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Biomedical subjects

S Mehta

Publications and source records attributed to S Mehta.

587 records · Page 33Linked to original sources

Nalbuphine pretreatment in cesarean section patients receiving epidural morphine.

A double-blind, placebo-controlled study of 60 patients post cesarean delivery was conducted to determine whether nalbuphine reverses the side effects of pruritus and respiratory depression associated with epidurally administered morphine. Patients randomly received either three doses of intravenous nalbuphine or the equivalent volume of saline. Vital signs, sedation, pain, pruritus and oxygen saturation were assessed hourly for 18 hours. There were no statistically significant differences in demographic data, sedation level, pain scores or analgesia requirements. Only three patients had no pruritus, one who received nalbuphine and two who received saline. Five patients had respiratory depression (respiratory rate lower than 10 BPM or oxygen saturation less than 90%); three occurred in the nalbuphine group and two in the saline group. Although theoretically advantageous, nalbuphine, as administered in this study of obstetric patients, offered no prophylactic benefit against the pruritus associated with epidural morphine. Its benefit with regard to respiratory depression remains unclear.

Adult↗

Cardiovascular dysautonomia in patients with lepromatous leprosy.

Autonomic functions were studied by six standard tests in 65 patients with lepromatous leprosy and 25 healthy controls. Dysautonomia was observed in 22 patients, all having the disease for more than five years. Associated peripheral neuropathy, judged clinically, was present in all, except one patient. Of the 22 dysautonomic patients, 9 each had mild or moderate dysantonomia and 4 had severe dysautonomia as per the scoring schedule devised by us. Syncope, gustatory sweating and impotence were the symptoms suggestive of dysautonomia. But not all affected patients reported these symptoms. Involvement of the sympathetic system was more frequent than that of the parasympathetic system. Statistically significant abnormality was seen with Atropine ratio, standing 30:15 beat ratio, postural hypotension and sustained hand grip test. Sustained hand grip test was the one which consistently gave abnormal results in all the 22 dysautonomic patients.

Adult↗

Immunological reaction of the demyelinating Semliki Forest virus with immune serum to glycolipids and its possible importance to central nervous system viral auto-immune disease.

The avirulent demyelinating strain A7(74) of Semliki Forest virus after passage through mouse brain in vivo and mouse brain cell cultures has been shown to react immunologically with immune sera against galactocerebroside, glucocerebroside, total ganglioside and GT1b ganglioside but not against myelin or sulphatide . Semliki Forest virus is known to take host membrane glycolipid into its coat. The importance of the findings is discussed in relation to the production of a possible anti-brain cell auto-immune phenomenon and its implication in a disease such as multiple sclerosis.

Animals↗

PTCA, thrombolysis or atherectomy: rational treatment of recently occluded saphenous vein grafts.

Recently occluded saphenous vein grafts (SVG) contain abundant thrombus. Distal embolization and myocardial infarction often occur when recanalization of such SVG is attempted. In 80 patients with occluded SVG, we employed transcatheter devices to lyse, compress or extract thrombus. Primary treatment for these SVG was performed in the following manner; PTCA 29, intragraft urokinase 12, TEC atherectomy 39. Following urokinase or atherectomy, adjunctive PTCA was performed to diminish the residual stenosis. All patients had class III or IV angina. Clinically, SVG occlusions were 3 days to 3 months old. TIMI flow was grade 0, and occlusion length was greater than 6 cm for all SVG. Each strategy resulted in a similar procedure success rate. However, when used as a primary treatment, TEC may be associated with lower rates of distal embolization and myocardial infarction.

Angioplasty, Balloon, Coronary↗