Browsing by Author "Mathew, A"

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    Intramedullary spinal cord glial tumours: Management philosophy and surgical outcome
    (MINIMALLY INVASIVE NEUROSURGERY AND MULTIDISCIPLINARY NEUROTRAUMATOLOGY, 2006) Nair, S; Menon, G; Rao, BRM; Rajesh, BJ; Muthurethinam, T; Mathew, A; Easwer, HV; Bhattacharya, RN
    A retrospective analysis of 88 consecutive cases of intramedullary glial tumours, which constituted 58% of 149 cases of intramedullary lesions surgically managed over a 22-year period, is presented. Fifty-six astrocytomas and 32 ependymomas formed the group, which comprised 55 males and 33 females. While majority of the astrocytomas were in the cervical or cervicodorsal location (70%), it was almost equally distributed between the cervical and conus regions in 23 cases of ependymomas. The management philosophy has changed over the years from biopsy to total removal for ependymomas and a generous inside out decompression in case of astrocytomas. While only a biopsy or decompression was done in 35 of the earlier patients of astrocytomas a radical removal (subtotal in 18 and total in 3) could be achieved in 21 of our recent patients. We could achieve total resection in all the last 17 patients of ependymomas. Low grade astrocytomas radically removed and all ependymomas were not given radiotherapy. Out of the 39 patients of astrocytomas who are in follow up, 13 have improved, 19 remaining static and 7 have deteriorated. While only three of the 25 patients of ependymomas on long term follow up have deteriorated 18 have improved and 6 are remaining static. Conclusion: Although total resection of ependymomas have become a procedure with good functional results in most hands, a radical resection can be achieved with long term stabilisation of neurological deficits in majority of astrocytomas.
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    Pharmacogenetic evaluation of ABCB1, Cyp2C9, Cyp2C19 and methylene tetrahydrofolate reductase polymorphisms in teratogenicity of anti-epileptic drugs in women with epilepsy
    (ANNALS OF INDIAN ACADEMY OF NEUROLOGY, 2014) Jose, M; Banerjee, M; Mathew, A; Bharadwaj, T; Vijayan, N; Thomas, SV
    Aim: Pregnancy in women with epilepsy (WWE) who are on anti-epileptic drugs (AEDs) has two- to three-fold increased risk of fetal malformations. AEDs are mostly metabolized by Cyp2C9, Cyp2C19 and Cyp3A4 and transported by ABCB1. Patients on AED therapy can have folate deficiency. We hypothesize that the polymorphisms in ABCB1, Cyp2C9, Cyp2C19 and methylene tetrahydrofolate reductase (MTHFR) might result in differential expression resulting in differential drug transport, drug metabolism and folate metabolism, which in turn may contribute to the teratogenic impact of AEDs. Materials and Methods: The ABCB1, Cyp2C9, Cyp2C19 and MTHFR polymorphisms were genotyped for their role in teratogenic potential and the nature of teratogenecity in response to AED treatment in WWE. The allelic, genotypic associations were tested in 266 WWE comprising of 143 WWE who had given birth to babies with WWE-malformation (WWE-M) and 123 WWE who had normal offsprings (WWE-N). Results: In WWE-M, CC genotype of Ex07 139C/T was overrepresented (P = 0.0032) whereas the poor metabolizer allele FNx012 and FNx012 FNx012 genotype of CYP2C219 was significantly higher in comparison to WWE-N group (P = 0.007 and P = 0.005, respectively). All these observations were independent of the nature of malformation (cardiac vs. non cardiac malformations). Conclusion: Our study indicates the possibility that ABCB1 and Cyp2C19 may play a pivotal role in the AED induced teratogenesis, which is independent of nature of malformation. This is one of the first reports indicating the pharmacogenetic role of Cyp2C19 and ABCB1 in teratogenesis of AED in pregnant WWE.