Search PubMed⌕ Search

Biomedical subjects

S Sood

Publications and source records attributed to S Sood.

At least 55 records · Page 3Linked to original sources
PubMed2000

Head and neck basal cell carcinoma: treatment using a 2-mm clinical excision margin.

Treatment of basal cell carcinoma (BCC) should completely remove the tumour whilst preserving the maximum amount of normal surrounding skin. Therefore, treatment is a compromise between safe excision margins and obtaining a satisfactory cosmetic result. We report the results of a prospective study of 63 patients who underwent excision of well-demarcated BCCs in the head and neck region. The surgical excision margin used was 2 mm. Histological assessment confirmed complete excision in 95% and there was no evidence of recurrence of the BCC over a 24-month follow-up period in all patients. We propose that a clinical excision margin of 2 mm is adequate for treatment of simple, well demarcated BCCs arising in the head and neck.

Adult↗
PubMed2000

The effect of hypertonicity on nasal mucociliary clearance.

The effect of the tonicity of saline nasal douching solutions on mucociliary clearance was studied in order to ascertain whether hypertonicity conferred any advantage. Thirty-eight normal subjects were included in a randomised double-blind crossover trial. Saline douching solutions of 0.9%, 3% and 5% tonicity were used and mucociliary clearance was measured by the saccharin clearance time (SCT). The resultant SCT after administration of 5% saline was significantly reduced compared to both 0.9% (P = 0.005) and 3% saline (P = 0.04). There was no difference between 0.9% and 3% saline administration. Thus hypertonic saline solutions improve mucociliary clearance, although this was only observed with solutions of 5% tonicity. The effect is probably brought about by changes in mucus rheology.

Adult↗
PubMed2000

Evaluation of shunt malfunction using shunt site reservoir.

OBJECTIVE: To determine the usefulness of a separate reservoir placed at the site of the shunt in evaluation of shunt malfunction. METHODS AND MATERIALS: A ventricular catheter was placed alongside the proximal catheter of the shunt and connected to a subgaleal reservoir in 17 patients, in 9 a double-lumen catheter with integrated reservoir and in 13 patients a dual catheter with a double-port reservoir was used. At presentation of suspected shunt malfunction, a standard shunt function evaluation using shunt tap, CT scan or shunt injection was performed, and subsequently, the pressure from the tap of the reservoir was obtained. RESULTS: Thirty-three patients presented with symptoms of malfunction at an interval of 2.3 +/- 3 months (range 2-429 days). The pretest probability of shunt malfunction in this population was 73%. Posttest probability of shunt malfunction was 82.5% with standard evaluation and improved to 100% by the separate reservoir tap pressure measurement. In 4 patients in whom the shunt tap was dry, shunt infection was diagnosed prior to revision using CSF obtained at the reservoir tap. In 5 patients with proximal malfunction and bradycardia, the reservoir tap allowed early ventricular decompression. CONCLUSION: This study shows that a reservoir placed at the site of the shunt remains patient even when the shunt malfunctions, suggesting that flow rather than catheter position is important in proximal malfunction. It is superior to shunt tap for detection of shunt malfunction and infection, and it allows early ventricular decompression in a sick patient awaiting surgery for shunt revision.

Adolescent↗
PubMed2000

Postural changes in intracranial pressure in chronically shunted patients.

A subset of hydrocephalic patients with indwelling shunts become symptomatic when they are upright and active. Intracranial pressure (ICP) measurements in these patients have shown a significant drop in pressure when the patient is upright with return to normal levels when the patient is supine. In 20 chronically shunted hydrocephalic patients who previously had no siphon protection devices, ICP changes in supine and upright position were studied at the time when the patient had external ventriculostomy for treatment of shunt infection. Our hypothesis was that these patients might display rapid changes in ICP from fluid shifts occurring in non-CSF compartments. To minimize the effects of hysteresis, drift and zero-point error, measurements were made using a fluid manometer rather than a strain gauge pressure transducer. The pressure-volume index was estimated using the standard technique of bolus injection. Intracranial CSF volume was estimated on CT scans. The fluid shift was calculated using a mathematical model of the CSF compartment that incorporates negative pressure and volume components that permits simulation of siphoning. Sixteen patients had small, slit ventricles; 3 patients had moderate-sized ventricles and in 1 patient the ventricular size was normal. The average intracranial CSF volume estimated on CT scan was 12 cm(3). There was a mean drop in ICP in the upright position of 159 mm H(2)O. The mean PVI of 42 ml suggested a volume displacement out of proportion to the available intracranial CSF volume. Based on these findings, we conclude that even in the absence of drainage through the shunt, chronically shunted patients still display a fall in ICP when assuming the upright position. This raises the possibility of fluid shifts other than of CSF through nonshunt pathways. Possible mechanisms involving altered CSF-venous system interaction are discussed.

Adolescent↗
PubMed2000

Lavage administration of dilute recombinant surfactant in acute lung injury in piglets.

In an acute lung injury model, we previously observed reversal of pulmonary dysfunction with natural surfactant administered by lavage (dose = 18 mg/kg phospholipid). The present study questioned whether a lower dose of phospholipid would be effective if a recombinant preparation rather than natural surfactant were used. Acute lung injury was induced by repeated saline lung lavage in ventilated, sedated, and paralyzed piglets. Three concentrations of recombinant surfactant were studied (low phospholipid, 1 mg/mL; medium phospholipid, 4 mg/mL; high phospholipid, 13.5 mg/mL). Control piglets received no surfactant. Thirty-five milliliters per kilogram of surfactant was administered by gravity, followed by passive drainage of excess fluid. All treatment groups retained similar volumes (4.7+/-0.3 mL/ kg), corresponding to phospholipid doses of 4+/-0.4, 22+/-3, and 67+/-4 mg/kg in low, medium, and high-dose groups, respectively. Treatment groups showed significant improvement in Pao2 compared with controls. Other parameters different from controls were found in only the medium and high-dose groups. All surfactant-treated groups showed improvement over time in Pao2, Paco2, lung resistance mean airway pressure, functional residual capacity, and dynamic compliance. These data support the statement that whereas there is a dose response to exogenous surfactant, the effective dose of recombinant surfactant in acute lung injury may be as low as 4 mg/kg phospholipid when administered by lavage.

Animals↗
PubMed2000

Endoscopic stapling of pharyngeal pouches in patients from the Yorkshire region.

The treatment of pharyngeal pouches by endoscopic stapling diverticulotomy has gained popularity over the last few years. We assessed the results of this technique in 44 patients by means of a clinical questionnaire and by reviewing case records. Thirty-six (82 per cent) patients commenced oral intake within 18 hours of the procedure and 37 (84 per cent) patients were discharged within 48 hours. Five patients had complications that included throat discomfort, a loose incisor tooth, shoulder pain, pharyngeal perforation and one mortality due to mediastinitis. Of the 37 patients that completed the questionnaire, nine (24 per cent) had some residual symptoms although only two (five per cent) felt that there had been no improvement at all following the stapling procedure. Thirty-five (95 per cent) of the patients stated that they would undergo the procedure again. It appears that pharyngeal pouches can be successfully treated by endoscopic stapling, with patients commencing oral intake within a few hours of surgery and having a short hospital stay. However, as there can be serious complications, we recommend that the procedure be performed by an experienced surgeon.

Aged↗
PubMed2000

Reply

Explore the source record for details and available documents.

Journal Article↗
PubMed2000

Salmonella. typhi OMPs induced immunomodulation in peritoneal macrophages.

The immunomodulatory properties of outer membrane proteins (OMPs) from S. typhi Ty2 were studied in mouse model at 72 hr and 20 days post-infection. Inspite of reduction in the number of macrophages and their protein content observed in the immunized group vis-à-vis infected group, OMPs activated macrophages showed significant upregulation of NO. At 20 days post infection, the level remained almost the same suggesting the prolonged cytotoxic and cytostatic activity due to the long lasting effects of OMPs activated macrophages. Higher activity of SOD in these aged cells pointed out towards the protective efficacy of OMPs to keep the macrophages themselves away from the noxious effects of O2-. Lower level of acid phosphatase in the macrophages from immunized mice group indicated the involvement of oxygen dependent rather than oxygen independent killing process. The enhanced uptake of organisms and their killing could be related to the production of oxygen and nitrogen radicals in the OMPs immunized group.

Adjuvants, Immunologic↗
PubMed1999

Typhoid fever in children aged less than 5 years.

BACKGROUND: Calculation of the incidence of typhoid fever during preschool years is important to define the optimum age of immunisation and the choice of vaccines for public-health programmes in developing countries. Hospital-based studies have suggested that children younger than 5 years do not need vaccination against typhoid fever, but this view needs to be re-examined in community-based longitudinal studies. We undertook a prospective follow-up study of residents of a low-income urban area of Delhi, India, with active surveillance for case detection. METHODS: A baseline census was undertaken in 1995. Between Nov 1, 1995, and Oct 31, 1996, we visited 8172 residents of 1820 households in Kalkaji, Delhi, twice weekly to detect febrile cases. Blood samples were obtained from febrile patients, and those who tested positive for Salmonella typhi were treated with ciprofloxacin. FINDINGS: 63 culture-positive typhoid fever cases were detected. Of these, 28 (44%) were in children aged under 5 years. The incidence rate of typhoid per 1000 person-years was 27.3 at age under 5 years, 11.7 at 5-19 years, and 1.1 between 19 and 40 years. The difference in the incidence of typhoid fever between those under 5 years and those aged 5-19 years (15.6 per 1000 person-years [95% CI 4.7-26.5]), and those aged 19-40 years (26.2 [16.0-36.3]) was significant (p<0.001 for both). The difference between the incidence of typhoid at 5-19 years and the incidence at 19-40 years was also significant (10.6 [6.3-14.8], p<0.001). Morbidity in those under 5 and in older people was similar in terms of duration of fever, signs and symptoms, and need for hospital admission. INTERPRETATION: Our findings challenge the common view that typhoid fever is a disorder of school-age children and of adults. Typhoid is a common and significant cause of morbidity between 1 and 5 years of age. The optimum age of typhoid immunisation and the choice of vaccines needs to be reassessed.

Adolescent↗
PubMed1999

Multiple regions of chromosome 4 demonstrating allelic losses in breast carcinomas.

Allelotyping studies suggest that allelic losses at one or both arms of chromosome 4 are frequent in several tumor types, but information about breast cancer is scant. A recent comparative genomic hybridization analysis revealed frequent losses of chromosome 4 in breast carcinomas. In an effort to more precisely locate the putative tumor suppressor gene(s) on chromosome 4 involved in the pathogenesis of breast carcinomas, we performed loss of heterozygosity studies using 19 polymorphic microsatellite markers. After precise microdissection of archival surgical cases, we analyzed DNA obtained from 44 breast carcinomas for loss of heterozygosity. In addition, DNA from tumor cell lines derived from 14 of these 44 breast carcinomas were also analyzed. We observed deletions of chromosome 4 at multiple sites in both tumor cell lines and breast carcinomas. The deletions in cell lines and their corresponding tumors were extensive in nature, whereas they were more localized in noncultured breast carcinomas. The localized deletions in the noncultured breast carcinomas clearly defined four nonoverlapping regions of frequent deletions: 4q33-34 (76%); 4q25-26 (63%); 4p15.1-15.3 (57%); and 4p16.3 (50%). Our results suggest that there may be multiple putative tumor suppressor genes, located on both arms of chromosome 4, whose inactivation is important in the pathogenesis of breast cancer.

Alleles↗
PubMed1999

Malignant mesothelioma of the tunica vaginalis testis: a report of two cases and review of literature.

Two cases of rare malignant mesothelioma of tunica vaginalis testis are presented. Both cases were advanced on clinical and radiological studies. One patient was treated with surgical excision followed by chemotherapy and radiotherapy and the other patient was treated with surgery and chemotherapy. Despite aggressive therapy both the patients died within 18 months of treatment. Review of the literature with suggested treatment protocol is presented. The response of malignant mesothelioma to chemotherapy and radiotherapy is poor as indicated by both of our cases. Initial aggressive surgery and adjuvant procedures are necessary soon after diagnosis to achieve long-term survival.

Aged↗
PubMed1999

Similarity between hypotheses and evidence.

We explore two novel consequences of similarity-based likelihood judgment. In Section I, we distinguish between the evidence on which judgments are based and the hypotheses that serve as the objects of judgment. The location of a feature, whether in the evidence or the hypotheses, influences the perceived similarity between evidence and hypotheses and consequently yields judgments that are inconsistent with the requirements of probability theory. In Section II, we examine judgment of disjunctive hypotheses. For certain types of disjunctions, the assessment of similarity produces consistent nonmonotonicities: the support of a disjunction is smaller than that of one of its components. Finally, we discuss the implications of our findings in terms of support theory and the principle of context independence.

Female↗
PubMed1999

Influence of sodium selenite and selenomethionine on DNA/RNA synthesis and BaP binding to spleen lymphocytes in culture.

In the present study, an attempt was made to provide some information regarding the effects of organic and inorganic selenium compounds on DNA/RNA synthesis and benzo(a)pyrene uptake in cultured lymphocytes from mice spleen. It was clear from the results that there was a significant inhibition of DNA/RNA synthesis with increasing concentration of either form of selenium from 0.1 microM to 1 mM in culture medium. However, when used at the same level as selenite with respect to selenium content, selenomethionine exerted more DNA/RNA synthesis inhibitory effect than selenite. Benzo(a)pyrene uptake by proliferating lymphocytes was also significantly reduced with increasing selenium concentration (0.1 microM to 1 mM). However, both forms of selenium at the same selenium concentration showed almost the same inhibitory effect on the cellular uptake of benzo(a)pyrene, which indicated that some factor(s) other than the DNA synthesis are also involved in the interaction between benzo(a)pyrene and cells. Involvement of the changes in the carcinogen metabolism and glutathione level has been discussed. Present studies show that organic selenium as a source of selenium is a more potent chemopreventive compared to the inorganic one. This information may have a useful therapeutic potential.

Animals↗
PubMed1999

Adjustable antisiphon shunt.

Overdrainage from siphoning, a result of negative distal pressure, has been a major problem with the existing differential pressure shunt devices. The antisiphon/siphon control devices used to reduce siphoning often malfunction owing to fibrous scar formation around the valve. Similarly, the functioning of gravity-actuated systems is adversely affected by body movements. Constant flow shunt systems may not be superior to existing differential pressure valves, as has been shown in a recent multicenter study. In view of these difficulties, we investigated the possibility of developing a shunt valve based on the Starling resistor concept of flow regulation that allows proximal pressure-dependent and distal pressure-independent flow. The valve designed is capable of proximal pressure-dependent and distal pressure-independent flow. The valve allows for adjustable negative pressure in the vertical position.

Cerebrospinal Fluid Shunts↗