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Biomedical subjects

A K Maity

Publications and source records attributed to A K Maity.

At least 19 recordsLinked to original sources
PubMed1990

Effect of isosorbide dinitrate on enzymatically estimated infarction size and on clinical condition of the patients of acute myocardial infarction.

With the aim of reducing myocardial infarction size, isosorbide dinitrate (ISDN) was tried in 27 patients of acute myocardial infarction (AMI). There was 11% reduction of infarction size, in the ISDN treated group, in comparison to that of non treated group, though the result was not statistically significant. But, many of the in-hospital complications were significantly less in the treated group. After a critical analysis of the result it was concluded that a statistically insignificant result, as regard reduction of infarction size in AMI, cannot always exclude the utility of a drug therapy in AMI.

Creatine Kinase↗
PubMedDate not supplied

Haemodynamic advantage with single chamber rate responsive pacemakers over dual chamber pacemakers during exercise in chronotropic incompetence.

Sequential cardiac chamber activation and chronotropic response are amongst the important determinants of cardiac performance. This study compared VVIR mode with DDD and VVI mode to assess the contribution of these two factors in the determination of cardiac performance during exercise. Ten patients with a mean age of 68 +/- 5 years were studied during 1988-90, who had complete heart block and sinus node dysfunction with a mean LV ejection fraction of 51.5 +/- 6.25%. Five patients had DDD pacemakers and the rest had VVIR pacemakers. Patients were exercised first in VVI mode followed by either DDD or VVIR mode. Exercise duration, maximum rate pressure product, exercise capacity and cardiac output were measured with graded treadmill test in Bruce protocol. There was remarkable increase in the exercise duration (P < 0.001) and the maximum rate pressure product (P < 0.001) in patients with VVIR as compared to DDD and VVI mode. In DDD mode, as compared to VVI mode, this increase was less remarkable, though statistically significant (P < 0.005). Therefore, it is concluded that patients with chronotropic incompetence as well as complete heart block do better during dynamic exercise when they have VVIR mode compared to VVI or DDD mode.

Aged↗
PubMedDate not supplied

Low dose amiodarone in refractory tachyarrhythmias.

Fifty patients with drug resistant tachyarrhythmias were treated with amiodarone for 6-22 months; 16 for recurrent ventricular tachycardia (VT), 2 for VT followed by ventricular fibrillation (VF), 14 for complex ventricular ectopics, and 18 for supraventricular tachyarrhythmias (SVT). Amiodarone was administered in a dose much lower than that used in western trials. The actual incidence of successful amiodarone therapy was 81.2% at 22 months for patients with VT. Among the patients with SVT, 88.6% patients were successfully treated for 22 months (range 3-22 months). Amiodarone toxicity appeared in 22 of 50 patients (44%) treated for more than 12 weeks. Withdrawal of therapy was required in 4 patients. Despite the lower dose, clinical efficacy and onset of action were comparable to the western experience.

Adolescent↗
PubMedDate not supplied

Anticoagulant therapy in acute myocardial infarction.

In 265 patients of acute myocardial infarction (AMI) heparin followed by warfarin sodium was used routinely whenever there was no contraindication to the drug. Patients were followed up to 2 years with weekly estimation of prothrombin time. Another 265 patients of AMI having identical clinical profiles were taken as control and neither any anticoagulant nor any antiplatelet agent was used in them. Both groups were also treated with identical coronary dilators whenever needed. 2 years cardiac mortality was 11.6% in the control group and 5.9% in the anticoagulant therapy (ACT) recipient group (P less than 0.05). Incidence of reinfarction (RMI) was 14.4% during the period in the control group whereas it was only 6.7% in the ACT group (P less than 0.05). The incidence of intracranial events were also more frequent in control group (8.4%) compared to ACT group (3.1%) (P less than 0.05). However on further analysis of intracranial events, it was found that haemorrhagic intracranial events were slightly more frequent in ACT (2.3%) than in the control group (2%), but this difference was statistically insignificant (P greater than 0.05); non-haemorrhagic intracranial events were however significantly less in ACT group (1.96%) compared to the control group (6%) (P less than 0.05). There was no major or fatal extracranial haemorrhagic complication in either group. Only minor extracranial haemorrhages were more commonly observed in the ACT group (4.3%) compared to the control group (1.2%) (P less than 0.05).

Adult↗
PubMedDate not supplied

Risk factors and their implication on silent myocardial ischaemia.

Sixty-five cases were evaluated for silent myocardial ischaemia (SMI) by computerised treadmill test (TMT) and ambulatory electrocardiographic monitoring (AEM). There were 59 males and 6 females. The cases were divided into GP-I-stable angina (35 cases) GP-II-stable angina after myocardial infarction (15 cases) and GP-III-asymptomatic (15 cases). Age in each group ranged from 36 years to 62 years (GP-I), 40 years to 68 years (GP-II) and 36 years to 48 years (GP-III). Conventional risk factors viz. hypertension, diabetes mellitus, hyperlipidemia, smoking and family history were assessed with a view to see their implication on SMI. 43 patients (62.2%) were found to have SMI including mixed episodes. Out of these 43, TMT was positive in 29 patients (67.4%), AEM was positive in 41 patients (95.3%) and both TMT and AEM were positive in 27 patients (62.7%). Correlative analysis between risk factors and SMI revealed that higher number of was associated with not only more positive TMT and AEM test along with increased episodes of SMI but also increased degree of ST-T depression. It was also found that AEM is more sensitive than TMT (80% Vs 48%) for diagnosing SMI (SED = 9.03%), though specificity of the tests is same (93.3%).

Adult↗
PubMedDate not supplied

An echo-cardiographic (M-mode & 2D) analysis of thalassaemia major.

25 cases of thalassaemia major were studied by 2D and M-mode echocardiography. A significantly increased (p less than 0.001) mean value (100.8 +/- 27.37 msec, range 80 to 140 msec) of A2-E (early relaxation period) interval on M-mode was observed in thalassemia in comparison to mean level (82.6 +/- 5.7, range 60 to 100 msec) of control population. No significant differences were noted in FS % (fractional shortening) and EF% (ejection fraction) when compared to corresponding normal values respectively. Mean serum iron concentration (142.2 +/- 29.1 micrograms/dl, range 102 to 192 micrograms/dl) was significantly higher in thalassaemia as compared to normal population (mean 106.3 +/- 11.4 micrograms/dl, range 75 to 120 micrograms/dl). There was also a direct correlation between serum iron concentration and A2-E interval. 11 patients (44%) showed abnormal A2-E interval but only 3 patients (12%) showed abnormal percentage of FS and EF. It is therefore concluded that A2-E interval will help to detect early left ventricular dysfunction much before overt and irreversible heart failure becomes manifest and which will also help to optimise transfusion and chelation therapy.

Adolescent↗
PubMedDate not supplied

Prognostic significance of risk factors in acute myocardial infarction in young.

The study included 45 consecutive patients in the age group of 27 to 39 years presenting with AMI diagnosed by typical history, ECG changes and enzyme response. Prognostic significance of various risk factors in AMI in young was evaluated. There were 41 M (91.1%) and 4 F (8.9%) with mean age of 34.6 years. ECG showed anterior myocardial infarction (MI) in 18 (40%), inferior MI in 15(33.3%), Subendocardial inf in 10(22.5%) and combined anterior and inferior MI in 2 (4.5%) cases. Various risk factors were: Smoking (60%), hyperlipidemia (44.4%), stress (40%), hypertension (28.9%), family history (28.9%), diabetes mellitus (15.7%) and obesity (8.8%). Attention was given on atherogenic index (AI) (22.2%). Coronary angiogram was done in 20, which revealed significant coronary arterial obstruction in 15 cases; 3-vessel disease (n = 7), 2 vessel disease (n = 4) and single vessel disease (n = 4). Both 3 VD and 2 VD were associated with high AI. Risk factors (RF) were grouped as RFGI when combination of 3 or more RF were present, and RFG II when 2 or less RF were present. RFGI and RFGII were present in 40% and 60% cases respectively. Prognostically, patients were divided in two groups of MI-fatal (6) and nonfatal (39), the latter were subdivided into complicated (14) and uncomplicated (25). It was observed that more fatal cases were found in RFGI, whereas nonfatal uncomplicated MI was more in RFG II (P less than .001).

Adult↗
PubMedDate not supplied

Experience with balloon valvuloplasty in pulmonary stenosis.

Fourteen patients of pure valvular pulmonary stenosis of moderate to severe degree underwent balloon valvuloplasty in the Department of Cardiology, SSKM Hospital, Calcutta. Haemodynamic study revealed that immediately after valvuloplasty, right ventricular pressure dropped down from 125 +/- 17.18 mmHg. to 56.67 +/- 8.72 mmHg. (mean +/- SD). Restudy was done in each case after 4 weeks, which showed that right ventricular systolic pressure had further dropped down to 46.71 +/- 5.06 mmHg. (Mean +/- SD). Patients were further followed up for 6 to 15 months (mean 10 months). During the follow-up period, all the patients remained asymptomatic. Drop of right ventricular systolic pressure was maintained except in one case in which the peak systolic pressure gradient across the pulmonary valve was raised to 61 mmHg. from 24 mmHg., the gradient achieved immediately after valvuloplasty.

Adolescent↗
PubMedDate not supplied

The surgical treatment of atrial myxomas. Clinical experience and results in eight patients.

Between 1983 and 1988, eight patients underwent excision of left atrial myxomas at the Institute of Postgraduate Medical Education & Research, Calcutta. There were five females and three males. The presenting symptoms and signs often simulated mitral stenosis or insufficiency, and the diagnosis was confirmed by echocardiography and angiocardiography. One patient presented with features of cerebral embolism. The myxomas were successfully removed under cardiopulmonary bypass in all patients, either by shaving them from the atrial septum, or by excising a portion of normal atrial septum with the tumour. Small tumours were removed through left atriotomy, while a biatrial approach was utilised for large tumours. There was one perioperative death, and another patient died one and half years later, probably due to tumour embolisation in brain. Late functional results have been excellent in all the other patients. Two dimensional echocardiography has proved to be extremely accurate in early diagnosis of myxomas and in the late follow up of patients. The pertinent literature is reviewed.

Adult↗