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Biomedical subjects

V Misra

Publications and source records attributed to V Misra.

At least 19 recordsLinked to original sources
PubMed2006

Ileoscopy in 39 hematochezia patients with normal colonoscopy.

AIM: To assess the role of retrograde terminal ileoscopy in hematochezia patients with normal colonoscopy. METHODS: Between January 1997 and March 2005, 39 hematochezia patients (males 36, females 3, mean age 44.7 years) with a reported normal colonoscopy underwent a repeat colonoscopy. After reaching the cecum, attempt was made to localize the ileocecal valve and intubate the terminal ileum. Any abnormality in the mucosa of the terminal ileum was carefully recorded and biopsies were obtained from suspicious-looking lesions. RESULTS: During the study period there were 39 patients admitted for hematochezia in whom colonoscopy till cecum did not reveal any abnormality. Full-length colonoscopy till the cecum could be performed in all the patients. The terminal ileum could be intubated in 36 patients. No abnormality was noted in 31 patients. Ileal ulcers were noted in two patients. Nodularity along with ulceration of the ileal mucosa, a Dieulafoy's lesion, and an angiomatous malformation were noted in one patient each. Histological examination of the biopsies obtained from the ulcers revealed typical tuberculous lesion in the patient with nodularity and ulceration. One of the patients had typhoid ulcers and another had non-specific ulcers. CONCLUSION: Retrograde terminal ileoscopy gives limited but valuable information, in patients with hematochezia and should be attempted in all such patients.

Adult↗
PubMed2005

Colonic changes in patients with cirrhosis and in patients with extrahepatic portal vein obstruction.

BACKGROUND AND STUDY AIMS: Figures for the prevalence of anorectal varices and portal hypertensive colopathy have varied considerably in the available studies of patients with cirrhosis, and few studies have observed these changes in patients with extrahepatic portal vein obstruction (EHPVO). Our aim was to investigate the colonic changes, if any, in patients with EHPVO and to compare them with those seen in patients with cirrhosis of the liver. PATIENTS AND METHODS: A total of 50 patients with cirrhosis and 35 patients with EHPVO, all of whom had a history of at least one episode of bleeding from esophageal varices, underwent both upper gastrointestinal endoscopy and colonoscopy. RESULTS: Anorectal varices were seen more commonly in patients with EHPVO than in patients with cirrhosis (63 % vs. 38 %, P < 0.03). Of the patients with anorectal varices, large anorectal varices were also more common in patients with EHPVO than in patients with cirrhosis (73 % vs. 32 %, P < 0.01). Colopathy was noted in 40 % of patients with EHPVO and in 62 % of patients with cirrhosis (P < 0.05). Of the patients with EHPVO, colopathy was noted in 27 % of patients who also had anorectal varices and in 61.5 % of patients without anorectal varices (P < 0.05). Similarly, patients with both cirrhosis and anorectal varices were found to have a lower prevalence of colopathy than cirrhotic patients without anorectal varices (42 % vs. 74 %, P < 0.03). CONCLUSIONS: Anorectal varices are more common in patients with EHPVO, while portal hypertensive colopathy is more common in patients with cirrhosis. Large anorectal varices are also more common in patients with EHPVO than in patients with cirrhosis and there is an inverse relationship between anorectal varices and colopathy in both cirrhotic patients and patients with EHPVO.

Adolescent↗
PubMed2005

Endoscopic band ligation as salvage therapy in patients with bleeding peptic ulcers not responding to injection therapy.

BACKGROUND AND STUDY AIM: Endoscopic band ligation has recently been used to control bleeding from a variety of nonvariceal upper gastrointestinal sources. However, it has not been used as salvage therapy in patients with peptic ulcer in whom injection therapy has failed to control bleeding. The objective was to study the role of band ligation in patients with bleeding peptic ulcer where injection therapy had failed. PATIENTS AND METHODS: Endoscopic band ligation was attempted in patients with upper gastrointestinal bleeding from peptic ulcers in whom at least two attempts to control bleeding by injection therapy failed. Anti- Helicobacter pylori therapy was given to patients who were infected with the bacteria. RESULTS: Endoscopic band ligation could be performed in all the 11 patients in whom it was attempted. It was successful in controlling the bleeding in all patients. Over a mean (SD) follow-up of 23.1 (14.8) months none of the patients had recurrence of ulcer or bleeding. CONCLUSIONS: Endoscopic band ligation is an effective means of controlling bleeding in patients with bleeding peptic ulcer in whom injection therapy is not successful. Band ligation followed by anti- H. pylori therapy is useful in preventing recurrence of ulcer and bleeding in such patients.

Adult↗
PubMed2005

Low grade B cell gastric mucosa associated lymphoma presenting as upper gastrointestinal bleeding from non-healing stomal ulcers.

Primary gastric lymphoma is a rare tumour. It is thought that low grade gastric mucosa associated lymphoid tissue lymphoma has not been previously reported to occur in a patient with gastrojejunostomy. This report describes such a case. The patient presented with bleeding from non-healing stomal ulcers. The ulcers healed and there was regression of the tumour after eradication of Helicobacter pylori.

Humans↗
PubMed2004

Endoscopic biopsies from normal-appearing terminal ileum and cecum in patients with suspected colonic tuberculosis.

BACKGROUND AND STUDY AIMS: Colonic tuberculosis is generally diagnosed by colonoscopy and targeted biopsy of lesions. However, the diagnostic yield of colonic biopsies is not very good. So far as we are aware, there have been no studies investigating the role of biopsies from endoscopically normal-appearing cecum and terminal ileum in diagnosing colonic or ileal tuberculosis, or both. PATIENTS AND METHODS: Patients with a clinical suspicion of colonic tuberculosis, in whom no endoscopic abnormalities were found on colonoscopy or ileoscopy, were included in the study. Multiple biopsies were obtained from the cecum and ileum. RESULTS: Fifty patients were studied. Intubation of the terminal ileum was possible in 43 patients (86 %). Histological examination of biopsies obtained from the cecum and terminal ileum showed noncaseating granuloma in two patients. Both of these biopsies were from the terminal ileum. In two other patients, collections of loosely arranged epithelioid cells were observed. This established the diagnosis in these four patients (8 %). In the remaining 46 patients, histology showed nonspecific inflammation in 18 patients (in the cecum in 15 and in the terminal ileum in seven). The other biopsies did not show any abnormalities (33 from the cecum, 34 from the terminal ileum). CONCLUSIONS: Histological examination of biopsies from the normal-appearing cecum and terminal ileum is useful in a small but significant number of patients with colonic tuberculosis.

Adult↗
PubMed2004

Tuberculous colonic strictures: impact of dilation on diagnosis.

BACKGROUND AND STUDY AIM: Colonic strictures are commonly encountered in patients with colonic tuberculosis. If the colonoscope cannot be negotiated past the stricture the procedure is abandoned, the colonic mucosa proximal to the stricture cannot be inspected, and therefore lesions in these locations may be missed. PATIENTS AND METHODS: 130 patients with colonic tuberculosis were studied. Of these 22 (17 %) had impassable colonic strictures. These strictures were dilated, the colonic mucosa proximal to the strictures was then inspected, and biopsies were obtained from lesions of suspicious appearance. RESULTS: All strictures could be dilated. No abnormality was found in 11 patients. In the other 11 patients one or more additional findings were noted on colonoscopy after dilation. A second stricture was found in three patients. Nodularity and/or ulceration was observed in the colon proximal to the site of the primary stricture in ten patients. Dilation of the strictures and histological examination of the biopsy from target lesions of the proximal colon contributed to making the definitive diagnosis in five patients. The diagnosis was not altered in the remaining six patients. CONCLUSION: Dilation of colonic strictures facilitates inspection of the colonic mucosa proximal to the strictures, enabling biopsy of target lesions. This approach offers important diagnostic clues and confirmation of the diagnosis in several patients in whom lesions might be missed if strictures are not dilated.

Catheterization↗
PubMed2003

Removal of chromium and reduction of toxicity to Microtox system from tannery effluent by the use of calcium alginate beads containing humic acid.

Removal of chromium (Cr) from tannery effluents by recovery of metal also reduces the ecotoxicological impact. To develop such a process, columns packed with calcium alginate (CA) beads with or without humic acid (HA) have been used as an adsorbent and tannery effluent was passed through it. Concentration of Cr in beads and in different fractions collected after adsorption was measured. Change in total organic carbon content during the process was also noticed. The fractions were also tested for toxicity towards Microtox assay. EC(50) values were determined with the help of Microtox analyser 500. Data showed that the CA beads along with HA could be effectively utilised in removal of 54% Cr and also in reducing the toxicity (EC(50) (%) in 5 min=>100 in fractions collected after 72 h).

Adsorption↗
PubMed2003

Muscle sarcopenia: an overview.

Sarcopenia is the physiological age related decline in muscle mass and strength. The aetiology is multifactorial involving changes in muscle metabolism, endocrine changes, nutritional factors and mitochondrial & genetic factors. Various treatment modalities have been utilized including hormone replacement therapies but only high resistance training (HIRT) exercise has been of significant benefit. Despite recent advances the exact pathogenesis and therapies are not well understood and need further investigation. This paper reviews the current knowledge of aetiopathogenesis and treatments of sarcopenia and suggests future strategies to enhance the understanding of muscle aging and potential therapies.

Aged↗
PubMed2002

Effect of esophageal variceal band ligation on hemorrhoids, anorectal varices, and portal hypertensive colopathy.

BACKGROUND AND STUDY AIMS: Although it is known that obliteration of esophageal varices following endoscopic variceal band ligation results in an increase in the incidence of portal hypertensive gastropathy, the effect of variceal ligation on hemorrhoids, anorectal/colonic varices and portal hypertensive colopathy is not known. The aim of this study was to investigate the effect of endoscopic variceal band ligation on hemorrhoids, anorectal/colonic varices and portal hypertensive colopathy. PATIENTS AND METHODS: A total of 60 consecutive patients with cirrhosis of the liver and portal hypertension were prospectively studied. Upper gastrointestinal endoscopy and full-length colonoscopy were carried out before the patients underwent endoscopic variceal band ligation for esophageal varices and after obliteration of the varices following band ligation. RESULTS: Obliteration of esophageal varices by endoscopic variceal band ligation did not affect the incidence of hemorrhoids (37 % before and after), anorectal varices (40 % before and after), and portal hypertensive colopathy (57 % before and after). CONCLUSIONS: It is concluded that esophageal variceal band ligation does not affect the incidence of hemorrhoids, anorectal varices or portal hypertensive colopathy in patients with cirrhosis of the liver.

Adolescent↗
PubMed2002

Percutaneous treatment of hepatic hydatid cysts using hypertonic saline.

BACKGROUND: Due to improvements in imaging techniques and immunodiagnostic methods there has been a spurt of cases of hepatic hydatidosis. Till now surgical management in the form of marsupialization and tube drainage, omentoplasty or hepatectomy was the mainstay of treatment. Recently treatment options have improved considerably after introduction of the PAIR (precutaneous aspiration, injection of scolicidal agent and reaspiration) procedure. In this study we report the results of ultrasound guided PAIR procedure in 39 hepatic hydatid cysts. METHOD: All patients with hepatic hydatid cysts underwent the PAIR procedure under ultrasound guidance. The scolicidal agent used was 20% hypertonic saline. Type I and II (n=24) cysts were managed by precutaneous aspiration while type III and IV showing a multiloculated or pseudotumour appearance (n=15) cysts were managed by the percutaneous placement of a Malecot's catheter which was removed after 3-7 days. RESULTS: All patients responded to the PAIR procedure. The commonest ultrasonographic appearance in hepatic hydatid cyst patients was a solitary uniloculated cyst with prominent back wall echoes in the right lobe of the liver. The complications encountered were in the form of mild hypotension (two cases), urticaria in one patient and severe hypotension leading to shock in one case. CONCLUSIONS: The PAIR procedure was found to be effective, cheap and safe in the non-surgical management of hepatic hydatid cysts.

Adult↗
PubMed2001

The use of a bioactive skin substitute decreases length of stay for pediatric burn patients.

BACKGROUND: To optimize burn care for children, the authors introduced a protocol incorporating the use of a bioactive skin substitute, TransCyte (Advanced Tissue Sciences, La Jolla, CA). This study was designed to determine whether this management plan was safe, efficacious, and decreased hospital inpatient length of stay (LOS) compared with conventional burn management in children. METHODS: All pediatric burns greater than 7% total body surface area (TBSA) that occurred after October 1999 underwent wound closure with TransCyte (n = 20). These cases were compared with the previous 20 consecutive burn cases greater than 7% TBSA that received standard therapy. Standard therapy consisted of application of antimicrobial ointments and hydrodebridement. The following information was obtained: burn mechanism, age, size of burn, requirement of autograft, and LOS. Data were analyzed using the student's t test. RESULTS: Data for age, percent TBSA burn and LOS are reported as means +/- SEM. The children who received standard therapy were 2.99 +/- 0.7 years compared with those receiving TransCyte were 3.1 +/- 0.8 years. There was no difference between the treatment groups with regard to percent TBSA burn: standard therapy, 14.3 +/- 1.4% TBSA versus TransCyte, 12.7 +/- 1.3% TBSA. There was no difference in the type of burns in each group, the majority were liquid scald type, 70% in the standard therapy group versus 90% in the TransCyte group. Only 1 child in the TransCyte group required autografting (5%) compared with 7 children in the standard therapy group (35%). Children treated with TransCyte had a statistically 6 significant decreaed LOS compared with those receiving standard therapy, 5.9 +/- 0.9 days versus 13.8 +/- 2.2 days, respectively (P =.002). CONCLUSIONS: This is the first study using TransCyte in children. The authors found that this protocol of burn care was safe, effective, and significantly reduced the LOS. This new approach to pediatric burn care is effective and improves the quality of care for children with burns.

Burn Units↗
PubMed2001

Helicobacter pylori and associated histopathological changes in gastric biopsies of patients with leprosy.

Two antral biopsies each from 104 patients of leprosy and 100 controls were studied to find out the prevalence of H. pylori and associated histopathological changes. Sections were stained with hematoxylene and eosin, AB/PAS (Ph 2.5) and Loeffler's methylene blue stains. Infection by H. pylori, inflammation and atrophy were found to be significantly more in leprosy patients as compared to controls (p < 0.01, < 0.005 and < 0.02 respectively). On comparing the histopathological changes in various subgroups of leprosy, H. pylori, inflammation and activity showed a statistically decreasing trend from tuberculoid to lepromatous subgroups (p < 0.05, < 0.001, < 0.01 respectively). Atrophy showed a significant increasing trend from tuberculoid to lepromatous group (< 0.001), it is concluded that despite a low prevalence of H. pylori and associated gastritis in patients with lepromatous leprosy, gastric epithelial damage is more marked due to altered immune response.

Adolescent↗
PubMed2000

Zhangfei: a second cellular protein interacts with herpes simplex virus accessory factor HCF in a manner similar to Luman and VP16.

Host cell factor (HCF, C1, VCAF or CFF) is a cellular protein that is required for transcription activation of herpes simplex virus (HSV) immediate-early (IE) genes by the virion protein VP16. The biological function of HCF remains unclear. Recently we identified a cellular transcription activator, Luman. As with VP16, the transactivation function of Luman is also regulated by HCF. Here we report a second human protein, Zhangfei (ZF) that interacts with HCF in a fashion similar to Luman and VP16. Although ZF shares no significant sequence homology with Luman, the two proteins have some structural similarities. These include: a basic domain-leucine zipper (bZIP) region, an acidic activation domain and a consensus HCF-binding motif. Unlike Luman, or most other bZIP proteins, ZF by itself did not appear to bind consensus bZIP-binding sites. It was also unable to activate promoters containing these response elements. Although in transient expression assays ectopically expressed ZF was unable to block transactivation by VP16 of a HSV IE promoter, ZF could prevent the expression of several HSV proteins in cells infected with the virus. The ability of ZF to block the synthesis of the HSV IE protein ICP0 relied on its binding to HCF, since a mutant of ZF that was unable to bind HCF was also unable to prevent viral IE protein expression.

5' Untranslated Regions↗
PubMed2000

Working with families of suddenly and critically ill children: physician experiences.

OBJECTIVE: To describe physicians' experiences in attempting to provide optimal care for families of children who suffer from sudden, acute life-threatening conditions (SALTC). DESIGN: To generate descriptive data in this exploratory study, we used qualitative methods including focus groups and in-depth interviews. Transcripts of focus groups and interviews were analyzed for content using standard phenomenologic analysis methods, which resulted in a participant-generated conceptual model of optimal care for families of children with SALTC. SETTING: The intensive care unit of an urban pediatric teaching hospital. PARTICIPANTS: Twenty-two pediatric intensive care unit physicians, including residents, fellows, and attendings. INTERVENTION: None. MAIN OUTCOME MEASURES: Each participating physician provided qualitative descriptions of experiences caring for families of children with SALTC. RESULTS: Physicians identified 4 components of optimal care for families: (1) providing timely, accurate information about their child; (2) maintaining privacy for confidential discussions and personal grieving; (3) giving adequate emotional support; and (4) granting family members the right to hold and comfort their dying child. Physicians also described barriers to, and facilitators of this optimal care. CONCLUSIONS: Descriptive information provided in this exploratory study offers a complex model of optimal family care. Issues that affect the quality of care to families include those related to the context of providing care in a large teaching hospital, as well as subtleties of communication between parents and staff. Physicians' beliefs about optimal care of families in the pediatric intensive care unit revealed implications for both practice and training in pediatrics.

Communication↗
PubMed2000

Stability constants of metal-humic acid complexes and its role in environmental detoxification.

Humic acid with hydroxyl-, phenoxyl-, and carboxyl-reactive groups can form coordination compounds with metals. The ion-exchange equilibrium method using Dowex AG 50W-X8, 20-25 mesh Na(+) form was used to determine stability constants of complexes formed between humic acid (isolated from the soil) 50-250 microg ( approximately 3x10(-5)-15x10(-5) mol/liter) and metal salts solution 200 microg at pH 3.5. The stability constant (log K) for different metal-humic acid complexes indicated the following order of the stabilities of complexes formed between humic acid and metal ions: Cu>Fe>Pb>Ni>Co>Ca>Cd>Zn>Mn>Mg. The data on stability constants demonstrated substantial deviation from Irwing-Williams series reported for divalent ions. The molar humic acid/metal ratios were also calculated. Some of the factors affecting the stability constants such as cation exchange capacity of humus soil, molecular radius, and molecular surface area of humic molecules were also estimated. The significance of the data to predict the behavior of these complexes in the environment is discussed.

Algorithms↗
PubMed2000

Argyrophilic nucleolar organizer regions in Helicobacter pylori-associated gastric lesions.

Three hundred and fifty biopsies from patients undergoing upper gastrointestinal endoscopy were studied for histopathological changes, H. pylori infection and argyrophilic nucleolar organizer region (AgNOR) counts. Histopathological examination revealed normal gastric mucosa in 10 (2.85%), gastritis in 254 (72.56%), intestinal metaplasia in 12 (4.0%), dysplasia in 13 (3.7%) and adenocarcinoma in 61 (17.4%). The mean (SD) AgNOR count was 1.66 (0.20) in normal, 2.43 (0.64) in gastritis, 3.09 (0.52) in intestinal metaplasia, 4.17 (0.31) in dysplasia, and 6.57 (0.98) in carcinoma. A statistically significant difference was observed between the AgNOR count of normal gastric mucosa and gastritis (p<0.001), gastritis and dysplasia (p<0.001), and dysplasia and adenocarcinoma (p<0.001). A statistically significant increase in mean AgNOR count was found with increase in H. pylori density in gastric biopsies (p<0.001) with gastritis. No significant difference was observed between mean AgNOR count of intestinal and diffuse type carcinomas. The AgNOR count in gastric biopsies with adenocarcinoma and H. pylori infection was 7.03 (0.85) as compared to 6.89 (0.73) in gastric biopsies with evidence of adenocarcinoma but without H. pylori infection. The difference was not statistically significant. The findings support the role of H. pylori as a promoting agent in gastric carcinogenesis by stimulating gastric epithelial cell proliferation at the stage of chronic inflammation, thereby making the cells more susceptible to endogenous or exogenous carcinogenic agents.

Adenocarcinoma↗