Biomedical subjects
Publications and source records attributed to A Bharani.
We present a case of primary amyloidosis with macroglossia and restrictive cardiomopathy, that was mistakenly diagnosed as carcinoma of the tongue. He had characteristic echocardiographic findings, and bone marrow plasmacytosis but with normal serum electrophoresis and no Bence Jones proteins in the urine.
A case of roadside accident victim is discussed who had electrocardiographic changes of hypothermia wrongly interpreted as "evolving myocardial infarction", which completely reverted after increasing core body temperature.
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Twelve patients with refractory chronic congestive heart failure (Class IV NYHA), related to idiopathic dilated cardiomyopathy (10 patients); previous myocardial infarction (one patient) and peripartum cardiomyopathy (one patient), received Terminalia Arjuna, an Indian medicinal plant, as bark extract (500 mg 8-hourly) or matching placebo for 2 weeks each, separated by 2 weeks washout period, in a double blind cross over design as an adjuvent to maximally tolerable conventional therapy (Phase I). The clinical, laboratory and echocardiographic evaluation was carried out at baseline and at the end of Terminalia Arjuna and placebo therapy and results were compared. Terminalia Arjuna, compared to placebo, was associated with improvement in symptoms and signs of heart failure, improvement in NYHA Class (Class III vs. Class IV), decrease in echo-left ventricular enddiastolic (125.28 +/- 27.91 vs. 134.56 +/- 29.71 ml/m2; P < 0.005) and endsystolic volume (81.06 +/- 24.60 vs. 94.10 +/- 26.42 ml/m2; P < 0.005) indices, increase in left ventricular stroke volume index (44.21 +/- 11.92 vs. 40.45 +/- 11.56 ml/m2; P < 0.05) and increase in left ventricular ejection fractions (35.33 +/- 7.85 vs. 30.24 +/- 7.13%; P < 0.005). On long term evaluation in an open design (Phase II), wherein Phase I participants continued Terminalia Arjuna in fixed dosage (500 mg 8-hourly) in addition to flexible diuretic, vasodilator and digitalis dosage for 20-28 months (mean 24 months) on outpatient basis, patients showed continued improvement in symptoms, signs, effort tolerance and NYHA Class, with improvement in quality of life.(ABSTRACT TRUNCATED AT 250 WORDS)
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A case of pulmonary varices with mitral valve disease is presented with a detailed review of the literature. Two distinct categories of the disease, with and without left atrial hypertension, are emphasized.
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BACKGROUND: Experience in Vellore suggests that pulmonary arterial hypertension develops at an earlier age in Indian patients with secundum atrial defects than it does in westerners. We examined the haemodynamic data on patients with secundum atrial defects to determine whether this was also true in Delhi. METHODS: We analysed the data on 461 patients with secundum atrial defects, grouping them according to their pulmonary (Qp) and systemic (Qs) flow rates as well as the ratio of pulmonary to systemic systolic pressure (Pap/Sap) into 4 groups: [table: see text] RESULTS: There were 8 (2%) patients in group 1, 282 (61%) in group 2, 124 (27%) in group 3, 28 (6%) in group 4a and 19 (4%) in group 4b. Of the 19 patients in group 4b, 6 (1%) were below 20 years of age and 13 (3%) above 20 years. CONCLUSION: Our findings indicate that obstructive pulmonary arterial hypertension does not develop early in patients in Delhi.