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Biomedical subjects

V Anantharaman

Publications and source records attributed to V Anantharaman.

53 records · Page 3Linked to original sources
PubMed1979

Urinary excretion levels of morphine and codeine in subjects consuming medicinal preparations containing morphine or codeine and in drug abusers.

Urinary levels of morphine and codeine were studied in two groups of people: Group A--urine samples of 76 subjects receiving three different medicinal preparations containing morphine or codeine. Group B--urine samples of 67 drug abusers detected at urinary mass screening. Distinct differences in these levels were observed. In Group A, UPPER 99% Confidence limits of morphine concentrations of 2.56 microgram/ml, 2.40 microgram/ml and 2.29 microgram/ml were reached after consumption of prescribed doses of Syrup Phensedyl, Tablet Codeine Co and Kaolin et Morphine mixture respectively. In Group B, the LOWER 99% Confidence limit of morphine concentration was 3 microgram/ml. In contrast, the codeine levels obtained for both groups were similar. The clear separation of the ranges of morphine values for the two groups shows that the urinary morphine level forms a reliable index for the differentiation between these two groups.

Adolescent↗
PubMed1979

Ratios of total morphine to total codeine in urine of subjects consuming medicinal preparations containing morphine or codeine and in drug abusers.

Urinary total morphine: total codeine ratios were studied in two groups of people. Group A consisted of 76 subjects receiving three different medicinal preparations containing morphine or codeine, while Group B consisted of 33 drug abusers detected at urinary mass screening. Distinct differences in these ratios were observed. In Group A, total morphine: codeine ratios of 1:2.6 and below were obtained for subjects consuming either Tablet Codeine Co or Syrup Phensedyl. Subjects consuming Kaolin et Morphine mixture did not excrete any codeine in the urine. In Group B, total morphine: total codeine ratios of 1.9:1 and above were obtained. In addition all subjects in Group B excreted both morphine and codeine. The clear separation of the morphine: codeine ratios makes this a possible index to differentiate between these groups.

Codeine↗
PubMedDate not supplied

A proposed universal medical and public health definition of terrorism.

The lack of a universally applicable definition of terrorism has confounded the understanding of terrorism since the term was first coined in 18th Century France. Although a myriad of definitions of terrorism have been advanced over the years, virtually all of these definitions have been crisis-centered, frequently reflecting the political perspectives of those who seek to define it. In this article, we deconstruct these previously used definitions of terrorism in order to reconstruct a definition of terrorism that is consequence-centered, medically relevant, and universally harmonized. A universal medical and public health definition of terrorism will facilitate clinical and scientific research, education, and communication about terrorism-related events or disasters. We propose the following universal medical and public definition of terrorism: The intentional use of violence--real or threatened--against one or more non-combatants and/or those services essential for or protective of their health, resulting in adverse health effects in those immediately affected and their community, ranging from a loss of well-being or security to injury, illness, or death.

Crisis Intervention↗
PubMedDate not supplied

Delays in the EMS response to and the evacuation of patients in high-rise buildings in Singapore.

BACKGROUND: Singapore is a highly urbanized and cosmopolitan city situated at the crossroads of Southeast Asia. High-rise buildings and "vertical living" are common, and the city serves as a major business, financial, and industrial hub in the region. More than 80% of the population live in high-rise apartments. This poses unique problems and challenges for emergency ambulance services personnel in the access to and evacuation of patients. OBJECTIVE: To estimate the arrival-to-patient contact delay when accessing patients in high-rise buildings and evacuating them to the hospital, compared with accessing patients in ground-level premises. METHODS: This was a prospective study carried out from February 2 to March 1, 1998, for emergency calls from two of the busiest fire stations. The first 150 consecutive cases were enrolled into each of the two groups. Cases of road traffic accidents were excluded because these did not require the crew to get into a building. The times were clocked by one of the paramedics, using a stopwatch. A high-rise building was defined as one where the crew had to ascend at least one flight of stairs. A ground-level building did not involve any stair climbing. We set forth to determine whether the interval between the following was statistically significant when comparing high-rise vs ground-level premises: 1) time when the ambulance arrives at the scene (taken as the time when the driver turns the engine off) and time of arrival at the patient's side; 2) time of leaving the dwelling with the patient and time when the ambulance starts its journey to the hospital (taken as the time when the driver starts the engine). Data analysis was done with the use of SPSS, and the one-tailed unpaired Student's t-test was used for significance testing, with the alpha error rate set at 0.05. Results. One hundred fifty runs were analyzed for each group. The mean delay from arrival to patient contact was 2.49 +/- 0.98 minutes for the high-rise group compared with 1.02 +/- 1.41 minutes for the ground-level group (difference was statistically significant with 95% CI: 1.20, 1.74 minutes; p = 0.0106). The mean delays from the time of leaving the building with the patient to the time when the ambulance turned its engine on to start its journey to the hospital were 3.24 +/- 1.58 minutes and 1.27 +/- 0.71 minutes for the two groups, respectively (difference was statistically significant with 95% CI: 1.68, 2.04 minutes; p = 0.0098). CONCLUSION: There were significant delays present when accessing patients in high-rise buildings and evacuating them to the hospital. Modification to buildings and increasing public awareness and education have been suggested to help minimize these delays.

Ambulances↗
PubMedDate not supplied

Bystander cardiopulmonary resuscitation in prehospital cardiac arrest patients in Singapore.

INTRODUCTION: The chain of survival emphasizes the importance of the four links associated with survival after cardiac arrest (CA). The involvement of laypersons has been increasing over the years. They have been contributing toward "early access," "early cardiopulmonary resuscitation" (CPR), and, of late, "early defibrillation," with the advent of automated external defibrillators (AEDs). Bystander CPR rates are difficult to assess due to the lack of formal documentation. OBJECTIVE: To assess the bystander CPR rate for CA patients brought to the emergency department (ED) of an urban, tertiary teaching hospital in the central part of Singapore, over a period of 12 months. METHODS: This was a retrospective cohort study carried out from May 1, 1999, to April 30, 2000. "Bystander CPR" refers to an attempt to perform basic CPR by someone who is not part of an organized emergency response system. In general, this refers to the person who witnesses the arrest. RESULTS: There were 155 adult patients with CA who satisfied the inclusion criteria over the 12-month period. The median age was 62.1 +/- 6.4 years, and the majority of patients were brought in by ambulances (126, or 81.3%). There were 142 (91.6%) non-trauma and 13 (8.4%) trauma CAs. Most patients had the CA at home (96, or 61.9%), and the most common initial rhythm at presentation upon the arrival of the paramedics was ventricular fibrillation (VF) (50 patients, or 32.2%). The bystander CPR rate was 20.0% (i.e., 31 of the 155 patients). A total of 32 (20.6%) patients had return of spontaneous circulation (ROSC, defined as the return of a palpable pulse) and 31 (96.9%, or 31/32) of them were those who had some form of bystander CPR performed. Of these 31 who had bystander CPR, four (12.9%) were subsequently admitted to the intensive care unit (ICU), while among those who did not have bystander CPR, all had death pronounced in the ED. Of the four patients admitted to the ICU, three (3 of 4, or 75.0%; or 3 of 155 CA patients, or 1.9%) were subsequently discharged alive from the hospital. CONCLUSION: The bystander CPR rate for prehospital CA was 20.0%. About 12.9% (4 patients) of those who had bystander CPR were admitted to the ICU, compared with none from the group that did not receive any form of bystander CPR. Three patients (1.9% of all prehospital CAs) were discharged alive from the hospital.

Aged↗
PubMedDate not supplied

Emergency department organisation for disasters: a review of emergency department disaster plans in public hospitals of Singapore.

Disaster management plans of emergency departments (EDs) in four major public hospitals were reviewed. A comparison was made between these plans, and they were analyzed to gain an understanding of the differing objectives and doctrines behind the practices. These were summarized into five major management concepts, which are considered to be critical to the success of a disaster plan: 1) staff mobilization systems (cascading vs batch mobilization); 2) staff deployment systems; 3) team organization (surgeons vs residents); 4) area management (the role of the area manager); 5) casualty volume management (accommodation vs expansion vs extension concepts). The concepts derived should serve as a useful guide to the development of an ED disaster plan and potentially influence how new ED facilities could be planned.

Disaster Planning↗
PubMedDate not supplied

Effects of ethanol and methanol on spontaneous electromyographic signals and neuromuscular latency.

The effect of alcohols (ethanol and methanol) on rat electromyogram (E.M.G.) and neuromuscular latency were studied in thiopentone anesthetized albino rats. Both alcohols were given intraperitoneally (100 mg/100 g of body weight) to the respective groups and the controls received saline. Electromyographic signals were recorded from gastrocnemius muscle. For latency studies both the alcohols were given intravenously (iv) at a dose of 20 mg/100 g of body weight, and response to in situ sciatic nerve stimulation was studied before and after alcohol administration. Our results show that both ethanol and methanol induce spontaneous electromyographic signals and in addition produce changes in the latent period and the amplitude of the response.

Animals↗
PubMedDate not supplied

Influence of age on residual latency.

From the conduction studies of ulnar nerve on normal individuals of different age groups and sexes the residual latencies were determined. The age has no influence on the residual latency. But the values of residual latency decreased significantly in the case of females as compared with males.

Adolescent↗