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Biomedical subjects

R Chandran

Publications and source records attributed to R Chandran.

31 records · Page 2Linked to original sources
PubMed1992

Spontaneous resolution of pre-eclampsia-related thrombocytopenia.

OBJECTIVE: To observe the spontaneous resolution of pre-eclampsia-related thrombocytopenia. DESIGN: A retrospective study. SETTING: High Risk Pregnancy Unit, John Radcliffe Maternity Hospital, Oxford. SUBJECTS: Thirty women with pre-eclampsia complicated by the HELLP/ELLP syndrome who did not receive any specific treatment for their thrombocytopenia. INTERVENTION: Serial platelet counts throughout labour and the puerperium until the platelet counts returned to levels above 100 x 10(9)/l. MAIN OUTCOME MEASURES: Time taken from delivery and platelet nadir for platelet counts to return to levels above 100 x 10(9)/l. The rate of recovery from the platelet nadir was measured by the slope of the serial platelet counts plotted against time. RESULTS: The mean time until platelet count exceeded 100 x 10(9)/l was 67 h (SD 25) after delivery and 44 h (SD 17) from the platelet nadir. All women had counts above 100 x 10(9)/l by 111 h after delivery, and by 88 h after the platelet nadir. Although the time to recovery appeared to depend on the degree of thrombocytopenia, the rate of resolution did not. CONCLUSION: These data can be used as a guide by clinicians as to the expected time course for postpartum resolution of pre-eclampsia-related thrombocytopenia.

Adolescent↗
PubMed1992

Internationalization of multi hospital systems.

Much like the manufacturing multinationals of yore, professional service establishments are now going abroad in large numbers. Two factors drive their expansion overseas--the increasing restrictions on their operations domestically, and the inviting opportunities in some of the global markets. A survey of multi hospital corporations both with and without experience in foreign markets was conducted regarding the expansion of their operations overseas. Examined were factors central to the decision-making process including: the various types of foreign health care systems; the entry strategies in penetrating foreign markets (fully owned, joint ventures, etc.); favorable factors and barriers considered in choosing foreign markets; the ability to transfer standardized systems from operations in the U.S.; and the profits from such operations. Respondents provided information regarding the above factors that are critical in determining an overseas expansion strategy.

Decision Making, Organizational↗
PubMed1992

Routine coagulation tests in cases of missed abortion--is it really necessary?

Many gynaecological units have a policy of performing routine coagulation tests in cases of missed abortion. For many years now, it has been accepted practice in our unit to perform routinely a platelet count, bleeding time (BT), clotting time (CT) and plasma fibrinogen (P. fib) level prior to evacuation in cases of missed abortion. We are not sure how or why these 4 tests came to be chosen as a coagulation 'screen'. As they are not totally adequate in detecting disseminated intravascular coagulation (DIC), we wondered if these tests added to the management in any way.

Abortion, Missed↗
PubMed1991

Effect of a fetal surveillance unit on admission of antenatal patients to hospital.

OBJECTIVE: To analyse the effect of a fetal surveillance unit, which undertakes a wide range of maternal and fetal tests on an outpatient or inpatient basis, on the number and length of antenatal hospital admissions. DESIGN: A comparison of the number and length of antenatal admissions six months before and five months after the opening of the unit on 1 July 1990. MAIN OUTCOME MEASURES: Admission rate, antenatal bed occupancy, and interval from admission to discharge or delivery. RESULTS: The antenatal bed occupancy rate fell by 22% from 174/100 deliveries during the six months before the unit was opened to 136/100 deliveries in the five months after it was opened. The difference in distribution of lengths of admission after the unit was opened from before was highly significant (Mann-Whitney test = 5.14, n = 752 and 679; p less than 0.0001), and this was due to shorter intervals from admission to discharge and from admission to delivery. In contrast, the antenatal admission rate did not change significantly (50/100 deliveries v 49/100 deliveries). There was no significant change in the stillbirth rate (6/1294 births v 8/1372 births; difference between rates = 0.0012, 95% confidence interval-0.0043 to 0.0067). CONCLUSION: Obstetricians are more prepared to discharge antenatal patients from hospital and, similarly, admit patients for delivery rather than for assessment if the patients are reliably monitored on an outpatient basis. If this change in practice is sustained substantial financial and social benefits will result as well as improvements in organisation, audit, teaching, and research.

Female↗
PubMed1991

Bilateral pure gonadoblastoma in a 46 XY individual--a case report.

We report here a rare case of bilateral pure gonadoblastoma which accounts for only 0.2% of all ovarian tumours seen at Universiti Kebangsaan Malaysia from 1980 to 1987. This tumour occurred in an 18 year old Chinese "female" who presented with primary amenorrhoea. Examination showed a phenotypic female with poorly developed external gentalia. Exploratory laparotomy revealed a hypoplastic uterus, rudimentary fallopian tubes and streak gonads. Histological examination of the gonads showed a mixed tumour comprising large germ cells and smaller sex cord derivatives arranged in characteristic nests or islands containing hyaline material.

Adolescent↗
PubMed1986

Biliary ascariasis: ultrasonography, endoscopic retrograde cholangiopancreatography, and biliary drainage.

Roundworms migrating into the biliary tract are a relatively common cause of biliary symptoms in areas where the parasite is endemic. Visualization of worms by conventional radiologic methods is often unsatisfactory, whereas ultrasonography offers a rapid, safe, and noninvasive approach to the diagnosis. Using real-time ultrasonographic scanning we demonstrated for the first time the characteristic morphology of the worms in a patient with biliary ascariasis. In addition, the motility of the worms in the biliary tract could be confirmed. Ultrasonography is also a convenient method for the follow-up of patients. Endoscopic biliary drainage and instillation of piperazine citrate through a nasobiliary drain is a logical therapy and was used successfully in this patient.

Adult↗