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Biomedical subjects

B M Kapur

Publications and source records attributed to B M Kapur.

At least 55 records · Page 3Linked to original sources
PubMed1988

Validation of self-reported cannabis use by urine analysis.

A study of 113 young multiple drug users, interviewed at one year follow-up, was designed to assess the validity of self-reported cannabis use. Subjects provided information about the recency, frequency and typical dose of their use of cannabis in the preceding 30 days. Urine samples were collected and analyzed for delta 9 THC metabolites. Recency of use was the best predictor of urine test result, but a measure of frequency of use significantly increased the proportion of variance accounted for. The results strongly supported the validity of self-reported cannabis use and indicate that valid self-reports of drug consumption can be obtained from multiple drug users in treatment.

Adult↗
PubMed1988

Carcinoma of the gall bladder--can we do anything?

A retrospective review of 143 cases of carcinoma of the gall bladder is presented. The disease was more common in females in the 5th and 6th decades. Pain, anorexia, weight loss and jaundice were the common presenting symptoms, and hepatomegaly and palpable gall bladder the common signs. Laboratory and radiological investigations were merely confirmatory as the diagnosis in a majority of the cases was clinically obvious. Aspiration cytology and laparoscopic biopsy were of help in obtaining histological diagnosis. Only 47 patients were considered fit enough to undergo laparotomy. In a majority of these patients biopsy alone was possible while palliative procedures were performed in the others. The operative mortality was 18% even in this selected group of patients, due to the poor general condition and the advanced stage of the disease at the time of diagnosis. Curative resection may be possible and long term survival is expected in incidentally found carcinoma at cholecystectomy. The only hope lies in prevention by prompt treatment of patients with benign biliary disease.

Adenocarcinoma↗
PubMed1988

Biliobiliary fistula: review of nine cases.

We have reviewed nine cases of biliobiliary fistula operated during 1983-85. Two of these patients also had a high hepatic duct stricture, an association not highlighted before. Eight of these patients had jaundice. A classical cholecystectomy in the presence of biliobiliary fistula entails grave risk to the integrity of the upper biliary tract. Preoperative endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography can detect these rare fistulae. It is proposed that all patients with cholelithiasis associated with jaundice be screened by sonography for evidence of biliobiliary fistula. They should then have an ERCP to detect and delineate the biliobiliary fistula. At surgery, all of these patients have a fused gall bladder with obliteration of the Calot's triangle. Both retrograde and antegrade cholecystectomy is hazardous in these cases. Instead, the gall bladder should be opened inferiorly and evacuated of all stones, followed by a partial cholecystectomy and common hepatic duct repair over a T-tube. In the presence of an associated high or low biliary stricture, a suitable bilioenteric anastomosis may be required.

Adult↗
PubMed1987

Oral phenobarbital loading: a safe method of barbiturate and nonbarbiturate hypnosedative withdrawal.

We tested the efficacy and safety of oral phenobarbital loading, 120 mg/h until the end-point of mild intoxication is reached, for the treatment of hypnosedative withdrawal in 48 physically dependent patients, 14 of whom had a history of withdrawal seizures. None of the patients experienced seizures or any other symptoms of withdrawal during the study period, regardless of the phenobarbital half-life. The phenobarbital loading technique can be used in any hospital, not only those with access to specialized drug analysis laboratories. The method of treatment we describe allows the clinician to focus on issues such as rehabilitation instead of drug administration and manipulation of doses.

Administration, Oral↗
PubMed1987

Drug use among a sample of males admitted to an alcohol detoxication center.

Urine samples were obtained from 93% of a sample of 111 consecutive male admissions to a nonmedical detoxication center in Toronto. Analysis of these samples revealed that 51 (50%) had traces of drugs other than alcohol and that 12 (12%) were alcohol free. Benzodiazepines were the most frequently detected drugs and these were found in 32% of all samples. Barbiturates were detected in seven (7%) samples and cannabinoids in 10 (10%) samples. A wide range of urine alcohol concentrations was found and some samples had zero or low concentrations. Although alcohol urine concentrations were generally lower in samples containing other drugs, the distribution of urine alcohol concentrations was similar for samples containing only alcohol and those containing alcohol and some other drug. Of the 51 samples found to contain drugs other than alcohol, subjects' self-reports were concordant in 27 cases (53%). Most of the discrepancies between self-reports and urine analysis were due to the under-reporting of the use of benzodiazepines. Subjects with drugs in their urine tended to be younger than others, but they were not distinguished with respect to their behaviors while in the detoxication center or length of stay. Those with the highest urine alcohol concentrations had shorter stays in the detoxication center. Implications for further studies are discussed.

Adult↗
PubMed1987

Traumatic intermuscular hernia in the anterior abdominal wall.

Traumatic ventral herniae are uncommon. The authors present a patient with traumatic intermuscular hernia in the anterior abdominal wall. Early recognition and differentiation from haematoma is important. In this case, the overlying intact muscle layer masked the classical clinical signs. The incision should be adequate and all internal organs carefully examined. Primary repair is usually possible.

Abdominal Muscles↗
PubMed1987

Ethanol vapours above lacrimal fluid in the rabbit.

Ethanol was administered intravenously to rabbits. The concentration of ethanol, determined by gas chromatographic analysis, in lacrimal fluid was shown to reflect the concentration in plasma. The vapour above lacrimal fluid was analyzed in situ by the use of a small resistivity sensor that measures ethanol vapours. After a dose of approximately 750 mg/kg, the metabolic rates of ethanol determined by gas chromatographic analysis of plasma (226 +/- 13 mg.kg-1.h-1) and by eye ethanol vapour analysis (210 +/- 8 mg.kg-1.h-1) were virtually identical. The data suggest that ethanol eye vapour analysis may be an attractive, noninvasive method for the determination of ethanol in animals.

Animals↗
PubMed1986

Cholesterol and pigment gallstones in northern India. A prospective analysis.

Two hundred one consecutive patients with gallstone disease who had undergone cholecystectomy were analyzed to determine the relative frequency of occurrence of cholesterol and pigment gallstones and to identify distinguishing features of the two stone types. Cholesterol stones (CS) formed the majority (94%) of gallstones. There were no distinctive clinical, biochemical, or radiological features of CS or pigment stones (PS). However, CS were found significantly more often than PS (P less than 0.05) in multiparous women leading a sedentary life-style. Although multiplicity of gallstones was somewhat commoner with CS (P less than 0.05) and radiopacity with PS (P less than 0.05) as compared with the other stone type, these differences were certainly not discriminatory between CS and PS.

Adult↗
PubMed1986

Intravenous abuse of propylhexedrine (Benzedrex) and the risk of brainstem dysfunction in young adults.

In 1949, amphetamine sulfate was replaced by propylhexedrine in the nasal decongestant agent Benzedrex because of psychosis, sudden death, and widespread abuse. Propylhexedrine is not without risks, and reported cases of psychosis, myocardial infarction, pulmonary vascular disease and pulmonary hypertension, and sudden death are well documented in the medical literature. We are reporting 2 cases of definite brainstem dysfunction and 5 cases of transient diplopia secondary to IV abuse of Benzedrex. This widely abused drug is prepared by heating Benzedrex and hydrochloric acid, and the resulting crystals are dissolved in water for injection. This agent is called "stove-top speed". All 7 patients had transient diplopia, within seconds after injection. One patient had evidence of a right-internuclear ophthalmoplegia, and another had a depressed right gag reflex and paralysis of the right half of the tongue. The deficits in these two patients, persisted for many months. In young adults with history of drug abuse, the IV use of Benzedrex should be considered in the differential diagnosis of transient or permanent focal brainstem deficits.

Adolescent↗
PubMed1986

Monitoring drinking behavior with the alcohol dipstick during treatment.

The present communication is the first report on the clinical use of the alcohol dipstick to continuously monitor alcoholics' drinking during treatment. Daily urine samples from 34 alcoholics were tested for alcohol by the clinical staff using the alcohol dipstick. The patients also provided self-reports of drinking daily. Patients' compliance for submitting urine samples and for completing daily monitoring sheets (DMS) was 93 and 95%, respectively. Over 75% of the patients drank on at least one occasion; about half of these patients denied drinking detected by the urine tests. Drinking was confirmed by both methods in 39% of the patients who drank, and by the urine testing alone in 54%. The patients in treatment for less than 2 months were abstinent on 85% of the days compared to 98% for those in treatment for 6 months or longer. Seventy-two percent of all alcohol-positive urine samples were submitted by patients on days when they denied drinking. Monitoring of patients' drinking was useful in their clinical management. The alcohol dipstick was a simple, inexpensive, and rapid alcohol measuring procedure that could be used by the clinical staff in the treatment setting.

Adult↗
PubMed1986

Ocular distribution of methyprylon after intravenous injection and transfer of the drug to recipient eye via corneal graft.

The purpose of the study was to determine chronologically the ocular distribution of methyprylon (Noludar) after a single intravenous injection (45 mg/kg) to rabbits, if the drug can be transferred from a donor treated with the drug to the recipient's eye via an allogeneic corneal graft, and the effect of methyprylon on corneal cell growth and protein synthesis. Gas chromatographic techniques showed that the drug was present in all the tissues and fluids of the eye from 0.5 to 18 hours after the injection. Postoperatively, the cornea and some of the other ocular tissues of the recipient contained methyprylon at least 24 hours after transplantation. Clinically, the graft remained clear, and there was no adverse reaction in the recipient eye for an observation period of 24 hours. Tissue culture studies showed that about 10 times more methyprylon than was found in the donor cornea was necessary to produce a cytotoxic reaction on the corneal cells in terms of cellular growth rate and protein synthesis. Our animal experiments and cytotoxicity tests suggest that corneas of donors treated with a high dose of methyprylon would be suitable for use as grafts.

Animals↗
PubMed1986

Serodiagnosis of intestinal tuberculosis by the soluble antigen fluorescent antibody test (SAFA test).

The diagnosis of intestinal tuberculosis can only be established by the tissue obtained during surgery or endoscopy. We investigated the role of the soluble antigen fluorescent antibody (SAFA) test with the possibility that it may prove to be a valuable technique for the serodiagnosis of intestinal tuberculosis. The sera of 38 patients and 60 control subjects were studied. Mycobacterial saline extract was used as an antigen in the test. Thirty-two (84%) of 38 patients with intestinal tuberculosis yielded positive values (fluorescence coefficient greater than 3). Among the control subjects a false positive result was observed in only one patient who had eosinophilic enteritis. Patients with intestinal tuberculosis had a significantly higher level of antibodies than patients with non-tuberculous intestinal disease and healthy subjects. These results suggest that this technique may be used for the diagnosis of intestinal tuberculosis and in differentiating it from other non-tuberculous intestinal diseases.

Adolescent↗