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Biomedical subjects

S Balakrishnan

Publications and source records attributed to S Balakrishnan.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Ischemic steal syndrome: a case series and review of current management.

BACKGROUND: Currently over 5000 patients are receiving hemodialysis in Australia, which is an increase by approximately 7% each year. Distal ischemia secondary to the steal syndrome (ISS) is an uncommon but recognized complication. Several methods are now available to manage this problem including ligation, banding, and distal revascularization with interval ligation (DRIL). The aim of this report is to review the experience of the authors on this complication and its management at Royal Perth Hospital. METHODS: The Vascular Physiology Laboratory Database was used to identify those patients referred for investigation of ISS. Data were collected retrospectively from these patients' files concerning their demographics, graft particulars, and type of interventional procedure. Patients were then recalled to assess long-term patency and current venous access and for postoperative vascular studies. RESULTS: Eighteen people were identified with ischemic symptoms. The mean age was 66 (range, 44 to 82). Fourteen (77.8%) were men, and 15 (83.3%) were diabetic. Renal failure was secondary to diabetes in 8 patients, hypertension in 3, and a combination of both in 7 patients. Intervention was via the DRIL procedure in 12, ligation in 5, and banding in 1. One patient underwent angioplasty of the ulnar artery before DRIL. At follow-up (between 1 and 12 months), all DRIL bypass were patents. The 5 ligated patients all improved, and the patient who underwent banding thrombosed their graft. CONCLUSION: The DRIL procedure should be considered the standard operation to manage ISS in that it manages the ischemia while maintaining the functional fistula. It is, however, still necessary to ligate some fistulae and seek alternative access. There are still no preoperative indicators as to who will suffer ISS.

Adult↗
PubMedDate not supplied

Anticonvulsant and psychomotor activity of nitrendipine alone and in combination with phenytoin and valproate in rats.

The effect of nitrendipine (NTP) alone and in combination with phenytoin (PHT) and valproate (VPA) against maximal electroshock seizures (MES) was studied in rats. In addition, the psychomotor effects of NTP alone and in combination with PHT and VPA were evaluated using the following tests: a) rotarod performance; b) spontaneous motor activity; c) despair behavior; d) righting reflex; e) hole board test; and f) passive avoidance test. ED50 values of PHT, VPA and NTP were 13,255 and 3.6 mg/kg, respectively. When NTP was combined with PHT or VPA, the ED50 values decreased to 0.9 and 226 mg/kg, respectively. In the psychomotor function tests, for the same degree of protection (50%) afforded against MES, PHT or VPA produced a greater impairment in all the parameters compared to NTP alone or a combination of NTP with PHT or VPA. Furthermore, NTP reversed the depression and long-term memory loss induced by PHT and VPA. Thus, NTP was effective against MES in rats, potentiating the anti-electroshock activity of PHT and VPA and producing less impairment of psychomotor activity. Thus, the agent can be considered a potential antiepileptic warranting further studies.

Animals↗
PubMedDate not supplied

Idiopathic hypothalamic dysfunction with precocious puberty and adipsic hypernatremia first presenting in adolescence.

BACKGROUND: Idiopathic hypothalamic dysfunction is a rare syndrome that has been described in young children. This syndrome is characterized by a disturbance of thirst regulation with hypernatremia, hyperosmolarity, and altered hypothalamic function. PATIENT REPORT: At age 6 years the reported patients presented with precocious puberty, by age 12 years she had hypernatremia presumed secondary to central diabetes insipidus and was treated with DDAVP, and at age 14 was identified to have hyperprolactinemia. At age 19 she presented with serum sodium of 185 mg/dl during an episode of illness associated with dehydration. After hydration, her sodium remained elevated. Arginine vasopressin was measurable but inappropriate to serum sodium, while urinary cyclic AMP response to vasopressin was appropriate. CONCLUSIONS: This is the first case of precocious puberty identified in association with the more classic features of idiopathic hypothalamic dysfunction, including later-onset hypernatremia, poor thermoregulatory function, obesity, and hyperprolactinemia.

Arginine Vasopressin↗
PubMedDate not supplied

Restoration of plantar sweat secretion in the feet of leprosy patients.

As part of the studies on nerve damage and its consequences in leprosy, the status of sweat gland function in the anaesthetic sole of the feet of leprosy patients was investigated qualitatively and semi-quantitatively, before and after surgical decompression of the posterior tibial neurovascular bundle. Sweat prints of the feet of the patients were obtained pre-operatively and postoperatively on Whatman's No. 1 filter paper. The paper was treated with one percent Ninhydrin and the intensities of the Ninhydrin positive areas were quantitated. Forty one feet of thirty six patients have been studied in this manner. Sweat print analysis of twenty normal people have also been done, and included for comparison. This operative procedure has been found to effect an improvement in the sweat gland function in the feet of more than fifty percent of leprosy patients studied so far.

Foot↗
PubMedDate not supplied

Implementation of tests for monitoring drug compliance of leprosy out-patients under multi-drug therapy.

The field workers of two MDT districts (Srikakulam in Andhra Pradesh and Ganjam in Orissa) were trained for implementation of 'Paper Spot Test together with Pill/Capsule count methods' of monitoring the treatment compliance of leprosy out-patients receiving MDT. All the workers recognized the importance of implementing these methods and found them operationally feasible, in field. Of the 672 Paucibacillary and 749 multibacillary cases monitored for drug compliance, 85-88% cases showed regular compliance (more than 75% drug intake) to dapsone. The compliance to Clofazimine among Multibacillary cases was better (94% regular) than dapsone compliance. Both these monitoring methods are advocated to be used on larger scale under our National Leprosy Eradication Programme.

Clofazimine↗
PubMedDate not supplied

Blood dapsone levels in leprosy patients treated with acedapsone.

The metabolism of the repository drug acedapsone (DADDS,4,4'-diacetyldiaminodiphenyl sulfone) was studied in 15 individuals receiving 225 mg of DADDS, intramuscularly for a period of 75 days. Plasma levels of DDS were determined on the 2nd, 7th, 15th, 30th, 60th and 75th day after administration of the drug by spectrophoto-fluorometric technique. The mean peak levels of DDS (85.36 ng/ml) were noticed on 7th day followed by a gradual decrease in DDS concentration. The mean half-life level (44.53 ng/ml) of DDS were observed around the 15th day. The mean DDS level for the entire period of observation after one dose was 41.95 ng/ml. On the 75th day, the DDS level reached the minimum value of 14.76 ng/ml which was still about 5 times more than the minimal inhibitory concentration (MIC) level of DDS against M. leprae (3 ng/ml). The results are discussed.

Acedapsone↗
PubMedDate not supplied

Thyroglobulin autoantibodies in leprosy.

Two hundred and five sera from lepromatous leprosy patients were tested for the presence of thyroglobulin autoantibodies using tanned red cell haemagglutination technique. Six out of 182 sera from LL patients and 5 out of 23 sera from LL patients with ENL gave a positive reaction for thyroglobulin autoantibodies.

Autoantibodies↗