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Biomedical subjects

N N Shah

Publications and source records attributed to N N Shah.

10 recordsLinked to original sources
PubMed1997

Alprazolam-reinforced medication use in outpatients with anxiety.

The reinforcing effects of alprazolam were investigated in 14 patients who had generalized anxiety or panic disorder, but were not current users/abusers of other psychoactive substances. Using a double-blind outpatient choice procedure, color-coded alprazolam (0.5 mg) and placebo capsules were provided to patients for use 'as needed' in the treatment of anxiety symptoms. Comparisons of alprazolam and placebo during a 2 week sampling period in which placebo and alprazolam were available sequentially revealed no significant differences on measures of medication usage or anxiety levels, although alprazolam did increase subjective ratings of drug effects side effects. During a 4 week choice period, alprazolam was strongly preferred over placebo in 11 out of 14 patients indicating that alprazolam functioned as a reinforcer. Medication usage ranged from zero to 4.0 mg alprazolam in a day. Variations in daily medication-use were positively correlated with anxiety level fluctuations for a majority of patients. For a majority of patients, the results indicate that alprazolam functioned as a reinforcer without accompanying signs of abuse or addiction.

Adult↗
PubMed1996

Structural brain scanning in psychiatric patients: a further look.

BACKGROUND: Indications for computed tomographic (CT) and magnetic resonance (MR) scans of the brain in psychiatric patients are not clearly defined. This survey attempted to refine indications suggested by an earlier survey. METHOD: All brain scans ordered in a psychiatric teaching hospital were surveyed over a period of approximately 23 months. A revised order sheet provided information about the assumed need for scanning as well as indicated those factors from the previous survey most likely to reveal pertinent information. Scan results were later correlated with this information. RESULTS: Of 68 scans reviewed, 40 were normal, 16 equivocal, and 12 were abnormal. Cognitive decline and/or confusion were indications for 30 scans; 7 were abnormal, all meriting a clinical diagnosis of Alzheimer dementia. Only 1 of 12 scans to investigate a history of head injury was abnormal. Only 2 of 11 scans based on a history of seizures were abnormal; all had other possible indications. In one patient a prior stroke was confirmed, and in another, active multiple sclerosis. Ten of the group of 12 abnormal scans were found in patients over the age of 40 years, emphasizing the influence of age. CONCLUSION: Revised indications based on this second survey were as follow: (1) The importance of new or unexplained focal neurologic signs was confirmed; (2) Scans are useful for bolstering a clinical diagnosis of Alzheimer disease; (3) A first psychotic break or personality change after the age of 50 years will require investigation; (4) Cognitive decline in a patient with a prior history of functional psychosis is most likely part of the psychosis rather than a confounding organic disorder; (5) Isolated seizures of long duration or abnormal EEG without other clinical findings are seldom associated with abnormal scans.

Adolescent↗
PubMed1991

Comparative bioavailability of slow release diclofenac (Voveran SR) with enteric coated tablet and internationally used Voltaren Retard.

The objective of the study was to compare the enteric coated diclofenac sodium (Voveran), the slow release formulation developed in India (Voveran SR) and the internationally marketed formulation Voltaren Retard. Ten healthy volunteers were administered 100 mg each of the three formulations in a three-way crossover fashion. Blood samples were collected over 24 hours following administration of the drug; plasma levels of unchanged drug were determined by gas chromatography. Pharmacokinetic parameters for the three formulations were compared. The extent of the drug available from the three formulations was the same as the mean AUC values were not significantly different. Cmax and MRT values for the two slow release formulations were comparable but were significantly different from the values obtained with the enteric coated formulation. Tmax values for the two slow release formulations were similar while the enteric coated tablet had faster time to peak. Voveran SR is comparable to Voltaren Retard and has the distinct advantage of a slow release formulation in that its Cmax is much lower and levels are maintained over 12 hours and detectable upto 24 hours. This slow release formulation will offer clinical advantages of better compliance, relief of early morning symptoms and better tolerability over long term usage.

Adult↗
PubMed1976

Comparison of left atrial size and pulmonary capillary pressure with P wave of electrocardiogram.

The amplitude and duration of P waves in Leads II (P II), P terminal force in V1, (PV1) and the sums of P II and PV1 were compared in 37 subjects with left atrial size obtained by echocardiographic technique in 36 instances and with hemodynamic estimates of pulmonary capillary wedge pressures in 16 cases. The 22 females and 15 males were subdivided into the following groups. Group I, four normal subjects, Group II, 11 patients with predominant aortic insufficiency (two of whom had a mild mitral insufficiency); Group III, 14 patients with mitral valve disease, seven of whom had mitral insufficiency (two with minimal aortic insufficiency) Group IIIa) and seven had mitral stenosis (Group IIIb); Group IV, eight patients with miscellaneous disorders, i.e., coronary artery disease (5), hypertension (2), and idiopathic hypertrophic subaortic stenosis (1). Good correlations were obtained between left atrial size and P in Lead II (P II) (r = 0.74; p less than 0.001) and between P terminal force in V1 (PV1) and left atrial size (r = -0.69; p less than 0.001). In Group IV good correlation between PV1 and atrial size was noted. Some correlation between the sum of P II and PV1 and left atrial size (r = 0.51; p less than 0.02) was noted, but a better correlation was obtained in the patients with aortic insufficiency (r = 0.80; p less than 0.01). Pulmonary capillary wedge pressures were not reflected in changes in P II or PV1, except for the group with mitral stenosis (Group IIIb). Adding P II to PV1 improved the correlation with wedge pressure for the entire group.

Adult↗