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Biomedical subjects

S Arora

Publications and source records attributed to S Arora.

At least 127 records · Page 7Linked to original sources
PubMed1993

Light reflection rheography: a simple noninvasive screening test for deep vein thrombosis.

PURPOSE: The clinical diagnosis of deep vein thrombosis (DVT) is unreliable. Contrast phlebography (CP) continues to be the gold standard, but it is invasive. Although duplex ultrasonography is an accurate, noninvasive alternative, it is expensive, technically demanding, and time-consuming. We postulated that light reflection rheography (LRR), a noninvasive method of assessing the quantity and rate of venous emptying, might be a reliable and inexpensive bedside approach to screening patients with clinically suspected DVT. METHODS: With LRR, infrared light is beamed onto the skin, and the amount of backscattered rays are detected, which indirectly measures the amount of blood present in a volume of the epidermis beneath the LRR probe. Applied to the calf muscle pump, LRR can provide a noninvasive method of assessing blood volume changes in the sample area of skin, in response to venous hemodynamic changes in the lower limb. RESULTS: Sixty-nine limbs in 61 patients undergoing CP for clinically suspected DVT over a period of 12 months also underwent LRR, either just before or within 24 hours of undergoing phlebography. The criteria for diagnosing DVT on CP were presence of filling defect or nonfilling of a venous segment. The result of LRR was considered positive for DVT if the rate of venous emptying was 0.35 or less. With these criteria a sensitivity of 96.4% and specificity of 82.9 were obtained. This resulted in a positive predictive value of 79% and a negative predictive value of 97.1%. CONCLUSIONS: LRR is a simple, inexpensive, and noninvasive bedside test that takes 10 minutes to perform. It is highly sensitive with a high negative predictive value, detecting most cases of DVT, reliably ruling out DVT, and eliminating the need for more time-consuming and costly studies. Therefore it seems to be an appropriate screening test in patients with clinically suspected DVT.

Adult↗
PubMed1993

Ascitic fluid cholesterol in differential diagnosis of ascites.

Cholesterol was estimated in ascitic fluid of 89 patients (29 malignant and 60 non-malignant ascites). Mean ascitic cholesterol level was significantly higher in malignant ascites (89.52 mg/dl) as compared to non-malignant ascites (29.93 mg/dl). At a cut off value of 48 mg/dl, the sensitivity, specificity, positive and negative predictive value and overall diagnostic accuracy for diagnosing malignant ascites is 96.5%, 96.6%, 93.3%, 98.3% and 96.6% respectively. Ascitic fluid cholesterol estimation is an easy and reliable test for differentiating malignant ascites from non-malignant ascites.

Ascites↗
PubMed1993

Mesalamine capsules for treatment of active ulcerative colitis: results of a controlled trial. Pentasa Study Group.

The efficacy of a capsule formulation of mesalamine was assessed in 374 patients with mild to moderately active ulcerative colitis. Patients, stratified to pancolitis or left-sided disease, received either placebo or mesalamine at 1, 2, or 4 g daily for 8 wk. Efficacy was assessed using clinical improvement--physician global assessment, sigmoidoscopic index, biopsy score, trips to the toilet, and clinical symptoms (abdominal pain, urgency, stool consistency, and rectal bleeding)--and induction of remission (more stringent criteria for physician global assessment, sigmoidoscopic index, and biopsy score). For physician global assessment of treatment benefit, 79% and 84% of patients on the 2-g and 4-g doses of mesalamine, respectively, received treatment benefit, compared with 54% on placebo (p < or = 0.0002). For the physician global assessment of treatment success, both the 2-g and 4-g doses of mesalamine were superior to placebo (57% and 59% of patients, p = 0.0021 and 0.0012, respectively), compared with 36% on placebo. Both the 2-g and 4-g doses produced statistically significant macroscopic (endoscopic) improvement compared with placebo (p < 0.004). The 4-g dose also produced a statistically significant microscopic (histologic) improvement compared to placebo (p < 0.002). Significant improvement compared to placebo was also observed at 2 g and 4 g for the four clinical symptoms and trips to the toilet (p < or = 0.003). Oral mesalamine capsules were significantly superior to placebo for inducing remission, with 29% of patients at 2 g and 29% at 4 g achieving remission by physician global assessment, compared with 12% on placebo. Forty-four percent and 48% of patients receiving 2 g and 4 g of mesalamine, respectively, achieved remission by sigmoidoscopic index (p < 0.05), compared with 31% on placebo. Thirty-nine percent of patients at 4 g daily achieved microscopic remission, compared with 23% on placebo (p < 0.03). Treatment response was not affected by extent of disease or prior steroid or sulfasalazine therapy. These data suggest that controlled-release mesalamine capsules are a safe and effective monotherapy in doses of 2-4 g daily for treating mild to moderately active ulcerative colitis, as well as for inducing remission, regardless of prior oral steroid or sulfasalazine therapy or extent of disease.

Adult↗
PubMed1992

Self-administered mixture of Entonox and isoflurane in labour.

Entonox (50% nitrous oxide premixed in oxygen) was compared with a mixture of Entonox and approximately 0.25% isoflurane (Entonox-isoflurane) for pain relief in the first stage of labour in 39 mothers. An Oxford Miniature Vaporizer was incorporated as the draw-over vaporizer for adding isoflurane to Entonox. The mixture was self-administered via the Entonox on-demand valve. The two mixtures were given in random sequence for five consecutive contractions of labour to each patient. Linear analogue pain relief scores were significantly higher (P=0.001) with Entonox-isoflurane. Fourteen patients continued using Entonox-isoflurane until delivery. No adverse effect from prolonged use was noted. Entonox-isoflurane is considered worthy of further investigation.

Journal Article↗
PubMed1992

Molecular basis of lactase levels in adult humans.

The molecular basis of adult human "lactase deficiency" has long been a subject of controversy. To address this issue, small intestinal biopsies from orienta, black, and white patients were analyzed. Adjacent samples were assayed for lactase and sucrase specific activities and the sucrase/lactase ratio (high ratio signifies lactase deficiency), and the results were compared to lactase steady-state mRNA levels detected in Northern blots probed with a human lactase mDNA. All oriental patients had high ratios and no detectable lactase mRNA. Four black patients had a similar pattern; two with low ratios had detectable mRNA. The group of white patients displayed a range of findings, from high ratio/no mRNA to low ratio/considerable mRNA. Elevated levels of lactase mRNA always correlated with the presence of elevated levels of lactase enzyme activity, suggesting that the difference in levels of adult human intestinal lactase activity among racial groups may be regulated at the level of gene transcription.

Adult↗
PubMed1992

Atrial fibrillation following electrical injury.

The development of atrial fibrillation in 2 patients, following an electrical shock is reported. One patient, with an underlying pre-excitation syndrome, had to be cardioverted due to rapid ventricular rate and hypotension. The other, with normal conduction, tolerated the arrhythmia well and atrial fibrillation reverted spontaneously after 24 hours.

Adult↗
PubMed1992

Diagnostic accuracy of IgM antibody detection in typhoid by a modification in Widal test.

Specific IgM antibodies were detected indirectly in sera of patients of typhoid by observing fourfold or more fall in the agglutinin titres after treatment of the serum with 2-mercaptoethanol (2-ME) for removal of IgM antibodies. Significant fall in titres was observed in 94 per cent patients of bacteriologically confirmed typhoid and 67 per cent patients in whom a diagnosis of typhoid was based only on a significant Widal test result. Patients of non-typhoid febrile illnesses showed either no fall or an insignificant fall in their titres. The detection of specific IgM antibodies by this simple modification of Widal test thus seems to enhance the sensitivity and specificity of the test.

Agglutination Tests↗
PubMed1992

Cranial sonography in preterm infants.

Fifty preterm newborn infants with gestational age of 28-36 weeks were subjected to real time cranial sonography to (a) evaluate the ventricular system and brain parenchyma, (b) determine the incidence of intracranial abnormalities, and (c) to establish the utility and advantages of routine cranial sonography in preterm infants. The lateral ventricular width varied from 6-12 mm (8.67 +/- 1.85 mm) while hemispheric width ranged between 3.68 to 3.95 cm with a mean of 3.84 +/- 0.25 cm. The lateral ventricular ratio ranged from 20.9 to 26.4% and it showed progressive decrease with increasing gestational age. Cavum septum pellucidum was found in 68% of the preterms. Incidental intracranial pathologies were detected in 12% of the preterms screened.

Anthropometry↗
PubMed1991

Acromegaly and gastrointestinal cancer.

A cohort of 1041 men who were discharged from the hospital with a diagnosis of acromegaly were examined for subsequent cancer. With a mean follow-up time of 8.3 years, an increased rate of cancers of the digestive organs was observed (27 cases; standard incidence ratio [SIR], 2.0; 95% confidence interval [CI], 1.3 to 2.9). Rates were elevated for cancers of the esophagus (7 cases; SIR, 3.1), stomach (4 cases; SIR, 2.5), and colon (13 cases; SIR, 3.1). The increased risk of colon cancer in acromegaly is consistent with previous clinical reports and suggests opportunities for etiologic research and early cancer detection. It would seem prudent to also evaluate this risk in current research on the use of growth hormone in older individuals to increase muscle mass and reduce body fat.

Acromegaly↗
PubMed1991

Calcium absorption in elderly subjects on high- and low-fiber diets: effect of gastric acidity.

In vitro studies suggest that the effect of fiber in inhibiting calcium absorption is pH dependent. In nine normal, elderly control subjects and eight elderly subjects with achlorhydria, 47Ca was ingested with three test meals: a low-fiber meal (0.5 g dietary fiber), a high-fiber meal (10.5 g), and a high-fiber meal with 120 mL of 0.1 mol HC/L. In control subjects calcium retention, measured in a whole-body counter, was 25.7 +/- 4.0% (mean +/- SD) with the low-fiber meal, 19.1 +/- 1.9% with the high-fiber meal (P less than 0.002 vs low fiber), and 18.9 +/- 3.3% with the high-fiber-plus-acid meal (P less than 0.002 vs low fiber, NS vs high fiber). Calcium absorption in achlorhydric subjects was not different from control subjects: 26.2 +/- 8.0% with low fiber, 19.6 +/- 4.1% with high fiber (P less than 0.04 vs low fiber), and 21.0 +/- 5.8% with high fiber plus acid (P less than 0.04 vs low fiber, NS vs high fiber). We conclude that, in humans, the reduction in calcium absorption with high fiber intake is unaffected by gastric pH.

Absorption↗
PubMed1991

Role of faecal leucocytes in the diagnostic evaluation of acute diarrhoea.

The value of faecal leucocyte examination was assessed in 400 infants with acute diarrhoea and 40 normal healthy infants. Enteropathogens were isolated from 28.75%. Escherichia coli was the commonest (16.5%) followed by Salmonella typhimurium (7%), Vibrio cholerae (3.25%) and Shigella flexneri (1.5%). Exudative response was observed in 57.1% of stools with Salmonella and 66.6% each with Shigella and E.I.E.C. infections. 81.3%, 89.5% and 87.7% of stools from which EPEC and ETEC and no enteropathogens respectively were isolated showed minimal or no Leucocytic response. The test is useful to recognise probable invasive bacterial diarrhoea and to decide the cases in which stool culture could be advantageous.

Diagnosis, Differential↗
PubMed1991

Dietary cholesterol induced changes in lipid profile in patients with nephrotic syndrome and chronic renal failure.

Fifteen patients with nephrotic syndrome (9 aged below 30 years), 6 patients with chronic renal failure and 26 healthy males (14 below 30 years) were studied. After estimating the basal serum levels of total cholesterol (STC), triglycerides (STG), high density lipoprotein (HDL) and low density lipoprotein (LDL), the patients were given a high cholesterol and high fat breakfast (containing 32 g fat and 527 mg cholesterol) for 7 days. Lipoprotein levels were again estimated on days 8 and 16. In the basal state, all patients with nephrotic syndrome had markedly elevated levels of STC and LDL. In patients aged below 30 years, STG and VLDL levels were also elevated, while HDL levels were similar in both the groups in comparison to their respective age group controls. In patients with renal failure, basal levels of all lipoproteins were similar to levels in controls. After the high cholesterol fat diet, there was an insignificant rise in all lipoprotein values in patients with nephrotic syndrome and renal failure. However, HDL levels rose significantly in patients with nephrotic syndrome aged below 30 years. Patients with nephrotic syndrome and chronic renal failure can safely be given high cholesterol and high fat diet despite abnormalities in lipid lipoprotein metabolism.

Adolescent↗
PubMed1991

Modulation of morphine induced antinociception by intracerebroventricularly administered captopril.

Captopril when administered intracerebroventricularly (icv) in doses of 100, 300, 500 and 1000 micrograms induced a dose dependent antinociceptive effect in rats. Naloxone pretreatment (10 mg/kg, ip) completely antagonised antinociceptive effect of captopril, suggesting thereby the involvement of brain enkephalinergic system. Captopril 300 micrograms, icv potentiated the antinociceptive effect of morphine in intact animals. The bilateral adrenalectomy did not have any effect on this potentiation as against the reported blockade of potentiation in adrenalectomized animals when captopril was administered by systemic route. Thus potentiation of morphine induced antinociception by icv captopril is unlikely to be exerted through an effect on adrenal function and is most likely due to increased brain enkephalin levels.

Analgesics↗
PubMed1990

Capnocytophaga infection involving a portal-systemic vascular shunt.

Capnocytophaga sp., a microaerophilic gram-negative isolate of the human oral cavity, has previously been reported to cause sinusitis, empyema, wound infections, conjunctivitis, subphrenic abscess, osteomyelitis, bacteremia, cervical abscess, and endocarditis. We report the unusual case of infection with this organism at the anastamotic site of a splenorenal portosystemic vascular shunt. In this case, the pathogenesis is presumed to be bacteremia related to mucosal trauma from endoscopic injection sclerotherapy or bacteremia secondary to dental infection. The characteristics and antibiotic sensitivities of Capnocytophaga are reviewed.

Bacterial Infections↗
PubMed1990

Recurrent acute pancreatitis as a manifestation of Wegener's granulomatosis.

We report a case of recurrent acute pancreatitis in a 57-year-old man with reactivation of Wegener's granulomatosis. An association between acute pancreatitis and Wegener's granulomatosis has not been reported previously. Six episodes of abdominal pain and hyperamylasemia occurred and were complicated by development of a pancreatic pseudocyst. New cavitary lung lesions typical of Wegener's granulomatosis led to treatment with increased glucocorticoid dosage, resulting in rapid resolution of the pancreatitis and pulmonary lesions. Acute pancreatitis may be a clinical manifestation of the histologic pancreatic vasculitis observed in Wegener's granulomatosis. Reactivation of Wegener's granulomatosis should be considered when a patient with the disorder develops otherwise unexplained acute pancreatitis.

Acute Disease↗