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Biomedical subjects

R Sehgal

Publications and source records attributed to R Sehgal.

At least 37 records · Page 2Linked to original sources
PubMed2000

Fasciolopslasis--a re-emerging infection in Azamgarh (Uttar Pradesh).

Fasciolopsiasis is endemic in the far east. In India, there have been a few reports of the infection, prior to the 1990's. We report two cases from Azamgarh district of Uttar Pradesh. Both the cases were from nearby villages where water chestnuts are cultivated. These may be a source of infection. Pigs are commonly observed in these areas and and may be the source of ova. The only missing link is the finding of infected snails. Presence of at least three cases (one reported earlier) in the area indicates the potential for the infection to re-emerge. Further epidemiological studies are needed to analyse the various ecological factors of transmission. Fasciolopsiasis is endemic in China, Taiwan, Vietnam and Thailand. In India, (Fascilopsis buski) infections in man have been reported earlier from Assam, Maharashtra, Tamil Nadu and parts of Uttar Pradesh. However, to the best of our knowledge, no such reports have been made since 1990's. We herewith report two recent cases from district Azamgarh, Uttar Pradesh (U.P.), India. Factors, such as cultivation of water chestnuts, presence of snails as intermediate hosts and pigs as definitive host in this geographical area seem to be suggestive of an endemic focus and thus needs further epidemiological survey for preventive and control measures, at the earliest.

Adult↗
PubMed1999

Characterization of Giardia lamblia groups A and B from North India by isoenzyme and random amplified polymorphic DNA analysis.

Giardia lamblia (syn. G. intestinalis) infection in young adults leads to acute/chronic diarrhea in some individuals and is asymptomatic in others. Recently, G. lamblia strains have been characterized as group A (symptomatic) and group B (asymptomatic or control) by advanced isoenzyme and molecular biology studies. In the present brief pilot study, ten G. lamblia isolates obtained from five symptomatic (group A) and five asymptomatic (group B) persons were characterized by isoenzyme and random amplified polymorphic DNA (RAPD) analysis. Isoenzyme analysis demonstrated remarkable homogeneity in seven enzyme patterns, the exception, being that of phosphoglucomutase, for which two zymodemes (I and III) were observed. In contrast, RAPD analysis showed homogeneity for eight primers; exceptions were two primers, A02 and B05, which separated group A G. lamblia isolates into two rapdemes (A(R1) and A(R2)) and group B G. lamblia isolates into four rapdemes (B(R1), B(R2), B(R3) and B(R4)). Further phenetic analysis showed average genetic distances of 0.105 within group A and 0.121 within group B G. lamblia isolates according to Jaccord's distance scale, which suggests that both lineages appear to consist of a range of variants with no significant (P < 0.05) genetic diversity. The two techniques demonstrated a positive association with regard to differentiation between group A and group B G. lamblia isolates. These very preliminary results indicate that RAPD analysis could be a potentially useful substitute for isoenzyme analysis.

Adolescent↗
PubMed1999

Early abortion by mifepristone (RU 486) followed by vaginal gel (meteneprost) versus oral (misoprostol) prostaglandin.

The present study was conducted to compare the therapeutic regimens of low-dose mifepristone (200 mg) plus vaginal meteneprost versus oral misoprostol in terms of efficacy and safety for medical termination of early pregnancy. A randomized clinical trial was conducted by the Department of Obstetrics and Gynecology at the All India Institute of Medical Sciences, New Delhi. A total of 101 subjects were enrolled within 56 days of amenorrhea. A single dose of 200 mg of mifepristone (RU 486) was given and, 48 hr later, prostaglandin was administered as either 5 mg of 9 methylene PGE2 vaginal gel, meteneprost (classified as group I) or 600 microg of oral PGE1 derivative misoprostol (classified as group II). In group I, 50 subjects and in group II, 51 subjects were treated with the respective schedule. The success rate with mifepristone + misoprostol (group II) was 88.63% which was significantly higher than that with mifepristone + meteneprost (group I) which was 82% (p < 0.05). The average duration of bleeding in cases with complete abortion was 8.95+/-5.67 and 9.77+/-6.51 in group I and II, respectively. There were no serious side-effects. Only one subject in group I (2%) required blood transfusion for heavy bleeding. This study indicated that oral prostaglandin after a low dose of mifepristone (200 mg) could be developed into an effective method to terminate early pregnancy. Oral administration of both drugs would be a more convenient, feasible, private and acceptable regimen.

16,16-Dimethylprostaglandin E2↗
PubMed1999

Awareness about a national immunization day programme in the Sunsari district of Nepal.

The initiative to eradicate poliomyelitis globally by the year 2000 was launched at the Forty-first World Health Assembly in May 1988, when all WHO Member States were challenged to help eradicate poliomyelitis from the world, a gift to the children of the twenty-first century. In Nepal, 100-250 children per year become disabled due to poliomyelitis. The government of Nepal is determined to eradicate the disease from the country by the year 2000 through the National Immunization Day (NID) Programme. Since 1996, about 3.3 million children under 5 years of age have been immunized each year in Nepal. In the present study, we analysed the impact of the campaign in the Sunsari district of Nepal. The study was carried out during the first NID (6 December 1996) to evaluate the local population's awareness of the programme and the impact of the media on such awareness. A total of 843 respondents were interviewed, 39% of whom were illiterate. Two important aspects of the mass campaign (whether a child previously immunized should be immunized again in the NID, and whether children should be brought to the next NID) were clearly understood by the majority of the people (93.1% and 98.8% of the respondents, respectively), although only a small proportion (24.4%) of individuals understood the purpose of the programme. Radio was the single most effective means of providing information, education, and communication about NIDs. The encouraging response, especially from a poor, illiterate rural population, augurs well for the goal of eradicating poliomyelitis from the world.

Adolescent↗
PubMed1999

Antibiotic prophylaxis in elective cholecystectomy: a randomized, double blinded study comparing ciprofloxacin and cefuroxime.

A prospective, randomised and double blind study was undertaken to compare the prophylactic efficacy of ciprofloxacin and cefuroxime in 155 patients undergoing elective cholecystectomy. Patients with past history of jaundice or presence of jaundice, diabetes mellitus, common bile duct stones and previous biliary tract surgery were excluded. Patients were allocated to the following groups: group A-no antibiotic (n = 30); group B-ciprofloxacin (200 mg i/v before surgical incision and a second dose after 12 hrs) (n + 45); group C-ciprofloxacin given only post operatively (200 mg i/v, 12 hourly X 2 days followed by oral 500 mg twice daily X 3 days) (n = 35); group D-cefuroxime (750 mg i/v before surgical incision and a second dose after 12 hrs) (n = 45). Efficacy of the antibiotic was defined as a patient being free of post operative wound infection. Maximum numbers of infection occurred in group A (26.67%) and group C (25.71%). The incidence of wound infection was significantly lower when ciprofloxacin was used as prophylaxis (group B) than when used post operatively (group C) only (P < 0.05). Patients who received ciprofloxacin (group B) and cefuroxime (group D) as prophylaxis had significantly reduced incidence of infection (4.44% and 6/67% respectively); no statistically significant difference was found between these groups. Ciprofloxacin could be used as prophylactic antimicrobial in elective cholecystectomy in developing countries because of its effectiveness, economy and ready availability.

Adolescent↗
PubMed1999

A high incidence of ciprofloxacin resistance in urinary isolates in eastern Nepal.

A study was conducted to examine the incidence of ciprofloxacin resistance in the strains of bacteria isolated from patients with suspected urinary tract infection (UTI) and to analyse the level of resistance. A total of 63 bacterial isolates were grown from quantitative urine culture and were in significant count. Antibiotic susceptibility tests were done by using disc diffusion method of Kirby-Bauer and the level of resistance was analyzed by break point minimum inhibitory concentration (MIC). Majority of bacteria isolated and tested were Gram negative with Escherichia coli as the commonest isolate. Antibiotic susceptibility testing revealed a high prevalence of resistance to nalidixic acid, ampicillin and norfloxacin.

Anti-Infective Agents↗
PubMed1998

In vivo crushing of an aortic stent enables endovascular repair of a large infrarenal aortic pseudoaneurysm.

PURPOSE: To report an unusual approach to endovascular exclusion of a large aortic pseudoaneurysm. METHODS AND RESULTS: A 63-year-old male had an unsuccessful endovascular repair of an aortic anastomotic pseudoaneurysm that left an expanded, uncovered Palmaz stent lying obliquely within the aorta. After nearly 3 years, the pseudoaneurysm enlarged to 7 cm, and the patient became symptomatic. Repair of the pseudoaneurysm was accomplished by crushing the indwelling stent to allow placement of a stent-graft. CONCLUSIONS: Malpositioned stents that are hindering an endoluminal procedure may be crushed against the arterial wall in vivo to facilitate passage of endovascular instruments or devices.

Aneurysm, False↗
PubMed1997

Coexpression of mRNA for the full-length neurotrophin receptor trk-C and trk-A in favourable neuroblastoma.

Neuroblastoma, a childhood tumour of the sympathetic nervous system, may sometimes regress spontaneously in infants, or progress to a poor clinical outcome despite intensive therapy. Neuroblastomas express neurotrophin receptors and high levels of mRNA for trk-A correlates with favourable outcome, whereas trk-B mRNA is expressed by more unfavourable tumours. Using a sensitive RNase protection assay, mRNA expression for the neurotrophin receptor trk-C was investigated in 50 tumour samples from 45 children at different stages including metastatic and relapsing tumour tissue, out of which 22 were also investigated for trk-A mRNA. Thirty-seven of 43 primary tumours (86%) showed trk-C mRNA with more than 300-fold difference between the highest and the lowest values. A higher trk-C index (trk-C mRNA/GAPDH mRNA) was associated with favourable features such as younger age (P = 0.009-0.003), favourable tumour stage (1, 2 or 4S; P < 0.001) and favourable prognosis (P = 0.044). Better survival probability was shown in children with intermediate or high trk-C index compared with patients with low or undetectable levels (P = 0.031). All localised tumours co-expressed mRNA for trk-A and trk-C receptors. RT-PCR analysis detected mRNA encoding the cytoplasmic trk-C tyrosine kinase region only in favourable neuroblastomas. We conclude that favourable neuroblastoma may express the full-length trk-C receptor while unfavourable tumours, especially those with MYCN amplification, seem to either express no trk-C or truncated trk-C receptors with unknown biological function. Trk-C and possibly its preferred ligand NT-3 may be involved in the biology of favourable neuroblastomas showing apoptosis or differentiation.

Age Factors↗
PubMed1996

Expression of mRNA for the neurotrophin receptor trkC in neuroblastomas with favourable tumour stage and good prognosis.

Childhood neuroblastoma tumours of the sympathetic nervous system show a remarkable clinical heterogeneity ranging from spontaneous regression to unfavourable outcome despite intensive therapy. Favourable neuroblastomas often express high levels of trkA mRNA, encoding the tyrosine kinase receptor for nerve growth factor. We have investigated mRNA expression for the neurotrophin receptor trkC in 23 primary neuroblastomas using a sensitive RNAase protection assay. TrkC expression was detected in 19 of these tumours at highly variable levels with a 300-fold difference between the highest and lowest values. Significantly higher levels of trkC mRNA were found in tumours from patients with favourable features such as low age (P < 0.012), favourable tumour stage (P < 0.012) and favourable prognosis (P < 0.05). Children with intermediate or high trkC mRNA expression had better prognosis compared with those with low or undetectable levels (83.3% vs 20%, P = 0.005). Further characterisation of trkC mRNA expression by reverse transcriptase-polymerase chain reaction (RT-PCR) showed that mRNA encoding the full-length cytoplasmic tyrosine kinase domain of the receptor was only expressed in a subset of favourable tumours. These data show that favourable neuroblastomas may express the full trkC receptor while advanced tumours, in particular MYCN-amplified neuroblastoma, seem to either express no trkC or truncated trkC receptors of as yet unknown biological function. These data are suggestive of a role for trkC and its preferred ligand neutotrophin-3, NT-3, in neuroblastoma differentiation and/or regression.

Age Factors↗
PubMed1995

Identification of a 148-kDa surface lectin from Giardia lamblia with specificity for alpha-methyl-D-mannoside.

A lectin specific for alpha-methyl-D-mannoside was purified from the membrane extract of Giardia lamblia by a combination of gel filtration chromatography on Sephadex G-75 and Superose 6-HR 10/30. The homogeneity of the lectin was established by sodium dodecyl sulfate polyacrylamide gel electrophoresis. The molecular mass of the native protein was 148 kDa. The lectin agglutinated rabbit erythrocytes in the presence of Ca2+ at 37 degrees C and pH 7.0. The maximum activity of the lectin was obtained after trypsin treatment. The inhibition study clearly suggests that the binding site of the lectin recognizes alpha-methyl-D-mannoside as the immunodominant sugar.

Animals↗
PubMed1995

Feasibility of exercise stress echocardiography for the follow-up of children with coronary involvement secondary to Kawasaki disease.

BACKGROUND: The development of coronary aneurysms as sequelae of Kawasaki disease can result in myocardial ischemia, infarction, and sudden death. Traditionally, these patients have undergone coronary angiography and nuclear stress imaging for risk stratification and follow-up. However, angiography is invasive, and both modalities expose the patient to repeated radiation, which is an important issue in children. The purpose of this study was to determine the feasibility of performing exercise stress echocardiography in children diagnosed with coronary abnormalities secondary to Kawasaki disease. METHODS AND RESULTS: Treadmill exercise stress echocardiographic studies were performed in 28 children ages 6 to 16 years. All had acute Kawasaki disease 1 to 10 years before study, and coronary artery abnormalities were identified during previous echocardiographic imaging. Patients were exercised using a standard Bruce protocol. Transthoracic echocardiographic images, obtained in the parasternal long, short, apical two- and four-chamber views immediately before and after exercise, were digitized for review and analysis. In baseline studies before exercise, wall motion abnormalities were identified in 2 patients; these segments became normal with exercise. Two patients developed new exercise-induced wall motion abnormalities that corresponded to angiographically defined critical stenosis of the left anterior descending coronary artery. No patients had resting or exercise-induced ECG evidence of ischemia. There were no adverse reactions, and 26 of 28 patients had normal exercise tolerance. CONCLUSIONS: Among patients with coronary artery involvement resulting from Kawasaki disease, exercise stress echocardiography is a safe, noninvasive procedure and may identify children with myocardial ischemia that was not detected with ECG stress test alone.

Adolescent↗