A case of pleural effusion due to development of peritoneopleural sinus secondary to ascites.
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Biomedical subjects
Publications and source records attributed to B K Das.
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The present study comprises of 208 term, 159 preterm and 18 post-term neonates born to mothers with no history of drug intake or any disease likely to effect coagulation of the newborn. PT, TT and KCCT were relatively prolonged and plasma fibrinogen reduced to varying degree in newborns (as compared to adults). There was further prolongation of TT and reduction in plasma fibrinogen levels amongst preterm newborns as compared to term babies; TT was more prolonged amongst post-term babies also. PT was significantly more prolonged till 30 weeks of gestation, after which a near plateau was formed. KCCT showed significant improvement after 33 weeks and a further trend to normalisation after 38 weeks of gestation. Serum FDP values showed too much of variation for any meaningful statistical analysis but generally FDPs were higher in preterm babies. Intrauterine growth rate had no significant effect on these parameters amongst preterms - similar values for SGA (small for gestational age), AGA (appropriate for gestational age) and LGA (large for gestational age). On the other hand, amongst term babies SGA neonates had significantly prolonged PT and low plasma fibrinogen as compared to AGA; LGA babies also showed more prolongation of TT as compared to AGA.
A sequential study of kaolin cephalin clotting time (KCCT), prothrombin time (PT), thrombin time (TT), plasma fibrinogen and serum FDP was conducted during the first four weeks of life on term and preterm babies. A "physiological dip" of PT and TT was noted inappropriate for gestational age (AGA) babies both term and preterm; in case of KCCT, the dip was significant in term AGA babies only. At the end of four weeks, PT and TT had moderately improved in term babies but showed little improvement in preterm ones; KCCT reached almost an adult value in all babies except in preterm AGA and term LGA (large for gestational age) ones. Plasma fibrinogen showed no "physiological dip" and reached adult level in two to four weeks. Serum FDP levels were appreciably raised in preterm AGA babies only at birth and there too normalised by 72 h.
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Forty subjects each were rapidly inducted by road to altitudes of 3200 and 3771 meters (m). Half of subjects at each altitude were maintained on digoxin and the other half received placebos. The digoxin group showed higher serum potassium at both altitudes. Serum sodium remained unaltered. When compared to control groups, urinary volume changes were less marked in the digoxin group. Similarly, the alterations in calcium and magnesium in serum and urine at 3771 m were less pronounced. However, none of these changes in the digoxin groups were statistically significant when compared with control groups.
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Two groups of 20 subjects each were separately exposed to altitudes of 3200 m and 3771 m for 10 days by rapid induction requiring 14 and 16 hours respectively to reach high altitude camps. A statistically significant fall in platelet counts was observed from day 2 at 3200 m and day 3 at 3771 m and counts remained decreased. Platelet aggregation was also decreased initially at both altitudes. Blood fibrinogen decreased only on day 2 at 3771 m with a significant increase over control values by day 10 at both altitudes.
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Twenty subjects each were rapidly inducted by road to 3200 ad 3771 m. Serum and urinary sodium, potassium, calcium, and magnesium were measured during 10 d at high altitude. At 3200 m, only serum potassium increased significantly on the 10th day. At 3771 m, serum potassium did not increase. Serum sodium generally remained low, serum magnesium increased, while calcium decreased significantly. Urinary volume over 24 h decreased more and for longer duration at 3771 m than at 3200 m. Urinary cations did not change significantly at 3200 m. At 3771 m, sodium and potassium excretion decreased on days 1 and 3 later returned towards preinduction levels. Magnesium and calcium decreased throughout the high-altitude stay. Significant changes were noticed in serum and urinary cations on exposure to high altitude when adequate caloric intakes were not ensured.
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