Surfactant therapy and nasal CPAP for newborns with RDS.
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Biomedical subjects
Publications and source records attributed to K Chugh.
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The results of an open randomized study on magnesium status and parenteral magnesium sulphate therapy in acute aluminium phosphide intoxication are presented. The study was conducted on 105 patients divided into two group (I & II). Patients of Group I did not receive parenteral magnesium and acted as blank. Magnesium levels were monitored every 6 h for 24 h. Patients of group II received magnesium sulphate therapy. It was administered as 1.0 g (8.1 mEq or 4.05 mmol) magnesium sulphate dissolved in 100 ml of 5 per cent dextrose intravenously as a bolus dose followed by 1.0 g every hour for three successive hours, then 1.0 g every 6 h as a maintenance dose for the next 24 h as intravenous infusion in 5 per cent dextrose. The total dose of magnesium sulphate infused was 30.0 mmol over a period of 24 h (initial dose), then 16.0 mmol (4.0 g) daily till final outcome or a maximum of five days. All the vital parameters were monitored. All the patients were followed till final outcome. The resuscitation methods used were the same in both groups. At the end of the study, mortality rates were calculated in both groups. Hypomagnesaemia was observed as the constant finding in patients of Group I. It was transient and reversed itself without MgSO4. The mortality rate was 52 per cent. On the other hand, magnesium levels rose immediately after parenteral MgSO4 administration in patients of group II and they remained persistently above normal during the observed period.(ABSTRACT TRUNCATED AT 250 WORDS)
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In lactating rats consuming a commercial diet adequate in calcium, phosphorus and vitamin D, the effect of supplementation of 3000 IU and 7,500 IU of vitamin D3 on the lactational performance of the dams and soft tissue and skeletal growth in the pups has been investigated. On 28th day of age, the pups in the supplemented groups were significantly heavier than in the control group. Study of the indices of cellular growth in the liver and gastrocnemius muscle revealed that the increase in the soft tissue weight was due to a significant increase in protein, RNA and DNA contents (cellular hyperplasia) without any change in protein/DNA ratio (cell size). In the tibia, compared to controls, the dry bone weight and ash weight were more in the supplemented groups, but ash weight/dry bone weight ratio was not altered. The improvement in the neonatal growth was most probably due to the greater milk yield observed in the dams in supplemented groups and not due to any anabolic effect in the pups since direct administration of 500 IU or 1,000 IU of vitamin D3 in 10 day old pups did not increase their body weight.
Female rats were fed low protein diet (10% casein) either as such or supplemented with 3% leucine during pregnancy and lactation. Changes in litter size and the survival rate, growth and protein status of the pups were noted. The milk yield and hepatic and mammary gland protein status of the mothers were also studied. Feeding low protein diet reduced litter size, increased their mortality and resulted in poor growth of the pups. It also resulted in poor hepatic and mammary gland protein status of the mothers, as well as reduced their milk yield. On adding 3% leucine to 10% casein in the diet, the changes observed in the low protein group, did not alter in any manner.
Ninety-five patients out of total 190 cases of aluminium phosphide (ALP) poisoning, who exhibited ECG changes were studied for incidence, type and pattern of ECG abnormalities, their effect on mortality and their relationship with histopathology of heart. Its incidence in the present study was 50%. The arrhythmias, conduction disturbances and ischaemic pattern occurred more or less in equal frequency. Certain ECG abnormalities which had not been reported previously ie, early repolarisation syndrome, varied sino-atrial blocks, bradycardia-tachycardia syndrome and electrical alternans were observed in this study. The clinical profile of these cases was similar irrespective of whether patients had ECG abnormalities or not. Shock was the cardinal feature. There was no effect of ECG abnormalities on mortality. The mortality which was otherwise high, depended upon severity of poisoning, dose of poison consumed, duration of shock, failure of response of shock to resuscitative measures and severe hypomagnesaemia. The pathogenesis of ECG abnormalities is still obscure. Hypomagnesaemia was observed in all the 18 cases studied, irrespective of ECG abnormalities. However, these were common when hypomagnesaemia was severe. Hypoxaemia and shock were not the contributory factors for these abnormalities. Autopsy revealed stereotyped histopathological changes of toxic myocarditis independent of ECG findings.
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Plasma renin activity (PRA) was estimated in 30 patients with aluminium phosphide (AIP) poisoning (study group) admitted in shock. Ten patients in shock other than due to AIP poisoning (Group II A) and 20 normal healthy subjects (Group II B) served as controls. The PRA was significantly higher in the study group and group II A as compared to normal healthy subjects (p less than 0.001). Significantly higher PRA was found in the study group as compared to Group II A (p less than 0.001). The initial higher PRA continued to rise further in the study group but it started decreasing in Group II A as the duration of shock advanced. Continuation of shock in AIP poisoning was probably due to slow release of toxic PH3 gas, which was detected by positive silver nitrate paper test. The rise in PRA was directly proportional to the dose of pesticide consumed. There was direct relationship of mortality with increased PRA. Angiotensin converting enzyme inhibitors may have a role in combating shock in AIp poisoning.
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Groups of rats on commercial diet were injected 3,000 IU (group 2) and 7,500 IU (group 3) of vitamin D3 on the 10th day of pregnancy. Compared to control pups (group 1), the pups in group 2 and 3 weighed significantly more on the 10th, 20th and 28th day of age. At 28th day of age, study of the gastrocnemius muscle revealed significantly greater organ weight, protein, DNA and RNA contents, protein/DNA and RNA/DNA ratios in group 2 and 3 pups than in controls. In the liver, whereas all these indices were significantly increased in group 3 pups, only protein/DNA and RNA/DNA ratios were significantly increased in group 2 pups. Brain weight, its RNA content and RNA/DNA ratio were significantly greater in group 2 and 3 pups than in controls. The results suggest that vitamin D administration in pregnancy promotes soft tissue growth in the pups by enhancing cellular proliferation and hypertrophy.
Cardiac necrosis was produced in rats by administering isoproterenol sulphate (85 mg/kg, sc for 4 days). The myocardial damage was proved by observing the elevated levels of serum aspartate amino-transferase, lactate dehydrogenase and creatine phosphokinase and the changes were confirmed by histopathology of the tissue. Both aspartate and glutamate (100 mg/kg, ip) significantly reduced the elevated levels of these enzymes. The average degree of cardiac necrosis produced in these rats when observed macroscopically and histologically was also found to be significantly reduced on pretreatment with aspartate and glutamate.
Silver nitrate impregnated paper test was performed with the gastric fluid and in breath in 50 patients of aluminium phosphide poisoning. The test was 100% positive with gastric fluid but was positive in 50% patients in breath. The test is simple, reliable and sensitive method to detect phosphine (PH3) for bed side diagnosis of aluminium phosphide (AIP) ingestion.
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Tryptophan oxygenase (EC 1.13.1.12), 3-hydroxyanthranilate oxygenase (EC 1.13.1.6) and leucine aminotransferase (EC 2.6.1.6) activities were determined in livers of rats subjected to different dietary restrictions, with and without excess leucine. The activities of all three enzymes were significantly increased with undernutrition in animals not receiving excess leucine. Excess leucine with moderate undernutrition (50% ad libitum intake) further induced this effect while excess leucine with severe restriction (25% ad libitum intake) acted in the opposite direction.
Hepatic tryptophan oxygenase (EC 1.13.1.12) 3-hydroxyanthranilate oxygenase (EC 1.13.1.6) and leucine aminotransferase (EC 2.6.1.6) activities were determined in livers of rat pups of various ages whose mothers were fed on diets with or without excess leucine. Tryptophan oxygenase activity was detectable on the 20th day in both the groups and thereafter increased with age. Low activity of 3-hydroxyanthranilate oxygenase was observed at birth, the levels increased on the 10th day and thereafter remained unaltered on both diets. Leucine aminotransferase activity was highest at birth and thereafter decreased with age. Tryptophan oxygenase and leucine aminotransferase activities were significantly higher at all ages in livers of pups born to mothers given excess leucine in their diet.