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Biomedical subjects

R Tandon

Publications and source records attributed to R Tandon.

At least 19 recordsLinked to original sources
PubMed1996

Biological predictors of 1-year outcome in schizophrenia in males and females.

This paper describes a prospective study designed to ascertain the predictive value of biological factors associated with schizophrenia in males and females. In a sample of 59 medication-free schizophrenic inpatients (41 males; 18 females), we assessed the correlation of four factors--rapid eye movement (REM) sleep latency, delta (slow-wave) sleep, dexamethasone suppression test (DST) cortisol levels, and ventricle-brain ratio (VBR)--with several dimensions of outcome at 1-year post-discharge. In the total sample, shorter REM latency was associated with poor outcome on all dimensions measured: rehospitalization, employment, social activity, symptomatology, and global functioning. However, none of the other biological factors were associated with any measure of outcome. The predictive value of REM latency appeared to be gender-specific; in general, the relationships between reduced REM latency and poor outcome were consistently noted in females, but were not significant in males. These results suggest that a common, possibly gender-related, pathophysiological mechanism might underlie both abnormal REM latency and poor outcome. The findings underscore the importance of considering gender differences in studies of schizophrenia.

Electroencephalography↗
PubMed1996

VBR in schizophrenia: relationship to family history of psychosis and season of birth.

Ventricular enlargement has been consistently demonstrated in schizophrenia using both CT and MRI. Despite this, the structural changes that underlie increased ventricle-brain ratio (VBR) and its relationship to environmental factors (intrauterine viral exposure, obstetric complications, etc.) and family history of schizophrenia remain poorly defined. Increased VBR has been shown in some studies to correlate with an absence of family history of schizophrenia and with Winter-Spring birth. In an attempt to obtain a clearer picture of the contribution of environmental and genetic factors to VBR, we studied 54 patients with DSM III-R schizophrenia. VBR was determined from head CT scans via computerized planimetry. Family history of psychosis and non-psychotic mood disorder was determined with the family informant method. Season of birth was encoded in several ways, including season, trimester and dichotomously. Patients without a family history of psychosis had significantly larger VBR than patients with such a history; family history of mood disorder was not related to VBR. Season of birth was not predictive of VBR. Family history of psychosis and season of birth were not related to each other. These results are in line with prior work demonstrating an association between increased VBR and sporadic (non-familial) schizophrenia. We did not find a relationship between VBR and season of birth, which suggests that risk of perinatal viral exposure and other seasonal environmental factors may not account for the ventricular enlargement in non-familial schizophrenia observed in our sample.

Adult↗
PubMed1996

Prevalence and patterns of smoking in Delhi: cross sectional study.

OBJECTIVE: To determine the prevalence and predictors of smoking in urban India. DESIGN: Cross sectional. SETTING: Delhi, urban India, 1985-6. SUBJECTS: Random sample of 13,558 men and women aged 25-64 years. MAIN OUTCOME MEASURES: Smoking prevalence; subjects who were currently smoking and who had smoked > or = 100 cigarettes or beedis or chuttas in their lifetime were defined as smokers. RESULTS: 45% (95% confidence interval 43.8 to 46.2) of men and 7% (6.4 to 7.6) of women were smokers. Education was the strongest predictor of smoking, and men with no education were 1.8 (1.5 to 2.0) times more likely to be smokers than those with college education, and women with no education were 3.7 (2.9 to 4.8) times more likely. Among smokers, 52.6% of men and 4.9% of women smoked only cigarettes while the others also smoked beedi or chutta. Compared with cigarette smokers, people smoking beedi or chutta were more likely to be older and married; have lower education, manual occupations, incomes, and body mass index; and not drink alcohol or take part in leisure exercise. CONCLUSION: There are two subpopulations of smokers in urban India, and the prevention strategy required for each may be different. The educated, white collar cigarette smoker in India might respond to measures that make non-smoking fashionable, while the less educated, low income people who smoke beedi or chutta may need strategies aimed at socioeconomic improvement.

Adult↗
PubMed1996

Spatial relationships of neuroanatomic landmarks in schizophrenia.

Two new morphometric techniques, landmark-based shape analysis and landmark-based image averaging, were applied to magnetic resonance images (MRIs) to investigate the sites and extent of structural neuropathology in schizophrenia. These analyses allow the identification of averaged anatomy through joint registration on multiple landmarks simultaneously. MRI scans obtained in the midsagittal plane were compared between 14 patients with schizophrenia and 14 normal subjects. The relation between averaged landmark configuration in the two groups was visualized as a deformation. There were no large-scale shape abnormalities noted, although the patients had significantly smaller brains. The data suggest that the neuroanatomic abnormality associated with schizophrenia, in the midsagittal plane, is circumscribed (focal), involving primarily the region of the posterior corpus callosum, upper brainstem, and quadrigeminal cistern. Also, the thickness of the corpus callosum is reduced all along its length. The findings are consistent with prior studies suggesting involvement in schizophrenia of the cerebellum, the corpus callosum and, possibly, the limbic structures contributing to the corpus callosum. The methods of image averaging and shape analysis used in this study complement the 'region of interest' method of investigating morphometric abnormalities by characterizing the precise locations and spatial relationships among relevant structural brain abnormalities in schizophrenia.

Adult↗
PubMed1995

Comparison of indices of premorbid function in schizophrenia.

There has been a resurgence of interest in the area of premorbid functioning in schizophrenia as it provides clues to onset and etiology. Most studies rely on retrospective estimates of premorbid status that are incomplete, such as the Premorbid Adjustment Scale (PAS). Even prospective high-risk studies are hampered by the narrow range of premorbid functions assessed and are thus unable to answer crucial questions related to onset of illness. This study was undertaken to assess the relationship between several indices of premorbid functioning. Sixty four in-patients with schizophrenia were assessed at medication-free baseline and post-treatment with BPRS and SANS. PAS scores were derived from all available sources. Premorbid cognitive ability was estimated by the mean of WAIS-R Vocabulary and Information subscale scores. Estimated premorbid IQ was obtained using a demographic regression formula. Years of education and predicted VIQ, PIQ, and FSIQ were found to correlate with estimated premorbid cognitive ability. Predicted VIQ, PIQ, and FSIQ were associated with years of education and PAS childhood, early and late adolescence, and general scores. Each estimate of premorbid ability demonstrated a different pattern of association with clinical ratings, symptom change, and outcome. The results suggest that education, PAS, predicted IQ, and WAIS-R estimates of premorbid cognitive ability assess different but overlapping areas of pre-morbid functioning.

Adult↗
PubMed1995

Tinnitus and ECT.

We report the case of a 69-year-old man with major depressive disorder and occupational tinnitus; both problems were refractory to several different treatment modalities, but were successfully treated with electroconvulsive therapy (ECT). The tinnitus was present for 15-20 years, but had worsened during the 3 years before treatment, causing him significant distress. Extensive organic workup did not identify a treatable etiology for his symptoms. To date, he has been hospitalized four times due to depressive symptoms associated with tinnitus. He has received ECT each time, and has responded well on each occasion.

Aged↗
PubMed1995

Subclinical status epilepticus following ECT.

Subclinical status epilepticus is a rare complication of electroconvulsive therapy (ECT). We describe the case of a 70-year-old man with psychotic depression who developed prolonged subclinical status epilepticus following an initial ECT treatment; he subsequently received a course of ECT without complications. It is important to consider status epilepticus in the differential diagnosis of patients who do not regain consciousness following ECT, even in the absence of overt motor seizure activity. The development of this complication does not preclude the future use of ECT; in fact, ECT has been repeated successfully in individuals who developed this complication, including this case. Identification of potential risk factors, appropriate preventive measures, and early intervention are important in the management of this complication. The literature is reviewed and appropriate preventive and treatment measures are discussed.

Aged↗
PubMed1995

Electroconvulsive therapy and intracranial aneurysm.

Little has been written regarding the safety of electroconvulsive therapy (ECT) administered to patients with intracranial aneurysms. The literature is reviewed and we report two additional cases of ECT safely and effectively employed to treat depressed patients with intracranial aneurysms. We found no reported cases of aneurysm rupture associated with ECT. We do not feel the presence of intracranial aneurysm is a contraindication to ECT, in most patients, with appropriate monitoring and control of arterial blood pressure.

Adult↗
PubMed1995

Significance of left ventricular inflow gradients in patients with ventricular septal defect.

Hemodynamic data of 167 patients of isolated ventricular septal defect (VSD) was retrospectively analyzed for the presence of left ventricular inflow gradients. End diastolic gradients of > 5 mm Hg between the pulmonary artery wedge pressure and the left ventricular end diastolic pressure were recorded in 40 of these patients. In three of these cases, left atrium was also entered and identical pressure gradients were recorded between the left atrial pressure and the left ventricular end diastolic pressure. Two dimensional and Doppler echocardiographic or operative findings were available in 32 of the 40 patients. No statistical correlation was found between the presence and degree of left ventricular inflow gradients at end diastole and the degree of left to right shunt. Out of a total of 40 patients with left ventricular inflow gradients, gradients of 6-10 mm Hg were present in 24 patients. Echocardiographic or operative findings available in 19 of these did not show any left ventricular inflow obstruction. Enddiastolic gradients of 11-15 mm Hg were present in 14 patients. Echocardiographic or operative findings were available in 11 of these and one of these had congenital mitral stenosis at surgery. End diastolic gradients of more than 15 mm Hg were present in 2 patients and one of these had congenital mitral stenosis at surgery. Thus organic left ventricular inflow obstruction is rare with inflow mitral gradients of upto 15 mm Hg in patients of VSD.

Adolescent↗