Bronchoscopic management of bronchopleural fistula with intrabronchial instillation of glue (N-butyl cyanoacrylate).

CONTEXT: Bronchopleural fistula (BPF) is a communication between the pleural space and bronchial tree. MATERIALS AND METHODS: A series of 9 cases are reported where BPF was identified and managed with intrabronchial instillation of glue (N-butyl-cyanoacrylate) through a video bronchoscope. RESULTS: Out of 9 patients the BPF was successfully sealed in 8 cases (88.88%). In 1 patient of postpneumonectomy, the fistula was big, that is >8 mm who had a recurrence after the procedure. In one case of pyopneumothorax the leak reduced slowly and it took us 14 days to remove the intercostal drainage tube. Rest of the patients had a favorable outcome. No complications were observed in a follow-up of 6 months. CONCLUSIONS: In our opinion, it is a cost-effective, viable, and safe alternative compared with costly, time-consuming, and high-risk surgical procedures.

Effective reduction of LDL cholesterol by indigenous plant product.

A herbal powder containing guar gum, methi, tundika and meshasringi was administered to 30 control and 30 type 2 (non-insulin dependent) diabetes mellitus patients for a month. Total serum cholesterol and its fractions eg, high density lipoprotein, low density lipoproteins, very low density lipoproteins and serum triglyceride were determined before and after the trial period. Total and low density lipoprotein (LDL) cholesterols were reduced significantly after the therapy. There were no significant changes in high density lipoproteins (HDL), very low density lipoproteins (VLDL) or triglyceride levels. Side-effects eg, mild flatulence and looseness of bowel were noticed in less than 40% cases.

Control of hyperglycaemia and hyperlipidaemia by plant product.

A herbal powder consisting of Guargum, Methi, Tundika and Meshasringi was administered to thirty control and thirty NIDDM patients twice daily before principal meals for four weeks. Oral GTT showed improvement in both control and patient groups. Serum total and LDL cholesterol also fell significantly in both the groups after the trial period. Test meal of the herbal powder with D-Xylose excretion was otherwise normal. Follow up for upto two years did not reveal any long term side effect of the powder. This powder, therefore, can be effectively used to reduce postprandial blood glucose and LDL cholesterol in NIDDM patients as a long term measure.

Electrocardiographic changes in experimental drowning.

Healthy mongrel dogs were subjected to aspiration of 20 ml/kg of fresh water (group I) or sea water (group II). Fresh water as well as sea water aspiration produced an immediate and significant bradycardia and the heart rate remained appreciably low throughout the forty minute study period. Appearance of tall T waves was the chief electro-cardiographic abnormality seen in both the groups. Out of seven dogs subjected to fresh water aspiration, two died of ventricular fibrillation and the other five survived. On the other hand, out of seven dogs subjected to sea water aspiration, five died of ventricular asystole within 10 min. This shows that equivalent volume of sea water is more lethal than fresh water. Further it is concluded that ventricular fibrillation is common after fresh water aspiration whereas sea water aspiration commonly leads to ventricular asystole.

Effects of aspirated and swallowed water in mongrel dogs subjected to fresh-water drowning.

The effects of aspiration or aspiration-cum-swallowing were studied in two groups of anesthetized dogs. Group I animals were subjected to aspiration (20 mlg/kg) whereas that of group II to aspiration (20 ml/kg) cum-swallowing (20 ml/kg) of fresh water. Aspiration produced decrease in plasma sodium and chloride whereas potassium, hemoglobin and haematocrit increased. These changes were transient and the values came back towards preaspiration level in the surviving animals. In animals subjected to aspiration-cum-swallowing, there was no initial increase in hemoglobin and hematocrit and both these values decreased significantly. The pattern of electrolyte changes was essentially similar to the aspiration group. All the animals in the two groups showed an immediate onset of significant asphyxia and acidosis that persisted throughout the period of observation. It is concluded that aspiration of 20 ml of fresh water per kg body weight produces only transient changes in hemoglobin, hematocrit and electrolyte balance, whereas the changes in arterial gas and pH are significant and persistent. It is further concluded that the swallowed water modifies the aspiration induced changes in fresh water drowning.