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Biomedical subjects

D Nag

Publications and source records attributed to D Nag.

At least 37 records · Page 2Linked to original sources

The Stanford Health Information Network for Education: integrated information for decision making and learning.

Although multiple decision support systems have been built for physicians, efficient delivery of valid and complete medical knowledge remains an elusive goal. In this paper we describe a new project, the Stanford Health Information Network for Education (SHINE). SHINE unifies core medical resources in an intuitive interface to support clinical decision making. Included in the description is a novel paradigm for continuing medical education (CME).

California↗

Alprazolam in chronic tension type headache.

Alprazolam was evaluated in the treatment of 62 patients of chronic tension type headache using a double blind cross over design with random allocation to drug or placebo. The duration of the trial was 4 months with a 2 week run in period and 2 week washout period separating two treatment periods of 4 weeks each. The patients were followed up for 4 weeks at the completion of the trial. 48 patients completed the trial. There was no significant difference in the overall response rate based in terms of percentage reduction in headache frequency per week, however a significant decrease in headache index was observed during treatment with alprazolam as compared to placebo (P < 0.05). The mean analgesic intake per week was also significantly lower during treatment with alprazolam as compared to the run in period. Side effects were seen in 16.67% patients. In none of the patients was it significant enough to require withdrawal from the study.

Adult↗

Sympathetic skin response and autonomic dysfunction in diabetes.

Study was conducted on 34 middle aged (35-52 years) diabetics of either sex to compare autonomic function in patients having and not having symptoms of dysautonomia. Fifteen age/sex matched healthy non-diabetic volunteers were control. No symptom of autonomic insufficiency was present in 19 (55.8%) while 15 (43%) diabetics had dysfunction in form of episodic syncope, vertigo, and palpitation, all on postural change. Tests of autonomic functions were restricted to evaluation of salivation, lacrimation, sweating, pilomotor response, reflex erythema and blood pressure changes with valsalva, posture and cold pressor. SSR was elicited using 5 stimuli on programmed Neuropack II and IV model machine. In asymptomatic diabetics, tests of autonomic functions were normal and comparable to controls but SSR was not recordable in 8 (42%). In remaining 11 (58%) asymptomatic diabetics, it was recordable. In 15 subjects who had symptoms of autonomic dysfunction, 6 (40%) had positive test of autonomic function but SSR was normal in only 5 (34%) and not recordable in 10 (66%) subjects. We conclude that SSR can be used as a easy, sensitive and probably early indicator of autonomic functions.

Adult↗

A double blind placebo controlled trial of ginkgo biloba extract in acute cerebral ischaemia.

A double blind placebo controlled trial was conducted in 55 patients of acute ischaemic stroke. Twenty one and twenty six patients were randomly allotted in group A and group B respectively. In group A, the patients received 40 mg Ginkgo biloba extract at 6 hourly intervals along with routine management. The placebo tablets were dispensed in the tablet form of same size, shape and colour and were given in the same way. After the patients were subjected to computerized tomographic (CT) scan to confirm acute ischaemic infarction, they were assessed on Mathew's scale and reassessed, at 2 weeks and 4 weeks of drug/placebo administration. Both groups showed significant improvement in Mathew's scale score after 2 weeks and 4 weeks. The difference in degree of change was negligible (p > 0.05) in either group. Estimation of relative changes of neurological deficit based on baseline values also showed negligible (p > 0.05) difference. A trial of Ginkgo biloba extract within 6 hours of stroke in a larger dose and in larger sample could be beneficial clinically in patients of cerebral ischaemic infarct, and needs further study. The usefulness of the plant extract has been demonstrated clinically and experimentally in more than 40 trials of chronic cerebral ischaemia, done elsewhere. This was not evident in our study as our study group was different (more than 48 hours after stroke). There appears to be no contraindication or adverse effect of this medication (Ginkgo biloba) in acute ischaemic stroke.

Brain Ischemia↗

Nifedipine in migraine and tension headache: a randomised double blind crossover study.

Nifedipine was evaluated in the prophylaxis of 28 patients each of migraine and tension headache using a double blind cross over design with random allocation to drug or placebo group. The duration of the trial was 3 months with a 2 week run-in period and 2 week wash-oat period separating two treatment periods of 4 weeks each. A satisfactory response was obtained in 71.4% of migraineurs (p < 0.001) and 28.6% of patients with tension headache (p = N.S). Minor side effects were observed in 5 patients. Nifedipine is a useful agent for the management of migraine as it reduces frequency and severity of pain but the drug cannot be recommended for tension headache.

Adult↗

Effect of age on P300 wave.

30 healthy elderly males (mean age 77.4 +/- 4.3 yrs) were subjects in this study. Equal number of young males (mean age 22 +/- 3.5 years) and middle aged subjects (mean age 46 +/- 3.2 years) served as control. P300 wave was estimated using a Neuropack 4 model of Nihon Kohden EMG machine. We observed a significantly increased latency, poorly defined and non reproducible P300 wave in 90% old subjects while in young the latency was in normal limits and the wave was well defined and reproducible. We presume P300 could serve as a future potential marker of the neurophysiological basis of aging.

Acoustic Stimulation↗

Some observations on clinical, cognitive and neurophysiological changes in subjects consuming indigenous alcohol.

Sixty-two subjects in age range of 25-50 years consuming more than 300 ml of alcohol daily, and an equal number of age matched non-alcoholic volunteers serving as control were tested. Their clinical and neurological evaluation, including electrophysiology was carried out. Their cognitive functions were measured using the modified WAIS system. In alcoholics there was a significant impairment of cognition, especially in orientation, attention and immediate recall. Their P300 wave was grossly abnormal as compared with the controls. Other electrophysiological investigations (EEG, NCV, EMG, BAER, VER) were normal. It is concluded that cognition may be grossly impaired in chronic alcoholics, which may not manifest clinically but is observed only after formal testing.

Adult↗

Effect of sodium valproate on serum amylase in epileptics.

Thirty-eight patients of generalised tonic-clonic seizures of epileptics in the age group of 15-30 years were included in this study. Of these 20 were started sodium valproate afresh and 18 already taking it for more than one year prior to inclusion. Serum amylase and serum valproic acid levels were measured in all of them, initially and at every 3 months interval for 9 months. Though no clinical evidence was present, there was significant increase in serum amylase levels in both the groups which has no correlation with dose or serum valproic acid levels.

Adolescent↗

Ultrasound and congenital dislocation of the hip. The importance of dynamic assessment.

One-hundred newborn children at high risk of hip instability were prospectively assessed clinically and by ultrasound. The decision to treat was based only on the clinical examination. At the age of three months all the children were evaluated clinically and with an anteroposterior radiograph of the pelvis. None of the standard ultrasound measurements of acetabular depth and femoral head cover correlated with the outcome at three months. Dynamic assessment of stability was the only ultrasound technique that had a significant relation with outcome.

Female↗

Ultrasound-guided aspiration for transient synovitis of the hip.

We reviewed 15 children with transient synovitis of the hip who had aspiration of an effusion under local anaesthesia with ultrasound guidance. There were no significant complications; aspiration was useful for diagnosis and gave considerable symptomatic relief. We discuss the role of ultrasound in diagnosis and treatment.

Acute Disease↗