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Biomedical subjects

S Sagar

Publications and source records attributed to S Sagar.

At least 55 records · Page 3Linked to original sources
PubMed1985

Double-blind crossover clinical trial of oxyfedrine and propranolol in angina pectoris.

The comparative efficacy and safety of oxyfedrine and propranolol in the management of angina pectoris was evaluated in a double-blind randomized cross-over study. Out of 21 patients registered, 14 completed the study. Three patients dropped out due to poor response and 4 were lost to follow up. Both the drugs i.e. oxyfedrine (8-24 mg three times a day) and propranolol (40-80 mg three times a day) produced a significant reduction in the incidence of anginal attacks and the consumption of nitroglycerine tablets. Propranolol produced a better response than oxyfedrine although the difference was not significant. This may be due to the small sample size. No change in heart rate and rate-pressure product was observed with oxyfedrine, in contrast to that seen with propranolol. The beneficial effect of treatment on exercise tolerance and ST-segment depression was more marked with propranolol. No significant change in laboratory parameters was observed with either drug.

Angina Pectoris↗
PubMed1984

A comparative randomized double-blind clinical trial of bumetanide and furosemide in congestive cardiac failure and other edema states.

The efficacy and safety of oral bumetanide, a pharmacologically new diuretic was compared with that of furosemide in 30 patients suffering from congestive cardiac failure and other edema states. In addition intravenous bumetanide was studied in 14 patients of congestive cardiac failure and nephrotic syndrome to determine the onset, peak and duration of action. In the controlled double-blind oral study bumetanide was equipotent with furosemide at one fortieth the molar dosage and did not differ from furosemide with regards to its pattern of water and electrolyte excretion. On continuous oral administration for seven days it produced sustained diuresis with minimal biochemical alterations. No hyperglycemia or hematological abnormalities were noted. Intravenous bumetanide had onset of action between 10 and 15 minutes with a peak at 50 minutes and a total duration of action of about 240 minutes. Bumetanide was well tolerated by patients and is on a weight basis the most potent diuretic available today.

Administration, Oral↗
PubMed1983

Technetium-99m labelled bran: a new agent for measuring gastric emptying.

Bran was labelled with 99mTc-pertechnetate, ingested as part of a normal meal and used to measure gastric emptying in 15 normal subjects and in 15 patients with ulcerative colitis. There was no significant difference between the gastric emptying curves of the normal subjects and the patients, suggesting that rapid gastric emptying does not contribute to diarrhoea in ulcerative colitis.

Animals↗
PubMed1980

Fibrinogen in the 'hepato-renal syndrome': an experimental study.

The pathogenesis of renal failure in jaundice is controversial. Several factors have been incriminated, including intravascular coagulation. We have investigated this hypothesis by by studying the deposition of radioactive fibrinogen in the kidney of jaundiced rats. Fibrinogen labelled with 125I was injected into rats whose bile duct was subsequently ligated. The radioactivity in the kidney was compared to that in blood and the renal uptake ratio calculated. This ratio (mean +/- s.e.mean) rose from 0.24 (+/- 0.04) to 2.93 (+/- 0.43) after ligation of the common bile duct. In contrast, in control rats who underwent a sham operation, the uptake ratio rose from 0.31 (+/- 0.03) to 0.96 (+/- 0.08). This deposition of 125I fibrinogen in the kidneys of jaundiced rats was significantly greater (P < 0.001) than that in control rats. The deposition was specific to the kidney compared with that in the heart, bowel, muscle and liver. In the control animal the uptake of 125I fibrinogen by the kidney was not different from that by other viscera.

Acute Kidney Injury↗
PubMed1980

Observations on the rare association between portal and pulmonary hypertension.

Pulmonary arterial hypertension with severe pulmonary vascular disease is a rare association of portal hypertension in man, be it the result of cirrhosis of the liver or obstruction of the portal vein. We induced portal hypertension in 23 rats by partially ligating the portal vein or by totally occluding it in two stages. The rats were killed between one and 15 months after operation. A collateral circulation of varicose, anastomotic vessels was established, and in six animals well-marked oesophageal varices developed. Despite this evidence of sustained portal hypertension, hypertrophy did not develop in the right ventricle or in the media of the pulmonary trunk or muscular pulmonary arteries in any of the animals. This suggests that mechanical obstruction of the portal vein per se is not responsible for the development of pulmonary hypertension. Other factors, perhaps of a humoral nature, appear to be required to induce this rare association of portal hypertension but we have been unable to identify these. In particular, blood levels of oestrogen were not raised after ligation of the portal vein.

Animals↗
PubMed1979

Early postoperative feeding with elemental diet.

The value of early postoperative feeding with an elemental diet was assessed in 30 patients after major gastrointestinal operations. The patients were allocated at random to conventional treatment (control group) or feeding with the elemental diet (ED group). The clinical and metabolic course of the 15 patients in the ED group was significantly better than that of the controls. Patients in the ED group lost less weight and had a shorter stay in hospital. Negative nitrogen balance was more pronounced in the control group throughout the seven postoperative days. Energy intake was higher in the ED group. Provided elemental feeding is used with caution, it may be given from the first postoperative day. Patients do better metabolically and require shorter stays in hospital.

Body Weight↗
PubMed1979

Emergency treatment of variceal haemorrhage.

For the initial control of haemorrhage from oesophageal varices, two methods of vasopressin administration have been compared--the conventional bolus of 20 units and a low dose infusion of 0.4 units per minute. Twenty patients bleeding from oesophageal varices, confirmed by endoscopy, were allocated into either treatment group (10 in each). Vasopressin infusion stopped bleeding in 86 per cent of the episodes in contrast to 12.5 per cent (P less than 0.01) with bolus doses. Balloon tamponade with a Sengstaken-Blakemore tube was used to control bleeding in only 2 episodes in patients on infusion and in 10 episodes in patients on bolus doses of vasopressin (P less than 0.05). Our study confirms that low dose vasopressin infusion in more effective in controlling bleeding from oesophageal varices than conventional bolus doses.

Blood Transfusion↗
PubMed1979

Terminal phalangeal tufts: earliest site of renal osteodystrophy findings in hemodialysis patients.

Direct magnificaiton of the hands of 44 patients on maintenance hemodialysis showed that the earliest unequivocal changes of renal osteodystrophy occur in the tufts. Some workers made a similar observation, but no previous objective study confirmed or refuted the sensitivity of the tufts in the diagnosis of renal osteodystrophy. The macroradiograph is consistently reproducible and serves as an excellent visual record of subtle changes.

Chronic Kidney Disease-Mineral and Bone Disorder↗
PubMed1977

Femoral vein thrombosis and total hip replacement.

Of 160 patients who underwent total hip replacement, 81 developed venographic evidence of thrombi in the operated leg. In 46 cases (57%) the thrombus originated from the femoral vein, and in 43 of these the exact site of origin was defined by venography. In 34 cases (74%) the thrombus arose from the wall of the femoral vein at the level of the lesser trochanter. This region was studied by intraoperative venography in eight patients undergoing total hip replacement, and in every case severe distortion of the common femoral vein was observed, producing almost total occlusion. We suggest that intraoperative damage to the femoral vein results from manipulation of the leg, and that this is one reason why the operation is followed by a high incidence of deep vein thrombosis in the upper femoral region.

Femoral Vein↗
PubMed1977

Intermittent plasminogen-streptokinase treatment of deep vein thrombosis.

The fibrinolytic response of 12 patients receiving single daily infusions of 600,000 units of streptokinase (SK) and 90 mg of plasminogen for the treatment of DVT has been studied. The mean plasminogen concentration was maintained throughout the treatment period (4-6 days) at between 20-40% the initial value, while mean circulating plasmin concentration rose to only about twice initial plasma levels. The degradation of fibrinogen as indicated by a fall in clottable fibrinogen did not fall below 1 mg/ml and serum FDP rose to greater than 1 mg/ml. Limited fibrinogenolysis occurred in 2 patients, while in another patient who bled there was immediate and extensive depletion to below 0.5 mg/ml. The beneficial clinical results obtained with this regimen (Kakkar et al. 1975), which produces only limited systemic plasminaemia, suggest that thrombolysis may be facilitated by higher levels of plasminogen than those maintained during conventional SK treatment.

Fibrin Fibrinogen Degradation Products↗
PubMed1976

Efficacy of low-dose heparin in prevention of extensive deep-vein thrombosis in patients undergoing total-hip replacement.

In a prospective trial, the prophylactic efficacy of low-dose heparin was investigated in 84 consecutive patients undergoing total-hip replacement. 52 of these were randomly allocated to receive heparin or a combination of heparin and dihydroergotamine (D.H.E.); the remaining 32 patients, who were operated on by one orthopaedic team and did not receive prophylaxis, acted as a control group. The frequency of deep-vein thrombosis (D.V.T.), determined by the 125I-fibrinogen test and venography, was 69% in the control group, 32% in the patients receiving heparin alone, and 16% in those receiving heparin and D.H.E. The difference between the control group and each group receiving prophylaxis was statistically significant. The frequency of femoral-vein thrombi, demonstrated by venography, was analysed separately because of its frequent association with major pulmonary embolism. Femoral-vein thrombi developed in 17 (53%) in the control group, while they developed in only 4 patients (8%) in the prophylaxis group (P less than 0.01). 1 patient in the control group died due to massive pulmonary embolism; in another patient, again in the control group, clinical features suggestive of major non-fatal pulmonary embolism developed. This complication was not observed in patients receiving prophylaxis. There was no difference in the amount of operative or postoperative blood-loss in the three groups. In 3 patients in the entire series wound haematomata developed; all 3 were controls and haematomata developed after the administration of streptokinase or large doses of heparin for the treatment of extensive femoral-vein thrombi. By use of a sensitive assay, heparin could be detected in the plasma in 67% of samples in patients in whom D.V.T. did not develop. In contrast, in those patients in whom D.V.T. developed, heparin could be detected in only 21% of blood-samples (P less than 0.01). It is concluded that in patients undergoing total-hip replacement, low-dose heparin prophylaxis is effective in reducing the frequency of life-threatening extensive thrombi in the femoral vein. Prophylaxis using a combination of heparin and D.H.E. requires further evaluation.

Clinical Trials as Topic↗
PubMed1976

Oral contraceptives, antithrombin- III activity, and postoperative deep-vein thrombosis.

Deep-vein thrombosis (D.V.T.) was detected by the fibrinogen-uptake test in six out of a total of thirty-one young women undergoing emergency abdominal surgery who gave a history of recent oral contraceptive intake. In contrast, no D.V.T. developed in nineteen similar patients who were not on oral contraceptives (P less than 0-01). Plasma-antithrombin-III activity was significantly lower preoperatively in patients taking oral contraceptives; postoperative D.V.T. subsequently developed in three out of five patients with preoperative antithrombin-III activity below 50%. In seventy-eight dental patients undergoing molar extraction, antithrombin-III activity was measured before, during, and after operation. Activity fell in all patients during operation, but the fall was significantly greater in women taking oral contraceptives (P less than 0-01). The intra-operative fall in antithrombin-III activity was prevented by a small preoperative dose of subcutaneous heparin.

Adolescent↗