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Biomedical subjects

R Varghese

Publications and source records attributed to R Varghese.

24 records · Page 2Linked to original sources
PubMed1980

Splenic abscess.

Fourteen cases of splenic abscess are reported and 159 cases previously cited in the literature are reviewed. The incidence, predisposing factors, pathogenesis, clinical features, bacteriology and radiologic findings are discussed. Infective endocarditis was the most common single antecedent infection. Hemoglobinopathies, non-penetrating abdominal trauma, and gastrointestinal malignancy appear to predispose the spleen to abscess formation. Emphasis is placed on clinical features and radiologic findings to aid practitioners in diagnosing this uncommon but often fatal infection. Also emphasized is the necessity for prompt surgical intervention when splenic abscess is suspected. An approach to the antimicrobial therapy in different clinical settings is outlined.

Abscess↗
PubMedDate not supplied

Right ventricular diastolic function after repair of tetralogy of Fallot.

The objective of this study was quantitate diastolic dysfunction in the postoperative phase of tetralogy of Fallot (TOF) and to correlate it with the type of surgical procedure and clinical parameters. Fifty consecutive patients (mean age, 5.0 years; mean weight, 13.5 kg), operated for TOF during the period November 2004 to May 2005, were prospectively studied [infundibular resection, 23; infundibular resection and transannular patch (TAP), 19; right ventricle --> pulmonary artery conduit, 8). Detailed echocardiography was done on postoperative days 3 and 9 with a focus on Doppler indices of right ventricular (RV) function, Antegrade late diastolic flow in the right ventricular outflow tract (RVOT) was taken as the marker of restrictive RV physiology. The previous parameters were correlated to the type of surgery and clinical indices of RV dysfunction. There was no mortality. Twenty-four patients showed restrictive RV physiology. This finding correlated with lower values of E/A ratio (0.98 +/- 0.17 vs 1.33 +/- 0.49, p < 0.002), tricuspid valve E-wave deceleration time (86.9 +/- 21.7 vs 151.4 +/- 152 msec, p < 0.05), index of myocardial performance (0.15 +/- 0.06 vs 0.26 +/- 0.09, p < 0.001), isovolumic relaxation time (19.4 +/- 17 vs 39+/-30 msec, p < 0.009), and a higher central venous pressure (15.1 +/- 1.5 vs 12.7 +/- 1.9, p < 0.001). Restrictive RV physiology correlated with prolonged intensive case unit (ICU) stay (5.1 +/- 3.7 vs 2.8 +/- 2 days, p < 0.015), longer duration of inotropic support (108.3 +/- 56.2 vs 55.5 +/- 28.3 hours, p < 0.02), and higher dosage of diuretics. RV diastolic dysfunction is demonstrable by Doppler echocardiography in the first week following surgery for TOF and tends to be worse with TAP. Restrictive physiology demonstrated by RVOT pulse Doppler predicts longer duration of inotropic support, prolonged ICU stay, and higher dosage of diuretics.

Adolescent↗
PubMedDate not supplied

Metronidazole treatment of Bacteroides fragilis infections.

Seven patients with Bacteroides fragilis infections were treated with intravenous and/or oral metronidazole. Infections treated included endocarditis, osteomyelitis, lung abscess, empyema, peritonitis, septicemia, and pelvic infection. Some patients had failed to respond to therapy with chloramphenicol or clindamycin or both. Metronidazole was used alone or in combination with aminoglycosides. Serum levels of metronidazole several times in excess of the minimal inhibitory concentrations for the organisms were easily achieved and in one patient the CSF metronidazole level was equal to that of the serum. Response to therapy with metronidazole was considered to be excellent. The only serious side effect noted was hypotension, which occurred in the last patient. Therapy was discontinued, and therefore therapeutic results could not be evaluated. Metronidazole appears to be a safe and effective agent in the treatment of B fragilis infections.

Adult↗
PubMedDate not supplied

Microfilariae in cytologic smears: a report of six cases.

BACKGROUND: Filariasis is a major public health problem in tropical countries, including India. Despite this high incidence, it is unusual to find microfilariae in fine needle aspiration cytology. (FNAC) smears and body fluids. Six cases of filariasis diagnosed by FNAC are reported. CASES: In case 1, a thyroid aspirate from a 23-year-old female showed a microfilaria with colloid and thyroid follicular cells. In case 2, pericardial fluid from a 50-year-old male with breathlessness and chest pain showed clusters of malignant cells and many microfilariae. In case 3, a bronchial aspirate from a 55-year-old male with fever and chest pain showed aggregates of acute inflammatory cells and a microfilaria. Cases 4 and 5 were lymph node aspirates from a 29-year-old male and 3-year-old female. Both smears showed microfilariae in a background of reactive lymphoid cells. In case 6, FNAC from a 21-year-old female with a cystic swelling in the breast showed clusters of microfilariae, lymphocytes and granular debris. CONCLUSION: In three of the six cases microfilariae were the cause of symptoms, whereas in the other three cases, microfilariae were associated with other diseases, including malignancy. Thus, careful screening of FNAC smears might be helpful in detecting microfilariae, even in asymptomatic patients.

Adult↗