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Biomedical subjects

V Ranade

Publications and source records attributed to V Ranade.

9 recordsLinked to original sources
PubMed2000

Hypercalcemia, arrhythmia, and mood stabilizers.

Recent findings in a bipolar patient receiving maintenance lithium therapy who developed hypercalcemia and severe bradyarrhythmia prompted the authors to conduct a retrospective study of bipolar patients with lithium-associated hypercalcemia. A printout of all cases of hypercalcemia that presented during a 1-year period was generated. After eliminating spurious hypercalcemias or those associated with intravenous fluids, the authors identified 18 non-lithium-treated patients with hypercalcemias related to malignancies and other medical conditions (group A) and 12 patients with lithium-associated hypercalcemia (group B). Patients in group B were not comparable to those in group A, as the latter were medically compromised and were receiving multiple pharmacotherapies. Thus, two control groups were generated: group C1, which included age- and sex-comparable lithium-treated bipolar normocalcemic patients, and group C2, which included bipolar normocalcemic patients treated with anticonvulsant mood stabilizers. The electrocardiographic (ECG) findings for patients in group B were compared with those of patients in groups C1 and C2. It was found that these groups did not differ in their overall frequency of ECG abnormalities; however, there were significant differences in the frequency of conduction defects. Patients with hypercalcemia resulting from medical diseases and bipolar patients with lithium-associated hypercalcemia had significantly higher frequencies of conduction defects. Patients in group A had significant mortality at 2-year follow-up (28%), in contrast to zero mortality in the other three groups. The clinical implications of these findings are discussed.

Adult↗
PubMed1999

Effect of angiotensin-converting enzyme therapy on QT interval dispersion.

Patients with chronic heart failure (CHF) have an increased risk for sudden death. This increased risk has been associated with increased QT dispersion (QTd), a reflection of the heterogeneity in ventricular repolarization. Angiotensin-converting enzyme (ACE) inhibitors have been reported to decrease heart size as well as decreasing morbidity and mortality in moderate-to-severe CHF. The aim of this study was to determine if ACE therapy is associated with a decrease in QTd, a marker for increased electrical instability. Ninety-seven patients were evaluated. The normalized QTd after 2 months of ACE therapy decreased from 16 +/- 4 to 12 +/- 3, a 25% reduction in dispersions. QTd also decreased from 61 +/- 14 to 47 +/- 12 (P < .001) and QTc dispersions decreased from 71 +/- 18 to 52 +/- 14 (P < .001). After 2 months of ACE inhibitor therapy, heart rate slowed significantly (RR intervals 765 +/- 198 before and 838 +/- 186 after ACE). There was a negative correlation between ejection fraction and QTd (r = -0.8; P < .001). The study also found no correlation between ACE level, percent converting enzyme inhibition, and QTd. The effects of ACE therapy appear early on in terms of repolarization changes. The reduction in QTd may explain the reduced sudden death mortality in patients with heart failure who are treated with ACE inhibitor therapy.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1993

Nutritional recommendations for children and adolescents.

A single food item cannot possibly provide all of the essential nutrients in the amounts required. The best way to insure an adequate diet is to choose a wide variety of foods from all food groups that are available. Toddlers, children, adolescents and even the elderly persons require sufficient calories for growth and the maintenance of body functions. Excessive calories however, can lead to obesity and therefore, those should be avoided. Ingestion of unsaturated fatty acids and consumption of carbohydrates, minerals, proteins and fiber are essential for optimal growth and development. A balance needs to be maintained in order to have lower average serum cholesterol levels and blood pressure. It has been shown that the lactating mother's diet does not have effect on the total fat content or the cholesterol content of breast milk. Breast milk has been strongly recommended for infants, provided the mothers remain healthy and normal. Finally, manufacturers of food items should be encouraged to promote consistently the recommended eating patterns especially among children and adolescents.

Adolescent↗
PubMed1993

Cholesterol detection, diagnosis and evaluation.

Children with parents who have premature cardiovascular disease often have high serum cholesterol levels. In order to prevent the formation of atherosclerotic lesions in the coronary arteries, efforts are called for identifying, treating and monitoring individual children and adolescents who have high serum cholesterol levels. The screening of children should be performed in the context of their continuing health care and particularly, adolescents who smoke cigarettes, have high blood pressure, or consume excessive amounts of saturated fatty acids, total fat and cholesterol and who are overweight should be subjected to cholesterol testing. On the basis of the data presented in this article, it will be prudent to test high serum cholesterol in all young people whose parents have a total serum cholesterol exceeding 240 mg/dl. A total serum cholesterol level of equal to or greater than 200 mg/dl or an LDL cholesterol level of equal to or greater than 130 mg/dl when associated with family history or parental hypercholesterolemia warrants further evaluation. Children and adolescents with high LDL cholesterol levels that are equal to or greater than 130 mg/dl should be considered to be possible secondary causes of hypercholesterolemia and therefore continuous monitoring and clinical evaluation of this population may be necessary. Other factors such as familial hyperlipidemia, hypoalphalipoproteinemia, diabetes and high alcohol intake also need careful assessment.

Adolescent↗
PubMed1978

Cervical pregnancy.

A case of cervical pregnancy is presented. The clinicopathologic criteria for the diagnosis are reviewed. Different modes of management are discussed. Our patient was a classic case of a woman with a cervical pregnancy who had had a pregnancy termination done in the antecedent pregnancy. The abdominal hysterectomy was performed as a lifesaving procedure when curettage could not control the hemorrhage.

Adult↗
PubMedDate not supplied

Influence of electrolyte abnormalities on interlead variability of ventricular repolarization times in 12-lead electrocardiography.

Increased QT dispersion (QT(d)) has been associated with increased risk for ventricular arrhythmias. Pathologic extracellular electrolyte concentrations may result in ventricular arrhythmias. The aim of this study was to evaluate the effect of electrolyte abnormalities on QT(d). Ten consecutive patients with isolated electrolyte abnormalities were selected for each of the following groups: hypokalemia, hyperkalemia, hypercalcemia, hypocalcemia, hypomagnesemia, and normal controls. Standard 12-lead electrocardiography was performed for each patient and average QT, JT, and RR intervals were calculated for each lead. Dispersion of QT, JT (JT(d)), and QTc (QTc(d)) intervals were calculated as the range between the longest and shortest measurements. Compared with controls, only patients with hypokalemia had a greater QT(d) (115 +/- 31 vs. 49 +/- 15 ms), JT(d) (116 +/- 34 vs. 52 +/- 12 ms), and QTc(d) (141 +/- 40 vs. 58 +/- 1 ms), (P < 0.05). In an experimental substudy, seven rats were maintained on K(+) and seven on Mg(2+)-free diet followed by normal diet. Experimental hypokalemia significantly increased QT(d) (10 +/- 4 to 37 +/- 7 ms), and QTc(d) (32 +/- 6 to 79 +/- 27 ms) (P < 0.05), whereas hypomagnesemia did not. Restoration of serum potassium resulted in normalization of dispersion (QT(d), 14 +/- 2; QTc(d), 34 +/- 6 ms). Hypokalemia increases the dispersion of ventricular repolarization that may be responsible for arrhythmias. Even though hyperkalemia, hypocalcemia, and hypercalcemia are known to affect ventricular repolarization, our study shows that they are not associated with increased dispersion.

Adult↗