Systemic amyloidosis in psoriasis, lepromatous leprosy & cutaneous tuberculosis.
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Biomedical subjects
Publications and source records attributed to S Anand.
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A total of 704 Salmonella strains isolated from various sources were tested for their resistance to chloramphenicol. The results indicate that 36 out of 46 serotypes, comprising 671 strains (95.4%), were sensitive to chloramphenicol up to a level of 10 mug per ml of medium. Most of the strains were sensitive at concentrations between 2 mug and 4 mug of chloramphenicol per ml of medium. None of the strains isolated from animals, including poultry, was resistant. The results indicate that in India resistance of Salmonella strains to chloramphenicol has not increased over the years though this may have occurred in other parts of the world.
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A patient with coexistent hemochromatosis and alpha-1-antitrypsin deficiency which led to cirrhosis and death despite adequate therapy for hemochromatosis is reported. Evaluation of the family revealed first degree relatives with iron overload and others with alpha-1-antitrypsin deficiency but none with both conditions. The role of family studies in the early recognition and possible prevention of overt clinical disease in individuals with either of these two genetic diseases is discussed.
Anterior fontanel tension (AFT) has been shown to reflect the intracranial pressure (ICP). A new transducer was designed for AFT measurement which overcomes the problems of replacement in subsequent use. Using the transducer AFT was monitored noninvasively over extended periods in about 200 normal and sick neonates. The results indicate that the technique can be used to identify elevated pressure due to different disease conditions and it has a potential to help in understanding physiological and pathological mechanisms causing alterations in the normal cerebrospinal dynamics. Further studies are underway to establish the full potentials of the technique.
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Biomedical engineering has been recognized in India for the last decade. Technological developments have been in areas of importance to the country, with several groups actively involved in the promotion of bioengineering, particularly in New Delhi. A group at the National Physical Laboratory has contributed significantly to the field of ultrasonics as well as to the development of piezoelectric transducers for other biomedical uses. The Centre for Biomedical Engineering of the Indian Institute of Technology and the All India Institute of Medical Sciences is one of the country's leading centres producing outstanding work in areas like instrumentation, rehabilitation, biomaterials, modelling and analysis. Research in technology applied to reproductive physiology (an area especially relevant to India's needs) was initiated at this centre. Research at the School of Environmental Sciences, Jawaharlal Nehru University has elucidated the effects and mechanisms of the action of low-energy electromagnetic radiation and ultrasound on biological systems--in one of the school's projects the use of bone material for ultrasonic transducers and optical detectors was successfully demonstrated. A selected list of publications shows the wide spectrum of research carried out at these institutions.
We describe an 8-year-old girl who had bilateral acute anterior uveitis, optic disc swelling, and positive findings on fluorescein angiography. A diagnosis of Kawasaki disease was made. This case highlights the posterior segment features of Kawasaki disease and positive correlation to angiographic findings that have not been previously reported.
Amphotericin B (AmB) remains the 'gold standard' for systemic antifungal therapy and newer drug delivery systems have been effectively developed for this drug. The newer azoles e.g. itraconazole, voriconazole and their derivatives are viable alternatives to AmB, and are suitable for oral administration. Combination antifungal therapy has been tried successfully. For instance, AmB plus flucytosine is preferred in cryptococcal meningitis and candidemia. A liquid preparation of itraconazole and cyclodextrin is pharmacokinetically superior to the conventional dosage form of itraconazole, and is particularly effective in mycoses following cytotoxic chemotherapy and bone marrow transplants. Newer potential antifungals such as echinocandins, benanomicins/pradimicins, aureobasidins and nikkomycins are under clinical trials. The role of -immunomodulation in systemic anti-fungal therapy has been proposed and recombinant cytokine therapy (G-CSF, GM-CSF, IFN-g, IL-I, TNF-a) either alone or in combination with AmB have shown good results.
Paradoxical exacerbation of the signs and symptoms of tuberculosis may occur not only after antituberculosis therapy, but also soon after the initiation of a potent combination of antiretroviral drugs in human immunodeficiency virus (HIV) serpositive patients with tuberculosis. We report a case of immune reconstitution syndrome in response to antiretroviral therapy in a HIV-positive patient on antituberculosis therapy for multidrug-resistant tuberculosis.
BACKGROUND: Human immunodeficiency virus (HIV) observational cohorts, which are established worldwide, support comparative studies across different regions. They have played an important role in developing international and country-specific HIV treatment and care guidelines. We describe the YRG CARE Chennai HIV observation database (YCHOD) and highlight its utility in monitoring trends in antiretroviral treatment use and HIV disease outcomes in India. METHODS: The baseline characteristics, time trends in antiretroviral treatment, trends in incidence of acquired immune deficiency syndrome (AIDS)-defining illness and mortality following the introduction of highly active antiretroviral therapy (HAART) in India were assessed using YCHOD. RESULTS: Till January 2005, 7647 HIV-positive patients had registered in YCHOD. A majority of the patients were men (69%) and had a mean age of 32 years. At baseline, 14% had an existing AIDS-defining illness. Among patients who required therapy by the WHO criteria, 14% initiated antiretroviral therapy (ART) in 1996 and 35% in 2000. Since the dramatic cost reduction of generic HAART in 2001, there has been an increase in the proportion of patients receiving ART to 57% in 2004. In patients who were started on HAART, the incidence of at least one AIDS-defining illness was 2% in 2001, and this decreased to 0.48% in 2004. CONCLUSION: We feel observational cohorts are useful as a surveillance tool for monitoring trends in treatment and disease progression. Standardized observational data collected systematically on HIV-infected individuals will help to assess the cost-effectiveness of ART and in planning ART strategies for India.
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