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Biomedical subjects

V Bhatia

Publications and source records attributed to V Bhatia.

98 records · Page 6Linked to original sources
PubMedDate not supplied

Brain natriuretic peptide in diagnosis and treatment of heart failure.

Currently we are in the midst of a chronic disease epidemic of congestive heart failure (CHF) worldwide. This epidemic is marked by a rapid rise in prevalent cases over the past decade that is due in part to the aging population and improved survival in patients with other cardiovascular conditions. At present there are 5 million Americans with congestive heart failure, with nearly 500000 new cases every year. To provide cost-effective treatment for patients with congestive heart failure, rapid and accurate differentiation of congestive heart failure from other causes of dyspnea must be accomplished. Although echocardiography is considered the gold standard for the detection of left ventricular dysfunction, it is expensive, is not always easily accessible, and may not always reflect an acute condition. B-type natriuretic peptide (BNP) is a cardiac neurohormone specifically secreted from the cardiac ventricles as a response to ventricular volume expansion, pressure overload, and resultant increased wall tension. BNP can be used in the diagnosis of CHF. However, the present American College of Cardiology/American Heart Association practice guidelines (2001) for the evaluation and management of CHF state that the role of blood BNP in the identification of patients with CHF remains to be fully clarified. We have discussed the role of BNP in the diagnosis and management of CHF.

Heart Failure↗
PubMedDate not supplied

Aetiology and clinical profile of osteomalacia in adolescent girls in northern India.

BACKGROUND: The adolescent age group is particularly prone to nutritional rickets/osteomalacia due to an increased demand for nutrients, especially calcium and vitamin D. Osteomalacia presents with non-specific signs and symptoms because of which diagnosis may be delayed. Vitamin D deficiency is unexpected in India, which is a tropical country with abundant sunshine. METHODS: We prospectively studied the clinical presentation, aetiology and social factors contributing to adolescent rickets/ osteomalacia in our region. RESULTS: We saw 21 symptomatic adolescents with osteomalacia during the study period (November 2000-July 2002). All were girls. Only 1 practised purda and 4 belonged to a low socioeconomic class. The mean (SD) duration of illness before correct diagnosis was 2.8 (2.1) years. Bone pains and muscular weakness were universally present. Non-specific complaints (especially limb pains being mistaken for joint involvement) led to a delay in diagnosis with consequent morbidity. All but 1 patient had low serum 25-hydroxyvitamin D levels (<10 ng/ml), with the mean (SD) being 4.9 (2.7) ng/ml. Their mean dietary calcium intake was low 1265 (199) mg/day, range 40-810 mg/day]. Restricted outdoor activities (n = 19) and the traditional dress code (n = 21) were contributory factors, as they led to poor exposure to sunshine. CONCLUSIONS: Nutritional osteomalacia among adolescents is a poorly recognized entity. Even in non-purda practising communities in the tropics, poor exposure to sunshine due to social factors, compounded by low dietary calcium intake, can lead to osteomalacia in adolescents.

Adolescent↗
PubMedDate not supplied

Vulnerable plaques, inflammation and newer imaging modalities.

Currently, inflammation is considered to be the central player in the pathogenesis of atherosclerosis. It leads to the formation of multiple plaques in the arterial beds including coronary vasculature. Recent studies using the latest imaging techniques have shown that in patients with acute coronary syndromes (ACS) multiple plaques are ruptured and have thrombus formation on them. Various factors make these plaques unstable, these include structural components of plaque like thin fibrous cap, high lipid content of the plaque core and inflammation, both localized and generalized. It has been shown that most of the ACS are caused by plaques causing non-critical stenosis as seen on traditional X-ray angiography. Also, the phenomenon of remodelling makes angiography a poor technique for plaque visualization. Hence newer modalities are required to identify these "vulnerable plaques". Intravascular ultrasound (IVUS), thermography and Magnetic Resonance Imaging (MRI) are a few such promising techniques. Here we review the invasive and non-invasive modalities that can be helpful in the identification of these plaques before they become unstable and cause ACS, and also the available therapies to stabilize these plaques.

Angioscopy↗
PubMedDate not supplied

Validation and reproducibility of a food frequency questionnaire to assess energy and fat intake in affluent north Indians.

BACKGROUND: India is currently witnessing a sharp rise in noncommunicable disorders such as obesity, diabetes, hypertension and cardiovascular diseases. This rise can be related in part to dietary changes such as increased intake of calories, fat (especially saturated fat) and cholesterol. A simple, accurate and reproducible method to measure these nutrients is essential to study the role of diet in these diseases in epidemiological studies. We aimed to develop and validate a food frequency questionnaire that could be used for this purpose. METHODS: Thirty urban north Indian subjects (age 23-64 years, 16 men) belonging to a high socioeconomic group were studied. The subjects were selected consecutively over a period of 3 weeks from among those participating in an epidemiological survey on cardiovascular risk factors in an affluent population. A 102-item food frequency questionnaire was developed to capture the intake of calories, fat, saturated fat and cholesterol. The results obtained by the food frequency questionnaire were compared with a 5-day diet record. To assess the reproducibility of the food frequency questionnaire, it was re-administered after 3 months to the 23 subjects available. RESULTS: It took the dietician 20 minutes or less to administer the questionnaire. There was good correlation between the nutrient values as calculated by the food frequency questionnaire and 5-day diet record. The correlation for energy intake was 0.80, and varied between 0.55 and 0.69 for unadjusted intake of other nutrients. After adjusting for calories, the correlation varied between 0.45 and 0.68. In general, the food frequency questionnaire overestimated the energy-adjusted nutrient intake by 6%-17%. When intake was classified into quartiles, there was good agreement between the two methods: 43%-100% for calories; 29%-86% for other nutrients for unadjusted intake; 29%-71% for nutrients after energy adjustment. On calculation of intake after re-administration of the food frequency questionnaire, there was a moderate to strong correlation (energy adjusted r=0.49-0.90) between the two evaluations for various nutrients. CONCLUSION: The food frequency questionnaire developed for the assessment of nutrient intake in a north Indian population was easy to administer, showed moderate to good correlation with the 5-day diet record and was reproducible.

Adult↗
PubMedDate not supplied

Extracorporeal shock wave lithotripsy for urolithiasis. Experience with 3000 patients.

Extracorporeal shock wave lithotripsy (ESWL) has dramatically changed the current therapeutic spectrum for urolithiasis and is currently the frontline modality for most upper tract calculi. We report our experiences of treating 3000 patients of urinary calculus disease with shock wave therapy on the Siemens Lithostar at our institution. There were 1350 patients with ureteric stones and 73 had vesical calculi. 20.2% patients had recurrent stones and 25.6% had associated medical disorders. The calculus size varied from 4-115 mm. 81 patients had coexisting congenital upper tract anomalies and 84 had a solitary kidney. General anesthesia was required in 4.1%. Pre ESWL auxiliary procedures were necessary in 96.4% with JJ stenting in 2852 patients. The overall 6-month stone free rate was 86.8% with major complication rate of 0.8%.

Adolescent↗