A procedure for eliminating interferences from ephedrine and related compounds in the GC/MS analysis of amphetamine and methamphetamine.
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Biomedical subjects
Publications and source records attributed to H Shah.
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The APACHE II score predicts mortality in severely ill patients. This score does not account for the serum albumin level. Ninety-three patients (28 with serum albumin levels less than 2.5 g/dL [group I] and 65 with serum albumin levels greater than or equal to 2.5 [group II]) were retrospectively reviewed. Patients were comparable in age, APACHE II score, and compliance with required protein needs. Patients with severe hypoalbuminemia had nearly double the death rate of patients with mildly low or normal albumin concentrations (54% compared with 29%). The death rate in the severely hypoalbuminemic patients was 5.1-fold higher than would be predicted by their APACHE II score. The death rate in those patients with mildly low or normal albumin levels had only a 1.9-fold higher rate than would be predicted by their APACHE II score. It is concluded that severe hypoalbuminemia increases the risk of death significantly higher than would be predicted by the APACHE II score. APACHE II score is not as accurate in a severely hypoalbuminemic population.
A common and conspicuous congenital hand anomaly, polydactyly commonly involves only the hand or the foot. Polydactyly involving both hands and feet is rare. We herewith report two cases of Crossed Polydactyly (Type I) and review the literature.
In view of the different modes of inheritance and the different prognoses of the two oro-facio-digital syndromes, type 1 and type 2, it is important to establish a correct diagnosis in these patients. A case of type II oro-facio-digital syndrome is being reported and the distinguishing clinicoradiological features with type I are compared.
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OBJECTIVE: To compare the degree of dyspnea experienced by ventilator-dependent patients receiving synchronized intermittent mandatory ventilation (SIMV) versus T-piece or pressure support ventilation (PSV) weaning. The relationship between self-reported perceptions of dyspnea and physiologic variables observed during weaning trials was examined. Variables included heart rate, respiratory rate, minute ventilation, and oxygen saturation as measured by a pulse oximeter. DESIGN: Quasi-experimental, counterbalanced design with repeated measures. SETTING: Medical intensive care unit of a large university-affiliated medical center. PATIENTS: Nine mechanically ventilated patients diagnosed with chronic obstructive lung disease. The patients were admitted for respiratory failure between May 1990 to November 1990. Six tolerated SIMV 4 versus T-piece trials; three were placed in the SIMV 8 versus PSV trials. PROCEDURE: Each patient's perception of dyspnea was measured using a visual analog scale (VAS) at the initiation and at 5-minute intervals of 20-minute weaning trials. Physiologic indicators were noted simultaneously with VAS ratings of dyspnea. RESULTS: Findings indicated no difference in the degree of dyspnea experienced between weaning methods compared. Within-subject regression analysis on VAS scores revealed individual differences in the relationship between physiologic indicators and perceptions of dyspnea. CONCLUSIONS: The patient's experience of dyspnea during the weaning process can be a valuable guide to observe the patient's progress. The VAS serves as a reliable, easy-to-use tool for quantifying the patient's perception of dyspnea.
A cross sectional study was conducted by taking a random sample of 204 households of 5 VDCs in Sunsari district, Nepal with the objective to verify the prevalence of visceral leishmaniasis with behaviors of the people in endemic rural areas. Interviews with structured questionnaires and k-39 tests were used to collect information. From a sample of 204 respondents, 28 (13.73%) cases of Kala-azar (KA) were identified with k-39 test positive. Of them, 43% KA cases were found among Mushar ethnic group, 32% among Muslims, 11% cases among Tharus and 4% in Uraus and 11% in others. The difference in the prevalence of Kala-azar in people who had lands and in those who did not have were significant. People not owning lands were at 4 times greater risk of developing Kala-azar in endemic areas. Seventy seven percent of the people were bed net users. From 46 nonusers, 11 (23.91%) developed Kala-azar, which was significant as compared to bed net users. From among 196 'ground-floor' sleepers, 85 (43.34%) were ground sleepers and 111 (56.63%) were 'plung' sleepers. Nineteen (22.35%) of ground sleepers had suffered from Kala-azar, while 9 (8.11%) of 'plung' sleepers had suffered from Kala-azar. From all cases of Kala-azar, 25 (89.25%) had cracks and crevices on the walls of their living rooms. Sleeping on ground, non-use of bed-nets, landlessness, cracks and crevices on the floor and wall of living houses, poor living condition and overcrowding in houses, labors, dalit groups were identified as risks for Kala-azar.
Blood culture reports were studied in 1266 cases of clinically suspected neonatal septicemia, to determine the bacteriological profile and antibiotic sensitivity pattern of the cultured isolates. Blood culture was positive in 24.88% of cases. Gram negative septicemia was encountered in 87.1% of these neonates. Klebsiella and Enterobacter species were the predominant pathogens amongst Gram negative organisms. Of Gram positive isolates, Staphylococcus aureus was the predominant isolate (79.0%). Salmonella species was isolated in 2.4% of these cases.