Unusual abdominal complications of a suicidal overdose of analgesic and psychotropic drugs in an elderly patient

A suicidal 67-year-old woman with manic-depressive psychosis took an overdose of asprin, amitriptyline and diazepam. The initial effects were pyrexia, tachycardia, hyperpnea, metabolic acidosis, electrocardiographic changes, hypoprothrombinemia, gastritis, and pancreatitis. Four to six weeks later, she was examined because of persistent abdominal pain with mausea, anorexia anemia, and possibly a malabsorption syndrome. An exploratory laparotomy was performed. The surgeon found several previous adhesions, a small intestinal volvulus, and a nodular pancreas. This suggested previous perforation of the small bowel from enteritis, causing a "blind-loop" syndrone. The invilved section of the small bowel was resected. With appropriate treatment, the patient is well three months after operation.

Pharmacokinetic study of antipyrine in malnourished children

Plasma half-life and metabolic clearance rate of antipyrine administered intravenously in a dose of 16 mg/kg body weight was studied in 10 children suffering from protein calorie malnutrition and five normal children matched in age and sex. Plasma half-life was increased and metabolic clearance rate was decreased in malnourished children (10.4 hr and 47.1 ml/hr per kg, respectively) in comparison to controls (6.3 hr and 70.1 ml/hr per kg, respectively). This observation indirectly reflects the lowered activity of microsomal oxidative enzyme of liver. Five children were restudied after nutritional rehabilitation of 17 to 25 days. Antipyrine plasma half-life decreased to 6.6 hr and metabolic clearance rate increased to 66.5 ml/hr per kg. These values were similar to those in normal children indicating biological recovery. The drug therapy in children with protein calorie malnutrition requires reconsideration in light of these observations.

Tardive dyskinesia in psychogeriatric patients: a five-year follow-up

The neurologic side effects of antipsychotic drugs in the treatment of major psychiatric disorders are causing great concern. The status of tardive dyskinesia in 13 elderly psychiatric patients at the 5-year follow-up point, is reported. In 11 of the 13, tardive dyskinesia persisted. tamong these 11 patients, the severity was reduced in 2, increased in 2, and unchanged in 7. Only in 2 of the total 13 subjects had the tardive dyskinesia disappeared. However, both of these patients were receiving neuroleptic drugs and had parkinsonism, a syndrome that might have masked the dyskinesia. Recommendations are made for prophylaxis and for good clinical judgment in the use of antipsychotic drugs.

A passive method of disposal of expired anaesthetic gases

A passive method for the disposal of waste anaesthetic gases is described. The resistance characteristics of the collector valve, the balancing device and the disposal system were studied. It was found that the resistances offered by the conduction channels and the terminal exhaust valve were extremely low. The collector valves were found to be responsible for most of the expiratory resistance. Swabs taken from various components of the system showed that these were contaminated mainly with commensals and non-pathogenic organisms.

Growth profile of preschool children from an urban low socio-economic community in India

A five years longitudinal study on the growth and development was carried out on 68 infants from a low-socio-economic urban community in India. Ninety four percent of them suffered from Protein Calorie Malnutrition of varying degree at some time or the other during their first six years and of them 30% suffered severe PCM. The effect on heights and head circumference followed the same pattern as body weight. Their developmental quotients correlated with the degree of PCM till age of four years. This observation brings into focus a growth profile of underprivileged toddlers which is far worse than what is brought out by cross sectionals surveys. The family at greatest risk is one with a young mother who is ill equipped with the techniques of successful breast feeding and supplemental feeding of her infant. Additional factor is early onset of diarrhoeal illnesses in these children. It is suggested that such a vulnerable family requires special support from the health delivery system planned for urban communities.

Energy metabolism of brain in human protein-calorie malnutrition

Cerebral blood flow (CBF) and carbohydrate metabolism were studied in 5 normal children and 25 children, aged 40 months or less, with varying degrees of protein-calorie malnutrition (PCM). CBF in normal children and those suffering from grade I PCM was 90.3 +/- 5.7 ml/100 g/min, a value comparable with that obtained by other investigators, but the proportion of glucose taken up by the brain which combined with oxygen, the oxygen/glucose index (OGI), was 65.8%, indicating significant conversion of glucose into lactic acid. Cerebral lactic acid production was 45.3 micronM/100 g/min, and the respiratory quotient (R.Q.) was 1.00. With increasing severity of PCM, there was increased glucose utilization and a progressive reduction in the OGI. In grade IV PCM, CBF was 68.7 +/- 5.4ml/100g/min, and the OGI was 34.7%. Cerebral lactic acid production was 27.4 micronM/100 g/min, and the R.Q. rose to 1.52. These findings suggest that in severe human PCM the proportion of glucose undergoing aerobic oxidation is reduced, and that in addition to being converted to lactic acid, a significant proportion of glucose is transformed by the brain into long chain fatty acids.

Rapid intubation with fazadinium and suxamethonium

Fazadinium at two dose levels (1 mg/kg and 1.5 mg/kg) and suxamethonium at three dose levels (50 mg, 75 mg and 100 mg) were investigated in 106 adult patients to determine the time interval from injection to tracheal intubation. The intubating conditions were graded according to the scheme described by Lund and Stovner. Suxamethonium 100 mg gave the shortest time interval between the end of injection and intubation. There was no significant difference between the intubation time when smaller doses of suxamethonium (50 mg and 75 mg were used and those when AH8165 (1 mg and 1.5 mg/kg) were given. Suxamethonium 100 mg also produced a significantly higher incidence of excellent intubating conditions. The clinical implications of the findings are discussed.

Activation of the classical complement pathway by Fc fragment of human IgA

Intact Fcalpha fragments from five human IgA myeloma proteins were produced by two different methods, high temperature trypsinolysis and IgA protease digestion. Three of the Fcalpha fragments activated the classical pathway as determined by the titers of the individual complement components. Two other fragments did not fix complement by either pathway.

Terminal gas-exhaust valve for a passive disposal system

A one-way gas-exhaust valve for use in passive disposal systems is described. The valve is explosion-proof and it does not offer any resistance at gas flow rates of up to 30 litres/minute. The design of the valve minimises the influence of wind velocities on pressure fluctuation in the disposal system.

Longitudinal analysis of growth of the soft palate and nasopharynx from six months to six years

Between the ages of six months and six years, longitudinal lateral headfilms were taken on 54 patients with palatal clefts or with unilateral and bilateral clefts of the lip and palate. They were measured and were compared to data on both normals and subjects with clefts of the lip only. The objectives of the study were: 1. To sutdy the effects of palatal surgery on the growth of the soft palate. 2. To compare the growth of the soft palate and nasopharynx among the patients with various types of clefts and normals. 3. To study the growth acceleration or so-called catch-up growth after palatal surgery at various ages. (Anterior palatal surgery at 14 months +/- 2 months. Posterior palatal surgery at 16 months +/- 2 months.) 4. To evaluate the relationship between velopharyngeal growth in cleft groups and voice quality.