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Biomedical subjects

Y Chawla

Publications and source records attributed to Y Chawla.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Cytokine mRNA expressions in symptomatic vs. asymptomatic amoebiasis patients.

Infection with Entamoeba histolytica results in high mortality worldwide. Studies on the cytokine response in symptomatic and asymptomatic amoebiasis (caused by E. histolytica, the pathogenic species and E. dispar, the non-pathogenic species) subjects and their correlation with symptomatology are lacking. The present study reports the cytokine response (TNF-alpha, IFN-gamma, IL-4, IL-10 and TGF-beta) in such subjects as measured by RT-PCR. The results showed significantly (< 0.05) higher expressions of IL-10 and TGF-beta in the symptomatic group as compared to the asymptomatic and healthy controls. The cytokine profile indicated the role of suppressive immune response in symptomatic amoebiasis patients.

Adolescent↗
PubMedDate not supplied

T-tube access for endoscopic sphincterotomy: a variant of combined percutaneous and endoscopic approach.

Selective deep cannulation of the common bile duct (CBD), which is essential for successful endoscopic sphincterotomy, may not be possible in all patients. Three patients with retained CBD stones with T-tube in situ in whom selective deep cannulation failed, underwent successful sphincterotomy using a combined percutaneous and endoscopic procedure through the T-tube. CBD stones were then extracted with a Dormia basket. In situ T-tube can provide percutaneous access for combined approach in patients with retained CBD stones in whom endoscopic cannulation is not successful.

Catheterization↗
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Assessment of malnutrition in alcoholic and non alcoholic cirrhotics.

OBJECTIVE: To study the nutritional status in patients with chronic liver disease using anthropometric techniques. METHODS: A total of 60 cirrhotic patients (30 Alcoholic (AC), 30 Non-alcoholic (NAC) and 30 control (CO) subjects were studied. Nutritional status was assessed using anthropometric measurements such as stature, body weight, body mass index, (BMI), skinfold thickness measurements and mid upper arm muscle circumference. Serum protein, serum albumin and globulin were measured. RESULTS: The skinfold thicknesses were significantly lower in NAC group of patients. In contrast the AC group of patients showed significantly lower mid upper arm muscle circumference values. Both groups of cirrhotic patients showed significantly lower total serum protein and serum albumin levels. CONCLUSION: Body fat is relatively more affected in NAC group of patients and muscle mass is more affected in AC group of patients.

Adult↗
PubMedDate not supplied

Effect of hepatitis C virus coinfection on liver function of patients infected with HIV.

AIMS: Both the human immunodeficiency virus (HIV) and Hepatitis C virus (HCV) share similar routes for their transmission, encouraging the possibility of a coinfection with the two viruses in some individuals. We wanted to find out the prevalence of HCV in patients infected with the HIV virus. METHODS: We tested 57 HIV positive patients for anti-HCV antibodies. Liver functions tests, ultrasound abdomen and upper gastrointestinal endoscopy were carried out in the anti-HCV positive patients. RESULTS: Coinfection with HCV was seen in 5.3% of patients. Of these 2 had acquired the infections through blood transfusions and one through heterosexual contact. One patient had cirrhosis with portal hypertension and one had raised alkaline phosphatase as the only abnormality on liver function tests. CONCLUSIONS: Because HCV is more infectious by the parenteral route, the incidence of coinfection is lower in our population possibly due to the fact that majority of our HIV positive patients acquire infection through heterosexual contact.

Adult↗
PubMedDate not supplied

Pulmonary function changes after large volume paracentesis.

OBJECTIVE: To study the effect of large volume paracentesis (LVP) on pulmonary function in patients with cirrhosis of liver and tense ascites. METHODS: Ten patients having alcoholic cirrhosis with ascites were subjected to LVP (mean 6.3 +/- 0.3 L). Pre and post paracentesis spirometry and arterial blood gas analysis were performed and compared. RESULTS: Baseline mean lung volumes and arterial pO2 were reduced from normal predicted values. Air flow was found normal. After LVP, an increase in absolute values of vital capacity, forced expiratory flow in first second (FEV1) and peak expiratory flow was observed; only the improvement in FEV1 was significant p 0.05). Arterial pO2 also showed significant (p < 0.01) improvement after LVP. CONCLUSION: LVP leads to improvement in measured pulmonary function.

Adult↗
PubMedDate not supplied

Effect of renal dysfunction in fulminant hepatic failure.

BACKGROUND: Effect of renal dysfunction in fulminant hepatic failure is not studied extensively. METHODS: Fifty consecutive patients of fulminant hepatic failure were studied prospectively to determine the prevalence of renal failure and its effect on survival. RESULTS: The mean age of these patients was 36 +/- 7.2 years and there were 21 males and 29 females. Twenty two patients (44%) were hepatitis B surface antigen (HBsAg) positive. Renal dysfunction was observed in 19 patients (38%). Acute tubular necrosis was seen in 7 patients (38%) while prerenal azotemia and functional renal failure occurred in six patients each (37%). Renal failure occurred more commonly in patients with jaundice. In these patients it occurred in less than four days and prior to onset of encephalopathy, ascites, and gastrointestinal hemorrhage. Histopathological examination of kidney (done in 8 patients) revealed acute tubular necrosis in 4 patients while patients with functional renal failure and prerenal azotemia had normal histology. A good correlation was observed between biochemical parameters and histology of kidney in all the patients. The survival amongst the patients with FHF was 28% (14 of 50 patients). Poor prognostic indicators were a leukocyte count of more than 16.5 x 10(9)/liter, prothrombin index of less than 34%, a peak serum bilirubin of more than 376 mumol/liter and presence of renal failure. Only 3 of 19 patients with renal failure survived. CONCLUSIONS: Renal dysfunction is a major indicator of poor prognosis in patients with FHF.

Acute Kidney Injury↗
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Hepatitis B virus co-infection in HIV infected patients.

AIM: Human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) share the same routes of transmission. Co-infection with the two viruses has been reported to occur in upto 90% of HIV infected patients, depending on the prevailing risk factors for acquiring infection in a given population. We studied our HIV positive patients for the prevalence of HBV co-infection in them. METHODS: Eighty consecutive HIV positive patients underwent ELISA for HBsAg and antiHBc antibodies. HBeAg was tested for in all HBsAg positive patients. Polymerase chain reaction for HBV DNA was carried out in 40 randomly selected patients who showed no serological evidence of HBV infection. RESULTS: There were 56 males and 24 females (mean age 33.2 +/- 8.3 years). Twenty seven (33.8%) patients (23 males, 4 females) had evidence of co-infection with HBV. Of these 6 (22.2%) were HBsAg positive, 22 had antiHBc antibodies and HBV DNA was positive in one. Four patients had evidence of replicating virus (3 HBeAg+ve, 1 DNA+ve). All 4 had normal transaminases and advanced HIV infection. HBV co-infection was significantly higher among males (p < 0.05). There was no significant difference in the liver functions of HBV positive and negative individuals. The risk factor for acquiring infection was heterosexual exposure in al HBV+ve patients except one. CONCLUSIONS: Hepatitis B virus co-infection was seen in 33.8% of our HIV positive patients. Males were more likely to be co-infected. All except one of the patients acquired infection through heterosexual exposure.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

Immunohistochemistry for core and surface antigens in chronic hepatitis.

BACKGROUND: Hepatitis B virus infection constitutes a significant proportion of patients presenting with chronic hepatitis. Chronic hepatitis is said to be due to HBV if HBsAg is demonstrated in the serum with or without replication as determined by the presence of HBeAg in the serum. Immunohistochemical staining for HBsAg and HBcAg in liver tissue has been reported to improve the detection rate of HBV. AIM: To study positivity of immunohistochemical staining of liver tissue for HBsAg and HBcAg in patients of chronic hepatitis and correlate it with histological activity index. METHODS: One hundred consecutive patients of chronic hepatitis were selected for this study. Histological scoring of liver biopsies was done using Knodell's numerical scoring system. Immunohistochemical staining was done by the Indirect immunoperoxidase technique using goat polyclonal anti-HBsAg and rabbit polyclonal anti-HBsAg. ELISA was used to detect HBsAg in the serum. RESULTS: Serum HBsAg was positive in only 40 patients whereas tissue HBsAg was positive in 48 patients. Thirteen of these forty-eight tissue positive HBsAg patients also showed HBcAg on immunohistochemical staining of liver tissue. Patients with higher grades of histological activity index (HAI) score had higher values of serum bilirubin and prothrombin time as compared to the patients with a low HAI score. Significantly higher levels of serum transaminases (AST/ALT) were observed in patients who were positive for both HBsAg and HBcAg when compared with patients positive for HBsAg or HBsAg negative patients. A mixed pattern (diffuse/focal cytoplasmic and membranous) of surface antigen expression was seen in 83.3% patients, whereas expression of core antigen was predominantly nuclear (77%). There was no significant correlation between the pattern of antigen expression and HAI score.

Adult↗
PubMedDate not supplied

Wilson's disease in young children from northern India.

Though Wilson's disease is not uncommon, there is paucity of reported cases from northern India. Out of 500 new cases registered during 1979-1986 in Chandigarh, nine were diagnosed to have Wilson's disease. Six children presented with a primary liver disease, two with neurological manifestations while one was an asymptomatic sib. All children with hepatic presentation were aged 8 yr or less (mean 6.5 yr). Kayser-Fleischer rings were demonstrable in 8 patients. The disease affects Indian children at a younger age and the diagnosis should be considered in those presenting with an typical hepatic/neurological disorder, Early diagnosis and treatment is mandatory for appropriate management.

Child↗
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Bifid pancreas: a case report.

Bifid pancreas is a rare anatomical anomaly in which the main pancreatic duct is bifurcated along its length. Although the pancreatographic appearance has been described in the literature, there is no mention of the computerised tomographic appearance of this condition. We report a case of bifid pancreas with the ERCP and CT appearances, who also had alcohol induced changes of chronic pancreatitis.

Alcoholism↗