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Biomedical subjects

R Tandon

Publications and source records attributed to R Tandon.

At least 55 records · Page 3Linked to original sources
PubMed2001

Burkitt's lymphoma of stomach: A case report and review of literature.

Primary gastrointestinal non-Hodgkin's lymphoma is a distinct clinicopathological entity. This is the commonest site of all extranodal lymphomas. Non-endemic Burkitt's lymphoma (high-grade, small non-cleaved lymphocytic type) is rare in non-HIV adult population. We hereby report Burkitt's lymphoma of stomach in a non-HIV adult. Gastric and lymph node biopsy confirmed the diagnosis. Patient was treated using a third generation chemotherapy protocol without any surgical resection. The patient relapsed within 3 months of completion of primary treatment and died of progressive disease.

Adult↗
PubMed2001

Treatment guidelines for depression in pregnancy.

Depression is a ubiquitous disorder in childbearing women with up to 10% of women experiencing depression in pregnancy. Postpartum depression occurs in 12-16% of pregnancies making it a common complication. Moreover, these illnesses are frequently underdiagnosed in obstetric settings, and a recent report of the Surgeon General's Office confirms that many women do not access services, or receive treatment of inadequate intensity or duration. This paper provides current treatment guidelines to aid in appropriate diagnosis and treatment of depression in pregnancy and postpartum. Review of current literature on psychotropic medication use in pregnancy is also provided.

Adult↗
PubMed2001

Oversized corneal grafts for corneal opacities with iridocorneal adhesions.

OBJECTIVE: To evaluate the efficacy of 1-mm oversized corneal grafts in patients with acquired corneal opacities and extensive peripheral iridocorneal adhesions. DESIGN: Prospective noncomparative case series. PARTICIPANTS: Twenty patients (20 eyes) aged 15 years or older with unilateral or bilateral corneal opacification and a shallow anterior chamber. INTERVENTION: Penetrating keratoplasty was performed with donor corneal buttons oversized by 1 mm. MAIN OUTCOME MEASURES: The various parameters evaluated were visual acuity, graft clarity, keratometry, anterior chamber depth, intraocular pressure, and spherical equivalent refraction 12 months after surgery. RESULTS: The keratoplasties were performed in 15 eyes with a corneo-iridic scar after infectious keratitis (75%) and 5 eyes with failed graft (25%). At the final follow-up, a clear graft was achieved in 17 eyes (85%), and 14 eyes (70%) achieved a best-corrected visual acuity of 6/12 or better. Three of the grafts failed because of rejection. The average keratometry was 44.1 +/- 1.0 diopters (D), and the mean spherical equivalent was -3.23 +/- 2.86 D. The oversized grafts provided a mean anterior chamber depth of 2.36 +/- 0.42 mm, and the mean intraocular pressure at the 12 month follow-up was 16.38 +/- 2.09 mmHg. CONCLUSIONS: Corneal grafts oversized by 1 mm provide adequate anterior chamber depth and reduce the risk of peripheral anterior synechiae and secondary glaucoma in patients with corneal opacities and extensive peripheral iridocorneal adhesions.

Adolescent↗
PubMed2001

Crater-and-chop technique for phacoemulsification of hard cataracts.

We describe a technique of in-the-bag phacoemulsification of large, hard, leathery brown nuclear cataracts. A large crater approximately 6.0 mm diameter is created by down-slope sculpting up to 90% of nuclear thickness, leaving the outer nuclear rim intact. The edge of the crater is held with the phaco probe using high vacuum, and small wedge-shaped pieces are created with a chopper. These small pieces are emulsified in the space created by the crater. This technique permits in-the-bag phacoemulsification of large brown cataracts without complications.

Cataract↗
PubMed2001

Topical ciprofloxacin-dexamethasone combination therapy after cataract surgery: randomized controlled clinical trial.

PURPOSE: To determine the efficacy of a combination of ciprofloxacin 0.3% and dexamethasone 0.1% eyedrops in controlling immediate inflammation after cataract surgery. SETTING: Dr. Rajendra Prasad Centre for Ophthalmic Sciences and Department of Pharmacology, All India Institute of Medical Sciences, New Delhi, India. METHODS: This randomized controlled clinical trial comprised 61 patients, 31 of whom were treated with a combined ciprofloxacin-dexamethasone suspension (study group) and 30, with a standard formulation of betamethasone and neomycin eyedrops (control group). One and 7 days postoperatively, pain, lid edema, lacrimation, conjunctival congestion, aqueous flare and cells, and side effects were noted. A conjunctival swab for bacteria and a fungus culture were sent for evaluation 7 days postoperatively. RESULTS: At 7 days, there was no statistically significant difference between groups in lid edema, conjunctival congestion, anterior segment inflammation, lacrimation, or pain. Two patients in the ciprofloxacin-dexamethasone group noted white deposits in and around the eye that resolved after the dose was reduced to 4 times a day. No patient reported or developed an allergic reaction to either drug combination. CONCLUSION: A ciprofloxacin-dexamethasone combination was effective in controlling inflammation after cataract surgery.

Administration, Topical↗
PubMed2001

Pharmacologic treatment of schizophrenia: what the future holds.

The advent of the newer "atypical" antipsychotics has revolutionized pharmacologic treatment of schizophrenia (SZ) and other psychotic disorders. In contrast to the first-generation conventional neuroleptics, these second-generation antipsychotic agents possess a broader spectrum of efficacy and cause fewer motor side effects such as extrapyramidal symptoms and tardive dyskinesia. Despite their substantial advantages, however, these second-generation agents also have significant limitations in terms of both efficacy and adverse effects. Several strategies to address these shortcomings are currently under study and some of these are likely to become part of our therapeutic armamentarium in the future. Current shortcomings in the pharmacologic treatment of SZ and strategies under investigation to address each of these deficiencies are reviewed. New formulations of existing medications and new antipsychotics under development are discussed. Developing adjunctive treatment strategies to address each of the major psychopathologic domains in SZ are summarized. The potential application of genetic information to treatment-matching in SZ is reviewed and likely refinements in the practice of evidence-based medicine in the pharmacotherapy of SZ are considered.

Journal Article↗
PubMed2001

Safety and efficacy of peribulbar block as adjunct to general anaesthesia for paediatric ophthalmic surgery.

METHODS: Fifty children (age 5-14 years, ASA I-II) undergoing elective ophthalmic surgery were chosen for the study. Of these, 25 received intravenous pethidine (control group) and 25 received a peribulbar block (block group) for perioperative analgesia, and were monitored intraoperatively and postoperatively by an investigator blinded to the analgesic technique. RESULTS: Intraoperative values of haemodynamic variables were significantly higher in the control group (P < 0.01). Requirement for intraoperative rescue analgesic and postoperative analgesia was higher in the control group (P < 0.05 and P < 0.001, respectively). Children in the block group had lower postoperative pain scores at all times. Incidence of oculocardiac reflex was significantly higher (P < 0.001) in the control group. Seventy-six percent of children in the control group had postoperative nausea and vomiting compared to 20% children in the block group (P < 0.001). CONCLUSION: There were no complications related to the block. Peribulbar block appears to be a safe and useful analgesic technique for paediatric ophthalmic surgery.

Adolescent↗
PubMed2001

Platelet 3H ketanserin binding in migraine.

Platelet 3H ketanserin binding was studied in 33 patients of migraine and 30 healthy controls. The binding characteristics: equilibrium dissociation constant (Kd) and maximal number of binding sites (Bmax) determined by Scatchard analysis revealed a significant decrease in Kd and no change in Bmax in migraine cases. No correlation was observed between the Kd and Bmax with the clinical features of migraine. The findings of the present study show that there is a decreased affinity of platelet 5-HT2 receptors in migraine.

Adult↗
PubMed2001

ECT and mental retardation: a review and case reports.

Electroconvulsive therapy (ECT) in patients with mental retardation has received limited study and is a subject of controversy. Specific difficulties in using ECT for this patient population include diagnostic dilemmas, difficulties with measuring outcome and monitoring side effects, and problems with professional attitudes. We report our experience with two cases in which ECT was applied to treat severe psychotic and catatonic symptoms. In case 1, a 22-year-old male patient with a history of moderate mental retardation, bipolar disorder, and neuroleptic malignant syndrome was admitted to manage his disruptive behavior and psychotic symptoms. The patient responded well to six bilateral ECTs with diminution of his psychotic symptoms and behavioral disturbances. In Case 2, a 39-year-old female patient with a history of mental retardation, schizoaffective disorder, and catatonic symptoms successfully responded to 11 bilateral ECTs. We conclude that ECT can be used safely and effectively in patients with mental retardation and severe or refractory psychotic symptoms.

Adult↗
PubMed2001

Immunomodulation by opioid peptidomimetic compound.

OBJECTIVE: As a follow-up to our earlier studies on immunomodulation with opioid peptides, we synthesized and evaluated immunomodulatory activity of four peptidomimetic compounds, i.e. Tyr-NH-C(Me)(2)-CH(2)-O-Phe-NH(2 )(1), Tyr-NH-C(6)H(5)-(o)-CH(2)-CH(2)-O-Phe-NH(2) (2), Tyr-NH-CH(2)-CH(2)-O-Phe-NH(2) (3) and Tyr-NH-CH(D-Et)-CH(2)-O-Phe-NH(2) (4). METHODS: These compounds were synthesized in solution phase and evaluated for their immunomodulatory properties in vitro by mixed lymphocyte reaction (MLR), proliferation of opioid receptor-expressing cells, production of tumor necrosis factor-alpha (TNF-alpha) and nitric oxide. RESULTS: This study shows the immunosuppressive potential of synthetic peptidomimetic compound 3. This compound inhibited two-way MLR and suppressed the proliferation of the mu-opioid receptor expressing human embryonic kidney cells HEK 293 in vitro. Inhibition of MLR by compound 3 was reversed by naloxone (opioid receptor antagonist) and beta-funaltrexamine hydrochloride (mu-opioid receptor antagonist). The immunosuppressive effect of compound 3 was further demonstrated by inhibition of TNF-alpha and nitric oxide production in lipopolysaccharide-stimulated human PBMCs and mouse macrophage cells RAW 264.7, respectively. CONCLUSION: These observations suggest that compound 3 inhibits MLR through mu-opioid receptor present on cells.

Animals↗
PubMed2001

Platelet dopamine receptors and oxidative stress parameters as markers of manganese toxicity.

The present study has been undertaken to investigate whether neurotoxic effects of manganese (Mn) are reflected in platelets in rats to monitor the usefulness of platelet as peripheral model. Exposure of rats to Mn (10 or 15 mg/kg bw, i.p.) for 45 days caused a significant increase in membrane fluidity as evidenced by decrease in fluorescence polarisation in platelets (11% and 14%) and striatum (9% and 13%). These rats exhibited a significant increase in superoxide dismutase activity both in platelets (24% and 37%) and striatum (31% and 42%), respectively, in comparison to controls. Exposure of rats to Mn for 45 days (15 mg/kg bw, i.p.) caused a significant decrease in reduced glutathione content (platelets 20%, striatum 24%) and catalase activity (platelets 35%, striatum 44%) compared to control rats. Rats exposed to Mn (10 or 15 mg/ kg bw, i.p.) for 15 days exhibited a significant increase in dopamine receptors both in platelets (55% and 40%) and striatum (38% and 31%). The results suggest that exposure to Mn may alter the membrane functions and impair the anti-oxidant defense mechanism both in platelets and brain. The study also suggests that dopaminergic mechanisms are impaired following Mn exposure and such changes are reflected in platelets. Interestingly, parallel changes both in striatum and platelets, as observed in the present study, strengthen the usefulness of platelets as a peripheral neuronal model.

Animals↗
PubMed2001

Visual performance of rigid gas permeable contact lenses in patients with corneal opacity.

PURPOSE: To evaluate the visual performance of rigid gas permeable (RGP) contact lenses in patients with nebular and nebulo-macular corneal opacity and correlate the improvement in visual acuity with other visual parameters. METHODS: In a prospective study, visual performance of RGP contact lenses was evaluated in eyes with corneal opacity involving the pupillary area. The baseline visual acuity and other visual parameters with glasses were compared with those recorded with RGP contact lenses. The visual functions evaluated were visual acuity, contrast sensitivity, glare acuity, and mesopic vision. Binocular status with RGP contact lenses was assessed. All patients were followed up for 3 months. RESULTS: Twenty-eight eyes (26 patients) with nebular or nebulo-macular corneal opacity were included in this study. All eyes (100%) achieved significantly better visual performance with RGP contact lenses than with glasses (P< 0.0020). Visual acuity of 6/9 or better was achieved in 50% of patients with RGP contact lenses compared to none with glasses. RGP contact lenses improved the visual acuity by 0.27 decimals over the baseline value with glasses, butthe improvement for mesopic vision and glare acuity was significantly lower at 0.15 and 0.06 decimals respectively. Similarly, contrast sensitivity did not improve to the same extent as visual acuity. Stereopsis was present only in patients with best corrected visual acuity of 6/9 or better with RGP lenses. CONCLUSION: RGP contact lenses improved the visual acuity and other visual performance in patients with reduced vision due to nebular or nebulo-macular corneal opacity. However, contrast sensitivity, glare acuity, and mesopic vision did not improve to the same extent as visual acuity.

Adolescent↗
PubMed2000

Phasic and enduring negative symptoms in schizophrenia: biological markers and relationship to outcome.

Negative symptoms have been associated with poor response to neuroleptics, enlarged ventricles, cognitive impairment, and poor outcome in schizophrenia. These associations appear, however, to be dependent on the phase of study, suggesting that acute-phase (phasic) negative symptoms may be pathophysiologically distinct from enduring negative symptoms that persist through the residual phase. To compare correlates of enduring and phasic negative symptoms, we studied 60 drug-free schizophrenic patients (DSM-III-R and SADS/RDC) at baseline, 4 weeks after neuroleptic treatment, and assessed the 1 year outcome. We rated positive and negative symptoms at baseline and 4 weeks after treatment. At baseline, premorbid function, neuropsychological function, ventricle-brain ratio (VBR) and symptom response to an anticholinergic agent were assessed, and a two-night sleep EEG and 1mg dexamethasone suppression test (DST) were conducted. Phasic negative symptoms were defined as the change in negative symptoms (baseline to 4 weeks) and enduring negative symptoms as severity of negative symptoms at 4 weeks. Patients had varying proportions of phasic and enduring symptoms; the two did not define distinct subgroups. Phasic negative symptoms were significantly correlated with global treatment response, positive symptom treatment response, response to anticholinergic agent, baseline post-dexamethasone cortisol, and shortened REM latency. Enduring negative symptoms were significantly correlated with residual positive symptoms and global psychopathology, VBR, poor performance on neuropsychological testing, decreased slow-wave sleep, poor premorbid function, and poor 1 year outcome. These data suggest that phasic negative symptoms and enduring negative symptoms may be caused by different pathophysiological mechanisms.

Adult↗
PubMed2000

Neutrophil beta2-integrin upregulation is blocked by a p38 MAP kinase inhibitor.

Tumor necrosis factor-alpha is known to upregulate the expression of surface adhesion molecules on polymorphonuclear leukocytes (PMNs). The purpose of this investigation was to study possible intracellular signaling pathways responsible for the upregulation of beta2 integrins on normal human PMNs induced by TNF. We report that treatment with TNF (10 ng/ml) for 30 min resulted in a significant increase in CD18 and MAC-1 surface expression (P < 0.001). In addition, pretreatment with 15 microM SB203580, a p38 MAP kinase inhibitor, for 10 min significantly inhibited TNF upregulation of CD18 and MAC-1 (P < 0.0001). Pretreatment with either 15 microM PD 98059, a p42/44 MAP kinase inhibitor, or 5 microM GO 6850, a protein kinase C inhibitor, had no significant inhibitory effect. These data suggest that the TNF-induced upregulation of beta2 integrins is mediated specifically through the p38 MAP kinase pathway and not through the p42/44 MAP kinase or protein kinase C pathways.

Antigens, CD↗
PubMed2000

Superior temporal gyrus in schizophrenia: a volumetric magnetic resonance imaging study.

The left superior temporal gyrus (STG) has been reported to be smaller in patients with schizophrenia. The volume of the STG has been found to correlate negatively with severity of hallucinations and thought disorder. In this study, we measured the STG volume of 20 normal controls and 20 patients with schizophrenia using 3 mm contiguous coronal T1 magnetic resonance images. We found that patients had a significantly smaller left anterior STG, and that the volume of this region negatively correlated with the severity of hallucinations. The left posterior STG was not significantly smaller in patients than in controls, but its volume negatively correlated with severity of thought disorder. We also found that the left anterior STG was smaller than the right STG in patients but not in controls. The STG has at least three histologically distinct areas, each with different connections to the rest of the brain. These data are consistent with the proposition that dysfunction of the primary auditory cortex in the anterior and middle STG and auditory association cortex in the posterior STG may play a role in the production of auditory perceptual abnormalities and poor organization of thought respectively.

Adult↗
PubMed2000

In vivo measurement of the vesicular monoamine transporter in schizophrenia.

Given evidence for excessive striatal dopamine activity in schizophrenia, we sought to test the hypothesis that dopaminergic innervation in the striatum is abnormally elevated, and a secondary hypothesis that age-related loss is accelerated. Twelve schizophrenic subjects on stable doses of medications, along with 12 age and sex-matched healthy control subjects, underwent positron emission tomography (PET) studies with [11C]dihydrotetrabenazine (DTBZ), which binds to the vesicular monoamine transporter, type 2 (VMAT2). DTBZ binding reflects principally dopaminergic projections in the striatum and appears in animal models, over treatment periods as long as two weeks, not to be regulated by antipsychotic drugs. Using an equilibrium analysis, we obtained measurements of the binding potential (BP) of [11C]DTBZ, as well as a transport (K(1)) measure, corresponding to regional cerebral blood flow. BP in the striatum showed no difference between the patient and control groups, and no differential effect of age. We did not find evidence supporting the hypothesis that excessive dopamine activity in schizophrenia could be explained by increased density of striatal dopamine terminals.

Adolescent↗
PubMed2000

Reduction of congenital nystagmus amplitude with auditory biofeedback.

PURPOSE: Treatment options for congenital nystagmus without null position are limited. The purpose of this study was to evaluate the role of auditory biofeedback in controlling congenital nystagmus. METHODS: Ten patients with congenital nystagmus without null position underwent 6 sessions (twice a week for 3 weeks) of auditory biofeedback. Each half-hour session had simultaneous electronystagmographic recording done during the session. RESULTS: The patients could reduce the nystagmus during the treatment sessions. Mean amplitude (degrees) of nystagmus was reduced from 6. 28 +/- 4.94 to 3.05 +/- 2.48 (P =.028) and mean intensity (amplitude x frequency) was reduced from 33.37 +/- 22.84 to 13.35 +/- 7.99 (P =. 0174), but the mean frequency change was not significant, from 5.8 +/- 1.05 to 4.98 +/- 1.35 (P =.148). The mean amplitude and mean intensity decreased by 51% and 60%, respectively. After completion of the session, although a subjective improvement was reported, the patient's binocular visual acuity on Snellen's charts and contrast sensitivity did not show any significant change. Also no sustained benefit was noted because the electronystagmographic recordings reverted to baseline after the auditory stimulus for biofeedback was discontinued. CONCLUSION: Simultaneous electronystagmographic recording shows significant reduction of nystagmus amplitude and intensity because of auditory biofeedback only during the treatment session. The beneficial effect does not persist after the auditory stimulus is discontinued. No objective effect on visual acuity and contrast sensitivity was noted after the therapy.

Acoustic Stimulation↗