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Biomedical subjects

P Padmaja

Publications and source records attributed to P Padmaja.

26 records · Page 2Linked to original sources
PubMed1998

Central venous catheter related infections in a tertiary care hospital.

Intravascular catheters are increasingly important causes of nosocomial infections. Catheter related complications range from local exit site or tunnel infections to frank bacteremias. A semiquantitative method of culture of central venous catheters (CVC) was done in our hospital from January to December 1996. A total of 119 catheter tips sent to the Microbiology Department were cultured and 11 (9.24%) showed significant growth with associated blood stream infection. 14 (11.76%) of the CVCs showed scanty or less than 15 colonies in roll or contents and there was no associated blood stream infection. 7 (5.88%) showed moderate to heavy growth in roll and contents and there was no blood stream infection. The age groups ranged from 2 months to 66 years. The results of the study indicate that Gram negative organisms formed the predominant isolates. Gram negative isolates included Klebsiella species, Enterobacter species, E. coli species, Serratia and non-fermenting Gram negative bacilli. Coagulase negative staphylococcus which is often believed to be an important pathogen was not associated with bacteremia or septicemia in our hospital, during this study period. Considering the fact that 1553 operations were performed during the study period, the infection rate through CVC's would work out to a negligible 0.71%.

Adolescent↗
PubMedDate not supplied

Cryopreservation of cardiac homografts.

A homograft valve bank for cryopreservation of cardiac homografts was established at the Institute of Cardiovascular Diseases in July 1995. From July 1995 to February 1999, 169 donor hearts were processed. All except four hearts were procured post mortem. Aortic valves (149) and pulmonary valves (139) were the common homografts dissected out for use. The valves were immersed in a cocktail of five broad spectrum antibiotics and antifungals for an average of 48 to 72 hours before cryopreservation. Fifty-three (35.57%) aortic and 42 (30.21%) pulmonary valves had to be discarded for various reasons like fungal contamination, failure to sterilise, HBsAg positivity etc.; 153 homografts have been released for use so far. Analysing the usual methods of procurement, sterilisation protocol, culture and cryopreservation used for cardiac homografts at this centre, this paper recommends observance of timeliness, use of appropriate media for preservation of heart parts, administration of specific drugs and safeguards necessary for cryopreservation procedure.

Cryopreservation↗
PubMedDate not supplied

Homograft valve bank: our experience in valve banking.

BACKGROUND: A cardiac homograft valve bank with cryopreservation facility was established at the Institute of Cardiovascular Diseases, Madras Medical Mission, Chennai in July 1995. METHODS AND RESULTS: During the last 7 1/2 years of its existence, from July 1995 to March 2003, 588 hearts were processed. The valves harvested were 390 aortic, 400 pulmonary and 39 others including mitral valve, aortic conduits, pericardium etc.; 176 (29.9%) hearts were discarded for various reasons which included failure to sterilize, HBV, HIV, HCV, treponema pallidum hemagglutination test positivity, atheromatous/fatty streaks, incompetent valves, and dissection mistakes. The valves were sterilized using an antibiotic cocktail of vancomycin, amikacin, streptomycin, cefotaxime and amphotericin B in Hank's balanced salt solution. Of the 585 valves issued for clinical use, 247 were aortic, 323 pulmonary and 15 others (mitral valve, pericardium, conduits). Gram negative bacilli were the predominant contaminants from the hearts during the first half (July 1995 to February 1999) and gram positive organisms were the predominant contaminants during the later half (March 1999 to March 2003) of the study period. A variety of fungal contaminants like candida, aspergillus, penicillium and other fungi were also isolated from the homograft hearts at procurement. The valves were used most commonly for Rastelli procedure/right ventricular-pulmonary artery conduit (48.71%) followed by Ross procedure (23.41%). The other procedures were aortic valve replacement (6.15%), truncus repair (5.81%), unifocalization with conduit repair (6.49%), aortoplasty (0.512%), left ventricular-pulmonary artery conduit (0.512%), pulmonary valve replacement (0.512%), aneurysm repair (0.34%), Norwood repair (0.34%), mitral valve replacement (0.17%) and other procedures (7%). CONCLUSIONS: We have established a viable and functioning cardiac homograft valve bank to suit Indian conditions and till date, have issued 585 homograft valves for clinical use.

Cryopreservation↗
PubMedDate not supplied

Fungal endocarditis following cardiac surgery.

This study analysed cases of fungal endocarditis following cardiac surgery encountered in our institute between January 1994 and December 1997. A total of 887 prosthetic valve and 114 homograft valve replacements were performed during the study period. In this group, eight cases of fungal endocarditis (aged 14-53 years) were encountered during the follow-up of which five were caused by candida species and three by aspergillus species. Four cases involved aortic homografts, two mitral prosthesis, one an aortic prosthesis and one was a Goretex patch endocarditis. Seven patients had early endocarditis; all presented with fever and two had embolic manifestations. Seven patients each had positive blood cultures and echocardiographically demonstrable vegetations. Despite management with amphotericin B and early repeat surgical interventions, six had a fatal outcome. One patient is doing well at nine months follow-up after a second valve replacement and one is lost to follow-up.

Adolescent↗