Role of stressful life events in induction or exacerbation of psoriasis and chronic urticaria.

BACKGROUND: The possibility of a causal influence of emotional stress, especially of stressful life events, on the course of various skin diseases has long been postulated. Previous reports addressing its influence on skin psoriasis and chronic urticaria have been mainly anecdotal. OBJECTIVE: The aim of this study was to evaluate the stressful events of life within 1 year preceding onset or exacerbation of skin disease in patients of psoriasis vulgaris and chronic urticaria. METHOD: Fifty consecutive clinically diagnosed psoriasis patients and 50 consecutive clinically diagnosed chronic urticaria patients were examined clinically and administered Gurmeet Singh's presumptive stressful life events scale. RESULTS: Stressful life events were seen in 26% of the patients in the psoriasis vulgaris group and 16% of the patients in the chronic urticaria group within 1 year preceding onset or exacerbation of skin disease. In the psoriasis vulgaris group, the most common stressful life event seen was financial loss or problems (8%), followed by death of close family member (4%), sexual problems (4%), family conflict (2%), major personal illness or injury (2%), and transfer or change in working conditions (2%), failure in examinations (2%), family member unemployed (2%), illness of family member (2%), getting married or engaged (2%), miscellaneous (2%). In the chronic urticaria group, the most common stressful life event seen was death of a close family member (6%), followed by family conflict (2%), financial loss or problems (2%), sexual problems (2%), illness of family member (2%), getting married or engaged (2%), trouble at work with colleagues, superiors, or subordinates (2%), going on a pleasure trip (2%) and extramarital relations (2%). CONCLUSION: Psychological stress plays a significant role in triggering or exacerbating dermatological diseases. Our study indicates the role of relaxation therapies and stress management programs in chronic diseases such as psoriasis and chronic urticaria. Psychological interventions can help individuals to reinterpret events and develop strategies to cope with stressful events, thus decreasing morbidity due to these diseases.

Anaesthetic considerations in a patient with wolff-Parkinson-white syndrome.

Wolff-Parkinson-White syndrome is an important variant of pre-excitation syndromes caused by congenital atrioventricular accessory pathway. It can lead to various types of serious cardiac arrhythmias. We describe general anaesthesia management using fentanyl-vecuronium-halothane technique to achieve haemodynamic stability.

Auditory functions in anaesthesia residents during exposure to operating room noise.

Twenty anaesthesia residents were exposed to a pre-recorded audio cassette of operating room noise. The noise level during exposure was maintained at 77.32 +/- 1 dB (A), which was the calculated average operating room noise in our institute. Two auditory functions i.e., speech reception threshold and speech discrimination were studied before and during exposure to noise in a pre-fixed order. The right and left ears were tested separately. Speech reception threshold showed a mean increase of 23.75 +/- 6.86 dB (A) for the right ear and 26.25 +/- 6.90 dB(A) for the left ear during exposure to noise, suggesting that speech communication may be possible only by raising the voice. Speech discrimination showed a mean percentage decrease of 23.3 +/- 4.82 per cent for the right ear and 23.5 +/- 3.89 per cent for the left ear implying that there can be a steep decrease in the ability to discriminate spoken words.

Effect of halothane exposure on motor skills & memory in anaesthetists.

In a prospective study involving 24 anaesthesia residents, each resident was assessed three times i.e., first as control group, not exposed to anaesthesia at all; the second group in which the resident was exposed to anaesthesia while using controlled respiration with closed circuit without halothane (non-halothane group) and the third group in which they were exposed to anaesthesia using spontaneous respiration with semiclosed circuit using halothane (halothane group). After each exposure of 3-4 h duration in each group, the resident was subjected to specific psychological tests to assess motor skills and memory. In the non-halothane group, a depression of motor skills by 5.51 per cent and of memory by 17.14 per cent was observed. In the halothane group, the reduction of motor skills was up to 27 per cent and of memory by 45 per cent as compared to the control values. It is concluded that 3-4 h exposure to halothane (1.5-4%) obtunds the motor skills and memory in anaesthetists.

Role of epidural analgesia on endocrine & metabolic responses to surgery.

Serum levels of cortisol, T3, T4 and blood levels of glucose, lactate and pyruvate were measured 15 min before anaesthesia, 15 and 60 min after skin incision and at 2 h after surgery, in 16 patients undergoing elective surgery on lower extremities either under epidural analgesia (group I) or general anaesthesia (group II). The results showed that as long as the effect of epidural analgesia persisted, it could inhibit the increases in cortisol and blood glucose and the decreases in T3 levels, observed under general anaesthesia. This is probably because of the blocking effect of epidural analgesia on the afferent neurogenic impulses from the area of surgery. T4, lactate and pyruvate levels were not affected to any significant extent. These observations could be of value in the operative management of patients with diabetes mellitus and others with a high surgical morbidity.

Role of d-tubocurarine in suppression of cardiovascular responses following endotracheal intubation.

The role of d-tubocurarine in blocking the hypertensive tachycardiac response following laryngoscopy and endotracheal intubation was evaluated in 45 female patients aged 20-40 yr. The patients belonging to grade I (of American Society of Anaesthesiologists) and undergoing elective surgical procedures under general anaesthesia were allocated in 3 equal groups. Patients in the 3 groups received 1.5 mg/kg succinylcholine, 0.6 mg/kg d-tubocurarine and 0.12 mg/kg pancuronium bromide, respectively for intubation. There were no dysrhythmias in any of the groups following endotracheal intubation. There was significant (P less than 0.01) fall in blood pressure following induction prior to intubation in all the three groups. Maximum fall was noted in group II (23.53 +/- 7.21 mmHg in mean arterial pressure). Following endotracheal intubation, blood pressure and heart rate increased significantly (P less than 0.01) in all 3 groups. Maximum increase was observed in group I (26.4 +/- 4.95 mmHg in mean arterial pressure and 19.07 +/- 6.54 beats/min in heart rate). Blood pressure and heart rate increases in groups II and III were comparable. Our findings indicate that hypotension produced by d-tubocurarine through ganglion blockade is not effective in attenuating the cardiovascular responses following endotracheal intubation. It is also possible that increased cardiovascular response following endotracheal intubation may not be due to sympathetic ganglion stimulation.

Chemotaxonomy of Pseudophyllidean cestodes: II. Amino acids of Bothriocephalus teleostei (Malhotra) from Indian hill - stream teleosts

Doce amino ácidos de Bothriocephalus teleostei (Malhotra, 1984) se describen utilizando la técnica de la cromatofotografía. También se describen las diferencias de concentración y distribución de amino ácidos en cestodes Pseudophyllidea, Tetraphyllides, Trypanorhyncha y Cyclophyllidea

Population biology of the Pseudophyllidean cestode Bothriocephalus teleosts (Malhotra, 1984) in the Indian hill- stream teleosts: I. Influence of season and temperature

La infección por el cestode Bothriocephalus teleostei (Malhotra, 1984) en teleósteos de aguas corrientes montañosas se ha presentado como un fenómeno asociado a la temperatura acuática. El cestode fue más prevalente en las épocas de comienzos de primavera y verano que en la época invernal, durante el período de 24 meses que duró el estudio (1979-1981)

Cestode fauna of hill-stream fishes in Grarhwal Himalayas, India. II. Bothricocephalus teleostei n. sp. from Barilius bola and Schizothorax richardsonii.

Cestodes de peces de corrientes montanosas en Garhwal, Himalayas, India. II. Bothricephalus teleostei n. sp. en Barilius bola y en Schizothorax richardsonii. Se describe Bothriocephalus teleostei n. sp. en Barilius bola y en Schizothorax richardsonii De acuerdo a informacion disponible, se ha hecho la evaluacion taxonomica de la nueva especie