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Biomedical subjects

R Chitkara

Publications and source records attributed to R Chitkara.

12 recordsLinked to original sources
PubMed2001

Foreign body aspiration diagnosed by microscopy.

We report a rare case of foreign body aspiration diagnosed by microscopic analysis of a sample of the foreign body. A 50-year-old man presented with a 5-month history of 40 pound weight loss and a nonresolving right lower lobe pneumonia. Medical history, radiographic studies, direct visualization of the foreign body by flexible fiberoptic bronchoscopy, and gross examination of a sample of the foreign body retrieved by a forceps biopsy catheter failed to yield the diagnosis. Moderate bleeding associated with the bronchoscopic "biopsy" procedure contributed to a preliminary misdiagnosis of endobronchial tumor. Microscopic analysis of the "biopsy" specimen demonstrated vegetable matter. The patient underwent rigid bronchoscopy and a peanut was retrieved from the bronchus intermedius. He was maintained on antibiotics for an additional 8 weeks and had complete clinical and radiographic recovery. The epidemiology, presentation, and management strategies of foreign body aspiration in the adult are briefly reviewed.

Arachis↗
PubMed1992

Tuberculosis prevention project.

This article reports the findings from a clinical study that examined the impact of health education and counseling on the decision of a patient infected with tuberculosis (TB) to complete a regimen of isoniazid (INH) chemoprophylaxis for 6 months to prevent TB. Forty patients were divided into two groups; both groups were administered a questionnaire to collect demographic data and medical history. One group received additional health education and counseling independent of clinic staff, and the other group only received health education and counseling from clinic staff. The proportion of patients in the first group who completed INH for 6 months (63.6%) was significantly greater than the proportion of patients in the second group (11.1%). These findings suggest that health education and counseling did make an impact on the decision of a patient infected with TB to conform with a rational choice when provided with information and a supportive relationship about the consequences of TB infection.

Adult↗
PubMed1991

Empyema due to ventriculopleural shunt.

Empyema developing seven weeks after craniotomy in a 62-year-old black woman with an ipsilateral ventriculopleural (V-PL) shunt is described. Infection of the pleural space presumably resulted from transfer of organisms from a proximal V-PL shunt infection to the thorax. Empyema resulting from V-PL shunt infection has not previously been reported. Pleural effusions in patients with V-PL shunts must be considered as a potential site of infection with possible development of empyema.

Cerebrospinal Fluid Shunts↗
PubMed1983

Positive airway pressure in patients receiving intermittent mandatory ventilation at zero rate. The role in weaning in chronic obstructive pulmonary disease.

Over a 20-month period, we treated 180 mechanically ventilated patients in our respiratory intensive care unit. Among these patients, we observed an interesting previously unreported phenomenon in 20 patients with severe chronic obstructive disease. During the weaning from mechanical ventilators of these 20 patients, there was a marked clinical deterioration when the mode of ventilation was changed from intermittent mandatory ventilation (IMV) at zero rate to that of a T-tube setup. To explain this previously unreported observation, we studied and compared nine different intubated patients for possible differences in airway pressure between IMV set up at zero rate and a T tube. We observed that peak airway pressures were greater on IMV at zero rate compared to the peak airway pressures on the T piece in all nine patients. At the end of expiration, seven out of the nine patients had higher airway pressures on IMV at zero rate compared to the T tube. These differences in the peak airway pressures and end-expiratory pressures were statistically significant in both groups. In spite of the obvious limitation of extrapolating the experimental results obtained in one group of patients to explain the clinical observations made in another group of patients, we believe that the higher airway pressures on the IMV system (even without any mechanical ventilation) prevent early collapse of the airways, and this may be of significant importance in successfully weaning patients with COPD.

Humans↗
PubMed1981

Results of gastric neutralization with hourly antacids and cimetidine in 320 intubated patients with respiratory failure.

In a retrospective analysis massive upper gastrointestinal (GI) hemorrhage, defined as blood loss requiring more than two units of blood transfusion over a 24-hour period, occurred in 40 (9.5 percent) of 420 intubated, mechanically ventilated patients with respiratory failure, irrespective of the etiology of the respiratory failure. In a prospective study hourly antacid gastric neutralization, maintaining the gastric pH over 5, the incidence of massive gastric bleeding was reduced to 3 (1.4 percent) of 210 patients. In 110 additional patients, cimetidine, a histamine H2 receptor blocker, was used to prevent gastric acid secretion; 3 (2.7 percent) of 110 patients had massive upper GI bleeding; all three had solitary chronic pyloric ulcers. We conclude that gastric neutralization, either with hourly antacids or with cimetidine, is effective in reducing the incidence of massive gastric hemorrhage in intubated, mechanically ventilated patients during respiratory failure. We recommend the use of either in all intubated patients with respiratory failure. In addition, in 17 patients who had gastric bleeding at the time of transfer to the respiratory intensive care unit, gastric neutralization with hourly antacids in 14 patients and with cimetidine in three patients stopped the bleeding in all 17 patients within 24 to 48 hours.

Aged↗
PubMed1978

Intravenous self-administration of metallic mercury in attempted suicide. Report of a case with serial roentgenographic and physiologic studies over an 18-month period.

This report describes a 23-year-old white man who injected metallic mercury from a thermometer into his antecubital vein in an attempt at suicide. Despite the persistence of mercury throughout both pulmonary fields on chest x-ray films over an 18-month period of observation, no clinical or physiologic derangement of pulmonary function has developed. In addition, no clinical or biochemical evidence of acute or chronic mercury poisoning in any other organ has appeared during these 18 months, even though metallic mercury is seen in the abdominal viscera on roentgenographic examination. The literature on suicidal and accidental poisoning with metallic mercury is reviewed.

Adult↗