Changes in myocardial & aortic lipids, lipolytic activity & fecal excretion of sterols & bile acids in isoproterenol-induced myocardial infarction in rats.
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Animals↗
Biomedical subjects
S Mathew
Publications and source records attributed to S Mathew.
ABO blood groups and fertility--with special reference to intrauterine selection due to materno-fetal incompatibility.
The purpose of the present investigation was to study whether there is differential fertility between different mating types of ABO blood group system. Selective force which is operating through maternal-fetal incompatibility has been observed in the differential fertility between compatible and incompatible mating groups in the present sample of 183 families of Visakhapatnam town of Andhra Pradesh,India. The differences in the mean numbers of pregnancies as well as living children between the two major mating groups, compatible and incompatible are significant. The fertility rates of O fathers and O mothers were significantly higher than those in matings in which neither parents belongs to O. The selection is operating to reduce the gene ratio of A and to increase the gene ratios of O and B in this sample.
ABO Blood-Group System↗
Epidemic gastroenteritis in children associated with rotavirus infection.
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Child, Preschool↗
The contribution of cytologic imprints of stereotactically guided core needle biopsies of the breast in the management of patients with mammographic abnormalities.
Between 1995 and 1996, 96 consecutive patients with nonpalpable breast lesions detected by abnormal mammogram underwent core needle biopsies under stereotactic guidance at Johns Hopkins Bayview Medical Center. The cytologic diagnoses rendered on touch imprints and the histopathologic diagnoses made on the core needle biopsies were retrospectively reviewed to ascertain the accuracy and the validity of this procedure. These imprints were made of the cores as on-site evaluation in order to assist the radiologist. Separate diagnoses were rendered on the imprints and the cores. Follow-up excisional/open biopsies were then correlated to determine the usefulness of making touch imprints from the core needle biopsies toward the overall management of a patient with an abnormal mammogram. The core needle biopsies were obtained with a 14-gauge needle and biopsy gun. The cytologic diagnoses rendered on touch imprints and histopathologic diagnoses on core needle biopsies were compared and the concordance rate was determined. The subsequent surgical follow-up was analyzed and correlated with the imprint cytology and the core needle biopsy interpretation to ascertain the pathologic outcome. A total of 100 cases were reviewed: 4 patients had two lesions biopsied. Eighty-four cases showed complete cytohistologic correlation, that is, a high concordance rate. These 84 cases were divided into four categories: malignant (24), atypical (2), benign (55), and unsatisfactory (3). Of these concordant cases, there were 34 subsequent excisional biopsies and all except one confirmed the core needle biopsy diagnosis. The exception had a benign touch imprint and core but the excisional biopsy showed multifocal ductal carcinoma in situ. Of the 100 cases, 16 were nonconcordant (the cytologic diagnosis fell into a different category from the histologic diagnosis). Seven of these nonconcordant cases resulted in excisional biopsies and all but one showed the core diagnosis to be correct. The only exception was a case with atypical cytology and a benign core biopsy with the follow-up excision showing atypia. The rest of the nonconcordant cases with atypical imprints and benign cores had no follow-up surgery, showing that the clinicians are inclined to depend on the core biopsy diagnosis. While our study demonstrates the accuracy and concordance of cytologic touch imprints, the surgical follow-up data reveal that there does not appear to be any additive value to rendering a separate diagnosis on touch imprints of core needle biopsies.
Biopsy, Needle↗
Genetic studies on total finger ridge count among Telaganya Brahmins of Andhra Pradesh, India.
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Dermatoglyphics↗
Ameloblastoma. Cytologic findings and literature review.
OBJECTIVE: To define and elaborate the cytomorphologic features of primary and metastatic ameloblastoma (ABL) on fine needle aspiration (FNA) and to discuss the differential diagnosis with closely related entities and review the cytologic literature on the subject. STUDY DESIGN: A retrospective study consisting of five cases of ameloblastomas, primary in the mandible (n = 3) and metastases (n = 2), diagnosed by FNA cytology with appropriate cytohistologic correlation, was done. Smears were stained with the Diff-Quik and Papanicolaou methods. Hematoxylin and eosin-stained sections of paraffin block as well as sections from the surgically resected specimens were also reviewed. RESULTS: The smears were hypercellular and occasionally showed tissue fragments of basaloid cells with peripheral palisading. A distinct, two-cell population was seen, consisting of small, hyperchromatic, basaloid-type cells and scattered larger cells with more open chromatin. Occasional fragments of mesenchymal cells with more elongated nuclei and ample, clear cytoplasm were also noted. Malignant cases that metastasized showed prominent cytologic pleomorphism, cellular crowding with molding and a high mitotic/karyorrhectic index. CONCLUSION: In the right clinical setting and with proper radiologic evidence, the cytologic features of primary and metastatic ameloblastoma are unique. Diagnostic problems may arise when these lesions are pleomorphic and frankly malignant, especially at metastatic sites, such as the lung. FNA, therefore, is a valuable diagnostic tool in the initial diagnosis and follow-up of patients with a history of ameloblastoma.
Adult↗
Surgical presentation of melioidosis in India.
BACKGROUND: Melioidosis, the disease caused by Burkholderia pseudomallei, is common in Southeast Asia. It has also been reported from India, where some investigators feel it is under-diagnosed and under-reported. We report our experience with melioidosis presenting as abscesses at unusual sites. METHODS: All consecutive patients with culture proven B. pseudomallei, who presented to a single surgical unit between 1995 and 1998, were evaluated. RESULTS: Three patients presented with splenic abscesses and one with a soft tissue abscess in the neck. One patient developed septicaemia. All patients responded favourably to ceftazidime and/or co-trimoxazole which was started as soon as the diagnosis was confirmed. CONCLUSION: Melioidosis is under-diagnosed in India, probably due to a low index of suspicion of this disease among clinicians. It should be considered as a possibility when abscesses are encountered at unusual sites. The pus must then be cultured to identify the causative agent.
Abscess↗
Conn's syndrome: a simple diagnostic approach.
BACKGROUND: Primary aldosteronism is usually diagnosed after a battery of biochemical tests and adrenal imaging. If an adrenal tumour (Conn's syndrome) is identified, patients need surgery. However, bilateral adrenal hyperplasia is treated medically. Till 1994, we diagnosed Conn's syndrome using simple biochemical tests and a CT scan of the adrenal glands. Aldosterone and plasma renin activity assay became available in our institution in 1994 and were used subsequently in the work up of patients suspected to have Conn's syndrome. We analysed our data to determine whether simple tests such as serum and urinary potassium values combined with CT imaging of the adrenal glands are adequate to arrive at a diagnosis in these patients. METHODS: All consecutive patients (n = 17) diagnosed to have Conn's syndrome, managed by the Departments of Endocrinology and Surgical Endocrinology of this institution during a nine-year period from 1990 to 1998, were studied retrospectively. RESULTS: Until 1994, Conn's syndrome was diagnosed after documenting hypertension, hypokalaemia, inappropriate kaliuresis, metabolic alkalosis and CT scanning to localize the tumour. Serum aldosterone and plasma renin activity (PRA) were used in addition since 1994. All patients underwent adrenalectomy after adequate preoperative preparation. There was no operative mortality. Postoperatively, normokalaemia was established in all patients. Persistent postoperative hypertension was present in 43.8% of patients. CONCLUSIONS: In our experience, Conn's syndrome could be diagnosed accurately with simple investigations and CT imaging of the adrenal glands. Extensive biochemical testing, including aldosterone and PRA assay, is helpful when the diagnosis is uncertain. While hypokalaemia is curable after surgery, residual hypertension persists in about 45% of patients.
Adrenal Gland Neoplasms↗
Predicting the composition of gallstones by infrared spectroscopy.
AIM: To determine the composition of gallstones in South India by comparing visual assessment with graphic interpretation of infrared spectra. METHODS: Infrared spectroscopy (IRS) was used in qualitative analysis of 168 gallstones from Tamilnadu, Kerala and Karnataka and compared with visual interpretation. The spectrum of cholesterol, calcium bilirubinate and calcium carbonate for each stone was correlated with visual inspection. RESULTS: Fifty four percent of gallstones were of pigment variety, 43% were of mixed and the remaining 3% were cholesterol gallstones as categorised by visual interpretation. Based on infrared spectrocopic interpretation the percentages were 58%, 39% and 2% respectively. There was a good agreement between the visual inspection and IRS in classification of gallstones (Kappa value 85%; 95% CI 77-93%). CONCLUSION: Visual inspection of gallstones can predict the composition of gallstone with good accuracy and was comparable to infrared spectroscopic interpretation.
Bilirubin↗
Percutaneous transluminal coronary angioplasty in patients over the age of 65 years.
PTCA performed in 672 patients (646 patients < 65 years and 26 patients > or = 65 years) from March 1986 to September 1990 consisting of 619 males and 53 females are being discussed for the purpose of comparison of the results between patients in the < 65 years and > or = 65 years age groups. It was found that diabetes mellitus (50 vs 24.4.%, P < 0.01), obesity (46.1 vs 26%, P < 0.05), and hyperlipidaemia (66 vs 37.1%, p < 0.01) had a higher incidence among the elderly. Of the total 1047 lesions observed, 662 lesions in the < 65 years age group and 37 lesions in the > or = 65 years age group were dilated by PTCA (1.02 lesions/patient and 1.4 lesions/patient respectively). The lesion morphology showed higher degree of irregular contour in the < 65 years age group (23.6 vs 8.1%, p < 0.05), though the number of lesions with PTCA attempted in all age groups were almost similar. Major complications included one MI (3.8%) and two deaths (7.6%) in the > or = 65 years age group. During followup (mean duration: 8.2 months > or = 65 years and 13.5 months < 65 years age group) significantly higher percentage of patients < 65 years were asymptomatic when compared to elderly (50.2 vs 15.4% p < 0.05). Angina status was same more often in the elderly (23.1 vs 2.8% p < 0.01). The cumulative rate for repeat PTCA was similar for elderly and younger patients.
Age Factors↗
Effect of inhaling heated vapor on symptoms of the common cold.
A double-blind, randomized study tested the efficacy of steam (technically, heated, humidified air) inhalation in the treatment of common cold symptoms. Two 20-minute treatments spaced 60 to 90 minutes apart were given at the time of enrollment. The active device (Rhinotherm, Netzer-Sereni, Beer Yaacov, Israel) delivered 40 L/min of saturated air at 40 degrees C to 42 degrees C, while the identical-appearing placebo delivered 2 L/min of ambient air at 20 degrees C to 24 degrees C. There were 34 patients in the placebo group and 32 in the active group. Significant improvements in the placebo-treated group were obtained on subjective symptom scores for nasal congestion, nasal drainage, and sneezing on isolated days during the treatment period (40%, vs 25% on day 3, 71% vs 60% on day 6, and 100% vs 67% on day 7). Improvement in nasal resistance as measured by rhinomanography was better in the placebo group than in the active group on day 7 (11% vs -6%). Our study demonstrated no beneficial effects of steam inhalation on common cold symptoms.
Adolescent↗
Evaluation of a cold staining method for acid-fast bacilli in sputum.
Comparison between the Ziehl-Neelsen staining method for acid-fast bacilli, applied with and without heating, was carried out in a controlled investigation using smears prepared from 306 sputum samples collected prior to treatment from suspected cases of pulmonary tuberculosis. Smear and culture positivity were graded and the colour intensity of bacilli recorded. Results showed that the chance corrected agreement (Kappa) between Z-N and cold methods was only 78%. The sensitivity of the Z-N and cold methods were 84% and 77% respectively when compared with culture results. Assuming 10% smear positivity among symptomatics reporting to Peripheral Health Institutions (PHIs), the positive predictive value of the cold method was very low (53%). When compared to culture, the positive predictive value is 71% for the Z-N method and 57% for the cold method for a symptomatic population with 15% culture positivity. In the absence of heating, penetration of the stain was significantly reduced and consequently the number of bacilli detected was less. The inability to take the stain without heating was seen in smears from all grades of culture positive samples; thus even heavy positives were missed by the cold method. The evaluation of the cold method against the standard Z-N method highlights its limitations and demonstrates that it is not as reliable as the standard Z-N method.
Bacteriological Techniques↗
Role of two-dimensional echocardiography in early diagnosis of suspected acute dissection of ascending aorta.
Seven patients with acute dissection of ascending aorta are presented and the role of two-dimensional echocardiography in the early diagnosis of this condition is emphasized. There were 5 male and 2 female patients. The mean age of the patients was 36.7 +/- 11.2 years. The presenting symptoms were chest pain in 7, associated interscapular pain in 4, dyspnoea in 4 and syncopal episodes in 2 patients. Examination revealed hypertension in 3, pulses paradoxus in 2, asymetrically weak carotid and brachial pulses in 3, aortic regurgitation in 5 and neurological deficit in 2 patients. Echocardiography showed aortic root diameter of 42mm and the presence of an intimal flap in all the 7 patients and flap oscillations in 6 patients. Echocardiographic evidence of pericardial effusion was present in 6, cardiac tamponade in 3, aortic regurgitation in 5 and regional left ventricular wall motion abnormality in 1 patient. Surgical correction was done in 5 patients with 60% success rate. Two patients received only medical treatment. Aortic root dilatation of 60 mm, presence of an oscillating flap, evidence of cardiac tamponade and regional wall motion abnormality were found to be associated with poor prognosis.
Acute Disease↗
Is vegetarianism a precipitating factor for gallstones in cirrhotics?
AIM: To study the association of factors such as alcohol, smoking and vegetarianism with presence of gallstones amongst cirrhotics. PATIENTS AND METHODS: Data on alcoholism, smoking and vegetarianism was collected from the case records of 669 cirrhotics with (76) or without gallstones (593) retrospectively. Relative risk for the factors was computed individually and in combination controlling for the effects of alcoholism and smoking on vegetarianism. RESULTS: Alcoholism and smoking were of low relative risk [R.R-1.27 (95% CI 0.82 to 1.96), and 1.02 (95% CI 0.65 to 1.61) respectively] while vegetarianism was associated with high risk for gallstone formation in cirrhotics [R.R 2.74 (95% CI 1.65-4.53)]. Vegetarian men had a relative risk of 3.02 (95% CI 1.75-5.22) irrespective of their alcoholic status. If women were alcoholic the relative risk increased to 7.03 (95% CI 3.26-15.12). Controlling for effects of gender and alcoholism, vegetarian cirrhotics had a 3 times greater risk for gallstone formation [Mantel Haenszel Relative Risk 3.18 (95% CI MHRR 1.82-5.56)]. CONCLUSIONS: Cirrhotic, vegetarian women in South India have a much higher risk for gallstones, if they are alcoholic. Alcoholic men who are vegetarians are at a greater risk for gallstone disease.
Alcoholism↗
Composition of gallstones in Coimbatore District of Tamil Nadu State.
BACKGROUND: Gallstones in northern India are predominantly of the cholesterol type; such information on gallstones in southern India is scant. AIM: To analyze the composition of gallstones from patients residing in Coimbatore District in Tamil Nadu State. METHODS: The stones were classified using the Bernhoft criteria and was correlated with the morphological characteristics. RESULTS: Of the 105 gallstones analyzed, 67 (63.8%) were of the pigment variety and 36 (34.8%) of the intermediate/mixed type. There were only two cholesterol stones. The mean proportions of cholesterol, bilirubin and calcium in the pigment and intermediate stones were 7.1%, 26.1% and 7.8% and 30.2%, 18.4% and 6.3%, respectively. The mean proportion of bilirubin in the pigment stones was higher than in the intermediate type. Morphologically, pigment stones were black in 55% and amorphous in 63%; the intermediate stones were hard in 50% and of variegated color ranging from yellow to ivory white in 61%; both cholesterol stones were multiple, hard and brown. CONCLUSIONS: There is a predominance of pigment and intermediate gallstones (98%) in this district. These stones have reduced cholesterol and an increase in bilirubin and calcium proportions.
Adult↗