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Biomedical subjects

V J Sarma

Publications and source records attributed to V J Sarma.

12 recordsLinked to original sources
PubMed1992

Use of ketamine in acute severe asthma.

Two patients with acute severe asthma, who failed to respond to conventional therapy, were given intravenous ketamine in sub-anaesthetic doses with good results. A bolus dose of 0.75 mg/kg was followed by the same dose over 10 min with relief of bronchospasm in both cases. An infusion of ketamine at a rate of 0.15 mg/kg/h was used in each case to prevent recurrence of bronchospasm. Intravenous ketamine can be used to relieve acute intractable bronchospasm provided expert anaesthetic help is at hand. A review of the literature concerning its use in such situations is also presented.

Adult↗
PubMed1991

Detection of interferon-gamma mRNA in psoriatic epidermis by polymerase chain reaction.

Psoriatic skin lesions contain HLA-DR positive T lymphocytes, and other activation antigens, which suggest that the T cells may be producing lymphokines. Gamma interferon is produced by activated T cells, and its presence in psoriasis has been inferred by the lesional keratinocyte expression of 3 gamma interferon-inducible proteins i.e. HLA-DR, intercellular adhesion molecule-1, and gamma-IP-10. To determine whether gamma interferon is being produced directly in psoriatic lesions, punch biopsies of normal and diseased skin were separated into epidermal sheets and dermal fragments. Total cellular RNA was isolated from each epidermal and dermal compartment, and reverse transcribed followed by amplification of the resultant DNA by polymerase chain reaction. The amplification process involved the use of 5' and 3' primers for gamma interferon, and tumor necrosis factor-alpha, with beta-actin serving as a control. Gamma interferon mRNA, but not tumor necrosis factor alpha mRNA, was detectable in 4 of 5 psoriatic epidermal specimens. Neither mRNA was detectable in any normal skin dermal/epidermal specimens. Gamma interferon mRNA was also detectable in a single psoriatic dermal specimen. If reverse transcriptase was omitted, no polymerase chain reaction products were detected, indicating that the fragments detected were not derived from contaminating genomic DNA. These results indicate that gamma interferon mRNA can be extracted and successfully detected from human psoriatic lesional skin biopsies, using polymerase chain reaction technology. This molecular approach can easily be expanded to measure many other cytokines in both epidermal and dermal locations. The detection of gamma interferon in this clinical setting may be of particular pathophysiological significance because injection of gamma interferon has been reported to induce psoriatic lesions.

Actins↗
PubMed1991

Monitoring of irrigating fluid absorption during transurethral prostatectomy. A study in anaesthetised patients using a 1% ethanol tag solution.

A simple, reliable method to detect absorption of irrigating fluid during transurethral prostatectomy is to tag irrigating fluids with 1% ethanol and monitor expired breath ethanol concentrations. This method correlated well (n = 0.79) with other existing methods of absorption monitoring in 20 anaesthetised patients. Ethanol (1%) tagging does not alter the optical quality of the irrigating fluid and is harmless to the patient. The technique is non-invasive, repeatable, cheap and gives instant results. It can be used in anaesthetised or awake patients and can detect absorption of as little as 100-150 ml in any 10-minute period.

Absorption↗
PubMed1990

Intrathecal anaesthesia for day-care surgery. A retrospective study of 160 cases using 25- and 26-gauge spinal needles.

The records of 160 day-care surgical patients who received intrathecal anaesthesia were reviewed. No major complications were recorded. The incidence of postspinal headache after puncture with a 25-gauge spinal needle was nearly four times more frequent compared to a 26-gauge needle. The occurrence of postspinal headache in patients over the age of 45 years was significantly less frequent (p less than 0.05) than in younger patients. Intrathecal anaesthesia was acceptable to 91% of outpatients in this group.

Adolescent↗
PubMed1990

Long-term continuous axillary plexus blockade using 0.25% bupivacaine. A study of three cases.

Three patients, presenting with various traumatic, vasospastic and chronic neuromuscular disorders of the upper body, received continuous axillary block ranging from 4 to 16 days. Intermittent injections of 0.25% bupivacaine were used to provide analgesia, sympathetic blockade and muscle relaxation. No systemic or neurological side-effects were recorded. Nerve function recovered promptly after stopping the injections. It is concluded that continuous brachial plexus blockade is a clinically safe and effective technique for the relief of acute traumatic pain and vasospastic disorders of the upper limb. The technique, its merits and possible complications are discussed.

Adult↗
PubMed1990

The use of a laryngeal mask airway in spontaneously breathing patients.

The Laryngeal Mask Airway (LMA) is a new type of oropharyngeal airway that provides an alternative to endotracheal intubation and standard mask anaesthesia in certain cases. Once the patient is adequately anaesthetised, it can be inserted blindly, without recourse to laryngoscopy or muscle relaxants. Anaesthetists of all grades, given minimum instruction, were able to provide a clinically satisfactory airway in 49 out of 50 spontaneously breathing, anaesthetised patients. The advantages over standard mask anaesthesia are: better airway control, minimal leakage of anaesthetic gases, secure airway during transport to the recovery ward, and it frees the anaesthetist's hands, as no mandibular support is needed. Postoperative problems were minimal and 97.6% of our patients said that they would prefer a similar anaesthetic in future. LMA does not guarantee against the risk of aspiration and it is not recommended for use in patients who may have a full stomach.

Adolescent↗