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Biomedical subjects

S Nundy

Publications and source records attributed to S Nundy.

At least 55 records · Page 3Linked to original sources

Indian medicine.

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Education, Medical↗

Subclinical encephalopathy after portosystemic shunts in patients with non-cirrhotic portal fibrosis.

Cerebral function was studied in patients with non-cirrhotic portal fibrosis who had no clinically detectable neurological abnormality, 14 before and 29 after a proximal lienorenal shunt operation. In each patient electroencephalography (EEG) and psychometric tests (the number connection test, construction of a five-pointed star and the reverse counting test) were performed. Psychometric tests were also done in an equal number of matched, healthy controls. Subclinical encephalopathy was diagnosed when any of these tests was abnormal. In the unoperated group the EEG was normal in all patients and there was no difference in the psychometric test results between patients and healthy controls. After portosystemic shunt operations, the EEG was abnormal in 10%, the number connection test in 38%, construction of a five-pointed star in 19% and the reverse counting test in 30% of the patients. Detection of subclinical hepatic encephalopathy in such a high proportion of operated patients with non-cirrhotic portal fibrosis suggests that the surgical procedure and its haemodynamic consequences per se could have been responsible.

Adolescent↗

Effect of tea on gastric acid secretion.

The gastric acid response to a 200-ml cup of tea was measured by in situ titration in 36 patients with duodenal ulcer (DU) and 56 without duodenal ulcer (controls). Tea resulted in an acid secretory response which was almost equal to that after a maximal dose (0.04 mg/kg) of histamine. The effect of tea was mainly due to its local chemical action on gastric mucosa. Tea without milk and sugar resulted in an acid response higher than that evoked by a maximal dose of histamine. The concentration of tea brew that had the greatest effect on gastric acid secretion was 15 g/200 ml, which was three times as much as that in a palatable cup of tea. Tea is a potent stimulant of gastric acid, and this can be reduced by adding milk and sugar.

Adolescent↗

Mastication and acid secretion.

The gastric acid response and the buffer capacity of the stomach were measured in 30 control subjects and 22 duodenal ulcer patients in response to a masticatory (solid) and a non-masticatory (homogenized) meal having the same chemical composition. The peak acid output values were equal after a masticatory and after a non-masticatory diet in control subjects (masticatory 18.1 +/- 1.2, non-masticatory 15.7 +/- 1.3 mmol/hr) as well as in duodenal ulcer patients (masticatory 35.7 +/- 1.5, non-masticatory 33.7 +/- 1.1 mmol/hr). The buffer capacity of the stomach contents 1 hr after the meal was significantly greater after a masticatory diet than a non-masticatory diet in both controls (14.6 +/- 1.4 and 9.0 +/- 1.9 mmol) and in duodenal ulcer patients (9.5 +/- 1.5 and 7.5 +/- 1.2 mmol). Duodenal ulcer patients had a significantly lower buffer capacity compared with controls. Masticatory diets may play a part in protecting individuals from developing duodenal ulcer.

Adult↗

Noradrenaline in upper gastrointestinal haemorrhage. A prospective, randomized, double blind controlled clinical trial.

The effect of noradrenaline (8 mg in 100 ml cold saline) gastric lavage was compared with that of cold saline alone in 42 patients with upper gastrointestinal haemorrhage in a prospective, randomized, double blind study. Fifty three per cent (11/21) of the patients given noradrenaline stopped bleeding within two hours of treatment compared with 14% (3/21) of those given saline alone. We suggest that noradrenaline gastric lavage is a simple, safe and effective method for controlling upper gastrointestinal haemorrhage and could be used with advantage in peripheral hospitals in tropical countries.

Adolescent↗

Balloon tamponade in the management of bleeding oesophageal varices.

Sixty-three patients with acute variceal haemorrhage were treated with the Sengstaken-Blakemore tube (SBT). Bleeding was initially controlled with the gastric balloon in 37 patients (60%) and with both gastric and oesophageal balloons in another 17 (27%), giving overall primary success in 54 patients (87%). Sixteen (26%) patients re-bled within 24 hours of deflation of the tube. Repeat balloon tamponade helped in controlling bleeding in 9 of these. Thus, a total of 47 (75%) patients stopped bleeding with SBT. There was no mortality. The only major complication was pulmonary infection (15%), which improved with antibiotics. Use of the SBT was found to be simple, quick, low cost and attended with few complications. Its use is recommended in patients with acute variceal bleeding, especially in developing countries with limited resources.

Esophageal and Gastric Varices↗

The causes, management and outcome of upper gastrointestinal haemorrhage in an Indian hospital.

Four hundred and eight consecutive patients with upper gastrointestinal haemorrhage, admitted to a large hospital in India over the 5-year period 1976-81, were studied prospectively. The mean age was 41 years, the male: female ratio was 3: 1, causes of bleeding were oesophageal varices in 45.5 per cent, duodenal ulcer in 25 per cent, gastric ulcer in 5 per cent and gastritis in 8.5 per cent. One hundred and twelve patients had operations with on overall mortality of 20 (18 per cent). Thirty-three (11 per cent) of the unoperated patients died. Eighty-seven per cent of patients left hospital alive and 76 per cent returned to their former way of life. Patients with upper gastrointestinal bleeding in North India are mainly young males, nearly half bleeding from oesophageal varices, and have a moderately good prognosis.

Adolescent↗