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Biomedical subjects

M Chandy

Publications and source records attributed to M Chandy.

90 records · Page 5Linked to original sources
PubMed1991

Hickman catheter implantation in the treatment of acute leukaemia.

Between June 1984 and May 1986, 13 Hickman catheters were introduced in 11 patients for the treatment of acute leukaemia. The catheters remained in situ for a mean period of 77 days (range 1-180). Two of the patients developed haematomas at the entry site and one patient had a blockage of the catheter due to a blood clot which required intervention. Six patients had documented bacteraemia which on blood culture showed enteric organisms and was not catheter related. No catheter had to be removed due to a catheter-related complication. Hickman right atrial catheter provides a safe and reliable venous access with minimum complications and is well tolerated by the patient.

Acute Disease↗
PubMed1989

Slow thaw siphon technique for cryoprecipitate production.

The efficacy of the slow thaw siphon technique for making cryoprecipitate was evaluated. A hundred consecutive bags of cryoprecipitate were subjected to analysis. The average Factor VIII:C level in donors plasma was 1.02 IU/ml with slightly lower levels of Factor VIII:C in O group persons and in the older age group. The average Factor VIII:C content per bag of cryoprecipitate was 132 units with the average Factor VIII:C yield of 57.8 per cent. Recovery of the cryoprecipitates made by this method was tested in vivo in ten haemophiliacs with less than 1 per cent activity. An average increment of 1.91 per cent in Factor VIII:C levels was obtained by infusion of 1 IU/kg body weight.

Adolescent↗
PubMed1989

Cellularity of bone marrow--a comparison of trephine biopsies and aspirate smears.

The estimation of cellularity of bone marrow was done on 212 trephine biopsies and their corresponding aspirate smears by a single observer using the visual scanning method. On applying the statistical test of agreement, it was found that the trephine biopsies and the aspirate smears were equally reliable in assessing marrow cellularity.

Biopsy, Needle↗
PubMed1987

Development of a coagglutination (COA) technic to detect Candida antigenemia. I. COA versus Candida isolation.

A coagglutination (COA) test to detect Candida antigenemia was developed using locally produced Candida antiserum and COA reagent. All 68 controls had normal results. Two patient groups were included in this study. In Group 1, consisting of eight patients, with definite systemic or deep candidiasis proved by repeat Candida isolation, COA detected antigenemia in 100% as against 50% by counterimmunoelectrophoresis (CIE). In Group 2, 9 of 19 patients had respiratory infection; 4 patients revealed antigenemia by COA, 2 of whom had no Candida isolation. In these 2 patients therapy was initiated based on COA results. Of another nine patients with hematologic and malignant diseases, five (56%) revealed antigenemia by COA, three of whom had no Candida isolation; two died and one was discharged against advice. Transient antigenemia was detected by COA in a single patient with ulcerative colitis with Candida isolation. Thus, the COA test was found to be rapid, sensitive, and specific for the detection of Candida antigenemia. Furthermore, it had early diagnostic (seven days) as well as prognostic value, as revealed by response to therapy and decrease in COA titer. Being highly cost effective, this test is recommended as a simple test within the reach of any routine diagnostic laboratory.

Adult↗
PubMed1983

Filarial chyluria with opportunistic infections.

A patient with long-standing filarial chyluria developed severe lymphocytopenia, extensive mucosal candidiasis and disseminated cryptococcosis when given small doses of prednisolone and azathioprine, for the treatment of a co-existing chronic active hepatitis. This report suggests that patients with chyluria are particularly susceptible to the complications of immunosuppressive therapy. This susceptibility is probably due to the immunological abnormalities associated with chyluria.

Azathioprine↗
PubMedDate not supplied

Hereditary factor XIII deficiency.

Twelve cases of hereditary factor XIII (FX III) deficiency diagnosed over five years (1986-1990) at Christian Medical College and Hospital, Vellore are presented here. Although all the cases had a history of umbilical cord bleeding and subsequent frequent bleeding episodes, diagnosis was considerably delayed. All but two patients required transfusions for bleeding episodes. Ten patients had a history of consanguinity in parents. Clinical features and family history are described in detail here. The ease of performing the Urea solubility test and problems in it's interpretation are highlighted. The role of prophylactic transfusion is also discussed.

Adolescent↗
PubMedDate not supplied

Infections in haematological malignancies: an autopsy study of 72 cases.

Autopsy material from 72 patients with haematological malignancies treated in India was reviewed. Thirty-seven patients (51%) had documented infections; 20 (27%) had bacterial infections, 14 of which were Gram-negative organisms (Pseudomonas species in 10); tuberculosis was present in 2 patients (2.7%). Twenty-one patients (29%) had systemic fungal infections; invasive pulmonary aspergillosis and gastrointestinal candidiasis were present in 10 patients each. Only 3 patients (4%) had viral infection, all of which were due to cytomegalovirus. Eleven patients (15%) had polymicrobial infections. No patient had any parasitic infection. Systemic fungal infections due to Aspergillus and Candida predominated, while Gram-negative bacterial infections were also common.

Adolescent↗
PubMedDate not supplied

Pediatric hyperfibrotic myelodysplasia: an unusual clinicopathologic entity.

This study is presented to highlight a rare pediatric bone marrow pathology in which features of bone marrow dysplasia coexist with severe fibrosis in a clinical setting of fever, anemia, and organomegaly. Fourteen children (nine males, five females) clinically presented with fever, anemia, and hepatosplenomegaly. Extensive bone marrow fibrosis with dysplastic features was seen in their marrow precursor cells. Peripheral blood smears showed teardrop poikilocytes thrombocytopenia, and occasional blasts. In conclusion, pediatric hyperfibrotic myelodysplasia is a distinct clinicopathologic entity. Myeloproliferative and dysmyelopoietic syndromes are complex disorders that are interrelated and not always easily diagnosed only on morphologic grounds.

Adolescent↗
PubMedDate not supplied

Haemostasis with cryoprecipitate in patients undergoing surgery for severe von Willebrand disease.

BACKGROUND: There are limited data on the management of haemostasis in patients with severe von Willebrand disease undergoing major surgery. Data on the use of cryoprecipitate in this setting are even more limited. In many developing countries cryoprecipitate is often the only available source of factor replacement. The minimum factor levels required for maintaining haemostasis after surgery have never been carefully evaluated. METHODS: Data from 3 patients with severe von Willebrand disease who underwent 4 major surgical procedures at our institution, using lower than standard recommended doses of cryoprecipitate were analysed for adequacy of factor replacement and complications. RESULTS: The average preoperative cryoprecipitate infusion was 22.5 i.u. of factor VIII/kg (range: 15-25). The bleeding time done by the modified Ivy method, 30 minutes after infusion, was normal in all these patients. The average cryoprecipitate support for days 1-3 was 16.5 i.u. of factor VIII/kg/day (range: 12.5-25) and for days 4-10 was 12.4 i.u. of factor VIII/kg/day (range: 8.3-16). The mean duration of factor replacement was 12 days (range: 7-17). Two patients had delayed bleeding, one on day 3 attributed to the inadvertent use of a non-steroidal anti-inflammatory drug and the second on day 10 which was probably secondary to septicaemia. Bleeding resolved in both these patients as soon as the precipitating factors were relieved. CONCLUSION: The total amount of factor replaced in our patients is approximately half of what would have been used if the usual recommendations were followed. The data suggests that lower doses of cryoprecipitate could be adequate for major surgery and wound healing in severe von Willebrand disease. This will lead to lowering of costs and reducing the risk of transfusion-associated virus infection.

Adult↗
PubMedDate not supplied

Arsenic trioxide in the management of acute promyelocytic leukaemia.

Arsenical compounds were used as early as 2000 BC, both as medicines as well as poisons. Arsenicals gained importance in the beginning of the last century as the primary mode of treating syphilis. In 1931, Folkner and Scott used an arsenical preparation called Fowler's solution in the treatment of chronic myeloid leukaemia. This continued to be used until the introduction of busulphan in 1953. In the 1970s, arsenic trioxide was introduced for the treatment of acute promyelocytic leukaemia in China and was found to be extremely effective in treating this condition. Since then, numerous in vitro and in vivo studies have confirmed this observation. This article reviews the pathogenesis of acute promyelocytic leukaemia, the possible mechanism of action of arsenic trioxide in this condition and the literature on its use in the treatment, with special reference to the clinical and molecular response rates, toxicity and pharmacology of this compound. It also attempts to address the role of arsenic trioxide in the present algorithm for the treatment of acute promyelocytic leukaemia.

Adolescent↗
PubMedDate not supplied

Surgery in patients with congenital coagulation disorders.

BACKGROUND: Surgery is occasionally necessary in patients with congenital coagulation disorders. Major surgery for patients with haemophilia was not being done in India until recently. This paper reports the experience of a single referral centre. METHODS: The data of 52 patients who were operated upon were collected from the hospital records retrospectively between 1984 and 1986 and prospectively thereafter. They included the surgical procedure performed, replacement therapy used and complications encountered. RESULTS: Fifty-nine procedures were performed of which 26 were major, 30 minor and 3 were diagnostic angiograms. Blood components produced in the hospital blood bank were commonly used for replacement and primary haemostasis was achieved in all patients. Delayed bleeding due to inadequate factor levels occurred in 12 procedures and was controlled by increasing the factor replacement. One patient died of suspected acute myocardial ischaemia. CONCLUSION: In India surgical procedures can be safely performed in patients with congenital coagulation disorders.

Adolescent↗
PubMedDate not supplied

Iron stores in patients on haemodialysis after renal transplantation.

BACKGROUND: Patients with chronic renal failure receive iron orally and parenterally which can lead to iron overload. However, iron deficiency is common among Indians and it is not known whether the Indian dialysis and transplant patient runs a similar risk of iron overload. The iron status is best quantified by measuring serum ferritin levels when there is no intercurrent inflammatory process. We used this method to assess the iron stores in a random sample of the Indian population on our dialysis and transplantation programme. METHODS: Serum ferritin assay was done using ELISA on samples obtained from 24 patients at entry to dialysis, before renal transplant surgery and 3 to 6 months following the surgery. All patients received 120 mg of elemental iron orally and third party transfusions according to a fixed protocol. RESULTS: None of the patients had iron deficiency despite low haemoglobin values. Fifteen patients at entry, 12 out of 16 pre-transplant and 10 out of 17 post-transplant patients had evidence of iron overload. Three patients developed iron overload during the period of observation and 6 of the 10 who entered the programme with evidence of iron overload continued to have iron overload. CONCLUSION: Indian patients with chronic renal failure have evidence of iron overload similar to those in developed countries. Oral iron supplements in Indian patients are therefore unnecessary.

Adolescent↗