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V R Joshi

Publications and source records attributed to V R Joshi.

At least 19 recordsLinked to original sources
PubMed1992

Tumour induced osteomalacia: a report of two cases. A disease of defective matrix synthesis?

Tumour induced hypophosphataemic osteomalacia or rickets is a well delineated clinical entity. There is confusion, however, about the nomenclature and classification of the associated tumours. The tumour factor responsible for the biochemical abnormalities has also not been identified. We report here two cases: one, a 43 year old male with a soft tissue tumour in the left vastus medialis, and the other, a 25 year old female with a soft tissue tumour in the right anterior axillary fold. Reversal of biochemical abnormalities and clinical improvement occurred after removal of the tumour in both cases. Both tumours showed unusual morphology characterised by spindle cell component, large vascular spaces, osteoclast-like giant cells, calcification and ossification. The tumour in the second patient was benign, while the nature of the tumour in the first patient was debated. We speculate that defective matrix may be the cause of unusual histology of the tumours, and also the source of the phosphaturic factor.

Adult↗
PubMed1992

Chloramphenicol resistance in Salmonella typhi. Report from Bombay.

Chloramphenicol resistance to Salmonella typhi in 1989 was 16% in Hinduja Hospital. From Jan to June 1990, this resistance has increased to 81%. 74 strains of blood culture isolated of S typhi obtained from Jan to June were subjected to antibiotic sensitivity testing by disc diffusion technique of Kirby and Bauer 60 strains were found to show a block resistance tochloramphenicol, Ampicillin, Co-trimoxazole, Streptomycin, Tetracycline and Carbenicillin. All strains were sensitive to quinolones. Resistance was record and MIC done in 50 resistant strains by modified National Committee for Clinical Laboratory Standards [NCCLS] according to recommended break points and resistance to Chloramphenicol was confirmed. Of the 47 strains isolated, 34 had received treatment with either chlorampheniicol, Ampicillin or Cotrimoxazole in adequate dosages. In 39 of these 47 patients, Salmonella typhi was isolated after 14 days duration of fever. Plasmid analysis revealed presence of 100 megadalton plasmid in majority of cases. Most patients responded to fluoroquinolones but amongst the admitted patients complications such as Myoglobinuria in 2 cases, perforation in 4 cases, acute Renal failure in 2 cases and typhoid spine in 1 case were seen. Phage typing results of 19 strains were E-8, 0-6.

Chloramphenicol Resistance↗
PubMed1991

Chlorpropamide induced syndrome of inappropriate secretion of antidiuretic hormone.

This is a report of a patient who developed symptomatic hyponatraemia during chlorpropamide therapy for diabetes mellitus. The patient's clinical and biochemical abnormalities were corrected by withdrawal of chlorpropamide. This represents a drug induced, reversible form of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH).

Chlorpropamide↗
PubMed1991

Predicting the immediate outcome of patients with cerebrovascular accident: a prognostic score.

A prognostic score was derived from a prospective study of 120 consecutive patients with cerebrovascular accident. Multivariate analysis was used to compare the presenting clinical features of 106 (88%) of these patients with their immediate outcome (survival or death). Similar analysis was also used to compare features on CT scan with immediate outcome in 45 patients. The immediate prognostic features included old age, history of previous stroke, mental obtundation at the onset, persistent altered consciousness greater than or equal to first 48 hours, altered consciousness appearing in the first 24-72 hours, complete hemiplegia, seizures, aspiration pneumonitis, and multiple/massive lesions and gross mass effect on CT scan. The prognostic score derived from discriminant function using CT scan variables was less accurate than that formulated from only clinical variables. In the latter (using clinical variables) a prognostic score of 46 or less suggested a 50% chance of recovery, scores of 47 or more a 50% chance of death, while scores of 12 or less and 63 or more suggested a 99% likelihood of survival and death respectively.

Brain Damage, Chronic↗
PubMed1990

Gemfibrozil in familial and type V hyperlipidaemias. Report of 3 cases.

Gemfibrozil, a lipid lowering agent, was administered to two patients with familial hyperlipidaemia and one patient with insulin dependent diabetes mellitus. It was partially effective in familial hyperlipidaemia. It dramatically reduced triglyceride and cholesterol levels in the patient with Type V hyperlipidaemia and insulin dependent diabetes mellitus. Patients with familial and Type V hyperlipidaemias should be given a trial of gemfibrozil therapy.

Adult↗
PubMed1990

Renal involvement in scleroderma.

Twenty four patients (20 females, 4 males; aged 10-65 years) with progressive systemic sclerosis have been analysed. Twenty three had proximal scleroderma (14 acrosclerosis, 9 proximal scleroderma). Two patients had CREST syndrome and two had incomplete CREST syndrome. Both patients with CREST syndrome had acrosclerosis; the two with incomplete CREST syndrome had proximal scleroderma. Cutaneous and vasospastic symptoms were the common initial symptoms. Two patients had pulmonary symptoms at the onset. Skin changes (24 cases), Raynaud's phenomenon (20), articular involvement (13) and upper gastrointestinal involvement (12) were the major manifestations during the course of the disease. Three patients had cardiac involvement. Another three had overlap syndrome. Two had clinically manifest renal involvement. Kidney biopsies were abnormal in 5 of 10 clinically normal patients. Three patients died, one each due to involvement of the heart and lung; in the third, the cause of death could not be ascertained.

Adolescent↗
PubMed1990

Gemfibrozil in hyperlipidaemia: an open, single blind trial.

The efficacy of Gemfibrozil on S. lipid levels was studied in 36 middle aged subjects with type IIA, IIB, IV hyperlipidemia. Gemfibrozil was well tolerated in the dose of 1200 mg/day and no dropouts were attributable to its use. An overall reduction in total cholesterol (39.91%), total triglycerides (71.10%), VLDL triglycerides (62.97%). LDL cholesterol (45.57%) and apolipoprotein B levels (26.83%) were observed at 24 weeks. At the same time HDL cholesterol, and apolipoprotein A levels showed increases by 26.23% and 53.67% respectively. It is concluded that Gemfibrozil is an effective lipid lowering agent. Further long term studies are necessary to determine its optimal dosage and its long term safety in Indian subjects.

Adult↗
PubMed1990

Study of iatrogenic thrombophlebitis.

This is an analysis of 42 adult patients with 97 episodes of thrombophlebitis following 167 venepunctures. Almost all commonly used fluids had contributed to the development of thrombophlebitis. The observations showed significantly higher chances of development of thrombophlebitis with the quantity of fluids more than 2500 ml. (chi 2 = 15.50, P less than 0.001), autoclaved containers (chi 2 = 5.5, P less than 0.05) use of rubber tubing for infusion set (chi 2 = 4.7, P less than 0.05) and infusion rate more than 20 drops per minute (chi 2 = 15.25. P less than 0.001). Average time interval between beginning of IV infusion and development of thrombophlebitis was found to be 18 hours and average extent of thrombophlebitis was 7 cm. The commonest micro-organism isolated from needles was Pseudomonas aeruginosa.

Adult↗
PubMed1989

Indian dispatch.

Explore the source record for details and available documents.

Humans↗
PubMed1989

Ankylosing spondylitis in females. Similarities and differences with male spondylitics.

Ten female and seventy two male patients suffering from ankylosing spondylitis were studied to evaluate differences between the two sexes. Low lumbar backache and inactivity stiffness were the commonest presenting complaints in females (8/10) as compared to males (34/72). They also had a later age of onset (25.4 + 6.16 yrs) compared to males (20.56 + 6.57 yrs). Females were found to be symptomatically milder with a more benign course of the disease. There were no significant differences in the frequency of extra-articular features and HLA B27 between males and females. A positive family history was more often seen in female ankylosing spondylitis (50%) than male (31.94%) patients.

Adolescent↗
PubMed1989

Cryoglobulin studies in systemic lupus erythematosus.

Twenty-two patients with systemic lupus erythematosus (SLE) were investigated to study the incidence and immunochemical nature of circulating immune complexes. In 68.18% of patients, the immune complexes were detected as cryoglobulins. A significantly high value of serum IgG and IgA (1980.64 +/- 1031.53 and 283.81 +/- 131.02 mg% respectively) were observed in these patients compared to those in normal (1097.04 +/- 298.10 and 200.93 +/- 89.96 mg% respectively). The patients also had significantly low levels of serum complement fraction C3 (61.35 +/- 22.64 mg%). Correlation of these parameters could help in understanding of the role of immunochemical factors in the pathogenesis of the disease.

Adolescent↗