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Biomedical subjects

M P Agarwal

Publications and source records attributed to M P Agarwal.

At least 19 recordsLinked to original sources

Role of Terminalia arjuna in ischaemic mitral regurgitation.

The bark powder of Terminalia arjuna, an indigenous plant has been found to have antianginal, decongestive and hypolipidemic effect. We planned a study to evaluate the role of T. arjuna in ischemic mitral regurgitation (IMR) following acute myocardial infarction (AMI). 40 patients with fresh AMI showing IMR were randomly divided into 2 groups of 20 each. They were given placebo or 500 mg of T. arjuna in addition to anti-ischemic treatment. After 1 and 3 months of follow up, patients receiving adjuvant T. arjuna showed significant decrease in IMR, improvement in E/A ratio and considerable reduction in anginal frequency.

Humans↗

Autonomic neuropathy in patients with hepatic cirrhosis.

BACKGROUND: Autonomic neuropathy has been reported in patients with alcoholic liver disease but information on its occurrence in patients with non-alcoholic liver disease is contradictory. AIM: To assess autonomic functions in patients with alcoholic and non-alcoholic liver disease. STUDY DESIGN: Autonomic function using five standard tests was examined in 20 cirrhotics (10 alcoholics and 10 non-alcoholics) and 20 age and sex matched controls. The extent of autonomic dysfunction was determined in the patients and a comparison between the characteristics of patients with and without autonomic neuropathy was made. RESULTS: Sixteen (80%) of the cirrhotic subjects were found to have evidence of autonomic neuropathy. Of these, three (15%) patients had early parasympathetic damage, five (25%) had definite parasympathetic damage, and eight (40%) had combined (that is, both parasympathetic and sympathetic) damage. Nine (90%) of the alcoholics and seven (70%) of the non-alcoholics had autonomic dysfunction. Only one patient belonging to the alcoholic group had clinical evidence of peripheral neuropathy. Moreover, there was no significant association between subjective symptoms of autonomic neuropathy and objective evidence of autonomic damage as assessed by autonomic function tests. Autonomic dysfunction was significantly more frequent in advanced liver disease compared with early liver damage. Nine (75%) out of 12 cirrhotic subjects belonging to Child class B and six (85.7%) of the seven patients belonging to Child class C had autonomic neuropathy. CONCLUSION: This study shows that autonomic neuropathy is common in cirrhotic subjects, that it is found with comparable frequency in alcoholics and non-alcoholics, and that it increases in severity with increase in extent of liver damage, suggesting that liver damage contributes to the neurological deficit.

Autonomic Nervous System Diseases↗

Concomitant Gilbert's syndrome and thalassemia trait.

A 23 years old male presented with fluctuating jaundice since age of five years. He was diagnosed to have thalassemia trait along with Gilbert's syndrome. He had disproportionately higher bilirubin concentration for either disorder alone. The importance of the concomitance of these disorders is highlighted.

Adult↗

Metrondazole-induced neurotoxicity.

A 50 year old male with history of prolonged intake of metronidazole for treatment of liver abscess developed acute ataxia, disorientation, distal symmetrical sensory and proximal motor neuropathy. Patients being treated with metronidazole particularly those on high doses for prolonged period should be monitored for neurotoxicity.

Anti-Infective Agents↗

Profile of hypertension in elderly subjects.

OBJECTIVE: To study clinical profile of hypertension in elderly subjects. METHODS: Two hundred and five consecutive subjects aged 60 years and above reporting to preventive cardiology clinic with cardiovascular disorders were studied. One hundred fifty six subjects (76.09%) were found to have essential hypertension (HTN). Newly detected hypertensives were classified as per JNC-VI classification. Detailed clinical examination and laboratory investigations were carried out to find evidence of associated ailments with HTN. RESULTS: Most of the patients belonged to 60-70 years age group. Mean age was 67.36 +/- 6.23 years (range 60 to 90 years) and male to female ratio was 1.44:1. Out of hypertensives 99 (63.46%) had HTN for long period, while 28 (17.94%), 17 (10.89%) and 12 (7.67%) belonged to mild, moderate and severe HTN categories, respectively. Out of newly detected hypertensives 14 (24.56%) were having isolated systolic HTN. Associated clinical conditions in hypertensives were coronary artery disease (CAD), non-insulin dependent diabetes mellitus (NIDDM), cerebrovascular disease (CVD), left ventricular hypertrophy (LVH) and chronic obstructive pulmonary disease (COPD) in 69 (57.05%), 49 (31.41%), 37 (23.71%), 20 (12.80%) and 10 (6.4%) subjects, respectively. HTN alone was found in 31 (19.87%) subjects only. Since most of these patients had other concomitant illnesses such as CAD. NIDDM etc. therapy was initiated accordingly. Four (20%) patients with LVH died within short period of 1 to 12 weeks. CONCLUSION: HTN is the commonest cardiovascular disorder in elderly subjects. CAD, NIDDM and CVD are commonly associated clinical conditions. Patients with associated LVH have very high short term mortality.

Age Distribution↗

Antianginal and cardioprotective effects of Terminalia arjuna, an indigenous drug, in coronary artery disease.

The effect of bark powder of Terminalia arjuna, an indigenous drug, on anginal frequency, blood pressure, body mass index, blood sugar, cholesterol and HDL-cholesterol was studied in 15 stable (Group A) and 5 unstable (Group B) angina patients before and 3 months after T. arjuna therapy. Tread mill test (TMT) and echocardiographic left ventricular ejection fraction was evaluated in some cases. There was 50% reduction in anginal episodes in Group A cases (P < 0.01). TMT performance improved from moderate to mild changes in 5 patients and one with mild changes became negative for ischemia. The time to the onset of angina and appearance of ST-T changes on TMT after T. arjuna was delayed significantly. However, in patients with unstable angina there was an insignificant reduction in anginal frequency. These patients also needed diltiazem, B-blockers and nitroglycerine in addition to T. arjuna. The drug lowered systolic blood pressure and body mass index to a significant level (p < 0.05) and increased HDL-cholesterol only slightly along with marginal improvement in left ventricular ejection fraction in stable angina patients. There were no deleterious effects on liver or kidney functions. Our results suggest that monotherapy with T. arjuna is fairly effective in patients with symptoms of stable angina pectoris. However, it has a limited role in unstable angina.

Angina Pectoris↗

Acute lymphatic leukemia and pregnancy.

Acute lymphatic leukemia (ALL) was diagnosed in a pregnant patient after she presented with features of superior vena cava obstruction. Patient received chemotherapy during the course of pregnancy. A premature but normal female child was born. A brief review of literature with respect to the toxicity of cytostatic drugs to fetus and mother is made. Although adults with ALL frequently achieve a complete remission, the decision about conception and pregnancy need to be individualized because of unpredictable course.

Adult↗