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Biomedical subjects

S Jain

Publications and source records attributed to S Jain.

773 records · Page 43Linked to original sources
PubMedDate not supplied

Dystrophin assay in muscular dystrophies: an Indian experience.

BACKGROUND: Dystrophin, a protein situated on the plasma membrane of skeletal muscle has been found to be abnormal in quality and quantity in patients with muscular dystrophies and may be useful in distinguishing between the different types. Experience with the technique has been limited to western countries. METHODS: We used dystrophin staining with monoclonal NCL-DYS (rod domain) antidystrophin antibody using the avidin-biotin conjugate immunoperoxidase technique in 16 out of 20 patients with various types of muscular dystrophies at a large tertiary care medical centre in India. RESULTS: The technique was unsuccessful in 4 cases. In the others the dystrophin staining pattern correlated well with the clinical diagnosis in 11 out of 16 patients. In the other 5 patients dystrophin assay helped to differentiate between Duchenne muscular dystrophy and the Becker muscular dystrophy in 2 patients suspected to have limb-girdle muscular dystrophy, it differentiated Duchenne muscular dystrophy from the Emery-Dreifuss muscular dystrophy and detected a manifest female carrier with Duchenne's dystrophy. CONCLUSION: Dystrophin staining may be useful in the differential diagnosis of patients with muscular dystrophies in India.

Adolescent↗
PubMedDate not supplied

Ibuprofen-induced thrombocytopenia.

Ibuprofen is a non-steroidal analgesic and anti-inflammatory drug widely used in current medical practice. After a thorough search of the literature I found no well-documented case of severe thrombocytopenia following its therapeutic use. Described below is a case of life-threatening thrombocytopenia induced by ibuprofen.

Female↗
PubMedDate not supplied

Maxillary sinusitis caused by Ascotricha chartarum Berk. (anamorph Dicyma ampullifera Boul.): a new phaeoid opportunistic human pathogen.

The first human infection caused by Ascotricha chartarum of the maxillary sinus is described. The patient, a 35-year-old woman, developed a hard bony swelling on the right cheek. Her maxillary X-ray showed complete opacity of the right maxillary antrum with a shadow of erosion. C.T. scan revealed a radio opaque mass having vacuolated appearance in the antrum. The debris removed from the antrum contained phaeoid fungal elements. At places, softening of the bone was observed. The mucoperiosteum exhibited acute inflammatory reaction and invasion by the pathogen. The pale brown to subhyaline fungal elements in biopsy tissue grew Ascotricha chartarum, a phaeoid ascomycetous fungus in culture. The patient had a smooth recovery when treated with betadine lavage and itraconazole after surgical intervention.

Adult↗
PubMedDate not supplied

Choice of incision in surgical management of small bowel perforations in enteric fever.

Fifty six patients with typhoid enteric perforation who underwent operative treatment were randomly assigned to 2 groups. Twenty seven patients in group A underwent laparotomy via the Rutherford-Morrison incision while 29 patients in group B underwent the same procedure via a right paramedian incision. Surgical treatment consisted of two layer closure of the perforation with peritoneal lavage and tube drainage in all cases. Mean operating time in group A and group B was 45 +/- 10 minutes and 73 +/- 6 minutes respectively (p < 0.001). Postoperative wound dehiscence in group A and group B was observed in 2 and 11 cases respectively (p < 0.001). Incisional hernia developed in 8 patients in group B and none in group A (p < 0.01). Two patients in group A and 10 in group B developed adhesion-obstruction (p < 0.05). Differences in wound sepsis, pelvic abscess and mortality were not significant. Mean hospital stay in groups A and B was 12.4 days and 16.8 days respectively (p < 0.001). We conclude that in the presence of a confirmed preoperative diagnosis of typhoid enteric perforation, laparotomy via the Rutherford-Morrison incision may significantly reduce postoperative wound complications and morbidity without significantly altering the overall outcome.

Female↗
PubMedDate not supplied

Multiple neoplasms of the salivary gland and the lung.

We describe a patient who presented with Warthin's tumour of the salivary gland which was followed by a bronchial carcinoid and subsequently by a squamous cell carcinoma of the lung. Such a presentation of three neoplasms in an individual is an uncommon occurrence.

Adenolymphoma↗
PubMedDate not supplied

Distribution of vascular lesions in ischaemic stroke: a magnetic resonance angiographic study.

BACKGROUND: Carotid endarterectomy is now an accepted modality for reducing the threat of recurrence of ischaemic strokes in patients with severe carotid artery stenosis. However, the incidence of carotid artery stenosis, and hence the applicability of carotid endarterectomy in the Indian population is not known. We conducted a prospective study to detect and quantify extracranial and intracranial arterial lesions using magnetic resonance angiography in consecutive patients with ischaemic strokes. METHODS: All patients with recent onset of ischaemic stroke (< 4 months) had a magnetic resonance angiography done to evaluate the neck vessels as well as the circle of Willis and its branches. The degree of stenosis of the internal carotid or common carotid artery was measured according to the criteria described by the North American Symptomatic Carotid Endarterectomy Trial (NASCET) collaborators. The site and extent of the extracranial and intracranial arterial lesions were correlated with the clinical features and the pattern of infarcts on magnetic resonance imaging or computerized tomographic scan of the brain. RESULTS: The magnetic resonance angiography was abnormal in 56 out of 100 patients included in the study. Severe stenosis (> 70%) of the extracranial carotid arteries was seen in 26 patients. Lesions suitable for carotid endarterectomy were present in only 11 patients (42.3% of those with severe stenosis). CONCLUSION: Our results are in contrast to those reported from western countries where the likelihood of a surgically correctable lesion being present is 60%-70%. We found operable lesions in only 11%. Intracranial atherosclerotic disease causing strokes is probably more common in India. Therefore, although carotid endarterectomy is the only accepted surgical procedure for secondary prophylaxis of stroke, there is a need to find an alternative surgical intervention for the predominantly intracranial pathology found in the Indian population.

Adolescent↗
PubMedDate not supplied

Acute isoniazid poisoning: presenting as seizure.

A case of young female who was brought in status epilepticus with history of isoniazid poisoning is discussed. Early institution of treatment with pyridoxine saves the patient's life.

Adult↗
PubMedDate not supplied

Antibodies to Cag A protein are not predictive of serious gastroduodenal disease in Indian patients.

OBJECTIVE: The present study was aimed at assessing the predictive utility of anti-Cag A antibodies in differentiating patients of duodenal ulcer (DU) and non ulcer dyspepsia (NUD) from asymptomatic controls in a developing country. METHODS: Sera from 120 subjects were tested for antibodies to Cag A using the immunodominant portion of a recombinant 37.5 kDa fusion protein by ELISA, in endoscopically proven cases of DU and NUD and healthy controls. RESULTS: The observed optical density (OD) in DU and NUD patients was 1,947 and 1,960 respectively, which was higher than that observed in controls (p < 0.01), but there was no difference in the anti-Cag A antibody titers between DU and NUD patients. CONCLUSION: Anti-Cag A antibodies do not seem to discriminate duodenal ulcer patients from non ulcer dyspepsia in the Indian population.

Adult↗
PubMedDate not supplied

Sigmoidopexy (tube sigmoidostomy) as definitive surgical procedure for sigmoid volvulus.

BACKGROUND: Volvulus of the sigmoid colon is associated with high mortality and high recurrence rate following nonoperative decompression of the colon. Therefore definitive surgery is required for its management. AIM: To evaluate the outcome following sigmoidopexy (tube sigmoidostomy) as a definitive surgical procedure to prevent recurrence of disease. METHODS: Seventeen patients with sigmoid volvulus who presented with features of large gut obstruction were studied; 12 patients underwent elective and 5 underwent emergent exploratory laparotomy. Malecot catheter fixed to the sigmoid colon and abdominal wall acted as fixator for the colon and rent for drainage of fecal matter. RESULTS: Sigmoidostomy started functioning the day following surgery and the stoma remained patent for approximately 12 days, although discharge started decreasing by the 5th postoperative day. No recurrence was noted over a period of 18 (5) months (range 13-23). CONCLUSIONS: Tube sigmoidostomy is an alternative effective procedure to prevent recurrence of sigmoid volvulus in patients who present without gangrene.

Endoscopy↗
PubMedDate not supplied

Blue rubber bleb nevus syndrome: a cause of gastrointestinal hemorrhage.

Blue rubber bleb nevus syndrome is an uncommon disorder manifested by cutaneous and gastrointestinal hemangiomas and gastrointestinal hemorrhage causing anemia. We describe a young man who presented with hematemesis and melena and had multiple bluish rubber bleb-like hemangiomas over the body and in the stomach, jejunum and colon. The patient was treated with iron supplements for anemia; he is doing well 6 months later.

Adolescent↗