Biomedical subjects
Publications and source records attributed to S K Kamath.
Anaesthesiologist may encounter problems while anaesthetising a patient following organophosphorus poisoning. These problems and the necessary precaution are described.
Anaesthetists at times encounter difficult intubation in an apparently normal individual in spite of using the best possible positioning and most profound relaxation. This study was carried out to find out the most simple and easy measurement that may predict a difficult intubation. The study was conducted in three groups of patients of twenty each. The first group consisted of patients in whom intubation was easy. Second group consisted of anticipated difficult intubation. Cases in whom very difficult intubation was encountered were analyzed retrospectively and were included in third group. An attempt has been made to predict difficult intubation with the roentgenographic study of lateral view of mandible along with the measurement of distance from chin to thyroid cartilage. Of all the parameters, ratio of effective mandibular length to posterior mandibular depth and distance from chin to thyroid cartilage were found to be important to predict difficult intubation.
A retrospective review of the medical records of 114 malnourished and 106 non-malnourished male veterans assessed the inpatient and 1 year post-discharge dietetic care given for the treatment of malnutrition. The malnourished sample consisted of subjects discharged with a protein-energy or protein malnutrition comorbidity. Subjects in the diagnosis-matched and age-matched control sample were discharged without a malnutrition comorbidity during the same period. Data collected from progress notes included diagnoses, inpatient dietetic feedings and services provided, discharge dietetic care, intervening clinic visits, and rehospitalizations. On initial admission, 79% of the diagnoses for the malnourished group fell into five diagnosis categories: neoplasms; respiratory system diseases; digestive system diseases; endocrine, nutritional, and metabolic diseases; and mental disorders (including alcohol-related disorders). Malnourished subjects received more specialized feedings and dietetic services than did the controls on initial admission. However, the discharge and post-discharge care received by surviving members of both groups was similar. Fewer than half the members of either group received post-discharge care. Fifty-four malnourished and 54 control patients were hospitalized more than once. The findings indicate that levels of inpatient and outpatient dietetic care need to be coordinated to alleviate malnutrition.
The use of atropine sulphate in the paediatric age group as a premedicant orally in a dosage of 0.02 mg/kg body weight 70 minutes prior to surgery was found to be as effective as atropine sulphate given intramuscularly 35 minutes prior to surgery in a dosage of 0.01 mg/kg body weight. This avoids the unpleasant memory of needle prick; The duration of effect as studied in the normal healthy children not subjected to surgery was found to be 2 1/2-3 hours.
The effect of a diet moderately restricted in tryptophan on the tumor and the nutritional status of C3H mice bearing mammary adenocarcinoma was examined. Five groups of female tumor-bearing mice were fed ad libitum a diet containing 1) 15% casein, 2) 15% amino acid mixture, 3) 15% amino acid mixture restricted in tryptophan 4) 15% zein supplemented with lysine and tryptophan or 5) 15% zein supplemented with lysine and restricted in tryptophan. Another group of tumor-free mice of similar age fed 15% casein served as a control for the tumor-bearing group fed the 15% casein diet. Moderate restriction of tryptophan in the diet appeared to have no effect on the tumor status of the animal. Tumor burden usually induced malnutrition in the animal. However, tryptophan restriction did not further aggravate this malnutrition. The source of protein, whether casein, amino acid mixture or zein, appeared to make a difference in nutritional status of tumor-bearing animals though not in tumor status. Casein-fed animals generally tended to have higher values for all the nutritional markers studied than did animals fed the amino acid mixture or zein.
A collaborative study involving nutrition screening of 3,047 patients (excluding 125 pregnant women) at admission to 33 hospitals in and around the greater Chicago area was carried out to identify patients at nutritional risk. Information on sex, age, admitting diagnosis, serum albumin, hemoglobin, total lymphocyte count, and height and weight was collected from the medical chart within 48 hours of admission. Nutrition screening could not be completed for a larger number of patients (60%) because data at admission were not available. Of the remaining 40% of patients, more than 50% had below normal values for one or more of the variables studied: serum albumin, hemoglobin, and total lymphocyte count. A large number of the patients (40%) also were considered at nutritional risk as judged by the criteria of weight/height (measured only). Early nutrition intervention for high-risk patients cannot be implemented, nor can the efficacy of nutrition services be evaluated, unless nutrition screening is carried out on patients at admission.
Taste sensitivity and preference in the suprathreshold ranges were compared for 20 pediatric patients with renal disease and 15 children with normal renal function. Nine patients had chronic renal insufficiency, and 11 had endstage renal disease. Subjects were also evaluated for various dietary, anthropometric, and biochemical parameters. All subjects were asked to pull out a tape measure to rate the strength of five varying concentrations of aqueous solutions of sucrose, sodium chloride, and quinine sulfate. The subjects' abilities to judge increasing concentrations with greater perceived intensity were measured by calculating individual and group slopes. No significant differences in the values were found between the groups. Similarly, no significant differences in mean peak preference concentrations were found between the groups. The patients with renal disease were found to be considerably growth retarded (height and weight less than 5th percentile), with a mean caloric intake less than 65% of the RDA even after an adjustment had been made for height. Serum zinc levels were all normal.
Ancient Mexican botanical literature was systematically searched for new plant sources of intensely sweet substances. Lippia dulcis Trev., a sweet plant, emerged as a candidate for fractionation studies, and hernandulcin, a sesquiterpene, was isolated and judged by a human taste panel as more than 1000 times sweeter than sucrose. The structure of the sesquiterpene was determined spectroscopically and confirmed by chemical synthesis. Hernandulcin was nontoxic when administered orally to mice, and it did not induce bacterial mutation.
A retrospective study on the effect of intensive nutrition counseling on weight gain of pregnant women and birth weight of their infants was conducted at an outpatient clinic by comparing one group of 86 women who attended only a nutrition class with another group of 114 women who attended the class plus multiple counseling sessions on appropriate weight gain and nutrient intake. The women receiving the counseling on an average gained 2.5 kg more weight, had fewer low-birth-weight infants (4% vs. 13%), and had infants weighing 100 gm more at birth. That indicates that intensive nutrition counseling results in a superior outcome of pregnancy. When the cost of intensive neonatal care for six infants was compared with the cost of nutrition counseling, a benefit-to-cost ratio of 1:5 was found.
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