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Naidu K, Patel S, Hong J, Ng KS. Identification and surgical management of acute severe ulcerative colitis: A guide for general practitioners. Aust J Gen Pract 2024; 53:211-216. [PMID: 38575541 DOI: 10.31128/ajgp-08-23-6953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
BACKGROUND Approximately 25% of patients with ulcerative colitis (UC) develop acute severe UC (ASUC), necessitating urgent care. General practitioners (GPs), whether based in rural or urban settings, are instrumental in detecting early warning signs, expediting emergency interventions, coordinating with medical teams, educating patients and overseeing outpatient care. This involvement ensures timely, appropriate surgical responses, especially if complications arise or medical treatments prove ineffective. OBJECTIVE This review provides GPs with an understanding of ASUC evaluation and risk assessment, emphasising surgical management and complementing existing medical methods. The objective is to equip GPs, whether in rural or urban environments, with the knowledge and confidence to play an integral role in the treatment team. DISCUSSION Identifying and diagnosing ASUC is crucial for timely emergency care. Moreover, effective ASUC management demands appropriate preoperative work-up. GPs should be adept at monitoring treatment efficacy and guiding patients through surgical aftercare. Thus, GPs should be well versed in diagnostic criteria and surgical approaches for ASUC, as well as their important role within a multidisciplinary team.
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Affiliation(s)
- Krishanth Naidu
- MS, FRACS, Colorectal Research Fellow, Colorectal Surgery Unit, Concord Hospital, Sydney, NSW; Colorectal Research Fellow, Concord Institute of Academic Surgery, Concord Hospital, Sydney, NSW; Clinical Lecturer, University of Sydney, Concord Clinical School, Clinical Sciences Building, Concord Hospital, Sydney, NSW
| | - Sunaina Patel
- MChD, FRACGP, General Practitioner, Rochedale Family Practice, Brisbane, Qld
| | - Jonathan Hong
- MS, FRACS, Colorectal Surgeon, Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW; Associate Professor of Surgical Education, RPA Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney, NSW
| | - Kheng-Seong Ng
- MBiostat, PhD, FRACS, Colorectal Surgeon, Colorectal Surgery Unit, Concord Hospital, Sydney, NSW; Senior Lecturer, Concord Institute of Academic Surgery, Concord Hospital, Sydney, NSW; Senior Lecturer, University of Sydney, Concord Clinical School, Clinical Sciences Building, Concord Hospital, Sydney, NSW
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Jin L, Naidu K. When you hear hoofbeats, think horses before zebras - a case of recurrent small bowel obstructions with a twist. J Surg Case Rep 2023; 2023:rjad555. [PMID: 37846413 PMCID: PMC10576990 DOI: 10.1093/jscr/rjad555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 09/21/2023] [Indexed: 10/18/2023] Open
Abstract
Mechanical small bowel obstructions (SBOs) account for a considerable proportion of hospital admissions for acute abdominal pain. SBOs are most frequently caused by adhesions; and very few SBOs are associated with intraperitoneal devices. An 84-year-old man was admitted to our tertiary institution with recurrent SBOs that were initially believed to be caused by his implantable cardioverter defibrillator which had undergone intraperitoneal migration. However, this was later found to be a misguided 'zebra'; as the cause was revealed to be a common 'horse' - adhesions. This article shares our key learnings from this diagnostic dilemma.
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Affiliation(s)
- LongHai Jin
- Department of General Surgery, The Canberra Hospital, Garran, ACT 2605, Australia
| | - Krishanth Naidu
- Department of General Surgery, The Canberra Hospital, Garran, ACT 2605, Australia
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Naidu K, Chapuis PH, Brown KGM, Chan C, Rickard MJFX, Ng KS. Splenic flexure cancer survival: a 25-year experience and implications for complete mesocolic excision (CME) and central vascular ligation (CVL). ANZ J Surg 2023; 93:1861-1869. [PMID: 36978261 DOI: 10.1111/ans.18434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 03/08/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND The management of splenic flexure cancers (SFCs) in the era of complete mesocolic excision (CME) and central vascular ligation (CVL) is challenging because of its variable lymphatic drainage. This study aimed to compare survival outcomes for SFCs and non-SFCs, and better understand the clinicopathological characteristics which may define a distinct SFC phenotype. METHODS An observational cohort study at Concord Hospital, Sydney was conducted with patients who underwent resection for colon adenocarcinoma (1995-2019). Clinicopathological data were extracted from a prospective database. Overall survival (OS) and disease-free survival (DFS) estimates and their associations to clinicopathological variables were investigated with Kaplan-Meier and Cox regression analyses. RESULTS Of 2149 patients with colon cancer, 129 (6%) had an SFC. The overall 5-year OS and DFS rates were 63.6% (95% CI 62.5-64.7) and 59.4% (95% CI 58.3-60.5), respectively. SFCs were not associated with OS (P = 0.6) or DFS (P = 0.5). SFCs were more likely to present urgently (P < 0.001) with obstruction (P < 0.001) or perforation (P = 0.03), and more likely to require an open operation (P < 0.001). These characteristics were associated with poorer survival outcomes. No differences were noted between SFCs and non-SFCs with respect to tumour stage (P = 0.3). CONCLUSION SFCs have a distinct phenotype, the individual characteristics of which are associated with poorer survival. However, the survivals of SFCs and non-SFCs are similar, possibly because the most important determinant of outcome, tumour stage, is no different between the groups. This may have implications for the surgical approach to SFCs with respect to standardization of CME and CVL surgery for these cancers.
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Affiliation(s)
- Krishanth Naidu
- Colorectal Surgery Unit, Concord Hospital, Sydney, New South Wales, 2139, Australia
- Concord Institute of Academic Surgery, Concord Hospital, Sydney, New South Wales, 2139, Australia
- Concord Clinical School, Clinical Sciences Building, Concord Hospital, University of Sydney, Sydney, New South Wales, 2139, Australia
| | - Pierre H Chapuis
- Colorectal Surgery Unit, Concord Hospital, Sydney, New South Wales, 2139, Australia
- Concord Institute of Academic Surgery, Concord Hospital, Sydney, New South Wales, 2139, Australia
- Concord Clinical School, Clinical Sciences Building, Concord Hospital, University of Sydney, Sydney, New South Wales, 2139, Australia
| | - Kilian G M Brown
- Colorectal Surgery Unit, Concord Hospital, Sydney, New South Wales, 2139, Australia
| | - Charles Chan
- Concord Clinical School, Clinical Sciences Building, Concord Hospital, University of Sydney, Sydney, New South Wales, 2139, Australia
- Department of Anatomical Pathology, Concord Hospital, Sydney, New South Wales, 2139, Australia
| | - Matthew J F X Rickard
- Colorectal Surgery Unit, Concord Hospital, Sydney, New South Wales, 2139, Australia
- Concord Institute of Academic Surgery, Concord Hospital, Sydney, New South Wales, 2139, Australia
- Concord Clinical School, Clinical Sciences Building, Concord Hospital, University of Sydney, Sydney, New South Wales, 2139, Australia
| | - Kheng-Seong Ng
- Colorectal Surgery Unit, Concord Hospital, Sydney, New South Wales, 2139, Australia
- Concord Institute of Academic Surgery, Concord Hospital, Sydney, New South Wales, 2139, Australia
- Concord Clinical School, Clinical Sciences Building, Concord Hospital, University of Sydney, Sydney, New South Wales, 2139, Australia
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Koneru S, Reece MM, Goonawardhana D, Chapuis PH, Naidu K, Ng KS, Rickard MJFX. Right hemicolectomy anastomotic leak study: a review of right hemicolectomy in the binational clinical outcomes registry (BCOR). ANZ J Surg 2023. [PMID: 36825639 DOI: 10.1111/ans.18337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 02/07/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUNDS Surgery remains mainstay management for colon cancer. Post-operative anastomotic leak (AL) carries significant morbidity and mortality. Rates of, and risk factors associated with AL following right hemicolectomy remain poorly documented across Australia and New Zealand. This study examines the Bowel Cancer Outcomes Registry (BCOR) to address this. METHODS A retrospective cohort study was undertaken of consecutive BCOR-registered right hemicolectomy patients undergoing resection for colon cancer (2007-2021). The primary outcome measure was AL incidence. Clinicopathological data were extracted from the BCOR. Factors associated with AL and primary anastomosis were identified using logistic regression. AL-rate trends were assessed by linear regression. RESULTS Of 13 512 patients who had a right hemicolectomy (45.2% male, mean age 72.5 years, SD 12.1), 258 (2.0%) had an AL. On multivariate analysis, male sex (OR 1.33; 95% CI 1.03-1.71) and emergency surgery (OR 1.41; 95% CI 1.04-1.92) were associated with AL. Private health insurance status (OR 0.66; 95% CI 0.50-0.88) and minimally-invasive surgery (OR 0.61; 95% CI 0.47-0.79) were protective for AL. Anastomotic technique (handsewn versus stapled) was not associated with AL (P = 0.84). Patients with higher ASA status (OR 0.47; 95% CI 0.39-0.58), advanced tumour stage (OR 0.56; 95% CI 0.50-0.63), and emergency surgery (OR 0.16; 95% CI 0.13-0.20) were less likely to have a primary anastomosis. AL-rate and year of surgery showed no association (P = 0.521). CONCLUSION The AL rate in Australia and New Zealand following right hemicolectomy is consistent with the published literature and was stable throughout the study period. Sex, emergency surgery, insurance status, and minimally invasive surgery are associated with AL incidence.
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Affiliation(s)
- Sireesha Koneru
- Department of Colorectal Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mifanwy M Reece
- Department of Colorectal Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Dulani Goonawardhana
- Department of Colorectal Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Pierre H Chapuis
- Department of Colorectal Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Krishanth Naidu
- Department of Colorectal Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Kheng-Seong Ng
- Department of Colorectal Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Matthew J F X Rickard
- Department of Colorectal Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Division of Colorectal Surgery, Macquarie University Hospital, Sydney, New South Wales, Australia
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Chia RX, Naidu K, Fadia M, Liang X. Inferior mesenteric vein pylethrombophlebitis as the predominant presentation of diverticulitis. ANZ J Surg 2023; 93:386-388. [PMID: 35651278 DOI: 10.1111/ans.17824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 05/02/2022] [Accepted: 05/07/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Rong Xian Chia
- Department of General Surgery, The Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Krishanth Naidu
- Department of General Surgery, The Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Mitali Fadia
- Department of Anatomical Pathology, The Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - XiaoMing Liang
- Department of General Surgery, The Canberra Hospital, Canberra, Australian Capital Territory, Australia
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Naidu K, Saksenberg V, Suliman MF, Bhana B. Thyroid paraganglioma – a rare entity. Journal of Endocrinology, Metabolism and Diabetes of South Africa 2022. [DOI: 10.1080/16089677.2022.2144428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- K Naidu
- Netcare Waterfall City Hospital, Midrand, South Africa
| | | | - MF Suliman
- Netcare Waterfall City Hospital, Midrand, South Africa
| | - B Bhana
- Lancet Laboratories, Johannesburg, South Africa
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Arora G, Taneja J, Bhardwaj P, Goyal S, Naidu K, Yadav SK, Saluja D, Jetly S. Adverse events and Breakthrough infections associated with COVID-19 vaccination in the Indian population. J Med Virol 2022; 94:3147-3154. [PMID: 35261064 PMCID: PMC9088477 DOI: 10.1002/jmv.27708] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/20/2022] [Accepted: 03/05/2022] [Indexed: 11/21/2022]
Abstract
Vaccines against COVID‐19 provide immunity to deter severe morbidities associated with the infection. However, it does not prevent infection altogether in all exposed individuals. Furthermore, emerging variants of SARS‐CoV‐2 impose a threat concerning the competency of the vaccines in combating the infection. This study aims to determine the variability in adverse events and the extent of breakthrough infections in the Indian population. A retrospective study was conducted using a pre‐validated questionnaire encompassing social, demographic, general health, the status of SARS‐CoV‐2 infection, vaccination, associated adverse events, and breakthrough infections in the Indian population. Informed consent and ethical approval were obtained as per Indian Council of Medical Research (ICMR) guidelines. Participants, who provided the complete information, were Indian citizens, above 18 years, and if vaccinated, administered with either Covishield or Covaxin, were considered for the study. Data have been compiled in Microsoft Excel and analyzed for statistical differences using STATA 11. The responses from 2051 individuals fulfilling the inclusion criteria were analyzed. Among 2051, 1119 respondents were vaccinated and 932 respondents were non‐vaccinated. Among 1119 vaccinated respondents, 7 were excluded because of missing data. Therefore, out of 1112 vaccinated, 413 experienced adverse events with a major fraction of younger individuals, age 18–40 years, getting affected (74.82%; 309/413). Furthermore, considerably more females than males encountered adverse consequences to vaccination (p < 0.05). Among vaccinated participants, breakthrough infections were observed in 7.91% (88/1112; 57.96% males and 42.04% females) with the older age group, 61 years and above (odds ratio, 3.25 [1.32–8.03]; p = 0.011), and males were found to be at higher risk. Further research is needed to find the age and sex‐related factors in determining vaccine effectiveness and adverse events. Significant higher adverse events following COVID‐19 vaccination in females in comparison to males. Breakthrough infections among Indian population was found to be 7.91%. Older people and males were found to be at high risk for getting breakthrough infections.
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Affiliation(s)
- G Arora
- Delhi School of Public Health, IoE & Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi-110007
| | - J Taneja
- Zoology Department, Daulat Ram College, University of Delhi-110007
| | - P Bhardwaj
- Department of Zoology, University of Delhi-110007
| | - S Goyal
- Manav Rachna International School, Sector 14, Faridabad, Haryana, 121007
| | - K Naidu
- IPCA Laboratories Ltd., Mumbai, 400067
| | - S K Yadav
- Zoology Department, Daulat Ram College, University of Delhi-110007
| | - D Saluja
- Delhi School of Public Health, IoE & Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi-110007
| | - S Jetly
- Department of Biomedical Sciences, Acharya Narendra Dev College, University of Delhi-110019
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8
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Chia RX, Fadia M, Naidu K. Calcifying fibrous pseudotumour of jejunal diverticulitis in a young male patient. ANZ J Surg 2021; 92:1238-1239. [PMID: 34585493 DOI: 10.1111/ans.17240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/18/2021] [Accepted: 09/19/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Rong Xian Chia
- Department of General Surgery, The Canberra Hospital, Garran, Australian Capital Territory, Australia
| | - Mitali Fadia
- Department of Anatomical Pathology, The Canberra Hospital, Garran, Australian Capital Territory, Australia
| | - Krishanth Naidu
- Department of General Surgery, The Canberra Hospital, Garran, Australian Capital Territory, Australia
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Jin L, Naidu K. Bouveret syndrome-a rare form of gastric outlet obstruction. J Surg Case Rep 2021; 2021:rjab183. [PMID: 34040753 PMCID: PMC8132588 DOI: 10.1093/jscr/rjab183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/09/2021] [Accepted: 04/14/2021] [Indexed: 11/30/2022] Open
Abstract
Bouveret syndrome is a rare form of gastric outlet obstruction. It is typically diagnosed in frail elderly patients with protracted biliary disease. Thus, it has disproportionally high rates of morbidity and mortality. A 90-year-old man presented to our tertiary hospital with acute abdominal pain and symptoms of bowel obstruction. He was diagnosed with Bouveret syndrome on abdominal computed tomography and required judicious resuscitation and an emergency laparotomy. This article highlights the key features of Bouveret syndrome, and reviews the current diagnostic modalities as well as the contemporary treatment paradigm.
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Affiliation(s)
- LongHai Jin
- Department of General Surgery, The Canberra Hospital, Garran, ACT, Australia
| | - Krishanth Naidu
- Department of General Surgery, The Canberra Hospital, Garran, ACT, Australia
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10
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Naidu K, Ackermann T, Serrao-Brown H, Fadia M, Davis I. Colonic adenocarcinoma following total colectomy and abdomino-perineal resection for ulcerative colitis. ANZ J Surg 2020; 91:1313-1315. [PMID: 33098360 DOI: 10.1111/ans.16405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/05/2020] [Accepted: 10/12/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Krishanth Naidu
- Department of General Surgery, The Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Travis Ackermann
- Department of General Surgery, The Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Hazel Serrao-Brown
- Department of General Surgery, The Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Mitali Fadia
- Department of General Surgery, The Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Ian Davis
- Department of General Surgery, The Canberra Hospital, Canberra, Australian Capital Territory, Australia
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Henning F, Heckmann JM, Naidu K, Vlok L, Cross HM, Marin B. Incidence of motor neuron disease/amyotrophic lateral sclerosis in South Africa: a 4-year prospective study. Eur J Neurol 2020; 28:81-89. [PMID: 32888367 DOI: 10.1111/ene.14499] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/26/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Little is known about the epidemiological features of amyotrophic lateral sclerosis (ALS) in sub-Saharan Africa, and data from the region are limited to clinical series or case reports. The aim of the study was to investigate the incidence rate and presentation of ALS in an ethnically diverse region of South Africa. METHODS We performed a 4-year prospective incidence study in the Western Cape Province of South Africa between 1 July 2014 and 30 June 2018, and used a two-source capture-recapture method for case ascertainment. Age- and sex-adjusted incidence rates (ASAIRs) were calculated using the 2010 US population as the reference. RESULTS A total of 203 incident cases were identified over the study period, resulting in a crude incidence rate (IR) of 1.09 [95% confidence interval (CI) 0.94-1.24] per 100 000 person-years in the at-risk population (aged >15 years). Capture-recapture analysis resulted in an estimated IR of 1.11 (95% CI 1.01-1.22) per 100 000 person-years. The ASAIR was 1.67 (95% CI 1.09-2.26) overall; 1.99 (95% CI 1.60-2.39) for men and 1.37 (95% CI 1.06-1.68) for women. When analysed separately, there was a substantial difference in ASAIRs between the different population groups, with the highest in the European ancestry group (2.62; 95% CI 2.49-2.75), the lowest in the African ancestry group (0.56, 95% CI 0.0-1.23), and an ASAIR in between these two in the mixed ancestry group (1.09, 95% CI 0.80-1.37). CONCLUSION The overall incidence of ALS in the Western Cape Province of South Africa appears to be lower than in North African and Western countries, but higher than in Asian countries. As suggested by previous epidemiological studies, ALS may be less frequent in people of African ancestry.
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Affiliation(s)
- F Henning
- Division of Neurology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - J M Heckmann
- Division of Neurology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - K Naidu
- Division of Neurology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - L Vlok
- Division of Neurology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - H M Cross
- Division of Neurology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - B Marin
- Ministere de la Sante et des Solidarites, Cellule Interministérielle Recherche MSS/MESRI, Paris, France
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Abstract
A case of a female patient presenting with clinical findings ominous for a neoplastic bowel obstruction is reported. Abdominal computed tomography demonstrated a bowel obstruction with evidence of intussusception. Laparotomy revealed an irreducible ileoileal intussusception and segments of the jejunum infiltrated with pigmented deposits. There was no perforation and no evidence of an ulcerating or fungating mass. Intestinal melanoma is not an uncommon sequela of cutaneous melanoma, yet the disease can occur as a primary intestinal process, albeit this is a rarity. Surgical resection is the primary treatment modality and may offer the hope of increased symptom-free survival and overall survival for those patients suffering from metastatic or primary melanoma of the small intestine.
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Affiliation(s)
- Krishanth Naidu
- Department of General Surgery, The Canberra Hospital, Garran, Australia
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Bouchekara H, Latreche Y, Naidu K, Mokhlis H, Dahalan W, Javaid M. COMPREHENSIVE REVIEW OF RADIAL DISTRIBUTION TEST SYSTEMS FOR POWER SYSTEM DISTRIBUTION EDUCATION AND RESEARCH. REFFIT 2019. [DOI: 10.18799/24056529/2019/3/196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
A comprehensive review of existing radial distribution test systems available for power system distribution research is presented. The review can be used to establish a record of cases suitable for distribution operation and planning studies. The importance of the distribution system, the structure of the system in the grid, and various configurations of the distribution network are discussed. The primary requirement of a distribution network is highlighted to underline the important system parameters that should be considered in the design and planning stages. Various research related to the distribution network can be conducted, such as load flow algorithms, optimal incorporation of distributed generation, network reconfiguration, and optimal capacitor allocation, such as important details pertaining to each test system are given. Additional information, such as active and reactive loads and losses, minimum voltage values, and bus location with the weakest voltage values, is provided. Application of the reviewed works based on the test system is tabulated and presented. The information presented in this paper will be beneficial for future research in distribution system design and planning.
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Bouchekara H, Latreche Y, Naidu K, Mokhlis H, Dahalan W, Javaid M. COMPREHENSIVE REVIEW OF RADIAL DISTRIBUTION TEST SYSTEMS FOR POWER SYSTEM DISTRIBUTION EDUCATION AND RESEARCH. REFFIT 2019. [DOI: 10.18799/24056537/2019/3/196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A comprehensive review of existing radial distribution test systems available for power system distribution research is presented. The review can be used to establish a record of cases suitable for distribution operation and planning studies. The importance of the distribution system, the structure of the system in the grid, and various configurations of the distribution network are discussed. The primary requirement of a distribution network is highlighted to underline the important system parameters that should be considered in the design and planning stages. Various research related to the distribution network can be conducted, such as load flow algorithms, optimal incorporation of distributed generation, network reconfiguration, and optimal capacitor allocation, such as important details pertaining to each test system are given. Additional information, such as active and reactive loads and losses, minimum voltage values, and bus location with the weakest voltage values, is provided. Application of the reviewed works based on the test system is tabulated and presented. The information presented in this paper will be beneficial for future research in distribution system design and planning.
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15
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Bathini R, Ramgopal K, Naidu K, Sreekanth S, Rao S. Demographic data and progression-free survival of the patients with biliary cancers receiving palliative chemotherapy in India. J Med Allied Sci 2019. [DOI: 10.5455/jmas.302643142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Branson R, Naidu K, du Toit C, Rotstein AH, Kiss R, McMillan D, Fooks L, Coombes BK, Vicenzino B. Comparison of corticosteroid, autologous blood or sclerosant injections for chronic tennis elbow. J Sci Med Sport 2017; 20:528-533. [PMID: 28089102 DOI: 10.1016/j.jsams.2016.10.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 09/26/2016] [Accepted: 10/21/2016] [Indexed: 01/24/2023]
Abstract
OBJECTIVES To compare three different ultrasound-guided injections for chronic tennis elbow. DESIGN Assessor-blinded, randomized controlled comparative trial. METHODS 44 patients with clinically diagnosed tennis elbow, confirmed by Doppler ultrasound, received under ultrasound guidance, a single corticosteroid injection (n=14), or two injections (separated by 4 weeks) of either autologous blood (n=14) or polidocanol (n=16). Clinical and ultrasound examination was performed at baseline, 4, 12 and 26 weeks. RESULTS Complete recovery or much improvement was greater for corticosteroid injection than autologous blood and polidocanol at 4 weeks (p<0.001, number needed to treat 1 (95% CI 1-2)). In contrast, at 26 weeks corticosteroid was significantly worse than polidocanol (p=0.004, number needed to harm 2 (1-6)). Recurrence after corticosteroid injection was significantly higher than autologous blood or polidocanol (p=0.007, number needed to harm 2 (1-4)). Corticosteroid injection produced greater reduction in tendon thickness and vascularity than autologous blood at 4 weeks only. Compared to autologous blood, polidocanol reduced tendon thickness at 4 and 12 weeks and reduced echogenicity and hyperaemia after 12 or 26 weeks respectively. CONCLUSIONS Injections of corticosteroid cannot be recommended over polidocanol or autologous blood, because despite beneficial short-term effect there were inferior long-term effects. Whether polidocanol or autologous blood injections are effective is unknown, especially as their global effect profiles are not unlike previously reported for wait-and-see.
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Affiliation(s)
- R Branson
- Olympic Park Sports Medicine Centre, Australia
| | - K Naidu
- Olympic Park Sports Medicine Centre, Australia
| | - C du Toit
- Olympic Park Sports Medicine Centre, Australia
| | - A H Rotstein
- Victoria House Medical Imaging, MIA Radiology, Australia
| | - R Kiss
- Victoria House Medical Imaging, MIA Radiology, Australia
| | - D McMillan
- Olympic Park Sports Medicine Centre, Australia
| | - L Fooks
- Olympic Park Sports Medicine Centre, Australia
| | - B K Coombes
- University of Queensland, School of Health and Rehabilitation Sciences, Physiotherapy, Australia; School of Biomedical Sciences, University of Queensland, Australia
| | - B Vicenzino
- School of Biomedical Sciences, University of Queensland, Australia.
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Naidu K, James T, Rotstein A, Balster S, Hoy G. Latissimu dorsi and teres major tendon avulsions in cricketers, a case series and literature review. J Sci Med Sport 2017. [DOI: 10.1016/j.jsams.2017.01.149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Naidu K, Beenen E, Gananadha S, Mosse C. The Yield of Fever, Inflammatory Markers and Ultrasound in the Diagnosis of Acute Cholecystitis: A Validation of the 2013 Tokyo Guidelines. World J Surg 2016; 40:2892-2897. [DOI: 10.1007/s00268-016-3660-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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19
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Plazy M, Newell ML, Orne-Gliemann J, Naidu K, Dabis F, Dray-Spira R. Barriers to antiretroviral treatment initiation in rural KwaZulu-Natal, South Africa. HIV Med 2015; 16:521-32. [PMID: 25857535 DOI: 10.1111/hiv.12253] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2015] [Indexed: 01/22/2023]
Abstract
OBJECTIVES Although antiretroviral therapy (ART) has been freely available since 2004 in South Africa, not all those who are eligible initiate ART. We aimed to investigate individual and household characteristics as barriers to ART initiation in men and women in rural KwaZulu-Natal. METHODS Adults ≥ 16 years old living within a sociodemographic surveillance area (DSA) who accessed the local HIV programme between 2007 and 2011 were included in the study. Individual and household factors associated with ART initiation within 3 months of becoming eligible for ART were investigated using multivariable logistic regression stratified by sex and after exclusion of individuals who died before initiating ART. RESULTS Of the 797 men and 1598 women initially included, 8% and 5.5%, respectively, died before ART initiation and were excluded from further analysis. Of the remaining 733 men and 1510 women, 68.2% and 60.2%, respectively, initiated ART ≤ 3 months after becoming eligible (P = 0.34 after adjustment for CD4 cell count). In men, factors associated with a higher ART initiation rate were being a member of a household located < 2 km from the nearest HIV clinic and being resident in the DSA at the time of ART eligibility. In women, ART initiation was more likely in those who were not pregnant, in members of a household where at least one person was on ART and in those with a high wealth index. CONCLUSIONS In this rural South African setting, barriers to ART initiation differed for men and women. Supportive individual- and household-level interventions should be developed to guarantee rapid ART initiation taking account gender specificities.
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Affiliation(s)
- M Plazy
- Centre INSERM U897 for Epidemiology and Biostatistics, Bordeaux, France.,ISPED, University of Bordeaux, France
| | - M-L Newell
- Africa Centre for Health and Population Studies, University of KwaZulu-Natal, South Africa.,Faculty of Medicine, University of Southampton, Southampton, UK
| | - J Orne-Gliemann
- Centre INSERM U897 for Epidemiology and Biostatistics, Bordeaux, France.,ISPED, University of Bordeaux, France
| | - K Naidu
- Africa Centre for Health and Population Studies, University of KwaZulu-Natal, South Africa
| | - F Dabis
- Centre INSERM U897 for Epidemiology and Biostatistics, Bordeaux, France.,ISPED, University of Bordeaux, France
| | - R Dray-Spira
- UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Team of Research in Social Epidemiology, INSERM, Paris, France.,UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Team of Research in Social Epidemiology, Sorbonne Universités, Paris, France
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Lachi P, Irrakula M, Syed F, Uppin M, Joseph D, Syed A, Nair D, Krishna V, Pamidighantam S, Naidu K. RT-16 * LARGE OCULOMOTOR NERVE SCHWANNOMA - RARE ENTITY. A CASE REPORT. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou270.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Syed F, Lachi P, Keshava R, Syed A, Nair D, Krishna V, Joseph D, Irrakula M, Pamidighantam S, Naidu K. RT-32 * CLINICAL PROFILE AND OUTCOMES IN BRAINSTEM GLIOMA. AN INSTITUTIONAL EXPERIENCE. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou270.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lachi P, Syed F, Keshava R, Syed A, Nair D, Joseph D, Irrakula M, Krishna V, Pamidighantam S, Naidu K. RT-17 * RADIOTHERAPY FOR INTRACRANIAL AND SPINAL EPENDYMOMAS. A RETROSPECTIVE ANALYSIS. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou270.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Syed F, Lachi P, Chakravarthy P, Uppin S, Syed A, Nair D, Joseph D, Irrakula M, Pamidighantam S, Naidu K. MS-26 * EXTRA CRANIAL METASTASIS IN A CASE OF CEREBRAL MENINGIOMA: A RARE CASE REPORT. Neuro Oncol 2014. [DOI: 10.1093/neuonc/nou260.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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24
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Lachi P, Syed F, Ramgopal K, Syed A, V D, E V, J D, I M, P S, Naidu K. Radiotherapy for Intracranial and Spinal Ependymomas. a Retrospective Analysis. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu330.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
INTRODUCTION Lower urinary tract foreign body insertions have a low incidence. The motives for insertion of a variety of objects are difficult to comprehend. This case warrants discussion given the great management challenge faced by the oddity and infrequency with which a fork is encountered in the penile urethra. PRESENTATION OF CASE A 70-year-old man presents to the Emergency Department with a bleeding urethral meatus following self-insertion of a fork into the urethra to achieve sexual gratification. Multiple retrieval methods were contemplated with success achieved via forceps traction and copious lubrication. DISCUSSION The presentation of urethral foreign bodies can vary widely, as can the type of object inserted. The most prevalent motivation for self-insertion of urethral foreign bodies is autoerotism. Motivations ought to be explored in light of possible underlying psychological or psychiatric conditions. The most appropriate surgical extraction technique can be guided by physical examination and imaging. Endoscopic removal is often successful, depending on the object's physical attributes and morphology. It is important to arrange appropriate follow-up, as late complications can occur such as urethral strictures. CONCLUSION Psychological and surgical arms encompass the management plan. Foreign body retrieval is determined by its physical attributes and morphology with the aim to minimise urothelial trauma and preserve erectile function. Essentially, endourological extraction serves the primary means of retrieval. Cystourethoscopy is important to diagnose urothelial injuries and to ensure complete removal of foreign bodies following extraction.
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Affiliation(s)
- Krishanth Naidu
- Department of Urology, The Canberra Hospital, Yamba Drive, Garran, Australian Capital Territory 2605 Australia.
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Lyon M, Schreiber M, Coker T, Naidu K. 297: Barriers to Use of Ultrasonography for Vascular Access by Emergency Nurses. Ann Emerg Med 2010. [DOI: 10.1016/j.annemergmed.2010.06.347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Subhas C, Naidu K, Reddy Y. Performance Degradation in Pre-rake Frequency-division Duplex/ Direct Sequence-code Division Multiple Access Systems. DEFENCE SCI J 2010. [DOI: 10.14429/dsj.60.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Dekker G, Louw HB, Pienaar M, Naidu K, Hlongwane ST, Andronikou S. Meningioma presenting as an oropharyngeal mass--an unusual presentation. S Afr Med J 2007; 97:342. [PMID: 17599213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Affiliation(s)
- G Dekker
- Department of Radiology, Tygerberg Academic Hospital and Stellenbosch University, South Africa.
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Louw HB, Pienaar M, Dekker G, Andronikou S, Hlongwane S, Naidu K. Unusual midline neck mass. S Afr Med J 2007; 97:30-1. [PMID: 17378277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Affiliation(s)
- H B Louw
- Department of Radiology, Tygerberg Hospital and Stellenbosch University.
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Naidu K. The injured eye—practical management guidelines and referral criteria for the rural doctor. S Afr Fam Pract (2004) 2006. [DOI: 10.1080/20786204.2006.10873426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Shingare M, Naidu K, Kale U. A stability-indicating thin-layer chromatographic and densitometric method for determination of nicorandil in tablet formulations. JPC-J PLANAR CHROMAT 2002. [DOI: 10.1556/jpc.15.2002.2.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abstract
The brain exhibits regional vulnerabilities to many insults, and age itself has differential effects on neuronal populations as exemplified by the age-dependent loss of dopaminergic neurons in the nigrostriatal system. We hypothesized that oxidative damage to DNA was more likely to occur in the nigrostriatal system which undergoes significant neurochemical and functional changes with age. To test this hypothesis, oxidative damage to DNA, indicated by levels of 8-hydroxy2'-deoxyguanosine (oxo8dG), was measured in pons-medulla (PM), midbrain (MB), caudate-putamen (CP), hippocampus (HP), cerebellum (CB), and cerebral cortex (CX) at 3, 18, and 34 months of age in C57/b1 mice. Steady-state levels of oxo8dG increased significantly with age in MB, CP, and CB, but not in PM, HP, or CX. Manganese superoxide dismutase (MnSOD) activity decreased with age in MB, CP, and HP, but not in PM, CB, or CX. Regional activities of Cu/Zn superoxide dismutase (Cu/Zn SOD) and glutathione peroxidase (Glut Px) did not change significantly with age. Concomitant with the regional alterations in DNA damage, there was a significant age-dependent decline in locomotor activity, motor coordination, and striatal dopamine content especially during the interval between 18 and 34 months. In conclusion, oxyradical-associated damage to DNA did not accumulate uniformly across brain regions with age and was highest in brain regions that subserve spontaneous locomotor activity and motor coordination.
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Affiliation(s)
- F Cardozo-Pelaez
- Department of Neurology, University of South Florida, and James Haley Veterans Affairs Hospital, Tampa 33620, USA
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Naidu K, Moodley J, Corr P, Hoffmann M. Single photon emission and cerebral computerised tomographic scan and transcranial Doppler sonographic findings in eclampsia. Br J Obstet Gynaecol 1997; 104:1165-72. [PMID: 9332995 DOI: 10.1111/j.1471-0528.1997.tb10941.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To define more clearly the neuropathophysiology of eclampsia utilising single-photon emission computed tomography (SPECT), cerebral computerised tomography (CT) and transcranial Doppler (TCD) ultrasonography. DESIGN A prospective study SETTING The obstetric unit in King Edward VIII Hospital, a large tertiary referral centre in Kwa-Zulu Natal, South Africa. PARTICIPANTS Sixty-five women with eclampsia. INTERVENTIONS Imaging and ultrasonographic investigations were performed within 48 hours postpartum. Unenhanced cerebral CT scans were performed in all the women and SPECT scans were performed on 63 women using Technetium-99m-hexamethylpropyleneamineoxime (99mTc-HMPAO) as a tracer of regional cerebral blood flow. Middle cerebral artery blood flow velocity waveforms were measured using 2 MHz pulsed Doppler ultrasound via the transtemporal approach. MAIN OUTCOME MEASURES Abnormalities in SPECT scan, CT scan and TCD ultrasound findings. RESULTS SPECT scanning revealed perfusion deficits in the watershed areas in all women, 75% of whom had concomitant deficits in the parieto-occipital areas of the brain. Hypodensities (cerebral oedema) were reported in 38 CT scans (58.5%), with parieto-occipital involvement in 97.4% of cases. Increased flow velocity measurements in the middle and posterior cerebral arteries were recorded in 36 (85.7%) women in whom TCD ultrasound was performed. CONCLUSION The pathophysiological mechanism of eclamptic seizures is primary cerebral vasospasm with resultant ischaemia and cerebral oedema involving mainly the watershed areas and parieto-occipital lobes of the brain. SPECT scanning has been shown to be superior to CT scanning and TCD ultrasonography in detecting neuropathophysiologic alterations in eclampsia. However, each of the three investigative tools provide its own unique information and all three are necessary research techniques to improve our understanding of the neuropathophysiological mechanism of eclamptic seizures.
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Affiliation(s)
- K Naidu
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Natal, Congella, South Africa
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Egan V, Chiswick A, Santosh C, Naidu K, Rimmington J, Best JJ. Size isn't everything: A study of brain volume, intelligence and auditory evoked potentials. Personality and Individual Differences 1994. [DOI: 10.1016/0191-8869(94)90283-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Kaplan ER, Naidu K, Rivett DEA. Diterpenoids of Leonotis species. Part III. 8β-Hydroxymarrubiin from L. dysophylla Benth. ACTA ACUST UNITED AC 1970. [DOI: 10.1039/j39700001656] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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