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Biomedical subjects

S Shah

Publications and source records attributed to S Shah.

At least 487 records · Page 27Linked to original sources
PubMedDate not supplied

Patients with inflammatory bowel disease: their response to information leaflets about medical therapy in particular azathioprine.

Thirty-eight patients with inflammatory bowel disease who had been treated with azathioprine were asked to complete an anonymous questionnaire about information they had received on the drug. Twenty responded of which 16 recalled having had information on azathioprine. Recall of the content on an information leaflet was poor with up to 25% of patients failing to recall warnings about side effects. Documentation of this advice on the clinical notes was also poor with this happening in only one case. This failure to both recall and record information must increase the chances of successful litigation.

Azathioprine↗
PubMedDate not supplied

Increased promoter diversity reveals a complex phylogeny of human immunodeficiency virus type 1 subtype C in India.

OBJECTIVE: To evaluate human immunodeficiency virus type 1 (HIV-1) long terminal repeat (LTR) sequence diversity among distinct populations within India and to determine the prevalent subtype. STUDY DESIGN/METHODS: Analysis of the 3'LTR was conducted from 28 HIV-1-positive samples: 1992-1993 (Pune, New Delhi) and 1995-1996 (Pune, Mumbai and Vellore). Genomic DNA was extracted from cocultivated peripheral blood mononuclear cells (PBMCs) and used for polymerase chain reaction (PCR) amplification and sequencing using dye terminator chemistry. Sequences were edited, aligned, and analyzed phylogenetically utilizing gap-stripped and bootstrapping parameters. Mobility shift assays were used to confirm binding activity. RESULTS: All nucleotide sequences were HWV-1 subtype C based on phylogenetic analysis. The isolates from Pune/Delhi formed subclusters when analyzed separately, irrespective of time or sample source. However, no significant subclustering was observed with isolates from Mumbai or Vellore or with the entire sample set when analyzed collectively. Subtype-specific enhancer analysis revealed an expected third NF-kappaB site but also revealed six isolates with insertions and deletions not previously described, one of which resembles an AP-1 binding site. CONCLUSIONS: The results confirm the prevalence of HIV-1C and suggest increasingly complex phylogeny of HIV-1C within India, such that the previously observed subclustering may no longer adequately reflect the diversity of isolates currently circulating throughout India.

Base Sequence↗
PubMedDate not supplied

Finding information on herbal therapy: a guide to useful sources for clinicians.

Many resources are available to patients and healthcare practitioners interested in learning about complementary and alternative medicine (CAM) therapies such as herbal medicine. This article provides a comprehensive review of herbal medicine sources that are general in scope, clinically oriented, evidence based, and focused on Western phytomedicinals. Tables list 15 books and 8 Internet sites that fulfill these criteria. Information also is provided on 4 monographs, literature databases, and many related sources that may be of interest to clinicians incorporating herbal medicines into their practice or counseling patients on the topic.

Books↗
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Diabetes insipidus after pituitary surgery: incidence after traditional versus endoscopic transsphenoidal approaches.

The endoscopic transnasal approach is gaining increasing popularity as the surgical method of choice for treatment of pituitary lesions. Previous studies have shown advantages such as quicker recovery and fewer cosmetic, dental, and nasal complications. However, no study has compared the rate of diabetes insipidus (DI) between the traditional and endoscopic approaches. This study will examine the incidence of short- and long-term postoperative DI after transnasal pituitary surgery and compare it with the incidence after traditional transseptal surgery. Eighty-one patients underwent transnasal surgery for the management of pituitary lesions. Fifty-five had the traditional sublabial, transseptal, transsphenoidal surgery and 26 patients had the direct transnasal, transsphenoidal endoscopic procedure. The incidence of immediate postoperative DI was 36% in the traditional group and 15% in the endoscopic group. Short-term (>2 weeks) DI that required treatment occurred in 11 patients (20%) in the traditional group and 2 patients (7.6%) in the endoscopic group. Long-term (>6 months) incidence of DI was 7.2% in the traditional group and 3.8% in the endoscopic group. We found a decreased incidence of immediate DI after transnasal endoscopic pituitary surgery as compared with the traditional sublabial transseptal approach. However, the incidence of long-term DI was not significantly different in the two groups.

Adenoma↗
PubMedDate not supplied

Management of cardiomyopathy resulting from incessant supraventricular tachycardia in infants and children.

BACKGROUND: Radiofrequency ablation is considered to be the treatment of choice in patients with ventricular dysfunction related to incessant supraventricular tachycardia. However, reservations regarding its use in infants and children prompted us to try alternative strategies for this group. METHODS AND RESULTS: Eight children (age range: 1 day to 10 years) were diagnosed to have tachycardia-related ventricular dysfunction in the past 6 years. They presented with symptoms of palpitation, dyspnea and/or generalized swelling over the body of 3 months to 2 years'duration. The cardiothoracic ratio at presentation was 64% (52%-70%) and ejection fraction was 22.2% (15%-45%). In 7 patients tachycardia was diagnosed to be ectopic atrial and in 1 it was permanent junctional reciprocating tachycardia. Six of these children were managed with intravenous/oral amiodarone in combination with digoxin (3) and/or propranolol (2). In one child addition of amiodarone to digoxin and propranolol led to polymorphic ventricular tachycardia, and amiodarone was withdrawn. Only one child underwent radiofrequency ablation as the first choice because regular follow-up was not possible due to logistic reasons. Sinus rhythm with normalization of ventricular function was achieved in 6 of the 7 children treated medically. One child continued to have frequent episodes of tachycardia and underwent successful radiofrequency ablation of a high right atrial ectopic focus. Two out of the 6 patients on amiodarone could be managed with only digoxin and propranolol after their ventricular function had returned to normal. A third patient relapsed on stopping amiodarone and underwent successful radiofrequency ablation of a left atrial ectopic tachycardia. CONCLUSIONS: Short-term amiodarone in combination with digoxin/propranolol is a safe and effective treatment strategy for infants/children with tachycardiomyopathy. Control of tachycardia is achieved in the majority, leading to recovery of ventricular function. This approach may avoid unnecessary ablations in children or at least postpone it till the procedure would be safer.

Amiodarone↗
PubMedDate not supplied

Laboratory diagnosis of leptospirosis.

Leptospirosis is a worldwide zoonosis caused by pathogenic Leptospira species, for which humans are accidental hosts. It is endemic in the tropical urban areas including our country, where seasonal epidemics are becoming increasingly common. Laboratory tests are necessary to confirm the diagnosis of clinically suspected leptospirosis due to its varied symptomatology. Moreover, leptospirosis must always be considered during the differential diagnosis of other tropical febrile illnesses. Laboratory analysis depends on the samples available and temporal stage of the illness. A confusing array of laboratory tests is described for the detection of this spirochete and antibodies. The conventional tests include direct microscopy, culture and the most widely used reference standard method -the microscopic agglutination test. In addition a variety of newer serological tests and those based on molecular techniques have been described. This review has attempted to describe the basis of these techniques and discussed the relative advantages and drawbacks of these assays with special emphasis on the selection of the most appropriate specimen and test, and the correct interpretation of the test result.

Bacteriological Techniques↗
PubMedDate not supplied

Ruptured abdominal aortic aneurysm in a 24-year-old African woman. Unusual presentation--unknown aetiology.

CASE REPORT: 24-year-old black female presenting with progressive paralysis of the left lower limb. The clinical examination and investigations describe an extensive retroperitoneal mass. An exploratory laparotomy reveals a ruptured saccular infrarenal aortic aneurysm, a narrowing of the distal aorta and a complete obstruction of the left common iliac artery. The aneurysm was resected, an aortoiliac bypass and femorofemoral crossover bypass were performed, with success. The clinical presentation of this ruptured abdominal aneurysm is unusual. Its etiology is discussed: the findings are suggestive of Takayasu's disease.

Adult↗
PubMedDate not supplied

Evaluation of moisture penetration through skin protectant barriers by paper chromatography.

Currently, there is no convenient and safe experimental method in the literature to evaluate skin protectant formulations for barrier properties. A novel and simple experimental method, based on paper chromatography, was developed to screen a broad spectrum of skin protectants available for moisture penetration. The method involves the use of paper chromatography for determining the Moisture Penetration Rate through a thin barrier film of a given skin protectant product. It is simple, inexpensive, convenient, and safe and was used to evaluate 12 products currently used as skin protectants. This method can be used by formulators in their development efforts and by caregivers to determine the barrier properties of various products in a short period of time without expensive instrumentation or extensive time commitments. Skin irritation resulting from fecal and urinary incontinence is a common problem for geriatric patients (Fiers & Siebert, 1993, Talbot, 1994). Various products on the market today are used as protective barriers to prevent skin irritation from moisture penetration. However, from the caregiver's perspective, there is a need for identifying the best product or the relative ranking of products based on suitable test methods. There is a lack of suitable in vitro test methods to screen skin protectant barriers (Guillemin, Murset, Lob, & Riquez, 1974; Pigatto, Bigardi, Legori, Altomare, & Finzi, 1993) on the market. For any method to be acceptable it must be convenient, simple, reproducible, and safe for use on human volunteers. More importantly, it must have clinical relevance.

Administration, Cutaneous↗
PubMedDate not supplied

Surgery for thyroid goiter in western India. A prospective analysis of 334 cases.

334 consecutive cases of thyroid swellings operated by a single surgical unit over 9 years have been analysed prospectively. There was a female preponderence (4.39:1). The swellings were clinically differentiated into uninodular (39.52%), multinodular (47.31%) and diffuse (13.17%). Hyperthyroidism was manifested in 49 cases (14.67%). Pressure symptoms were present in only 1.5% cases. FNAC detected malignancy in 14 of 162 cases (8.64%). The initial 100 cases were operated upon by standard Lahey's technique and the latter 234 by modified technique described by Bapat et al for benign thyroid disease. Operations performed included nodulectomies (5.39%), hemithyroidectomies (41.92%), partial thyroidectomies (25.75%), subtotal (25.45%) and near total thyroidectomies (1.5%). Post-operative complications were higher in the first group and included unilateral cord palsies-5 (5%). hypocalcemia-4 (4%) hypoparathyroidism-1 (1%) haemorrhage-1 (1%) and mortality-1 (1%) vis a vis cord palsies-2 (0.85%), hypocalcemia-3 (1.28%), hypoparathyroidism-1 (0.43%) and there was no mortality. Histopathology revealed 83 (24.85%) colloid goiters, 193 (57.78%) nodular goiters, 21 (6.29%) follicular adenomas, 7 (2.10%) cases of thyroiditis and 30 (8.98%) malignancies. This study reveals the lower incidence of RLN palsy after modified thyroidectomies, and a low incidence of malignancy.

Adolescent↗
PubMedDate not supplied

A multicentre study of the safety and efficacy of amlodipine in mild to moderate hypertension.

An open, non-comparative study of 10 weeks' duration was conducted in general practice to assess the safety of amlodipine in patients with mild to moderate hypertension. Of the 5352 patients entering the study, 5135 received amlodipine; 4621 patients (90%) with a mean age of 58.2 years completed the study. Normalisation of blood pressure was achieved in over 80% of patients with a mean reduction of 21/15 mmHg. The mean final dose of amlodipine was 6.8 mg/day. Adverse experiences possibly related to amlodipine were reported by 19.3% of patients, and overall adverse events led to withdrawal in 6.7% of patients. The most common reported side-effect was oedema. The frequency of headache was almost identical in older and younger patients and oedema, flushing and dizziness were seen only slightly more often in elderly patients. Ninety per cent of patients were considered by their GP to have shown excellent or good toleration of therapy. Over 85% of patients elected to continue on amlodipine therapy after completion of the study.

Adolescent↗