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Biomedical subjects

N P Verma

Publications and source records attributed to N P Verma.

At least 19 recordsLinked to original sources

Prior head injury accounts for the heterogeneity of the alcohol-epilepsy relationship.

Fifty-five adult male patients with alcoholism and seizures were divided into three groups. In group I, all seizures were consistently produced by alcohol withdrawal (N = 16); in group II, some seizures were clearly precipitated by alcohol withdrawal and others were not (n = 18); and in group III none of the seizures had a consistent relationship with drinking (N = 21). The three groups were compared for age, frequency of seizures, compliance, Bear-Fedio and Boston-Naming scores, those for memory of words and faces, and finger-tapping scores, and neuropsychological impairment ratings as well as EEG background frequencies. The incidence of severe head injury preceding the onset of seizure disorder was significantly higher in groups II and III. This was further supported by a greater prevalence of asymmetric alpha rhythm, abnormal CT scans and multiple seizure types in those two groups. These data indicate that a prior head injury is a major variable accounting for the heterogeneity of the alcohol-epilepsy relationship.

Alcoholism

Enalapril monotherapy in essential hypertension.

Thirty adults with essential hypertension (systolic BP greater than 150 mmHg or diastolic BP greater than 100 mmHg) were treated with 5-20 mg of enalapril to study its anti-hypertensive efficacy and safety. Ten patients had mild hypertension (diastolic BP greater than 90 mmHg and less than 105 mmHg), 10 had moderate hypertension (diastolic BP greater than 105 mmHg and less than 115 mmHg) and 6 had severe hypertension (diastolic BP greater than 115 mmHg). Of the 20 patients who completed the trial, 9 (45%) showed optimum reduction of BP to less than 130/90 mmHg) and a further 7 (35%) showed significant reduction. The mean fall in systolic BP was 32.5 mmHg (0-80 mmHg) and in diastolic BP was 18.5 mmHg (0-50 mmHg). The peak fall in BP was achieved in 3.5 weeks (1-6 weeks) with a mean dose of 7.2 mg of enalapril daily (5-15 mg/day). Mild side effects not needing drug withdrawal were seen in 8/20 patients (40%). Monotherapy with enalapril appears to be effective and safe as step one therapy for patients with essential hypertension.

Adult

Plasma renin activity in diabetics with and without microangiopathy.

Plasma renin activity was measured in ten diabetics with nephropathy, 10 uncomplicated diabetics and 10 normal healthy controls. All the groups were comparable for age, sex, and duration of diabetes. Plasma renin activity was found to be significantly lower in patients with nephropathy in comparison to uncomplicated diabetics and normal healthy controls. There was no correlation between plasma renin activity and mean blood pressure or degrees of renal failure. These findings raise the possibility that microangiopathic changes occurring in the glomeruli and juxta-glomerular apparatus may alter the renin-angiotensin system. Also the finding of low renin in diabetics with nephropathy may modify management policies.

Adult

Waves earlier than P3 are more informative in putative subcortical dementias: a study with mapping and neuropsychological techniques.

Thirty subjects (normal controls, patients with putative subcortical dementia and non-demented patient controls) were studied using advanced neurophysiological (16 scalp-electrode positions, computer-assisted brain electrical activity mapping, auditory oddball paradigm) and neuropsychological techniques. Our study suggests that waves earlier than P3 (N1, P2 and N2) are all correlated with global measures of cognitive functions. They are, however, differentially correlated with specific measures of cognitive functions, N1 and P2 with mental speed and N2 with short-term memory. The abnormalities of these waves (earlier than P3) may be an electrophysiologic marker of dementia in patients with putative subcortical states.

Aged

Pathogenesis of reduplicative paramnesia.

The incidence of reduplicative paramnesia was sampled with a structured interview in 50 consecutive alcoholic inpatients. Four had reduplicative paramnesia (RP group) and 46 did not (non-RP group). Three of four patients in RP group had acute right hemispheric lesions and none had a left hemispheric lesion; 19 non-RP patients had left hemispheric lesions, 2 had right, and 25 had none. These data are in keeping with the previous suggestions that the neuroanatomical basis for reduplicative paramnesia is an acute right hemispheric lesion superimposed on chronic diffuse or bifrontal deficit.

Adult

Sensory evoked responses in Tourette syndrome.

Based on an earlier study of EEGs and the present article on sensory evoked responses, with a total of 32 patients, it appears that routine electrophysiologic studies do not provide a good biological marker in Tourette Syndrome.

Adolescent

Dose-response effects of chronic methylphenidate administration on late event-related potentials in attention deficit disorder.

Stimulants, such as methylphenidate, are extensively used in the treatment of attention deficit disorder. In the present study, we used a double-blind placebo-controlled, prospective protocol to evaluate the effects of methylphenidate (MP) (dose 0.1 and 0.33 mg/kg three times daily) on the late event-related potentials, some of which are considered biological attention correlates. Sixteen patients, 6-15 years old, were tested, using an auditory target selection paradigm. The latencies of N200 and amplitudes of P150 increased with MP (p less than 0.01). These effects are in the direction of normal maturational change. The latencies of P300 tended to be shorter in adolescents than in children, and with high MP dose the P300 latencies became even shorter in adolescents but were prolonged in children (p less than 0.05). This pattern of change supports the view that pharmacological interactions with various cerebral phenomena including cognition may be age-specific.

Adolescent

Ear-to-ear derivation in short latency brainstem auditory evoked responses.

We utilized an ipsilateral to contralateral earlobe (Ai-Ac) derivation in addition to the scalp to ipsilateral ear (Cz-Ai) and scalp to contralateral ear (Cz-Ac) derivations, in 12 normal hearing community volunteers and 36 patients with a variety of referrals and varying degrees of hearing loss. In normal subjects, the latency of wave I in the Ai-Ac derivation was identical to that in Cz-Ai, but amplitude was consistently smaller (0.21 +/- 0.1 vs. 0.30 +/- 0.13 microV, p less than 0.005). The wave III behaved in a reverse manner. These data can be easily explained based on traditional principles of near- and far-field potentials. The amplitude differences of the wave I in Cz-Ai and Ai-Ac derivations were, however, small and the phase-reversals of that wave between the 2 derivations were striking and consistent in all subjects and patients. This observation indicates that the addition of Ai-Ac derivation to the conventional 1 or 2 channel montage may aid in the identification of wave I.

Adolescent