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Biomedical subjects

S Singh

Publications and source records attributed to S Singh.

At least 163 records · Page 9Linked to original sources
PubMed2003

Non-adherence to tuberculosis treatment in the eastern Tarai of Nepal.

SETTING: Tarai districts, eastern Nepal. OBJECTIVES: To identify potential methods of increasing adherence to tuberculosis (TB) treatment by determining factors that patients felt influenced adherence. METHODS: New pulmonary TB patients registered from July to November 1998 with an outcome of non-adherence to treatment (NA) were identified from District TB Registers, traced and interviewed using a semi-structured questionnaire. An equivalent number of adherent (A) patients were interviewed. RESULTS: Of 81 NA patients traced, 30 were interviewed, 16 had been incorrectly classified, age was incorrectly recorded in four, 13 had migrated and 18 were not found. The groups were similar in demographics, type and knowledge of TB. More A patients knew their diagnosis (P = 0.07) and reported haemoptysis as an initial symptom (P = 0.03). NA patients had longer travel to a health facility (P < 0.001), and fewer had been informed by health care workers (HCW) about the consequences of not completing treatment. The most common reasons given for stopping treatment were side-effects, HCWs' mistakes or behaviour, and health service failure. Desire for cure and knowledge that TB was curable were most the important reasons for completing treatment. CONCLUSION: Non-adherence seemed related to treatment delivery failures. The health system needs strengthening in Nepal. Intensified HCW training and supervision, better health education for patients and families, more flexibility for treatment supervisors, adequate supplies for treatment centres and decentralisation of treatment delivery to the lowest health service level practicable are urgently needed.

Adolescent↗
PubMed2003

7th Yahya Cohen Lecture. Significance of the lateral epiphysis of the acetabulum to hip joint stability.

Normal development of the acetabulum is crucial to the growth and stability of the hip. Twenty-five New Zealand white rabbits (postweaning) weighing 1.5 to 2.2 kg were used. Both hips were exposed through an anterolateral approach. On the right hip, a fixed area of superolateral physeal cartilage was damaged with drills. Sham open reduction was performed for the left hip. Radiographic changes of the right hips were evident at 6 weeks. At 12 weeks, the right hip dislocated in a posterior and superior direction. The left hip remained normal. Histopathologic analysis correlated strongly with the radiographic findings. There were thinning of cartilage cells of the acetabulum, with disorganisation. The acetabular roof was poorly formed. The lateral acetabular epiphysis is vital to the development of the acetabular roof. Damage to this epiphysis may result in acetabular maldevelopment and subsequent hip instability. We tested the hypothesis that abnormality in this epiphysis can give rise to abnormal acetabular development.

Acetabulum↗
PubMed2003

Annual risk of tuberculous infection in rural areas of Uttar Pradesh, India.

SETTING: Rural areas in Uttar Pradesh, the most populous state in India. OBJECTIVES: 1) To estimate the average annual risk of tuberculous infection (ARI), 2) to study ARI trends with age, and 3) to compare tuberculin reactions among children with and without BCG scar. STUDY DESIGN: A cross-sectional tuberculin survey was conducted among children aged 1-9 years residing in Rae Bareli, Hardoi and Jaunpur districts, Uttar Pradesh. Tuberculin testing was performed using 1TU of PPD RT23 with Tween 80, and indurations were measured 72 hours later. Prevalence of infection was estimated in children without BCG scar based on the cut-off point identified on the frequency distribution of reaction sizes. The ARI was computed from the estimated prevalence. RESULTS: The proportion of children with BCG scar varied from 25% to 31% in the study districts. Using a cut-off of 14 mm among children without BCG scar, the ARI was estimated at 2.3% in Rae Bareli, 1.9% in Hardoi and 1.5% in Jaunpur, and was observed to increase with age. Tuberculin test results among children with BCG scar suggest that they may be included in tuberculin surveys to estimate ARI. CONCLUSION: High rates of transmission of tuberculous infection suggest that tuberculosis control measures need to be intensified.

Adjuvants, Immunologic↗
PubMed2003

Regional gastrointestinal permeability of rifampicin and isoniazid (alone and their combination) in the rat.

OBJECTIVE: To determine if rifampicin (RMP) and isoniazid (INH) are absorbed from different gastrointestinal tract (GIT) sites, and to ascertain the feasibility of producing new fixed-dose combination (FDC) products containing RMP and INH by segregating drug delivery at different sites along the GIT. DESIGN: Permeability of RMP and INH (alone and in combination) was determined in various segments of rat GIT (stomach, duodenum, jejunum and ileum) at concentrations of respectively 2.4 and 1.2 mg/ml, using a ligated loop technique. Drug analysis was performed by HPLC. Extent of absorption was considered as the total drug disappearing from the loop. Permeability was correlated with solubility and decomposition data at pH corresponding to different GIT sites. RESULTS: RMP was well absorbed from the stomach due to its solubility, which was maximum between pH 1-2. INH was poorly absorbed from the stomach, but was well absorbed from all three segments of the intestine. In combination, RMP disappearance was enhanced in the presence of INH in the stomach and jejunum, but INH disappearance was not influenced by RMP. CONCLUSION: The study shows higher in situ RMP disappearance in the presence of INH, attributable to drug degradation due to catalysis by INH. As the two drugs show regional specific permeability, FDCs without reduced RMP bioavailability resulting from its decomposition in the presence of INH can be designed by segregating delivery of the two drugs by around 3-4 h. RMP should be released in the stomach and INH in the intestine.

Animals↗
PubMed2003

Issues of environmental compliance in developing countries.

Environmental laws define the scarcity of environmental resources as they affect the factor endowment of a country and therefore its position in the international division of labour. There is now also a general agreement that applying the "polluter pays" principle should solve environmental problems. As the burden of abatement increases, as measured by the ratio of abatement expenditure to sales, there is definitely an incentive for firms to either invest in cleaner technology or more efficient abatement technology. There is also evidence that taxes and charges, designed to internalise externalities, can actually affect trade. It is interesting to know if the developing countries face particular market access problems in the face of stringent environmental standards and regulations. While it is true that stringent measures impose market access restrictions and cause limitations on competitiveness, this is much more widely felt by the developing countries because of lack of infrastructure and monitoring facilities, limited technology choices, inadequate access to environment-friendly raw materials, lack of complete information, presence of small-scale exporters and emergence of environmental standards in sectors of export interest to developing countries. The small and medium enterprises often divert sales either to the domestic market or to external markets where environmental requirements are less stringent, in order to save on their costs. In developing countries, 80% of the tanning industry is comprised of small and medium enterprises (SMEs) processing raw to semi-finished leather, usually less than 2 tons per day. In Europe and other developed countries the SMEs in the leather sector have vanished due to strict environmental legislation and this will likely occur in developing countries also. The environmental legislation has not always been practical, either because the laws are too ambitious or unrealistic in certain parameters, or because they have lacked effective instrumentation and institutional support. Some environmental regulations have not succeeded as they do not match the technical requirements and economic reality of the country or region, or because they do not take the institutional capabilities of the society that has to implement them into consideration. For the survival and sustenance of the SMEs in the leather industry, it may be a viable alternative to carry out the tanning process in a decentralized fashion such that the raw to semi-finished process is carried out in the large scale sector while the semi-finished to finished process could either be reserved or open to competition as per the countries' requirements. But the issue of concern is whether it is fair that the raw to semi-finished tanning process, containing 70% of the pollution discharge should be undertaken by developing countries alone, especially if it is at the cost of their survival! However, the game analysed in the paper reveals that tanning units in developing countries would prefer to comply with the regulations and stay in the industry, the alternatives being to collude or to compete!

Commerce↗
PubMed2003

A study of malnutrition among children aged 6 months to 2 years from a resettlement colony of Delhi.

Nutritional status of 1661 children aged 6 months to 2 years who attended the Well Baby Clinic of UHC Gokulpuri, Delhi during the year 2000 was studied. 60.7% of them were malnourished. Undesirable practices of discarding the colostrum, not exclusively breast feeding the child till at least 4 months of age, delayed weaning, dilution of top milk, use of bottle and nipple for feeding the children are still widely prevalent.

Age Factors↗
PubMed2003

Isolated lipid abnormalities in rural and urban normotensive and hypertensive north-west Indians.

BACKGROUND: Lipid abnormalities are common in patients with hypertension. The prevalence of isolated lipid abnormalities is not known in normotensive and hypertensive population of north-west India. METHODS: We studied the prevalence of isolated low high density lipoprotein cholesterol (IL-HDLC), isolated high low density lipoprotein cholesterol (IH-LDLC) and isolated high triglycerides (IH-TG) abnormalities among rural and urban normotensive and hypertensives of north-west India. RESULTS: The prevalence of lipid abnormalities was 47.6% and 51.4% in rural normotensives and hypertensives and 43.8% and 46.8% in urban normotensives and hypertensives respectively. The prevalence of IL-HDLC varied from 3.8% to 23.7% among hypertensives and 19.4% to 30.4% among normotensives. The prevalence of IH-TG abnormalities was 11.8% to 18.8% among hypertensives and 7.0% to 15.4% among hypertensives. The prevalence of isolated high LDLC abnormalities was low (0.8-9.2%). There was no significant difference in these abnormalities in relation to age and sex except IH-LDLC in male hypertensives. CONCLUSION: Isolated low HDLC and isolated high TG were the commonest isolated lipid abnormalities among rural and urban population of north-west India whereas isolated high LDLC was uncommon.

Adult↗
PubMed2003

Homocysteine and lipid levels in young patients with coronary artery disease.

AIMS AND OBJECTIVES: Indians are more prone to premature coronary artery disease (CAD). The importance of homocysteine as a risk factor for CAD in Indian patients needs to be recognized. The aim of this study was to note the independent association of this novel risk factor with traditional ones in young CAD patients. METHODOLOGY: This study included 51 patients, < 45 years of age, with proven CAD. They were further divided into two subgroups based on their lipid profile. Group A (n = 30) hyperlipidemic CAD patients and Group B (n = 21) normolipidemic CAD patients. They were compared with 15 age and sex matched healthy controls. Plasma homocysteine was assayed using high pressure liquid chromatography, fasting lipid profile and other risk factors were compared. RESULTS: The mean level of homocysteine in patient group was 27.8 +/- 13.11 nmol/ml. In subgroup A it was 28.86 +/- 13.02 while in subgroup B it was 26.46 +/- 13.44. In the patient group (n = 51), 37 (72.55%) had homocysteine levels greater than 18 nmol/ml. In the control group mean homocysteine was 13.22 nmol/ml +/- 7.36 and only 4 (26.77%) had homocysteine levels greater than the cut-off. CONCLUSIONS: Thus in spite of some baseline variations, plasma homocysteine emerged as a significant (p = 0.0009, OR 6.05) independent risk factor for young CAD patients and was not altered by the baseline lipid profile of the patient. Therefore it should be evaluated in all young patients of CAD in the absence of traditional risk factors.

Adult↗
PubMed2003

Isolated fourth ventricular cysticercus cyst: MR imaging in 4 cases with short literature review.

We describe the magnetic resonance imaging (MRI) signal characteristics of isolated (solitary lesion) intra fourth ventricular cysticercus cyst in 4 patients who clinically presented with obstructive hydrocephalus. All patients had routine MRI sequences (T1, T2, & proton density-weighted imaging), Fluid Attenuation Inversion Recovery (FLAIR), and post-gadolinium imaging followed by cerebrospinal fluid (CSF) flow study. It revealed a CSF signal intensity (on all pulse sequences), intra fourth ventricular cyst with a nidus (scolex), and wall enhancement. On T1-weighted and FLAIR images, the cyst wall and nidus (scolex) were seen in 3 cases, which were not seen in other routine sequences. The CSF flow study showed the intraluminal nature of the cyst. The MRI features suspected a cysticercus cyst, and per-operative findings and histopathological examination confirmed the diagnosis. The review of literature of the intra fourth ventricular cyst is briefly discussed.

Adult↗
PubMed2003

Comparison of the effect of topical fluorides on the commercially available conventional glass ionomers, resin modified glass ionomers and polyacid modified composite resins--an in vitro study.

This study was undertaken to assess the effect of a single application of three professionally applied topical fluoride agents (Sodium fluoride 2%, Stannous fluoride 8% and APF 1.23%) on the surfaces of six modern esthetic restorative materials used in pediatric dentistry viz., two conventional glass ionomers (Fuji II and Shofu-restorative), two resin modified glass ionomers (Vitremer, with and without glaze, and Photac-fil Quick) and two Polyacid modified composite resins (Luxat and Hytac Aplitip). Mean surface roughness and surface micro hardness (SMH) measurements were the parameters employed for comparison. Results showed that APF gel applications significantly increased the surface roughness measurements and decreased SMH of all tested materials, which was pronounced in conventional glass ionomers when compared with resin modified glass ionomers and polyacid modified composite resins. NaF and SnF2 produced a statistically significant increase in the surface roughness of conventional glass ionomers without any significant change in surface roughness and SMH on rest of the materials tested, except for NaF on SMH values of Fuji II, which was statistically significant.

Acidulated Phosphate Fluoride↗
PubMed2003

Pituitary tuberculoma: magnetic resonance imaging.

A case report of a pituitary tuberculoma, with magnetic resonance imaging (MRI) features is described. The patient was treated with anti-tuberculous chemotherapy, and a follow-up MRI after 6 months showed good response. The relevant literature is briefly reviewed.

Adult↗
PubMed2003

Herniation of the buccal fat pad into the oral cavity: a case report.

An interesting lesion is presented, wherein a tiny traumatic perforation of the buccal mucosa and buccinator muscle forced a large portion of the buccal fat pad to extrude into the oral cavity. Such a situation can alarm any clinician & reinforces the importance of careful history taking and thorough examination, before treating patients.

Accidental Falls↗
PubMed2003

Human immunodeficiency virus infection in a patient with systemic lupus erythematosus.

We describe a 47 years lady with systemic lupus erythematosus (SLE) who was infected with human immunodeficiency virus (HIV), due to transfusion either by blood or platelet concentrate. There was a near remission in the disease and during the course of follow up she developed cryptococcal meningitis. The approach to the diagnosis of HIV infection in a patient with SLE, the effect of SLE on the virus and vice versa and some management issues in this setting are discussed.

AIDS-Related Opportunistic Infections↗
PubMed2003

Clinical profile in gelatinous bone marrow transformation.

OBJECTIVE: To study the clinical spectrum associated with gelatinous bone marrow transformation (GMT). METHODS: All subjects whose bone marrow aspiration showed pink purple material on Leishman stain underwent a detail history, clinical examination and investigation (biochemical/microbiological/radiological). Additionally, in each subject the smear was stained with special stains of Periodic Acid Schiff and Alcian blue. RESULTS: Out of total 1498 marrows, 65 showed evidence of GMT. All of these had anaemia. The associated clinical spectra of diseases noticed were: Infection (31 cases), Nutritional deficiency (5 cases), Haematological disorders (Aplastic/toxic depression) (17 cases), Malignancies (3 cases), and Miscellaneous (9 cases). CONCLUSION: Based on the heterogenecity of associated clinical disorders, GMT indicates severe illness and not a particular disease. GMT may be a result of bioregulatory process (which presently needs further prospective studies) that are activated in different pathologic conditions but resulting in similar lesion in the bone marrow and so till then it may be concluded that GMT is a symptom of bone marrow.

Adolescent↗
PubMed2003

Fatal 2,4-D (ethyl ester) ingestion.

2,4-D (2,4-dichlorphenoxyacetic acid) is widely used in agriculture and forestry to destroy broad leaved weeds (herbicide). It has a moderate mammalian toxicity and human poisoning has rarely been reported except following ingestion with suicidal intent. We report two young adults who ingested it with suicidal intent, developed neurological, cardiac, hepatic and renal toxicity and died.

2,4-Dichlorophenoxyacetic Acid↗
PubMed2002

Solution structure and DNA-binding properties of the C-terminal domain of UvrC from E.coli.

The C-terminal domain of the UvrC protein (UvrC CTD) is essential for 5' incision in the prokaryotic nucleotide excision repair process. We have determined the three-dimensional structure of the UvrC CTD using heteronuclear NMR techniques. The structure shows two helix-hairpin-helix (HhH) motifs connected by a small connector helix. The UvrC CTD is shown to mediate structure-specific DNA binding. The domain binds to a single-stranded-double-stranded junction DNA, with a strong specificity towards looped duplex DNA that contains at least six unpaired bases per loop ("bubble DNA"). Using chemical shift perturbation experiments, the DNA-binding surface is mapped to the first hairpin region encompassing the conserved glycine-valine-glycine residues followed by lysine-arginine-arginine, a positively charged surface patch and the second hairpin region consisting of glycine-isoleucine-serine. A model for the protein-DNA complex is proposed that accounts for this specificity.

Amino Acid Motifs↗