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Biomedical subjects

R Agarwal

Publications and source records attributed to R Agarwal.

386 records · Page 22Linked to original sources
PubMedDate not supplied

Immunologic parameters in infective endocarditis: a prospective study.

To evaluate the role of immunoglobulins, complement, circulating immune complexes (CIC), heart antibodies (HAb) and rheumatoid factor (RF) in infective endocarditis, we studied 28 consecutive patients before and after therapy. Statistically significant elevation was seen in IgG (p less than 0.001) and IgA (P less than 0.001) level prior to initiation of therapy as compared to a control group. Following drug treatment a fall was noted in IgA (P less than 0.01) and IgM (p less than 0.01) level as compared to basal values. Low C3 levels were seen in those with renal involvement (p less than 0.05). CIC levels estimated by 4% PEG precipitation assay were found to be elevated in 64% of patients. Patients with shorter duration of illness (less than three months) had higher levels of CIC containing IgG (P less than 0.005), IgA (P less than 0.05) and IgM (P less than 0.05), as compared to those with a longer duration. Initial CIC levels did not predict the clinical course and were found to be of no value in prognosis, although an improvement in congestive heart failure was associated with a rise in C3 (P less than 0.05) and IgM (P less than 0.05) containing CIC and an overall clinical improvement with a rise in IgA (p less than 0.05) containing CIC. There was no statistically significant difference in CIC level, for the entire group studied, before and after therapy. Patients who had rheumatoid factor in their initial serum sample demonstrated a fall in IgG, IgA and IgM containing CIC and a rise in C3 with therapy. The converse was true for those who lacked RF.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Gold-induced hypersensitivity pneumonitis in a patient with rheumatoid arthritis.

A case of gold-induced hypersensitivity pneumonitis in a patient with rheumatoid arthritis is reported. Its differentiation from interstitial pulmonary fibrosis associated with rheumatoid arthritis is discussed and the low T4/T8 ratio in the bronchoalveolar lavage fluid of these patients is highlighted.

Alveolitis, Extrinsic Allergic↗
PubMedDate not supplied

Complete intraventricular dissociation. Electrocardiographic manifestation of a rare intracardiac complete dissociation.

Complete Intraventricular Dissociation manifesting as dual ventricular rhythm was observed on surface electrocardiography in two middle-aged males with acute myocardial infarction. The first patient had a dominant accelerated (AV) junctional rhythm, and there was a sudden emergence of an additional independent slow and regular idioventricular escape rhythm. These ventricular complexes were bizarre and markedly widened, waveform with prolonged undulating electric potentials. In the second case, the emergence of a dominant idioventricular rhythm was coexistent with an additional independent escape rhythm with monophasic wider agonal ventricular complexes. Terminal tracings recorded later were essentially the same, except that an ill sustained ventricular fibrillation had replaced the ectopic agonal beats, and there was an enhanced automaticity in the dominant ventricular part. The sites of ectopic ventricular rhythms were thought to be in the ischaemic damaged ventricular myocardium, with a surrounding zone of conduction block.

Adult↗
PubMedDate not supplied

Search for CNS active agents: synthesis of N,N'-bis-[potassium-alkyl/aryl carboxylate]-5-arylidene barbituric acids.

5-Arylidene barbituric acids (1--5, Fig. 1) were obtained by the Perkin's condensation between the corresponding aryl aldehyde and active methylene group of barbituric acid. By the condensation of these 5-arylidene barbituric acids with different alkyl/aryl-chloroacids, fifteen new N,N'bis[potassium-alkyl/aryl carboxylate]-5-arylidene barbituric acids (6--8 Fig. 1) were prepared. Eight of the fifteen final compounds were screened for their pharmacological actions on CNS. They have shown irregular behavioral changes on the CNS; some of them were the CNS stimulants, whereas others were CNS depressants at 1/5 of ALD50 dose level (316--1000 g/kg).

Animals↗
PubMedDate not supplied

Our experience with Palmaz-Schatz coronary stent.

Between September 1993 and August 1994 we have implanted Palmaz-Schatz coronary stents in 44 patients. Twenty eight patients presented with stable angina and 16 with unstable angina. Stenting was carried out for denovo, focal lesions in large coronary arteries (n = 27), significant dissection during PTCA with acute threatened closure (n = 9), suboptimal results (n = 5), restenosis after PTCA (n = 2) and saphenous vein graft stenosis (n = 1). Successful delivery of the stent was achieved in 43 cases. Percent diameter stenosis was reduced from 77 +/- 11% to 10 +/- 8% and minimal luminal diameter increased from 1.08 +/- 0.28 mm to 2.92 +/- 0.39 mm. There was 1 death due to left main dissection secondary to guiding catheter trauma in a patient taken up for bail out stenting. Vascular/bleeding complications occurred in 3 patients (6.7%). There was no instance of acute or subacute stent thrombosis. Forty patients are symptom free. Eighteen patients underwent six month angiography. Restenosis (> 50% diameter reduction) was seen in 2 and a new lesion distal to stent occurred in 1 case. All have been successfully redilated. A high rate of successful delivery of the Palmaz-Schatz coronary stent can be achieved in a wide spectrum of patients with very few complications. Long term results are very gratifying and encouraging.

Angina Pectoris↗
PubMedDate not supplied

Left ventricular function and geometry in juvenile mitral stenosis.

The purpose of this study was to investigate possible differences between juvenile and adult variety of mitral stenosis (MS) with regard to left ventricular preload, afterload, contractile function and geometry by two-dimensional echocardiography. Thirty six consecutive children and adolescents with MS (Group 1, mean age +/- 1 standard deviation 16 +/- 3 yrs) were compared with an equal number of adults with MS of comparable mitral valve area (Group II, mean age 30 +/- 8 yrs). Patients with juvenile versus adult MS had similar left ventricular ejection fraction (0.57 +/- 0.09 vs 0.57 +/- 0.11, p = not significant (NS)), end-systolic wall stress (64.8 +/- 21 vs 64.3 +/- 25 Kdynes/cm2, p = NS), wall stress to end-systolic volume ratio (2.6 +/- 1.2 vs 2.71 +/- 0.9, p = NS) and mass (77 +/- 19 vs 83 +/- 26 gm/m2 p = NS) but the former had greater end diastolic volume (68 +/- 16 vs 57 +/- 18 ml/m2, p = 0.008) and sphericity index (0.62 +/- 0.19 vs 0.50 +/- 0.19, p = 0.01) and lower mass to volume ratio (1.01 +/- 0.32 vs 1.36 +/- 0.42, p (0.01). Compared to normal controls, adult patients with MS had similar end-diastolic volume (58 +/- 13 vs 57 +/- 18 ml/m2), mass (84 +/- 20 vs 83 +/- 26 gm/m2), mass to volume ratio (1.45 +/- 0.4 vs 1.36 +/- 0.42) but greater wall stress (45.6 +/- 11.7 vs 64.3 +/- 25 Kdynes/cm2, p < 0.001) and lower ejection fraction (0.66 +/- 0.07 vs 0.57 +/- 0.11, p < 0.001). Thus patients with juvenile MS have significantly altered left ventricular geometry and increased preload in response to comparably elevated afterload due to compensatory adaptive process.

Adolescent↗