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Biomedical subjects

R Avasthi

Publications and source records attributed to R Avasthi.

At least 19 recordsLinked to original sources

Correlation between dispersion of repolarization (QT dispersion) and ventricular ectopic beat frequency in patients with acute myocardial infarction: a marker for risk of arrhythmogenesis?

BACKGROUND: QT dispersion (QTd) has evoked a lot of interest in recent years as regards the basic concept of dispersion of repolarization, which it is supposed to reflect on a surface ECG, as being a marker or substrate for arrhythmogenesis. QTd has been shown to be high in patients with ventricular fibrillation and tachycardia. But there is still some debate about its possible role as a marker or substrate for arrhythmogenesis. We studied whether it has any correlation with simple benign ventricular ectopic beats (VEB) after acute myocardial infarction. STUDY: We studied four different dispersion parameters (QTd, QTcd, JTcd, AQTd) on 2 different days after AMI and also obtained a 24-h ambulatory ECG on the 2nd day after admission in 64 out of a total of 90 patients. Patients were divided into five groups based on VEB frequency/h on a 24-h ambulatory ECG. RESULTS: We found a gradual increase in dispersion parameters across the five groups with increasing frequency of VEB. A significant difference was noticed between group 1 (VEB 0.0-0.9/h) and group V (>30/h) on the day of admission: QTd 88.8+/-28.5 versus 123.3+/-23.4, P<0.02; QTcd 100.5+/-27.6 versus 160.3+/-30.7, P<0.01; JTcd 95.5+/-31.0 versus 160.4+/-30.9, P<0.01; AQTd 29.6+/-8.2 versus 48.6+/-13.7, P<0.01. We also noticed a significant positive correlation between VEB frequency and dispersion parameters on both days. CONCLUSION: We hypothesize that with increasing dispersion of repolarization the chances or the frequency of ventricular arrhythmias increase. Our findings also point to a definite role of QTd as an arrhythmogenic marker or substrate.

Analysis of Variance↗

A clinical trial of the efficacy and safety of montelukast as monotherapy in patients with chronic stable bronchial asthma.

This study is aimed to evaluate the efficacy and safety of montelukast, as monotherapy, in the treatment of chronic stable bronchial asthma in adults. This was a multicentre, open label, non-comparative, prospective, 4-week study. Eligible patients discontinued all anti-inflammatory medication (steroids, chromoglycate sodium) 2 weeks prior to starting therapy with montelukast (10 mg daily). The primary efficacy criteria were improvements in forced expiratory volume in one second (FEV1), peak exploratory flow rate (PEFR) after 4 weeks of therapy. Secondary efficacy criteria were improvement in the patients' symptoms (assessed on an ordinal scale), decrease in discomfort levels (scored on a scale of 0-100), change in peripheral eosinophil counts, decrease in total daily dose of inhaled beta2 agonist (salbutamol). A total of 148 patients, mean age (+/- SD) 40.21 +/- 13.70 years, were enrolled into the study. At the end of the study there were significant improvements in FEV1 and PEFR (29% and 28% increase respectively from baseline values, p<0.000001). The mean total daily dose of inhaled salbutamol decreased significantly from prestudy values of 461 +/- 332 microg/day to 161 +/- 207 microg/day (p<0.000001). The mean eosinophil counts fell from 5.80 +/- 4.90% (+/- SD) to 4.84 +/- 4.42% (+/- SD) (p=0.02). Symptom scores improved significantly as did subjective assessment of discomfort. A total of 29 (19.6%) adverse events were reported, all of which were of mild to moderate intensity. Monotherapy with montelukast significantly improved parameters of asthma control. It was well tolerated with no reports of serious or severe adverse events.

Acetates↗

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↗

Evaluation of oxidative stress in some cases of argimone oil poisoning during a recent outbreak of epidemic dropsy in India.

The study was designed to evaluate the oxidative stress and modulation of anti-oxidant enzymes in 10 accidental argimone oil poisoning cases admitted in a hospital in Delhi, India during a recent outbreak of epidemic dropsy in 1998. Serum malondialdehyde (MDA) level, oxygen free-radical scavenging enzymes such as superoxide dismutase (SOD) and catalase (CAT), and glutathione (GSH) and related enzymes, e.g. glutathione reductase (GR), glutathione peroxidase (GPx), gamma glutamyl transpeptidase (GGT) and glutathione-S-transferase (GST) in erythrocytes were assayed. The sanguinarine level in serum was measured by high-performance liquid chromatography. The serum MDA level was higher and the GSH level in erythrocytes was lower in argimone oil poisoning cases than those in controls. There was a significant decrease in SOD and GPx activities in erythrocytes of epidemic dropsy cases but no changes were observed in CAT, GR and GST assay. The depletion of GSH in erythrocytes, serum MDA level and clinical severity were dependent on serum sanguinarine level. The results indicate that sanguinarine (argimone oil) poisoning creates an oxidative stress in humans. The oxidative stress and differential modulation of anti-oxidant enzymes by sanguinarine might play a pathogenic role in epidemic dropsy, which suggests the incorporation of anti-oxidant drugs in the treatment protocol of the disease.

Chromatography, High Pressure Liquid↗

Behavioural parameters in hypertensives on atenolol therapy.

Behavioural responses which included psychological tests and cold pressor test as a stress test were studied in 20 mild to moderate hypertensives of both sexes, excluding smokers, alcoholics, secondary hypertensives and patients of chronic obstructive pulmonary diseases. Subjects were put on 2 weeks of placebo washout period followed by 6 weeks of treatment with atenolol. Following treatment with atenolol they showed no significant alteration in the scores of psychological tests which included Weschler adult intelligence scale for orientation, while showing significant depression in the rise of heart rate, systolic blood pressure and diastolic blood pressure following cold pressor test. On further analysis, the results showed that hypertensives on placebo had lower scores of memory and attention test as compared to normotensive controls. Besides this, hypertensives on placebo had higher rise of heart rate and systolic blood pressure as compared to normotensive controls after cold pressor test.

Adrenergic beta-Antagonists↗

Leukemoid reaction in amoebic liver abscess.

A case of amoebic liver abscess with leukemoid reaction is described. This patient also had jaundice as the presenting feature. Therapy with metronidazole resulted in improved general condition and both blood picture and liver function tests also became normal.

Adult↗

Fat and oil inhibit phosphine release from aluminium phosphide--its clinical implication.

Poisoning by suicidal or accidental ingestion of aluminium phosphide (AlP) is a frequent medical emergency seen all over the world. AlP, a grain fumigant and rodenticide, on exposure to moisture, liberates highly toxic gas, phosphine. The rapidly inhibits mitochondrial respiration and has cytotoxic action. No specific antidote is known against it till date and prognosis depends much on dose and time lag between AlP ingestion and the stomach wash in the hospital (critical period). Physicochemical properties of AlP and nonmiscibility of fat and water promoted us to study the effect of different fats and oils as possible antidotes to inhibit phosphine liberation. In vitro experiments revealed that vegetable oils and liquid paraffin were much more effective than butter and ghee in inhibiting release of phosphine from AlP. These findings may have significant clinical implication.

Aluminum Compounds↗

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↗

Copper, zinc, calcium and magnesium in chronic renal failure.

Estimation of copper, zinc, calcium and magnesium was done in plasma, erythrocytes and urine of twenty patients with chronic renal failure of diverse aetiologies. Twenty normal individuals formed the control group. Significant plasma hypozincaemia and hypozincuria was observed in uraemic patients, though the concentration of zinc in erythrocytes was significantly higher than in controls. The copper content of the erythrocytes was significantly higher in patients when compared to controls, while the reverse was true for its excretion in the urine. The increased level of copper in the erythrocytes showed a correlation with increasing severity of renal failure. Significant hypocalcaemia was seen in the erythrocytes and plasma of uraemic patients, though magnesium level was elevated. Urinary excretion, however, of both calcium and magnesium were markedly reduced in these patients. The magnesium levels in plasma and urine showed a significant correlation with the severity of renal failure.

Adult↗