Biomedical subjects
Publications and source records attributed to S Agrawal.
Embelin, extracted from Embelia ribes Burm. berries, altered the testicular histology and glycogen, gametogenic counts and accessory sex gland fructose at the dose levels 0.3, 0.4 and 0.5 mg/kg body weight administered subcutaneously for 35 days. The compound is suggested to possess antiandrogenic activity.
Human leukocyte antigens (HLAs) are an inherent system of alloantigens, which are the products of genes of the major histocompatibility complex (MHC). These genes span a region of approximately 4 centimorgans on the short arm of human chromosome 6 at band p 21.3 and encode the HLA class I and class II antigens, which play a central role in cell-to-cell interaction in the immune system. These antigens interact with the antigen-specific cell surface receptors of T lymphocytes (TCR) thus causing activation of the lymphocytes and the resulting immune response. Class I antigens restrict cytotoxic T-cell (CD8+) function thus killing viral infected targets, while class II antigens are involved in presentation of exogenous antigens to T-helper cells (CD4+) by antigen presenting cells (APC). The APC processes the antigens, and the immunogenic peptide is then presented at the cell surface along with the MHC molecule for recognition by the TCR. Since the MHC molecules play a central role in regulating the immune response, they may have an important role in controlling resistance and susceptibility to diseases. In this review we have highlighted studies conducted to look for an association between HLA and infectious diseases; such studies have had a variable degree of success because the pathogenesis of different diseases varies widely, and most diseases have a polygenic etiology.
We have evaluated the antiproliferative effect of a novel mixed backbone antisense oligonucleotide generated against the 5'-coding region of the human CRIPTO mRNA in GEO human colon cancer cells. We have also evaluated the effects of this anti-CRIPTO antisense oligonucleotide in combination with a chimeric anti-human epidermal growth factor receptor (EGFR) monoclonal antibody (MAb C225) and with 8-Cl-cAMP, a cAMP analog that specifically inhibits type I protein kinase A (PKAI), since a functional EGFR-driven autocrine pathway is operative and PKAI is overexpessed in GEO colon cancer cells. Treatment with a single agent at low doses determined a 15-35% growth inhibition. A synergistic antiproliferative effect was observed when combinations of two agents were used with a co-operativity quotient ranging between 1.5 and 2.2. Furthermore, the combined treatment with all three drugs caused an almost complete suppression of the ability of GEO cells to form colonies in soft agar. We next evaluated whether any combination of 8-Cl-cAMP, the anti-CRIPTO antisense oligonucleotide and MAb C225 could induce programmed cell death in GEO cells. Treatment with each agent alone at all doses tested did not cause DNA fragmentation. The treatment with any combination of two agents was not able to induce apoptosis. In contrast, treatment with all three compounds determined an approximately three-fold increase in DNA fragmentation. In conclusion, the combination of selective antineoplastic agents directed against different but related key signal tranduction pathways efficiently inhibits cell growth and causes apoptosis in human colorectal cancer cells.
BACKGROUND: The Acute Physiology and Chronic Health Evaluation (APACHE II) scoring system is widely used for assessing the severity of disease and prognostication in cases of perforation peritonitis. Investigations like arterial pH and oxygenation (PaO2), which are considered important in APACHE II, are not available in most hospitals. We therefore attempted to validate a modified APACHE II (without arterial pH and oxygenation) in cases of perforation peritonitis. METHODS: Fifty consecutive patients with perforation peritonitis admitted in the general surgical ward were prospectively analyzed vis-a-vis risk factors and mortality according to the modified APACHE II. RESULTS: The mean modified APACHE II score of those who died was 15.3 (SD 5.7) as compared to 6.6 (4.7) (p < 0.001) in those who survived. As the score increased, mortality rate rose (p < 0.001). When the score was greater than 15, mortality was 88.9%; there was 100% mortality with score greater than 17. CONCLUSION: The modified APACHE II, excluding arterial pH and oxygenation, is simplified, reliable and objective for prediction of outcome in perforation peritonitis.
Tuberculosis of the stomach and duodenum is rare in patients with pulmonary tuberculosis. Primary involvement is even rarer. Two cases of primary tuberculosis of the localised to the pyloro-duodenal area are presented. The most common symptoms are non-specific leading to a difficulty in establishing a pre-operative diagnosis. A high degree of suspicion is therefore required for its diagnosis and to differentiate it from more frequent causes of gastric outlet obstruction such as chronic peptic ulcer disease and gastric carcinoma. The treatment of gastric tuberculosis is primarily medical with anti-tuberculous drug therapy. The role of surgery lies in the cases with obstruction following hypertrophic tuberculosis. The surgery done is usually a gastroenterostomy. With the relative rate of extra-pulmonary tuberculosis increasing, tuberculosis of the pyloro-duodenal area should be considered in the differential diagnosis of gastric outlet obstruction.
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Laparoscopic appendectomy is an established procedure in the treatment of appendicitis. Complications of the procedure are related to the Veress needle and trocar insertions or pertain to actual operative procedures. Trocar-elated major bleeding is rare, and, if it occurs, is detected on the table or during the immediate postoperative period. Delay in recognition may lead to significant morbidity and mortality. We report a case of giant parietal wall hematoma in a 34-year-old female, presenting one week after discharge from the hospital. The hematoma was completely evacuated by exploration through paramedian incision, followed by an uneventful recovery.
A simple and reproducible high-performance thin-layer chromatographic method was developed for the simultaneous determination of bergenin and gallic acid in Bergenia ligulata. Water and methanol were used as the extracting solvents. The concentrations of bergenin and gallic acid in both of these solvents were found to be almost the same. The method involves separation of the components by thin-layer chromatography on a precoated Silica Gel 60 F254 plate with a solvent system of ethyl acetate-formic acid-acetic acid-water (100 + 11 + 11 + 27). The sensitivity of the method for bergenin was 0.30 microg, whereas for gallic acid it was 0.25 microg. The proposed method is precise and sensitive and can be used for the detection, monitoring, and simultaneous quantification of bergenin and gallic acid in B. ligulata.
OBJECTIVE: To evaluate the efficacy of laparoscopic cholecystectomy (LC) in acute and chronic cholecystitis and compare it with the open procedure. METHODS: This is a 5-year retrospective analysis performed at our hospital. Surgical treatment of gallbladder disease was performed in 1003 patients. Acute cholecystitis was present in 120 (11.9%) patients, and chronic cholecystitis was present in 830 (88.1%). Acute patients underwent surgery within 72 hours of symptom onset. The patients selected for LC or open cholecystectomy (OC) depended on the severity of disease, comorbid factors, and surgeon's preference. We reviewed age, sex, operating time, length of stay, perioperative complications, conversion rates, and cost. RESULTS: Patients chosen to undergo LC for acute cholecystitis tended to be younger females. Patients treated with LC for acute or chronic cholecystitis on average had a shorter operating time and length of hospital stay when compared with patients treated with OC (P < 0.005 by ANOVA with Bonferroni). Conversion rates (CR) for all LC decreased considerably from the first to the fifth year: 9% in 1995 (10/103), 9% 1996 (22/232), 4% in 1997 (8/188), 2% in 1998 (5/226) and 2% in 1999 (5/193). CONCLUSIONS: LC appears to be a reliable and cost-effective procedure for acute and chronic cholecystitis; however, the surgical approach should be chosen with caution because of the potential spectrum of technical difficulties. CR is also improving as surgeons' experience broadens.
Conventional radiography has limitations in accurate diagnosis of gallbladder cancer (GBC). Ultrasonography (USG) allows correct diagnosis in 70-80% advanced and 23% early GBC. Present study was initiated to identify morphology and flow characteristics in GBC using conventional USG and Colour Doppler USG (CD-USG). In 100 patients, USG assessed morphology of mass lesion/wall thickening together with associated features. Of these, 60 cases were studied using CD-USG for intralesional/perilesional vascularity, peak systolic flow velocity (V max), resistive index (RI) and pulsatility index (PI). USG identified GB with mass lesion in 44% cases (Group-I) and only mass in GB fossa in 56% cases (Group-II). Findings identified calculi (73%), liver infiltration (74%), intrahepatic ductal dilatation (IHDD) (52%), lymphadenopathy (19%) and ascites (5%). CD-USG revealed vascularity, mainly pulsatile flow, in 78.3% cases (in 91.3% Group-I cases). Mean Vmax was 0.3037 m/sec (0.109 - 0.646 m/sec.), mean RI was 0.6621 (0.526 - 1.000) and PI was 1.282 (0.772 -2.140), Mean Vmax and PI were higher in Group-I compared to Group-II. Presence of calculus in 73% cases suggests a high association between calculus and malignancy. As flow signals were seen in 78% of all cases and 91.3% Group-I cases undergoing CD-USG, USG and CD-USG together can improve pickup rate of GBC.
A hospital-based retrospective study on childhood leprosy was carried out at B.R. Koirala Institute of Health Sciences, Dharan, covering the period April 1998-April 2002. 20 (4.45%) leprosy patients were detected in children aged 6-14 years. The male:female ratio was 4:1. History of contact was found in 10% of the patients. The commonest type of leprosy was borderline tuberculoid leprosy (550%), followed by borderline lepromatous leprosy (301%). Most of the patients had more than one lesion. Nerve involvement and grade 2 deformity were noted in 55% and 20% of the patients respectively. Slit skin smear was positive in 30% of patients.
Fifty one angiographically proved cases of tetralogy of Fallot (TOF) in the age group of 5-50 years were analysed retrospectively for the level(s) of right ventricular outflow tract (RVOT) obstruction. Mean age was 18.1 +/- 11 yrs. Subvalvular stenosis was found to be the commonest site of RVOT obstruction in 49 (96.1%) patients. Evidence of valvular pulmonary stenosis was seen quite commonly (42/51, 83.9% cases), mostly in association with obstruction at other sites. Supravalvular stenosis was also seen in 17 (33.3%) cases. Higher incidence of pulmonary valvular involvement in patients with TOF, in higher average age of patient population may represent valvular involvement to be an acquired phenomenon.
The effect of raw garlic on normal blood cholesterol level in males of the age group of 18-35 years was studied. The subjects, who never ingested garlic before, were given 10 g of garlic daily with their diet for two months. Fasting blood samples were investigated in respect of cholesterol before and after two months of garlic intake. Initially the blood cholesterol level ranged between 160-250 mg% which decreased significantly in all the subjects of experimental group after two months of ingestion of garlic. The slight decrease or increase in the blood cholesterol level of control group was not significant. The raw garlic can be advocated for daily ingestion in order to lower one's blood cholesterol level even if it is within normal limits.
The defective recognition of foetal alloantigens by the maternal immune system is associated with recurrent pregnancy failure and may be prevented by boosting the maternal immune response with paternal or third party leucocyte immunization. The mechanism by which this process achieves success is not known. Clinical trials on recurrent spontaneous abortion have shown an up to 70% successful pregnancy rate after immunotherapy but the importance of this is unclear because there have been success rates of between 29% and 76% even in the control population. These variations could be due to small sample sizes and heterogeneity in the populations studied as well as co-intervention by the placebo. This article reviews the state-of-the-art for immunotherapy and discusses its mechanism of action in the prevention of recurrent foetal loss.
Angiotensin given by intravenous route in rabbits caused a marked rise in blood glucose within 45 min. Guanethidine, bretylium, alpha methyl DOPA, adrenalectomy and reserpinization significantly influenced the changes in blood glucose induced by angiotensin II. It is suggested that the rise in blood glucose level induced by angiotensin II appears to be mediated by facilitation of catecholamine release or due to inhibition of reuptake.
A simple method to measure Candidal biofilm activity using pH change of Stomastat was developed and used to evaluate the efficacy of 11 commercial denture cleansers on Candida albicans biofilm. The initial number of yeasts inoculated correlated with the pH value of Stomastat after both 24- and 30-hour incubation periods (r=0.992; r=0.988, respectively; P<.01), which supported the method's validity. The ability of the cleansing agents to decrease fungal biofilm activity varied depending upon the components of the agents. In general, peroxide denture cleansers, a disinfectant, and one enzyme cleanser were more efficacious than the other types tested in this study.
The effects of angiotensin II were studied on blood sugar level in dogs. Intracerebroventricular administration of pressor dose of angiotensin caused a rise in blood sugar level. The hyperglycaemia and pressor response was not affected by bilateral vagotomy and was less marked in adrenalectomized dogs. The hyperglycaemic effect and pressor response was not observed in reserpinized and spinal vagotomized dogs. It is suggested that centrally administered angiotensin stimulates the hypothalamic or medullary accelerator neurons (central sympathetic structures) to cause a marked release of catecholamines from peripheral stores specially adrenal medulla. This excessive release of catecholamines is responsible for hyperglycaemia and pressor response of angiotensin II in dogs.