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Biomedical subjects

A Koshal

Publications and source records attributed to A Koshal.

43 records · Page 3Linked to original sources
PubMed1975

Ileocaecal tuberculosis.

A retrospective study of 92 cases of ileocaecal tuberculosis, carried out at the Institute Hospital, New Delhi, is reported. The maximum incidence of the disease appeared to be between the ages of 20 and 40 years. There were 57 females and 35 males in the series. The majority of patients had symptoms for more than a year before they presented for treatment. Varying grades of intestianl obstruction constituted the usual clinical presentation, 44% of patients having subacute and 16% acute intestinal obstruction. Perianal fistula and abscesses were not seen. Most patients had no evidence of pulmonary tuberculosis. Barium X-ray studies were very helpful in the diagnosis. Bowel resection or short-circuiting gave very satisfactory results.

Adolescent↗
PubMedDate not supplied

Bilateral infective endocarditis.

Two patients presenting with simultaneous right- and left-sided infective endocarditis requiring surgical intervention are reported. One patient developed aortic and pulmonic valve endocarditis following dental extraction, while the second patient developed mitral and tricuspid valve endocarditis secondary to a large body burn. The bilateral semilunar valve endocarditis was treated by porcine aortic valve replacement and debridement of the pulmonic valve. The bilateral atrioventricular valve endocarditis was treated by mitral and tricuspid valve replacement with porcine valves. The frequency and clinical settings in which this condition is likely to present are discussed.

Adolescent↗
PubMedDate not supplied

The management of non-traumatic cardiac arrest in the operating room with cardiopulmonary bypass.

We present a case of a 29-year-old woman whom, while undergoing an elective gynecological procedure, acutely arrested. Closed chest cardiopulmonary compressions were not effective. Fortuitously, the cardiac surgical team was in an adjacent operating room, about to start an elective bypass case. After sternotomy, the patient was placed on cardiopulmonary bypass within 20 min of the arrest. The patient achieved return of spontaneous circulation and was ultimately discharged with only mild extremity weakness. The etiology of the arrest was never fully explained. Open chest massage and cardiopulmonary bypass should be considered early in the management of unexpected cardiac arrest, especially in the operating room where surgical expertise should be immediately available. Surgeons and anesthesiologists need to be aware of, and consider, the possibility of employing these techniques.

Adult↗
PubMedDate not supplied

Survival after spontaneous primary left main coronary artery dissection. Acute surgical intervention with the Jarvik 7-70 artificial heart.

Spontaneous primary dissection of a coronary artery is extremely rare, and when it involves the left main trunk the outcome is catastrophic. A 41-year-old woman who survived such a dissection and resultant myocardial infarct with cardiogenic shock is reported here. The patient required a Jarvik 7-70 artificial heart to sustain life until an orthotopic cardiac transplant was performed, and she is now alive and well.

Adult↗
PubMedDate not supplied

Fatal gastrointestinal hemorrhage caused by cytomegalovirus duodenitis and ulceration after heart transplantation.

The case of a 61-year-old man, in whom heart transplantation was complicated by fatal gastrointestinal hemorrhage from duodenal ulcers 50 days after surgery, is described. Autopsy examination revealed extensive mucosal ulceration and hemorrhage into the bowel and peritoneal hemorrhage. Microscopy showed classical cytomegalovirus inclusions in clusters of cells in necrotic foci in the duodenum, lungs, and colon. This unusual case is the first reported example of cytomegalovirus-associated fatal gastrointestinal hemorrhage after heart transplantation. It is discussed in the context of the known features of the morbidity and mortality associated with cytomegalovirus infection in transplant patients.

Cytomegalovirus↗