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Biomedical subjects

V Singh

Publications and source records attributed to V Singh.

At least 109 records · Page 6Linked to original sources

Low-cost technology for screening uterine cervical cancer.

We report on an illuminated, low-cost (Rs 1500 (US$ 36)) magnifying device (Magnivisualizer) for detecting precancerous lesions of the uterine cervix. A total of 403 women attending a maternal and child health care clinic who had abnormal vaginal discharge and related symptoms were referred for detailed pelvic examination and visual inspection by means of the device after the application of 5% (v/v) acetic acid. Pap smears were obtained at the same time. The results were compared with those obtained using colposcopy and/or histology. The Magnivisualizer improved the detection rate of early cancerous lesions from 60%, for unaided visual inspection, to 95%. It also permitted detection of 58% of cases of low-grade dysplasia and 83% of cases of high-grade dysplasia; none of these cases were detectable by unaided visual inspection. For low-grade dysplasia the sensitivity of detection by means of the Magnivisualizer was 57.5%, in contrast with 75.3% for cytological examination. However, the two methodologies had similar sensitivities for higher grades of lesions. The specificity of screening with the Magnivisualizer was 94.3%, while that of cytology was 99%. The cost per screening was approximately US$ 0.55 for the Magnivisualizer and US$ 1.10 for cytology.

Adolescent↗

Phytosterols in the aleurone layer of corn kernels.

Corn hulls are composed of two major layers: the outer layer, the pericarp, is made up of non-living cell walls, and an inner layer, the aleurone, consists of a single layer of living cells, surrounded by thick cell walls. Dissected pure pericarp and aleurone fractions were ground and extracted with hexane and the yields and compositions of the resulting oils were examined. This study revealed that the high levels of ferulate-phytosterol esters and the high concentration of sitostanol previously reported in corn-fibre oil actually originate in the aleurone cells.

Chromatography, High Pressure Liquid↗

Variation of axillary temperature and its correlation with oral temperature.

UNLABELLED: Unilateral axillary temperature is recorded in unconscious patients and children due to its easy approach. OBJECTIVE: To evaluate variation of axillary temperature on the two sides and its correlation with oral temperature. SUBJECTS: One hundred and 46 healthy men and women, aged 12 through 52 years. METHODS: Axillary temperature from both sides and oral temperature were recorded using digital electronic thermometer in supine position with due precautions. RESULTS: Difference in temperature on the two sides of axilla was found to vary by as much as 0 degree F to 3.4 degrees F. Therefore, the data was grouped into higher and lower temperature ranges. The difference between mean oral and mean higher axillary temperature was found to be 0.5 degree F +/- 0.6 degree F (r = 0.564) while that in comparison to mean lower axillary temperature was 1.0 degree F +/- 0.89 degree F (r = 0.64). The difference between mean oral and mean axillary temperature was 1.0 degree F +/- 0.80 degree F (r = 0.84). CONCLUSIONS: Based on our observations, it is found that an average of temperature of both sides of axilla represents the axillary temperature more accurately and to get the correct oral equivalent of axillary temperature one should add 1 degree F to the mean axillary temperature.

Adolescent↗

Role of oxygen free radicals in shock.

AIMS OF THE STUDY: To study lipid peroxidation, magnesium levels (Mg) in plasma and red cells (RBC), superoxide dismutase (SOD) and catalase (CAT) activities in the plasma and RBC of shock patients. METHODOLOGY: Twenty five patients with clinically defined septic shock and 30 healthy volunteers were selected for the study to study the parameters of oxidative stress. RESULTS: Septic shock patients had higher activities of plasma and RBC SOD and CAT activities as compared to control. Also, plasma Mg and malonaldehyde (MDA) levels were higher in shock patients as compared to controls. While, RBC Mg levels were similar in two groups. CONCLUSIONS: The finding of increased concentration of MDA, Mg, SOD and CAT in sepsis implicates oxygen free radicals in the pathophysiology and free radical scavengers may have a role in organ preservation.

Adult↗

The role of cough and hyperventilation in perpetuating airway inflammation in asthma.

Air flowing through a pipe exerts frictional stress on the walls of the pipe. Frictional stress of more than 40 N/m2 (velocity equivalent of air 113 m/s) is known to cause acute endothelial damage in blood vessels. The frictional stress in airways during coughing may be much greater, however, since the velocity of air may be as high as speed of sound in air. We suggest that high levels of frictional stress perpetuate airway inflammation in airways which are already inflamed and vulnerable to frictional stress-induced trauma in patients with asthma. Activities associated with rapid ventilation and higher frictional stress (e.g. exercise, hyperventilation, coughing, sneezing and laughing) cause asthma to worsen whilst activities that reduce frictional stress (Yoga 'Pranayama', breathing a helium-oxygen mixture and nasal continuous positive airway pressure) are beneficial. Therefore control of cough may have anti-inflammatory benefits in patients with asthma.

Asthma↗

Serum vitamin E in chronic myeloid leukaemia.

OBJECTIVE: Experimental evidence suggests that free radicals can participate in tumour promotion and malignant conversion and free radical scavengers like alphatocopherol act as first line of defense against peroxidation of polyunsaturated fatty acids. The present study was planned to estimate serum vitamin E levels in patients of chronic myeloid leukaemia (CML). METHODS: Serum vitamin E levels were estimated in 25 CML patients before and after the treatment. Twenty five age and sex matched healthy individuals served as control. RESULTS: Mean serum vitamin E levels were significantly decreased in CML patients before starting the treatment as compared to control. Also, vitamin E levels increased significantly after the treatment, but, remained lower than the control. CONCLUSION: Vitamin E levels were lower in CML patients as compared to control and the levels increased significantly after treatment in these patients. This could be due to decrease in oxidative stress due to decrease in tumour load.

Adult↗

Glutathione levels in health and sickness.

We speculate that the glutathione (GSH) status of human subjects could be an indicator of health and functional age. In this regard, in a study in which, 80 young and 40 elderly healthy individuals were selected as control. We also studied 145 patients with chronic illnesses namely, ischaemic heart disease, diabetes, preeclampsia, cataract, chronic renal failure and leukaemia (age 52 +/- 8.6 years). We observed that all the subjects had high malonadildehyde and low glutathione levels as compared to control. These early observations support the hypothesis that oxidative stress may have an important aetiological rule and antioxidants a potential therapeutic role.

Adult↗

Magnesium deficiency potentiates free radical production associated with myocardial infarction.

OBJECTIVE: Oxidative injury and magnesium deficiency may accompany cardiovascular disease states and the study was planned to find out whether magnesium deficiency promotes oxidative injury. METHODS: Serum malonaldehyde (MDA), magnesium, vitamin E and total glutathione levels (GSH) were estimated in 22 patients with acute myocardial infarction and 15 healthy controls. RESULTS: Low levels of Mg, GSH, vitamin E and elevated levels of MDA were observed in patients of acute myocardial infarction. Statistically significant correlations were observed between Mg and MDA, MDA and GSH, Mg and vitamin E. CONCLUSION: Our findings suggest that Mg deficiency can potentiate oxidative injury to post ischaemic myocardium and that antioxidants may have a role in protection against the prooxidant influence(s) of Mg deficiency.

Aged↗

Effect of esophageal and gastric distention on bronchial hyper-responsiveness in patients with bronchial asthma.

OBJECTIVE: Over-eating is said to aggravate asthma though the mechanism is still unclear. We tried to study the mechanism by causing distention in oesophagus and stomach. METHODS: Fifteen patients with nocturnal asthma were studied in a random cross-over design. The esophagus and stomach of the subjects were distended with a balloon. The effect of the distention on the airways was measured by taking forced expiratory volume one second (FEV1), forced vital capacity (FVC) and bronchial hyper-responsiveness (BHR). RESULTS: Distention of stomach caused significant reduction in FEV1 on FEV1/FVC ratio but similar distention of esophagus did not. Histamine PD20 was decreased by 0.43 (SEM 0.28) doubling dose with gastric distention. However, with oesophageal distention no significant change was observed in PD20. CONCLUSION: It can be concluded that gastric distention leads to broncho-constriction as measured by FEV1, FEV1/FVC ratio along with increase in BHR probably by inducing airway inflammation. Therefore asthmatic patients should be advised to avoid large meals.

Adolescent↗

Does nasal breathing cause frictional trauma in allergic rhinitis?

OBJECTIVES: Frictional stress on the walls of a tube increases with increased air flow and as the diameter of the tube is reduced. High values of frictional stress may occur in the nose during nasal obstruction which could damage the nasal mucosa particularly when the mucosa is inflamed and fragile as in allergic rhinitis. The effect of nasal airflow induced frictional stress on the nasal mucosa was studied in patients with allergic rhinitis. METHODS: We studied nasal peak flow rate in eight patients with allergic rhinitis and nasal obstruction comparing the change in peak expiratory flow after they breathed for 30 minutes through an obstructed and a patent nostril. Patients were studied in the right and left lateral decubitus positions to increase and decrease the resistance in the lower and upper nostril respectively and thus minimize any effects of cyclical changes in nasal resistance. Subjects breathed for 30 minutes through the upper patent nostril (schedule 1) and for a further 30 minutes through the lower obstructed nostril (schedule 2). Nasal peak expiratory flow rate was measured in both nostrils separately in both positions after each schedule. RESULTS: There was a significant reduction in mean (SD) nasal peak flow rate (-12.8 (4.06) L/min) after subjects had breathed for 30 minutes through the obstructed nostril. There was no significant change in nasal peak flow rate after subjects had breathed through the patent nostril, or in the nostril that had no flow for 30 minutes. CONCLUSIONS: These findings are compatible with the hypothesis that frictional stress due to airflow through an obstructed nostril induces trauma and swelling of the nasal mucosa of patients with allergic rhinitis.

Adolescent↗

Diagnostic dilemma: aspergillosis.

Two cases of varied forms of Aspergillosis are reported who were being diagnosed and treated on different lines. One case, who was treated on lines of allergic bronchitis, had very high total eosinophil count and, fleeting pulmonary infiltrates over a period of 5 years along with history of cough, fever and weight loss. Aspergillus fumigatus was grown on sputum culture. On the background of a long standing history of bronchial asthma with evidence of peripheral as well as central eosinophilia, fleeting pulmonary infiltrates and A. fumigatus grown on sputum culture, we kept the diagnosis of Allergic Bronchopulmonary aspergillosis (ABPA) and put the patient on steroids and Itraconazole. Patient showed good response to therapy. Another case, a 50 year old male, presented to us with clinical picture of subacute myelitis. Being a known case of ABPA and on steroid therapy for long duration, we kept the diagnosis of invasive aspergillosis. Growth of Aspergillus fumigatus on sputum culture on three occasions and MR imaging of spine further supported our view. Aspergillosis of the lung do not have characteristic clinico-radiological features of permit the diagnosis and should be considered in the differential diagnosis of tuberculosis, pneumonia, bronchiectasis, lung abscess and bronchial asthma.

Aspergillosis↗

Comparative study of visceral and parietal pleural biopsy in the etiological diagnosis of pleural diseases.

OBJECTIVE: The present study was planned to evaluate the efficacy and diagnostic reliability of conoctional parietal pleural biopsy to a technique of visceral pleural biopsy. METHOD: Study comprises of 54 diagnosed cases of pleural effusion and after establishing the clinical diagnosis for probable etiological causes. Then parietal pleural biopsy using absents punch biopsy needle and vesceral pleural biopsy using Prabhudesai et al technique was taken in all these patients. Size of the tissue yield; percentage of biopsies; diagnostic yield and sensitivity for these two techniques were compared. RESULTS: A definitive etiological diagnosis could be reached in 52 out of 54 patients on the basis of pleural biopsy (33 tuberculous, 16 malignant and 3 pyogenic), 23 (69.7%) tuberculous effusion patients were diagnosis by visceral pleural biopsy and 14 (42.4%) by parietal pleural biopsy out of 33 diagnosed tuberculous effusion cases. While for the 16 malignant effusions the visceral pleural biopsy showed suggestive histological change in 13 (81.25%) patients and the parietal pleural biopsy in seven (43.8%) with five (31.25%) of these patients being positive by both. All three pyogenic effusions showed only nonspecific inflammatory change in both pleurae. CONCLUSION: The mean size of biopsy sample obtained with modified Prabhudesai et al technique was significantly larger than that of the parietal pleural biopsy with Abrams punch (4.85 mm2 V/s 2.5 mm2 with P < 0.01). Adequate pleural tissue was identifiable in 94.4% and 90.7% of cases, respectively. The modified Prabhudesai et al technique proved to be effective safe and easily learnt. Visceral pleural sampling using this technique is a definite superior addition to the present diagnostic armamentarium of an idiopathic pleural effusion and its routine application together with parietal pleural biopsy will help to establish a definitive diagnosis in majority of patients with idiopathic pleural effusions.

Adolescent↗

Adequacy assessment of oxygen therapy.

OBJECTIVES: Oxygen administration in the wards is usually not according to prescription and therefore the patients requiring oxygen therapy does not get optimal benefits. We planned to assess the need and adequacy of oxygen therapy as was given in wards of SMS Hospital, Jaipur. METHODOLOGY: We studied sixty-six patients in medical and surgical wards who were receiving oxygen therapy through various modes of delivery. Oxygen therapy system was checked in detail and oxygen saturation (SaO2) was measured by pulse oximetery. RESULTS: In our study, we found that no oxygen was flowing from cylinder head in 24 cases (35.5%) while in another 23 cases (35.2%) oxygen was flowing at lower than prescribed flow rates. Leakage in tubes and connections were found in nine cases (13.4%). None of our case was receiving oxygen as per prescription. After correction of faults, all patients showed improvement in SaO2. The criteria of starting oxygen therapy were met only in 47 patients (69%) as per American College of Chest Physicians (ACCP). CONCLUSIONS: Oxygen therapy should be administered according to guidelines. Proper monitoring of oxygen therapy is recommended to ensure adequate oxygenation and to save precious oxygen from wastage. Pulse oximeter is a simple, noninvasive and reliable method to assess it.

Adolescent↗

Oxidative stress after acute myocardial infarction: effect of thrombolytic treatment.

OBJECTIVE: Treatment with thrombolysis plays a crucial role in salvaging the myocardium in myocardial infarction (MI) patients, but reperfusion of ischaemic areas may itself be associated with reperfusion injury mediated by free radical induced oxidation. Hence the present study was planned to evaluate oxidative stress in patients receiving thrombolytic therapy during MI and to compare them with those not receiving thrombolysis. METHODS: Thiobarbituric acid reactive substance (TBARS) was used as a marker of lipid peroxidation in 30 patients after acute MI. Thirteen were treated by intravenous thrombolysis and 17 served as control. Also, vitamin E levels were estimated in these patients. RESULTS: Patients treated with thrombolysis showed a fall in vitamin E and increase in TBARS within first hours. The decrease in vitamin E was independent of a change in cholesterol. However, the levels were similar at 72 hours. CONCLUSION: The results indicate increased free radical production after MI and reperfusion also increases in free radical production and antioxidants may have a part in improving thrombolytic reperfusion of ischaemic myocardium.

Aged↗

Effect of intraesophageal acid instillation on airway reactivity in patients with asthma.

OBJECTIVE: To study the change in airway reactivity due to presence of acid in lower esophagus and its reversibility by antacid. METHOD: In this double blind study 12 subjects with asthma and gastroesophageal reflux received acid (N/10 hydrochloric acid) and antacid (mixture of magnesium trisilicate and aluminum hydroxide) perfusion in lower esophagus via a nasogastric tube. The four combinations were antacid-antacid (control), antacid-acid, acid-antacid and acid-acid. Airway reactivity (Histamine PD20) was recorded after each perfusion. RESULTS: Histamine PD20 significantly decreased (airway reactivity increased) (p < 0.05) with all three combinations containing acid as compared to control. No significant difference in airway reactivity was observed if the antacid was given before or after the acid. CONCLUSION: Presence of acid in lower esophagus can increase airway reactivity. This effect lasts longer than the presence of acid in esophagus itself.

Adolescent↗

Intradiscal electrothermal therapy: a preliminary report.

Internal disc disruption is a common cause of disabling low back pain in a substantial number of young, healthy adults. A clinical diagnosis of internal disruption, in absence of objective clinical findings, is convincingly established only by means of provocation discography. Intradiscal electrothermal therapy has been shown to be effective in managing chronic disabling discogenic pain. This prospective pilot outcome study was designed to investigate the effectiveness of intradiscal electrothermal annuloplasty in a series of patients with chronic functionally disabling discogenic low back pain. The results showed greater than 50% pain relief in 67% of the patients. In addition, a significant decrease in visual analog pain scores was also seen. Further, the assessment of functional status showed significant improvement with standing and walking, whereas sitting also demonstrated significant improvement in 62% of the patients, though it was not statistically significant. No complications were noted in the perioperative period or during the follow-up period. In conclusion, intradiscal electrothermal therapy is a safe and effective procedure in patients suffering with chronic functionally limiting discogenic pain who fail to respond to aggressive conservative modalities of treatments as well as interventional therapy with injections.

Journal Article↗

Interventional techniques in the management of chronic pain: Part 1.0.

The practice guidelines for interventional techniques in the management of chronic pain are systematically developed statements to assist practitioner and patient decisions about appropriate health care related to chronic pain. These guidelines are professionally derived recommendations for practices in the diagnosis and treatment of chronic or persistent pain. They were developed utilizing a combination of evidence and consensus to improve quality of care, increase patient access,improve patient outcomes, improve appropriateness of care, improve efficiency and effectiveness, and achieve cost containment. Included in the guidelines is a discussion of their purpose,rationale, importance, and methodology, and patient population, pathophysiologic basis, and various interventional techniques utilized in the management of chronic pain including rationale, outcomes, and cost effectiveness. They also describe the role of diagnostic blocks and therapeutic blocks with suggested algorithms for interventional techniques in the management of conservative care of chronic pain.

Journal Article↗