Impact of type II diabetes mellitus on phrenic nerve conduction velocity and respiratory functions

Background: Diabetes is a common cause of peripheral neuropathy. Phrenic neuropathy may be an important, albeit rare, complication of diabetes. Diaphragmatic function should be considered in any patient with unexplained breathlessness and orthopnea. Neurological problems of the diaphragmatic muscle occur when a disease process decreases or terminates the impulse of respiratory stimuli originating in the brain. The diaphragm receives its role muscular neurologic impulse of the respiratory impulse from the phrenic nerve. Phrenic neuropathy may impair respiratory function. Aim of the work: To compare respiratory functions and phrenic nerve electrophysiological activity in diabetics and non-diabetics

Methods: An electrophysiological study of phrenic nerve was performed, using motor nerve conduction velocity study to determine its possible involvement in 30 diabetic patients and 30 non-diabetics. Respiratory functions [FVC,FEV1, FEV1/FVCratio, and FEF25-75]were also measured

Reuslts: Most of diabetics showed impaired respiratory function. Twelve patients of all diabetics showed pathological phrenic nerve latency. Phrenic nerve conduction velocity is significantly lower in those diabetics who have impaired respiratory functions than those without respiratory function impairment. Delayed phrenic nerve latency correlated clearly with impaired respiratory functions, fasting blood sugar and glycosylated hemoglobin

Conclusion: Diabetes is correlated with delayed phrenic nerve conduction velocity and respiratory function impairment

Pharmacological studies on the venomous spotted butterfish (Scatophagus argus Linn) sting extract on experimental animals.

A sting of the fish S. argus, a venomous edible spotted butterfish, produces tremendous local pain, severe swelling, rise of body temperature, throbbing sensation etc. To establish the pharmacological activities of S. argus sting extract, the present investigation, was carried out on experimental animals. The LD50 of extract was found to be 9.3 mg/kg (iv) in male albino mice. The extract showed loss of sensation, urination and salivation in mice. It potentiated pentobarbitone induced sleeping time in male albino mice and produced hypothermia. Extract produced a fall of cat and guinea pig blood pressure, which was completely abolished by mepyramine. It produced a transient reduction of respiratory rate in rat, but decreased respiratory amplitude in cat, which was abolished after vagotomy. On isolated toad heart, the extract increased both the amplitude and rate of contraction. On isolated guinea pig heart, the sting extract decreased both the rate and amplitude of contraction leading to cardiac arrest, but it had no effect on isolated guinea pig auricle. The extract produced a reversible blockade of electrically induced twitch response of isolated chick biventer cervices preparation, but it had no effect on the isolated rat phrenic nerve diaphragm preparation. It produced a slow contractile response on isolated guinea pig ileum, rat uterus and rat fundal strip preparations but produced slow relaxation on isolated rat duodenum preparation. The contractile response on isolated guinea pig ileum and rat fundal strip was antagonised by SC19220. It did not produce any significant cutaneous haemorrhage in mice and did not produce any haemolysis on saline washed erythrocytes. The sting extract significantly increased capillary permeability of guinea pig dorsal flank and produced oedema in mice hind paw.

Complicaciones respiratorias en el postoperatorio inmediato de la cirugia coronaria / Respiratory complications immediately after coronary surgery

La influencia de la incisión quirúrgica, anestesia y condiciones específicas de la cirugía cardíaca sobre las alteraciones de la función pulmonar es analizada. La hipoxemia (presente aún en los post-operatorios no complicados) puede adjudicar-se a hipoventilación alveolar, alteraciones de la relación ventilación-perfusión o shunt. Los mecanismos de producción de atelectasias (presentes en 50-92 por ciento de los pacientes) y derrame pleural (42-87 por ciento) son discutidos. El daño del frénico se debe habitualmente a injuria térmica. Otras complicaciones menos frecuentes son descriptas. Se analiza la influencia de la edad, el tabaquismo y la enfermedad pulmonar previa sobre las complicaciones respiratorias. Se discuten los distintos aspectos del manejo respiratorio post-operatorio como el momento e indicaciones de extubación y los resultados de las distintas modalidades respiratorias (uso de PEEP, CPAP, y dispositivos de incentivación inspiratoria).