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Biomedical subjects

S Vaidyanathan

Publications and source records attributed to S Vaidyanathan.

At least 181 records · Page 10Linked to original sources
PubMed1983

Modulation of urinary bladder function with thyrotropin-releasing hormone in patients with spinal cord injuries during the spinal shock phase.

Injury to the spinal cord is associated with large increases in plasma beta-endorphin immunoreactivity. To investigate the effect on vesical function of thyrotropin-releasing hormone (TRH), 13 patients with spinal injury were studied during the spinal shock phase. In seven of them (Group A), after basal cystometry together with anal sphincter electromyography (EMG), 1 mg of TRH was administered intravenously as a bolus dose, followed by 1 mg infused over 5 minutes. After the administration of the bolus dose of TRH, cystometry + EMG was repeated (Study I). These seven cases received TRH 1 mg intravenously 12 hourly for the next three days. On day 4, after basal cystometry + EMG, TRH was administered as above and the urodynamic study was repeated (Study II). Detrusor pressure (Pdct) with bladder filled to 800 ml (or upto tolerance) and bladder compliance were noted. Six cases underwent study I alone and received normal saline instead of TRH (Group B). After TRH in group A, the mean (+/- SE) Pdct increased by 10 +/- 3 cm H2O (p less than 0.05) in study I and by 10 +/- 3 cm H2O (p less than 0.05) in study II whereas the mean compliance decreased by 37 +/- 20 ml/cm H2O (NS) in study I and by 44 +/- 18 ml/cm H2O (p less than 0.05) in study II. In group B, the mean Pdct decreased by 1 +/- 2 cm H2O (NS) and the mean compliance increased by 1 +/- 2 ml/cm H2O (NS) in the post-normal saline study. These results show that TRH may improve bladder function in patients with injury-induced spinal shock by increasing detrusor pressure and by decreasing bladder compliance.

Adult↗
PubMed1982

A modulation of vesicourethral function with naloxone in traumatic paraplegics during the spinal shock phase: preliminary report.

Experimental studies have suggested that endorphins released in response to spinal injury might play a part in the pathogenesis of spinal shock and that an interaction might occur between the endorphin systems and central parasympathetic centres in such circumstances. To investigate the role of endorphins in the causation of detrusor areflexia during spinal shock, the effect of intravenous administration of 10 mg of naloxone upon vesicourethral function was studied in eight traumatic paraplegics during the spinal shock phase. Naloxone caused a significant rise in detrusor pressure during bladder distension in the post-naloxone cystometrogram. The compliance decreased in six patients. Voiding occurred in one patient although it was transient and did not result in complete emptying of the bladder. An increase in the sphincter electromyographic activity in response to bulbocavernosus stimulation was observed after naloxone in three patients. In conclusion, the significant increase observed in detrusor pressure in traumatic paraplegics during the spinal shock phase subsequent to naloxone (10 mg intravenously) provides evidence for the role of endorphins in the causation of detrusor areflexia in spinal shock.

Adult↗
PubMed1981

Operative management problems in nephrobronchial fistula.

During left subcapsular nephrectomy in a patient with nephrobronchial fistula, the purulent material entered the bronchial tree through the fistulous tracts and flooded the dependent right lung. Patchy atelectasis and later massive consolidation of the lower lobe of the right lung ensued ultimately causing her death. A plea is made to use double-lumen endobronchial tubes for anesthesia to prevent such spillover of purulent secretions to the contralateral lung from the kidney. The fistulous tracts should be divided as the first step during surgery, before mobilization of the kidney. In a suspected case, retrograde pyelography should be done preferably under local or regional anesthesia, so that the patient could cough out the contrast material and purulent secretion that might enter the bronchial tree under pressure during the procedure.

Adult↗
PubMed1981

Enhancement of detrusor reflex activity by naloxone in patients with chronic neurogenic bladder dysfunction. Preliminary report.

An intravenous injection of 0.4 mg. naloxone enhanced detrusor reflex activity in 5 patients with chronic neurogenic bladder dysfunction caused by incomplete suprasacral spinal lesions. The intravesical volume at which detrusor reflex occurred showed a decrease from 498.2 to 346.2 ml. The naloxone-induced effect was short-lived, being absent 1 hour after the injection. In the same dosage naloxone did not induce detrusor reflex in 2 patients with areflexic bladder caused by complete suprasacral spinal lesions.

Adolescent↗
PubMed1981

Clinical import of serotonin activity in the bladder and urethra.

It has been observed in animal studies that 5-hydroxytryptamine produces bladder contractions. The role of 5-hydroxytryptamine in human vesicourethral function was studied by administering 75 mg. clomipramine daily for 4 days to 8 patients with neurogenic bladder dysfunction. Clomipramine inhibits the uptake of serotonin into 5-hydroxytryptamine containing presynaptic nerve endings and, thus, makes more neurotransmitter available to the postsynaptic site. The intravesical volume, at which first detrusor reflex activity was observed, showed a decrease from 329.5 to 178.5 ml. after clomipramine therapy. The residual urine also decreased from 111.25 to 30.0 ml. No side effect was observed. Further investigations involving a larger number of patients are indicated to study the possible use of serotonin activity in the bladder for promoting bladder emptying.

Adolescent↗
PubMed1981

Creation of caverno-glandular shunt for treatment of priapism.

Caverno-glandular shunt was performed in 8 patients with priapism during the past 3 years. Complete and sustained detumescence was achieved immediately in all patients. Only one case developed a complication, viz. cavernositis which responded to antibiotic administration systemically as well as locally. This procedure was performed under local anaesthesia in 5 patients. The technical details and advantages of this procedure over conventional operations for priapism are discussed.

Adult↗
PubMed1980

Ureterocalycostomy for postpyelolithotomy stenosis after failure of intubated infundibuloplasty.

Extended pyelolithotomy for staghorn calculus in a uremic patient with solitary functioning kidney was followed by development of stenosis of the infundibulum draining the superior and middle calyces. Drainage of the lower calyx down the ureter remained intact. Intubated infundibuloplasty proved unsuccessful since scarring and occlusion promptly recurred. Anastomosis of the middle calyx to the ureter was then performed with good results. We believe this is the first reported case of ureterocalycostomy for providing drainage to the middle calyx without lower polar nephrectomy.

Adult↗
PubMed1980

Peripelvic extravasation and formation of perinephric urinoma after cystoscopy.

A hitherto undescribed complication of cystoscopy is reported wherein peripelvic extravasation and perinephric collection of urine resulted from conventional cystoscopic examination in a patient with a small-capacity bladder and vesicoureteral reflux. Prompt recognition, institution of indwelling catheter drainage, and massive antibiotic therapy led to spontaneous resolution of the flank mass. In similar cases, we suggest the use of an Iglesias resectoscope with a continuous flow and suction evacuation, even for cystoscopy and bladder biopsy.

Contrast Media↗