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Biomedical subjects

A Biswas

Publications and source records attributed to A Biswas.

At least 91 records · Page 5Linked to original sources

Caesarean and postpartum hysterectomy.

AIM OF STUDY: To review the cases of caesarean and post-partum hysterectomy performed over a 10-year period (1986-1996) in a teaching hospital, looking specifically at the associated morbidity. METHOD: Retrospective review of case files. RESULTS: During the study period, there were 14 cases of caesarean and post-partum hysterectomy. Caesarean hysterectomy was performed in 0.17% of caesarean sections and a hysterectomy was done in 0.02% of cases following a vaginal delivery. Uterine atony was associated with 43% of cases. Histological evidence of placenta accreta or increta was noted in 7 (50%) cases, while 8 (57%) cases had placenta praevia. A subtotal hysterectomy was performed in 7 cases, where the mean operating time was significantly shorter than that in cases of total hysterectomy. There were no maternal deaths. Fever (28%), urinary tract infection (21%) and chest infection/atelectasis (21%) were the common post-operative morbidity. Relaparotomy for continuing vaginal bleeding was required in 2 cases. CONCLUSIONS: Emergency peri-partum hysterectomy for obstetric haemorrhage is a rare operation (1 in 2,550 deliveries). In spite of the intra-operative risks and post-operative morbidity, it remains a potentially life-saving procedure.

Adolescent↗

Microbiological assay of ampicillin in serum and aqueous humor of patients given ampicillin-sulbactam injection.

The aim of this study was to determine the bacterial growth inhibitory activities of ampicillin in aqueous humor and serum of patients administered ampicillin-sulbactam combination intramuscularly prior to cataract surgery. 43 patients received a combination of both antibiotics intramuscularly at varying periods (60-140 minutes) prior to surgery. Aqueous humor and venous blood were collected at the beginning of the surgery. For microbiological assay, spores of Bacillus subtilis were incorporated in the agar. The test sample and the standard solutions (calibrators) of ampicillin and ampicillin-sulbactam combination were placed in 3 mm wells in the agar. The diameter zones of growth inhibitory activities of ampicillin of the calibrators and the test samples measured in mm were extrapolated to the standard curve and were recorded as ampicillin activity in micrograms/ml. The results of the assay were placed in 5 groups according to the time intervals between injection and collection of serum and aqueous humor (< or = 70, 75, 80, 90, > 90 minutes). Ampicillin activities in sera and aqueous humor of group 5 (> 90 minutes) were significantly higher than the others (p < 0.001). The ratio of ampicillin activities of sera and aqueous humor in group 5 patients was significantly lower indicating higher concentration of ampicillin activity in aqueous humor during this period. Bacterial growth inhibitory activities of ampicillin-sulbactam combination were adequate in aqueous humor of all patients with highest activity being 90 minutes after intramuscular administration indicating the potential usefulness of this antibiotic combination as chemoprophylaxis prior to cataract surgery.

Adult↗

Effects of medical and psychotherapeutic treatment on the survival of women with metastatic breast carcinoma.

BACKGROUND: The authors previously reported a statistically significant effect of psychosocial intervention on survival time of women with metastatic breast carcinoma. In this study, the authors investigated whether this effect could be explained by differences in the medical treatment patients received subsequent to their group participation or differences in causes of death. METHODS: Of the original 86 study participants, medical treatment charts for 61 and death certificates for 83 were available for further analysis. The authors reviewed the course of the medical treatment they received subsequent to their entry into the randomized psychotherapy trial. RESULTS: Although there were no statistically significant differences with regard to chemotherapy and hormone therapy between the control and treatment groups, women in the control group tended to have received more adrenalectomies, although this procedure did not account for the difference in survival time between the control group and the treatment group. Furthermore, women in the control group developed more bone and lung metastases than the women in the treatment group. CONCLUSIONS: Differences in disease course between the control and treatment groups appeared to be independent of any differences in medical treatment received.

Adult↗

Trans-tracheal ventilation complicated by bilateral pneumothoraces and pneumoperitoneum.

Following induction of general anaesthesia for emergency caesarean section the trachea could not be intubated, and ventilation was established only following two cricothyroidotomies. The baby was delivered unimpaired, and tracheostomy subsequently performed. On the intensive care unit, maternal cardiorespiratory variables were satisfactory, although surgical emphysema of the face and neck became apparent. Increasing abdominal distension was relieved by suction to a pelvic drain. Radiographs revealed bilateral pneumothoraces, pneumomediastinum and pneumoperitoneum, which were resolved by intrapleural drainage.

Journal Article↗

Amniotic fluid volume in spurious labour.

OBJECTIVE: A prospective study was undertaken to assess the amniotic fluid index (AFI) in women with spurious labour and its possible role in management. METHODS: Eight hundred and ninety-three women in early labour, who had uncomplicated pregnancy, were recruited for the study. Of these, 133 were later diagnosed to have had spurious labour, while 760 were in true labour. An admission cardiotocography and determination of AFI was done for all patients at the time of their admission to the labour ward. Labour was induced within 24 hours for those women in spurious labour who had severe oligohydramnios. RESULTS: The incidence of severe oligohydramnios (AFI < 5) was significantly higher in the patients later diagnosed to have had spurious labour (15.7%) compared with those in true labour (2.1%). With this management protocol, the obstetric and the neonatal outcome was similar in the spurious labour and the true labour groups. CONCLUSION: The assessment of AFI could be a simple and useful screening tool to avoid adverse perinatal outcome in women who experience spurious labour.

Adult↗

Ambulatory blood pressure monitoring in pregnancy induced hypertension.

OBJECTIVE: To determine the role of ambulatory blood pressure monitoring in the diagnosis of pregnancy-induced hypertension in women detected as hypertensive in the clinic by the conventional method. DESIGN: An observational study of ambulatory blood pressure monitoring. SETTING: A teaching hospital in Singapore. METHODS: One hundred and twenty-eight women between 28-37 weeks of pregnancy diagnosed to have non-proteinuric pregnancy-induced hypertension in the clinic had 24 hours ambulatory blood pressure monitoring. The mean systolic and diastolic BP, systolic and diastolic 'white coat effect' and the diastolic load were the main parameters noted. RESULTS: One hundred and twenty subjects had valid recordings. Only 46 (38.3%) were found to be truly hypertensive on ABP monitoring, using a mean diastolic pressure cut off of 85 mmHg. The 'white-coat effect' was seen in both groups of women--the hypertensives as well as the normotensives, although the magnitude of the white coat effect had poor correlation with the clinic diastolic BP. A cut-off value for diastolic load of 20 per cent was found to detect all hypertensives correctly (sensitivity 100%) with a modest false positive rate of 17.5 per cent. CONCLUSIONS: 'White-coat hypertension' is common in pregnancy and ambulatory blood pressure monitoring would be helpful in identifying the true hypertensive without requiring unnecessary hospitalization.

Adult↗