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Handa R, Wali JP, Singh S, Aggarwal P. A prospective study of Lyme arthritis in north India. Indian J Med Res 1999; 110:107-9. [PMID: 10612913 DOI: pmid/10612913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Twenty seven patients presenting with mono/oligoarticular disease of unknown etiology were prospectively screened for Lyme arthritis. In addition, 12 healthy blood bank donors, 25 individuals with rheumatoid arthritis (disease controls), and 20 deer handlers and veterinarians were also screened for IgG antibodies to Borrelia burgdorferi. Only one patient tested borderline positive for antibodies to B. burgdorferi (more likely false positive). None of the healthy subjects, disease controls or occupationally exposed individuals exhibited serological evidence of exposure to B. burgdorferi. Screening for Lyme disease may not be warranted while investigating mono/oligoarthritides of unknown etiology in this part of the country.
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Aggarwal P, Handa R, Wig N, Biswas A, Saxena R, Wali JP. Intravascular hemolysis in aluminium phosphide poisoning. Am J Emerg Med 1999; 17:488-9. [PMID: 10496516 DOI: 10.1016/s0735-6757(99)90255-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Intravascular hemolysis is most often secondary to exposure to a variety of drugs or infections, and usually occurs in patients who are deficient in glucose-6-phosphate dehydrogenase (G-6-PD) enzyme. Aluminium phosphide, a fumigant widely used in India, has been reported to produce intravascular hemolysis in only one patient who also had concomitant G-6-PD deficiency. This report describes the occurrence of intravascular hemolysis with aluminium phosphide poisoning in a patient with normal G-6-PD levels. This is of significance as jaundice in patients with this poisoning is often attributed to hepatic damage alone.
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Handa R, Aggarwal P, Wali JP. Pictorial CME. Complex regional pain syndrome, type I. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 1999; 47:804. [PMID: 10778627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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129
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Handa R, Gupta K, Malhotra A, Jain P, Kamath PK, Aggarwal P, Dwivedi SN, Wali JP. Cardiac involvement in limited systemic sclerosis: non-invasive assessment in asymptomatic patients. Clin Rheumatol 1999; 18:136-9. [PMID: 10357119 DOI: 10.1007/s100670050071] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Nineteen patients with limited systemic sclerosis (SSc) and without any cardiac symptoms were evaluated non-invasively for silent cardiac involvement using electrocardiography; M-mode, two-dimensional and Doppler echocardiography, and resting and post exercise radionuclide ventriculography. Left anterior hemiblock and mild pericardial effusion were seen in two patients. The interventricular septal thickness and left ventricular posterior wall thickness were greater in patients compared with controls. Patients with limited SSc also exhibited low early diastolic filling velocities and a low early diastolic atrial filling ratio. However, these values did not correlate with the age of the patient or disease duration. Eight patients (42.1%) were found to have cardiac dysfunction, of which four had combined systolic and diastolic dysfunction. Isolated systolic and diastolic dysfunction was seen in three patients and one patient, respectively. The age and disease duration in patients with cardiac dysfunction did not differ from patients without cardiac dysfunction. Functional cardiac involvement occurs in a large proportion (42.1%) of patients with limited SSc, and can be easily picked up by non-invasive methods such as echocardiography and radionuclide ventriculography. The prognostic significance of these findings requires further long term studies.
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Handa R, Biswas A, Bal CS, Gulati MS, Aggarwal P, Wig N, Wali JP. Pictorial CME. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 1999; 47:614. [PMID: 10999159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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131
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Singh S, Biswas A, Wig N, Aggarwal P, Sood R, Wali JP. A new focus of visceral leishmaniasis in sub-Himalayan (Kumaon) region of northern India. THE JOURNAL OF COMMUNICABLE DISEASES 1999; 31:73-7. [PMID: 10810593 DOI: pmid/10810593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A localised focus of visceral leishmaniasis is reported for the first time from Kumaon region of North India. During a period of 18 months from July 1997 to December 1998 several cases of pyrexia of unknown origin with unresponsiveness to antibiotics and anti-tubercular treatments were referred to the All India Institute of Medical Sciences, New Delhi. Five of these were diagnosed to have visceral leishmaniasis. One of these was also co-infected with HIV-1. All the five cases came from an adjoining area falling under Almora (4) and Nainital(1) districts. Of these four were males and one female. One patient died within 48 hours of hospitalization at AIIMS while rest of four responded completely to sodium stibogluconate therapy.
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Aggarwal P, Handa R, Wali JP, Wig N, Biswas A. Pulmonary hamartoma in a patient with testicular seminoma. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 1999; 47:552-3. [PMID: 10778572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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133
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Handa R, Aggarwal P, Biswas A, Wig N, Wali JP. Microscopic polyangiitis associated with antiphospholipid syndrome. Rheumatology (Oxford) 1999; 38:478-9. [PMID: 10371294 DOI: 10.1093/rheumatology/38.5.478] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Handa R, Aggarwal P, Wali JP. Necrotizing vasculitis confined to the nerves: comment on the concise communication by Rosenbaum et al. ARTHRITIS AND RHEUMATISM 1999; 42:824; author reply 825. [PMID: 10211903 DOI: 10.1002/1529-0131(199904)42:4<824::aid-anr31>3.0.co;2-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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135
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Wig N, Aggarwal P, Kailash S, Handa R, Wali JP. Awareness of brain death and organ transplantation among high school children. Indian J Pediatr 1999; 66:189-92. [PMID: 10798059 DOI: 10.1007/bf02761204] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The objective of this study was to assess the awareness of the concepts of brain death and organ transplantation among high school children. One hundred and eighty eight students of class 12th of a reputed public school were studied. Structured questionnaires were used to assess their knowledge in various aspects of brain death and organ transplantation. Following the questionnaire, they were provided with educational information on brain death and organ transplantation. This was followed by similar questionnaires to assess any change in awareness of brain death and organ transplantation. Results spoke of widespread awareness and acceptance of organ transplantation in the high school children. However, the awareness of various aspects of brain death was quite low. There was significant increase in awareness and acceptance of brain death after educating the students. Education about various aspects of brain death, its immense importance for organ donation and legality of brain death needs to be highlighted.
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Wali JP, Biswas A, Aggarwal P, Wig N, Handa R. Validity of tourniquet test in dengue haemorrhagic fever. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 1999; 47:203-4. [PMID: 10999092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
OBJECTIVE Dengue haemorrhagic fever (DHF), a public problem in most of the tropical countries of South-East Asia, is diagnosed on the basis of demonstrating an increased capillary permeability and thrombocytopenia with concurrent haemoconcentration. Tourniquet test has been recommended as the initial screening procedure of patients with suspected DHF, particularly grade I DHF. The objective of the present study was to study the value of this test as an indicator of haemorrhagic tendencies in patients of DHF. METHODS One hundred and ten adult patients hospitalized with DHF during outbreak of DHF in 1996 in north India were prospectively studied. The diagnosis of DHF was considered on the basis of haemoconcentration > 20%, evidence of transudation, or presence of shock along with thrombocytopenia. A tourniquet test was conducted in these cases in the standard method. RESULTS Of the 110 patients of DHF studied, 62 patients (56.4%) had bleeding but tourniquet test was positive in only half of these patients. Forty eight patients (43.6%) did not have any bleeding and the tourniquet test was positive in only 27% cases. CONCLUSIONS The tourniquet test was positive in only 39.1% of all DHF cases. It is concluded that a negative tourniquet test may not be sufficient to exclude a diagnosis of DHF in a febrile patient. This necessitates the need for the re-defining the clinical criteria for the diagnosis of DHF, particularly grade I DHF.
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Aggarwal P. Prevention of dengue at the grass-root level. JOURNAL OF THE INDIAN MEDICAL ASSOCIATION 1999; 97:30. [PMID: 10549187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
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138
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Abstract
Kala-azar is an endemic disease in many parts of India. Traditionally, diagnosis of this disease was based on demonstrating the parasites in various tissues like bone marrow or splenic aspirates. However, lack of high sensitivity of these methods led to the use of various immunodiagnostic methods in the diagnosis of kala-azar. Antigen detection and polymerase chain reaction to detect parasitic DNA have been found to be useful in patients with an underlying immunosuppressive disease like AIDS. For treating kala-azar, pentavalent antimonial compounds are still the first-line agents. However, due to increasing resistance to this agent, many patients at present require other drugs including amphotericin B and pentamidine. Toxic effects of these second-line agents have led to development of drug delivery systems like liposomal amphotericin B, which has shown uniform efficacy in clinical trials. Combining stibogluconate with either paromomycin or interferon-gamma has also been shown to be useful in many patients with drug-resistant kala-azar.
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Seth A, Mathur A, Chandra P, Aggarwal P, Khanna N. Revascularization of a thrombosed, previously stented aorto-renal graft using combined directional atherectomy and AngioJet thrombectomy. Catheter Cardiovasc Interv 1999; 46:85-8. [PMID: 10348574 DOI: 10.1002/(sici)1522-726x(199901)46:1<85::aid-ccd21>3.0.co;2-h] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We report an interesting case with bilateral PTFE aorto-renal grafts of which one graft underwent balloon angioplasty and stenting for proximal stenosis. Combined debulking by AngioJet thrombectomy and Simpsons directional atherectomy was performed within the stent following reocclusion of the graft 9 months later.
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Kapoor H, Aggarwal P. Resistance to Quinolones in Pathogens Causing Urinary Tract Infections. J Urol 1999. [DOI: 10.1016/s0022-5347(01)62190-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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141
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Wali JP, Biswas A, Handa R, Aggarwal P, Wig N, Dwivedi SN. Dengue haemorrhagic fever in adults: a prospective study of 110 cases. Trop Doct 1999; 29:27-30. [PMID: 10418277 DOI: 10.1177/004947559902900110] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
One hundred and ten adult patients hospitalized with dengue haemorrhagic fever (DHF) during the recent outbreak in North India were prospectively studied. Of these, 48 (43.6%) were grade I, 40 (36.4%) grade II, 10 (9.1%) grade III and 12 (10.9%) grade IV DHF. Dengue shock syndrome (DSS) was seen in 22 (20%) patients. Fever, headache, myalgias and arthralgias were the common symptoms seen in 100%, 80.9%, 76.2% and 52.3% patients, respectively. Spontaneous bleeding was seen in 62 patients (56.4%) with mucocutaneous bleeding being the most common (46 patients). Gastrointestinal bleeding was seen in 38 (34.5%) patients. In as many as 40 patients, the haemorrhagic manifestations occurred after the fever had come down. Fifty-five patients (50%) required platelet transfusions. Twelve patients died, giving a mortality rate of 10.9% in the present study. Prompt recognition and supportive treatment can be lifesaving.
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Mohan A, Handa R, Aggarwal P, Wig N, Chaturvedi V, Biswas A, Wali JP. Generalised wasting in a young diabetic. Postgrad Med J 1998; 74:683-5. [PMID: 10197219 PMCID: PMC2431596 DOI: 10.1136/pgmj.74.877.683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
An overview of emergency medical care in the New Delhi area is presented. Emergency medicine does not exist as an organized specialty, and emergency departments are staffed by a combination of residents and attending physicians from various specialties. An infrastructure for providing emergency care exists at all levels of the state-owned medical system, and in private hospitals. At every level, medical centers lack adequate resources to manage the breadth of clinical problems encountered. Tertiary EDs care for large numbers of patients with high-severity conditions. Like their Western counterparts, urban EDs in New Delhi serve a diverse population with many indigent patients. Injury and gastrointestinal illness are the most common reasons for ED use. Organized prehospital care is scanty. A survey conducted at a leading medical school and hospital in New Delhi shows medical students and physicians are highly interested in the development and practice of emergency medicine as a specialty. This interest can be nurtured through continued international collaboration.
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Abstract
One hundred and fifty-eight patients with SLE were prospectively studied at a tertiary referral centre in India to ascertain the prevalence and clinical profile of fibromyalgia (FM) in Indian patients with lupus. An attempt was made to determine whether socio-demographic factors or disease characteristics differ in SLE patients with and without FM. Only 13 patients (8.2%) in our cohort were found to have fibromyalgia. Their clinical profiles were similar to that reported in other series. Corticosteroid withdrawal or dose reduction was the probable precipitating factor in nearly one-third of our patients. Age, sex, marital status, educational level, disease duration, disease activity and the organ involvement in patients with SLE and FM were comparable to those in patients not having FM. Fibromyalgia appears to be distinctly uncommon in Indian patients with lupus. A strong family support system, the virtual lack of disability benefits and/or racial variations in pain threshold could be the likely factors responsible for the low prevalence of the disease observed in Indian patients with SLE.
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Gibbs RB, Aggarwal P. Estrogen and basal forebrain cholinergic neurons: implications for brain aging and Alzheimer's disease-related cognitive decline. Horm Behav 1998; 34:98-111. [PMID: 9799621 DOI: 10.1006/hbeh.1998.1451] [Citation(s) in RCA: 155] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Recent studies suggest that estrogen replacement therapy can reduce the risk and severity of Alzheimer's disease (AD)-related dementia in postmenopausal women. Many different mechanisms by which estrogen therapy may help to reduce the risk and severity of AD-related pathophysiology have been proposed. Recent animal studies suggest that one way in which estrogen replacement may help to reduce cognitive deficits associated with aging and AD is by enhancing the functional status of cholinergic projections to the hippocampus and cortex. Here we review the evidence that estrogen is important in the maintenance of cholinergic neurons projecting to the hippocampus and cortex and that estrogen replacement can enhance the functional status of these neurons, as well as reduce cognitive deficits associated with muscarinic cholinergic impairment. Based on these studies, we conclude that, in animals, short-term treatment with physiological levels of estrogen, or estrogen and progesterone, has significant positive effects on cholinergic neurons in the medial septum and nucleus basalis magnocellularis and on their projections to the hippocampus and cortex. We hypothesize that similar effects in humans may help delay the decline in basal forebrain cholinergic function associated with aging and AD and thereby reduce the risk and severity of AD-related dementia in postmenopausal women.
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Kapoor H, Murlidhar S, Jais M, Thakur R, Aggarwal P. Evaluation of efficacy of Dettol-H in hospital use. THE JOURNAL OF COMMUNICABLE DISEASES 1998; 30:167-70. [PMID: 10093423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
A study was conducted at Safdarjang Hospital, New Delhi, to elucidate the bactericidal effect of a new disinfectant having benzalkonium chloride (40%) + disodium edetate (1.5%) and commercially available as Dettol-H, in comparison with that of a disinfectant already in-use in this hospital and having chlorhexidine gluconate (7.5%) + cetrimide (15%) + isopropyl alcohol (commercially available as Alpilon). The modified Capacity test of Kelsey-Sykes and In-use test of Kelsey-Maurer were carried out using control strains and random gram positive and gram negative bacterial isolates from clinical specimens. The two disinfectant solutions were analysed at three dilutions viz. weak, recommended and strong. From the study it could be inferred that both Dettol-H and Alpilon were equally effective in recommended and strong dilutions against the organisms tested. Weak dilutions were not effective in both and hence Dettol-H and Alpilon are effective only if used in prescribed concentrations.
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Handa R, Aggarwal P, Wali JP, Wig N, Dinda AK, Biswas A. Sarcoidosis presenting with peripheral lymphadenopathy. SARCOIDOSIS, VASCULITIS, AND DIFFUSE LUNG DISEASES : OFFICIAL JOURNAL OF WASOG 1998; 15:192. [PMID: 9789900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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148
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Handa R, Aggarwal P, Biswas A, Wig N, Mohan A, Chaturvedi V, Wali JP. Lead poisoning in a schizophrenic. INDIAN JOURNAL OF MEDICAL SCIENCES 1998; 52:414-6. [PMID: 10085622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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149
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Aggarwal P, Chaudhury D, Handa R, Wig N, Biswas A, Wali JP. Paracetamol poisoning. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 1998; 46:830. [PMID: 11229262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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150
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Ingavale SS, Kaur R, Aggarwal P, Bachhawat AK. A minisatellite sequence within the propeptide region of the vacuolar carboxypeptidase Y gene of Schizosaccharomyces pombe. J Bacteriol 1998; 180:3727-9. [PMID: 9658023 PMCID: PMC107348 DOI: 10.1128/jb.180.14.3727-3729.1998] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
We describe the presence of a minisatellite sequence that displays length polymorphisms in the fission yeast Schizosaccharomyces pombe. The minisatellite sequence was found to reside within the propeptide region of the vacuolar carboxypeptidase Y gene. The minisatellite sequence, which was found only at a single locus, was mitotically stable and displayed length polymorphisms between the two varieties of S. pombe (S. pombe var. pombe and S. pombe var. malidevorans). The minisatellite sequence, however, appeared to be species specific and was absent in other members of the Schizosaccharomyces genus. This report constitutes the first experimental demonstration of the presence of such sequences in yeasts.
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