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Biomedical subjects

S N Sinha

Publications and source records attributed to S N Sinha.

At least 19 recordsLinked to original sources

Chromatographic studies on the isolation of peroxydisulphate oxidation products of primaquine.

Eight compounds from peroxydisulphate oxidation of primaquine were fractionated on Bio-Gel P-2 column using water as an eluent. A HPLC method employing acetonitrile-methanol-1 M perchloric acid-water (30:7:1:95, v/v) as a mobile phase at 1.0 ml/min on microBondapak reversed-phase column and UV detection at 254 nm was developed for the separation and identification of different oxidation products of primaquine. A combination of Bio-Gel chromatography with reversed-phase HPLC was found to be the most suitable analytical technique for the semipreparative isolation of various products formed from the oxidation. Two oxidation products that were isolated had three or four times higher gametocytocidal activity as compared to primaquine.

Antimalarials

Initial parathyroid exploration: current trends in Australia.

BACKGROUND: An Australia-wide multicentre prospective study was undertaken to audit cases of initial parathyroid exploration between 1 January and 31 December 1992. One hundred and sixty-two cases were audited. The audit was designed to study pre-operative biochemical assessment, localization techniques and the technique of exploration. METHOD: A pro forma audit form was circulated to all Australian surgeons known to perform parathyroid surgery. Eleven responded. RESULTS: Free serum ionized calcium (iCa) was measured in 30% of cases, with the majority of pre-operative calcium assays being performed using total serum calcium (tCa). In 40 cases (29%) pre-operative localization techniques were used. These proved inaccurate in 10 cases. The intra-operative technique of localization with methylene blue infusion was used in 11% of cases. All four glands were biopsied in 11% of cases. No deaths were reported and a postoperative morbidity rate of 3.1% was noted. Eighty-eight per cent of patients were discharged within 5 days of surgery with a third going home within 48 h of neck exploration surgery. Only one patient (0.6%) required re-exploration for persistent hypercalcaemia due to a second adenoma. CONCLUSIONS: The surgical treatment of hyperparathyroidism can be regarded as safe, with minimum morbidity in experienced hands. Pre-operative localization studies in initial parathyroid exploration are not indicated.

Adolescent

Burns admissions to Port Moresby General Hospital 1978-1984.

A retrospective survey of 169 burns cases admitted to Port Moresby General Hospital was conducted for the period 1978 to 1984. A third of the patients were young children. Hot-water burns were the commonest type of injury, accounting for 43%. This was followed by accidental falls into a fire and suicidal kerosene burns, which accounted for 28% and 13% respectively. Post-burn contractures were the commonest long-term complications. Prevention of burns is theoretically very attractive but hard to achieve in rural and squatter populations who rely almost entirely on open fires for cooking and heating. Burns awareness campaigns by all government and community groups stressing the dangers of open fires and leaving children unattended would no doubt take a long time but might ultimately produce tangible results.

Adolescent

Immunohistochemical detection of p53 and the recurrence of rectal adenocarcinoma.

The relationship between immunohistochemical detection of the p53 tumour-suppressor gene and recurrence of disease in 66 cases of rectal adenocarcinoma treated at the Royal Hobart Hospital, Hobart, Tasmania, between 1984 and 1992 was investigated. Fifty-five per cent (n = 36) of patients demonstrated p53 nuclear immunoreactivity consistent with the presence of the stabilized protein derivative of a mutation at the p53 gene locus. No correlation between p53 immunoreactivity and tumour site, differentiation and stage was noted. An overall recurrence rate of 64% (n = 42) was noted. Multivariate analysis confirmed the absence of p53 immunoreactivity and anatomical site of tumour below 7 cm from the anal verge to be significant predictors of tumour recurrence (P < 0.001). A review of the current literature on p53 suggests caution in using the immunohistochemical detection of p53 to predict the clinical outcome in cases of rectal adenocarcinoma because of discordant results between studies.

Adenocarcinoma

Review of liver trauma management in Tasmania: an analysis of risk factors for mortality and morbidity.

A review of liver trauma treated by the major trauma care facilities of Tasmania in the 5 year period between 1989 and 1993 is presented. The aim of this retrospective review was to provide an audit of the management of liver trauma in the island of Tasmania and to analyse the risk factors contributing to mortality and major morbidity. Thirty-seven patients were treated with a median Injury Severity Score (ISS) of 14 (range 9-34). The overall mortality rate of this series was 5.8%. Age, mechanism of injury (blunt or penetrating), delay prior to hospital presentation and modality of treatment (operative or non-operative) were not significant risk factors for mortality and morbidity; however, transfusion requirement of over 10 units of blood (P < 0.005), ISS score of over 20 (P < 0.0005), haemodynamic instability at presentation (P < 0.05) and a Hepatic Injury Score (HIS) grade of 3 or more (P < 0.05) were statistically significant risk factors.

Abdominal Injuries

Binding pattern of eight different lectins in healthy subjects and patients with dysplastic and malignant lesions of the oral cavity.

The present investigation was undertaken to assess the binding characteristics of eight different lectins to normal oral mucosa (11 cases), leukoplakia with varying degrees of dysplasia (five cases), and oral mucosal squamous cell carcinoma (12 cases) by the use of biotinylated lectins and avidin biotin peroxidase complexes. The lectins employed were soybean (SBA), peanut (PNA), Dolichos biflorus (DBA), concanavalin A (Con A), wheat germ (WGA), Ulex europaeus (UEA), Ricinus communis (RCA), and Lotus tetragonolobus (LTA). It was observed that SBA, DBA, WGA, UEA, RCA, and LTA showed very strong to strong binding in healthy oral mucosa but no or very weak binding in squamous cell carcinoma. On the contrary, PNA showed weak binding to normal mucosal epithelial cells but showed strong binding to malignant cells. The dysplastic mucosa had an intermediate binding pattern. The lectin Con A was not bound at all or seen in very low concentration in the malignant cells and dysplastic epithelium, but it showed weak binding in the normal mucosa. Hence, we conclude that lectins may be utilized as probes to determine the dysplastic and malignant status of the oral mucosal epithelium.

Adult

Peptide alpha-amidation activity in human plasma: relationship to gastrin processing.

OBJECTIVE AND DESIGN: C-terminal amidation is an essential processing step towards bioactivation of many peptides including gastrin. This reaction is catalysed by peptidylglycine alpha-amidating mono-oxygenase (PAM, EC 1.14.17.3) which converts the glycine extended precursors on their carboxyl termini to the des-glycine amidated peptide products. In the case of gastrin, most of the amidation is thought to occur in the antrum. However substantial quantities of glycine extended gastrin and PAM are present in plasma. It is unclear whether circulating PAM reflects the secretory activity of the gastrin secreting cell or whether PAM is involved in the postsecretory processing of gastrin. The aim of the present study was to relate the circulating amidation activity to the plasma concentrations of glycine extended and amidated gastrins. PATIENTS AND MEASUREMENTS: Plasma PAM, gastrin-amide and gastrin-gly were measured in subjects with different gastrin secretory status: healthy subjects basally and following a meal, members of families with multiple endocrine neoplasia type 1 (MEN-1) with normal and high plasma gastrin, and patients with hypergastrinaemic atrophic gastritis. RESULTS: Patients with MEN-1 and hypergastrinaemia tended to have a higher plasma PAM activity than MEN-1 subjects with normal circulating G-NH2 indicating a cosecretion of hormone and PAM. However in contradistinction to patients with medullary thyroid carcinoma, PAM activity does not appear to be a useful tumour marker of gastrinoma. Hypergastrinaemia from a non-tumour source (hypergastrinaemic non-atrophic gastritis) was associated with a lower plasma PAM activity than in normal subjects and may reflect the secretion of a greater proportion of already amidated gastrin. In general, there was no relationship between plasma PAM activity and the ratio of amidated to non-amidated gastrin suggesting that circulating PAM was not involved in the amidation of gastrin. Feeding increased circulating gastrin but had no effect on plasma PAM activity. CONCLUSION: The results support the view that gastrin is amidated at the site of its synthesis and that hypergastrinaemia is associated with elevated plasma amidating enzyme activity only when the gastrin originates from tumour sources.

Anemia, Pernicious

Surgical thyroid disease in Papua New Guinea.

A clinical and histopathological analysis was carried out on 376 thyroid specimens removed under various diagnoses from the surgical clinics of Papua New Guinea over a period of 11 years (1980-90). Solitary nodular goitre (solid and cystic) was the most common clinical diagnosis. Nineteen per cent of the solid and 35% of the cystic solitary nodular goitres were found to be malignant. Malignant goitres were confirmed histologically in 73.3% of the clinically diagnosed cases of malignancy. The presence of amyloid goitre (1.9%) posed a significant diagnostic and therapeutic problem due to its clinical features resembling that of malignant goitre. Hemithyroidectomy (lobectomy) was the most common surgical procedure employed for all unilateral thyroid lesions and partial or subtotal thyroidectomy was performed for benign and most malignant lesions.

Adolescent

Early childhood mortality--a rural study.

The present study was conducted in 9 villages of Rural Health Training Centre, Jawan, Aligarh, India, having 1792 registered families. The infant mortality rate was 79.3 per 1000 live births. Higher mortality in children between 1-2 years (29.6/1000) in comparison to 2-5 years (16.2/1000) reflected the higher vulnerability of children below 2 years. Diarrhoea (21.2%) and neonatal factors (21.2%) were the major cause of infant mortality followed by pneumonia (18.2%) and tetanus (15.1%). Diarrhoea (32.2%), pneumonia (22.6%) and malnutrition (12.9%) were the major killers in children between 1-5 years. Mortality in females was higher than males in infancy. Risk factors associated with infant mortality included extremes of maternal age (< 20+ > 35 years) primipara or multipara and illiterate mothers.

Cause of Death

Intramural haematoma of the duodenum.

Intramural duodenal haematoma secondary to blunt abdominal trauma is a rare injury. One case is reported, and the clinical features, diagnosis and management are discussed.

Abdominal Injuries

Deliberate self-harm by means of kerosene fire by women in Papua New Guinea.

This paper reports the results of an investigation into the psychosocial and sociodemographic factors relating to 10 females admitted to the Burns Unit of the Port Moresby General Hospital with a common diagnosis of deliberate self-inflicted burns by kerosene fire. All 10 patients were admitted during the first six months of 1990 and all originated from Gulf Province. 6 of the 10 patients died despite intensive, standard surgical management. Discussion of the results centres around the possible causes of the sudden increase in the number of patients presenting with burns caused by self-inflicted kerosene fire. Recommendations are made for some preventive measures.

Adolescent

Clinicopathological features of primary gastrointestinal lymphomas: a study of 42 cases.

The clinicopathological features of 42 patients with gastrointestinal lymphoma during the period 1982-88 are described. Ten cases (23.8%) were seen in the stomach, 23 cases (54.8%) in the small intestine and 9 cases (21.4%) in the large intestine. In 4 cases multiple sites were involved. The tumours occurred most frequently in the 2nd to 4th decade. Histologically, using the working formulation for non-Hodgkin's lymphoma, all were found to be diffuse and mostly of the high grade type (45%). Seven lymphomas were seen in children. Three were of the Burkitt's type. Patients presented quite late in a large number of cases (43%). Compared with most other published series small intestinal involvement was common. There was a high incidence in males. Predominant small intestinal involvement did not result in malabsorption syndrome and primary lymphomas constituted 3.5% of all malignancies of the gastrointestinal tract.

Adolescent

Trauma patients in an Indian hospital.

The study was carried out at the Emergency Department of Jawaharlal Nehru Medical College Hospital, Aligarh Muslim University, Aligarh, India, to ascertain the pattern of trauma in the patients. A total of 2446 trauma cases were recorded in the year 1987. Accidental falls were the commonest cause of injury, i.e 35.7%, followed by motor-vehicle collisions (23.5%), pedal cyclists (8%), occupational injuries (5.2%) and sports injuries (5.2%). The commonest age group involved was 5-15 years which accounted for 32.8% of all trauma. Fractures (44%) were the most frequently observed nature of injury. Death due to trauma was highest in motor-vehicle collisions (31%) followed by accidental falls (16%), and occupational injuries (12%).

Adolescent

Anthropometric measurements in rural school children.

Anthropometric measurements of 1012 rural school-going children, selected randomly, were performed. There were 776 males and 236 females in the age group of 5-15 years. The values of weight and height were recorded for every child in the study sample. Age and sex break-up was studied and compared with the ICMR (Indian Council of Medical Research) standard. The comparison made separately for boys and girls showed that the values for both sexes and in all age groups were less than the ICMR standard. The majority (83.6%) of the children belonged to the middle and low social class according to the modified Prasad's classification. An inference is, therefore, drawn that rural school children of middle and low socio-economic status are shorter and lighter as compared with even their own counterparts on whom the ICMR values are based. The state of health of school-going children in India is far from satisfactory despite the fact that school health programmes along with other nutritional programmes have been in operation for several decades. School-going children constitute a sizeable section of India's population, i.e. about 27%, which is easily accessible and also receptive. An early and convenient method of assessing nutritional and socio-economic status of growing children is anthropometry. Physical growth, in terms of weight and height, is considered an important parameter reflecting the pattern of growth and development in a community. In the developing countries, the growing children by and large are deprived of good nutrition on account of their poor socio-economic status, ignorance and lack of health promotional facilities. This nutritional deprivation results in relative stunting of growth.

Adolescent