs to early surgery:the response to medical therapy is not clear. To examine this issue the present prospective therapeutic trial was carried out on 39 patients with symptoms of bowel obstruction and radiological evidence of intestinal stricture. All patients were treated with conventional antituberculous drugs (streptomycin, rifampicin, and isoniazid) under close supervision. Thirty four (87%) patients completed the trial, five were lost to follow up. Thirty one (91%) of these showed significant clinical improvement:26 became completely symptom free, while the remaining five complained of only vague abdominal discomfort. Only three (8%) patients failed to respond to treatment and were subjected to surgery. Barium series were repeated in 23 of 31 who completed the treatment; the remaining eight refused further investigations. Complete resolution of the radiological abnormality was seen in 16 (70%) patients. In the remaining seven (30%) the stricture persisted; in two of these the treatment was continued for another year and both showed substantial radiological improvement. It is concluded that most patients with tuberculous strictures respond well to medical treatment and surgery should be resorted to only if drug therapy fails.

Adolescent↗
PubMed1987

Longitudinal study of craniofacial growth in Macaca fascicularis.

This paper is an analysis of normal craniofacial growth in adolescent crab-eating macaques (Macaca fascicularis). Eight female adolescent monkeys were used in this study. Their individual craniofacial growth was studied for a 24-month period utilizing tantalum implants and roentgenographic cephalograms. Throughout the observation period, each monkey consistently showed a class I molar relationship with a good overjet and overbite. The amount of anterior displacement of the maxilla and the mandible was significantly dominant compared to the vertical displacements at every observation period. The midface exhibited a maxillary differential growth pattern in which the premaxilla displaced superiorly and the posterior maxilla moved inferiorly, resulting in a counterclockwise rotation of the entire maxilla. Growth of the lower anterior teeth and alveolar bone compensated for the incremental vertical spaces which were induced by superior displacement of the premaxilla and inferior repositioning of the chin. In addition, the amount of anterior displacement of the upper and lower anterior teeth were significantly larger than that of the premaxilla and the chin. The dentocraniofacial growth pattern in Macaca fascicularis was quite similar to that seen in Macaca mulatta.

Aging↗
PubMed1987

Facial growth subsequent to Le Fort I osteotomies in adolescent monkeys.

The study goal was to assess qualitatively and quantitatively the craniofacial adaptations following total maxillary osteotomy with and without mandibular autorotation. Six adolescent female Macaca fascicularis monkeys were randomly divided into two surgical groups, and eight others served control. Prior to surgery, metallic implants were inserted in the anterior part of the cranial base, on opposite sides of craniofacial sutures, and in multiple sites of the maxilla and mandible. Group I animals underwent a Le Fort I advancement of 4 mm, while Group II animals had a 5-mm advancement and a 2.5-mm impaction. Lateral cephalometric head-films were taken at monthly intervals for a total follow-up of 12 months after surgery. At least two cephalograms were taken on each occasion, one with the teeth in occlusion and the other with the mouth wide open. The latter was used to ascertain accurately the outline of the mandibular condyle. Cephalometric superimposition methods were used to quantify the growth changes. The findings indicated that the growth changes in the maxilla and mandible were related to the extent of injury caused by maxillary surgery. The largest increments and rates of growth were observed respectively in the control animals, Group I animals (anterior maxillary repositioning), and Group II animals (anterior and superior maxillary repositioning). The most interesting finding was that mandibular growth pattern followed maxillary growth pattern in both experimental groups, and the immediate postsurgical occlusion in Class II molar relationship was maintained with increased overjet in both experimental groups throughout the postsurgical observation period.

Animals↗
PubMed1987

Effect of tensile force magnitude on release of cranial suture cells into S phase.

An in vitro model was used to study the effect of tensile force magnitude and duration on cell proliferation in cranial suture tissue. Helical springs were calibrated to deliver specific magnitudes of force to rat midsagittal suture in organ culture. The explants were incubated for time periods ranging from 1 to 48 hours. The in vitro model system facilitates study of the effects of a single parameter of an applied force on suture tissue without the interference of the complicated craniofacial anatomy. Specifically, the influence of tensile force magnitude and duration on DNA synthesis was investigated. Using autoradiography, cells incorporating tritiated thymidine were counted, indicating cells released into DNA synthesis (S) phase.

Animals↗
PubMed1987

Relative efficacy and safety of absolute alcohol and 50% alcohol as variceal sclerosants.

Absolute alcohol and 50% alcohol were compared as sclerosants in 79 patients who underwent sclerotherapy for esophageal varices every 3 weeks with either of the solutions. Active variceal bleeding could be controlled more often (p less than 0.05) with absolute alcohol (93.3%) compared with 50% alcohol (53.8%). Variceal eradication could be achieved with absolute alcohol in a significantly shorter time with smaller amounts and fewer sclerotherapy sessions than with 50% alcohol. Except for a higher incidence of retrosternal pain and fever noted with the use of absolute alcohol, there was no significant difference in the incidence of various complications, rebleeding rate, or mortality between the two sclerosants. Absolute alcohol is a more effective and equally safe sclerosant compared with 50% alcohol.

Adolescent↗
PubMed1987

Mandibular growth following Le Fort I osteotomy in adolescent monkeys.

Le Fort I osteotomy with anterior and superior repositioning of the maxilla was performed on adolescent Macaca fascicularis monkeys to study its effect on the subsequent growth and remodeling changes of the mandible. Six adolescent Macaca fascicularis monkeys were randomly divided into two surgical groups and eight others served as controls. Group I animals underwent a Le Fort I advancement and Group II animals experienced a Le Fort I advancement and impaction. All monkeys received tantalum implants in the anterior part of the cranial base, on opposite sides of craniofacial sutures and in multiple sites of the maxilla and mandible. The immediate postsurgical occlusion of all experimental animals was a Class II molar relationship. The animals were followed for up to 12 months postoperatively. Analysis of cephalometric head films taken at monthly intervals showed that both the maxilla and the mandible of all experimental monkeys grew in a coordinated fashion, although the amount, rate, and direction of growth varied between control and experimental animals as well as between Group I and Group II animals. The largest increments and rates of growth were observed in the control animals, Group I animals, and Group II animals, respectively. This study indicates that the growth changes in both maxilla and mandible are related to the extent of injury caused by maxillary surgery. The results also showed that although the surgical procedures were performed in the maxilla, mandibular growth was significantly modulated by the surgically changed maxillary environment.

Animals↗
PubMed1987

Biliary lipid composition in patients with non-cirrhotic portal fibrosis--a comparison with compensated cirrhosis of the liver.

Patients with non-cirrhotic portal fibrosis (NCPF) are known to have mild hepatic functional abnormalities. To study the biliary lipid composition in these patients, duodenal bile was collected from 18 patients with NCPF, 15 patients with non-alcoholic compensated cirrhosis of the liver and 18 matched, non-obese, healthy control subjects. There were no significant differences in the mean (+/- SD) concentrations of cholesterol, phospholipids and bile acids in patients with NCPF and healthy controls. On the other hand, patients with cirrhosis had significantly lower concentrations of all the three biliary lipids as compared with the NCPF patients and controls (p less than 0.05). The cholesterol solubilizing capacity of the bile was the same in NCPF patients, cirrhotics and controls. It is concluded that the relative proportions of the three biliary lipids remain unchanged in patients with NCPF despite mild hepatic derangement.

Adolescent↗
PubMed1987

Measurement and correlation of wedged hepatic, intrahepatic, intrasplenic and intravariceal pressures in patients with cirrhosis of liver and non-cirrhotic portal fibrosis.

In order to examine the relationship of various haemodynamic parameters in two different liver diseases, 10 patients with cirrhosis of liver and 14 patients with non-cirrhotic portal fibrosis were studied. In cirrhotics, mean (+/- SD) wedged hepatic (25.8 +/- 6.4 mmHg), intrahepatic (24.5 +/- 6.2 mmHg) and intrasplenic (25.0 +/- 5.6 mmHg) pressures correlated significantly (p less than 0.001) with intravariceal (25.2 +/- 6.7) pressure measurements. In patients with NCPF, mean (+/- SD) wedged hepatic (9.1 +/- 3.7 mmHg) and intraphepatic (15.4 +/- 5.8 mmHg) pressures were significantly (p less than 0.01) lower than the intrasplenic (24.5 +/- 4.2 mmHg) and intravariceal (23.96 +/- 5.6 mmHg) pressures. Two independent pressure gradients, one between intrasplenic and intrahepatic pressure (8.9 +/- 6.5 mmHg) and another between intrahepatic and wedged hepatic venous pressure (6.2 +/- 5.6 mmHg) were seen in non-cirrhotic portal fibrosis patients, indicating the likelihood of both pre- and perisinusoidal resistance to flow of portal venous blood in these patients. A highly significant (p less than 0.001) correlation between intravariceal and intrasplenic pressures was found in patients with cirrhosis of liver (r = 0.93), as well as in patients with non-cirrhotic portal fibrosis (r = 0.85). No correlation was found between the size of oesophageal varices and wedged hepatic and intrahepatic pressures. Patients with grade 4 varices had significantly higher intravariceal (p less than 0.01) and intrasplenic (p less than 0.05) pressure than patients with grade 2 varices. It can be concluded that intravariceal pressure is representative of portal pressure in patients with cirrhosis of liver as well as in non-cirrhotic portal fibrosis patients and it can be recommended as the single haemodynamic investigation in patients with portal hypertension and oesophageal varices.

Blood Pressure↗
PubMed1987

Intravariceal versus paravariceal sclerotherapy: a prospective, controlled, randomised trial.

Fifty four consecutive patients with oesophageal variceal bleeding were randomised to undergo intravariceal (28 patients) or paravariceal (26 patients) sclerotherapy, every three weeks. Intravariceal technique was found significantly (p less than 0.01) more effective in controlling active variceal bleeding than the paravariceal technique (91% v 18.7% respectively). The mean (+/- SD) time taken for variceal eradication by intravariceal sclerotherapy (15.4 +/- 5.3 weeks) was significantly (p less than 0.001) less than paravariceal (26.8 +/- 6.6 weeks) technique. The number of sclerotherapy sessions needed with intravariceal technique were also significantly less. Rebleeding was seen in 38.5% patients after para and 14.3% after intravariceal injections (NS). Except for retrosternal pain, which occurred more often (p less than 0.01) with paravariceal technique, there was no difference in the incidence of other complications or mortality between the two groups. Variceal recurrence was seen in seven patients (25%) in the intra and one (3.9%) patient in the paravariceal group (p less than 0.01) after a mean follow up of 29.4 +/- 9.1 weeks. Intravariceal sclerotherapy was superior to paravariceal in the control of active variceal bleeding and for total variceal obliteration, but was associated with a higher variceal recurrence.

Adolescent↗
PubMed1986

The effect of chin cup therapy on the growth and development of the cranial base and midface.

The purpose of this study was to determine how the growth rates of certain cranial base and midfacial points and dimensions were affected by force application to the mandible by the chin cup. Control and treated samples consisting of Japanese girls with skeletal Class III relationships were analyzed. Each sample consisted of lateral cephalometric radiographs taken annually (control group) or semiannually (treated group) from early childhood through adolescence. The control sample was composed of seven persons and the treated sample of ten persons. The subjects of the treated sample were required to wear a chin cup a minimum of 12 hours per day. The total force delivered was 500 g, 250 g per side, and the direction of force was, on average, through the condyle. No other appliances were used. The results of this study indicate that the chin cup causes a closing of the cranial flexure angle N-S-Ba, inhibits posterior growth of the point basion, and imposes a vertical growth tendency on the points nasion and sella. The chin cup significantly inhibits anterior and posterior vertical maxillary growth and growth of upper anterior facial height. Because development of vertical posterior facial height is inhibited more than anterior facial height, a clockwise rotation of the maxilla occurs. The chin cup also causes flaring and a decrease in eruption rate of the maxillary incisors. It has no effect on the eruption rate of the maxillary molars, but accelerates their rate of mesial movement as compared with controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Photodensitometric evaluation of osseous repair following Le Fort I osteotomy.

This study evaluated photodensitometry as a noninvasive method for quantitating bone mineral content (BMC) and osseous repair after Le Fort I osteotomy. Le Fort I osteotomies were performed on 6 Macaca fasicularis monkeys; maxillas were either advanced (Group I, n = 3) or impacted and advanced (Group II, n = 3). Postoperative, standardized lateral cephalometric films were taken at weekly intervals up to 25 weeks and osteotomy site repair was studied using photodensitometry. Segment stability was also evaluated and correlated with measured densities. In both experimental groups, clinical stability occurred at about the same time (45.7 and 48.7 days postoperatively) despite large differences in the size of the initial surgical defects. The net rate (slope) of osteotomy site remineralization was significantly different (Group II greater than Group I), but the relative difference in film absorbance between the osteotomy site and adjacent bone at the time of clinical stability was the same. This difference can be extrapolated from early postoperative films and may constitute a useful parameter for predicting when clinical stability will be achieved.

Animals↗
PubMed1986

Isoenzyme studies of Giardia lamblia isolated from symptomatic cases.

Strains of Giardia lamblia were isolated from symptomatic cases of giardiasis and axenized in the laboratory. Electrophoretic mobility patterns of four enzymes, viz., EC 5.3.1.9 glucose phosphate isomerase (GPI); EC 1.1.1,4.0.L-malate; NADP+ Oxidoreductase (Oxaloacetate decarboxylating) (ME); EC 2.7.5.1 phosphoglucomutase (PGM); and EC 2.7.1.1 hexokinase (HK) of the lysates prepared from these isolates were studied using starch-gel. Based on differences in mobility patterns of PGM and HK, the four strains studied could be grouped into three different isoenzyme types (Zymodemes). ME mobility was identical in all the four strains. Some relative difference was seen in the mobility of GPI, though the pattern of mobility was similar in all the strains.

Adolescent↗
PubMed1986

Oesophageal ulceration after sclerotherapy--a complication or an accompaniment?

Forty eight patients with oesophageal varices were serially endoscoped over a period of 3 weeks for the presence of oesophageal ulcers after the first course of sclerotherapy with absolute alcohol. Post-sclerotherapy oesophageal ulcers were seen in 94% patients on day 1, in 69% patients at 1 week and in only 12.5% patients at the end of 3 weeks. A strong correlation (r = + 0.88) was observed between the incidence of ulceration and the amount of sclerosant injected. In fact, all patients who received 3 ml or more of the sclerosant showed development of oesophageal ulcers. It can be concluded that oesophageal ulcers are probably a necessary accompaniment of sclerotherapy and should not be considered an avoidable complication.

Adult↗
PubMed1986

Follow-up of patients after variceal eradication. A comparison of patients with cirrhosis, noncirrhotic portal fibrosis, and extrahepatic obstruction.

One hundred one patients, 54 with cirrhosis of liver, 31 with noncirrhotic portal fibrosis (NCPF), and 16 with extrahepatic obstruction (EHO), were followed up at monthly intervals for a mean (+/- SD) period of 17.9 +/- 4.8 months after achieving total variceal eradication with endoscopic sclerotherapy. Recurrence of esophageal varices was seen in 19 (18.8%) patients, 12 with cirrhosis and seven with NCPF, within a mean (+/- SD) period of 5.7 +/- 1.6 months. No patient with EHO showed recurrence. Three (2.9%) patients rebled from the recurred varices. Mean (+/- SD) number of sclerotherapy sessions and the amount of absolute alcohol required for eradication of recurred varices were 1.6 +/- 0.8 and 3.6 +/- 1.8 ml, respectively. Dysphagia and esophageal stricture were present in 15 (14.9%) patients with nearly similar frequency in patients with cirrhosis, NCPF, and EHO. Dysphagia in four patients with stricture improved without dilatation. While there were no deaths in patients with NCPF and EHO, 11 patients with cirrhosis died. There was significant (p less than 0.01) improvement in the liver status of surviving patients with cirrhosis after variceal eradication. It can be concluded that variceal recurrence and rebleeding are not major problems after sclerotherapy. Sclerotherapy probably helps in spontaneous improvement of the liver status of surviving cirrhotics and reduces long-term morbidity and mortality of patients with NCPF and EHO.

Adult↗
PubMed1986

Comparison of the two time schedules for endoscopic sclerotherapy: a prospective randomised controlled study.

To compare the efficacy and safety of one week versus three weeks interval treatment schedules of endoscopic sclerotherapy, injections were carried out in a prospective manner in 96 patients with variceal bleeding; 47 on a one week and 49 on a three weeks treatment schedule. Weekly endoscopic sclerotherapy eradicated oesophageal varices significantly (p less than 0.01) earlier (mean +/- SD 7.1 +/- 2.43 weeks) as compared with the three weeks regimen (mean +/- SD 14.86 +/- 4.86 weeks). The rebleeding rate was also significantly less (p less than 0.05) with weekly endoscopic sclerotherapy (8.5%) as compared with three weeks endoscopic sclerotherapy treatment (26.5%). The amount of alcohol and the number of endoscopic sclerotherapy courses required for complete variceal eradication did not differ significantly between the two groups. Patients undergoing weekly injections were seen to have significantly more oesophageal ulcers (p less than 0.01) as compared with the three weeks group, necessitating at times (23%) postponement of the procedure. There was, however, no difference between the two groups in the frequency of oesophageal stricture formation, dysphagia, retrosternal pain, and fever. Mortality was also similar in the two groups. It can be concluded that a weekly schedule of endoscopic sclerotherapy appears superior to a three weeks schedule.

Adult↗