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Biomedical subjects

D Behera

Publications and source records attributed to D Behera.

At least 37 records · Page 2Linked to original sources
PubMed2000

Hypothalamo-pituitary-adrenal axis function in asthmatics taking low dose inhaled beclomethasone dipropionate.

OBJECTIVES: Anti-inflammatory drugs, particularly inhaled corticosteroids remain the mainstay of treatment of bronchial asthma. However, these drugs have potential side effects. This study was undertaken to evaluate the effects of inhaled beclomethasone dipropionate (400 and 800 micrograms) over a period of six months on the hypothalamo-pituitary-adrenal axis (HPA) suppression. METHODS: Assessment of the hypothalamo-pituitary-adrenal axis function was carried out by tetracosactrin test at time zero, (before start of treatment), three months, and six months. The baseline values served as the controls for each patient. Serum cortisol was estimated by radioimmuno assay. The response to short tetracosactrin test was classified as normal if serum cortisol levels rose at least 200 nmol/L to a minimum of 500 nmol/L. RESULTS: There were seven patients who were inhaling beclomethasone dipropionate in a dose of 400 micrograms/day and another seven patients were taking the same drug in a dose of 800 micrograms/day. There was no side effect of the drug in any patient except in one patient who had dysphonia. The mean basal cortisol levels were normal in all the subjects at 0, 3 and 6 months of therapy. Tetracosactrin stimulation test was also normal in all patients at all the times who were receiving the dose of 400 micrograms/day. However, one patient (14%) receiving 800 micrograms/day had HPA axis suppression at six months. Two patients in this group also had low basal cortisol levels. There was no clinical evidence of such suppression/deficiency. CONCLUSION: Beclomethasone dipropionate in a dose of 800 micrograms/day may suppress the hypothalamo-pituitary-adrenal axis if used for long periods (six months). However, this may not have any clinical significance.

Administration, Inhalation↗
PubMed1999

Pulmonary function changes in patients with psoriasis on methotrexate therapy.

Methotrexate is known to induce pulmonary fibrosis. The present study was undertaken to assess pulmonary toxicity, if any, in psoriasis patients on methotrexate therapy and correlate the dose and duration of the treatment with any changes in pulmonary function. Ten patients who had taken methotrexate for one year and ten patients receiving methotrexate were included in the present study. Detailed lung function studies including arterial blood gas analysis were carried out. In both groups, the only pulmonary function abnormalities detected were FEF200-1200, FEF25-75%, residual volume (RV), and RV/TLC%, which showed a decline after six months of treatment. However, this was not significant. No changes were detected in the arterial blood gas values following methotrexate therapy. Therefore, the present study did not find any significant deterioration of lung functions in psoriasis patients on methotrexate therapy.

Adult↗
PubMed1998

Respiratory symptoms in Indian children exposed to different cooking fuels.

Smoke emission from fuels is an important source of indoor air pollution. Children spend considerable time indoors. It is therefore important to determine whether air contaminants from indoor air sources affect incidence of respiratory illness, cause symptoms and changes in pulmonary function status in them. Two hundred children in the age group of 7-15 were selected randomly. They were stratified according to the fuel used in their homes and respiratory symptoms were inquired from them according to a questionnaire recommended by the American Thoracic Society. The most symptomatic children were those whose households used kerosene (52%) and mixed fuels (46%) although different symptoms were present in varying extent in all 4 groups of children. Cough, cold, congestion or phlegm for one week or more occurred more frequently with mixed fuel use followed by kerosene. The present study thus showed that mixed fuel and kerosene fuel had worst effects on respiratory system in children whose households used these fuels.

Adolescent↗
PubMed1998

Yoga therapy in chronic bronchitis.

Fifteen patients of chronic bronchitis received yoga therapy in the form of pranayam and 8 types of 'asans' for a period of 4 weeks. They had a perceptible improvement in dyspnoea as was measured by visual analog. Lung function parameters (VC, FEV1, and PEFR) also improved after the practice of yoga. This preliminary study indicates that, yoga may be an useful adjunct to other conventional form of therapy for COPD.

Aged↗
PubMed1998

Exposure to Parthenium hysterophorous pollen extract leads to bronchospasm in stable patients of bronchial asthma.

Role of Parthenium hysterophorous as an allergen evoking bronchial hyper-responsiveness was assessed in twenty five adult patients with stable asthma and ten healthy controls. Assessment was made with the help of skin prick and bronchial provocation tests (BPT) using a commercially available Pathenium extract. Eleven patients (44%) of the study group had a positive skin reaction and 4 (16%) showed a significant fall in FEV1 and PEFR (p < 0.05) on bronchial provocation. In the control group only one patient (10%) had a positive skin test while there was none with a positive bronchial challenge. There was a significant fall in the mean values of FEV1 and PEFR over base line after the BPT in patients of asthma than controls. It is concluded that a significant proportion of bronchial asthma patients are sensitized to Parthenium hysterophorous and it may act as a cofactor in seasonal exacerbation of their symptoms.

Adult↗
PubMed1997

Computed tomography features of lung parenchymal changes in pulmonary tuberculosis.

Twenty-five patients with active pulmonary tuberculosis were prospectively studied with CT. Three major parenchymal patterns were noted. The nodular opacities pattern was seen in all cases. Confluent consolidation was seen in 37% of patients and consolidation with associated loss of volume (CWALV) was seen in 69% of patients. High-resolution CT (HRCT) features of bronchogenic spread included (i) a centrilobular nodule or a branching linear structure (92.3%); (ii) bronchial wall thickening (61.5%); (iii) a 'tree in bud' appearance (92.3%); and (iv) poorly marginated 5-8 mm nodules (61.5%). Most of the patterns showed satellite lesions in the form of small nodules or peripheral areas of increased attenuation. Cavitation was most common in CWALV lesions. Bronchiectasis was a common accompaniment (81.3%), and its occurrence paralleled the distribution of parenchymal lesions. Associated pleural thickening was noted in half the cases. To conclude, distinctive parenchymal changes were noted with CT in cases of pulmonary tuberculosis, which may suggest the diagnosis in the appropriate clinical setting.

Adult↗
PubMed1997

Reactive oxygen species formation in peripheral blood neutrophils in different types of smokers.

The present study was envisaged to assess the state of oxidative metabolism of neutrophils, recovered from smokers (cigarette, beedi, hookah and mixed products) and non-smokers. Superoxide anion (O2.-) production was significantly higher in neutrophils from all groups of smokers (P < 0.001). Total leukocyte count (TLC) was significantly more in symptomatic subjects among the cigarette, hookah and mixed smokers (P < 0.05). Total neutrophil count (TNC) was significantly higher in symptomatic than asymptomatic subjects of hookah and mixed smoking groups (P < 0.05). In the pathogenesis of chronic obstructive pulmonary disease (COPD) in tobacco smokers, the role of leukocytosis, increased neutrophil sequestration into the lung, increased neutrophil toxic oxygen species including superoxide release in the lung may cause direct injury to lung tissues.

Adult↗
PubMed1995

Positive end expiratory pressure reduces bronchial blood flow after aspiration injury.

We hypothesized that since added airway pressure compresses bronchial vessels, the airway hyperemia found following airway injury would be reduced by positive end-expiratory pressure (PEEP). Accordingly, we measured the effect of 15 cm H2O PEEP on bronchial and pulmonary blood flows by the radioactive microsphere reference flow technique in closed chested goats (n = 7) before and after aspiration injury to the left lung with 0.1 N HCl. Thirty minutes after aspiration, the pulmonary blood flow to the injured left lung was reduced by one third, whereas the total bronchial blood flow to the left lung (normalized to mean systemic pressure of 100 torr) doubled (11.3 +/- 2.2 to 20.6 +/- 1.0 ml/min 100 torr; p < 0.01). Increasing PEEP from 5 to 15 cm H2O decreased total bronchial blood flow by about half both before (11.3 +/- 2.2 falling to 5.7 +/- 1.4 ml/min/100 torr) and after injury (20.6 +/- 1.0 falling to 10.3 +/- 2.7 ml/min/100 torr). The airway portion (down to 2-3 mm airways) of the total bronchial blood flow of the injured lung increased more than three-fold (1.4 +/- 0.5 rising to 5.5 +/- 1.3 ml/min/100 torr; p < 0.01). This increased flow after aspiration was less affected by PEEP of 15 cm H2O (5.5 +/- 1.3 to 2.8 +/- 0.7 ml/min/100 torr, p = 0.09) than before injury (1.4 +/- 0.5 falling to 0.5 +/- 0.1 ml/min/100 torr; p < 0.05). The increase of the parenchymal portion of the bronchial blood flow after injury, although apparent (9.9 +/- 1.8 increasing to 15.1 +/- 1.2 ml/min/100 torr), was not significant (p = 0.08).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Cough reflex threshold in diabetes mellitus with and without autonomic neuropathy.

The cough reflex, a vagus-mediated respiratory protective reflex, was investigated in diabetics and healthy controls by establishing a cough reflex threshold to increasing concentrations of citric acid aerosol. Diabetics with autonomic neuropathy (n = 20), whether overtly symptomatic (n = 5) or evident only on certain non-invasive cardiovascular autonomic function tests, were found to have significantly (p < 0.05 by chi 2 test) raised cough reflex threshold (range 1 to > 100%, median value 50%) in contrast to either the non-neuropathic diabetics (n = 20) or normal controls (n = 20; range 1-10%, median value 2%). This difference suggests vagal (parasympathetic) denervation of the respiratory tract, with possible serious consequences, hitherto little appreciated.

Administration, Inhalation↗
PubMed1995

Alterations in circulating thyroid hormones in Indian smokers (bidi and cigarette).

T4, T3 and TSH were estimated in 56 bidi and 50 cigarette smokers and their mean estimates were compared with the corresponding values in 25 healthy non-smokers. T4, T3 and their ratios were significantly lower in both bidi and cigarette smokers (p < 0.001). Circulating TSH in both groups of smokers was similar to that in nonsmokers. T4 and T4/T3 were lower in bidi smokers compared to those in cigarette smokers (p < 0.05 and < 0.01, respectively). Severity of smoking affected T4/T3, and TSH in bidi smokers and T4 in cigarette smokers. Normal TSH excluded any significant decrease in thyroid function in smokers. The alterations in circulating T4 and T3 might have been influenced by thyroid hormone production, protein binding as well as peripheral metabolism of T4 by adverse constituents of bidi/cigarette smoke.

Adult↗
PubMed1994

Ventilatory function in nonsmoking rural Indian women using different cooking fuels.

Lung function parameters, forced vital capacity (FVC), forced expiratory volume in 1st s (FEV1), peak expiratory flow rate (PEFR), were measured in 3,318 nonsmoking Indian women using four different types of cooking fuels (biomass, liquified petroleum gas, kerosene and mixed). Biomass fuel users had FVC values less than 75% predicted (73.42 +/- 0.90; mean +/- SE) whereas in other groups it was more than 75% of predicted, though less than 80% of the predicted values. However, FEV1, FEV1/FVC (%) and PEFR were within normal limits in all the four groups. The absolute values of all the three parameters of lung functions were the lowest in the biomass and mixed fuel users. A negative correlation was observed between these parameters and the duration of cooking and exposure index. Thus the present study showed that, lung function, particularly FVC, is affected by indoor air pollution due to domestic cooking more so with biomass fuel. Better housing and use of smokeless devices for cooking might be helpful to avoid this effect on lung. This ventilatory impairment seems to be more of the restrictive (parenchymal) type, since obstruction could be ruled out. A longitudinal study is needed to demonstrate whether or not these changes are variable, reversible or progressing to fibrosis.

Adult↗
PubMed1994

Neutrophil count and myeloperoxidase activity in Indian bidi smokers.

Myeloperoxidase (MPO) level and MPO scoring were estimated in Indian bidi smokers and compared with those in cigarette smokers and non-smokers. The values were higher in the neutrophils of 20 bidi smokers compared to 20 age-matched non-smokers (p < 0.001). However, they were similar to those in 20 cigarette smokers. No correlation of MPO activity was observed with blood carboxyhaemoglobin levels and smoking indices except in bidi smokers. Total leucocyte count and total neutrophil counts were also higher in bidi and cigarette smokers. This increased MPO activity in the neutrophils of bidi and cigarette smokers may contribute to the greater risk of obstructive pulmonary disease.

Adult↗
PubMed1994

Normal variations in spirometry in health following placebo inhalation.

Normal i.e., chance variations in spirometry were evaluated in 80 healthy Indian adults by the measurement of base-line spirometric indices (FVC, FEV1 and FEF25-75%) and the per cent changes following placebo administration of aerosolized saline. There was a mean per cent change of 0.7, 0.4 and 0.3 per cent over the base-line values in FVC, FEV1 and FEF25-75% respectively following placebo inhalation. The cut off responses for 95 per cent confidence limits were 11.2 per cent for FVC and 12.7 per cent for FEV1 following placebo inhalation. Since the test sample represents a healthy Indian population, a per cent change greater than 12.7 per cent in FEV1 is more than that observed in 95 per cent of healthy Indians. It is suggested that for both delta FEV1 per cent and delta FVC per cent, the lower limit should be fixed at more than 15 per cent to define 'abnormality' in clinical practice.

Administration, Inhalation↗
PubMed1992

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↗
PubMed1992

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↗