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Biomedical subjects

R Primhak

Publications and source records attributed to R Primhak.

8 recordsLinked to original sources
PubMed1997

Congenital renal tubular dysplasia and skull ossification defects similar to teratogenic effects of angiotensin converting enzyme (ACE) inhibitors.

An apparently autosomal recessive syndrome of congenital renal tubular dysplasia and skull ossification defects is described in five infants from two separate, consanguineous, Pakistani Muslim kindreds. The clinical, pathological, and radiological features are similar to the phenotype associated with fetal exposure to angiotensin converting enzyme (ACE) inhibitors: intrauterine growth retardation, skull ossification defects, and fetal/ neonatal anuric renal failure associated with renal tubular dysplasia. There was no fetal exposure to ACE inhibitors in the affected infants. Phenotypic similarities between these familial cases and those associated with ACE inhibition suggest an abnormality of the "renin-angiotensin-aldosterone" system (RAS). It is postulated that the molecular pathology in this uncommon autosomal recessive proximal renal tubular dysgenesis could be related to mutations of the gene systems governing the RAS.

Abnormalities, Drug-Induced↗
PubMed1993

Comparison of the efficacy and safety of inhaled fluticasone propionate 200 micrograms/day with inhaled beclomethasone dipropionate 400 micrograms/day in mild and moderate asthma.

This study was designed to compare the efficacy and safety of a new inhaled corticosteroid, fluticasone propionate at a total daily dose of 200 micrograms, with beclomethasone dipropionate 400 micrograms/day in childhood asthma. A total of 398 asthmatic children (aged 4-19 years) were randomised to receive either fluticasone propionate 200 micrograms daily or beclomethasone dipropionate 400 micrograms daily for six weeks inhaled via a spacer device from a metered dose inhaler. During the study the patients recorded morning and evening peak expiratory flow rate (PEFR), symptom scores, and use of beta 2 agonist rescue medication. In addition, clinic visit PEFR and forced expiratory volume in one second were measured. Safety was assessed by recording all adverse events and by performing routine biochemistry and haematology screens including plasma cortisol concentration before and after treatment. For the purposes of analysis the diary card data were grouped into three periods: week 3 (days 15-21), week 6 (days 36-42), and weeks 1-6 (days 1-42). The results showed no significant difference between treatments on most efficacy parameters. However, there were significant differences in changes from baseline in favour of fluticasone propionate for % predicted morning PEFR both at week 3 (fluticasone propionate 6.1%, beclomethasone dipropionate 3.9%) and at week 6 (fluticasone propionate 8.3%, beclomethasone dipropionate 5. 9%) and % predicted evening PEFR at week 6 (fluticasone propionate 7.3%, beclomethasone dipropionate 4.9% and over weeks 1-6 (fluticasone propionate 5.5%, beclomethasone dipropionate 3.6%. Comparison between groups showed that the group receiving fluticasone propionate had a lower % of days with symptom-free exercise at week 6 (fluticasone propionate 87%, beclomethasone dipropionate 81%) and % days without rescue medication at week 6 (fluticasone propionate 87%, beclomethasone dipropionate 80%) and over weeks 1-6 (fluticasone propionate 80%, beclomethasone dipropionate 73%). Except for a higher incidence of sore throat in the fluticasone propionate group, the two treatments did not differ with regard to safety. There was no evidence of adrenal suppression with either treatment. In conclusion, fluticasone propionate 200 microgram daily ws at least as effective and as well tolerated as beclomethasone dipropionate 400 microgram daily in childhood asthma.

Administration, Inhalation↗
PubMed1989

Gestational assessment of the newborn Melanesian infant.

A population of 211 Melanesian babies born in Port Moresby after a known gestation were studied using the Dubowitz gestational assessment in order to assess the method in Melanesians. After exclusion of obvious outliers the regression equation for gestational age on total score was not significantly different from that of Dubowitz. Melanesian babies had relatively more mature neurological scores than external scores. The Dubowitz method of gestational assessment may be used without restandardization in a Melanesian population.

Gestational Age↗
PubMed1988

Malnutrition and peak expiratory flow rate.

In order to assess the effects of malnutrition on the growth of lung function, 376 Indian schoolchildren aged 6-12 yrs were studied. Peak expiratory flow rate (PEFR) was measured with a Wright peak flow meter, and nutritional status assessed by calculation of the percentage predicted height for age (HFA) and weight for height (WFH) using Harvard standards. After standardizing for height and sex, the PEFR of 30 wasted children (WFH below 80%) was significantly reduced (p less than 0.01), but that of 135 stunted children (HFA below 90%) was higher than average (p less than 0.05). It is concluded that current malnutrition has a negative effect on PEFR, possibly due to impaired muscle function, but that past or chronic malnutrition affects growth of lung function less than it affects somatic growth.

Child↗
PubMed1987

Causes of delay in the adequate treatment of childhood illness in India.

A retrospective study of children attending a government hospital in Bangalore was performed to assess the causes of delay in providing appropriate treatment. Delay had occurred in 59% of children with significant illness, and in over half the cases the primary cause of delay was inappropriate treatment or delayed referral by a doctor trained in Western-style medicine. It is concluded that there are a large number of ill children in Bangalore whose parents are seeking the help of such doctors but where management is at fault.

Adolescent↗
PubMed1982

Assessment of neurologic outcome in asphyxiated term infants by use of serial CK-BB isoenzyme measurement.

Brain-type isoenzyme of creatine kinase was measured serially in 45 healthy and 22 severely asphyxiated term infants. The enzyme was measured in cord blood and in venous, capillary, or arterial blood at six to eight hours, 24 to 30 hours, and 72 to 80 hours after birth. In the healthy infants a brief rise of CK-BB occurred at six to eight hours; CK-BB activities were greater than 2.5 log-transformed standard deviations above the mean of the control values in ten of the asphyxiated infants and in none of the control infants. When normal CK-BB activity was used as a predictor of good neurologic outcome and elevated CK-BB as a predictor of subsequent neurologic abnormality, the outcome was predictable from the CK-BB activity in 17 of 22 cases (77%) and in 11 of the 12 survivors (92%). Eight of the 12 surviving infants had neonatal seizures and outcome was predictable from CK-BB activity in all cases. We conclude that serum CK-BB activity, especially when measured in cord blood and at six to 12 hours of life, correlates with neurologic outcome after severe asphyxia, and that measurement of CK-BB compares favorably with radionuclide and computerized tomographic scanning as a method of predicting neurologic outcome after asphyxia.

Asphyxia Neonatorum↗