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Biomedical subjects

D Behera

Publications and source records attributed to D Behera.

At least 19 recordsLinked to original sources

Airway response to inhaled fenoterol in hyperthyroid patients before and after treatment.

Bronchodilatory response to inhaled fenoterol was studied in 15 hyperthyroid patients before and after successful treatment with antithyroid drugs. Baseline forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV1) were lower than the predicted values in 12 and 11 patients, respectively. Improved values were seen after treatment for hyperthyroidism although statistical significance was not reached. Even if some improvement occurred in PEFR (a rise by 0.24-0.48 L/s) and FVC (increase of 73-78 ml) in the hyperthyroid state in response to fenoterol inhalation after various time intervals, the increase in different parameters of lung function was significantly more after the patients achieved euthyroid state (increases in FVC by 290-165 ml; in FEV1 by 333-193 ml; in peak expiratory flow (PEFR) by 0.75-0.52 L/s and in forced expiratory flow (FEF50%) by 0.55-0.31 L/s). In the euthyroid state the mean absolute improvements from the baseline values were significantly higher (< 0.05-0.001). These observations indicate that bronchodilatory response is impaired in the presence of excess thyroid hormones and improves after euthyroid state is achieved.

Administration, Inhalation

Adreno-cortical reserve in pulmonary tuberculosis.

Serum cortisol in response to ACTH was assessed in 28 patients with moderately severe to far advanced pulmonary tuberculosis. Ten healthy individuals served as controls. Whereas the basal values were comparable in the two groups the mean delta peak, mean and area under the response curve were significantly lower in the tubercular patients (p < 0.05 to 0.001). Six patients had negligible cortisol response to ACTH stimulation while five others exhibited an inadequate response (rise between 200-300 nmol/L0. None of the subjects had any clinical evidence of adrenocortical insufficiency. The data thus revealed a functional impairment of adrenal cortical reserve in patients of pulmonary tuberculosis.

Adolescent

Carboxyhaemoglobin in women exposed to different cooking fuels.

Blood carboxyhaemoglobin levels were estimated by double wavelength spectrophotometry in non-smoking women living in Chandigarh and its environs and related to the cooking fuel they used. Twenty nine used kerosene, 28 biomass fuel, and 30 liquified petroleum gas; the 27 control subjects had not done any cooking for seven days. The carboxyhaemoglobin concentrations were significantly higher in the women using the three types of fuel (mean (SEM) concentration 7.49% [corrected] (0.67%) for kerosene, 15.74% (0.83%) for biomass fuel, and 17.16% (0.62%) for liquified petroleum gas, compared with 3.52% (0.33%) in the control subjects. It is concluded that cooking with any of the three fuels causes indoor air pollution. It is important to have better designed houses with adequate ventilation and stove vents that are cleaned regularly if pollution is to be reduced.

Adult

Blood carboxyhaemoglobin levels in Indian bidi and cigarette smokers.

Blood carboxyhaemoglobin (COHb) was estimated by double wave length spectrophotometry in 58 healthy non-smokers, 27 bidi smokers, 25 cigarette smokers, 25 mixed smokers (all asymptomatic) and 20 symptomatic cigarette smokers. The blood COHb levels were significantly higher among all smoking groups compared to the normal healthy controls (p less than 0.001). Among the various smoking groups, the symptomatic cigarette smokers had marginally higher COHb levels compared to the other groups. There was no correlation between the smoking indices and COHb levels and COHb and the packed cell volume of red cells.

Adult

Drug interaction between rifampicin and cotrimoxazole in patients with tuberculosis.

1. Patients (n = 15) who were admitted with complications of tuberculosis, were given antitubercular therapy (ATT) with rifampicin (RIF), for a minimum period of 15 d, and cotrimoxazole (CTZ), concurrently, for 5-10 d. 2. The serum RIF levels were measured before the start of CTZ treatment and at the end of its administration. 3. The plasma half-life (t1/2) of RIF increased significantly from 1.92 +/- 0.57 h to 2.31 +/- 0.134 h after CTZ treatment. 4. The mean serum levels of RIF increased significantly at 4 and 6 h after CTZ administration.

Adolescent

Respiratory symptoms in Indian women using domestic cooking fuels.

The effect of domestic cooking fuels producing various respiratory symptoms was studied in 3,701 women. Of these, 3,608 were nonsmoking women who used four different types of cooking fuels: biomass, LPG, kerosene, and mixed fuels. The overall respiratory symptoms were observed in 13 percent of patients. Mixed fuel users experienced more respiratory symptoms (16.7 percent), followed by biomass (12.6 percent), stove (11.4 percent), and LPG (9.9 percent). Chronic bronchitis in chulla users was significantly higher than that in kerosene and LPG users (p less than 0.05). Dyspnea and postnasal drip were significantly higher in the women using mixed fuels. Smoking women who are also exposed to cooking fuels experienced respiratory symptoms more often than nonsmokers (33.3 percent vs 13 percent).

Adult

Pleural effusions in Wegener's granulomatosis: report of five patients and a brief review of the literature.

Wegener's granulomatosis (WG) is an uncommon disease of unknown aetiology which is characterised histologically by a necrotising granulomatous angiitis. The airway, lungs and the kidneys are predominantly involved, but the disease has been documented to affect virtually every organ system. The clinical course is variable and ranges from a short, rapidly fatal illness at one end of the spectrum to indolent involvement compatible with several years of survival at the other. A majority of patients have pulmonary disease evidenced clinically by cough, sputum production and haemoptysis and radiologically by infiltrates, nodules and cavitation. Pleural effusions, however, are rare. No detailed information regarding the nature and clinical behaviour of these effusions is available and only a recent French study has listed the nature of the fluid in passing. We have observed pleural effusions in five patients with WG who are the basis of this report.

Adolescent

Comparison of bronchodilatation produced by an anticholinergic (ipratropium bromide), a beta-2 adrenergic (fenoterol) and their combination in patients with chronic obstructive airway disease. An open trial.

Fenoterol hydrobromide (200 micrograms), ipratropium bromide (40 micrograms) and a combination of the two in the same dosage were administered by metered dose inhaler on 3 separate days to 20 patients with chronic bronchitis and emphysema. On each day, baseline forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEFR) and mid maximum flow rate (MMFR) were recorded. The values were again recorded after administration of the drug at 15, 30, 45 and 60 minutes. Side effects if any were recorded. There was a significant increase from baseline in FVC and FEV1 with all the three regimens at 15, 30 and 45 minutes. However, the rise in MMFR was significant only with ipratropium bromide and the combination regimen. At 60 minutes, the rise in FVC, FEV1 and MMFR was significant only with the combination regimen. There was no significant change in the PEFR values at any time with any drug. The difference in rise in all the four parameters with the 3 regimens was not statistically significant. No side effects were noted. Thus, a combination fenoterol and ipratropium bromide produced a more prolonged bronchodilatation, and ipratropium bromide perhaps acts both in the major (indicated by rise in FEV1) and small airways (measured by MMFR).

Aerosols

Blood carboxyhaemoglobin levels in smokers of Indian cigarettes with and without filters.

Blood carboxyhaemoglobin levels showed no significant difference between smokers of Indian cigarettes with and without filters (14.66 +/- 1.85 vs 16.07 +/- 1.92%; p greater than 0.05), although the value was slightly lower in the former. This may be because filters do not provide protection against absorption of carbon monoxide in the smoke. Further study in a large number is required.

Carboxyhemoglobin

Fiberoptic bronchoendoscopic examination in patients with haemoptysis and normal chest roentgenogram.

The role of flexible fiberoptic bronchoendoscopic (FOB) examination was evaluated in a retrospective analysis in 155 patients with unexplained haemoptysis and normal chest skiagrams. The procedure was helpful in reaching a specific diagnosis in 11 (7.1%) patients, 4 of whom revealed mycobacteria in bronchial secretions and 7 had neoplastic lesions. In another 68 (43.9%) cases only non-specific findings like inflammation were found, but the site of abnormality could be localized. We recommend the use of FOB in the routine assessment of haemoptysis.

Adolescent

Wegener's granulomatosis in north India. An analysis of eleven patients.

Eleven patients with Wegener's granulomatosis were seen at this Institute over a period of 20 years. There were six men and five women. The average age of presentation was 38.3 years, and the mean duration of symptoms was 10.5 months. Constitutional symptoms (82%), cough (82%), ocular symptoms (64%), arthralgias (55%), rhinorrhoea (55%), haemoptysis (45%), nasal granuloma (45%), otorrhoea (36%), sinusitis (36%), skin lesions (27%), and renal failure (27%) were the clinical manifestations encountered. All patients had an elevated ESR, and 55% had leucocytosis. Proteinuria and haematuria were observed in 64% and 55% respectively. Chest radiographs were abnormal in 82%. In four patients the disease had a fulminant course and the patients died before adequate treatment was given. Two patients received corticosteroids alone and have since been lost to follow up. Five (45%) received adequate cytotoxic therapy and have done well for 8-46 months (mean, 24.8 months) after diagnosis. Wegener's granulomatosis in India is apparently similar to that seen elsewhere, but the high incidence of tuberculosis interferes with early diagnosis and treatment.

Adolescent