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Biomedical subjects

S Lal

Publications and source records attributed to S Lal.

At least 379 records · Page 21Linked to original sources

Outpatient termination of pregnancy.

Termination of pregnancies ranging from 6 to 10 weeks' gestation is described in 127 women who attended the hospital as outpatients. The technique employed was to aspirate the products of conception through a narrow plastic tube using a high negative pressure. Infiltration of the cervix with local anaesthetic proved so effective that the procedure could be carried out on the fully conscious patient. The short time taken to evacuate the uterus, the small blood loss, and the low incidence of complications in the latter part of the study suggest that the technique is a valuable procedure. Relatively more women can be terminated as outpatients than as inpatients with a corresponding reduction in the demands made on gynaecological beds.

Abortion, Legal↗

Acute brucellosis treated with trimethoprim and sulphamethoxazole.

Four patients with acute brucellosis are described, none of whom had any connexion with farming or milk industry, the source of infection being different in each case. The diagnosis was made by serological tests, and in three of the four cases was confirmed by positive cultures from bone marrow (one case) and liver biopsy (two cases). Treatment with the combination of trimethoprim/sulphamethoxazole was successful in three out of four cases, and in the fourth case failure may have been due to the development of trimethoprim resistance.

Acute Disease↗

Haemodynamic effects of glucagon.

The central and peripheral vascular haemodynamic effects of glucagon were studied in 29 patients. With a single dose method of 2 or 5 mg. glucagon intravenously the inotropic action of the drug produced immediate increased myocardial contractility with significant increase in cardiac output and enhanced cardiac performance, and lowering of pulmonary arterial pressure and pulmonary vascular resistance. No primary peripheral vascular effect was evident, and the increased systemic pressure and lowered systemic resistance appear to be secondary to the central action of the drug. With the dosage used there were no undesirable side-effects apart from a feeling of slight nausea. Though the haemodynamic effects are abrupt, reaching their maximum values in the first 10 minutes after injection, they tend to be dissipated within half an hour, presumably due to the very rapid destruction of the drug. Repeated booster doses rather than continuous infusion may be the method of choice to maintain an increased cardiac output. The positive chronotropic action of the drug may cause transient palpitations. Glucagon increased the cardiac output in the acute phase of myocardial infarction by 42 per cent. The haemodynamic effects in chronic rheumatic heart disease are more varied, and it may increase left atrial pressure in mitral stenosis, which is undesirable. Hyperglycaemia results from liver glycogenolysis but blood sugar levels rarely exceeded 200 mg./100 ml. These results warrant further study of the value of glucagon as a positive inotropic agent in low output heart failure, especially in acute myocardial infarction with cardiogenic shock, or after cardiac surgery, or in unrelieved chronic congestive heart failure.

Acute Disease↗