Biomedical subjects
Publications and source records attributed to M K Das.
A clinic based descriptive (case series) study was conducted among 106 study subjects with poor glycaemic control in a tertiary care hospital, Kolkata. Poor compliance was observed in 89.62% and 10.38% had good/acceptable compliance. Compliance was better in above 60 years age group, in males, in married and educated persons. Non-compliance factors acted mostly in combination.
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In 265 patients of acute myocardial infarction (AMI) heparin followed by warfarin sodium was used routinely whenever there was no contraindication to the drug. Patients were followed up to 2 years with weekly estimation of prothrombin time. Another 265 patients of AMI having identical clinical profiles were taken as control and neither any anticoagulant nor any antiplatelet agent was used in them. Both groups were also treated with identical coronary dilators whenever needed. 2 years cardiac mortality was 11.6% in the control group and 5.9% in the anticoagulant therapy (ACT) recipient group (P less than 0.05). Incidence of reinfarction (RMI) was 14.4% during the period in the control group whereas it was only 6.7% in the ACT group (P less than 0.05). The incidence of intracranial events were also more frequent in control group (8.4%) compared to ACT group (3.1%) (P less than 0.05). However on further analysis of intracranial events, it was found that haemorrhagic intracranial events were slightly more frequent in ACT (2.3%) than in the control group (2%), but this difference was statistically insignificant (P greater than 0.05); non-haemorrhagic intracranial events were however significantly less in ACT group (1.96%) compared to the control group (6%) (P less than 0.05). There was no major or fatal extracranial haemorrhagic complication in either group. Only minor extracranial haemorrhages were more commonly observed in the ACT group (4.3%) compared to the control group (1.2%) (P less than 0.05).
Sixty-five cases were evaluated for silent myocardial ischaemia (SMI) by computerised treadmill test (TMT) and ambulatory electrocardiographic monitoring (AEM). There were 59 males and 6 females. The cases were divided into GP-I-stable angina (35 cases) GP-II-stable angina after myocardial infarction (15 cases) and GP-III-asymptomatic (15 cases). Age in each group ranged from 36 years to 62 years (GP-I), 40 years to 68 years (GP-II) and 36 years to 48 years (GP-III). Conventional risk factors viz. hypertension, diabetes mellitus, hyperlipidemia, smoking and family history were assessed with a view to see their implication on SMI. 43 patients (62.2%) were found to have SMI including mixed episodes. Out of these 43, TMT was positive in 29 patients (67.4%), AEM was positive in 41 patients (95.3%) and both TMT and AEM were positive in 27 patients (62.7%). Correlative analysis between risk factors and SMI revealed that higher number of was associated with not only more positive TMT and AEM test along with increased episodes of SMI but also increased degree of ST-T depression. It was also found that AEM is more sensitive than TMT (80% Vs 48%) for diagnosing SMI (SED = 9.03%), though specificity of the tests is same (93.3%).
The study included 45 consecutive patients in the age group of 27 to 39 years presenting with AMI diagnosed by typical history, ECG changes and enzyme response. Prognostic significance of various risk factors in AMI in young was evaluated. There were 41 M (91.1%) and 4 F (8.9%) with mean age of 34.6 years. ECG showed anterior myocardial infarction (MI) in 18 (40%), inferior MI in 15(33.3%), Subendocardial inf in 10(22.5%) and combined anterior and inferior MI in 2 (4.5%) cases. Various risk factors were: Smoking (60%), hyperlipidemia (44.4%), stress (40%), hypertension (28.9%), family history (28.9%), diabetes mellitus (15.7%) and obesity (8.8%). Attention was given on atherogenic index (AI) (22.2%). Coronary angiogram was done in 20, which revealed significant coronary arterial obstruction in 15 cases; 3-vessel disease (n = 7), 2 vessel disease (n = 4) and single vessel disease (n = 4). Both 3 VD and 2 VD were associated with high AI. Risk factors (RF) were grouped as RFGI when combination of 3 or more RF were present, and RFG II when 2 or less RF were present. RFGI and RFGII were present in 40% and 60% cases respectively. Prognostically, patients were divided in two groups of MI-fatal (6) and nonfatal (39), the latter were subdivided into complicated (14) and uncomplicated (25). It was observed that more fatal cases were found in RFGI, whereas nonfatal uncomplicated MI was more in RFG II (P less than .001).
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Fourteen patients of pure valvular pulmonary stenosis of moderate to severe degree underwent balloon valvuloplasty in the Department of Cardiology, SSKM Hospital, Calcutta. Haemodynamic study revealed that immediately after valvuloplasty, right ventricular pressure dropped down from 125 +/- 17.18 mmHg. to 56.67 +/- 8.72 mmHg. (mean +/- SD). Restudy was done in each case after 4 weeks, which showed that right ventricular systolic pressure had further dropped down to 46.71 +/- 5.06 mmHg. (Mean +/- SD). Patients were further followed up for 6 to 15 months (mean 10 months). During the follow-up period, all the patients remained asymptomatic. Drop of right ventricular systolic pressure was maintained except in one case in which the peak systolic pressure gradient across the pulmonary valve was raised to 61 mmHg. from 24 mmHg., the gradient achieved immediately after valvuloplasty.
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125Iodine-labeled human immunoglobulin G-encapsulated dipalmitoyl phosphatidylcholine liposomes were prepared with or without asialoganglioside. Distribution of radioactivity following the oral administration of these liposomes in rats was checked in liver and in blood of the portal vein and heart. Gel filtration of plasma from the portal vein showed the presence of intact liposomes and protein. In contrast, neither liposomes nor protein were detected in cardiac blood but only lower molecular weight materials. The presence of liposomes in portal blood was further suggested from experiments using 6-carboxyfluorescein-entrapped liposomes. The level of liposomes in portal venous blood plasma was found to be lower in asialoganglioside liposomes. But this level could be increased substantially, almost to that in liposomes without asialoganglioside, by injection (iv) of asialofetuin.