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Biomedical subjects

B M Singh

Publications and source records attributed to B M Singh.

At least 55 records · Page 3Linked to original sources
PubMed1990

Changing sex ratio in diabetic ketoacidosis.

An annual audit of diabetic ketoacidosis and hyperosmolar non-ketotic state was made in one hospital from 1971 to 1988. There were 846 episodes of ketoacidosis and 126 episodes of hyperosmolar state. A relative fall occurred in the number of episodes of ketoacidosis compared with hyperosmolar state over this time (p less than 0.05), and there was a change of female:male ratio for episodes of ketoacidosis occurring in established diabetes from 2.79 to 1.59 (p less than 0.01). In contrast the female:male ratio remained unchanged (mean 1.16) for episodes of hyperosmolar state and remained less than 1.0 for all episodes of ketoacidosis in previously undiagnosed diabetes mellitus. Among patients who suffered recurrent ketoacidosis there was a reduction in the number of episodes occurring in female patients and an increase in the number of episodes occurring in male patients in each successive 6-year period with consequent change in female:male ratio for this subgroup from 7.33 to 4.75 to 1.12 (p less than 0.001).

Adolescent↗
PubMed1989

Use of combined oral contraceptive preparations alters the insulin sensitivity of fatty acid and ketone metabolism.

Eight women taking low-dose-oestrogen combined oral contraceptive preparations were compared to eight women in the luteal phase of the menstrual cycle during hourly incremental insulin infusions of 0 (basal), 0.005, 0.01 and 0.05 U/kg/h short-acting insulin. Dose-response relationships between insulin and intermediary metabolites were sought by analysis of variance applied to regression. For insulin (log) and glucose the slope of the relationship was significantly shallower in the oral contraceptive group. For insulin (log) and non-esterified fatty acids the slopes of the regression lines were not different between groups but lines were significantly displaced. For insulin (log) and total ketone bodies (log) slopes of the regression lines were not different but significant displacement was observed. At identical insulin concentrations women taking an oral contraceptive had higher non-esterified fatty acids (NEFA) (difference between groups +0.15 mmol/l, P less than 0.001) and total ketone bodies (log: -0.26 mmol/l, P less than 0.001). The potency of insulin action in oral contraceptive users versus the luteal group was 0.47 (P less than 0.01) for NEFA and 0.38 (P less than 0.001) for total ketone bodies. The results demonstrate, for the first time, in-vivo insulin resistance of NEFA and ketone bodies' metabolism induced by oral contraceptive use.

Adult↗
PubMed1989

The metabolic effects of fatal cyanide poisoning.

Metabolic and toxicological data were obtained during the first 24 hours following severe and eventually fatal cyanide poisoning. Initial blood cyanide concentrations were 804 mumol/l but fell rapidly over 24 hours following cobalt edetate therapy to 15 mumol/l. However, plasma thiocyanate concentrations rose over 24 hours (147-267 mumol/l) suggesting continued tissue detoxification. The major metabolic abnormality was lactic acidosis (initial pH 7.21, blood lactate 17.5 mmol/l) which corrected over 12 hours. Despite high circulating insulin concentrations the responses of blood glucose, plasma non-esterified fatty acid, blood glycerol and 3-hydroxybutyrate suggested marked insulin resistance.

Acidosis, Lactic↗
PubMed1989

The effects of verapamil, diltiazem, nifedipine and propranolol on metabolic control in hypertensives with non-insulin dependent diabetes mellitus.

The effects of one month's treatment with each of nifedipine, verapamil, diltiazem, propranolol and placebo, given in random order, on fasting plasma glucose, haemoglobin Alc, serum fructosamine, immunoreactive insulin, cholesterol, and triglyceride were studied in a group of 19 patients with hypertension and non-insulin dependent diabetes mellitus. The metabolic effects of the active drugs were generally small but fasting plasma glucose was increased by propranolol from 9.3 +/- 3.0 to 10.4 +/- 3.4 mmol/l (P less than 0.01) (mean +/- SD) and to 10.1 +/- 3.2 mmol/l (P less than 0.05) by nifedipine. Serum fructosamine was increased from 2.75 +/- 0.53 to 2.89 +/- 0.62 mmol/l (P less than 0.05) by diltiazem and to 2.91 +/- 0.65 (P less than 0.05) by propranolol. Verapamil increased fasting serum immunoreactive insulin: diltiazem and propranolol tended to reduce it. Propranolol but not the other drugs significantly increased serum triglyceride. Calcium antagonists may be preferable to beta adrenoceptor blockers for the treatment of hypertensive diabetics. Of the three calcium antagonists we studied, verapamil may have advantages over nifedipine and diltiazem.

Aged↗
PubMed1988

Following weight loss in massively obese patients correction of the insulin resistance of fat metabolism is delayed relative to the improvement in carbohydrate metabolism.

Intermediary metabolite and serum insulin concentrations have been measured during incremental intravenous low-dose insulin infusion in massively obese patients before, and 3 months and 12 months after gastroplasty. Fasting blood glucose was similar on the three occasions, but fasting serum insulin was significantly higher preoperatively and showed a progressive fall with weight loss. Significant negative linear correlations were found between serum insulin and blood glucose, plasma nonesterified fatty acids, blood glycerol and blood total ketone bodies concentrations. The insulin-glucose dose-response curve showed a significant left shift at 3 months with a further significant improvement at 12 months. No significant change in the responses for nonesterified fatty acids, glycerol, and ketone bodies was observed at 3 months, but all three showed a significant left shift at 12 months. Massively obese patients are resistant to the action of insulin on carbohydrate and fat metabolism. Weight loss following gastroplasty results in an improvement in sensitivity to insulin, which is evident earlier in carbohydrate metabolism than in fat metabolism.

Adult↗
PubMed1987

Caloric-induced nystagmus with isoelectric electroencephalogram.

Caloric vestibular testing induced nystagmus in a patient with an isoelectric electroencephalogram after cardiopulmonary arrest. This has been demonstrated previously in patients in a chronic persistent vegetative state with intact brainstem reflexes, but never in a patient with an isoelectric electroencephalogram. Animal studies indicate that the quick phase of nystagmus and horizontal saccades are generated in the paramedian pontine reticular formation. The present case supports the conclusion that caloric-induced nystagmus originates in the brainstem in rudimentary form.

Brain Death↗
PubMed1987

Metabolic effects of combined oral contraceptive preparations.

Fasting intermediary metabolite concentrations were measured in comparable groups of women either in the follicular or luteal phase of the menstrual cycle or taking low-dose estrogen combined oral contraceptive preparations. Blood total ketone bodies concentrations were significantly elevated in oral contraceptive users (p less than 0.05 v follicular and luteal groups) whilst blood alanine levels were lower (p less than 0.01 v follicular).

3-Hydroxybutyric Acid↗
PubMed1987

Blood fuel metabolites in asthma during and after progressive submaximal exercise.

Ten male stable asthmatic subjects and 10 matched control subjects performed a progressive exercise test on a treadmill to 85% of their predicted maximum heart rate. Blood lactate, pyruvate, hydrogen ion, glucose, alanine, glycerol and total ketone body concentrations were measured at frequent intervals during and up to 60 min after exercise. Carbon dioxide production, oxygen consumption, ventilation, respiratory exchange ratio and oxygen saturation were also measured during and up to 10 min after exercise. There were no significant differences between the asthmatic and control subjects in levels of carbon dioxide production, oxygen consumption and ventilation. The respiratory exchange ratio was greater in the asthmatic subjects during recovery from exercise (P less than 0.05). No changes in oxygen saturation were observed during exercise in either group. In both asthmatic and control subjects, lactate, pyruvate, hydrogen ion, alanine and glycerol concentrations showed an increase from baseline levels, reaching maximum levels up to 10 min after exercise and returning to baseline within 1 h after exercise. Total ketone body concentrations decreased during exercise. There were no significant differences between the asthmatic and control subjects in the concentration of any metabolite over the study period. These data indicate that fuel metabolism during and after short-term progressive exercise is similar in stable asthmatic and normal subjects.

Adult↗
PubMed1987

Blood lactate changes during exercise at high altitude.

Blood lactate concentrations were measured in 18 normal subjects at the end of an exercise test designed to maintain heart rate at 85% of maximum for 15 minutes. Blood lactate concentrations were reduced at high altitude (4846 m) and correlated positively with basal pH and negatively with basal Pa,O2 levels. Blood lactate concentrations tended to be lower in those subjects on acetazolamide but were not correlated with the severity of acute mountain sickness or with the workload of the exercise test. We conclude that the pH changes are probably the most significant factor in reducing lactate concentrations.

Acetazolamide↗
PubMed1987

Multiple aspects of insulin resistance. Comparison of glucose and intermediary metabolite response to incremental insulin infusion in IDDM subjects of short and long duration.

Glucose and intermediary metabolite responses during incremental insulin infusion (basal, 0.005, 0.01, and 0.05 U X kg-1 X h-1) were examined in IDDM subjects with duration of diabetes of greater than 5 yr (group D5: n = 8, duration 13.5 +/- 3.9 yr, mean +/- SD) and less than 1 yr (group D1: n = 8, duration 0.3 +/- 0.1 yr) from diagnosis. Group D5 had significantly elevated basal plasma free-insulin levels (D5 27.4 +/- 9.6, D1 15.5 +/- 9.4 mU/L; P less than .05). Nonetheless, basal blood glucose (D5 13.8 +/- 4.8, D1 7.1 +/- 1.5 mM; P less than .01), plasma nonesterified fatty acid (NEFA) (D5 1.26 +/- 0.12, D1 0.89 +/- 0.10 mM; P less than .01), blood glycerol (D5 0.12 +/- 0.05, D1 0.07 +/- 0.02 mM; P less than .05), and blood ketones (D5 1.25 +/- 0.91, D1 0.26 +/- 0.20 mM; P less than .01) were higher in group D5. During insulin infusion, group D5 had significantly elevated plasma free-insulin (P less than .05) and blood glucose (P less than .01) levels. Isotopically determined glucose turnover showed metabolic clearance rates were significantly diminished in group D5 during all insulin infusions, indicating a marked impairment of peripheral glucose metabolism. In individual subjects the relationship of blood glucose, plasma NEFA, and blood total ketones (log scale) with the simultaneously occurring plasma insulin level (log scale) was linear for each metabolite.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Spinal cord syndromes in the acquired immune deficiency syndrome.

Two patients with AIDS developed paraparesis. Neuropathological post mortem examination in one revealed cytomegalovirus polyradiculopathy, and in the second, vacuolar myelopathy which occurred in association with brain lesions resembling Marchiafava-Bignami Syndrome.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Coexisting carotid stenosis in patients undergoing cardiac surgery: indications and guidelines for simultaneous operations.

The coexistence of critical carotid stenosis with coronary artery or valvular heart disease occurs in a small percentage of patients requiring open heart surgical procedures. Recognition of such combined lesions by noninvasive carotid testing identifies patients at risk for neurologic events. Our experience with 62 patients having combined simultaneous carotid and cardiac operations among 2,400 open heart surgery patients was compared with the results in 110 patients with only carotid endarterectomy operations. The outcomes indicated that carotid endarterectomy can be performed simultaneously with open heart surgical procedures with morbidity and mortality rates similar to those of isolated cervical artery operations. Thus, patients with significant coexisting carotid artery disease defined with specific criteria and coronary artery disease need not be exposed to cerebral ischemic events or to myocardial infarctions that often accompany staged operations.

Carotid Artery Diseases↗
PubMed1984

Metabolic control of diabetes in general practice clinics: comparison with a hospital clinic.

An assessment was made of the degree of metabolic control achieved in diabetic patients attending mini clinics run by general practitioners compared with that in matched diabetic patients attending a hospital clinic. Patients were grouped according to whether they were being treated with diet alone, an oral hypoglycaemic, insulin once daily, or insulin twice daily. Statistical analysis showed no significant difference between patients attending mini clinics and those attending the hospital clinic in retrospective mean blood glucose, retrospective mean glycosylated haemoglobin (HbA1), or prospective HbA1 concentrations. General practitioners providing diabetic care on an organised basis can achieve a degree of glycaemic control in diabetic patients equal to that reached by a hospital clinic.

Adult↗