Chander Lulla
University of Mumbai, Radiology, Faculty Member
Research Interests:
Anion exchange high performance liquid chromatography (AX-HPLC) has been widely used for separating and quantifying various haemoglobin fractions especially in the haemoglobinopathies. We have evaluated the reliability of this technique... more
Anion exchange high performance liquid chromatography (AX-HPLC) has been widely used for separating and quantifying various haemoglobin fractions especially in the haemoglobinopathies. We have evaluated the reliability of this technique to measure low concentrations of adult haemoglobin (HbA) in fetal blood to enable differentiation between affected and unaffected fetuses at risk for beta-thalassaemia (85) and other haemoglobinopathies such as delta beta/beta-thalassaemia (1), E-beta-thalassaemia (2), S-beta-thalassaemia (1), and sickle cell anaemia (1). The HbA values obtained ranged between 0 and 9.51 per cent. The HbA for 27 affected fetuses was 0 per cent, while two showed a HbA value of 0.5 per cent. The mean HbA for 61 unaffected fetuses was 4.8 +/- 2.08 per cent. Thirty cord blood samples (cord abortus in cases of affected fetuses and cord full term in cases of unaffected fetuses) were analysed to reconfirm the diagnosis. Ten babies between 8 and 18 months of age could be followed up for confirmation. AX-HPLC was found to be a simple and rapid procedure with high sensitivity and there was a good correlation between the HbA values obtained by AX-HPLC and the diagnosis by carboxymethyl cellulose (CMC) chromatography.
Research Interests: Sickle Cell Anemia, Hemoglobinopathies, Medicine, India, Pregnancy, and 13 moreHumans, Hemoglobinopathy, Cord Blood, Female, High Performance Liquid Chromatography, Clinical Sciences, High Pressure Liquid Chromatography, Adult, Prenatal Diagnosis, Fetus, Beta Thalassemia, Fetal Hemoglobin, and Paediatrics and reproductive medicine
Research Interests:
Research Interests:
We report a case of spina bifida in the upper thoracic spine with an accompanying meningocoele suspected at 8... more
We report a case of spina bifida in the upper thoracic spine with an accompanying meningocoele suspected at 8 weeks' gestation via transvaginal sonography and confirmed at 13 weeks' gestation via 3-dimensional sonography. The fetal cranial vault and intracranial structures were normal. The only finding in the 8-week sonogram was a subtle angulation or "step" in the posterior contour of the embryo; this may be attributed to kyphosis, which often accompanies this condition. The presence of a "step" in the fetal contour must alert the sonologist to the possibility of spina bifida. To our knowledge, this is the earliest antenatal diagnosis of spina bifida.
Research Interests:
We report a case of a large fetal oropharyngeal teratoma in a 19‐week fetus evaluated with 3‐dimensional (3D) sonography. The 3D sonographic surface and maximum mode rendering of the tumor allowed detailed visualization of the mass lesion... more
We report a case of a large fetal oropharyngeal teratoma in a 19‐week fetus evaluated with 3‐dimensional (3D) sonography. The 3D sonographic surface and maximum mode rendering of the tumor allowed detailed visualization of the mass lesion and thus enabled active patient participation in the management of the pregnancy. © 2008 Wiley Periodicals, Inc. J Clin Ultrasound, 2008.
Research Interests:
Research Interests:
Research Interests:
Research Interests:
We have offered first trimester prenatal diagnosis to 55 couples at risk for β-thalassemia, originating from various parts of India, using polymerase chain reaction and denaturing gradient gel electrophoresis. Apart from the six common... more
We have offered first trimester prenatal diagnosis to 55 couples at risk for β-thalassemia, originating from various parts of India, using polymerase chain reaction and denaturing gradient gel electrophoresis. Apart from the six common mutations, codon 30 (CAG→CAA), Cap site +1 (A→C), as well as three uncharacterized mutations were seen among the parents. in the majority of cases, the diagnosis was possible by scanning only one fragment (B) where most of the Indian mutations are situated. in 18 out of 55 cases, framework analysis could also have been used to offer prenatal diagnosis without characterizing the β-thalassemia mutations. in the two cases where the mutations were uncharacterized, prenatal diagnosis was done only on the basis of the anomalous denaturing gradient gel electrophoresis patterns seen in the parents and in previously affected children. This is the first attempt of prenatal analysis using denaturing gradient gel electrophoresis in the extremely diverse Indian population where the prof...
Research Interests:
Research Interests:
The study group consisted of 75 high risk singleton pregnancies in whom color duplex Doppler evaluation of the uteroplacental circulation was determined and correlated with perinatal outcome. Uterine, umbilical and middle cerebral artery... more
The study group consisted of 75 high risk singleton pregnancies in whom color duplex Doppler evaluation of the uteroplacental circulation was determined and correlated with perinatal outcome. Uterine, umbilical and middle cerebral artery flow velocity waveforms (FVW) were analysed and the resistance index (RI), pulsatility index (PI) and the systolic/diastolic (S/D) ratios measured. On the basis of the FVW the uteroplacentofetal blood flow was classified as normal, increased resistance to flow, absent end diastolic flow (AEDF), and reversed end diastolic flow (REDF). Ultrasound biometry was simultaneously performed for all fetuses, while non stress testing was performed as and when indicated. Of the 75 fetuses studied 33 (44%) had abnormal FVWs and only 30.3% of these had an uncomplicated outcome as compared to 81% of those with normal flows. The mortality in cases with abnormal flows was 43% as compared to 7% in those with normal flows. There were 40 growth retarded fetuses in the ...
Research Interests:
Research Interests:
Research Interests:
This study reports our experience with 67 intrauterine transfusions (IUTs) carried out for 27 cases of severe Rh alloimmunization, which could be useful to other developing countries with similar situations. Most of the mothers were from... more
This study reports our experience with 67 intrauterine transfusions (IUTs) carried out for 27 cases of severe Rh alloimmunization, which could be useful to other developing countries with similar situations. Most of the mothers were from sections of India other than Mumbai, their socioeconomic status was low, and they were referred during the second or third trimester. The mean gestation age at first IUT was 27+/-2.9 weeks and maternal anti-D titer ranged from 1:32 to 1:512. Ultrasonography (USG) was normal in eight cases, but showed minimal or gross ascites in 8 and 11 cases, respectively. The mean +/- SD hematocrit (HCT) in three groups defined by USG was 23.5+/-1.7, 15.9+/-4, and 12+/-5.9, respectively. Amniotic fluid analysis, which proved to be an important investigation, indicated IUT in eight cases having normal USG. Six cases were severely anemic (Hb deficit >7 g/dl). By fetal cell staining, the percentage of the donor's red cells in the fetal circulation was determined. Besides Hb, blood group, direct antiglobulin test, and mean cell volume, this parameter was also useful in assessing efficacy of IUT and the need for an exchange transfusion after birth. Of 11 fetuses having gross ascites, eight and one each from the remaining two groups, were stillborn. One death may be procedure related. Two neonates died due to hemorrhagic disorder and prematurity. The overall survival rate was 55.6%. Late referral, severe Rh alloimmunization, volume overload, delay in IUT because of nonavailability of blood and use of nonirradiated blood could be the reasons for the poor outcome. Strategies for improving results are discussed.
Research Interests:
The relationship between insulin resistance and atherosclerosis (ATH) in non-diabetic hypertensive patients from the Asian Indian population remains poorly understood. To resolve this issue, the present study was designed to analyze... more
The relationship between insulin resistance and atherosclerosis (ATH) in non-diabetic hypertensive patients from the Asian Indian population remains poorly understood. To resolve this issue, the present study was designed to analyze whether insulin sensitivity in a non-diabetic individual is related to the development of ATH.(by using IMT as an index) and whether this relationship is dependent on the presence of other cardiovascular disease (CVD) risk factors such as dyslipidemia and hypertension. This study included 68 healthy controls with no diabetes and hypertension and 41 hypertensive patients who underwent four-point oral glucose tolerance test (OGTT) and intravenous glucose tolerance test (IVGTT). A biochemical profile, beta mode ultrasonography for intima media thickness of carotid artery, and ECG determination was carried out. Hypertensive patients in our study exhibited significantly increased abdominal obesity. Blood pressure, fasting and 2 hr plasma glucose (4.62 +/- 0.08 and 5.55 +/- 0.17 mmol/l), and triglyceride (1.47 +/- 0.067 mmol/l) levels were compared to those of control subjects (p < 0.05). The fasting insulin levels and HOMA-IR were also significantly increased and Composite Insulin Sensitivity Index (CISI) reduced compared to controls with p < 0.01. Intima media thickness of the left (0.08 +/- 0.01) and right (0.069 +/- 0.008) CA were both significantly increased in hypertensives (p < 0.01). Correlation analysis showed that IMT of the left carotid artery was significantly associated with triglyceride levels (r = 0.813, p < 0.05) but not with insulin measures such as HOMA-IR and CISI. Hyperinsulinemia was observed in our non-diabetic hypertensive patients, but no association was found between IMT and insulin resistance. That IMT of hypertensives was associated with triglyceride levels suggests that high levels of insulin may be related to the development of ATH indirectly through its effects on lipid metabolism in our population.
Research Interests: Atherosclerosis, Medicine, Electrocardiography, Insulin Resistance, Humans, and 15 moreInternal Medicine, Blood Glucose, Hypertension, Insulin, Diabetes mellitus, Blood Pressure, Female, Clinical, Male, Clinical Sciences, Adult, Dyslipidemia, Glucose Tolerance Test, Abdominal Obesity, and Case Control Studies
Research Interests: Kidney diseases, Medicine, Prospective studies, Pregnancy, Humans, and 15 moreKidney, Female, Newborn Infant, Adult, Urinary System, Survival Rate, Renal Dysplasia, Sensitivity and Specificity, Oligohydramnios, Cohort Studies, Renal agenesis, hydronephrosis , mass Screening, Hypoplasia, and Paediatrics and reproductive medicine
not abstract availabl
Research Interests:
Research Interests:
Fanconi Anemia (FA) is a rare autosomal recessive disorder associated with pancytopenia, sponta- neous chromosome instability and a variety of congenital anomalies. Hypersensitivity to bifunctional alkylating or DNA crosslinking agents... more
Fanconi Anemia (FA) is a rare autosomal recessive disorder associated with pancytopenia, sponta- neous chromosome instability and a variety of congenital anomalies. Hypersensitivity to bifunctional alkylating or DNA crosslinking agents like Mitomycin C (MMC), Diepoxybutane (DEB) and Nitrogen Mustard (HN2) is used as a differential diagnostic test. A variable phenotype and age of onset of anemia make diagnosis difficult in some cases. We report a case of Fanconi anemia detected by the MMC stress test in a 2 year old boy, operated for bilateral syndactyly and contractures of fingers. He had a bifid thumb on the left hand and bilateral triphalangeal thumbs. There was no history of consanguinity or malformations, though a maternal uncle had a bifid thumb. USG in a subsequent pregnancy showed bony anomalies like scoliosis, talipes, contractures and radial aplasia, consistent with FA. The parents opted for termination. An early diagnosis of FA in a non-manifesting child would provide more...
Research Interests:
1 Amrita Institute of Medical Sciences, Kochi, Kerala, India 2 Ria Clinic, Mumbai, Maharashtra, India Editor-In-Chief’s Note Ever since 3D ultrasound became available for us as a diagnostic modality, the opinions are divided regarding it... more
1 Amrita Institute of Medical Sciences, Kochi, Kerala, India 2 Ria Clinic, Mumbai, Maharashtra, India Editor-In-Chief’s Note Ever since 3D ultrasound became available for us as a diagnostic modality, the opinions are divided regarding it being superior to hysteroscopy as diagnostic modality. Hysteroscopy was considered ideal to accurately diagnose intracavitary structural abnormalities, and later when 3D ultrasound was introduced, it was considered an option to reduce the number of hysteroscopies in such cases. Clinicians may find it difficult to choose the right modality in different clinical situations in their practice. Both these tools give valuable information on clinical conditions like abnormal uterine bleeding, infertility recurrent pregnancy loss, neoplastic conditions, etc. what are the indications for hysteroscopy? Can noninvasive 3D USG replace the time tested modality, hysteroscopy? To find answers to these queries, authors experienced in their own fields are debating i...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Anion exchange high performance liquid chromatography (AX-HPLC) has been widely used for separating and quantifying various haemoglobin fractions especially in the haemoglobinopathies. We have evaluated the reliability of this technique... more
Anion exchange high performance liquid chromatography (AX-HPLC) has been widely used for separating and quantifying various haemoglobin fractions especially in the haemoglobinopathies. We have evaluated the reliability of this technique to measure low concentrations of adult haemoglobin (HbA) in fetal blood to enable differentiation between affected and unaffected fetuses at risk for beta-thalassaemia (85) and other haemoglobinopathies such as delta beta/beta-thalassaemia (1), E-beta-thalassaemia (2), S-beta-thalassaemia (1), and sickle cell anaemia (1). The HbA values obtained ranged between 0 and 9.51 per cent. The HbA for 27 affected fetuses was 0 per cent, while two showed a HbA value of 0.5 per cent. The mean HbA for 61 unaffected fetuses was 4.8 +/- 2.08 per cent. Thirty cord blood samples (cord abortus in cases of affected fetuses and cord full term in cases of unaffected fetuses) were analysed to reconfirm the diagnosis. Ten babies between 8 and 18 months of age could be followed up for confirmation. AX-HPLC was found to be a simple and rapid procedure with high sensitivity and there was a good correlation between the HbA values obtained by AX-HPLC and the diagnosis by carboxymethyl cellulose (CMC) chromatography.
Research Interests:
We report a case of spina bifida in the upper thoracic spine with an accompanying meningocoele suspected at 8... more
We report a case of spina bifida in the upper thoracic spine with an accompanying meningocoele suspected at 8 weeks' gestation via transvaginal sonography and confirmed at 13 weeks' gestation via 3-dimensional sonography. The fetal cranial vault and intracranial structures were normal. The only finding in the 8-week sonogram was a subtle angulation or "step" in the posterior contour of the embryo; this may be attributed to kyphosis, which often accompanies this condition. The presence of a "step" in the fetal contour must alert the sonologist to the possibility of spina bifida. To our knowledge, this is the earliest antenatal diagnosis of spina bifida.
Research Interests:
We report a case of a large fetal oropharyngeal teratoma in a 19-week fetus evaluated with 3-dimensional (3D) sonography. The 3D sonographic surface and maximum mode rendering of the tumor allowed detailed visualization of the mass lesion... more
We report a case of a large fetal oropharyngeal teratoma in a 19-week fetus evaluated with 3-dimensional (3D) sonography. The 3D sonographic surface and maximum mode rendering of the tumor allowed detailed visualization of the mass lesion and thus enabled active patient participation in the management of the pregnancy.