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Biomedical subjects

A K Basu

Publications and source records attributed to A K Basu.

At least 91 records · Page 5Linked to original sources
PubMed1981

Red blood cell survival in patients with ventricular septal defect and patent ductus arteriosus.

Hemolysis of red blood cells (RBC) in stenotic or regurgitant cardiac valvular lesions has been felt to be due to mechanical trauma and shearing stress caused by turbulence of blood. RBC are also under a shearing stress from turbulence in high-pressure shunts, such as ventricular septal defect (VSD) and patent ductus arteriosus (PDA). The RBC survival time was measured in five patients with VSD and in 11 patients with PDA to determine if there was hemolysis of RBC. Six children without cardiac disease were also studied to obtain the control values for RBC survival times in th laboratory. Two patients with PDA were restudied one year postoperatively. Additional parameters studied were hemoglobin, packed cell volume, reticulocyte cell count, peripheral smear, and urinary hemosiderin. The hemoglobin values and the packed cell volumes were comparable in the two groups. The reticulocyte cell count was normal in all. Urinary hemosiderin was negative in all and the peripheral smear did not reveal abnormal red cell morphology. Mean red cell survival half-life in the two groups was identical. The red cell survival was abnormally low in two patients of PDA. Since one of these two patients had persistently low RBC survival postoperatively, the authors believe that the low red cell survival in this patient was unrelated to the presence of PDA. Based on findings in the small number of cases, the authors conclude that left to right shunt through a VSD or PDA is probably not associated with significant red blood cell destruction.

Adolescent↗
PubMed1980

Status of ascorbic acid in iron deficiency anaemia and thalassaemia.

The status of ascorbic acid was studied at the levels of platelet and leucocyte in 32 cases of iron deficiency anaemia, 35 cases of thalassaemia and 18 normal subjects. It was found that in iron deficiency anaemia, platelet ascorbic acid was significantly higher than normal values indicating tissue excess and came down sharply after treatment with iron. In thalassaemia, associated presumably with iron overload, ascorbic acid status of platelets was definitely lower than normal indicating tissue deficiency. Leucocytic level of ascorbic acid was not as good an index of ascorbic acid status as the platelet level.

Anemia, Hypochromic↗
PubMed1980

Direct splenocaval shunt for selective decompression of portal hypertension in children.

A new operation for selective decompression of portal hypertension in children with diminutive splenic veins is desired. The operation, direct splenocaval shunt (S-D-SCS), produces transplenic decompression of gastric-esophageal varices without interfering with the existing portal flow status in any significant measure. The proximal free end of the inferior vena cava (IVC) is joined to the side of the splenic vein, which is ligated on the hepatic side of the anastomosis. Addition of partial gastric devascularization completes the operation. Technically the operation is simple and easily executable. Because the IVC is utilized in creation of the shunt, anastomoses as large as 1.72 +/- 0.45 cm in diameter are obtained with splenic veins of less than 1 cm in diameter. S-D-SCS was performed in 10 children with a mean age of 9.25 +/- 3.36 years and a mean splenic vein size of 8.2 +/- 2.25 mm in diameter. Shunt thrombosis occurred in one patient who died. Nine patients survived the operation and obtained class A surgical results over a follow-up period of 7 to 12 months. None rebled, developed postshunt encephalopathy (PSE), or manifested laboratory evidences of protein intolerance. Insignificant alterations were brought about in liver blood flow (EHBF) and sinusoidal pressure (CSP); portal blood flow to the liver was maintained; and liver function tests were preserved at preoperative levels. The surgical results were superior to those following mesentericocaval and portacaval shunts in our earlier series of children with comparable mean age, body weight, and postoperative interval when studied functionally. About 30% of all of the shunt patients died of liver failure within weeks or months after the operations, and an additional 30% of the patients developed clinically significant PSE over variable periods of follow-up. These high mortality and morbidity rates were preceded by significant reductions in EHBF and CSP and concomitant precipitation of liver function abnormalities.

Adolescent↗
PubMed1978

Graft interposition splenocaval shunt for total or selective decompression of portal hypertension.

A new operation for selective or total decompression of the portal venous system in cases of intrahepatic portal hypertension is described. It involves interposition of a large-caliber Dacron graft between the splenic vein and the inferior vena cava. The graft-interposition splenocaval shunt is performed readily and quickly, satisfying the variable hemodynamic needs of patients with portal hypertension. It can be either selective (S-SCS) or total (T-SCS) from the beginning, or a T-SCS may be converted subsequently to a S-SCS should surgically induced hepatic decompensation supervene. It is less demanding technically than distal splenorenal shunt (D-SRS). The S-SCS conserves portal venous perfusion of the liver, preserves hepatocellular function and architecture at the preoperative levels, avoids precipitation of postshunt portal-systemic encephalopathy, and decompresses gastric-esophageal varices with prevention of further variceal bleeding even better than D-SRS. One hundred percent graft patency has been obtained, and the surgical results have been superior to those following portacaval shunt in patients with large liver blood flow and relative benignity of the liver disease, be it cirrhosis or noncirrhotic portal fibrosis. In patients with advanced cirrhosis, variceal bleeding, and small liver blood flows, T-SCS would be indicated. Patients of this category obtained inferior surgical results and had operative deaths (16.7%) following S-SCS. The concept of the operation has merits and deserves further evaluation.

Adolescent↗
PubMed1977

The pacemaker-twiddler's syndrome: another disadvantage of abdominal implantation of pulse generators.

Breakage of a pacer lead due to the pacemaker-twiddler's syndrome (PTS) occurred in 4 of 62 survivors following epicardial-intramural pacer lead implantation with the pulse generator placed in each case in a subcostal left upper quadrant subcutaneous pocket. The abdominal pulse generator pocket appears to invite spontaneously occurring PTS, more so in a pregnant woman. The important predisposing factor to the development of PTS is an excessively spacious pulse generator pocket containing a pool of fluid. Addition of a few simple modifications to the technique of cardiac pacing would prevent the complication; these include implantation of the pulse generator in a plane deeper to the pectoral muscles, suspending the pulse generator from the clavicle and application of vacuum-suction drainage to the generator pocket in the initial phase of wound healing. In the presence of an optimally fitting pulse generator pocket, PTS should be rare with subclavicular subpectoral pulse generator implantation without active patient participation. The syndrome may not be as rare a cause of pacer lead malfunction as may appear from the relative paucity of reports in the literature.

Abdomen↗