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Biomedical subjects

N C Saxena

Publications and source records attributed to N C Saxena.

At least 37 records · Page 2Linked to original sources

Estimation of parity progression ratios from the truncated distribution of closed and open birth intervals.

A procedure to estimate parity progression ratios in a population from the truncated distribution of open and closed birth intervals is presented. The approach is quite simple in computation and data needs. It does not require any separate data on age at last birth to the women of completed fertility as in earlier methods. The procedure is illustrated with an observed set of data.

Biometry↗

Phase II randomized comparative clinical trial of Norplant (six capsules) with Norplant-2 (two covered rods) subdermal implants for long-term contraception: report of a 24-month study. National Programme of Research in Human Reproduction.

In a randomized clinical study, contraceptive efficacy and bleeding patterns were studied in a group of healthy, regularly menstruating, non-lactating women (n = 84) using two 4.4 cm covered silastic rods containing levonorgestrel, Norplant(R)-2, and compared with another group of women (n = 88) using six 3.4 cm capsules also containing levonorgestrel, Norplant(R). The silastic rods or capsules were placed subdermally in the medial aspect of the upper arm. No method failure was reported up to 24 months of use in this study with either of the device. The bleeding pattern was also similar for both devices as indicated by average episode length, number of bleeding runs and number of spotting days. The continuation rates with both devices were over 80 per 100 users at the end of 12 months and over 65 per 100 users at the end of 24 months. Discontinuations due to expulsion of the device, bleeding problems or personal reasons were few and similar for both devices. The results suggest that silastic-covered rods, Norplant(R)-2, which are comparatively easier to insert and remove and have similar clinical effect, could replace capsules, Norplant(R), as a long-term reversible subdermal contraceptive.

Adolescent↗

Indian Council of Medical Research. Task Force on Hormonal Contraception: Phase II randomized clinical trial with norethisterone oenanthate 50 mg alone and in combination with 5 mg or 2.5 mg of either estradiol valerate or cypionate as a monthly injectable contraceptive.

A Phase II multicentric study was carried out to compare the different contraceptive treatment schedules of the monthly injectable consisting of norethisterone oenanthate (NET OEN) 50 mg either given alone or in combination with estrogen esters, 2.5 or 5 mg of estradiol valerate (E2 Val.) or estradiol cypionate (E2 Cyp.). A total of 364 women were observed for 1686 months of use. Analysis of the bleeding pattern data indicated that NET OEN 50 mg when given alone gave rise to delayed cycles and/or amenorrhoea. However, the addition of estrogen esters in a dose of either 2.5 or 5 mg provided significantly better bleeding patterns. Of the different treatment schedules investigated, the combination of NET OEN 50 mg with E2 Val. 5 mg provided more consistent and better cycle control. These findings however need further validation on a larger study sample.

Adult↗

Relationship between platelet count and cardiotomy suction return.

A simple, inexpensive, accurate method of measuring the amount of blood returned by the cardiotomy suction system was devised and calibrated. Preoperative and postoperative platelet counts were obtained in 76 patients with congenital heart disease in whom the amount of cardiotomy suction return was measured. The mean percentage of total perfusate returned by the cardiotomy suction system was 8.9%. Both postoperative platelet count and the percentage change between preoperative and postoperative platelet counts correlated with the amount of blood returned by the cardiotomy suction system, time on bypass, and the percentage of total perfusate aspirated by the system.

Adolescent↗

Transatrial resection of the obstructed right ventricular infundibulum.

Obstructions of the right ventricular infundibulum were resected through the orifice of the tricuspid valve in 21 patients, 15 of whom had tetralogy of Fallot. At operation the systolic pressure difference between the right ventricle and pulmonary artery after repair averaged 18 mm Hg (range 0-40 mm Hg). In patients with tetralogy, cardiac index four hours after operation averaged 2.8 L/M2/min. One patient with tetralogy and severe pulmonary hypertension died. Twelve patients with tetralogy were recatheterized 10 to 186 days after operation. The mean systolic pressure difference between right ventricle and pulmonary artery was 23 mm Hg. Residual obstructions were in the pulmonary valvular annulus. Cineangiograms did not show paradoxical motion of the right ventricular wall. Transatrial resection of right ventricular infundibular obstructions carries with it none of the consequences that often follow right ventriculotomy and this surgical approach satisfactorily relieves infundibular obstructions.

Adolescent↗

Transatrial repair of tetralogy of Fallot.

In 12 months since March, 1975, 25 of 27 patients with tetralogy of Fallot have had corrective operations without ventriculotomy. Infundibular obstructions were excised and ventricular septal defects were closed through a right artiotomy with retraction of the anterior leaflet of the tricuspid valve. Pulmonary valve stenosis was relieved through a pulmonary arteriotomy. In five patients the pulmonary annulus was patched 0.5 to 1.5 cm. into the right ventricle. Immediately after repair peak right ventricular-pulmonary arterial systolic pressure difference averaged 17 mm. Hg and ranged between zero and 40 mm. Hg. Cardiac indices averaged 2.85 L. per square meter per minute 4 hours after operation. All but two patients developed right bundle branch block. One patient with severe pulmonary hypertension died. Fourteen patients have been recatheterized. Right ventricular-pulmonary peak systolic pressure differences ranged between zero and 45 mm. Hg (mean, 22). Cineangiograms show contraction of the free right ventricular wall during systole. Transatrial repair of tetralogy of Fallot is feasible technically in many patients, avoids muscle necrosis and coronary arterial injury, and improves cardiac output in the immediate postoperative period.

Adolescent↗

First reported successful management of Serratia marcescens bacteremia after open heart surgery in a child.

A 7 and one-half yr-old girl developed bacteremia from S. marcescens following debanding of the pulmonary artery and closure of multiple ventricular septal defects with a Dacron patch and multiple Teflon pledgets. The site of entry was probably a radial arterial catheter left in place for 8 days. Infection was eradicated by a combination of gentamicin and carbenicillin over a 4-wk period. Of 12 cases of postoperative Serratia bacteremia in adults following valve replacement, only four survived. Antibiotics of proven effectiveness against the specific isolated Serratia strain, prompt therapy sustained for 6 wk offers the prospect for cure of this serious complication of cardiac surgery.

Anti-Bacterial Agents↗

Indian experience of home based mothers card: ICMR task force study.

To improve the quality of MCH services, a Home Based Mothers Card (HBMC) prepared and recommended by World Health Organization was adapted to Indian situation, and introduced in 1.5 lakh population of rural area covered by 6 participating centres under the aegis of Indian Council of Medical Research. Two thousand four hundred and forty six mothers were given this card and were followed up for a period of 2 years. Only 89.2 percent retrieval of the cards was possible after a period of 18 months. Screening of the population for "at risk" women monitoring and referral could be undertaken with the help of this card. Improved antenatal, and referral services were observed during the study period. The card (HBMC) was acceptable to the mothers as well as to the health workers, as a tool for improving the quality and coverage of MCH services being rendered at the Primary Health Centre.

Feasibility Studies↗

Ultrasound in abdominal tuberculosis.

BACKGROUND: The present study was done to emphasize the importance of ultrasound (US) and US-guided fine-needle aspiration biopsy (FNAB) in the diagnosis of abdominal tuberculosis. METHODS: Sixty-six proven cases of abdominal tuberculosis were selected for this study. The diagnosis was based on clinical features, US observations, FNAB, operative findings, and responses to appropriate antitubercular treatment. The US findings were interpreted with regard to the involvement of lymph nodes, intestine, peritoneum, solid viscera, and abdominal abscesses. Patients with disease limited to the musculoskeletal and genitourinary systems were not included in the study. RESULTS: Peritoneal tuberculosis was the most common form, of the "wet" ascitic type. Ascites was clear in 19 patients and complex in 17. Tuberculous lymphadenopathy was seen in 37 patients. There was a predilection of periportal, peripancreatic, and mesenteric locations compared with the degree of retroperitoneal involvement. Calcification and heterogeneous echotexture were seen in seven cases. FNAB confirmed the diagnosis of tubercular lymphadenopathy in 19 patients. Intestinal disease was seen in 14 patients. Hepatic or splenic involvement was seen as diffuse organomegaly; less commonly, focal lesions were seen. CONCLUSION: This combination of US findings in proper clinical settings are diagnostic of tuberculosis. FNAB confirms the diagnosis in lymphadenopathy, abscesses, and focal lesions of the viscera.

Adolescent↗

An unusual mediastinal mass due to metastasis.

During childhood the common anterior middle mediastinal masses are either lymph node enlargement or teratomas/dermoids. A case of ossific mediastinal metastasis and pleural metastases from osteosarcoma, presenting three years after the primary disease (late metastasis) is reported for its rarity.

Bone Neoplasms↗