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Biomedical subjects

R S Wadia

Publications and source records attributed to R S Wadia.

At least 19 recordsLinked to original sources
PubMed2001

Neurological manifestations of HIV disease.

We report the results of neurological evaluation of 1,527 HIV positive subjects. Neurological complications were seen in 457 patients (481 neurological events). The prevalence was 20.24% of patients attending the out-patient clinic and in 44.57% of in-patients. Involvement of all levels of neuraxes was documented. The commonest manifestations were neuropathies, including herpes zoster (28.27%), meningitis (17.88%) and mass lesions (16%). Cryptococcal meningitis was clearly commoner than tubercular meningitis (67.44% vs 18.60% of all cases of meningitis, respectivelv). Amongst mass lesions, 14/24 single lesions and 27/38 multiple lesions responded to anti-toxoplasma treatment and were diagnosed as CNS toxoplasmosis. In abscence of biopsy, it would be prudent to initiate empirical anti-toxoplasma treatment for all HIV patients with mass lesions and assess clinical and radiological response. To our knowledge this is the largest series of neurological manifestations of HIV disease documented in Indian literature.

Adult↗
PubMed2000

Renal cell carcinoma as significant manifestation of tuberous sclerosis complex.

We present a case of renal cell carcinoma diagnosed in 1982; aged 20 years. Regular follow up of the abdomen by USG noted first the presence of 2 nodules in the remaining kidney in 1994, age 30 and more lesions in 1997, aged 35. These were suspected to be angiomyolipomas on USG. The radiologist on this basis raised the question of tuberous sclerosis. Subsequent evaluation by internist/neurologist showed few adenoma sebaceum lesions a single ash leaf macule, a shagreen patch on the back, and characteristic multiple subependymal calcifications diagnostic of tuberous sclerosis on CT scan brain. The mentation was normal, there was history of only a single fit in childhood. The renal cell carcinoma was thus the first significant manifestation of tuberous sclerosis complex (TSC).

Adult↗
PubMed1994

Ring or disc enhancing lesions in epilepsy in India.

In India a common CT finding in epilepsy is a ring/disc enhancing lesion (RDEL). This lesion is hypodense on plain scan and shows a ring or disc-like enhancement on contrast CT scan. This study reports on 186 cases with such lesions, found in 26.1% of all focal epilepsy. It was commoner in children. Fifty-three per cent of the cases had had fits for less than 3 months, 29.6% had had fits for more than 6 months and 17.6% for more than a year. Focal signs were seen in 20% of cases and focal EEG slowing in 57.1%. The lesion cleared on anticonvulsants alone in 75% of cases. At present this is the preferred method of treatment unless there is coexisting CNS tuberculosis or close family contact with TB or extraneural cysticercosis. Biopsy was done in 16 cases and the two commonest causes were found to be cysticercosis and tuberculosis. A review of 58 biopsies in four centres in India is included. The frequency of this entity is apparently highest in India and even in other countries where cysticercosis is common, the lesion is not reported as frequently.

Adolescent↗
PubMed1992

Familial intracranial haemorrhage due to factor V deficiency.

Strokes may occur with a large number of genetic disorders. Natowicz and Kelley have reviewed the single gene disorders capable of causing familial haemorrhagic strokes. These may be classified into four groups: a) hereditary disorders affecting clotting factors or platelets; b) hereditary disease producing vascular anomaly; c) hereditary disease causing hypertension and d) miscellaneous group including neurofibromatosis, sickle cell disease and tuberous sclerosis.

Blood Coagulation Tests↗
PubMed1987

Focal epilepsy in India with special reference to lesions showing ring or disc-like enhancement on contrast computed tomography.

In 150 consecutive cases of simple partial epilepsy significant CT abnormalities were found in 68%. The commonest lesion noted was a hypodense lesion on unenhanced scan, with a ring or disc-like enhancement on contrast scan, and surrounding hypodensity. This lesion was seen in 39 cases and was more common in patients below the age of 15 years and in those with shorter duration of fits (less than 6 months). Nineteen of these cases had focal signs, 16 showed focal slow activity on EEG and 17/39 had neither signs nor focal slowing on EEG. Ten cases with a ring or disc enhancing lesion had evidence of tuberculosis elsewhere in the body, three more had a past history of tuberculosis and four others had a history of close contact with a case of tuberculosis. After 3 months of antitubercular treatment, 23 out of 25 patients who were rescanned showed clearing of the lesion. The two who did not were operated upon, and the lesion was shown histologically to be a tuberculoma. Ten other cases have done well, but have not been rescanned. Only one case was not treated with antitubercular therapy. She developed fits, altered consciousness, and meningitis and recovered from this serious illness after starting antitubercular therapy. Though not histologically verified, it seems justified to conclude that in India a ring or disc enhancing lesion is the commonest accompaniment of focal epilepsy, and that at least one third (and probably more) of these lesions are tuberculomas.

Adolescent↗
PubMed1987

Electrophysiological studies in acute organophosphate poisoning.

Electrophysiological studies in suicidal patients with organophosphate poisoning are reported. Patients often developed muscular weakness of variable severity owing to diplorisation block at nicotinic receptors. During such paralysis nerve conduction velocity and distal latencies were normal even in severely paralysed patients. The amplitude of the compound action potential was smaller than in controls and often showed a repetitive response. The amplitude tended to be lower in those more severely affected. On repetitive stimulation there was usually no decrement with three stimuli per second and only occasional decrement at 10 per second. At 30 Hz several cases showed a decrement even in the absence of paralysis. This response to repetitive stimuli is thus quite distinct from that seen in either myasthenia or Eaton Lambert syndrome. On three occasions after poisoning with dichlorovos there was first anticholinesterase insecticide poisoning and later delayed neurotoxicity as seen with triorthocresylphosphate. These cases showed all the features of a severe pure motor axonal degeneration neuropathy.

Action Potentials↗