Biomedical subjects
Publications and source records attributed to M Mehta.
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A total of 1330 children who attended a hospital-based child guidance clinic in last three years were studied retrospectively. 7.37% of these were found to have no psychiatric disorder. Epilepsy and scholastic backwardness without any psychiatric disorder, together constituted 70.41% of this group. Children referred to a child guidance clinic require proper assessment to detect psychiatrically normal children who would otherwise receive unnecessary label of psychiatric disorder and treatment.
A retrospective study of children presenting with pain to the Child Guidance Clinic, during 1984-85 revealed 101 cases of hysteria and 22 of psychalgia. Children in these two groups did not differ significantly with respect to sex, age, education or occupation of parent. Children with psychalgia presented significantly later, and more frequently complained of headaches and abdominal pain. Children with hysteria presented with seizures, abdominal pain and anxiety symptoms. Pain can be of psychological origin also. Early diagnosis is essential to avoid unnecessary investigations and reinforcement of the "sick role".
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The long-term effect of lithium treatment on the digestive and absorptive function has been investigated in male albino rats. The uptake of D-glucose, amino acids and activities of cellular and brush border enzymes were evaluated after every 3 months. Significantly increased uptake was observed in 6-month lithium-treated rats. The absorptive capacity (Vmax) for D-glucose increased significantly without alteration in the Michaelis constant. Activities of cellular, brush border membrane disaccharidase, leucine aminopeptidase and Na+,K+-ATPase enzymes were significantly augmented in 6-month lithium-treated animals. The elevation in sucrase activity may be due to induction of enzyme since only Vmax was increased in lithium-treated animals. The present biochemical alterations suggest that long-term lithium ingestion stimulates the small bowel digestive and absorptive functions.
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Tornwaldt's bursae or nasopharyngeal bursae originate at the interface between the embryonic tissue from which the vertebrae develop (the notochord), and the developing foregut. If the opening through which the bursa drains into the nasopharynx becomes obstructed, a Tornwaldt's cyst will develop. The history, clinical and radiological findings and the operative management of a patient with an infected Tornwaldt's cyst are presented.
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The clinical and radiological findings in the first case in the literature of spontaneous, bilateral and asymptomatic herniation of soft tissue from the temporomandibular joint into the anterior wall of the external canal are presented. With the patient's mouth closed, the herniations appeared as a dome-shaped swelling located on the anterior wall of each bony external auditory canal. With the patient's mouth opened, the dome-shaped swellings were retracted anteriorly, producing an invagination of the skin of the external canal at the site of the previous herniation. A high resolution CT scan of the temporal bones revealed that the soft tissue of both temporomandibular joints was protruding through a congenital dehiscence in the anterior wall of the tympanic bones.
Circulating thyroxine (T4) and triiodothyronine (T3) concentrations in rhesus monkeys were determined after various periods of cadmium administration in diet. No significant change in serum T4 and T3 levels was observed after 2 months of cadmium treatment. However, cadmium treatment for 4 months and 6 months showed a significant decrease in serum T4 and T3 levels indicating the adverse effect of long-term cadmium intake which increased gradually with duration of treatment.
A dilated portal vein has been reported as a cause of a portal defect on liver scan. This report describes a similar defect caused by tumor thrombus casts invading the portal vein and its main branches.
The incidence of neonatal hypothyroidism, as reflected in cord-blood thyroxine and thyrotropin levels, varied from 0.6% to 13.3% in iodine-deficient and normal regions of India (selected districts of Uttar Pradesh and Kerala and the city of Delhi), depending on the degree of environmental iodine deficiency. In populations with a high incidence of neonatal hypothyroidism, an increased prevalence of nerve deafness and a shift to the left in the distribution of IQ scores (towards lower scores) have been demonstrated. These indications of mild brain damage suggest that nutritional iodine deficiency can present in other ways than goitre or cretinism. Determination of the incidence of neonatal hypothyroidism using dried cord-blood spot screening appears to be the most useful and reliable method to assess the risk of brain damage in iodine-deficient areas.
X-ray monitoring was used to confirm the accuracy of extradural block in 100 patients who attended the Pain Relief Clinic for treatment of a variety of different conditions. A Tuohy needle was introduced by the central or paramedian approach and conventional physical signs, notably loss of resistance, used to identify entry into the extradural space. A radio-opaque dye was introduced prior to the analgesic solution, to display the injection site. X-ray screening confirmed the accuracy of the block in 83 patients, but unexpectedly in 17 the point of the needle was either just outside the spinal canal or only partly in the extradural space. There was no difficulty in correcting the needle position with the X-ray facilities available. Imprecise needle siting is only partially explained by technical problems. Imprecise siting of the needle may be responsible for at least some cases of inadequate analgesia or unexpected complications. In our view X-ray confirmation of site is essential for difficult extradural blocks, or when neurolytic solutions are introduced into the spinal canal. It may also be useful in teaching and research.
Cardiovascular responses and acid-base changes with graded volumes of intravenously injected air were measured in dogs anesthesized with pentobarbital and either 100% oxygen or 50% oxygen and nitrous oxide. Mean arterial blood pressure decreased significantly with 2.5 ml of air/kg in the oxygen group and at all volumes in the nitrous oxide group. The volume of air embolus appeared to increase more than twice in the presence of 50% nitrous oxide. Pulmonary artery wedge pressure increased significantly in both groups, while end-tidal carbon dioxide decreased significantly in both groups. The changes in pulmonary artery wedge pressure and end-tidal carbon dioxide were simultaneous, suggesting that the less invasive monitoring technique may be utilized in diagnosing significant air embolism. Right atrial pressure increased while left atrial pressure decreased significantly in both groups. With injected volumes of 2.0 and 2.5 ml or air/kg, right atrial pressure exceeded left atrial pressure creating the potential of paradoxical air embolism. The pH and PaO2 decreased while PaCO2 increased significantly during air embolization.
Atracurium was administered in a dose range of 0.027-0.4 mg/kg and dose-response curves were established for both balanced and isoflurane anesthetic techniques. With balanced anesthesia, ED50 and ED95 were 0.12 and 0.27 mg/kg, respectively, while with isoflurane they were 0.07 and 0.13 mg/kg and the least-squares regression line R2 values were 0.71 and 0.64, respectively. With balanced anesthesia there was a significant increase in systolic blood pressure at the 0.04 mg/kg dose (P = 0.02), while with isoflurane the systolic and diastolic blood pressures decreased at the 0.3 mg/kg dose (P less than 0.03). These changes were clinically insignificant. Atracurium is a potent nondepolarizing muscle relaxant which is potentiated by isoflurane. Its cardiovascular effects appear clinically nonsignificant. There is no evidence of histamine release.
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The haemodynamic effects of atracurium were studied in 16 patients (ASA I and II) undergoing major surgical procedures under nitrous oxide, oxygen and isoflurane anaesthesia. Atracurium was administered in two doses 0.2 and 0.4 mg kg-1 in the presence of 1.25 MAC isoflurane in nitrous oxide and oxygen. There were no significant changes in mean arterial pressure, systemic vascular resistance or central venous pressure with either dose. There were statistically significant alterations in heart rate and cardiac index at the 10-min observation in those patients receiving atracurium 0.4 mg kg-1. These changes were deemed to be clinically unimportant in this group of patients. There was no indication of histamine release manifested in the form of allergic reaction or decrease in systemic resistance. It is concluded that those two doses of atracurium have no untoward side-effects on cardiovascular performance at least in this group of healthy patients.