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Biomedical subjects

M T Mathew

Publications and source records attributed to M T Mathew.

13 recordsLinked to original sources
PubMed1993

Raynaud's phenomenon and gangrene following snake envenomation.

Local necrosis and gangrene at the site of the bite are commonly observed after snake envenomation. However, Raynaud's phenomenon and gangrene occurring in a limb other than that bitten by the snake is encountered rarely. So far, there is only one report of such an episode in literature. Here we are reporting a case of patient with snake bite on the right foot following which he developed Raynaud's phenomenon of the left upper limb and dry gangrene of the tips of the left index and middle fingers. The snake was identified as Russel's viper.

Arm↗
PubMed1981

Renal involvement in leprosy.

Renal involvement in 13 non-lepromatous and 17 lepromatous leprosy patients were assessed by routine urinalysis, detailed biochemical analysis of blood and urine and by renal histopathological studies and compared with 10 normal healthy controls. The presence of RBC and pus cells were detected in the urinary deposit of only one lepromatous leprosy patient in reactional phase. A reversal of albumin/globulin ratio was observed in 17.6% of non-lepromatous and 15.3% of lepromatous patients. 24 hours urinary excretion of sodium, potassium, chloride and aminonitrogen of the patients were within the normal range. Forth seven percent of the non-lepromatous and 46% of the lepromatous patients had proteinuria. Even though the mean serum creatinine values of the patients showed no difference from that of the normals, the creatinine clearance was low in 82.3% of the non-lepromatous and in all of the lepromatous patients. Serum phosphorus, serum uric acid, urinary phosphate excretion and the renal tubular reabsorption of phosphorus of the patients were normal. Twenty one percutaneous renal biopsy specimens showed nonspecific pathological changes such as nephritis of various varieties in 71.4% of the specimens. Among the lepromatous group renal involvement was observed in 5 out of 9 cases (55.6%) and in the non-lepromatous group 10 out of 12 cases (83.3%). No acid fast bacilli, amyloid and granuloma were seen in any of the renal tissues studied. There was no definite correlation between the type of renal pathology and biochemical changes. None of the patient showed any clinical evidence of renal involvement.

Adolescent↗
PubMed1978

Aortic root motion determined by ultrasound: relation to cardiac performance in man.

The purpose of this study was to determine if aortic root systolic anteroposterior excursion measured ultrasonically is related to cardiac performance. Aortic motion was 9 +/- 1.5 mm (mean +/- SD) in 30 normal subjects (range 7-12 mm). Ten patients with coronary artery disease and congestive failure and 10 with congestive cardiomyopathy had significantly smaller values of 4 +/- 1.2 and 5 +/- 1.7 mm, respectively (P less than 0.001). In 28 subjects undergoing cardiac catheterization, aortic root motion correlated positively with stroke volume (r = 0.59), but did not correlate significantly with ejection fraction. By increasing heart rate in 14 subjects from 75 to 174 beats/min with atrial pacing, stroke volume decreased from 81 +/- 22 to 34 +/- 14 ml/beat and aortic excursion from 10 +/- 1.6 to 5 +/- 1.5 mm (P less than 0.001). This study has shown: 1) Aortic root motion less than or equal to 6 mm indicates left ventricular dysfunction; 2) stroke volume correlates positively with, but cannot be accurately predicted from, root motion.

Adult↗
PubMed1976

Nitroglycerin ointment in acute myocardial infarction.

The hemodynamic effects of nitroglycerin ointment were studied in 22 patients with acute myocardial infarction. Control measurements were obtained and observations were made over the ensuing 240 minutes. There was no change in heart rate, cardiac index or stroke index. Ninety minutes after application of the ointment, peak decrements were evident in mean arterial pressure (from 100 to 88 mm Hg) (P less than 0.001), pulmonary capillary wedge pressure (from 19 to 13 mm Hg) (P less than 0.001), right atrial pressure (from 8 to 5 mm Hg) (P less than 0.001) and heart X systolic blood pressure (from 1,155 to 1,044 mm Hg/min X 10(-1) (P less than 0.02); significant changes were still present at 240 minutes. Total peripheral resistance decreased maximally from 19.8 to 17.2 units (P less than 0.02); the transmyocardial gradient (arterial diastolic -- pulmonary capillary wedge pressure) did not decrease during the study. These data indicate that nitroglycerin ointment improves cardiac performance in patients with acute myocardial infarction while reducing the determinants of myocardial oxygen consumption and preserving the transmyocardial gradient for coronary blood flow.

Acute Disease↗
PubMed1976

Comparative effects of lidocaine and procainamide on acutely impaired hemodynamics.

Controversy exists regarding the relative safety of intravenously administered lidocaine and procainamide to patients with acutely impaired hemodynamics. Accordingly, their effects were studied in 15 such patients, 14 with acute myocardial infarction and one with cardiomyopathy and severe congestive heart failure. All had elevated levels of pulmonary capillary wedge pressure (greater than 15 mm Hg) and/or low cardiac index (less than 2.5 liters/min/m2). Patients were given lidocaine, a 100 mg bolus followed by a 3 mg/min infusion and, after at least a 30 minute recovery period, procainamide, a 100 mg bolus over 2 minutes followed by a 20 mg/min infusion for 20 to 25 minutes. Hemodynamic measurements were compared early and late in the infusion of each drug. Small, clinically insignificant differences were observed in the hemodynamic responses to the drugs, and no clinically significant deterioration occurred with either. Conventional therapeutic doses of intravenous procainamide can be administered by this regimen, to patients with acute myocardial infarction complicated by cardiac failure or low cardiac output, without producing deleterious hemodynamic effects.

Acute Disease↗
PubMed1976

Acute renal failure of obstetric origin.

Acute renal failure of obstetric origin is common among North Indian patients and comprised 72 (22.1%) of 325 patients undergoing dialysis over an 11-year period. Of these, 46 gravidas had developed renal failure following abortion, and 29 cases were due to complications of late pregnancy. The most striking feature of this study was a high incidence of irreversible renal lesions of bilateral diffuse cortical necrosis in early (18.6%) as well as late pregnancy (37.8%). Overall incidence of diffuse cortical necrosis was 25%. In the remainder, acute tubular necrosis was seen in 52 (72.2%), patchy cortical necrosis in 1 (1.4%), and tubular necrosis along with glomerular involvement in 1 patient (1.4%). Pathogenetic factors which contributed to the development of renal failure, either singly or in combination, were loss of blood failure, either singly or in combination, were loss of blood (79.1%), septicemia (31.9%), hypotension due th hemorrhagic and septicemic shock (51.4%), eclamptic toxemia (11.1%), and disseminated intravascular coagulation in 12.5% patients. Infrequent occurrence of disseminated intravascular coagulation in the septic anc eclamptic patients who developed diffuse cortical necrosis was an interesting finding, as was the fact that coagulopathy was more frequently observed in acute tubular necrosis. Late referral, frequent sepsis, and high incidence of bilateral diffuse cortical necrosis contributed significantly to a high mortality (55.3%).

Abortion, Induced↗
PubMed1975

Acute renal failure following snakebite.

Eight patients with acute renal failure following snakebite were studied. Intravascular hemolysis and disseminated intravascular coagulation contributed to the development of acute renal failure in 6 patients. Direct nephrotoxicity causing acute renal failure is postulated in 2 patients, 1 of whom also revealed evidence of mild, disseminated intravascular coagulation. Three patients had histopathological lesions of acute symmetrical cortical necrosis and 3 had acute tubular necrosis. In 1 patient with acute tubular necrosis, in whom direct nephrotoxicity seemed to be responsible for renal failure, the striking histological feature was a uniform debasement and disappearance of tubular epithelium. In 2 patients with a clinical course of acute tubular necrosis, histological lesions could not be documented. All the 5 patients with acute tubular necrosis regained full recovery of renal function, 3 of them with the help of dialysis and 2 with conservative management. None of the 3 patients with acute cortical necrosis survived in spite of intermittent dialysis therapy.

Acute Kidney Injury↗