High-dose methyl prednisolone for autoimmune thrombocytopenia in sarcoidosis.
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Adult↗
Biomedical subjects
D Behera
Publications and source records attributed to D Behera.
Reactive oxygen species formation in peripheral blood neutrophils in different types of smokers.
The present study was envisaged to assess the state of oxidative metabolism of neutrophils, recovered from smokers (cigarette, beedi, hookah and mixed products) and non-smokers. Superoxide anion (O2.-) production was significantly higher in neutrophils from all groups of smokers (P < 0.001). Total leukocyte count (TLC) was significantly more in symptomatic subjects among the cigarette, hookah and mixed smokers (P < 0.05). Total neutrophil count (TNC) was significantly higher in symptomatic than asymptomatic subjects of hookah and mixed smoking groups (P < 0.05). In the pathogenesis of chronic obstructive pulmonary disease (COPD) in tobacco smokers, the role of leukocytosis, increased neutrophil sequestration into the lung, increased neutrophil toxic oxygen species including superoxide release in the lung may cause direct injury to lung tissues.
Adult↗
Positive end expiratory pressure reduces bronchial blood flow after aspiration injury.
We hypothesized that since added airway pressure compresses bronchial vessels, the airway hyperemia found following airway injury would be reduced by positive end-expiratory pressure (PEEP). Accordingly, we measured the effect of 15 cm H2O PEEP on bronchial and pulmonary blood flows by the radioactive microsphere reference flow technique in closed chested goats (n = 7) before and after aspiration injury to the left lung with 0.1 N HCl. Thirty minutes after aspiration, the pulmonary blood flow to the injured left lung was reduced by one third, whereas the total bronchial blood flow to the left lung (normalized to mean systemic pressure of 100 torr) doubled (11.3 +/- 2.2 to 20.6 +/- 1.0 ml/min 100 torr; p < 0.01). Increasing PEEP from 5 to 15 cm H2O decreased total bronchial blood flow by about half both before (11.3 +/- 2.2 falling to 5.7 +/- 1.4 ml/min/100 torr) and after injury (20.6 +/- 1.0 falling to 10.3 +/- 2.7 ml/min/100 torr). The airway portion (down to 2-3 mm airways) of the total bronchial blood flow of the injured lung increased more than three-fold (1.4 +/- 0.5 rising to 5.5 +/- 1.3 ml/min/100 torr; p < 0.01). This increased flow after aspiration was less affected by PEEP of 15 cm H2O (5.5 +/- 1.3 to 2.8 +/- 0.7 ml/min/100 torr, p = 0.09) than before injury (1.4 +/- 0.5 falling to 0.5 +/- 0.1 ml/min/100 torr; p < 0.05). The increase of the parenchymal portion of the bronchial blood flow after injury, although apparent (9.9 +/- 1.8 increasing to 15.1 +/- 1.2 ml/min/100 torr), was not significant (p = 0.08).(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Cough reflex threshold in diabetes mellitus with and without autonomic neuropathy.
The cough reflex, a vagus-mediated respiratory protective reflex, was investigated in diabetics and healthy controls by establishing a cough reflex threshold to increasing concentrations of citric acid aerosol. Diabetics with autonomic neuropathy (n = 20), whether overtly symptomatic (n = 5) or evident only on certain non-invasive cardiovascular autonomic function tests, were found to have significantly (p < 0.05 by chi 2 test) raised cough reflex threshold (range 1 to > 100%, median value 50%) in contrast to either the non-neuropathic diabetics (n = 20) or normal controls (n = 20; range 1-10%, median value 2%). This difference suggests vagal (parasympathetic) denervation of the respiratory tract, with possible serious consequences, hitherto little appreciated.
Administration, Inhalation↗
Alterations in circulating thyroid hormones in Indian smokers (bidi and cigarette).
T4, T3 and TSH were estimated in 56 bidi and 50 cigarette smokers and their mean estimates were compared with the corresponding values in 25 healthy non-smokers. T4, T3 and their ratios were significantly lower in both bidi and cigarette smokers (p < 0.001). Circulating TSH in both groups of smokers was similar to that in nonsmokers. T4 and T4/T3 were lower in bidi smokers compared to those in cigarette smokers (p < 0.05 and < 0.01, respectively). Severity of smoking affected T4/T3, and TSH in bidi smokers and T4 in cigarette smokers. Normal TSH excluded any significant decrease in thyroid function in smokers. The alterations in circulating T4 and T3 might have been influenced by thyroid hormone production, protein binding as well as peripheral metabolism of T4 by adverse constituents of bidi/cigarette smoke.
Adult↗
Ventilatory function in nonsmoking rural Indian women using different cooking fuels.
Lung function parameters, forced vital capacity (FVC), forced expiratory volume in 1st s (FEV1), peak expiratory flow rate (PEFR), were measured in 3,318 nonsmoking Indian women using four different types of cooking fuels (biomass, liquified petroleum gas, kerosene and mixed). Biomass fuel users had FVC values less than 75% predicted (73.42 +/- 0.90; mean +/- SE) whereas in other groups it was more than 75% of predicted, though less than 80% of the predicted values. However, FEV1, FEV1/FVC (%) and PEFR were within normal limits in all the four groups. The absolute values of all the three parameters of lung functions were the lowest in the biomass and mixed fuel users. A negative correlation was observed between these parameters and the duration of cooking and exposure index. Thus the present study showed that, lung function, particularly FVC, is affected by indoor air pollution due to domestic cooking more so with biomass fuel. Better housing and use of smokeless devices for cooking might be helpful to avoid this effect on lung. This ventilatory impairment seems to be more of the restrictive (parenchymal) type, since obstruction could be ruled out. A longitudinal study is needed to demonstrate whether or not these changes are variable, reversible or progressing to fibrosis.
Adult↗
Neutrophil count and myeloperoxidase activity in Indian bidi smokers.
Myeloperoxidase (MPO) level and MPO scoring were estimated in Indian bidi smokers and compared with those in cigarette smokers and non-smokers. The values were higher in the neutrophils of 20 bidi smokers compared to 20 age-matched non-smokers (p < 0.001). However, they were similar to those in 20 cigarette smokers. No correlation of MPO activity was observed with blood carboxyhaemoglobin levels and smoking indices except in bidi smokers. Total leucocyte count and total neutrophil counts were also higher in bidi and cigarette smokers. This increased MPO activity in the neutrophils of bidi and cigarette smokers may contribute to the greater risk of obstructive pulmonary disease.
Adult↗
Normal variations in spirometry in health following placebo inhalation.
Normal i.e., chance variations in spirometry were evaluated in 80 healthy Indian adults by the measurement of base-line spirometric indices (FVC, FEV1 and FEF25-75%) and the per cent changes following placebo administration of aerosolized saline. There was a mean per cent change of 0.7, 0.4 and 0.3 per cent over the base-line values in FVC, FEV1 and FEF25-75% respectively following placebo inhalation. The cut off responses for 95 per cent confidence limits were 11.2 per cent for FVC and 12.7 per cent for FEV1 following placebo inhalation. Since the test sample represents a healthy Indian population, a per cent change greater than 12.7 per cent in FEV1 is more than that observed in 95 per cent of healthy Indians. It is suggested that for both delta FEV1 per cent and delta FVC per cent, the lower limit should be fixed at more than 15 per cent to define 'abnormality' in clinical practice.
Administration, Inhalation↗
Airway response to inhaled fenoterol in hyperthyroid patients before and after treatment.
Bronchodilatory response to inhaled fenoterol was studied in 15 hyperthyroid patients before and after successful treatment with antithyroid drugs. Baseline forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV1) were lower than the predicted values in 12 and 11 patients, respectively. Improved values were seen after treatment for hyperthyroidism although statistical significance was not reached. Even if some improvement occurred in PEFR (a rise by 0.24-0.48 L/s) and FVC (increase of 73-78 ml) in the hyperthyroid state in response to fenoterol inhalation after various time intervals, the increase in different parameters of lung function was significantly more after the patients achieved euthyroid state (increases in FVC by 290-165 ml; in FEV1 by 333-193 ml; in peak expiratory flow (PEFR) by 0.75-0.52 L/s and in forced expiratory flow (FEF50%) by 0.55-0.31 L/s). In the euthyroid state the mean absolute improvements from the baseline values were significantly higher (< 0.05-0.001). These observations indicate that bronchodilatory response is impaired in the presence of excess thyroid hormones and improves after euthyroid state is achieved.
Administration, Inhalation↗
Adreno-cortical reserve in pulmonary tuberculosis.
Serum cortisol in response to ACTH was assessed in 28 patients with moderately severe to far advanced pulmonary tuberculosis. Ten healthy individuals served as controls. Whereas the basal values were comparable in the two groups the mean delta peak, mean and area under the response curve were significantly lower in the tubercular patients (p < 0.05 to 0.001). Six patients had negligible cortisol response to ACTH stimulation while five others exhibited an inadequate response (rise between 200-300 nmol/L0. None of the subjects had any clinical evidence of adrenocortical insufficiency. The data thus revealed a functional impairment of adrenal cortical reserve in patients of pulmonary tuberculosis.
Adolescent↗
High neutrophil myeloperoxidase activity in smokers.
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Biomarkers↗
Carboxyhaemoglobin in women exposed to different cooking fuels.
Blood carboxyhaemoglobin levels were estimated by double wavelength spectrophotometry in non-smoking women living in Chandigarh and its environs and related to the cooking fuel they used. Twenty nine used kerosene, 28 biomass fuel, and 30 liquified petroleum gas; the 27 control subjects had not done any cooking for seven days. The carboxyhaemoglobin concentrations were significantly higher in the women using the three types of fuel (mean (SEM) concentration 7.49% [corrected] (0.67%) for kerosene, 15.74% (0.83%) for biomass fuel, and 17.16% (0.62%) for liquified petroleum gas, compared with 3.52% (0.33%) in the control subjects. It is concluded that cooking with any of the three fuels causes indoor air pollution. It is important to have better designed houses with adequate ventilation and stove vents that are cleaned regularly if pollution is to be reduced.
Adult↗
Blood carboxyhaemoglobin levels in Indian bidi and cigarette smokers.
Blood carboxyhaemoglobin (COHb) was estimated by double wave length spectrophotometry in 58 healthy non-smokers, 27 bidi smokers, 25 cigarette smokers, 25 mixed smokers (all asymptomatic) and 20 symptomatic cigarette smokers. The blood COHb levels were significantly higher among all smoking groups compared to the normal healthy controls (p less than 0.001). Among the various smoking groups, the symptomatic cigarette smokers had marginally higher COHb levels compared to the other groups. There was no correlation between the smoking indices and COHb levels and COHb and the packed cell volume of red cells.
Adult↗
Drug interaction between rifampicin and cotrimoxazole in patients with tuberculosis.
1. Patients (n = 15) who were admitted with complications of tuberculosis, were given antitubercular therapy (ATT) with rifampicin (RIF), for a minimum period of 15 d, and cotrimoxazole (CTZ), concurrently, for 5-10 d. 2. The serum RIF levels were measured before the start of CTZ treatment and at the end of its administration. 3. The plasma half-life (t1/2) of RIF increased significantly from 1.92 +/- 0.57 h to 2.31 +/- 0.134 h after CTZ treatment. 4. The mean serum levels of RIF increased significantly at 4 and 6 h after CTZ administration.
Adolescent↗
Respiratory symptoms in Indian women using domestic cooking fuels.
The effect of domestic cooking fuels producing various respiratory symptoms was studied in 3,701 women. Of these, 3,608 were nonsmoking women who used four different types of cooking fuels: biomass, LPG, kerosene, and mixed fuels. The overall respiratory symptoms were observed in 13 percent of patients. Mixed fuel users experienced more respiratory symptoms (16.7 percent), followed by biomass (12.6 percent), stove (11.4 percent), and LPG (9.9 percent). Chronic bronchitis in chulla users was significantly higher than that in kerosene and LPG users (p less than 0.05). Dyspnea and postnasal drip were significantly higher in the women using mixed fuels. Smoking women who are also exposed to cooking fuels experienced respiratory symptoms more often than nonsmokers (33.3 percent vs 13 percent).
Adult↗
Pleural effusions in Wegener's granulomatosis: report of five patients and a brief review of the literature.
Wegener's granulomatosis (WG) is an uncommon disease of unknown aetiology which is characterised histologically by a necrotising granulomatous angiitis. The airway, lungs and the kidneys are predominantly involved, but the disease has been documented to affect virtually every organ system. The clinical course is variable and ranges from a short, rapidly fatal illness at one end of the spectrum to indolent involvement compatible with several years of survival at the other. A majority of patients have pulmonary disease evidenced clinically by cough, sputum production and haemoptysis and radiologically by infiltrates, nodules and cavitation. Pleural effusions, however, are rare. No detailed information regarding the nature and clinical behaviour of these effusions is available and only a recent French study has listed the nature of the fluid in passing. We have observed pleural effusions in five patients with WG who are the basis of this report.
Adolescent↗
Recent advances in the management of lung cancer.
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Antineoplastic Combined Chemotherapy Protocols↗
Comparison of bronchodilatation produced by an anticholinergic (ipratropium bromide), a beta-2 adrenergic (fenoterol) and their combination in patients with chronic obstructive airway disease. An open trial.
Fenoterol hydrobromide (200 micrograms), ipratropium bromide (40 micrograms) and a combination of the two in the same dosage were administered by metered dose inhaler on 3 separate days to 20 patients with chronic bronchitis and emphysema. On each day, baseline forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEFR) and mid maximum flow rate (MMFR) were recorded. The values were again recorded after administration of the drug at 15, 30, 45 and 60 minutes. Side effects if any were recorded. There was a significant increase from baseline in FVC and FEV1 with all the three regimens at 15, 30 and 45 minutes. However, the rise in MMFR was significant only with ipratropium bromide and the combination regimen. At 60 minutes, the rise in FVC, FEV1 and MMFR was significant only with the combination regimen. There was no significant change in the PEFR values at any time with any drug. The difference in rise in all the four parameters with the 3 regimens was not statistically significant. No side effects were noted. Thus, a combination fenoterol and ipratropium bromide produced a more prolonged bronchodilatation, and ipratropium bromide perhaps acts both in the major (indicated by rise in FEV1) and small airways (measured by MMFR).
Aerosols↗