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Biomedical subjects

R Bhagat

Publications and source records attributed to R Bhagat.

At least 19 recordsLinked to original sources
PubMed2001

Amiodarone and cyclophosphamide: potential for enhanced lung toxicity.

Antineoplastic therapy can be associated with drug-induced lung toxicity. With the increasing use of amiodarone for cardiac dysrhythmias there is an increasing possibility of its combined use with chemotherapies for various malignancies. We report a patient on long-term amiodarone who developed biopsy-proven drug-induced lung toxicity after receiving high-dose cyclophosphamide, at a time-frame much shorter than would have been predicted with cyclophosphamide alone. The potential for enhanced lung toxicity secondary to combination of amiodarone and cyclophosphamide is discussed.

Amiodarone↗
PubMed2000

An evaluation of resin-ionomers to prevent coronal microleakage in endodontically treated teeth.

While a gutta-percha system is most commonly used by practitioners for canal obturation, there is no agreement on how best to close the chamber of an endodontically treated tooth. Some materials used in restorative dentistry may have endodontic applications. Restorative materials of particular interest to endodontists are those used as subgingival restorations. Their properties include insolubility in oral fluids, adhesiveness, dual-cure capabilities, radiopacity, hardness and fluoride release, low cure shrinkage and a low coefficient of thermal expansion. The purpose of this in vitro study was to test three products that could be used to seal pulp chambers of endodontically treated teeth to prevent bacterial infiltration. A bacteriological assay system was used to determine the efficacy of three commercially available restorative materials to prevent penetration of Streptococcus salivarius from the pulp chambers into the prepared canals. The materials evaluated were: Geristore two-paste system with Tenure Quik with fluoride, Dispersalloy with Tenure Quik with fluoride, and Marathon posterior composite with Tenure Quik with fluoride. During the sixty days of the study, the analysis indicated that the Geristore two-paste system with Tenure Quik with fluoride provided a statistically significant improved seal when compared to the Marathon posterior composite and Dispersalloy amalgam with Tenure Quik with fluoride.

Composite Resins↗
PubMed1999

Breast health practices and South Asian women.

Breast cancer is an important women's health issue in all communities. To detect breast cancer early, all women should practise monthly breast self-examination, have regular clinical breast examinations and attend mammography screening at suggested intervals. Participation in these breast health practices is influenced by a wide variety of factors, including how women define health and health practices, priorities in women's lives and their explanations of the causes of diseases such as cancer.

Adult↗
PubMed1998

Chronic anaerobic pneumonitis in a seven-year-old girl.

A 7-year-old girl was referred for evaluation of chronic pulmonary disease associated with nasal symptoms of 4 years duration for which she had received frequent courses of antibiotics. Serial chest roentgenograms over a period of 2 years revealed a nonhomogeneous opacity in the right lower lung zone for which she had received 18 months of antituberculous therapy without relief. Evaluation of the patient led to the diagnosis of chronic anaerobic pneumonitis, a rare clinical entity in children. In addition, the patient also had bronchial asthma and chronic rhinitis. Therapy with oral phenoxymethylpenicillin and metronidazole for 6 weeks along with appropriate antiasthma medications abolished her symptoms and resulted in roentgenologic clearance.

Anti-Asthmatic Agents↗
PubMed1998

Comparison of 3 different doses of budesonide and placebo on the early asthmatic response to inhaled allergen.

BACKGROUND: A simple laboratory method to evaluate relative potency of inhaled corticosteroids in asthma would be valuable. Single-dose studies with the allergen-induced late asthmatic response have failed to show a useful dose-response relationship. Treatment for several days with inhaled corticosteroids will also inhibit the allergen-induced early asthmatic response. METHODS: Twelve atopic asthmatic subjects were studied during a season when no medications were required except ipratropium bromide as needed. These subjects had positive allergen and methacholine inhalation tests and FEV1 greater than 70% of predicted value. A double-blind, randomized, cross-over study compared placebo and budesonide 100, 200, and 400 microg administered by means of Turbuhaler twice daily for 7 days with 6-day washout periods. Methacholine PC20 was measured before and after 6 days of treatment, and allergen PC15 was measured after 7 days of treatment. RESULTS: The allergen PC15 (n = 11) was significantly larger (P = .0001) for all doses of budesonide compared with placebo, but there was no significant difference between the 3 doses of budesonide, and no dose response was demonstrated. The methacholine PC20 was significantly larger after all budesonide treatments compared with placebo (P = .024), but there was no difference between the 3 doses. There was a progressive increase in the allergen PC15 chronologically (sequence effect) that was not explained by improvement in FEV1 or airway responsiveness; sequence effects were not seen for FEV1 or for pretreatment or posttreatment methacholine PC20. Statistical adjustment for sequence effect did not alter allergen PC15 statistics. CONCLUSION: A 7-day course of budesonide administered by means of Turbuhaler at 200, 400, or 800 microg per day provided marked and significant inhibition of the allergen-induced early asthmatic response compared with placebo. There was, however, no difference between the 3 doses. Therefore this method with these doses is not useful for providing assessment of relative potency.

Administration, Inhalation↗
PubMed1998

Beliefs related to breast health practices: the perceptions of South Asian women living in Canada.

Breast cancer is becoming a major concern for many South Asian women. Clinical observations of women from a South Asian community living in Canada revealed an under use of early detection strategies. The purpose of this qualitative ethnoscience study was to examine breast health practices from the perspective of South Asian women to provide a foundation for the development of culturally suitable breast health services for this group. Open-ended interviews were conducted with a convenience sample of 50 South Asian women over the age of 30 who had not been diagnosed with breast cancer. Adequate representation of the main religious groups (i.e. Sikh, Hindu, Muslim and Christian) was ensured through sampling techniques. Analysis of translated interviews involved identification of themes and the development of a taxonomy to represent relationships among emerging cultural themes and domains. Four central domains of beliefs related to breast health practices were identified: beliefs about a woman's calling, beliefs about cancer, beliefs about taking care of your breasts and beliefs about accessing services. These beliefs hold important implications for how health promotion strategies should be structured and offered, In particular, attention must be paid to the language that is used to talk about breast cancer, the importance of the role of the family in women's health decisions and traditions related to using narratives to share information and advice.

Adult↗
PubMed1997

Allergic bronchopulmonary aspergillosis: the spectrum of computed tomography appearances.

Although computed tomography (CT) of the thorax has been compared to plain chest radiography and bronchography for demonstration of central bronchiectasis (CB) in allergic bronchopulmonary aspergillosis (ABPA), the CT presentation of the disease is yet to be highlighted. With this in view, the CT appearances in 23 patients with ABPA were evaluated. The scans were assessed for bronchial, parenchymal and pleural abnormalities. Central bronchiectasis was identified in all patients, involving 114 (85%) of the 134 lobes and 210 (52%) of the 406 segments studied. Other bronchial abnormalities such as dilated and totally occluded bronchi (11 patients), air-fluid levels within dilated bronchi (five patients), bronchial wall thickening (10 patients) and parallel-line shadows (seven patients) were also observed. Parenchymal abnormalities, which had a predilection for upper lobes, included consolidation in 10 (43%) patients, collapse in four (17%) patients and parenchymal scarring in 19 (83%) patients. A total of six cavities were seen in three (13%) patients, and an emphysematous bullae was detected in one (4%) patient. The pleura was involved in 10 (43%) patients. Ipsilateral pleural effusion with collapse was observed in one patient, while in nine other patients, parenchymal, lesions extended up to the pleura. Concomitant allergic Aspergillus sinusitis (AAS) was also detected in three (13%) of the 23 patients. Computed tomography of the thorax in patients with ABPA provides a sensitive method for the assessment of bronchial, parenchymal and pleural abnormalities, and should constitute a part of the diagnostic work of the disease.

Adolescent↗
PubMed1997

Sleep disturbances in clinically stable young asthmatic adults.

BACKGROUND: Although nocturnal asthma is a well documented clinical problem, the effect of asthma on sleep itself and morbidity caused thereby have not received adequate attention. It is now recognized that partial sleep deprivation has a considerable effect on human functions. OBJECTIVES: With this in view, we conducted a study to determine the occurrence and nature of sleep disturbances in a homogeneous group of patients with clinically stable bronchial asthma in their home environment. METHODS: Thirty young adult unmarried university students with clinically stable bronchial asthma attending the Institute's outpatient department were asked to respond to an asthma/sleep questionnaire and were requested to maintain a sleep diary for 1 week. A similar group of 30 unmarried healthy young university students also underwent an identical workup and functioned as controls. Ten subjects from each group maintained a peak expiratory flow rate (PEFR) diary. RESULTS: The questionnaire revealed that 28 (93%) of the 30 patients experienced sleep disturbances (average 2.7/subject) as compared to 10 (33%) subjects in the control group (average 0.4/subject). The sleep diary confirmed that 27 (90%) of the 30 patients had sleep disturbances (2.4/subject/wk) as compared with 8 (27%) subjects (0.3/subject/wk) in the control group. These differences were statistically significant. Daytime sleepiness and tiredness (63%) and difficulty in maintaining sleep (60%) along with early morning awakening (46%) were more frequently seen. The asthmatic patients also had a shorter duration of sleep (427 min) as compared with the controls (474 min). These findings were significantly different from the control group. CONCLUSIONS: Increased daytime sleepiness and tiredness was perhaps a reflection of the poor quality of sleep experienced by patients with clinically stable asthma. This consequently may lead to impaired daytime performance which can have a potentially serious effect for the patient and society.

Administration, Inhalation↗
PubMed1997

Inhibitory effects of an anti-IgE antibody E25 on allergen-induced early asthmatic response.

Inhaled allergens, acting through IgE-dependent mechanisms, are important triggers of asthma symptoms and inducers of airway hyperresponsiveness and airway inflammation. The effect of anti-IgE recombinant humanized monoclonal antibody-E25 (rhuMAb-E25) on the provocation concentration of allergen causing a 15% fall in FEV1 (allergen PC15) during the allergen-induced early asthmatic response (EAR) was assessed in a multicenter, randomized, double-blind, parallel group study. Ten of 11 allergic asthmatic subjects randomized to receive intravenous rhuMAb-E25, 2 mg/kg on study day 0 and 1 mg/kg on Days 7, 14, 28, 42, 56, and 70 completed the study; nine received intravenous placebo. The allergen PC15 was measured on Days -1, 27, 55, and 77 and methacholine PC20 on Days -2, 42, and 76. rhuMAb-25 was well tolerated and only one patient (active group) was withdrawn because of a generalized urticarial rash after the first dose. Compared with baseline values (Day -1), the median allergen PC15 on Days 27, 55, and 77 were increased by 2.3, 2.2, and 2.7 doubling doses (delta log PC15/0.3) respectively with rhuMAb-E25 and -0.3, +0.1, and -0.8 doubling doses with placebo (p < or = 0.002). Methacholine PC20 improved slightly after rhuMAb-E25, this change becoming statistically significant on Day 76 (p < 0.05); no change was observed in the placebo group. Mean serum-free IgE fell by 89% after rhuMAb-E25 while there was no significant change after placebo. The inhibitory effects of rhuMAb-E25 on allergen-induced EAR suggest that it may be an effective, novel antiallergic treatment for asthma.

Adult↗
PubMed1996

Salbutamol-induced increased airway responsiveness to allergen and reduced protection versus methacholine: dose response.

BACKGROUND: Two adverse effects of inhaled beta 2-agonists are increased airway responsiveness to allergen and tolerance to the bronchoprotective effect of beta 2-agonists versus bronchoconstrictors (e.g., methacholine). OBJECTIVE: We studied three doses of inhaled salbutamol, 200, 400, and 800 micrograms/day, to determine dose-response curves for these two adverse effects. METHODS: Ten atopic patients with mild, stable asthma free of all asthma medications, allergen exposure, and respiratory tract infection for at least 4 weeks participated in a double-blind, random-order, crossover study. There were four 1-week treatment periods with a 1-week washout period: placebo, salbutamol 200 micrograms, 400 micrograms and 800 micrograms per day. After each treatment, we assessed FEV1, bronchodilation 10 minutes after administration of 200 micrograms of salbutamol, methacholine PC20, methacholine dose-shift after administration of 200 micrograms of salbutamol, and allergen PC20. RESULTS: There was no significant difference in baseline FEV1, bronchodilation, or methacholine PC20. The methacholine dose shift was maximum after the placebo (3.4 +/- 0.22 doubling doses) and was significantly greater (p < 0.01) than all salbutamol regimens (2.2 to 2.6), which were not significantly different from each other (p > 0.05). Allergen PC20 was significantly lower (p < 0.02) after salbutamol 800 micrograms/day (geometric mean = 288 protein nitrogen units [PNU]/ml) than each of the other treatments (447 to 550 PNU/ml), which were not significantly different from each other (p > 0.05). CONCLUSION: Significant increase in airway responsiveness to allergen occurred only with the largest dose of inhaled salbutamol (800 micrograms/d); however, tolerance to the acute bronchoprotective effect of salbutamol was observed with all the three salbutamol regimens, even 200 micrograms/day. This suggests different mechanisms may be operative in producing these two effects.

Adolescent↗
PubMed1996

Inhaled corticosteroids do not prevent the development of tolerance to the bronchoprotective effect of salmeterol.

INTRODUCTION: Twice-daily inhaled salmeterol produces rapid reduction in its acute bronchoprotective effect against methacholine in patients with mild asthma. This investigation examined this effect in patients with moderate asthma who were using inhaled corticosteroids. SUBJECTS AND METHODS: Eight asthmatic volunteers who required inhaled corticosteroids for control of their symptoms and who were able to withhold treatment with beta 2-agonists for 4 weeks before and during the study participated in a double-blind, crossover, placebo-controlled study with two random-order treatment periods: inhaled salmeterol, 50 microg twice a day for seven doses, and placebo in similar fashion, with a 7-day or greater washout between these periods. Methacholine inhalation tests were done 1 h after doses 1, 3, 5, and 7, and then 24 h after the last dose of the study inhaler, 10 min post-200 microg salbutamol. RESULTS: Baseline FEV1 measurements before doses 3, 5, and 7 of salmeterol, ie, 12 h after salmeterol, were significantly higher than all other baseline values. Twenty-four hours after the last dose of salmeterol, the FEV1 was no different from that during the placebo period. The geometric mean methacholine concentration causing a 20% fall in FEV1 (PC20) following the third dose of salmeterol (6.8 mg/mL) was significantly lower than after the first dose of salmeterol (12.0 mg/mL; p=0.031), and this reduction of bronchoprotection persisted following doses 5 and 7. The methacholine PC20 10 min postsalbutamol measured after the salmeterol period was significantly lower than after placebo (5.6 vs 13.3 mg/mL; p<0.001). CONCLUSIONS: Tolerance to the acute bronchoprotective effect of salmeterol was significant after the first two doses and persisted after the seventh dose. Tolerance to the acute bronchoprotective effect of salbutamol was also significant after regular use of salmeterol for seven doses. These effects, in subjects using inhaled corticosteroids regularly, were similar to the those previously seen in patients with mild asthma using as-required beta 2-agonists only, indicating that tolerance is not prevented by use of inhaled corticosteroids.

Administration, Inhalation↗
PubMed1996

Allergic bronchopulmonary aspergillosis with aspergilloma mimicking fibrocavitary pulmonary tuberculosis.

A 47-year-old male, who presented with chronic fibrocavitary pulmonary disease, had received three courses of antituberculous therapy over a period of 17 years without relief. Four years prior to referred he had developed hemoptysis and rhinitis. Evaluation of the patient led to the diagnosis of allergic bronchopulmonary aspergillosis with coexistent aspergilloma, a rather uncommon association. Both his pulmonary and nasal symptoms showed a remarkable response to treatment with oral prednisolone. However, the possibility of concomitant allergic Aspergillus sinusitis remained open as the patient refused to undergo any invasive procedure.

Adult↗
PubMed1995

Regular use of inhaled albuterol and the allergen-induced late asthmatic response.

BACKGROUND: We have recently demonstrated that a 2-week course of inhaled albuterol 200 micrograms four times daily caused a near doubling of the allergen-induced early asthmatic response. We hypothesized that this might extend to the more clinically relevant late asthmatic response. METHODS: We studied 11 patients with atopic asthma who were free from all medications including inhaled beta 2-agonists for more than 4 weeks. We performed a double-blind, random-order, crossover study, comparing the effect of 1-week treatment periods of albuterol 200 micrograms four times daily and placebo 2 puffs four times daily on the early and late asthmatic responses to the same dose of allergen. RESULTS: Regular use of albuterol did not influence the baseline forced expiratory volume in 1 second (FEV1) (3.40 vs 3.42 L, p = 0.84) or the baseline methacholine provocative concentration causing a 20% fall in FEV1 (PC20) (geometric mean, 2.4 mg/ml vs 1.9 mg/ml, p = 0.38). However, all aspects of the allergen-induced asthmatic response were increased. After the 1-week albuterol treatment, the early asthmatic response was slightly greater (21.1% vs 17.9% FEV1 fall, p = 0.26), the late response was greater (23.1% vs 13.2% FEV1 fall, p = 0.0027), and the allergen-induced increase in airway responsiveness (change in log methacholine PC20) was greater (0.37 vs 0.20, p = 0.045). CONCLUSIONS: One week of albuterol treatment (200 micrograms four times daily) increased the late asthmatic response and allergen-induced increase in airway responsiveness. This suggests that the combination of regular use of inhaled beta 2-agonist and allergen exposure may cause more airway inflammation than allergen exposure alone.

Administration, Inhalation↗
PubMed1995

Interaction of inhaled beta 2 agonist and inhaled corticosteroid on airway responsiveness to allergen and methacholine.

Regular treatment with salbutamol increases airway responsiveness to allergen but not to methacholine and produces tolerance to the bronchoprotective effect of salbutamol. The current study addresses the effect of inhaled corticosteroid on these aspects of regular beta 2 agonist use. A group of 13 atopic asthmatic subjects free from all asthma medications and remote from allergen exposure were studied. We used a double-blind, random-order, crossover study to compare four 1-wk treatment periods with > or = 1 wk washout: placebo, salbutamol, 200 micrograms four times per day, budesonide, 400 micrograms four times per day, and the combination of salbutamol and budesonide. We measured the methacholine PC20 and the methacholine dose shift produced acutely by 200 micrograms salbutamol after 7 d and the allergen PC15 after 8 d treatment. Blinded medications were withheld for 8 to 10 h before measurements. The methacholine PC20 was not affected by regular salbutamol but increased significantly (p < 0.014) after both budesonide-containing regimens. Neither the dose shift nor its significant reduction by regularly used beta 2 agonist were influenced by the inhaled corticosteroid. The four allergen PC15 values were significantly different from each other. Compared with placebo, the allergen PC15 was 0.6 doubling doses lower after salbutamol (p = 0.021) and 1.3 doubling doses higher after budesonide (p < 0.001); the allergen PC15 was reduced by 0.53 doubling doses from this new baseline (p = 0.039) when salbutamol and budesonide were used together.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗
PubMed1995

Self-injection with olive oil. A cause of lipoid pneumonia.

A 48-year-old man with unipolar depression and a psychosexual problem concerning his body image was injecting his scrotum repeatedly with olive oil to increase the size of his genitals. He developed respiratory failure following accidental intravenous injection of olive oil and was found to have lipogranulomatous lesions in the lung and the scrotum.

Body Image↗