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Main E, Prasad A, Schans C. Conventional chest physiotherapy compared to other airway clearance techniques for cystic fibrosis. Cochrane Database Syst Rev 2005; 2005:CD002011. [PMID: 15674888 PMCID: PMC7388307 DOI: 10.1002/14651858.cd002011.pub2] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Cystic fibrosis is an inherited life-limiting disorder, characterised by pulmonary infections and thick airway secretions. Chest physiotherapy has been integral to clinical management in facilitating removal of airway secretions. Conventional chest physiotherapy techniques (CCPT) have depended upon assistance during treatments, while more contemporary airway clearance techniques are self-administered, facilitating independence and flexibility. OBJECTIVES To compare CCPT with other airway clearance techniques in terms of their effects on respiratory function, individual preference, adherence, quality of life and other outcomes. SEARCH STRATEGY We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group trials register which comprises references identified from comprehensive electronic database searches and handsearching of relevant journals and abstract books of conference proceedings. We also searched CINAHL from 1982 to 2002 and AMED from 1985 to 2002. Date of most recent search: January 2004. SELECTION CRITERIA Randomised or quasi-randomised clinical trials including those with a cross-over design where CCPT was compared with other airway clearance techniques. Studies of less than seven days duration were excluded. DATA COLLECTION AND ANALYSIS Two reviewers allocated quality scores to relevant studies and independently extracted data. If we were unable to extract data, we invited authors to submit their data. We excluded studies from meta-analysis when data were lost or study design precluded comparison. For some continuous outcomes, we used the generic inverse variance method for meta-analysis of data from cross-over trials and data from parallel-designed trials were incorporated for comparison. We also examined efficacy of specific techniques and effects of treatment duration. MAIN RESULTS Seventy-eight publications were identified by the searches. Twenty-nine of these were included, representing 15 data sets with 475 participants. There was no difference between CCPT and other airway clearance techniques in terms of respiratory function measured by standard lung function tests. Studies undertaken during acute exacerbations demonstrated relatively large gains in respiratory function irrespective of airway clearance technique. Longer-term studies demonstrated smaller improvements or deterioration over time. Ten studies reported individual preferences for technique, with participants tending to favour self-administered techniques. Heterogeneity in the measurement of preference precluded these data from meta-analysis. AUTHORS' CONCLUSIONS This review demonstrated no advantage of CCPT over other airway clearance techniques in terms of respiratory function. There was a trend for participants to prefer self-administered airway clearance techniques. Limitations of this review included a paucity of well-designed, adequately-powered, long-term trials.
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M. Bass F, Krishnamoorthy A, Prasad A, P. Sethi S. Advertising competition with market expansion for finite horizon firms. ACTA ACUST UNITED AC 2005. [DOI: 10.3934/jimo.2005.1.1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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153
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Burneo JG, Miller S, Bebin EM, Prasad A. Video-EEG study in an adult and a child with eyelid myoclonia with absences. Epileptic Disord 2004; 6:287-91. [PMID: 15634626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2004] [Accepted: 08/10/2004] [Indexed: 05/01/2023]
Abstract
Two patients with eyelid myoclonia with absences (EMA) are described. Videotape of the eyelid myoclonia in one patient is presented. An interesting feature in one patient was the induction of clinical seizures only with daylight, and in another the presence of rare, focal, epileptiform discharges during drowsiness. Valproic acid only partially controlled eyelid myoclonia in both cases. Lamotrigine, alone or in combination with valproate, can be used as an alternative but was ineffective in our cases. [Published with video sequences].
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MESH Headings
- Adult
- Anticonvulsants/adverse effects
- Anticonvulsants/therapeutic use
- Child
- Dominance, Cerebral/physiology
- Drug Therapy, Combination
- Electroencephalography/drug effects
- Epilepsies, Myoclonic/diagnosis
- Epilepsies, Myoclonic/drug therapy
- Epilepsies, Myoclonic/physiopathology
- Epilepsy, Absence/diagnosis
- Epilepsy, Absence/drug therapy
- Epilepsy, Absence/physiopathology
- Epilepsy, Reflex/diagnosis
- Epilepsy, Reflex/drug therapy
- Epilepsy, Reflex/physiopathology
- Evoked Potentials/physiology
- Female
- Frontal Lobe/physiopathology
- Humans
- Lamotrigine
- Male
- Myoclonus/diagnosis
- Myoclonus/drug therapy
- Myoclonus/physiopathology
- Phenytoin/adverse effects
- Phenytoin/therapeutic use
- Photic Stimulation
- Sunlight/adverse effects
- Triazines/adverse effects
- Triazines/therapeutic use
- Valproic Acid/therapeutic use
- Video Recording
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Prasad A, Kuzniecky RI, Knowlton RC, Welty TE, Martin RC, Mendez M, Faught RE. Evolving Antiepileptic Drug Treatment in Juvenile Myoclonic Epilepsy—Reply. ACTA ACUST UNITED AC 2004. [DOI: 10.1001/archneur.61.8.1328-b] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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155
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Palmer D, Prasad A, Arbab-Zadeh A, Zhang R, Dijk E, Williams K, Webster K, Martini E, Fu Q, Levine BD. Six Months of Endurance Training Increases Left Ventricular Stroke Volume and Diastolic Reserve in Sedentary Seniors. Med Sci Sports Exerc 2004. [DOI: 10.1249/00005768-200405001-00407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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156
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Prasad A, Younger DS. Lyme neuroborreliosis. Drugs Today (Barc) 2004; 34:537-40. [PMID: 15010714 DOI: 10.1358/dot.1998.34.6.485251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The series on treatable neuromuscular disorders continues with the present article on the peripheral nervous system manifestations of Lyme neuroborreliosis.
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157
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Prasad A. A quantitative analysis of low density polyethylene and linear low density polyethylene blends by differential scanning calorimetery and fourier transform infrared spectroscopy methods. POLYM ENG SCI 2004. [DOI: 10.1002/pen.10342] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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158
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Dente JM, Herman CJ, Allen P, Prasad A. 401 ETHNIC DIFFERENCES IN THE USE OF COMPLEMENTARY AND ALTERNATIVE THERAPIES AMONG ADULTS WITH OSTEOARTHRITIS. J Investig Med 2004. [DOI: 10.1136/jim-52-suppl1-401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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159
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Martin R, Burneo JG, Prasad A, Powell T, Faught E, Knowlton R, Mendez M, Kuzniecky R. Frequency of epilepsy in patients with psychogenic seizures monitored by video-EEG. Neurology 2003; 61:1791-2. [PMID: 14694050 DOI: 10.1212/01.wnl.0000098890.13946.f5] [Citation(s) in RCA: 102] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study examined the frequency of epilepsy in a consecutive series of patients who received a definitive diagnosis of psychogenic nonepileptic seizures (PNES) after completing inpatient video-EEG (VEEG) monitoring. Of the 1,590 patients receiving definitive diagnosis, 514 (32.3%) were diagnosed with PNES. Twenty-nine (5.3%) of these patients were found to have both PNES and epilepsy. When strict diagnostic criteria are applied, there is little overlap between epileptic seizures and PNES among patients referred for VEEG monitoring.
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160
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Burneo JG, Martin R, Powell T, Greenlee S, Knowlton RC, Faught RE, Prasad A, Mendez M, Kuzniecky RI. Teddy bears: an observational finding in patients with non-epileptic events. Neurology 2003; 61:714-5. [PMID: 12963774 DOI: 10.1212/wnl.61.5.714-a] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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161
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Burneo JG, Limdi N, Kuzniecky RI, Knowlton RC, Mendez M, Lawn N, Faught E, Welty TE, Prasad A. Neurotoxicity following addition of intravenous valproate to lamotrigine therapy. Neurology 2003; 60:1991-2. [PMID: 12821749 DOI: 10.1212/01.wnl.0000065915.68602.91] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Reversible neurotoxic symptoms were observed in three adult patients with absence status epilepticus on lamotrigine (LTG) therapy after administration of an IV bolus followed by oral valproic acid (VPA). Neurotoxicity was likely related to elevated serum LTG levels, as improvement correlated with discontinuing or reducing LTG dosage.
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162
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Prasad A, Bhoi KK, Bala K, Anand KS, Pal HK. Phenylpropanolamine-induced intraventricular hemorrhage. Neurol India 2003; 51:117-8. [PMID: 12865543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Intracranial hemorrhage is an uncommon complication of phenylpropanolamine. There is an increasing awareness of this complication in the West. However, to the best of our knowledge there have been no cases reported from India. Here we report a patient who developed Intraventricular hemorrhage following ingestion of Phenylpropanolamine, from which he made an uneventul recovery over the next two weeks.
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163
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Prasad A, Sarin YK, Ramji S, Suri VS, Sinha A, Malhotra V. Mediastinal enteric duplication cyst containing aberrant pancreas. Indian J Pediatr 2002; 69:961-2. [PMID: 12503660 DOI: 10.1007/bf02726014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The purpose of the study is to report a unique association of clinical and pathological findings in a neonate. Foregut enteric duplication cysts--rare developmental anomalies that are associated with midline vertebral fusion anomalies. METHODS We had a neonate with foregut duplication cyst who presented at birth with respiratory distress. The child also had associated communicating hydrocephalus. The patient underwent excision of the duplication cyst along with a ventriculo-peritoneal shunt. RESULT The excised specimen revealed a duplication cyst lined by aberrant pancreatic tissue. CONCLUSION The present case demonstrates histologically the presence of both pancreatic and gastric tissue.
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164
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Poddar U, Thapa BR, Prasad A, Sharma AK, Singh K. Natural history and risk factors in fulminant hepatic failure. Arch Dis Child 2002; 87:54-6. [PMID: 12089125 PMCID: PMC1751142 DOI: 10.1136/adc.87.1.54] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The natural history of fulminant hepatic failure (FHF) without liver transplantation is not well known. AIMS To study the natural history and prognostic factors, especially the presence of ascites and spontaneous bacterial peritonitis (SBP), in children with FHF. METHODS FHF was defined by the onset of encephalopathy within 12 weeks of onset of jaundice. From August 1997 to December 2000, 67 children (< or =12 years) were diagnosed with FHF. Their clinical features, investigations and outcome were noted. Viral markers A to E (IgM, anti-HAV; IgM, anti-HEV, HBsAg, and anti-HCV) were determined by ELISA. SBP was defined by the presence of > or =250 neutrophils with or without a positive culture in ascitic fluid. RESULTS Mean age of the children was 5.8 years with an almost equal sex distribution. Viral markers were positive in 63 (94%) cases: hepatitis A in 34 (54%), E in 17 (27%), A+E in seven (11%), and B in five (8%). Thirty one children presented with grade I or II encephalopathy and all recovered, whereas 17 of 36 children who had grade III or IV encephalopathy died. Ascites was detected (both clinically and ultrasonically) in 34 (51%) cases, nine (26%) of which had SBP. Overall mortality was 25%. Mortality was higher in those who had ascites than in those who did not (32% v 18%); among those with ascites it was maximum in those who had SBP (78% v 16%). Total serum bilirubin and grade of encephalopathy were significantly higher, serum albumin was significantly lower, and prothrombin time was significantly prolonged in those who died than in those who recovered. CONCLUSION The natural history of FHF in Indian children depends on age, grade of encephalopathy, ascites, and SBP. SBP depicts worse outcome. In all cases of FHF with ascites, the presence of SBP should be investigated.
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165
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Mandelkern L, Prasad A, Alamo RG, Stack GM. Melting temperature of the n-alkanes and the linear polyethylenes. Macromolecules 2002. [DOI: 10.1021/ma00217a025] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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166
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167
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Naqvi AA, Mandal S, Chattopadhyay A, Prasad A. Salt effect on the quality and recovery of essential oil of citronella (Cymbopogon winterianus Jowitt). FLAVOUR FRAG J 2002. [DOI: 10.1002/ffj.1059] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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168
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Prasad A, Mir R. Digging Deep for Meaning: A Critical Hermeneutic Analysis of CEO Letters to Shareholders in the Oil Industry. ACTA ACUST UNITED AC 2002. [DOI: 10.1177/002194360203900105] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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169
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Prasad A, Mincemoyer R, Quyyumi AA. Anti-ischemic effects of angiotensin- converting enzyme inhibition in hypertension. J Am Coll Cardiol 2001; 38:1116-22. [PMID: 11583891 DOI: 10.1016/s0735-1097(01)01506-6] [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: 11/22/2022]
Abstract
OBJECTIVES We investigated whether augmentation of bradykinin (BK) bioavailability with angiotensin-converting enzyme (ACE) inhibition is associated with reduced exercise-induced myocardial ischemia in hypertension. BACKGROUND Bradykinin responses are depressed in hypertension, and endothelial dysfunction contributes to myocardial ischemia by promoting abnormal coronary vasomotion during stress. METHODS Fourteen hypertensive (HT) and 17 normotensive (NT), mildly symptomatic patients with coronary artery disease (CAD) and ST-segment depression during exercise were studied before and after seven days of oral enalapril (EN), which was titrated from 2.5 to 20 mg daily. Patients underwent two treadmill exercise tests and determination of forearm vasodilator response to BK. RESULTS Despite receiving a lower dose of EN (7.8 vs. 14.8 mg, p < 0.001), NT patients had a significant reduction in blood pressure compared to HT patients. Compared to pre-EN, the ischemic threshold, defined as the rate-pressure product at the onset of 1-mm ST depression (p = 0.045), the duration of exercise to 1-mm ST depression (180 +/- 54 s, p = 0.007) and the maximum exercise duration (94 +/- 18 s, p < 0.001) were greater after EN in HT patients, but not in NT subjects (all p > or = 0.3). Patients with a greater drop in blood pressure experienced no improvement in exercise-induced ischemia. Forearm blood flow responses to BK were improved with EN in all patients to a similar extent. Moreover, no correlation was observed between the basal response to BK or the magnitude of its improvement with EN and with either the dose of EN or the improvement in exercise ischemic threshold. CONCLUSIONS Exercise-induced myocardial ischemia is ameliorated in HT patients with CAD by ACE inhibition.
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170
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Prasad A, Halcox JP, Waclawiw MA, Quyyumi AA. Angiotensin type 1 receptor antagonism reverses abnormal coronary vasomotion in atherosclerosis. J Am Coll Cardiol 2001; 38:1089-95. [PMID: 11583887 DOI: 10.1016/s0735-1097(01)01511-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study was performed to determine whether angiotensin type 1 (AT1) receptor inhibition improves abnormal coronary vasomotion and endothelial dysfunction in patients with atherosclerosis or its risk factors. BACKGROUND Endothelial dysfunction, an early feature of atherosclerosis, contributes to abnormal vasomotion during stress. Angiotensin II may contribute to endothelial dysfunction in atherosclerosis. METHODS In 25 patients, mean age 59 +/- 2 years, with atherosclerosis or its risk factors, we measured coronary vasomotion during flow-mediated dilation (FMD) in response to adenosine, cold pressor test (CPT) and exercise before and after AT1 receptor blockade with intracoronary losartan (5 mg). RESULTS Losartan did not alter resting coronary vascular tone, but epicardial FMD improved from 5.6 +/- 1.5% to 8.9 +/- 1.8% (p = 0.02). Abnormal epicardial vasomotion during CPT and exercise also improved with losartan from -1.7 +/- 0.8% to 1.5 +/- 0.1% (p = 0.02) and -0.6 +/- 0.9% to 3.4 +/- 1.2% (p = 0.009), respectively. Improvement in epicardial vasomotion was most prominent in segments with baseline endothelial dysfunction evidenced as constriction during stress. Microvascular dilation during adenosine, an endothelium-independent response, was unchanged with losartan. CONCLUSIONS Inhibition of the coronary vascular AT1 receptors in patients with atherosclerosis improves epicardial vasomotion during stress, probably by improving endothelial dysfunction. Whether AT1 receptor blockade will provide long-term therapeutic benefits in atherosclerosis needs further investigation.
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171
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Sudha V, Prasad A, Khare S, Bhatia R. Antimicrobial susceptibility testing in India - a status survey. Indian J Med Microbiol 2001; 19:222-3. [PMID: 17664840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Resistance to a variety of antimicrobial agents is emerging in bacterial pathogens throughout the world. Since the accuracy of the antimicrobial susceptibility data is associated with the performance standard of the test, strict adherence to the standard procedures is essential. The Kirby-Bauer disc diffusion susceptibility test, performed in accordance to NCCLS method gives reliable results and hence predicts clinical efficacy of the antibiotic tested. To assess the standard of performance of the antimicrobial susceptibility test, a survey was conducted by National Institute of Biologicals during 1999-2000. The findings indicated an urgent need of setting up a national quality control laboratory to provide the performance standards, reference Q.C. strains and quality antibiotic discs to ensure reproducible and reliable results.
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172
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Prasad A, Koh KK, Schenke WH, Mincemoyer R, Csako G, Fleischer TA, Brown M, Selvaggi TA, Quyyumi AA. Role of angiotensin II type 1 receptor in the regulation of cellular adhesion molecules in atherosclerosis. Am Heart J 2001; 142:248-53. [PMID: 11479463 DOI: 10.1067/mhj.2001.116699] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Inflammation is a central feature of coronary artery disease (CAD) that is characterized by increased expression of cellular adhesion molecules with the exception of L-selectin. L-selectin is a leukocyte adhesion molecule that is rapidly shed after leukocyte activation so that it appears to be decreased in CAD. The renin-angiotensin system (RAS) is implicated in atherogenesis and up-regulates these molecules. OBJECTIVES The aim of this study was to investigate the effect of angiotensin type 1 (AT1) receptor antagonism on serum and leukocyte adhesion molecule expression in patients with CAD. Blood samples were collected from 31 patients before and after 8 weeks of treatment with losartan (44 +/- 2 mg/d, mean +/- SE), an AT1 receptor antagonist. We measured serum intercellular adhesion molecule-1, vascular cell adhesion molecule-1, endothelial-leukocyte adhesion molecule, and C-reactive protein (CRP). By flow cytometry, we also measured the expression of leukocyte CD11a, CD11b, CD11c, CD18, CD31, CD49d, and CD62L (L-selectin) in 13 patients. RESULTS Treatment with losartan decreased systolic blood pressure (141 +/- 3 vs 135 +/- 4 mm Hg, P =.04) and increased plasma renin activity (1.2 +/- 0.4 vs 2.7 +/- 0.5 ng/mL/h, P =.001). There was a significant increase in L-selectin expression on monocytes (86 +/- 6 vs 118 +/- 10 MESF units, P =.007), lymphocytes (52 +/- 10 vs 79 +/- 8, P =.01), and granulocytes (124 +/- 7 vs 156 +/- 18, P =.056). However, there were no changes in the other leukocyte and serum adhesion molecules or CRP. CONCLUSIONS These findings suggest that AT1 receptor antagonism selectively modulates L-selectin expression on leukocytes and that endogenous stimulation of AT1 receptors by the RAS contributes to the activation of leukocytes and decreased expression of L-selectin in CAD.
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173
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Prasad A, Pandey KK. Tuberculous biliary strictures: uncommon cause of obstructive jaundice. AUSTRALASIAN RADIOLOGY 2001; 45:365-8. [PMID: 11531768 DOI: 10.1046/j.1440-1673.2001.00940.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Tuberculous biliary stricture is a very rare cause of obstructive jaundice. A case of a man who had had pulmonary tuberculosis 20 years ago is reported. He now presented with obstructive jaundice due to multiple strictures just below the confluence of the hepatic ducts and in the right hepatic duct. At surgery these turned out to be tuberculous in origin. There was also tuberculous involvement of the gall bladder and cystic duct. The commonest differential diagnosis in such cases is cholangiocarcinoma (as in the present case). Imaging helps in defining the extent of bile duct obstruction. Suspicion of the disease and establishing a tissue diagnosis is very important in treating this potentially curable condition, especially with the worldwide resurgence of tuberculosis.
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Abstract
A three-and-half-year-old boy presented with recurrent chest infections, fever and weight loss of three month duration not responding to antibiotics. The chest X-ray and CT scan revealed a large well-circumscribed mass in right upper thorax with collapse of right upper lobe. A preoperative diagnosis could not be made even after fine needle aspiration cytology. Thoracotomy and right upper lobectomy was done and the biopsy report was an inflammatory pseudotumor. The child remained well for three months after which his symptoms and the mass recurred. The histopathology slides were reviewed and revealed a biphasic malignant tumor suggestive of Pulmonary Blastoma (PB). Patient received four cycles of chemotherapy followed by re-exploration. The recurrent tumour could only be excised partly and the child succumbed to persistent shock postoperatively. The final histopathological diagnosis was confirmed as PB. Primary pulmonary neoplasms in children are rare and of these PB which is even rarer, constitutes less than 15%. The report highlights that the lack of familiarity with this entity still causes error in the diagnosis of PB.
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175
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Prasad A, Kaur S, Malla N, Ganguly NK, Mahajan RC. Ca2+ signaling in the transformation of promastigotes to axenic amastigotes of Leishmania donovani. Mol Cell Biochem 2001; 224:39-44. [PMID: 11693198 DOI: 10.1023/a:1011965109446] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The present study is an attempt to look into the role of Ca2+ in signaling the transformation of promastigotes to axenic amastigotes. An estimation of intracellular free calcium concentration at 6 h intervals during the conversion of promastigotes to axenic amastigotes (72 h) revealed a 10 fold increase in [Ca2+]i at the initial 6-12 h during the conversion. This was followed by declining levels till 60 h and the concentration thereafter remained constant. Axenic amastigotes (72 h) had a 5 fold higher [Ca+]i as compared to the promastigotes. A 30-40% decrease in [Ca2+]i after pretreatment of cells with dentrolene and a gradual rise of intracellular Ca2+ in [Ca2+] free medium indicates the role of intracellular calcium pools in the elevation of [Ca2+]i. A sudden increase in [Ca2+]i on addition of NH4Cl (20 mM) in the cells grown in Ca2+ free medium indicates the presence of acidocalcisomes, as intracellular Ca2+ storing pool, in L. donovani. To study the role of Ca2+ influx from the external medium in the morphogenetic transformation and in the elevation of [Ca2+]i a 45Ca2+ uptake study was performed. Maximum uptake of 45Ca2+ was observed in the initial 24 h of transformation and maximum Ca2+ ATPase activity was also observed between 24-42 h. So the presence of low Ca2+ in the cytosol, existence of intracellular Ca2+ pools and presence of mechanisms to maintain the Ca2+ homeostasis in the cells suggests that Ca2+ can be an appropriate candidate for a second messenger during the morphogenetic transformation of L. donovani.
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