M B Agarwal

Bombay Hospital & Medical Research Centre, Mumbai, Mahārāshtra, India

Are you M B Agarwal?

Claim your profile

Publications (14)59.21 Total impact

  • Source
    British Journal of Haematology 03/2008; 85(2):430 - 430. · 4.94 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Thirty five patients with acquired aplastic anaemia (AAA) were treated with anti-lymphocyte globulin (ALG). Fifteen (42.9%) had non-severe aplastic anaemia (NSAA), 14 (40%) severe aplastic anaemia (SAA) and 6 very severe aplastic anaemia (VSAA). There were 17 (48.6%) responders to the first course of ALG while 2 out of 5 (40%) responded to a second course, the overall response rate being 54.3%. Eleven out of 15 (73.3%) with NSAA responded, 8 out of 20 (40%) with SAA responded while none of VSAA responded. All the non-responders have died. Out of the responders, 1 died of non-A non-B hepatitis, and 1 with relapse of AA and sepsis. One has developed paroxysmal nocturnal haemoglobinuria (PNH) and one myelodysplasia. Another 2 needed infrequent red cell transfusion support. Remaining 13 (37.1%) are asymptomatic and without any external support since 18-78 months (35 +/- 21). We conclude that ALG is an effective modality of treatment for patients with AAA.
    The Journal of the Association of Physicians of India 07/1993; 41(6):371-3.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Twelve out of 72 (16.7%) multi-transfused patients with thalassemia major (age range: 7-22 years) were found to be positive for antibody to hepatitis-C virus (anti-HCV). Nine (75%) of these 12 cases were positive for hepatitis B core antibody (anti-HBc) and/or hepatitis B surface antibody (anti-HBs). Out of the remaining 60 patients (83.3%), 27 patients (45%) were positive for anti-HBc and/or anti-HBs, while six (10%) were HBsAg positive Anti-HCV positive patients had significant higher levels of liver enzymes than those who were negative (p < 0.01). S. Ferritin was also significantly higher in those with seropositivity for anti-HCV than those who were negative (p < 0.01). It is concluded that HCV (besides HBV) is a major problem in multi-transfused thalassemia major patients and routine pre-transfusion screening of blood for anti-HCV must be introduced in the blood banks.
    The Journal of the Association of Physicians of India 04/1993; 41(4):195-7.
  • [Show abstract] [Hide abstract]
    ABSTRACT: From August 1989 to May 1991, 52 patients with transfusion dependent thalassaemia major received L1 (1,2-dimethyl-3- hydroxypyrid-4-one), the oral iron chelator, for a period of 3-21 months (mean +/- SD: 14.2 +/- 6.8). Mean (+/- SD) urinary iron excretion varied from 6.2 +/- 4.6 mg/d on 25 mg/kg/d of L1 to 42.3 +/- 37.1 mg/d on 100 mg/kg/d of L1. Mean (+/- SD) drop in S ferritin was 1465 +/- 990 micrograms/l after 5.0 +/- 0.8 months to 3641.2 +/- 2299.3 micrograms/l after 20.1 +/- 0.9 months of therapy. There was no evidence of neutropenia, thrombocytopenia, ear or eye toxicity. L1-related arthralgia, which was reversible on dose reduction or stoppage, was seen in 20 patients (38.5%), while minor gastrointestinal (GI) tract symptoms occurred in seven (3.5%) cases. We conclude that although L1 is an effective iron chelator, further studies are required to understand the mechanism of L1 related arthralgia and also to find a safer but effective dose on which incidence of L1 related arthralgia is minimal.
    British Journal of Haematology 11/1992; 82(2):460-6. · 4.94 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: From August 1989 to May 1991. 52 patients with transfusion dependent thalassaemia major received L1 (1.2-dimethyl-3-hydroxypyrid-4-one), the oral iron chelator, for a period of 3–21 months (mean±SD: 14.2±6.8). Mean (±SD) urinary iron excretion varied from 6.2±4.6 mg/d on 25 mg/kg/d of L1 to 42.3±37.1 mg/d on 100 mg/kg/d of L1. Mean (±SD) drop in S ferritin was 1465±990 μg/l after 5.0±0.8 months to 3641.2 ±2299.3 μg/l after 20.1 ±0.9 months of therapy. There was no evidence of neutropenia, thrombocytopenia, ear or eye toxicity. L1-related arthralgia, which was reversible on dose reduction or stoppage, was seen in 20 patients (38.5%), while minor gastrointestinal (GI) tract symptoms occurred in seven (3.5%) cases.We conclude that although L1 is an effective iron chelator, further studies are required to understand the mechanism of L1 related arthralgia and also to find a safer but effective dose on which incidence of L1 related arthralgia is minimal.
    British Journal of Haematology 09/1992; 82(2):460 - 466. · 4.94 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Seventy-two transfusion-dependent iron loaded thalassemia patients were investigated for thyroid dysfunction by estimating circulating thyroid hormones (T4 and T3) and basal thyroid stimulating hormone (TSH). They were also evaluated for their liver function (biochemically) and iron overload by estimating serum ferritin. Thyroid failure (hypothyroidism) was documented in 14 patients (19.4%). In all, 3 groups were seen, i.e. Group 1: Normal T4, T3, TSH (58 patients: 80.6%); Group 2: Compensated hypothyroidism characterized by normal T4, T3 and raised TSH (9 patients: 12.5%); Group 3: Decompensated hypothyroidism characterized by decreased T4 and increased TSH (5 patients: 6.9%). Interestingly, impaired thyroid function could not be correlated with age, amount of blood transfused, liver dysfunction or degree of iron overload. It is postulated that an inter-play between chronic hypoxia, liver dysfunction and iron overload may be responsible for the thyroid damage.
    Indian pediatrics 09/1992; 29(8):997-102. · 1.04 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: During January 1981 to June 1991, 20 patients from 16 unrelated families were detected to have Glanzmann's thrombasthenia (GT). Twelve families (75%) had history of consanguinity, with 6 first cousins and 3 uncle-niece marriages; of these 7 were Muslims, 6 Hindus and 3 Christians. There were 12 girls and 8 boys; the mean age at diagnosis was 7.05 +/- 6.03 yr (range 1 day-22 yr). All cases had initial bleeding prior to the age of 5 yr with the mean age at the initial episode of bleeding being 2.21 +/- 1.34 yr (range 1 day-5 yr). Common pattern of bleeding included epistaxis, gingival bleeding, post-traumatic bruises, menorrhagia, gastrointestinal (2 cases), post-operative (2 cases) and spontaneous bleeding (2 cases). No patient showed hemarthrosis, intracranial bleeding or hemoptysis. Menorrhagia was a serious problem necessitating repeated transfusions and hormonal therapy. Twelve cases (60%) required 1-120 units of blood transfusions while five received platelet concentrates.
    Indian pediatrics 08/1992; 29(7):837-41. · 1.04 Impact Factor
  • Indian pediatrics 08/1992; 29(7):895-7. · 1.04 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The frequency of anti-nuclear antibodies (ANA) was evaluated in multi-transfused patients of thalassemia major. Twelve out of 83 patients (14.5%) had positive ANA at titres of 1:80 or above. The results were compared with age and sex matched healthy controls who showed positive results in only 1 of 52 cases (1.9%; p less than 0.05). Antibody against double stranded DNA was absent. ANA positivity was found to correlate with higher age (p less than 0.01), more amount of blood transfused (p less than 0.01), splenectomy status (p less than 0.01), higher levels of serum ferritin (p less than 0.01) and presence of hepatitis B surface antigen (p less than 0.01) and antihepatitis C antibody (p less than 0.01).
    Indian pediatrics 06/1992; 29(5):607-10. · 1.04 Impact Factor
  • Source
    M B Agarwal, C Vishwanathan
    Indian pediatrics 03/1992; 29(2):234-7. · 1.04 Impact Factor
  • M B Agarwal, U M Agarwal, B M Pai
    [Show abstract] [Hide abstract]
    ABSTRACT: A case of acquired haemoglobin H (HbH) disease with underlying myelodysplastic syndrome in the form of acquired idiopathic sideroblastic anaemia is reported. Family studies and subsequent drop in HbH percentage strongly supported the acquired nature of the defect.
    The Journal of the Association of Physicians of India 11/1991; 39(10):769-70.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Twenty-four patients with beta thalassaemia major, aged 8-22 years (mean 15.3 +/- 8.1) were given 1-2, dimethyl-3-hydroxypyrid-4-one (L1) orally for a period of three months. The drug was given in the dose of 25 mg/Kg/day for the first week and gradually increased to 100 mg/Kg/day which was continued until 3 months. The mean urinary iron excretion was 5.73 +/- 3.648 mg/day on 25 mg/Kg/day of L1; 15.2 +/- 11.225 mg/day on 50 mg/Kg/day; 24.2 +/- 12.69 mg/day on 75 mg/Kg/day and 36.3 +/- 19.4 mg/day on 100 mg/Kg/day of L1. Serum ferritin estimated by ELISA before and 3 months after L1 therapy in 21 patients showed significant drop in levels, the mean drop being 964.3 +/- 844.4 (P less than 0.001). The only side-effects noted were transient gastrointestinal symptoms in 5 patients and skeletomuscular pain in 3 patients. Both these groups of symptoms were of transient nature. The efficacy of L1 appears to be excellent and equivalent to the standard iron chelation therapy available at present i.e. desferrioxamine. It appears to be free of major toxicity. L1 is also a specific chelator for iron as it does not deplete trace metals. L1 appears to be a cheap and effective oral alternative to desferrioxamine for treating iron overloading.
    The Journal of the Association of Physicians of India 10/1991; 39(9):669-72.
  • M B Agarwal, U M Agarwal
    [Show abstract] [Hide abstract]
    ABSTRACT: Eight cases with lupus anticoagulants (LA) were diagnosed over the last five years (1984-88). Of these, three were established cases of systemic lupus erythematosus (SLE), where bad obstetric history (2 cases) and recurrent deep venous thrombosis (DVT--1 case) prompted execution of laboratory tests for LA. In the remaining 5 cases, there was no clinical evidence of SLE. However, one case developed laboratory findings suggestive of SLE at a later date. One of these 5 patients was referred for unexplained abnormality in partial thromboplastin time (K). Three had recurrent abortions (one with additional history of DVT) while one had DVT with raised PTT (K). The clinical findings and laboratory tests by which lupus anticoagulants can be diagnosed have been discussed.
    The Journal of the Association of Physicians of India 04/1991; 39(3):243-5.
  • The Lancet 04/1990; 335(8689):601. · 39.21 Impact Factor