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Biomedical subjects

V Singh

Publications and source records attributed to V Singh.

At least 163 records · Page 9Linked to original sources
PubMed1997

Post-cholecystectomy external biliary fistula.

BACKGROUND: External biliary fistula (EBF) following bile duct injury is a serious complication of cholecystectomy. METHODS: From January 1989 to December 1994, 37 patients with post-cholecystectomy external biliary fistula were seen at this centre. There were 14 partial, 22 complete and one sub-vesical duct of Luschka injury. Sixteen patients had a controlled EBF at presentation; 10 patients had intra-abdominal collections and seven patients presented with peritonitis. RESULTS: A staged approach to the management of these patients was adopted in which the initial management aimed at creating a 'controlled' fistula. This approach comprised conservative treatment (n = 9), percutaneous catheter drainage of intra-abdominal collections (n = 10), biliary drainage (n = 6), and surgical intervention (n = 7). One patient died because of progressive liver failure in spite of intensive management. Definitive management comprised the surgical repair of biliary strictures wherever indicated, after waiting for the acute problems to settle. CONCLUSIONS: By adopting a staged approach along with a judicious use of endoscopy, radiology and surgery that were based on clinical circumstances, it was possible to achieve satisfactory results for this otherwise distressing condition.

Adult↗
PubMed1997

Stroke recurrence in diabetics. Does control of blood glucose reduce risk?

BACKGROUND AND PURPOSE: Patients with diabetes are at increased risk of stroke. Risk might be reduced if blood glucose level were controlled. METHODS: In a population-based study, we enrolled 621 patients within a month of an initial ischemic stroke and followed them regularly twice annually; 198 were diabetic. We monitored blood glucose level in 142 (72%) using glycosylated hemoglobin (HbAlc). Recurrent stroke frequency was determined by history, examination, and medical records. Cox proportional hazards models were used to examine the relationship between risk of recurrent stroke and HbAlc level. The models included interaction with time-dependent HbAlc level and history of diabetes, selected medical comorbidities, age, and sex. HbAlc level was analyzed as both a continuous and a dichotomous variable (ie, controlled versus uncontrolled); "controlled" was defined with different cut points. RESULTS: All but 17 patients (12%) whose blood glucose was monitored were well controlled (HbAlc < 8%). HbAlc level was not associated with increased risk of stroke recurrence (hazard ratio [HR], 0.87 per 1% increment in HbAlc; 95% confidence interval [CI], 0.623 to 1.219), nor was there a trend toward increased risk of recurrent stroke as the cut point defining "controlled" increased: with HbAlc at < 6%, the HR for the uncontrolled group was 0.51 (95% CI, 0.176 to 1.503); at < 7%, it was 0.43 (95% CI, 0.089 to 1.923); and at < 8%, it was also 0.43 (95% CI, 0.057 to 3.317). CONCLUSIONS: Among diabetic patients with an initial stroke, no association between HbAlc level over time and risk of stroke recurrence was found. However, most patients in this cohort were well controlled, and any adverse effect of poor control could not be adequately tested.

Aged↗
PubMed1997

Genotype-phenotype correlation in Duchenne/Becker muscular dystrophy patients seen at Lucknow.

The molecular basis of two allelic forms of muscular dystrophy, Duchenne (DMD) and Becker (BMD), has been explained by frame shift hypothesis. In order to test this hypothesis, deletional mutations in 59 patients confirmed to have DMD and 11 BMD patients were analysed using multiplex polymerase chain reaction and Southern hybridization with dystrophin cDNA probes. Translational reading frame of the dystrophin gene was derived from 'Border type' analysis of exons flanking the intragenic deletions. The correlation between genotype (reading frame) and phenotype (clinical severity) showed higher number of DMD patients (approximately 20%) deviating from the frame shift hypothesis. The patients who deviated had deletions at the central hot spot region of the dystrophin gene. The presence of these deviations in a large number of DMD patients highlights the difficulties in predicting the clinical progression of the disease based only on DNA profile.

Gene Deletion↗
PubMed1997

Lipids in biliary lithogenesis.

Serum and biliary lipoproteins, total cholesterol (Tc) and triglycerides (TG) were measured in patients with gallstones and in those without gallstones. Serum and biliary LDLc, TG and Tc were significantly higher (P < 0.001) in cases having gall stones than those without stones while HDLc were low (P < 0.001) in those with stones. No difference was found in very low density lipoproteins (VLDLc) in the two groups. Present data showed that there is a statistically significant correlation of serum and biliary lipoproteins specifically LDLc and HDLc (r = +.67 and r = +.56). This report shows that serum HDLc (67.42%) and LDLc (70.28%) play a more critical role in comparison to total cholesterol (59.43%) and triglyceride (57.15%) levels in the formation of gallstone.

Adolescent↗
PubMed1996

Occupational exposure amongst locomotive shed workers and welders using neutron activation analysis of scalp hair.

Elemental analysis of scalp hair of locomotive shed workers and industrial welders was used to study occupational exposure. Instrumental neutron activation analysis (INAA) was used for the determination of 17 elements, Ba, Br, Ca, Co, Cr, Cu, Fe, Hg, K, Mn, Na, P, Sb, Sc, Se, Th and Zn. Most elements show normal distribution at 95% confidence level. Further statistical significance was tested by correlation coefficient and regression coefficients (r2). Comparison of mean elemental contents of the subjects with controls shows a significant enhancement of Ca, Cr, Fe, Co, Na, Sc and Th, but declining trends for Br, Cu, P, Sb and Zn in locomotive shed workers. In the case of welders: Ba, Co, Cu, K, Mn, Sc and Sb show enhancement whereas Br, Cr, Hg, Se, Th and Zn exhibit depletion. Elemental contents have been correlated with possible sources of origin. Comparison of mean elemental data for the present population around Nagpur city matches well with the reported data for Bombay and Delhi. Comparative data from other countries are also presented.

Adult↗
PubMed1996

N'Dow sees water as key to a sustainable peace. Outlines a new strategy for the new century.

Water availability has emerged as the most important element of peace, so it is central to the UN's peacekeeping mandate as it moves into the next century, Wally N'Dow said Wednesday. Addressing a panel on the growing water needs of cities, N'Dow, the Secretary General of Habitat II, said lack of water is one of the 'most critical factors' that cause conflict. N'Dow urged city officials, nongovernmental organizations and other Habitat players to act on the recommendations of the panel, which he labeled "the single most important dialogue at this conference." N'Dow stressed cost effectiveness, better technology, and new management systems as the three most important elements of a new strategy. More than 1 billion people worldwide--mostly in poor countries--do not have access to safe drinking water. Also, most of the world's largest cities, including some in rich countries, do not treat their waste water adequately. The challenge for growing cities, UN officials say, is not just to provide safe water but also to ensure the poor can afford it. "Habitat is a wake-up call, as 40% of city residents do not have water," said Beatrice Labonne, director of the UN's Division for Environment Management and Social Development. Currently, subsidies skew water prices overwhelmingly in favor of the rich. In Jakarta, Indonesia, piped water accounts for only 14% of the total water supply, according to the World Bank. Many poor residents shut out of the system have to pay more than 20 times the price paid by the rich. Water pricing has long been a hot political issue, which is partly why the World Bank and the UN have called for privatization of the water sector. But, they say, governments must regulate the firms to guarantee safe water and fair pricing. Privatization is seen as a solution to manipulation of government utilities by vested interests. For example, governments often grant huge concessions to industry as a means of helping the latter create more jobs. Last March, Habitat organized a meeting in Beijing of more than 150 city officials, NGOs, and other conference participants as a precursor to the Istanbul event. With the official conference underway, they will brief delegates on the future vision of these players.

Conservation of Natural Resources↗
PubMed1996

Intrahepatic segment III cholangiojejunostomy in advanced carcinoma of the gallbladder.

The majority of patients with advanced carcinoma of the gallbladder have irresectable disease and require palliation for jaundice, pruritus and cholangitis. Intrahepatic segment III cholangiojejunostomy has been described for palliation of high biliary obstruction in these patients. Forty-one patients with stage IV gallbladder cancer underwent intrahepatic segment III cholangiojejunostomy. Subsequent jaundice, pruritus and cholangitis were documented; liver function tests and isotope hepatobiliary scans were performed. All patients had jaundice, 29 had pruritus and 12 had cholangitis. Postoperative complications included anastomotic leak in six patients and wound infection in six. Five patients died within 30 days of operation. Thirty-two patients were available for follow-up. The procedure failed to relieve jaundice, pruritus or cholangitis in four patients; 18 were free of jaundice, pruritus and cholangitis until death or last follow-up, and ten had recurrent jaundice or cholangitis. Isotope scanning was found to be useful to predict success of the procedure. Intrahepatic segment III cholangiojejunostomy provided excellent palliation from jaundice, pruritus and cholangitis with acceptable mortality and morbidity rates in patients with advanced carcinoma of the gallbladder.

Adult↗
PubMed1996

Immune regulation in Cushing's syndrome: relationship to hypothalamic-pituitary-adrenal axis hormones.

Hormones of the hypothalamic-pituitary-adrenal (HPA) axis are connected closely with immune measures. To investigate whether Cushing's syndrome (CS) is associated with immune dysregulation, we compared the percentage of specific lymphocyte subsets as well as natural cell activity (NKCA) in 48 patients with Cushing's syndrome and 48 age- and sex-matched normal controls. Lymphocyte subset analysis included the percentage of lymphocytes expressing CD3 (total T), CD4 (T helper/inducer), CD8 (T suppressor/cytotoxic) and CD56 (NK cell) antigens. Baseline plasma concentrations of cortisol, ACTH and beta-endorphin as well as 24 h urinary-free cortisol (UFC) levels also were determined. Results indicated a decrease in the percentage of CD4+ cells (p < 0.05), an increase in percentage of CD8+ cells (p < 0.05), a decrease in CD4/CD8 ratios (p < 0.01), and a reduction in NKCA (p < 0.05) in patients with CS compared to matched controls. We also found significant negative correlations between NKCA on the one hand and 24 h UFC (p < 0.05) and plasma beta-endorphin (p < 0.05) on the other. These results indicate there is immune dysregulation in CS patients which can be explained in part by an increase in HPA-axis hormones.

Adrenocorticotropic Hormone↗
PubMed1996

Epstein-Barr Virus DNA recombination and loss in sporadic Burkitt's lymphoma.

Epstein-Barr virus (EBV) antigens in tumor tissue define associations of virus with human malignancies and provide clues as to mechanisms of viral oncogenesis. In Burkitt's lymphoma, EBV markers are absent from 85% of sporadic cases and 4% of endemic (African) cases, raising questions as to the exact role EBV in the disease. Standard screening criteria may be insufficient to determine the EBV status of all tumors. One of 9 tumors from American patients expressed EBV nuclear antigen 1 (EBNA1) and contained standard episomal EBV DNA, making this series consistent with the 15% EBV association traditionally ascribed to sporadic Burkitt's lymphoma. Surprisingly, 3 tumors without detectable EBNA1 contained partial EBV genomes. Identification of defective, integrated viral DNA in some tumors indicates greater involvement of virus in sporadic Burkitt's lymphoma than previously documented and suggests a process of viral DNA rearrangement and loss during malignant progression most consistent with an initiating role for EBV in tumorigenesis.

Adolescent↗
PubMed1996

High frequency of new mutations in North Indian Duchenne/Becker muscular dystrophy patients.

Accurate carrier determination is an important aspect in providing prenatal diagnosis and genetic counselling to families with Duchenne/Becker muscular dystrophy patients. Using quantitative polymerase chain reaction, we have analyzed the carrier status of 31 mothers (5 familial and 23 sporadic) who have an affected son with known deletion in the dystrophin gene. Only four out of 23 mothers of sporadic cases turned out to be heterozygous for the deleted exons. The lower number of carrier mothers in sporadic cases suggests a higher frequency of new mutations in North Indian DMD@BMD patients.

Dystrophin↗
PubMed1996

Clinicocolonoscopic profile of colonic tuberculosis.

BACKGROUND: Colonic tuberculosis is common in developing countries. However, its diagnosis is difficult. Nevertheless, colonoscopy and biopsy examination have shown promising results. METHODS: We evaluated the clinical spectrum and colonoscopic features of 62 patients with colonic tuberculosis. RESULTS: Abdominal pain, fever, anorexia, weight loss, and change in bowel habit were seen in more than 50% of the patients. Massive rectal bleeding was frequently (13%) observed. Colonoscopy revealed strictures in 17, deformed ileocecal valve in 34, ulcers in 52, nodules in 49, polypoidal lesions in three, and fibrous bands in five patients. Segmental tuberculosis, lesions mimicking carcinoma, and multiple site involvement were observed in 19%, 20%, and 50% of the patients, respectively. Histopathologically, well formed granulomas were seen in 27, collections of epithelioid cells in 18, and chronic, nonspecific inflammatory changes in 17 of the cases. Acid-fast bacilli could not be isolated from any of the patients. All of the patients responded to the anti-tubercular treatment. Follow-up colonoscopy in 22 patients demonstrated regression of lesions. CONCLUSIONS: Colonic tuberculosis is common in India. Our findings indicate that colonoscopy is useful for its diagnosis. However, histopathology many not always be helpful. Therefore, in a given clinical and colonosopic setting, a therapeutic trial may be indicated.

Adolescent↗
PubMed1996

Postcholecystectomy problems and the role of endoscopic retrograde cholangiopancreatography.

Many patients continue to have symptoms even after cholecystectomy. We studied 4 patients with postcholecystectomy problems over a period of seven years; 208 were females, males and their mean age was 41.8 years (range 14-70). Presenting symptoms were abdominal pain (217), jaundice (74), cholangitis (38) and external biliary fistula (eight). Fifteen patients also had a t-tube in situ. Endoscopic retrograde cholangiopancreatography was successfully performed in 239 patients and revealed abnormal findings in 179. These included: stones (89), strictures (53), choledochoduodenal fistula (10), choledochal cyst (three), biloma (three), ligation of bile duct (five), ascaris in bile duct (three), pancreatitis (nine), long cystic duct stump (11), and various other findings. Endoscopic sphincterotomy was carried out in 59 patients with stones. Seven patients with strictures were managed with stents. Ascaris in the bile duct of three patients was removed with the help of a Dormia basket. To conclude, stones and strictures are common postcholecystectomy problems and endoscopic retrograde cholangiopancreatography is very helpful in the diagnosis and management of postcholecystectomy patients.

Adolescent↗
PubMed1996

Release of aldehydic products from glutamate or deoxyuridine by delta-aminolevulinic acid in presence of copper ions.

Glutamate or deoxyuridine in the presence of Cu2+ and delta-aminolevulinic acid (ALA) reaction resulted in the formation of thiobarbituric acid reactive compounds (TBAR), which was linear up to 2 hr. TBAR increased linearly with the increase of both ALA and copper ion concentration. Oxygen consumption was directly proportional to the concentration of formaldehyde perhaps formed by secondary oxidation of dimethyl sulfoxide. Addition of oxyradical scavengers in the reaction mixture resulted in the inhibition of TBAR formation.

Aldehydes↗