Biomedical subjects

A Banerjee

Publications and source records attributed to A Banerjee.

562 records · Page 32Linked to original sources

PubMedDate not supplied

Cardiac tumours: an observational study.

We studied 38 patients with cardiac tumours. Of these, 30 had primary cardiac tumours while the rest had secondary tumours. The commonest manifestations in patients with primary tumours were exertional breathlessness (23), fever (9), mitral diastolic murmur (15), loud pulmonary component of the second heart sound (16), and mitral systolic murmur (21). Left atrial myxoma was the commonest diagnosis (24) followed by left ventricular leiomyoma (2), right atrial myxoma (2, one with RA and RV both), RV myxoma (1), and left ventricular haemangioma (1). The commonest modes of presentation of secondary cardiac tumours were atrial extrasystoles (5) and pericardial friction rub (4). Histopathological reports revealed bronchogenic carcinoma (4), breast carcinoma (2), seminoma of the testis (1) and lymphoma (1). The unexpectedly low number of secondary cardiac tumours in this series is attributed to the lack of routine autopsy studies in our institute.

Adolescent↗

PubMedDate not supplied

Stress in informal carers of hospitalised elderly patients.

The aim of this study was to assess psychological well-being in carers of elderly hospitalised patients and to identify factors predicting those at risk. There are over six million informal carers in the UK. An objective measure of carers' mental health was obtained using the General Health Questionnaire and a subjective assessment (from the carer's point of view) of how caring affected their own everyday lives was also made. Of the 93 carers interviewed, 42 (45%) showed objective evidence of significant psychiatric disturbance. When questioned about their caring roles, 32% felt their health was affected by caring and 46% their social lives; 63% subjectively reported stress and 47% depression; 15% changed their employment patterns. Patients and carers received few statutory social services: 26% home care, 11% district nursing input, 8% meals on wheels and 5% either day centre or day hospital attendance. Cohabitation made it more likely that the carer's mental health would show some impairment. The informal carers' high stress levels and interference with their daily lives have implications for future care planning for the elderly.

Aged↗

PubMedDate not supplied

Anaesthetic management of patients undergoing surgery for tachyarrhythmias. Initial experience with 16 patients.

Sixteen patients suffering from various cardiac arrhythmias were treated surgically. Intraoperative computerised electrophysiologic mapping was used in 14. Thirteen patients were suffering from Wolff-Parkinson-White syndrome. They underwent surgical division or cryoablation of accessory pathways. Two patients who had rheumatic mitral stenosis with left atrial clot underwent "Maze III" procedure with open mitral commissurotomy and clot removal. One patient with paroxysmal refractory ventricular tachycardia and a left ventricular aneurysm had an aneurysmectomy with subendocardial resection of the arrhythmic focus. All antiarrhythmic medications were discontinued preoperatively. Morphine was the principal anaesthetic agent, supplemented with halothane. Muscle relaxation was provided with pancuronium bromide. The various problems encountered included hypotension and arrhythmia during placement of epicardial band array for mapping (4 patients), ventricular tachycardia during internal jugular vein cannulation (1 patient) and continuance of delta wave after cryoablation in 2 patients. Halothane may have interfered with electrophysiologic mapping and accurate localization of accessory pathway leading to persistence of delta wave. The choice of anaesthetic agents should be guided by the electrophysiologic effects and potential influence of these agents on the accessory pathways.

Adult↗

PubMedDate not supplied

Post-cardiotomy intra-aortic balloon counter pulsation: application and prognostic evaluation.

Cardiac assistance by intra-aortic balloon counter pulsation was studied in 113 cardiac surgical cases comprising 91 male and 22 female patients. This included 82 percent of patients having coronary artery bypass surgery, while 18 percent were operated for valvular lesions. It was observed that the time of institution of cardiac assistance by intra-aortic balloon counter pulsation, following cardiac surgery, was of prime importance to decrease patient mortality. It was lowest (16%) when the balloon was inserted for assistance before termination and highest (50%) when there was delay of more than 15 minutes following termination of cardiopulmonary bypass. Early balloon assistance significantly lowered the pulmonary capillary wedge pressure and usually 1:2 augmentation was more effective, probably because of existing tachycardia in most patients. Advances in catheter technology have reduced the vascular complication at the insertion site. Percutaneous insertion had less local complications (13.3%) than open arteriotomy technique (31.2%). Similarly with sheathless insertion, complications were less (6.6%) in comparison to sheathed insertion (21.7%). Proper placement of balloon avoided position-related complications and there was no compromise of blood flow through left internal mammary artery as noticed in our series.

Adolescent↗