Biomedical subjects
Publications and source records attributed to R K Verma.
Self-strangulation for committing suicide by the use of ligature is admittedly rare. A suicidal strangulation case from Haryana State, India is discussed in the light of scene of occurrence, investigations of the ligature and its knot. Initially the case was suspected by the police to be a murder, but proved to be of suicidal strangulation.
Two cases of giant bullae were treated by intracavitary suction and drainage procedure under local anesthesia because of the poor pulmonary function. After staged bullectomy, the patients returned to normal life. The first case was admitted to our intensive care unit (ICU). Tube drainage was performed in the giant bulla of the left lung immediately after admission. One month after recovery from right heart failure and mediastinal shift to the right side, bullectomy was performed using linear stapler. The patient was discharged 20 days later. The second case was admitted with severe dyspnea and bilateral giant bullae were noticed. We performed tube drainage for larger bulla of the left lung under local anesthesia. Two months later, bullectomy was performed on the right side, because the bulla on the left side became smaller and the general condition of the patient improved. The patient was discharged three months later on foot and has since been asymptomatic. Giant bulla is a well-established clinical entity which includes abnormal dilatation of various parts of the tracheo-bronchial tree and other discrete sacs originating from the interstitial portion of the lung. Giant bullae are frequently associated with marked dyspnea and emphysematous symptoms. However, these symptoms depend upon various factors: size, location, valvular mechanism, condition of the contiguous lung parenchyma and the changes that may take place in the intrathoracic pressure.
A young homosexual man presented with slowly progressive weakness and diffuse fasciculations. Muscle biopsy was compatible with clinical diagnosis of motor neuron disease. The patient died from opportunistic infections related to acquired immunodeficiency syndrome. Autopsy revealed evidence of myelopathy, patchy fiber loss from anterior nerve roots, marked demyelination within intramuscular twigs of peripheral nerves, and primary myopathic features superimposed on advanced neurogenic atrophy of the skeletal muscles.
A study of glutamic oxaloacetic transaminase (GOT) and lactic dehydrogenase (LDH) enzymes in serum and cerebrospinal fluid (CSF) was carried out on 30 cases of acute cerebrovascular accident (CVA) to determine their role in precise diagnosis and prognosis of the cases. The CSF GOT and LDH activities were well correlated with the severity, mortality and peak and proper timing in relation to infarct, same is about serum GOT. A characteristic rise of GOT and LDH was observed in cerebral haemorrhage especially in fatal cases. However, in cerebral thrombosis and embolism specially in non-fatal cases, the enzyme change was not so marked. GOT and LDH enzyme pattern in CSF and serum may, therefore, serve as an early, relatively easy and widely available tool for differential diagnosis and prognosis of cases of acute CVA.
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