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Biomedical subjects

M L Bhatia

Publications and source records attributed to M L Bhatia.

At least 91 records · Page 5Linked to original sources

Haemodynamic studies in veno-occlusive disease of the liver.

Haemodynamic studies in 8 tribal patients from central India with veno-occlusive disease of the liver are reported. The disease was caused by eating cereals contaminated with seeds of a crotalaria species rich in toxic pyrrolizidine alkaloids similar to monocrotaline and fulvine. All patients showed raised hepatic venous wedge pressures and pressure gradients between hepatic venous wedge and free hepatic vein. Significant pressure gradients were also observed in the inferior vena cava. Right and left heart pressures were normal. Cardiac and stroke indices and ventricular work were significantly increased while systemic and pulmonary resistances were reduced. Hepatic blood flow was also reduced. Hepatic venograms were abnormal and the changes correlated well with the pressure gradients between hepatic venous wedge and free hepatic vein and with the histological changes in the liver.

Adolescent↗

Metoprolol--a new cardioselective beta-adrenoceptor blocking agent for treatment of tachyarrhythmias.

The antiarrhythmic effect of the cardioselective beta-adrenoceptor blocking agent metoprolol, given intravenously, was studied in 44 patients with various tachyarrhythmias, including patients with congestive heart failure and signs of digitalis intoxication. All patients with atrial tachycardia (12 cases) reverted to normal sinus rhythm. In 3 out of 18 patients with atrial fibrillation, sinus rhythm was restored, and in the others there was a significant reduction in ventricular rate. In 6 of 10 patients with ventricular ectopic beats, and 1 of 2 patients with ventricular tachycardia, the ectopic rhythm was abolished. The drug was well tolerated, without any significant changes in blood pressure, even by patients with signs of digitalis intoxication and varying degrees of pulmonary or peripheral circulatory congestion. Metoprolol is of clinical value for treatment of tachyarrhythmias, especially those of supraventricular origin.

Adolescent↗

Study of an epidemic of venoocclusive disease in India.

Twenty-five cases of rapidly developing ascites occurring in an epidemic form were observed in a tribal district in Central India during August 1972-May 1973. Eleven of the patients died. Six patients were brought to hospital and studied for periods of two to 17 months. Necropsy was performed on one patient who died. The clinical features suggested an outflow tract obstruction such as a Budd-Chiari-like syndrome or venoocclusive disease. Radiographic and haemodynamic studies demonstrated a combination of post and perisinusoidal blocks. Liver dysfunction was indicated by the presence of a marked bromsulphthalein retention and mild to moderate hypoalbuminaemia. Histological examination of the liver biopsies showed changes that ranged from centrizonal haemorrhagic necrosis to an extensive centrilobular fibrosis associated with central vein occlusion. The disease was apparently caused by a food toxin, and the possible nature of this is discussed.

Adolescent↗

Systolic time intervals in constrictive pericarditis. A study before and after digitalis.

Systolic time intervals were studied in 9 patients with documented constrictive pericarditis before and 15 to 20 minutes after intravenous administration of peruvoside (a quick acting digitalis-like glycoside) to determine underlying myocardial dysfunction. Data were compared with those of similarly studied normal subjects and patients with known myocardial dysfunction. Left ventricular ejection time index (LVETI) decreased in normal subjects (P less than 0.01) and in most patients with constrictive pericarditis, and increased marginally in those with myocardial dysfunction (NS) after peruvoside administration. Pre-ejection period index (PEPI) shortened significantly (P less than 0.01) after peruvoside in normal subjects and in patients with myocardial failure, but not in constrictive pericarditis. Likewise the predicted ejection fraction was insignificantly altered in constrictive pericarditis but significantly so (P less than 0.01) in myocardial failure and normal subjects. The response of one patient with constrictive pericarditis to parenteral peruvoside administration was similar to that seen in patients with myocardial failure. This patient had a delayed recovery after pericardiectomy. PEPI/LVETI ratio and ejection fraction were also abnormal in other patients with constrictive pericarditis when compared to normal subjects. Such abnormalities and the unusual response of some patients to administration of peruvoside may reflect underlying myocardial dysfunction in patients with constrictive pericarditis. However, it is possible that the rigid pericardium also contributes to these abnormalities to a varying extent. Systolic time indices and their response to digitalis appear to be a useful, atraumatic method for detecting underlying myocardial dysfunction in patients with constrictive pericarditis.

Adolescent↗