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Biomedical subjects

A G Patel

Publications and source records attributed to A G Patel.

49 records · Page 3Linked to original sources
PubMed1994

Case report: computed tomography appearances in a right paraduodenal hernia.

The computed tomography (CT) appearances of a right paraduodenal hernia are described. The working diagnosis at the time of the scan was of acute pancreatitis and we discuss the differentiation of the two conditions on CT. The CT findings are compared with those previously reported in other types of internal hernia.

Acute Disease↗
PubMed1994

Placebo-controlled efficacy of antidepressants in continuation treatment.

All episodes of depression require treatment after symptomatic response of the acute episode in order to consolidate response. If treatment is discontinued early, 30% to 50% of patients will suffer a relapse of the inadequately treated episode. Placebo-controlled studies with a variety of antidepressants, old and new, have provided compelling evidence of the efficacy of anti-depressants on relapse prevention. A recent study of citalopram has also shown the need for long-term treatment with anti-depressants in patients whose acute episode of depression appeared to respond to placebo since their response was not maintained.

Antidepressive Agents↗
PubMed1993

Septic arthritis of the knee: complication of intra-arterial thrombolytic therapy.

A case of septic arthritis of the knee complicating intra-arterial thrombolysis is reported. Septic complications following the use of intravascular catheters are usually relatively minor. This serious case and the discussion that arises highlights the need for shortening the duration of intravascular thrombolysis regimes.

Arthritis, Infectious↗
PubMed1993

Inadequacies of hospital medical records.

We have assessed the extent to which hospital records follow the Guidelines for Medical Records and Notes published by the Royal College of Surgeons of England. Notes of 100 consecutive discharges were reviewed from two surgical units, one at a District General Hospital (DGH) and the other at a London Teaching Hospital (TH). Overall, only 65 per cent (DGH) and 67 per cent (TH) of the entries specified by College guidelines were both present and correct. Substandard categories included the regular update of notes, post-operative instructions, comments about post-operative recovery, the record of advice given to relatives and incorrect consent. The guidelines produced by the Royal College of Surgeons are being applied, but there is room for considerable improvement. Inadequate medical records limit audit and may have medico-legal consequences. We recommend regular assessment of the standard of note keeping.

England↗
PubMed1992

The treatment of sleep disorders.

Narcolepsy is clinically associated with cataplexy, sleep paralysis and hypnagogic hallucinations. It is treated by reassurance (that there is no physical disease) and by stimulants such as ephedrine and amphetamine on an intermittent basis. The special tricyclic antidepressant clomipramine is also used, and mono-amine oxidase inhibitors (MAOIs) are useful in theory. Obstructive sleep apnoea is an important and often unrecognised cause of daytime somnolence. It is treated by weight reduction (pickwickian syndrome), hormones, or recently, with continuous positive pressure apparatus. Night terrors (pavor nocturnus) and sleepwalking typically occur during deep sleep (stage 3 and 4 throughout the episode) in children. In a night terror the child sits up with a scream, with eyes open, but inaccessible. He eventually falls asleep calmly. Sleepwalking, too, shows the features of inaccessibility and subsequent amnesia for the episode. Both conditions are normally treated with reassurance (to the parents) but may occasionally warrant benzodiazepines. Enuresis usually occurs in non-rapid eye movement (NREM) sleep, especially stages 3 and 4. The reason for the efficacy of tricyclic antidepressants is not precisely known. Delirium tremens (DT) is treated as a rebound excess of REM sleep, with benzodiazepines and other drugs. It is the withdrawal syndrome (with or without major seizures) to the barbiturate-alcohol group of drugs, which includes alcohol, chloral, paraldehyde, glutethimide, methylprylone, ethchlorvynol, meprobamate and meprobamate-diphenhydramine. Insomnia may be treated by the above drugs, by analgesics, antidepressants, major tranquillisers (neuroleptics) and miscellaneous other compounds. For the majority of patients, however, the most suitable group seems to be the benzodiazepines. The benzodiazepines are much safer than their predecessors, in both acute and chronic usage.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

A comparison of the hypnotic effects of temazepam capsules and temazepam elixir.

The effect of temazepam as a hypnotic was assessed with two different formulations, the solution-filled soft gelatin capsule and the more recently introduced elixir. Sixty psychiatric in-patients were included in the trial and 59 completed it. The study followed a double-blind crossover design for two consecutive nights. Patients took a capsule and elixir each night, but only one would contain the active ingredient (in a dose of 20 mg temazepam). In contrast to earlier work with volunteers, the elixir failed to reveal more of the characteristics of an ideal hypnotic. In fact, in those measures that were statistically significant, the balance favoured the capsule. We conclude that although there are many situations where an elixir is clearly clinically preferable, the essential hypnotic effect of the elixir is not conspicuously different to that of the capsule.

Adolescent↗
PubMed1988

Regulation of viral and cellular genes in a human neuroblastoma cell line latently infected with herpes simplex virus type 2.

A latent state of the herpes simplex virus type 2 genome was established in a human neuroblastoma cell line (SMS-KCNR) to initiate studies on the mechanism by which host cells interact and regulate latent viral genes. To establish viral latency, it was necessary to prevent virus replication by briefly exposing the infected cells to antiherpetic acycloguanosine (20 microM) and human interferon (120 U/ml). Subsequently however, these cells could be propagated without any antiherpetic agents and almost 60% of the cell population contained viral genome. While these cells did not produce any infectious virus, immunoblot analysis revealed two intracellular polypeptides with molecular weights of 87.5 kDa and 67 kDa, respectively, that interacted with hyperimmune anti-HSV2 rabbit serum. Two cellular enzymes, acetylcholinesterase and choline acetyltransferase, involved in metabolism of neurotransmitters were expressed at a higher level in the latently infected cells than in the mock-infected control cells. Infectious HSV-2 could be reactivated from these cells only after the cells had undergone massive morphological differentiation and maturation to flat cell types by extensive treatment with 20 micron bromodeoxyuridine.

Acetylcholinesterase↗
PubMedDate not supplied

Liquid chromatographic determination of clobetasone-17-butyrate in ointments.

A liquid chromatographic (LC) method has been developed for determination of clobetasone-17-butyrate in ointment using clobetasone propionate as an internal standard. Separation was carried out on a C18 reverse-phase column using water-methanol as a mobile phase. Methylparaben and propylparaben (both sodium salt) used as preservatives did not interfere with separation. Compounds are detected photometrically at 235 nm. Mean assay results for 0.05% commercial ointments were 100.36% (n = 5). Mean recovery of clobetasone-17-butyrate added to commercial ointment was 99.89%.

Administration, Topical↗
PubMedDate not supplied

Priapism associated with psychotropic drugs.

Priapism, a rare, potentially dangerous but largely preventable condition, remains associated with the use of drugs, many of which are of the psychotropic variety. This article reviews various aspects of this condition, with a view to increasing awareness and understanding of the condition among clinicians.

Adult↗