A supraglottic oropharyngeal airway.
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Airway Obstruction↗
Biomedical subjects
S Mehta
Publications and source records attributed to S Mehta.
Rifampicin-induced upper gastrointestinal bleeding.
Gastrointestinal disturbances like anorexia, nausea, vomiting, abdominal discomfort and diarrhoea are known adverse effects of rifampicin. We report an upper gastrointestinal bleeding due to haemorrhagic gastric erosions after ingestion of rifampicin for pulmonary tuberculosis. The cause and effect relationship between development of haemorrhagic gastric erosions and rifampicin administration was confirmed by rechallenge with rifampicin. To our knowledge no such adverse effect of rifampicin has been reported previously.
Child↗
Malnutrition and drugs: clinical implications.
Elimination kinetics determined by a timed plasma concentration curve on chloramphenicol, antipyrine, acetaminophen and sulphadiazine showed that plasma half-life was increased and elimination rate constant was diminished in malnourished children compared to those with normal nutrition. Area under the curve (AUC) was increased. Decreased urinary excretion of metabolites of chloramphenicol and sulphadiazine in malnourished children suggested an alteration in biotransformation. These findings were supported by a significant increase in steady-state levels of chloramphenicol and phenobarbitone in malnourished patients receiving drugs for therapy. In a subhuman primate animal model (young rhesus monkey) which was akin to the human situation both for protein energy malnutrition and for drug pharmacokinetics it was observed that hepatic aminopyrine demethylase and chloramphenicol glucuronyl transferase activity was diminished. Thus drugs metabolised by the liver apparently clear at a slower pace in malnourished children. Therapy needs to be modified appropriately to achieve therapeutic response and avoid toxicity. Hepatotoxicity monitoring of antitubercular therapy with isoniazid and rifampicin was found to be 3 times higher in malnourished children. The acetylator status of the child did not correlate with hepatotoxicity. The majority of the children were slow acetylators. AUC of isoniazid was higher in malnourished children.
Animals↗
Clinical dysautonomia in patients with bronchial asthma. Study with seven autonomic function tests.
Fifty asthmatic patients and 20 healthy control subjects, carefully age- and sex-matched, were subjected to seven standardized tests to evaluate their autonomic status. Due care was taken to remove factors which could interfere with results. Of the tests concerned with the parasympathetic system, the intravenous atropine test (p greater than 0.10) and heart rate response to standing (p greater than 0.01) which measured the basal parasympathetic tone, did not show a significant difference. Tests requiring stimulation of the parasympathetic system, ie, deep breathing test (p less than 0.001), Valsalva maneuver (p less than 0.001), and carotid sinus massage (p less than 0.001) showed significantly heightened response. Postural fall of blood pressure (p greater than 0.10) and sustained hand grip test (p greater than 0.10), chiefly concerned with the sympathetic system, did not show a significant difference. Of the 50 asthmatic patients, nine were atopic and 41 nonatopic. When the results were compared in the two groups separately, we found that there was no alteration in the measurements except the intravenous atropine test which showed heightened response with atopic subjects (p less than 0.05). These results suggest that hyperresponsiveness of the parasympathetic system is an important factor in producing bronchial spasm in asthmatic patients, and atopic and nonatopic subjects do not differ much in their autonomic status.
Adolescent↗
Chondrosarcoma of the head in children.
Chondrosarcoma usually manifests in adult and elderly patients and involves primarily the long bones of the extremities and the osseous pelvis. Children and adolescents may be affected, however. In the young, these neoplasms tend to grow in atypical anatomic sites. A review of clinical experience at a pediatric institution disclosed three chondrosarcomas, including one of mesenchymal type, arising in tissues of the head in patients aged 15, 9, and 13 years. From a review of the pertinent literature as well as clinical experience, it appears that pediatric pathologists are apt to encounter chondrosarcomas rarely, and in those cases the clinical and pathologic features are at variance with those described for chondrosarcoma in adult patients. Low-grade lesions may pursue an indolent course, necessitating prolonged surveillance.
Adolescent↗
Cardiovascular response to dynamic treadmill exercise in patients with essential hypertension before and after therapy with atenolol or captopril.
Thirty eight patients with essential hypertension and 20 healthy volunteers were subjected to treadmill exercise test. The hypertensives were then controlled with atenolol or captopril by randomly forming two groups of 19 patients each, and treadmill evaluation was repeated. The resting rate-pressure product (RPP) and myocardial oxygen consumption (MVO2), as well as peak RPP and MVO2 and recovery time, were increased and exercise duration decreased significantly in uncontrolled hypertensives (p less than 0.001). Control of hypertension resulted in significant improvement of exercise performance in both the groups. Atenolol, when compared to captopril, resulted in better exercise conditioning with considerable lowering of resting and peak RPP and MVO2 (p less than 0.001), though the difference in exercise duration, maximum work load and recovery time were not significant (p greater than 0.05). Thus, where myocardial oxygen consumption is an important consideration while treating hypertension, atenolol offers a better choice.
Adult↗
Physical growth in school girls: relationship to socio-economic status and dietary intake--II.
Growth of 955 healthy normal girls between ages 5-16 years was measured with a mixed-longitudinal design to observe variations due to socio-economic status and the dietary intake. Five hundred and thirteen girls belonged to upper socio-economic status (USES) and 442 girls to lower SES. The 24 hours diet-intake of each girl was recorded by 24 hour-recall method. The LSES girls were significantly smaller in every physical measurements compared to USES girls. Annual mean increments for the linear and circumferential measurements were also lower among LSES girls till the peak velocity was attained. The mean increments for triceps were also lower in LSES for all ages. The girls on inadequate calories were significantly smaller in their growth than who consumed adequate or more than adequate calories. The effect of protein was less evident. A higher percentage of LSES girls (91.2%) consumed inadequate calories than those of USES girls 38.2%). The present study thus established that SES and dietary intake had significant bearing on the physical growth of the pre-adolescent and adolescent girls.
Adolescent↗
Evaluation of anthropometric indices for the assessment of nutritional status in girls--III.
Total subjects were regrouped into three, based on the growth velocity indicating pre-adolescent, adolescent and post-adolescent stages. Three nutritional indices based on 4 body measurements (weight, height, triceps, midarm circumference) were calculated for each subject. It was found that the energy protein index was the only reliable and suitable index for evaluating the nutritional level of adolescents and post-adolescents while weight/height2 and arm circumference were more suitable for determining the nutritional status of pre-adolescent girls.
Adolescent↗
Acquired haemophilia.
Two cases of acquired haemophilia A are described. Neither had history of excessive bleeding in the past following operative procedures and both presented with spontaneous bruising as a result of F. VIII:C deficiency due to production of anti-F. VIII:C antibodies. The antibody titre of one case remained unchanged after 4 weeks of therapy with prednisolone and cyclophosphamide. No attempt was made to treat the second case as the antibody titre was very high.
Aged↗
Molecular epidemiology of human rotavirus infections in Chandigarh (India).
Molecular epidemiology of rotavirus infections was studied in children with acute gastroenteritis attending the Nehru Hospital, Chandigarh. A total of 87 stool samples were studied for RNA migration pattern by polyacrylamide gel electropherosis. Only 33 strains could be electropherotyped and two different RNA types 'Short' and 'Long' were observed. Fifteen had a Short RNA pattern and 18 had a Long RNA pattern. There were no intergenomic variations between the Short or Long RNA types. On analysis of subgroup specificity by ELISA using monoclonal antibodies, all Long strains belonged to subgroup 2 and all Short strains to subgroup 1. Our results show that only two electropherotypes were prevalent in the area studied and during a particular peak of infection, only one electropherotype was predominant.
Acute Disease↗
The effect of gold sodium thiomalate and its constituent part, thiomalate, on the virus titres and the lysosomal enzyme activity in peritoneal macrophages of Swiss/A2G mice infected with the avirulent strain of Semliki Forest virus.
Treatment of adult mice with gold sodium thiomalate made the normally non-lethal Semliki Forest virus infection lethal. Associated with this was a significant increase in brain virus titre and a depression of peritoneal macrophage lysosomal enzyme activity. In contrast, treatment of adult mice with the constituent part, thiomalate, did not make the non-lethal Semliki Forest virus infection lethal. Brain virus titre and peritoneal macrophage lysosomal enzyme activity were comparable to the controls. The mechanism by which gold sodium thiomalate increases the virulence of Semliki Forest virus is discussed.
Acid Phosphatase↗
Synovial sarcoma of the nasopharynx.
A case of primary synovial sarcoma of the nasopharynx in a 28-year-old man is presented. The patient was treated with operation followed by radiotherapy and is free of recurrence or evidence of metastasis 40 months after treatment. Because of the extreme rarity of this tumor in this site, the importance of its recognition is stressed.
Adult↗
Juvenile polyposis coli: a management problem.
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Adenomatous Polyposis Coli↗
Enteric infections and persistent diarrhea in developing countries.
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Child, Preschool↗
Management of foreign bodies in the upper gastrointestinal tract.
Records of 55 consecutive patients who had ingested foreign bodies were reviewed retrospectively. Foreign bodies were located in the esophagus, stomach and duodenum in 25, 27 and 3 patients respectively. Eleven of these passed through the entire gastrointestinal tract spontaneously and uneventfully. Endoscopic extraction was successful in 36 patients while 8 needed surgical removal of the ingested object. Only one death was encountered. We conclude that using simple guidelines, foreign body ingestion can be managed with a low incidence of complications and mortality.
Adolescent↗
Gastrointestinal bleeding in malaria.
Hematological alterations are frequent in patients with malaria. However, these rarely manifest clinically, except for symptoms due to anemia. Two cases with gastrointestinal hemorrhage as a complication of malaria are reported.
Animals↗
A mixed longitudinal study of physical growth in girls--I.
A total of 492 apparently normal healthy Punjabi girls belonging to upper socio-economic status between 5-15 years of age were selected from the schools for the study of physical growth. Twenty one measurements were made on each girl. Girls below the age of 13 years were examined five times at interval of six months each. Beyond 13 years, only those girls who had not attained menarche, were followed-up 6 monthly. The linear and circumferential measurements followed similar pattern while skinfold thicknesses showed different pattern. Each linear and circumferential measurement and weight increased progressively from age 5 to 15 years. Annual growth gain per year was slow upto 9/10 years followed by a rapid growth with a peak velocity between 11-13 years of age. Thereafter, growth rate declined. The skin-fold thicknesses showed decrease in absolute values upto 10 years of age. Beyond 13 years of age, these increased rapidly. However, no peak velocity in either of the skinfold was detected. Thus, three periods of growth rate, viz., preadolescent (age 5-9 years); adolescent (10-13 years) and post adolescent (beyond 13 years) could be identified.
Adolescent↗