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Biomedical subjects

R Uppal

Publications and source records attributed to R Uppal.

At least 37 records · Page 2Linked to original sources
PubMed1994

Pharmacoepidemiology of drug use at two primary health care centres in northern India.

There is a consensus amongst most health care centers that limited drugs should be available to meet most requirements at the first tier of health care. However, few studies have addressed themselves to determining this. The objectives of this study were to provide a description of the availability and prescription of modern pharmaceuticals at 2 selected Primary Health Care Centres in Northern India. The main results of this study are: documentation of age/sex of patients on prescriptions was not kept in all cases; prescribing by both generic/brand names was observed with generics predominating; most patients received 0-2 drugs; dosages were not specified in 10% of the cases, duration not specified in 30% of the cases, and dosage form not indicated in 30% of all drugs prescribed; treatment was sought for problems pertaining to gastrointestinal, respiratory, dermatological and musculoskeletal systems; and the most prescribed drugs were analgesics, antipyretics, antimicrobials, hematinics and antihistaminics.

Ambulatory Care Facilities↗
PubMed1993

The efficiency of pulmonary blood transport following single lung transplantation.

Perioperative right ventricular (RV) dysfunction remains a significant problem following single lung transplantation (SLT), especially in patients with pulmonary hypertension. Total RV power (Wt), a determinant of RV function, is the sum of the mean component (Wm) which contributes to actual blood flow and the oscillatory component (Wo) which is the energy expended on arterial pulsation. Calculation of Wo is possible only through harmonic analysis of pulmonary arterial (PA) pressure and flow waveforms, and as much as 33% of RV power is attributed to it. The purpose of this study was to precisely quantify changes in RV power output using Fourier analysis of PA pressure and flow waveforms after SLT. Fourteen dogs (donors) were instrumented with a PA ultrasonic flow probe, PA and left atrial (LA) micromanometers, and LA epicardial pacing leads. Control (Pre-Tx) pressure-flow data were acquired during transient occlusion of the right PA at a heart rate of 140. The PA was cannulated, the lungs were flushed with 1 liter of modified Euro-Collins solution at 4 degrees C, and the left lung was harvested and transplanted to 14 recipient dogs in a standard manner. After 1 hr of reperfusion, PA (Post-Tx) pressure-flow data were acquired as above. All recipient animals survived SLT with a mean ischemic time of 183 +/- 3 min. Following SLT, both the mean, Wm, (69 +/- 9 to 161 +/- 23 mW) and oscillatory, Wo, (23 +/- 3 to 46 +/- 10 mW) components of RV power output increased significantly after SLT (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1993

1985: left thoracotomy for reoperative coronary artery bypass procedures. 1993 update.

This paper describes our experience in performing saphenous vein bypass grafts to the circumflex coronary artery system with a left thoracotomy in 9 patients. Illustrative case reports demonstrate the spectrum of patients for whom this approach has been useful. The advantage of this technique is that it allows the surgeon to avoid the adhesions that make a redo sternotomy time-consuming and potentially dangerous when previously patent saphenous vein or internal mammary grafts are present. It is particularly useful for patients requiring grafting to the circumflex coronary artery system, especially if the patient is in relatively unstable condition and would benefit from rapid institution of cardiopulmonary bypass. The technique generally employs cannulation of the descending thoracic aorta for arterial inflow and of the main pulmonary artery for venous return. Usually the proximal end of the graft is easily placed to the left subclavian artery. Coronary anastomosis is performed on the cold (15 degrees C), fibrillating heart, and aortic cross-clamping and cardioplegic arrest have not been necessary. Venting is possible through the left atrial appendage should any rise in filling pressures occur. Saphenous vein or internal mammary artery may be used. All patients undergoing this technique have had expeditious discharge from the hospital and excellent relief of symptoms. The technique is an alternative to median sternotomy for properly selected patients.

Coronary Artery Bypass↗
PubMed1993

Antimicrobial drug use in primary health care.

A survey was carried out to assess the extent and pattern of use of antimicrobials at two primary health care centres (PHCs) in northern India. At both PHCs 20-40% of all drugs prescribed were antimicrobials. The most prescribed antimicrobials at both PHCs were sulfa drugs (29%), followed by cotrimoxazole (15%) and penicillins (10%). The pattern of infectious diseases was similar at both PHCs; with respiratory tract infections heading the list (12%), followed by skin infections (10%), enteritis (7%), injuries (4%), unknown pyrexias (3%) and worm infestations (2%).

Anti-Infective Agents↗
PubMed1993

Prescription drug use in lactating mothers: an experience at a referral hospital and in a community in India.

The aim of the study was to investigate the extent of prescription drugs administered for common disorders during the post partum period. This is a prospective survey of disorders and drug use in 1) immediate postpartum mothers (n = 200) admitted to the maternity wards, 2) in post-natal hospital follow-up clinic (n = 200) and in 3) the rural home based community (n = 100). A pretested questionnaire was filled in by medical officers after interviewing the mothers. The mean age of the mothers was 25 years and a literacy rate of 50% above the 10th grade. Over 80% of the women were multigravida in the entire sample; 45% underwent Caesarean Section in a hospital; 97.6% had a normal delivery in the community. In the hospital settings 4.1% infants had jaundice and 1% had congenital anomalies. In the community setting, diarrhoea and pneumonia was seen in 2.6% of the infants. Apart from the use of nutritional supplements, such as iron, calcium, multivitamins etc., most commonly prescribed drugs were analgesics (in 70% of patients in the hospital settings, 56% of the patients in the postnatal clinic and 37.6% patients in the community), and antibiotics (90% of the patients in the hospital settings, 86% of the patients in the postnatal clinic and 13% of the community based patients). Antihypertensives agents (2.5% of the patients), digoxin (1.5% of the patients), bronchodilators (1% of the patients) and sedatives (3.5% of the patients) were prescribed to admitted patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Drug interaction between rifampicin, isoniazid and cotrimoxazole in rabbits.

1 The results of cotrimoxazole (CTZ) co-administration (15 mg kg-1 trimethoprim + 40 mg kg-1 sulphamethoxazole) on plasma concentration and various pharmacokinetic parameters of rifampicin (RIF, 24 mg kg-1) and isoniazid (INH, 14 mg kg-1) were studied. 2 In the test group (n = 6), CTZ was administered on the 24th day of antitubercular treatment (ATT) and given for 7 d. 3 At the end of concurrent treatment with CTZ, RIF half-life (t1/2) and plasma concentration were both increased. However, there was no effect on INH half-life and plasma concentration.

Animals↗
PubMed1991

Chronic alcoholic gastritis. Roles of alcohol and Helicobacter pylori.

We assessed the relative roles of alcohol and infection with Helicobacter pylori in the pathogenesis of chronic gastritis in alcoholic patients. Helicobacter pylori was found in 14 of 18 alcoholics with dyspepsia and was associated with chronic antral gastritis. Gastric biopsy specimens were normal in four H pylori-negative alcoholics. Studies were repeated 3 to 4 weeks after controlled abstinence. There was no change in histologic findings during this period, indicating that alcohol itself was not the major causative agent. We then eliminated H pylori in 10 subjects by giving triple therapy (bismuth subsalicylate, amoxicillin, and metronidazole). Treatment for H pylori was associated with almost complete normalization of histologic findings. Four control subjects who received antacids alone showed no improvement. Dyspeptic symptoms in H pylori-positive patients significantly improved after elimination of this organism, whereas there was no change with antacid treatment.

Adult↗
PubMed1991

An unusual presentation of systemic lupus erythematosus.

A case of right hemiparesis in a 22-year-old, caucasian male is presented. Echocardiography and an indirect left ventriculogram revealed a mass in the left ventricle which was eventually removed at surgery. Histology of the ventricular wall revealed thrombus superimposed on a full thickness myocardial infarction with florid intimal proliferation of small arteries. This histological picture suggested a diagnosis of systemic lupus erythematosus. Serum immunology revealed raised antibody titres in keeping with systemic lupus erythematosus. This is an unusual presentation where the only manifestation of disease was hemiparesis secondary to an embolic episode, from thrombus in the left ventricle subsequent to a small localised myocardial infarct.

Adult↗
PubMed1991

Drug interaction between rifampicin and cotrimoxazole in patients with tuberculosis.

1. Patients (n = 15) who were admitted with complications of tuberculosis, were given antitubercular therapy (ATT) with rifampicin (RIF), for a minimum period of 15 d, and cotrimoxazole (CTZ), concurrently, for 5-10 d. 2. The serum RIF levels were measured before the start of CTZ treatment and at the end of its administration. 3. The plasma half-life (t1/2) of RIF increased significantly from 1.92 +/- 0.57 h to 2.31 +/- 0.134 h after CTZ treatment. 4. The mean serum levels of RIF increased significantly at 4 and 6 h after CTZ administration.

Adolescent↗
PubMed1991

Patients' attitude towards health care at a teaching hospital in India.

Using a questionnaire, 362 patients attending the outpatients services of Internal Medicine of Nehru Hospital attached to our institution were randomly interviewed. Seventy per cent of the patients were in the 21-50 years age range; 50% came from rural and 50% from urban areas. Forty per cent travelled more than 30 Km; 72% used a public transport to reach hospital. Most patients had an income less than Rs. 1000/-. Ninety per cent had already consulted another medical practitioner earlier. The largest number of complaints related to the gastrointestinal, cardiovascular and respiratory systems. On an average 1-2 drugs were prescribed per patient; only 13% of these were available at the hospital dispensary. Most patients were willing to purchase the prescribed drugs from the market.

Adult↗
PubMed1991

Contribution of exogenous ethanol and endogenous substrates to acetaldehyde-adduct formation in liver injury.

Acetaldehyde was found to be transported in the blood mainly bound reversibly to 2 components of the red blood cells (RBC): a) hemoglobin, which provides binding of a high affinity, but low capacity, and b) a non-protein component (presumably cysteine), which has a lower affinity but a higher capacity. In alcoholics, the main increase in RBC-acetaldehyde binding occurred in the protein-free fraction, in association with a marked increase in RBC-cysteine. Elevated RBC-acetaldehyde persisted for at least 2 weeks after alcohol withdrawal in 83% of the blood samples from alcoholics. Even in the absence of alcohol consumption, liver injury increased acetaldehyde from sources other than ethanol. This was associated with high serum antibody titers against acetaldehyde adducts. In an animal model of non-alcoholic liver cirrhosis, a target protein for the formation of acetaldehyde adducts appears to be procollagen type I.

Acetaldehyde↗
PubMed1991

Antimicrobial drug use in urology.

Antimicrobial drug utilization patterns were studied on patients in the Urology Ward of Nehru Hospital attached to the Postgraduate Institute of Medical Education and Research, Chandigarh. The study was done over a six-month period in which antimicrobial prescription for all patients admitted under urology services were monitored and followed. There were 57 cases of benign hypertrophy of the prostate, 40 of urinary calculi and 20 each of congenital malformation, malignancies, strictures and other conditions. Gentamycin and cotrimoxazole were the most frequently used antimicrobials, as calculated by the DDD/100 bed days.

Adult↗
PubMed1991

Topical corticosteroids usage in dermatology.

Prescribing of topical corticosteroids was studied in 200 patients attending the dermatology outpatients, randomly auditing the written prescriptions. Data with regard to potency, quantity, frequency, duration and site of application was collected and analyzed. Potent topical steroids were commonly used in 86 (43%) patients. The quantity of topical steroid was mentioned in only 4% patients whereas the frequency was specified in 77%, the site in 69% and the duration in 55% patients, respectively. The importance of these parameters is discussed, guidelines regarding use of topical steroids suggested.

Administration, Topical↗
PubMed1990

Human gastric alcohol dehydrogenase: its inhibition by H2-receptor antagonists, and its effect on the bioavailability of ethanol.

Two types of alcohol dehydrogenase isoenzymes (differing in their affinity for ethanol, sensitivity to 4-methylpyrazole, and electrophoretic migration) have been identified in the human stomach. At the high ethanol concentrations prevailing in the gastric lumen during alcohol consumption, the sum of their activities could account for significant oxidation of ethanol. In vitro, these activities were inhibited by cimetidine and ranitidine, but not by famotidine. In vivo, therapeutic doses of cimetidine (but not of famotidine) increased blood ethanol levels when ethanol was given orally, but not when it was given intravenously, indicating a significant contribution of the gastric ADH to the bioavailability and thereby the potential toxicity of ethanol.

Alcohol Dehydrogenase↗