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Biomedical subjects

V S Mehta

Publications and source records attributed to V S Mehta.

At least 55 records · Page 3Linked to original sources
PubMed1999

A correlative study of gliomas using in vivo bromodeoxyuridine labeling index and computer-aided malignancy grading.

An in vivo bromodeoxyuridine (BrdU) labeling index (LI) was estimated in 43 cases of astrocytic tumors and mixed gliomas by one hour intra-operative intravenous infusion at a dose of 200 mg/m2 and correlated with (a) histological grading using a computer aided malignancy classifier TESTAST-268; and (b) histological typing using WHO classification. The lowest BrdU LI was seen in pilocytic and gemistocytic astrocytomas followed by astrocytomas, anaplastic astrocytomas and glioblastoma multiforme in that order. Mixed oligoastrocytomas followed the pattern of their astrocytic counterparts. Tumors of similar histological type showed different BrdU LI values especially amongst astrocytomas and glioblastomas. A statistically significant difference in the BrdU LI was also noted between the higher TESTAST grades of astrocytomas (T III and IV) versus the lower TESTAST grades (T II). Unlike earlier reports in literature, in the present study the category of BrdU LI of <1 contained no case of anaplastic astrocytoma or glioblastoma multiforme (TESTAST grades III and IV). Likewise, the category of BrdU LI >5 contained only anaplastic astrocytoma and glioblastoma multiforme (TESTAST grades III and IV). Maximum spread of cases was seen in the BrdU LI category of 1-5, not only in terms of histological types but also TESTAST grades. Thus there appeared to be a positive trend of increasing BrdU LI values both with histological types and increasing TESTAST grades. Further, an interesting observation was that by using a combination of TESTAST grades and BrdU LI, the histologically homogenous glioblastoma group could be further subdivided into 4 categories which showed a trend towards prognostic correlation. Thus, this study though preliminary with number of cases being small in some groups, highlights the possible usefulness of combined histological typing, TESTAST grading and in vivo BrdU LI for prognostication of gliomas especially glioblastoma multiforme.

Astrocytoma↗
PubMed1998

Gliofibroma: mixed glial and mesenchymal tumour. Report of three cases.

Gliofibromas are rarely encountered astrocytic tumours comprising of astrocytic and benign fibroblastic components. They commonly occur in first two decades of life. However, the exact behaviour is not fully known and their histogenesis is also still debatable. We report three cases of gliofibroma in which we studied proliferative markers (MIB-1) and p53 protein expression. In these tumours, occurrence in adult life is in contrast to that reported in the literature. Depending upon the morphology and proliferative Labelling Index we classified these tumours into low grade (benign) and high grade (malignant/anaplastic).

Adult↗
PubMed1998

The microbial spectrum of brain abscess with special reference to anaerobic bacteria.

The bacteriological and clinical findings of 18 cases of brain abscess are presented. Identification and antimicrobial susceptibility of anaerobic strains was performed both by conventional methods and the newer RapID ANA II panel and E-test methods, respectively. Characterization of the anaerobic isolates was done by restriction fragment length polymorphism (RFLP). Anaerobic or aerobic organisms alone were recovered in three (16.6%), and mixed aerobic and anaerobic in another three (16.6%) patients. There were nine anaerobic isolates. The predominant anaerobes were Prevotella melaninogenicus (four isolates), Bacteroides preacutus (three isolates), Fusobacterium nucleatum and Peptostreptococcus sp. (one isolate each). A total of six aerobic isolates, all of which were Gram-positive cocci were recovered. All the anaerobic isolates were susceptible to metronidazole, but two isolates of P. melaninogenicus were resistant to penicillin. There was complete agreement between the identification based on biochemical profiles and RFLP patterns. These findings indicate the microbial complexity of brain abscess and the need to target antimicrobial therapy against both the aerobic and anaerobic components of infection.

Adult↗
PubMed1998

Development of neurogenic pulmonary edema at different grades of intracranial pressure in cats.

Development of neurogenic pulmonary edema (NPE) subsequent to increased intracranial pressure (ICP) was evaluated in an experimental model in cats. Experiments were conducted in chloralose anaesthetised animals, either on spontaneous respiration or on intermittent positive pressure ventilation. Hemodynamic parameters i.e., mean arterial pressure (MAP) and heart rate (HR) were continuously monitored. Pulmonary artery/right ventricular systolic pressure was recorded in cats on spontaneous respiration. Increase in ICP for 180 minutes caused an increase in extravascular lung water (EVLW) content in both spontaneously breathing and artificially ventilated animals. In spontaneously breathing animals EVLW to blood free dry weight ratio (EVLW/BFDW) was 3.95 +/- 0.16 and 4.96 +/- 0.16 at ICP 40 and 80 mm Hg respectively while in animals on artificial ventilation, at 40, 60, 80 and 100 mm Hg ICP, it was 3.88 +/- 0.11, 4.09 +/- 0.10, 4.50 +/- 0.13 and 5.03 +/- 0.17 respectively. These values were significantly greater (P < 0.05) as compared to that in sham operated animals (3.43 +/- 0.10). This was accompanied by rise in MAP, HR and pulmonary artery pressure. The study establishes the graded development of NPE, the severity of which is proportional to the levels of ICP.

Animals↗
PubMed1996

Intracranial intraparenchymal schwannomas: a series of eight cases.

Intraparenchymal schwannomas of the CNS are extremely rare. Between 1979 and 1993 400 cases of intracranial schwannomas were operated on and among them were eight patients with intraparenchymal schwannomas comprising 2% of intracranial benign nerve sheath tumours. Four of them were located in the cerebral hemispheres and two each in the brain stem and in the cerebellum. In two cases, there was associated neurofibromatosis (NF-1 and NF-2, one case each). The age ranged from 6 months to 45 years with a male/female ratio of 3:1 and, surprisingly, six of them were in the left cerebral or cerebellar hemisphere.

Adolescent↗
PubMed1995

Ruptured intracranial aneurysm complicating pregnancy.

Three cases of ruptured intracranial aneurysm during pregnancy are presented. Rupture occurred near term in all three cases. Simultaneous elective cesarean section and clipping of the aneurysm was performed in two cases. Successful maternal and perinatal outcome was achieved in all three patients. The diagnosis and management of the cases are described and discussed.

Aneurysm, Ruptured↗
PubMed1994

Lymphocytic hypophysitis. Case report.

A case of lymphocytic hypophysitis is described in a patient presenting with panhypopituitarism 8 years after her last childbirth. The patient developed headache, vomiting, and diplopia (due to palsy of the right lateral rectus muscle) 7 months after delivery of her last baby. The diplopia disappeared after a few days with symptomatic treatment, and the headache and vomiting decreased in intensity with analgesic therapy. Eight years later the patient developed symptoms suggestive of hypoadrenalism, hypothyroidism, and amenorrhea. Investigations revealed panhypopituitarism with a pituitary mass lesion. Repeat evaluation 1 year later demonstrated no change in the size of the pituitary gland. The patient underwent transsphenoidal surgery with a provisional diagnosis of pituitary adenoma. Histological examination of the resected gland revealed evidence of lymphocytic hypophysitis. Symptoms suggestive of a pituitary mass lesion were noted during the peripartum period, but features of hypopituitarism developed much later. Such a long latent period has not been reported before. This report also highlights the fact that glandular enlargement may persist for many years after the onset of lymphocytic hypophysitis.

Adult↗
PubMed1993

Surgical treatment of brachial plexus injuries.

Ninety-nine consecutive patients with brachial plexus injuries were operated upon over a period of 8 1/2 years. Among them, 70% sustained traction injuries. The surgical procedures included neurolysis in 35, excision of a lateral neuroma in six and interfascicular sural nerve grafting in 27 patients. In 25 patients, after an exploration, no further surgical procedure was carried out. In four patients, an intercosto-musculocutaneous anastomosis, and in two a trapezius muscle transplant were carried out. Just over two-thirds (68%) of the patients were operated upon 6 months after the injury. Water soluble contrast myelography was performed in 60 patients. These included patients where a root injury had been diagnosed clinically or electrophysiologically. MRI was performed in 14 patients to visualize root avulsions and distal lesions. Operative confirmation of MRI findings were obtained in more than 85% of patients. While an early improvement was seen in patients where only a neurolysis was required, at longer follow-up, gratifying results were recorded even in patients with interfascicular grafts of 6-8 cm length. All 49 patients who came for follow-up and in whom a definitive surgical procedure had been carried out improved. Of these patients, 61% showed near normal or satisfactory functional recovery. The other patients were followed for periods of less than 1.5 years and may show further improvement with time.

Adolescent↗
PubMed1992

The role of radiation therapy in the management of spinal cord compression due to extramedullary haematopoiesis in thalassaemia.

Extramedullary haematopoiesis associated with thalassaemia leading to spinal cord compression is an extremely rare event in the course of the disease. The efficacy of radiation therapy is advocated in the management of such a complication. Two patients with thalassaemia, who had presented with spinal cord compression, were successfully treated by a modest dose of local radiotherapy. In one of the patients, however, radiotherapy was resorted to after an initial decompressive laminectomy and partial removal of the intraspinal haematopoietic mass proved unsuccessful. The other patient was managed solely by radiation therapy.

Adult↗
PubMed1990

Schwannoma of the oculomotor nerve.

A case is described of oculomotor nerve sheath tumour presenting with signs and symptoms of a posterior fossa space occupying lesion with minimal involvement of the IIIrd nerve.

Adult↗
PubMed1989

MR evaluation of brachial plexus injuries.

Ten cases of brachial plexus injury were subjected to magnetic resonance (MR) to demonstrate the roots, trunks, divisions or cord abnormalities. Both normal and abnormal brachial plexuses were imaged in sagittal, axial, coronal and axial oblique planes. Myelography, using water soluble contrast agents, was performed in seven cases. MR demonstrated one traumatic meningocele, one extradural cerebrospinal fluid (CSF) collection, trunk and/or root neuromas in four, focal root fibrosis in two and diffuse fibrosis in the remaining two cases. Results of MR were confirmed at surgery in four cases with neuromas, while myelography was normal in two and was not carried out in the remaining two. In two cases, where MR demonstrated diffuse fibrosis of the brachial plexus, myelography showed C7 and T1 traumatic meningocele in one and was normal in the other. Both these patients showed excellent clinical and electrophysiological correlation with MR findings and in one of them surgical confirmation was also obtained. In the other two cases with focal nerve root fibrosis, myelography was normal in one and showed a traumatic meningocele in another. Operative findings in these cases confirmed focal root fibrosis but no root avulsion was observed although seen on one myelogram. Focal fibrosis, however, was noted at operation in more roots than was observed with MR. Initial experience suggests that MR may be the diagnostic procedure of choice for complete evaluation of brachial plexus injuries.

Adolescent↗
PubMed1989

Head injury mortality in two centers with different emergency medical services and intensive care.

The authors report data collected prospectively on 551 cases of head injury in New Delhi, India, and 822 cases in Charlottesville, Virginia. The mortality rate, adjusted for initial severity of injury, was 11.0% in New Delhi versus 7.2% in Charlottesville (p less than 0.02). There was a striking similarity in mortality rates at both centers when comparing patients with the least severe head injuries and those with the most severe injuries according to the motor score of the Glasgow Coma Scale (GCS M). However, in the group with an abnormal but purposeful motor response (GCS M = 5), the mortality rate was 12.5% in New Delhi versus 4.8% in Charlottesville (p less than 0.01). The relative absence of prehospital emergency care and the delay in admission after head injury in New Delhi are cited as two possible causes for the differences in mortality rates in this subgroup of patients with "moderate" head injuries.

Adult↗
PubMed1987

Intracerebellar schwannoma. Case report.

A rare case of a solitary schwannoma arising within the cerebellum is reported. The diagnosis was confirmed by electron microscopy and immunohistochemical staining.

Adult↗
PubMed1984

Neuroenteric cyst of the cerebellum.

Intracranial neuroenteric cysts are rarely encountered and no more than 13 cases have been reported in the literature. This paper reports another case located in the cerebellum. These occur mostly in adults and there is no typical clinical presentation. The computed tomographic scan shows them as low attenuating lesions with no peripheral contrast enhancement. These cysts are believed to be developmental in origin.

Cerebellar Diseases↗