Biomedical subjects

D Hariparsad

Publications and source records attributed to D Hariparsad.

10 recordsLinked to original sources

PubMed1986

Morphine in tetanus--the management of sympathetic nervous system overactivity.

Morphine was administered intravenously in bolus doses 6-hourly to 10 patients; 9 developed signs of sympathetic overactivity and required increased morphine dosage. The mean daily morphine dosage was 103 +/- 36 mg and the maximum daily dosage was 170 +/- 65 mg. In all cases morphine decreased the mean arterial blood pressure (mean 18%; P less than 0.01) and heart rate (mean 7%; P less than 0.01). In 7 cases the cardiac output fell minimally (mean 7%; P = 0.07), while the systemic vascular resistance decreased (mean 12%; P less than 0.01) in 8 cases. Nine patients survived, 1 died from renal failure and septicaemia. There were no apparent problems with either opiate withdrawal or addiction. No patient required either alpha- or beta-adrenergic blockers and the consequent simplified management constitutes a significant improvement in control of these patients.

Adolescent↗

PubMed1985

Mesangial proliferative glomerulonephritis with Legionnaires' disease. A case report.

Although the clinical and biochemical features of renal involvement in Legionnaires' disease have been well described, only a few case reports detailed the histological changes. A patient with Legionnaires' disease who developed acute renal failure is described; a biopsy specimen revealed mesangial proliferative glomerulonephritis. The renal morphological changes in Legionnaires' disease are reviewed.

Acute Kidney Injury↗

PubMed1985

Nasotracheal intubation versus tracheostomy for intermittent positive pressure ventilation in neonatal tetanus.

Fifty-two neonates with tetanus who required muscle paralysis and IPPV were managed alternatively with naso-tracheal intubation or tracheostomy. The complications of the two techniques were compared. Planned extubation caused less problems in the intubated than in the tracheostomized children, and secondary infection occurred less often. Accidental extubation, however, was a significant hazard in the intubated child.

Humans↗

PubMed1984

Renal function in tetanus.

In twenty-eight patients suffering from tetanus, renal function was evaluated from admission for a period of 2 weeks. Investigations included daily blood urea, osmolality and creatinine and urinary osmolality and sodium. Free water clearance (CH2O) was calculated. The patients were divided into those requiring tracheostomy and sedation alone (Group I) and those with more severe tetanus requiring total muscle paralysis and IPPV (Group II). The latter group also had evidence of sympathetic nervous overactivity (SOA). Daily blood urea, serum creatinine and osmolality showed no significant difference between the two groups except during the phase of uremia. Mean urinary sodium was significantly different between the two groups (p less than 0.001). Four patients in Group II developed an abnormal plasma urea (Group IIb). In one patient the rise in urea followed resuscitation from cardiac arrest and the remaining three patients had in common severe cardiovascular instability associated with SOA. All four patients were non-oliguric during the phase of uremia. Only one patient with renal failure survived, compared with a 75% survival in the patients with SOA without renal failure and a 100% survival in Group I. Tetanus complicated by renal failure has a poor prognosis.

Adolescent↗

PubMed1984

Oral tartrazine challenge in childhood asthma: effect on bronchial reactivity.

Ten asthmatic children who gave a history of cough or wheeze after orange drinks, were tested for tartrazine sensitivity. On separate days, either oral tartrazine (1 mg) or a placebo capsule were administered double blind. Bronchial reactivity was measured before, 30 and 60 min after ingestion by means of a histamine-inhalation challenge test. There was no change in baseline lung function after tartrazine, but histamine sensitivity (PC20) increased significantly in four of the children. No response was obtained to a larger dose of tartrazine (10 mg) in four of the non-responders. Alteration in the bronchial reactivity after an oral challenge, appears to be a sensitive means of detecting tartrazine sensitivity.

Adolescent↗

PubMed1983

Labetalol in tetanus. The treatment of sympathetic nervous system overactivity.

The cardiovascular instability in some cases of severe tetanus is due to increased circulating catecholamines. In 15 patients with this complication of tetanus, labetalol, a drug with alpha- and beta-peripheral adrenergic blocking properties, was used in management. The drug was administered orally, by i.v. bolus or by continuous infusion. Wide variation in dosage was needed both from case to case and in the same patient during the course of his disease. In most cases the pulse and blood pressure were reduced by labetalol, although their variability was not much improved. The effect on the cardiac output and systemic vascular resistance ranged from modest reduction in both, to marked effect on cardiac output without any change in systemic vascular resistance. The alpha-adrenergic blockage of labetalol is known to be less powerful than the beta-blocking effect, and this property could be a disadvantage in the management of sympathetic overactivity in tetanus.

Adolescent↗

PubMed1983

Reproducibility of histamine challenge tests in asthmatic children.

The measurement of bronchial reactivity by histamine challenge testing is of increasing clinical importance in paediatrics. By means of a simple tidal breathing technique for the measurement of histamine sensitivity (expressed as PC20--the concentration of histamine which produces a 20% fall in peak flow rate) in childhood asthma, the reproducibility of pairs of tests was estimated over one hour and 24-hour intervals in 22 children. Under carefully controlled conditions the 95% confidence limits of PC20 were 0.8-1.25 X baseline PC20 after one hour and 0.36-2.8 X baseline PC20 after 24 hours.

Adolescent↗

PubMed1982

Serum angiotensin-converting enzyme estimation and the Kveim-Siltzbach test in sarcoidosis.

Serum angiotensin-converting enzyme (SACE) and Kveim-Siltzbach test results were obtained in 25 patients with clinically active sarcoidosis. Twenty of these patients had elevated SACE levels and 17 had positive Kveim-Siltzbach tests. One patient had normal SACE activity and a negative Kveim-Siltzbach test. Four of the 6 patients with a normal SACE level had a positive Kveim-Siltzbach test and 7 of the 8 patients with a negative Kveim-Siltzbach test had elevated SACE levels. These results indicate that the two tests are complementary and increase the diagnostic specificity in sarcoidosis. We conclude that the concurrent use of SACE measurement and Kveim-Siltzbach tests is of value in the diagnosis of sarcoidosis.

Adult↗

PubMed1981

Legionnaires' disease in Durban. A case report.

An isolated case of Legionnaires' disease occurring in Durban is described. The patient presented with bilateral extensive pneumonia. Diagnosis was made by the indirect immunofluorescent antibody test, which showed a fourfold rise in titre from 1 : 128 to 1 : 512. Awareness of the fact that Legionnaires' disease occurs here should result in early recognition and appropriate management of this disease.

Diagnosis, Differential↗

PubMed1980

Serum angiotensin-converting enzyme in sarcoidosis.

Serum angiotensin-converting enzyme (SACE) activity was measured in 29 patients with sarcoidosis, 51 reference subjects, 7 patients with active tuberculosis and 8 patients with other lung diseases. SACE activity was increased in 93% of the patients with sarcoidosis as compared with the reference subjects. Patients with active tuberculosis and other lung diseases did not have increased SACE activity.

Adult↗