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Biomedical subjects

D K Kochar

Publications and source records attributed to D K Kochar.

70 records · Page 4Linked to original sources

Propranolol in acute intermittent porphyria.

Twenty cases of acute intermittent porphyria were studied during the acute phase. Cardiovascular manifestations were noted in all the cases, with tachycardia in 20 and with hypertension in 17. Propranolol in doses ranging from 20--200 mg was given to all the cases and produced adequate control of tachycardia and hypertension. At follow-up, smaller doses of propranolol were found to maintain the pulse rate and BP within normal limits and also to prevent acute attacks.

Acute Disease↗

Cardiac autonomic neuropathy and its correlation with QTc dispersion in type 2 diabetes.

This study was conducted on 50 patients of diabetes mellitus type 2 and 20 healthy controls to correlate severity of diabetic cardiac autonomic neuropathy with QTc interval and QTc dispersion. Five standard cardiovascular response tests were carried out (i.e. Valsalva ratio, expiration-inspiration ratio, immediate heart rate response to standing, fall of systolic blood pressure on standing and sustained hand grip test) to determine the severity of cardiac autonomic neuropathy by scoring system. QTc dispersion was determined by subtracting heart rate-corrected minimum QTc interval (QTc min) from maximum QT interval (QTc max) from standard electrocardiogram. Severity of cardiac autonomic neuropathy strongly correlated with QTc dispersion (r = 0.760; p = 0.0001). Correlation of severity of cardiac autonomic neuropathy with QTc max and QTc mean was also found but weaker than with QTc dispersion (r = 0.663, r = 0.542, p = 0.0001 each) and no correlation was found with QTc min (r = 0.177; p = 0.17). This shows that QTc dispersion is a better predictor of cardiac autonomic neuropathy than any of above three QTc intervals. QTc max, QTc mean and QTc dispersion were significantly higher (p < 0.001) in diabetics with autonomic neuropathy (450 +/- 23, 423 +/- 22 and 57 +/- 12 msec; n = 30) than without neuropathy (407 +/- 14, 397 +/- 15 and 20 +/- 7 msec; n = 20) and control subjects (408 +/- 20, 399 +/- 19 and 19 +/- 7 msec; n = 20) but QTc min remained same in the three groups (393 +/- 21, 387 +/- 12, 388 +/- 19 msec, respectively) (p > 0.05). Correlation of QTc dispersion was stronger with QTc max (r = 0.781; p < 0.001) than QTc mean (r = 0.625; p = 0.001) but not with QTc min (r = 0.097; p = 1.0) which suggests that regional increase in QT interval due to regional autonomic denervation leads to increased QTc dispersion. Thus, QTc dispersion is a sensitive, non-invasive, simple and cost-effective predictor of cardiac dysautonomia.

Adult↗

Effect of arteether on electrocardiogram in the patients of falciparum malaria--a preliminary study.

The effect of intramuscular arteether (150 mg daily for 3 days) on electrocardiogram was studied in 16 patients having falciparum malaria. This included three patients with cerebral malaria, three patients with jaundice (S. bilirubin > 3 mg per cent) and ten patients with uncomplicated malaria. Five patients had tachycardia prior to arteether treatment. The mean RR interval before starting the treatment was 0.59 sec which increased progressively--0.60, 0.68 and 0.69 sec on Day 1, 2 and 3 respectively after starting the treatment. There was no significant difference statistically in the mean corrected QT interval (p > 0.05), PR interval (p > 0.05), QRS duration (p > 0.05) and diastolic BP (p > 0.05) before starting and at the end of treatment on Day 3. One patient had developed first degree heart block (PR 0.24), while another patient had prolonged QTc (0.48 sec) on Day 3. Subsequent ECG of both these patients was normal on Day 5. The profile of ECG changes was same in the patients of uncomplicated and complicated malaria. Absence of any significant effect on BP and ECG changes precludes the significant effect of arteether on the cardiovascular system when compared to quinine which may cause hypotension, arrhythmia and QTc prolongation.

Adult↗

Extraintestinal manifestations of idiopathic ulcerative colitis in northwestern India.

OBJECTIVE: To determine the frequency of extraintestinal manifestations in patients with idiopathic ulcerative colitis. METHODS: 46 patients underwent detailed clinical, biochemical and radiological evaluation. RESULTS: One patient (2%) had peripheral arthritis and two patients (4%) had ocular involvement in the form of anterior uveitis. No patient had mucocutaneous, vascular, or hepatobiliary manifestations, or sacroiliitis. CONCLUSIONS: The frequency of extraintestinal manifestations in patients with IUC in northwestern India is low.

Adolescent↗

Somatosensory evoked potentials (SSEPs); sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity (MNCV) in chronic renal failure.

Somatosensory evoked potentials, sensory and motor nerve conduction velocity were studied in 25 patients of chronic renal failure and the results were compared with 15 healthy persons. The values more than +/- 3 S.D. were considered abnormal. SNCV was reduced in 11/25 patients; average reduction being 18 m/s (highly significant, p < 0.001); MNCV was reduced in 11/25 patients, average reduction being 20 m/s (highly significant, p < 0.001). Both SNCV and MNCV in same person were reduced in 6/25 patients. In SSEP N9, N13 and N20 were delayed in almost all the patients (highly significant, p < 0.001). Amplitude of N20 and N13 were reduced in 1 and 4 patients respectively but amplitude of N9 was normal. Out of different IPLS, Ebw-N9 was delayed in 5/25 patients (p < 0.9, insignificant); N9-N13 was delayed in 8/25 patients (p < 0.001, highly significant); N13-N20 was delayed in 1/25 patients (p < 0.01, significant). The evidence of these neurophysiological abnormalities collectively suggest the presence of central-peripheral axonopathy in this disease.

Adult↗

Somatosensory evoked potentials in cerebral malaria. A preliminary study.

Somatosensory evoked potentials were recorded in patients of cerebral malaria by (R) median nerve stimulation. Important observations of this study were delayed absolute latency of N20, increased N13-N20 IPL i.e. central conduction time and distorted and dispersed waveforms of N9 and N20 peaks. The possible pathologic mechanism is discussed.

Action Potentials↗