Search PubMed⌕ Search

Biomedical subjects

R Sinha

Publications and source records attributed to R Sinha.

At least 217 records · Page 12Linked to original sources
PubMed1967

Controlled field trial of the effectiveness of cholera and cholera El Tor vaccines in Calcutta.

To assess the effectiveness of cholera vaccines, 2 controlled field trials were made in Calcutta-an endemic area-during 1964 and 1965. Three Indian vaccines of which 1 was grown on casein hydrolysate and 2 on agar, a freeze-dried vaccine from the Walter Reed Army Institute of Research (WRAIR), Washington, D.C., and an El Tor vaccine from the Philippines were used, with typhoid-paratyphoid (TAB) vaccine as a control. The 210 112 volunteers were vaccinated subcutaneously with a single dose of one of the vaccines.In the 1964 trial, the number of bacteriologically confirmed cases was not enough to show statistically significant differences in incidence between the 5 vaccine groups and the control group. However, the WRAIR freeze-dried vaccine protected about 40% of the vaccinees for 6 months after vaccination, although the efficacy was higher (57%) during the first 3 months than during the subsequent 3 months (28%). Agar-grown vaccine, produced by the Central Research Institute, Kasauli, was 37% efficacious.In the 1965 trial, owing to the small number of cases in the study area, the Kasauli vaccine was the only one to show statistically significant protection (40%).

Adolescent↗
PubMedDate not supplied

Drinking variables, affective measures and neuropsychological performance: familial alcoholism and gender correlates.

The relationships between five measures of alcohol consumption and five summary measures of diverse neuropsychological test performances were studied in 76 male and 67 female alcoholics as a function of family history of alcoholism and affective symptomatology. No significant relationships were obtained between drinking variables and neuropsychological performance scores for the overall groups of male and female alcoholics. In family history positive (FH+) males, correlations between a number of drinking variables and neuropsychological measures neared significance. The Beck Depression Inventory (BDI) scores correlated most strongly with the overall impairment index in both family history positive (FH+) and family history negative (FH-) alcoholics. Depression and anxiety scores in the female alcoholics significantly correlated with three of the five alcohol consumption variables. Possible confounding factors in the relationships between alcohol intake measures and cognitive functioning were discussed.

Adult↗
PubMedDate not supplied

Electrophysiological indices predict resumption of drinking in sober alcoholics.

Eighty-nine alcoholics and 54 nonalcoholic controls were tested on measures of late component event-related potentials (ERPs) using a visual "oddball" stimulus task. The alcoholics had just completed inpatient alcoholism treatment programs and were 21-45 days sober. Approximately 13 months later, subjects returned for retesting; alcoholics were classified as resumers or abstainers based on thier drinking patterns during the interest interval. Using the ERP measures from the initial testing session, alcoholics differed significantly from controls in the multivariate analysis and on P300 amplitude (P3A). Resumer alcoholics showed significantly longer N200 latencies (N2L) than abstainer alcoholics. Discriminant function analyses predicting resumer/abstainer status from N2L, P3A and N1A indicated a 63% prediction rate, chi 2 = 5.67, p < 0.02. Addition of N2L to previously tested psychological and social predictor variables indicated an increase in the amount of variance explained. The results support a biopsychosocial model for understanding and predicting relapse in chronic alcoholics.

Action Potentials↗
PubMedDate not supplied

Can line clinicians master the conceptual complexities of dialectical behavior therapy? An evaluation of a State Department of Mental Health training program.

Dialectical behavior therapy for borderline personality disorder has rapidly attained wide-spread popularity, with one indication being the development of training initiatives by the Department of Mental Health within at least two States in USA. Efficacy data published by the originator of the treatment, Marsha Linehan, and her colleagues, probably accounts at least in part for this popularity. However, the complexity of DBT raises a fundamental question regarding these broader applications: can clinicians of diverse backgrounds acquire a shared and sophisticated understanding of the treatment theory? The clinical utility of a treatment rests heavily upon ease of dissemination (APA, Template for developing guidelines: Interventions for mental disorders and psychosocial aspects of physical disorders. Washington, DC: Author, 1995), and in that regard DBT--a complicated, multifaceted approach--could appear vulnerable. This vulnerability is heightened when institutional adoption involves the collaboration of numerous clinicians, who, despite occupying diverse roles, must nevertheless develop a shared understanding of the treatment. Using a detailed examination of DBT knowledge, we evaluated the conceptual mastery of 109 clinicians trained via a State Department of Mental Health initiative. Performance on the examination correlated specifically with DBT training. Prior education or background in behavior therapy accounted for little variance, indicating that clinicians occupying diverse roles acquired reasonable intellectual mastery over this complex model.

Adult↗
PubMedDate not supplied

Povidone iodine plus neosporin in superficial burns--a continuing study.

A total of 1053 patients with superficial burn injury were treated with povidone iodine plus neosporin (PVP + N) and the results after treatment were compared with those obtained after treating 1089 patients with silver sulphadiazine (SSD). Qualitative analysis showed Staphylococcus aureus and Pseudomonas spp. to be the most common infecting organisms. Quantitatively, fewer patients showed infection on the 7th and 18th day post-treatment in the PVP + N group (P < 0.01 and P < 0.001, respectively). Similarly, healing times were also better with PVP + N, with a maximum number of patients having healed within 15 days (P < 0.001). However, the mortality rates were not much different between the two groups.

Administration, Topical↗
PubMedDate not supplied

Naturalistic follow-up of drinking behavior following participation in an alcohol administration study.

Administration of alcohol to alcohol-dependent individuals for research purposes, while contributing significantly to the fund of knowledge on etiology and treatment of alcohol dependence, has often raised clinical and ethical concerns that such exposure may adversely affect the individual's motivation to reduce drinking or abstain from drinking. In an attempt to evaluate these concerns, we conducted a naturalistic follow-up of subsequent drinking among individuals who participated in an alcohol self-administration study and also received a brief motivational intervention. Twenty-one non-treatment-seeking alcoholics participated in a study examining the effects of naltrexone on alcohol self-administration. Assessment of drinking during the 3 months following the laboratory study indicated that participants had significantly reduced the total number of drinking days and the number of drinks consumed per occasion, as compared to baseline levels. The findings suggest that participation in alcohol administration research does not adversely influence the subsequent drinking of alcohol-dependent individuals. Further, when the alcohol administration research is conducted carefully, with specific attention to the clinical needs of the participants, the risks of adverse effects on participants' drinking behavior is minimal, and, in fact, there is scientific benefit to society and clinical benefit to the participants with regard to their alcoholism.

Adult↗
PubMedDate not supplied

Craving for alcohol: findings from the clinic and the laboratory.

This paper presents a review of the current status of empirical research in the area of alcohol craving. After an introduction on the origins of the construct of craving, we first present clinical studies that have examined craving as a hallmark symptom of alcohol dependence and demonstrated its sensitivity as an outcome measure in assessing change in pharmacotherapy trials of alcohol dependence. There is also discussion regarding new multifactorial self-report instruments of alcohol craving with good reliability and predictive validity, that may be sensitive to detecting alcohol craving and assessing change in craving as it relates to relapse during treatment. Next, we examine the experimental paradigms that have been used to induce alcohol craving in the laboratory. Further, the methodological issues affecting laboratory-based paradigms are presented, while also elucidating the potential use of effective laboratory-based craving induction paradigms, both in clinical studies as well as in laboratory studies that examine the brain mechanisms associated with the concept of craving. Finally, directions for future research on craving in the laboratory and the clinic are presented in the context of developing more effective treatments for different phases of recovery from alcohol dependence.

Alcoholism↗
PubMedDate not supplied

Cardiovascular differentiation of emotions.

This study examined the cardiovascular mechanisms governing differential blood pressure changes during the emotions of joy, sadness, fear, and anger. Heart rate, blood pressure, stroke volume, peripheral vascular resistance, cardiac output, and indices of myocardial contractility were measured during fear, anger, joy, sadness, physical action, and neutral imagery conditions in 27 right-handed male volunteers screened for imagery ability, alexithymia, anxiety, and depression. Anger imagery, rather than fear, was accompanied by the largest effects on the cardiovascular system. Increased diastolic blood pressure in anger was associated with maintained levels of peripheral vascular resistance and increased cardiac output and heart rate compared with changes during neutral imagery. Sadness produced a distinct pattern with moderate increases in blood pressure and vascular resistance and a decrease in cardiac output compared with changes during neutral imagery. Fear, action, and joy produced similar blood pressure changes in which systolic pressure increased and diastolic pressure was relatively unchanged. The measurement of cardiac output and determination of vascular resistance changes during emotional imagery demonstrate that previously observed emotion-specific blood pressure responses are produced by underlying patterns of cardiovascular activation, which differ between the major categories of emotions.

Adult↗
PubMedDate not supplied

Serum aldosterone concentrations and urine output in oliguric intensive care unit patients receiving low-dose dopamine.

OBJECTIVE: To determine whether the diuretic and natriuretic effects of low-dose dopamine (2.5 micrograms/kg/min) are associated with changes in serum aldosterone concentration. DESIGN: Prospective clinical study. SETTING: Surgical intensive care unit (SICU) of a university hospital. PARTICIPANTS: Oliguric (urine output < 0.5 mL/kg/h) SICU patients. All patients were resuscitated to pulmonary artery occlusion pressure > 10 mm Hg, mean arterial pressure > 65 mm Hg, and cardiac index > 2.5 L/min/m2. Patients with a serum creatinine concentration > 176.8 mumol/L (2.0 mg/dL), those who received diuretics within 12 hours prior to entry into the study, and renal transplant recipients were excluded. MAIN OUTCOME MEASURES: Hourly urine output (mean +/- SD) was recorded 2 hours before and for 6 hours after the initiation of low-dose dopamine. Urine sodium and serum aldosterone concentrations were obtained prior to and 6 hours after the start of low-dose dopamine. RESULTS: Fifteen patients were enrolled in the study. Urine output (mean +/- SD) increased from 0.31 +/- 0.11 mL/kg/h before to 0.80 +/- 0.34 mL/kg/h following low-dose dopamine (p < 0.01). Urine sodium concentrations increased from 46 +/- 32 mmol/L baseline to 72 +/- 53 mmol/L following low-dose dopamine (p < 0.05), and serum aldosterone concentrations decreased from 415.82 +/- 341.48 pmol/L prior to low-dose dopamine infusion to 256.04 +/- 204.17 pmol/L (p < 0.05). Cardiac output, pulmonary artery occlusion pressure, mean arterial pressure, and heart rate did not change. CONCLUSIONS: Low-dose dopamine significantly increases urine output and urine sodium excretion in oliguric, critically ill, surgical patients, and is associated with a decrease in serum aldosterone concentration. The diuretic and natriuretic effects of low-dose dopamine may be, in part, related to a dopamine-mediated inhibition of aldosterone secretion.

Adult↗
PubMedDate not supplied

Abdominal hydatids: a minimally invasive approach.

BACKGROUND: The conventional surgical procedures for managing abdominal hydatids, including those of the liver, have a very high morbidity rate in terms of hospital stay and wound complications. Less invasive procedures may thus be logical alternatives. METHOD: We enrolled 58 patients in the study. Using guided ultrasound aspiration followed by instillation of 15% saline, we were able to manage 16 patients as outpatients. In the remaining 42 patients, saline instillation was combined with laparoscopic aided percutaneous evacuation combined with partial pericystectomy. Omental packing was added in four patients. A pericystic drain tube was left in every patient managed laparoscopically. RESULTS: In the aspiration group, two sittings were required in 12 patients and more than two sittings (3 x) in two patients. Laparoscopic parameters showed an average IV infusion time of 12.3 hrs, drain removal time of 3.2 days, and discharge time of 3.2 days. Short-term complications included prolonged tube drainage for six days in one patient, intracystic bile collection in two, and intracystic pus in four patients. The aspiration group did not have any complications. Conversion to open evacuation was done in one patient. Fifty-four months of follow-up has been recurrence free. CONCLUSION: Minimally invasive management, including aspiration and laparoscopic intervention, appear to be viable alternatives to open surgery because they result in less morbidity.

Abdomen↗
PubMedDate not supplied

Determinants of plasma ascorbic acid in a healthy male population.

The antioxidant properties of vitamin C may be involved in the prevention of cancer. The correlation between dietary vitamin C intake as estimated by a dietary questionnaire and plasma ascorbic acid (AA) was examined in 68 nonsmoking male volunteers aged 30-59 years. Determinants of plasma AA as well as interrelationships between various antioxidants in plasma were also explored. The determinants of plasma AA were examined by a multiple regression model containing dietary vitamin C, calories, body weight, and amount of beverages consumed. Higher vitamin C intake (P < 0.0002) increased plasma AA, while greater body weight (P < 0.005) decreased plasma AA. A significant correlation (r = 0.43; P < 0.0003) between vitamin C intake and plasma AA was observed. There was a negative correlation between plasma AA and plasma uric acid (r = -0.32; P < 0.007) and positive associations between plasma beta-carotene and plasma alpha-tocopherol (r = 0.39; P < 0.001) and between plasma beta-carotene and plasma glutathione peroxidase (r = 0.32; P < 0.008). Vitamin C supplement users had higher plasma AA compared to nonusers. The relationship between plasma AA and vitamin C intake appears to be curvilinear with the non-supplement users at the linear part of the curve and the supplement users at the plateau. Plasma AA is an appropriate biomarker, in our subjects, of dietary vitamin C except for people consuming large amounts of this vitamin either in their diet or in supplemental form.

Adult↗
PubMedDate not supplied

Cancer risk and diet in India.

India is a developing country with one of the most diverse populations and diets in the world. Cancer rates in India are lower than those seen in Western countries, but are rising with increasing migration of rural population to the cities, increase in life expectancy and changes in lifestyles. In India, rates for oral and oesophageal cancers are some of the highest in the world. In contrast, the rates for colorectal, prostate, and lung cancers are one of the lowest. Studies of Indian immigrants in Western societies indicate that rates of cancer and other chronic diseases, such as coronary heart disease and diabetes, increase dramatically after a generation in the adopted country. Change of diet is among the factors that may be responsible for the changing disease rates. Diet in India encompasses diversity unknown to most other countries, with many dietary patterns emanating from cultural and religious teachings that have existed for thousands of years. Very little is known, however, about the role of the Indian diet in causation of cancer or its role, if any, in prevention of cancer, although more attention is being focused on certain aspects of the Indian diet, such as vegetarianism, spices, and food additives. Of particular interest for cancer prevention is the role of turmeric (curcumin), an ingredient in common Indian curry spice. Researchers also have investigated cumin, chilies, kalakhar, Amrita Bindu, and various plant seeds for their apparent cancer preventive properties. Few prospective studies, however, have been conducted to investigate the role of Indian diet and its various components in prevention of cancer. From a public health perspective, there is an increasing need to develop cancer prevention programs responsive to the unique diets and cultural practices of the people of India.

Diet↗
PubMedDate not supplied

A new approach to the management of burn injuries using PVP + neosporin.

Treating superficial burns by forming a "crust" using povidone iodine (PVP) lotion and neosporin powder (N) is markedly superior to other known methods as shown by the minimal infection rate and markedly reduced healing time. This is basically because of the wide spectrum of action, tenning effect of PVP and attainment of a dry burn surface. At the same time the subescharal injection of PVP shows a distinct reduced septicaemia and local infection rates, early escharolysis followed by early graft take up and subsequent healing. In addition being an open method of treatment psychological advantage is also notable in the absence of pain during dressing.

Adult↗
PubMedDate not supplied

Renal allograft rupture and its management.

Renal allograft rupture, although a rare complication, was encountered in 11 of our 137 cases of live kidney donor transplants. The commonest finding was an associated acute rejection. Our cases were mainly given conservative treatment with repair of the rupture and antirejection therapy. Eight of our kidneys were saved in this way, thus eight of the 11 patients survived. None of the deaths were related to the graft rupture or its effects.

Acute Disease↗