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Biomedical subjects

R Guleria

Publications and source records attributed to R Guleria.

65 records · Page 4Linked to original sources
PubMedDate not supplied

Allergic bronchopulmonary aspergillosis: a retrospective study of 35 cases.

Clinical profile of 35 patients with allergic bronchopulmonary aspergillosis (ABPA) was analysed. The disease was found to be more frequent among females. Constitutional symptoms, expectoration, increased breathless and poor control of asthma were the main presenting features. Skin reactivity against aspergillin and Candida was positive in 30 and 2 cases, respectively. Precipitating antibodies against Aspergillus species was positive in 28 cases, and against Candida albicans in 2 cases. Sputum grew either Aspergillus or C. albicans or both in 19 patients. Absolute eosinophilia was observed only in one third of cases. Chest skiagram revealed characteristic central/proximal bronchiectasis and/or fleeting shadows in all cases. No specific pattern was observed on spirometry. There was no correlation between the duration of bronchial asthma, sputum culture and serology results. Most patients responded well to steroids. One striking feature of the study was that one third of the cases were misdiagnosed as pulmonary tuberculosis and were treated with antitubercular drugs for varying periods of time. A high index of clinical suspicion with appropriate laboratory tests are required to identify these cases.

Adolescent↗
PubMedDate not supplied

Effect of additional oral ofloxacin administration in the treatment of multidrug-resistant tuberculosis.

The effect of additional oral ofloxacin administration was evaluated in 19 HIV-negative patients with multidrug-resistant tuberculosis (MDR-TB). Their mean duration of illness was 3.6 years. Based on chest roentgenograms, 13 patients had advanced disease and 6 had moderate disease. In addition to 'second-line drugs', patients were treated with oral ofloxacin; high dose 800 mg per day (12 patients), low dose 400 mg per day (2 patients) and intermittent twice a week regimen of 800 mg a day (5 patients). With treatment, there was a significant clinical improvement. Sputum smear conversion occurred in 18 patients (mean duration 15 weeks) and this sputum smear negativity persisted for a mean duration of 7 months. Chest roentgenograms revealed regression of lesions in 18 patients. Reversible side effects were encountered in four patients. Results of present study suggest that additional administration of oral ofloxacin is both effective and safe for the treatment of MDR-TB.

Administration, Oral↗
PubMedDate not supplied

Pulmonary nocardiosis.

A case of pulmonary nocardiosis is described in a patient who had alcoholic cirrhosis of liver and portal hypertension. The patient also had diffuse proliferative glomerulonephritis and was on prednisolone treatment.

Anti-Bacterial Agents↗
PubMedDate not supplied

Intersubject variability of serum theophylline concentration after single dose of uncoated controlled release theophylline tablet administration in asthmatic patients.

Various reports indicate significant intersubject variation in the rate of absorption of controlled release theophylline products that are commercially available. Serum theophylline concentration was estimated in 17 asthma patients treated with controlled release theophylline tablet (mean dose: 5.6 +/- 0.6 mg/kg, mean body wt: 49.82 +/- 9.05 kg). The mean maximal concentration (Cmax) of 5.57 +/- 1.65 micrograms/ml occurred at mean time of maximal concentration (Tmax) of 3.3 +/- 1.36 (mean +/- SD) hours. Mean minimal concentration (Cmin) was 3.164 +/- 1.1 micrograms/ml (mean +/- SD) at mean time of minimal concentration (Tmin) of 5.77 +/- 1.77 (mean +/- SD) hours. The mean percent fluctuation was 112.95 +/- 183.45 (mean +/- SD) but in 4 out of 17 patients, percent fluctuation was 107.29 to 823.10. Therefore, 23.5% patients treated with controlled release theophylline tablet had wide fluctuations in serum theophylline concentration.

Administration, Oral↗
PubMedDate not supplied

Endobronchial tuberculosis simulating lung cancer.

We describe an atypical presentation of endobronchial tuberculosis in a 45-year-old female who presented to us with a non-resolving pneumonia. Her radiological examination including contrast enhanced CT-scan suggested a diagnosis of bronchogenic carcinoma or adenoma. Gross bronchoscopic finding also favoured malignancy. But her bronchoscopic biopsy revealed caseating granulomatic lesion. She responded to antitubercular treatment.

Antitubercular Agents↗
PubMedDate not supplied

Chronic post traumatic thoracic aortic aneurysm mimicking a benign cyst.

Aneurysm of thoracic aorta may mimic cystic lesions like bronchogenic cyst or hydatid cyst. We report a case of chronic post traumatic thoracic aortic aneurysm in a young lady, initially diagnosed as benign cystic lesion. MRI scan of chest confirmed the diagnosis and subsequently surgical removal of aneurysm was done.

Aorta, Thoracic↗
PubMedDate not supplied

Theophylline clearance in undernourished asthma patients.

Theophylline clearance is altered by many drugs and diseases that may be associated with undernutrition. Therefore, we studied theophylline clearance in 12 undernourished [body mass index (BMI) less than 19] and 12 well nourished asthma patients (body mass index more than 19). Uncoated theophylline tablet (200 mg, 300 mg dose 5 mg/kg approx) was administered orally to each asthma patient after 12 hours overnight fasting. Serum theophylline concentrations were estimated after 2, 4, 6, 8 hours of drug administration and it was calculated from log conc: time curve. Undernourished asthma patients had a mean theophylline clearance of 85.6 (SE = 6.2) ml/hr/kg while it was 125.6 (SE = 3.8) ml/hr/kg in well-nourished asthma patients. The difference between two groups was highly significant (p < 0.01). We conclude that theophylline clearance is significantly lower in undernourished asthma patients and they will require a lower maintenance dose of theophylline.

Adult↗