PubMed Health⌕ Search

Biomedical subjects

S K Jindal

Publications and source records attributed to S K Jindal.

At least 19 recordsLinked to original sources
PubMed1992

Fatal pulmonary sporotrichosis caused by Sporothrix schenckii var. luriei in India.

The first case of fatal pulmonary sporotrichosis caused by Sporothrix schenckii var. luriei in a patient from the northwestern region of India is described. In the absence of cultures, the diagnosis was suspected by notation, in lung tissue, of large, thick-walled, hyaline fungal cells that divided internally by septation or a budding process. The thick-walled, internally septated cells often became muriform. The presence of an "eyeglass" configuration of incompletely separated cells characteristic of S. schenckii var. luriei in large numbers aided the diagnosis. The identity of the etiologic agent was confirmed by application of a fluorescent-antibody reagent specific for S. schenckii.

Adult↗
PubMed1992

Pathogenesis of congestive state in chronic obstructive pulmonary disease. Studies of body water and sodium, renal function, hemodynamics, and plasma hormones during edema and after recovery.

BACKGROUND: The pathogenesis of salt and water accumulation in patients with chronic obstructive pulmonary disease is unclear and may differ from that in patients with congestive heart failure due to myocardial disease. This study was undertaken to investigate some of the mechanisms involved. METHODS AND RESULTS: Hemodynamics, water and electrolyte spaces, renal function, and plasma hormone concentrations were measured in nine patients with edema due to chronic obstructive pulmonary disease and in six patients after recovery. Mean cardiac output (3.8 +/- 0.26 l/min.m2) was normal, but right atrial (11 +/- 1 mm Hg) and mean pulmonary arterial (41 +/- 3 mm Hg) pressures were increased. Mean pulmonary arterial wedge pressure (11 +/- 1 mm Hg) was normal. Pulmonary vascular resistance (8.6 +/- 1.3 mm Hg.min.m2/l) was increased, but systemic vascular resistance (19.3 +/- 1.3 mm Hg.min.m2/l) and mean arterial pressure (83 +/- 4 mm Hg) were low. All patients were hypoxemic (PaO2, 40 +/- 2 mm Hg) and hypercapnic (PaCO2, 60 +/- 2 mm Hg). There was a significant increase in total body water (+21%), extracellular volume (+45%), plasma volume (+45%), blood volume (+88%), and exchangeable sodium (+38.2%). Renal plasma flow was severely reduced (-63.2%), but glomerular filtration rate was only mildly decreased (-32%). Significant increases were seen in plasma norepinephrine (3.5-fold normal), renin activity (7.6-fold normal), vasopressin (twice normal), atrial natriuretic peptide (9.4-fold normal), growth hormone (10.7-fold normal), and cortisol (1.9-fold normal). After recovery, the PaO2 increased (50 +/- 3 mm Hg) and PaCO2 fell (45 +/- 4 mm Hg), and the patients became free from edema. All the body compartments returned toward normal, although they did not entirely reach normal values. Renal plasma flow increased significantly, and glomerular filtration became normal. Right atrial and pulmonary arterial pressures and pulmonary vascular resistance decreased (p less than 0.01). Cardiac output decreased but not significantly. Blood pressure increased but not significantly. However, systemic vascular resistance increased significantly to a normal value. CONCLUSIONS: We conclude that patients with edema due to chronic obstructive pulmonary disease have severe retention of salt and water, reduction in renal blood flow and glomerular filtration, and neurohormonal activation similar to that seen in patients with edema due to myocardial disease. However, unlike the latter, in chronic obstructive pulmonary disease cardiac output is normal, and systemic vascular resistance and arterial blood pressure are low. This probably is due to the vasodilator properties of hypercapnia. The consequent low arterial blood pressure may be the stimulus for the neurohormonal activation and retention of salt and water.

Adult↗
PubMed1992

Airway response to inhaled fenoterol in hyperthyroid patients before and after treatment.

Bronchodilatory response to inhaled fenoterol was studied in 15 hyperthyroid patients before and after successful treatment with antithyroid drugs. Baseline forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV1) were lower than the predicted values in 12 and 11 patients, respectively. Improved values were seen after treatment for hyperthyroidism although statistical significance was not reached. Even if some improvement occurred in PEFR (a rise by 0.24-0.48 L/s) and FVC (increase of 73-78 ml) in the hyperthyroid state in response to fenoterol inhalation after various time intervals, the increase in different parameters of lung function was significantly more after the patients achieved euthyroid state (increases in FVC by 290-165 ml; in FEV1 by 333-193 ml; in peak expiratory flow (PEFR) by 0.75-0.52 L/s and in forced expiratory flow (FEF50%) by 0.55-0.31 L/s). In the euthyroid state the mean absolute improvements from the baseline values were significantly higher (< 0.05-0.001). These observations indicate that bronchodilatory response is impaired in the presence of excess thyroid hormones and improves after euthyroid state is achieved.

Administration, Inhalation↗
PubMed1992

Wegener's granulomatosis: clinical experience with eighteen patients.

Wegener's granulomatosis is being recognised with increasing frequency in India. Our 18, histologically confirmed, patients had a clinical profile similar to that described from developed countries. Delayed diagnosis led to the death of nine patients, usually within days of hospital admission, due to extensive vasculitis and renal failure. Tuberculosis was the most frequently considered diagnosis and 12 patients had been treated for it in spite of progressive clinical deterioration. Those who could be adequately treated with low dose daily cyclophosphamide and corticosteroids did well. Six of seven such patients are alive and well 1-8 years later. We believe that if prompt lung biopsy and ANCA determination are resorted to in patients with "resistant tuberculosis", it will greatly expedite case detection, diagnosis and optimum treatment of this remediable disease.

Adolescent↗
PubMed1992

Adult respiratory distress syndrome following non-thoracic skeletal trauma.

Thirty adult patients with severe non-thoracic skeletal trauma were monitored over the first five days for evidence of adult respiratory distress syndrome (ARDS). Three of the patients developed progressive respiratory distress, refractory hypoxaemia and pulmonary infiltrates suggestive of ARDS. Two patients died while one recovered completely. Close monitoring is suggested for early recognition of the disease and institution of therapy.

Adult↗
PubMed1992

Normal maximal expiratory and inspiratory pressures in healthy teenagers.

Maximal expiratory pressure at total lung capacity and maximal inspiratory pressure at residual volume were measured in 364 male and 325 female healthy teenage subjects. Predictive equations have been drawn based on coefficients of age, height and weight. The pressures may be used to evaluate respiratory muscle strength and follow the progress in patients with neuromuscular disorders, dyspnoea and respiratory failure.

Adolescent↗
PubMed1991

Idiopathic pulmonary fibrosis (IPF) necessitating therapeutic midtrimester abortion: a case report.

A 35-year old multiparous lady was admitted at 19 weeks of pregnancy with rapid onset of dyspnoea which progressed to grade III in 2 months. She was diagnosed as a case of idiopathic pulmonary fibrosis (IPF). She had a vital capacity of 1.25 l, 46.5% of predicted and PaO2 of 60 mmHg at rest, dropping to 35 mmHg on mild exercise testing. She did not respond to prednisolone 40 mg daily given orally for one month. In view of lack of improvement, therapeutic abortion was carried out at 24 weeks by abdominal hysterotomy combined with tubal ligation. Subsequent to termination of pregnancy, her clinical status and pulmonary function improved markedly and she had only grade I dyspnoea 30 months later without corticosteroids. Effect of pregnancy on interstitial lung disorders especially IPF is not yet clear because of extreme rarity of their association. Therapeutic abortion should be seriously considered in patients who cannot increase their oxygen consumption 3 times normal without uncorrectable hypoxaemia.

Abortion, Therapeutic↗
PubMed1991

Drug interaction between rifampicin and cotrimoxazole in patients with tuberculosis.

1. Patients (n = 15) who were admitted with complications of tuberculosis, were given antitubercular therapy (ATT) with rifampicin (RIF), for a minimum period of 15 d, and cotrimoxazole (CTZ), concurrently, for 5-10 d. 2. The serum RIF levels were measured before the start of CTZ treatment and at the end of its administration. 3. The plasma half-life (t1/2) of RIF increased significantly from 1.92 +/- 0.57 h to 2.31 +/- 0.134 h after CTZ treatment. 4. The mean serum levels of RIF increased significantly at 4 and 6 h after CTZ administration.

Adolescent↗
PubMed1991

Respiratory symptoms in Indian women using domestic cooking fuels.

The effect of domestic cooking fuels producing various respiratory symptoms was studied in 3,701 women. Of these, 3,608 were nonsmoking women who used four different types of cooking fuels: biomass, LPG, kerosene, and mixed fuels. The overall respiratory symptoms were observed in 13 percent of patients. Mixed fuel users experienced more respiratory symptoms (16.7 percent), followed by biomass (12.6 percent), stove (11.4 percent), and LPG (9.9 percent). Chronic bronchitis in chulla users was significantly higher than that in kerosene and LPG users (p less than 0.05). Dyspnea and postnasal drip were significantly higher in the women using mixed fuels. Smoking women who are also exposed to cooking fuels experienced respiratory symptoms more often than nonsmokers (33.3 percent vs 13 percent).

Adult↗
PubMed1991

Comparison of bronchodilatation produced by an anticholinergic (ipratropium bromide), a beta-2 adrenergic (fenoterol) and their combination in patients with chronic obstructive airway disease. An open trial.

Fenoterol hydrobromide (200 micrograms), ipratropium bromide (40 micrograms) and a combination of the two in the same dosage were administered by metered dose inhaler on 3 separate days to 20 patients with chronic bronchitis and emphysema. On each day, baseline forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEFR) and mid maximum flow rate (MMFR) were recorded. The values were again recorded after administration of the drug at 15, 30, 45 and 60 minutes. Side effects if any were recorded. There was a significant increase from baseline in FVC and FEV1 with all the three regimens at 15, 30 and 45 minutes. However, the rise in MMFR was significant only with ipratropium bromide and the combination regimen. At 60 minutes, the rise in FVC, FEV1 and MMFR was significant only with the combination regimen. There was no significant change in the PEFR values at any time with any drug. The difference in rise in all the four parameters with the 3 regimens was not statistically significant. No side effects were noted. Thus, a combination fenoterol and ipratropium bromide produced a more prolonged bronchodilatation, and ipratropium bromide perhaps acts both in the major (indicated by rise in FEV1) and small airways (measured by MMFR).

Aerosols↗
PubMed1991

Physiological dead space & arterial to end-tidal CO2 difference under controlled normocapnic ventilation in young anaesthetised subjects.

Physiological dead space and its components were determined in 27 young, otherwise healthy anaesthetised individuals before start of surgery. A squarewave inspiratory flow pattern and an end inspiratory pause (25 and 10% of cycle time respectively) were used at a respiratory rate of around 16 bpm with minute ventilation adjusted to maintain normocapnia. The physiological dead space was found to be 2.23 ml/kg with anatomical dead space forming 110.66 +/- 27.55 ml out of 125.55 +/- 27.06 ml. While VD alv was positively correlated to pause pressure, VD ant was correlated to age, weight, and body surface area. Mean arterial end tidal carbon dioxide difference was quite low (0.24 +/- 0.44 kPa).

Adult↗
PubMed1990

Adult subacute mountain sickness--a syndrome of congestive heart failure in man at very high altitude.

A new type of mountain sickness is described. 21 men (age 22.2, standard deviation [SD] 1.8 years) had severe congestive heart failure with oedema and ascites after 10.8 (SD 5.9) weeks at altitudes of 5800-6700 m. Investigation, within 3 days of transfer to 300 m, showed polycythaemia, cardiomegaly with right ventricular enlargement, and (in 17) pericardial effusion. The heart failure resolved rapidly after transfer from high altitude.

Acute Disease↗
PubMed1990

Exposure of nonsmoking women to environmental tobacco smoke: a 10-country collaborative study.

The interpretation and interpretability of epidemiologic studies of environmental tobacco smoke (ETS) depend largely on the validity of self-reported exposure. To investigate to what extent questionnaires can indicate exposure levels to ETS, an international study was conducted in 13 centers located in 10 countries, and 1,369 nonsmoking women were interviewed. The present paper describes the results of the analysis of self-reported recent exposure to ETS from any source in relation to urinary concentrations of cotinine. Of the total, 19.7 percent of the subjects had nondetectable cotinine levels, the median value was 6 ng/mg, and the cut-point of the highest decile was 24 ng/mg. The proportion of subjects misreporting their active smoking habit was estimated at between 1.9 and 3.4 percent, depending on whether cut-points of 50 or 100 ng/mg creatinine were used. Large and statistically significant differences were observed between centers, with the lowest values in Honolulu, Shanghai, and Chandigarh, and the highest in Trieste, Los Angeles, and Athens. Mean cotinine/creatinine levels showed a clear linear increase from the group of women not exposed either at home or at work, to the group of those exposed both at home and at work. Values were significantly higher for women exposed to ETS from the husband but not at work, than for those exposed at work but not from the husband. The results of linear regression analysis indicated that duration of exposure and number of cigarettes to which the subject reported being exposed were strongly related to urinary cotinine. ETS exposure from the husband was best measured by the number of cigarettes, while exposure at work was more strongly related to duration of exposure. After adjustment of number of cigarettes for volume of indoor places, a similar increase in cotinine (5 ng/mg) was predicted by the exposure to 7.2 cigarettes/8 h/40 m3 from the husband and 17.9 cigarettes/8 h/40 m3 at work. The results indicate that, when appropriately questioned, nonsmoking women can provide a reasonably accurate description of ETS exposure. Assessment of individual exposure to ETS should focus on daily duration and volume of indoor places where exposure occurred.

Adult↗
PubMed1990

Short course chemotherapy for endometrial tuberculosis in infertile women.

A daily regimen of rifampicin (450 mg) and isoniazid (300 mg) was tried for 9 months in 14 women with histologically diagnosed endometrial tuberculosis (TB). Follow-up endometrial biopsies were negative for tubercular disease in all patients. Three (21.4%) of the 14 women conceived between 3 and 12 months after starting treatment.

Adult↗
PubMed1990

Fiberoptic bronchoendoscopic examination in patients with haemoptysis and normal chest roentgenogram.

The role of flexible fiberoptic bronchoendoscopic (FOB) examination was evaluated in a retrospective analysis in 155 patients with unexplained haemoptysis and normal chest skiagrams. The procedure was helpful in reaching a specific diagnosis in 11 (7.1%) patients, 4 of whom revealed mycobacteria in bronchial secretions and 7 had neoplastic lesions. In another 68 (43.9%) cases only non-specific findings like inflammation were found, but the site of abnormality could be localized. We recommend the use of FOB in the routine assessment of haemoptysis.

Adolescent↗
PubMed1989

Relative bronchodilatory responsiveness attributable to sympathetic and parasympathetic activity in bronchial asthma.

A single blind, cross-over study was performed in 12 male, nonsmoker, stable asthmatics, to assess the bronchodilatory responsiveness attributable to sympathetic and parasympathetic mechanisms. Serial doses of one agent (salbutamol or ipratropium) were administered to the supramaximal level to produce the maximum achievable bronchodilatation; thereafter, the other drug was given. The sequence was reversed on the 2nd day. On the 3rd day, both drugs were given together from the very beginning. Significant initial bronchodilatation was observed with either agent given alone, but was more marked with salbutamol. Further additional bronchodilatation was seen when salbutamol was administered after ipratropium, but not with ipratropium given after salbutamol. It was concluded that all achievable bronchodilatation was obtained with the adrenergic agent (salbutamol) given alone and that the dominant autonomic control of bronchomotor tone in bronchial asthma is through adrenoceptors.

Administration, Intranasal↗