Biomedical subjects
Publications and source records attributed to M Varghese.
This article describes a campaign for the safe use of fireworks and the prompt application of cold water to skin burned by them. Some success was achieved in the latter regard as a result of frequently repeated television announcements.
Lungs of the human infant and those of other mammals are filled with fluid immediately prior to birth. Studies of the ionic composition of this fluid indicate that active ionic transport processes occur in the epithelial cells of the potential airspaces. The purpose of this study was to see if these active ion pumps were present in developing species other than mammals thus providing a possible evolutionary link to mammals. A series of samples of lung liquid, amniotic fluid, and plasma were taken from embryonic marine turtles gathered from clutches incubating in the beach at Mon Repos, Queensland, Australia during the summer of 1986-87. The concentrations of sodium, potassium and chloride ions and protein measured in these liquids indicated that active pumping processes similar to that seen in the mammalian lung were present in the developing lungs of these marine reptiles and further, circumstantial evidence was gathered to suggest that this liquid was partially reabsorbed prior to hatching. The results support the notion that processes responsible for the normal development of the human lung and lungs of other mammals are also present in the hollow lungs of marine turtles. Thus there is an evolutionary counterpart controlling lung development in more ancient species. It may be possible to generalize this observation to the development of hollow lungs of other species.
Several factors could explain the effect of warm, sunny weather on kidney stone formation. To determine the role of sun exposure, we used a light box to administer artificial ultraviolet B radiation during the winter months in New York City. Eleven male stone formers and 7 age- and sex-matched controls received 10 UVB light exposures over a two-week period while maintaining a 400 mg calcium diet. 25-OH vitamin D levels increased significantly (p less than 0.001) in both patients (25.9 +/- 9.8 to 51.6 +/- 14.1 ng/ml) and controls (21.3 +/- 7.1 to 49.6 +/- 3.1 ng/ml). However, 1,25 dihydroxyvitamin D levels rose in the patients (50.8 +/- 14.8 to 55.9 +/- 13.1 pg/ml) but fell (60.1 +/- 6.5 to 49.4 +/- 3.1 pg/ml) in the controls. Only 2 of the 11 patients but all of the controls demonstrated this down regulation of 1,25 dihydroxyvitamin D levels (p less than 0.002). 24,25 dihydroxyvitamin D levels tended to rise in both groups but parathyroid hormone levels were unchanged. There was a trend, which did not reach statistical significance, for parameters of calcium excretion to increase after UVB radiation. 24-hour urinary calcium excretion rose 24% from 140 to 173 mg in the patients and 31% from 113 to 148 mg in the controls. The ratio of calcium/creatinine following a one gram calcium load showed a small increase after UVB radiation from 0.17 to 0.20 in patients and 0.118 to 0.124 in the controls. However, no correlation could be discerned between changes in vitamin D metabolite concentrations and changes in urinary calcium.(ABSTRACT TRUNCATED AT 250 WORDS)
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Erythrocyte acetylcholinesterase (EC 3.1.1.7) and plasma pseudocholinesterase (EC 3.1.1.8) were determined from the day of admission up to 10 days in patients who have consumed organophosphate or carbamate poisons. In a number of patients, plasma pseudocholinesterase was completely inhibited on the day of admission but increased with the passage of days. Erythrocyte acetylcholinesterase was not completely inhibited and it also tended to increase with time in most cases. Patients in whom the erythrocyte acetylcholinesterase was very low and did not show an increase within the first few days expired indicating the prognostic importance of erythrocyte acetylcholinesterase. The profile of aryl acylamidase (EC 3.5.1.13) activity in plasma or erythrocytes showed a pattern similar to the respective cholinesterases. Moreover, whole blood aryl acylamidase activity was found to be a good index of erythrocyte acetylcholinesterase suggesting the prognostic usefulness of blood aryl acylamidase in the poisoned patients.
The pharmacokinetics of cefoperazone were evaluated in 25 infants (mean age, 26 days) after intramuscular and intravenous routes of administration. The levels in blood that were achieved were severalfold higher than those required to inhibit common pathogens. The mean half-life of 240 min was one-half of that observed in 1- to 2-day-old infants but about twice that seen in adults. Further evaluation is needed to study the efficacy of the drug in infants and children.
Cefotaxime, a third generation cephalosporin antibiotic, was evaluated in 26 infants and children for the treatment of documented or suspected bacterial infections, including pneumonia (10 cases), soft tissue skin infection (13 cases), and urinary tract infection (3 cases). An average daily dose of 60 mg/kg in 3 to 4 divided doses was administered parenterally for an average of 7 days. In 14 of the cases, primary pathogens, including Haemophilus influenzae b (resistant to ampicillin), Staphylococcus aureus, Staphylococcus pyogenes, Streptococcus pneumoniae and Escherichia coli, were eradicated. Clinical recovery occurred in each case. Blood levels at different time intervals and biological half-life were similar to those reported for adults. Mild and transient side effects observed were elevation of SGOT in two cases, alkaline phosphatase in one, and eosinophilia in one case.
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High-affinity IgM and IgG monoclonal antibodies (anti-HBs) against hepatitis B surface antigen (HBsAg) determinants were used to study a confined Australian Aboriginal population, 51% of which showed evidence of exposure to hepatitis B virus (HBV). A conventional radioimmunoassay which uses polyvalent anti-HBs antisera indicated that 4.4% of the subjects were positive for HBsAg; a monoclonal IgM anti-HBs radioimmunoassay detected all these HBsAg-positive samples and showed enhanced binding activity in a further 5.4% of subjects. Detailed analysis of this binding activity in serum by different IgG and IgM monoclonal anti-HBs antibodies demonstrated additional HBsAg-associated determinants as well as remarkable homogeneity of the determinants in this population. It was concluded that there are HBV or HBV-like agents in this community not previously detected by conventional assays.
Moxalactam, a new beta-lactam antibiotic was evaluated in the treatment of 21 pediatric patients including 16 with clinical and radiological evidence of pneumonia and 5 with urinary tract infection (UTI). Clinical and radiological resolution of pneumonia occurred in all. Bacteriological efficacy in pneumonia, however, was assessed in only 1 patient whose blood culture grew H. influenzae type b. In patients with UTI, the therapy was successful, bacteriologically as well as clinically. The only side effects observed were mild transient elevation of SGOT and alkaline phosphatase in 6 cases. The peak and trough levels of the drug were manyfold higher than the known minimum inhibitory concentrations of common pathogens. The mean t1/2 projected of 95 and 124 min with intravenous and intramuscular route, respectively, were similar to those reported in adults.
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Seven patients with acute dissection of ascending aorta are presented and the role of two-dimensional echocardiography in the early diagnosis of this condition is emphasized. There were 5 male and 2 female patients. The mean age of the patients was 36.7 +/- 11.2 years. The presenting symptoms were chest pain in 7, associated interscapular pain in 4, dyspnoea in 4 and syncopal episodes in 2 patients. Examination revealed hypertension in 3, pulses paradoxus in 2, asymetrically weak carotid and brachial pulses in 3, aortic regurgitation in 5 and neurological deficit in 2 patients. Echocardiography showed aortic root diameter of 42mm and the presence of an intimal flap in all the 7 patients and flap oscillations in 6 patients. Echocardiographic evidence of pericardial effusion was present in 6, cardiac tamponade in 3, aortic regurgitation in 5 and regional left ventricular wall motion abnormality in 1 patient. Surgical correction was done in 5 patients with 60% success rate. Two patients received only medical treatment. Aortic root dilatation of 60 mm, presence of an oscillating flap, evidence of cardiac tamponade and regional wall motion abnormality were found to be associated with poor prognosis.
BACKGROUND: Paralysis due to poliomyelitis is common in rural areas. The extent of paralysis, type and place of treatment and effect of local treatment on children with poliomyelitis was assessed in a house-to-house survey conducted between 1990 and 1991 in a rural area of north India. METHODS: Trained field workers conducted a house-to-house survey in 9 villages of Haryana with a total population of 22,883. All cases of deformity and muscular weakness suspected to be due to poliomyelitis were examined and details regarding immunization, diagnosis, treatment and follow up were recorded. The late consequences of neglect as well as inappropriate medical advice were also assessed by physical examination and direct questioning of the parents. RESULTS: Thirty-seven cases of paralytic poliomyelitis were identified indicating a prevalence rate of 1.6 per 1000 population. Of these, 97% were paralysed before they were 2 years old and 60% had a history of intramuscular injections preceding paralysis. Only 14% of them had received either partial or complete immunization. The majority of families preferred to take treatment from traditional healers or in city hospitals but not from primary health centres. CONCLUSION: Despite the national immunization programme, paralytic poliomyelitis continues to be a significant problem in the villages surveyed. Primary health centres are an unreliable source of epidemiological data for paralytic poliomyelitis as villagers do not prefer to visit them for treatment of the disease. Injections given for treatment of fevers in rural areas may play a role in precipitating paralytic poliomyelitis. These findings highlight the urgency of a broad-based primary health care approach at primary health centres. Traditional healers and private practitioners should be trained to provide physiotherapy to children with polio and educated about the importance of not giving injections to children with minor fevers.