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Biomedical subjects

S K Mathur

Publications and source records attributed to S K Mathur.

At least 91 records · Page 5Linked to original sources

Early serodiagnosis of leprosy by indirect immunofluorescence.

A method of fluorescent leprosy antibody absorption (FLA-ABS) test was described. This test was so sensitive that 81.8% of tuberculoid leprosy cases gave positive reaction even in early stage of the disease. More than 50% of indeterminate and contact cases were also positive in this test. The positive percentages as well as antibody-titers were increasing with clinical spectrum of leprosy, from TT to LL, being the highest in the latter. Using absorbed and diluted serum from known lepromatous patient, enumeration of M. leprae in skin smear showed a good coincidence with the bacterial index expressed by Ridley's scale. Therefore, FLA-ABS test will be useful for early serodiagnosis of leprosy not only by the detection of antibodies but also by the identification of M. leprae.

Fluorescent Antibody Technique↗

The effects of ciprofloxacin on human chondrocytes in cell culture.

Ciprofloxacin is a highly potent antibacterial agent that is used extensively in bone and joint infections. Because of reports of potential chondro-toxicity in animals, the effects of this drug on cells derived from human cartilage were tested in liquid micromass and agarose gel cultures. An inhibition of cell proliferation as indicated by a decrease in [3H]-thymidine uptake and bromodeoxyuridine labeling at ciprofloxacin concentrations of 0.5 and 50 mg/l was found which corresponded to the therapeutic and toxic serum levels. There was no effect on proteoglycan synthesis as indicated by 35SO4 incorporation. Immunocytochemistry showed no changes in morphology or staining patterns for type-I procollagen, type-II collagen, keratan sulfate and unsulfated chondroitin. Because the amount of inhibition of DNA synthesis varied with different ciprofloxacin concentrations, this data suggests that this agent has a differential effect on newly differentiating cells and might be the basis for contraindication in pediatric patients.

Adult↗

Endoscopic esophageal variceal sclerotherapy using 3% aqueous phenol.

Endoscopic esophageal variceal sclerotherapy was performed in 301 patients with portal hypertension (emergency, 72 and elective, 229) using 3% aqueous phenol as sclerosant. The cause of portal hypertension was cirrhosis of the liver in 189 patients (Child's class A-48, B-66, and C-75), extrahepatic portal venous obstruction (EHPVO) in 90, and non-cirrhotic portal fibrosis in 22 patients. In the emergency group, active bleeding was controlled in 87% of cases. Re-bleeding occurred in 101 of 290 (35%) surviving patients. Obliteration of varices was achieved in 228 (84%) patients, with a mean of 5.14 +/- 2.27 sclerotherapy sessions. Of 301 patients, 29 (9.6%) had an early in-hospital mortality (30.5% in emergency and 3% in elective group), with 16 deaths due to variceal bleeding. Of the remaining 272 patients, 40 (15%) died during follow-up, of which only 11 died of variceal bleeding. Complications, such as superficial ulcers, dysphagia, and strictures, were observed in 14%, 7% of emergency, and 3% of elective patients. None of the patients developed systemic toxicity. In conclusion, 3% aqueous phenol is an effective, safe, and economical sclerosant for esophageal variceal sclerotherapy.

Adult↗

Isokinetic concentric versus eccentric training of shoulder rotators with functional evaluation of performance enhancement in elite tennis players.

Thirty elite tennis players were randomly assigned to three groups to evaluate shoulder isokinetic internal and external rotation training: an isokinetic concentric group, an isokinetic eccentric group, and a control group with no training. Subjects were tested before and after training both concentrically and eccentrically using an isokinetic dynamometer. Functional output before and after training was assessed by the average and peak velocity of six maximal serves. The effect of training on serve velocity endurance was also assessed. Statistically significant concentric and eccentric strength gains (11%) were obtained in both training groups when compared with controls (decreased total average strain of 2%) (P < 0.0004). Serve velocity increased by greater than 11% in both training groups, which was a significant increase from the average of 1% in the control group (P < 0.0001). In the endurance study, training group subjects displayed a tendency to maintain their serve velocity (loss of approximately 2%) greater than controls (loss of 6.4%) (P < 0.05). Isokinetic training led to increases in objective and functional output in elite tennis players. This training regimen may have significance in the final stages of the rehabilitation of injured shoulders as well as in improved performance and reduced injury risk.

Adolescent↗

Hypophosphatemic rickets and osteomalacia in polyostotic fibrous dysplasia.

A 17 year-old girl with polyostotic fibrous dysplasia and hypophosphatemia had inappropriately low tubular reabsorption of phosphate. She had radiological evidence of rickets and osteomalacia. The patient showed clinical improvement after treatment with phosphate supplementation, active vitamin D (calcitriol) and alendronate. It is postulated that either a phosphaturic substance elaborated from the dysplastic bone or target-organ (kidney) unresponsiveness may interfere with phosphate reabsorption in the renal tubule.

Alendronate↗

Surgical management of the Budd-Chiari syndrome: early experience.

BACKGROUND: Early decompression is needed in the Budd-Chiari syndrome (BCS) to prevent liver dysfunction and death. AIMS: To study the technical difficulties during surgery and the results of surgery for BCS. METHODS: Retrospective review of nine patients operated on between 1994 and January 1998 for BCS--1 for uncontrolled fundal variceal bleed and 8 for chronic BCS. Isolated hepatic vein block was found in 5, inferior vena cava (IVC) block in 1 and a combination in 3 patients. Preoperative liver biopsies did not reveal cirrhosis in any patient. Portacaval shunt (3), portorenal shunt (2), mesocaval shunt (1), mesoatrial shunt (2) and devascularisation (1) were the operations performed. RESULTS: In 3 patients, side-to-side portacaval shunt was not possible because of caudate lobe hypertrophy (1), aberrant right hepatic artery (1) and presence of IVC stent (1); they required portorenal (2) or interposition mesocaval (1) shunts. Both mesoatrial shunts were unsuccessful. Devascularisation was effective in controlling the acute bleed. There was no intraoperative death. Postoperatively there were 3 deaths. Of the 6 survivors, 5 are asymptomatic over a mean follow up of 19.7 months. CONCLUSIONS: Side-to-side portacaval shunt is effective in the management of BCS; results with the mesoatrial shunt are disappointing.

Adult↗

Bleeding isolated gastric varices: a retrospective analysis.

OBJECTIVE: Isolated gastric varices (IGV) are rare and are believed to be associated with left-sided portal hypertension. We studied patients presenting with bleeding from IGV and compared them with those bleeding from both esophageal and gastric varices. METHODS: A retrospective analysis of 14 patients with bleeding from IGV was carried out. Portovenography findings (pattern of collateralization and natural shunts) in these patients were compared with a matched group of 69 patients with both esophageal and gastric varices. RESULTS: Of 14 patients with IGV, 2 had isolated splenic vein thrombosis and 12 had generalized portal hypertension. Portovenograms in 11 of the latter 12 revealed predominantly 'left-sided' collateralization in 8 patients as compared to 17 of 69 (25%) patients with esophageal and gastric varices (p = 0.004); natural shunts were seen in 6 of 11 cases and 15 of 69 (22%) patients in the two groups, respectively (p = 0.05). Abdominal devascularization operation gave good short- and long-term control of bleeding. CONCLUSIONS: Contrary to belief most patients with isolated gastric varices may have generalized portal hypertension rather than splenic vein obstruction as the cause and hence should be treated by a more extensive procedure than just splenectomy. The IGV could be a result of predominant collateralization to the retroperitoneal area (left-sided collateralization and natural shunts) rather than the usual pattern to the azygos system which results in esophageal varices.

Esophageal and Gastric Varices↗

Use of adrenal vein conduit for splenorenal shunts: a case report.

We report a case with extrahepatic portal venous obstruction (EHPVO), who presented with recurrent bleeding following a previous devascularization procedure and needed an emergency distal spleno-renal shunt (DSRS). Due to technical difficulty because of previous scarring, the adrenal vein was used as a conduit between the splenic vein and renal vein. The shunt's patent and the patient has been bleed-free for 2 years.

Adolescent↗

Laparoscopic spinal fusion.

We have reviewed the history of laparoscopic fusions and our results over the past two years, utilizing a femoral ring allograft and bone graft in 51 patients. The rate of fusion in this series is nearly 100%, with relief of radicular pain in about 90%. The average hospital stay is approximately two days and return to work is about six weeks. Minimally invasive techniques for spinal surgery will evolve with time and will become the standard of care in the near future.

Diskectomy↗

Neuroendocrine differentiation in hepatocellular carcinoma.

A patient with hepatocellular carcinoma with neuroendocrine features is reported. Identification of this tumor is essential due to its aggressive behavior and the differences in the treatment and clinical control of the patient.

Aged↗

Tuberculous cold abscess simulating pancreatic pseudocyst.

A patient with a peripancreatic lymph node tuberculosis mimicking pancreatic pseudocyst is reported, which was diagnosed on exploration to be a tuberculous cold abscess. The patient responded to antituberculous drugs after drainage of the cold abscess.

Abscess↗

Gastric angina secondary to acute thrombosis of celiac artery.

We report a 48-year-old woman with foregut ischemia with splenic infarct due to isolated celiac artery obstruction. The patient presented with acute-onset pain in the epigastrium 10-15 min after every meal. Investigations revealed obstruction of the celiac artery by artheromatous plaque. This patient had an acute thrombosis, which responded to anticoagulation.

Acute Disease↗