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Biomedical subjects

V Bhatia

Publications and source records attributed to V Bhatia.

At least 55 records · Page 3Linked to original sources
PubMed1997

Extrahepatic portal vein obstruction in children: anthropometry, growth hormone, and insulin-like growth factor I.

BACKGROUND: Extrahepatic portal vein obstruction has been shown to cause growth retardation in children, though literature is scant. No information is available regarding the cause of growth retardation in these patients. METHODS: To document the presence of growth retardation in this disease, we studied growth and nutrition in 33 consecutive prepubertal patients. Anthropometry, fasting growth hormone, and insulin-like growth factor I levels were compared in 22 well-nourished patients from this group with 35 age-matched well-nourished controls. RESULTS: Mean +/- SD height standard deviation score of well-nourished patients (-1.88 +/- 1.33) was significantly below that of the controls (-1.06 +/- 0.64, p < 0.01). Patients also had significantly lower midarm muscle circumference z scores (-2.65 +/- 1.09) than controls (-1.17 +/- 1.09, p < 0.0001), though triceps skinfold thickness z scores were comparable in the two groups (-1.06 +/- 0.68 vs -1.24 +/- 0.79, p = NS). Insulin-like growth factor I z scores were significantly lower in patients (-1.48 +/- 0.88) than in controls (-0.49 +/- 1.09, p < 0.001), whereas basal growth hormone was significantly higher in patients (4.60 +/- 3.70 mIU/L) compared with controls (2.66 +/- 0.82, p < 0.01). CONCLUSION: Extrahepatic portal vein obstruction in children leads to growth retardation. Anthropometric and preliminary hormonal evaluation suggest resistance to the action of growth hormone as a possible mechanism.

Anthropometry↗
PubMed1996

Islet-cell antibodies in malnutrition-related diabetes mellitus from north India.

The etiology of malnutrition-related diabetes mellitus (MRDM)--protein-deficient pancreatic diabetes (PDPD) and fibro-calculous pancreatic diabetes (FCPD)-is unclear. We studied the role of autoimmunity against pancreatic islet cells in the etiology of these two subtypes of MRDM by measuring islet-cell antibodies (ICA) in 23 patients with PDPD, 25 with FCPD and 62 with Type 1 diabetes. Three patients (13%) with PDPD had detectable ICA. Including a patient with a high titre of ICA (> 80 JDF units). The frequency of ICA in patients with PDPD was significantly lower than subjects with Type 1 diabetes (22/62, 35%; P < 0.05). Among patients studied at onset. ICA prevalence was lower in the PDPD patients (1/7, 14%) compared to subjects with Type 1 diabetes (8/20, 40%). No patient of FCPD had detectable ICA (P < 0.001 vs. Type 1 diabetes subjects). We conclude that autoimmunity may play a role in the etiology of some patients with the PDPD subtype of MRDM. However, FCPD is unlikely to have an autoimmune etiology.

Adolescent↗
PubMed1995

Brain metabolite changes on in vivo proton magnetic resonance spectroscopy in children with congenital hypothyroidism.

Localized in vivo proton magnetic resonance spectroscopy and imaging were performed in five children with untreated congenital hypothyroidism to look for biochemical markers of abnormal myelin and neuronal development. The patients had high levels of choline-containing compounds, which returned to normal with euthyroidism. These metabolic alterations may reflect blocks in myelin maturation that are reversible by thyroid hormone replacement throughout childhood.

Adolescent↗
PubMed1995

Growth stimulating antibodies in endemic goitre: a reappraisal.

OBJECTIVE: Previous studies, using a variety of methods, have reported growth-promoting immunoglobulins (IGs) in a large proportion of patients with endemic goitre. We sought to determine whether thyroid growth-promoting immunoglobulins (TGI) are present in the serum of Indian patients with endemic goitre. DESIGN: IgG was prepared by protein G-Sepharose affinity purification and added to FRTL-5 thyroid cells in the presence of suboptimal concentrations of TSH. PATIENTS: We studied 30 sequential patients with endemic goitre and 16 euthyroid controls without a goitre from the same area. MEASUREMENTS: Two assays for thyroid cell growth were used: 3H-thymidine incorporation, and flow cytometric measurement of the proportion of cells in the S phase and G2/M phase of the cell cycle. RESULTS: Both assays were shown to detect growth produced by TSH and by thyroid stimulating antibodies in IgG preparations from 3 patients with Graves' disease. There was no significant increase in either 3H-thymidine incorporation or the distribution of cells in S or G2/M phase with IgGs from endemic goitre patients, and no difference between the effects of these IgGs and those from the normal subjects. CONCLUSIONS: Thyroid growth-promoting immunoglobulins cannot be detected in Indian patients with endemic goitre.

Adolescent↗
PubMed1995

Extracorporeal shockwave therapy for urolithiasis with renal insufficiency.

Management of urolithiasis with renal insufficiency poses a multidimensional nephrourological situation. Sixty-two patients of potentially reversible calculus obstructive nephropathy and azotemia were treated with extracorporeal shockwave lithotripsy (ESWL) on the Sieman's Lithostar. These patients were treated under sedoanalgesia after the initial therapeutic ureteral stenting. Satisfactory fragmentation was achieved in all the patients. The incidence of major complications was 3.2% with an 85% stone-free rate at 6 months. Pre- and post-ESWL hemodialysis was required in 14 and 3 patients, respectively. All patients had variable levels of improvement in the renal function. Proper selection of cases is mandatory for satisfactory outcome. The combination of ureteral stenting followed by phased ESWL represents an attractive alternative to traditional surgical management of stones with renal insufficiency.

Female↗
PubMed1995

The prevalence and spectrum of colonic lesions in patients with cirrhotic and noncirrhotic portal hypertension.

Portal hypertension diffusely affects the gastrointestinal tract. The frequency and profile of distinct colonic mucosal lesions (portal colopathy) and rectal varices (RV; veins > 4 cm above the anal verge) is not well studied. Fifty consecutive patients with portal hypertension (25 with cirrhosis, 10 with noncirrhotic portal fibrosis [NCPF], and 15 with extrahepatic portal vein obstruction [EHPVO]) were assessed clinically and by upper and lower gastrointestinal (GI) endoscopy. Colorectal lesions were seen in 35 (70%) patients, significantly more often in bleeders than in nonbleeders. Rectal varices were detected in 22 (44%) patients; larger and more often seen in EHPVO (80%) than in cirrhosis (28%) and NCPF (30%) (P < .01) patients. Portal colopathy was seen in 26 (52%) patients, with nearly similar frequency in cirrhotics, NCPF, and EHPVO patients. Previous sclerotherapy or presence of gastric varices had little influence on the development of these lesions. An association (P < .01) was, however, seen between the presence of colopathy and portal gastropathy. Overt bleeding was seen in 8% and 4% of patients with RV and colopathy, respectively. In conclusion, our results demonstrate that colorectal lesions are present in about two thirds of patients with portal hypertension. Patients with portal hypertension and lower GI bleeding should be colonoscoped. Patients with extrahepatic portal vein obstruction may in turn benefit from baseline sigmoidoscopic examination to define the presence and size of rectal varices.

Adolescent↗
PubMed1994

GAPO syndrome in a child without dermal hyaline deposit.

A 5-year-old girl with GAPO syndrome from India lacked PAS-positive hyaline material in the skin biopsy from thigh and scalp. The role of this pathological change, earlier reported by Wajntal et al. [1990] in the pathogenesis of GAPO syndrome, needs to be reexamined.

Abnormalities, Multiple↗
PubMed1994

A comparative study of cystolithotripsy and extracorporeal shock wave therapy for bladder stones.

This study compares the safety and efficacy of mechanical cystolithotripsy (MCLT) and extracorporeal shock wave lithotripsy (ESWL) in the treatment of vesical stones. In the last four years we have treated 144 bladder lithiasis patients with MCLT (86; group A) and ESWL (58; group B). All patients in group A were treated under spinal anaesthesia while 47 patients in group B needed intravenous sedation. The early complication rates in groups A and B were 19.7 and 6.8%, respectively. The corresponding mean hospital stay was 60 and 18 hours. ESWL should be considered as an effective, safe and least invasive alternative to MCLT in the therapeutic options for vesical lithiasis.

Adolescent↗
PubMed1994

Vesical lithiasis: open surgery versus cystolithotripsy versus extracorporeal shock wave therapy.

We compare the different methods of treating vesical calculi to establish the most effective and safe modality. Of 128 patients with bladder calculi 5 underwent an open operation, 80 underwent mechanical cysto-lithotripsy and 43 underwent extracorporeal shock wave therapy. Severe complications included hematuria, bladder perforation and mucosal injury in the mechanical cystolithotripsy group. We find extracorporeal shock wave therapy to be a simple, effective and safe modality for the management of vesical lithiasis.

Adolescent↗
PubMed1994

Urolithiasis with congenital upper tract anomalies: a 4-year experience with extracorporeal shock wave lithotripsy.

Calculus formation is a natural sequela of anatomic anomalies of the upper urinary tract, and endourologic and open surgery can be difficult in these cases. Since July 1988, 81 patients with urolithiasis and renoureteral anomalies were treated with SWL on the Siemens Lithostar. Retrograde ureteropyelography and double-J stenting was done in 75 and 73 patients, respectively. All patients had satisfactory fragmentation, although 48% needed more than one session. The 6-month stone-free rate was 90%. Follow-up of 3 to 44 months in 32 patients revealed urinary infection in 1 patient and asymptomatic residual calculi in 3. SWL may be considered safe and successful for noninvasive management of calculus disease in patients with upper tract anomalies.

Adolescent↗
PubMed1994

Retrograde manipulation for proximal ureteric stones before extracorporeal shockwave lithotripsy: technique, observations and results.

OBJECTIVE: To determine the factors affecting the success of retrograde manipulation (RM) of upper ureteric stones. PATIENTS AND METHODS: A total of 601 patients with upper ureteric calculi underwent attempted RM. In 216 patients, RM was performed irrespective of the respiratory phase, stone characteristics and ureteric anatomy (group 1). In the remaining 385 patients RM was performed at the height of expiration (group 2). Patients with large or impacted stones, ureters with a fusiform or funnel shape appearance on urography and grade IV hydronephrosis were not included in group 2. RESULTS: The success rate was significantly greater in group 2. The rates of fever and perforation in groups 1 and 2 were 6.9/2.3% and 3.2/0.2% respectively. The incidence of residual fragments was also less in group 2. CONCLUSION: RM at the height of expiration is associated with a higher success rate and lower complication rate.

Humans↗
PubMed1994

Extracorporeal shock wave lithotripsy in 1,178 ureteric calculi patients--lessons learnt.

In the last 40 months 1,178 ureteric stone patients have been treated on the Siemens Lithostar. The commonest site was upper ureter (54%) followed by the lower (24%) and midureter (22%). Patients were stratified into two groups (A and B) chiefly on the basis of calculus size, degree of back pressure changes, presence of infection and associated local or systemic complicating factors. The mean number of shocks and sessions, complications, pre- and posttreatment auxiliary procedures and failure rates were higher in group B. The overall failure rate was 1.27 and 3.5% needed after extracorporeal shock wave lithotripsy auxiliary procedures. We attribute our high success and low complications rate mainly to the liberal use of JJ stent, attempt of retrograde calculus manipulation at the height of expiration and selection of appropriate position for calculus localization based on stone location.

Female↗