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Biomedical subjects

R Vohra

Publications and source records attributed to R Vohra.

54 records · Page 3Linked to original sources
PubMed1988

Ruptured aortic aneurysms: postoperative complications and their management.

Postoperative complications in 92 patients undergoing repair of ruptured abdominal aortic aneurysms are reviewed. Renal failure and cardiac complications were fatal in 74% and 85% of the patients, respectively. Preoperative renal function at the time of presentation had no correlation with the development of renal failure. All but one patient in whom the left renal vein was divided developed renal failure postoperatively. There also was a preponderance of this complication in the patients needing suprarenal aortic control. Respiratory complications were seen in 29% of patients with 22% mortality. Peripheral emboli and ischemic colitis developed in 8% and 9% of the patients, respectively.

Aged↗
PubMed1988

Evaluation of factors influencing survival in ruptured aortic aneurysms.

During the six year period ending in December 1986, 103 patients with ruptured abdominal aneurysms presented to the unit. Ninety-two patients underwent surgery with a mortality of 39%. There was an increase in mortality with preoperative risk factors, extent of surgery, prolonged stay in ICU, complications and amount of blood transfused. However, only the latter was statistically significant. Age, the distance traveled by the patient before arrival at the hospital, systolic blood pressure on presentation and duration of operation did not affect the mortality.

Aorta, Abdominal↗
PubMed1988

Long-term results of mitral valve reconstruction with Carpentier techniques in 148 patients with mitral insufficiency.

There have been few relatively complete follow-up studies of long-term mitral valve function after Carpentier-type surgical reconstruction. Between January 1980 and May 1986, 148 patients underwent Carpentier reconstruction for mitral valve disease (43% degenerative and 30% rheumatic). Operative mortality was 5.4% overall (1.2% for isolated mitral reconstruction), and follow-up (mean, 26 months) was completed for all survivors. Five-year survival from late cardiac death was 90.0%, as was 5-year freedom from postreconstruction mitral valve replacement. Postreconstruction mitral replacement was needed in eight patients, in only five for failure of repair. Follow-up echocardiographic studies on 83.2% (104 of 125) of eligible patients showed 92.3% were free of significant (3+ or 4+) mitral regurgitation. Freedom from mitral valve replacement or recurrent severe (4+) insufficiency was 84.4% at 5 years overall, but was lower for the rheumatic type of mitral disease than for the degenerative type (71.6% vs. 88.3%). At 5 years, 95.2% of patients were free from thromboembolism without the necessity for long-term warfarin (Coumadin) therapy. At follow-up, 95.3% of survivors had improved to New York Heart Association Class I or II. The functional durability of mitral reconstruction and consistently high level of freedom from late endocarditis and thromboembolic and anticoagulant complications support the value of the Carpentier method of mitral reconstruction for mitral insufficiency, especially insufficiency due to degenerative disease.

Adolescent↗
PubMed1987

Sealed versus unsealed knitted Dacron prostheses: a comparison of the acute phase protein response.

Twenty patients were randomized to receive either an untreated Dacron aortic bifurcation graft (n = 10), or a similar graft impregnated with gelatin (n = 10). Venous blood samples were taken preoperatively and at frequent intervals until five weeks after surgery. C-reactive protein (normal range less than 10 mg/l) and alpha l-acid glycoprotein (normal range 0.3-1.0 g/l) were measured. The peak mean value of C-reactive protein for the sealed group was 226.3 +/- 49.2 mg/l and 221.3 +/- 56.4 mg/l for the unsealed group. The corresponding values for alpha 1-acid glycoprotein were 1.49 +/- 0.25 g/l and 1.44 +/- 0.3 g/l. The C-reactive protein response returned more quickly to normal, with only two patients in each group having a slightly elevated response after four weeks, while the value for alpha l-acid glycoprotein remained elevated at five weeks for the same two patients in each group. There was no significant difference between the serum acute phase protein response in either group. This suggests that a knitted Dacron graft sealed with gelatin does not exaggerate the inflammatory response.

Acute-Phase Proteins↗
PubMed1984

Pancreatic abscess: a review of seventeen cases.

Seventeen patients out of a total of 190 cases of acute pancreatitis, over a period of 12 years, developed the rare but serious complication of pancreatic abscess. Presence of toxaemia, fever, tachycardia and a tender epigastric mass suggested the possibility of abscess formation. Significant hyperamylasaemia was present in 2 patients only. Barium enema examination showed colonic changes due to direct involvement in 3 patients. Pre-operative management included complete rest to the gastrointestinal tract, correction of fluid and electrolyte imbalance, monitoring of vital signs and other parameters and antibiotic cover with penicillin in combination with broad spectrum antibiotic. In recent years Metronidazole was added in 7 patients, and this resulted in significant improvement of results. Surgical drainage was performed in all cases. The postoperative course was stormy and a significant number of patients developed both local as well as systemic complications with multiorgan failure. Residual/recurrent abscess was seen in one case only. Ten patients died in the immediate postoperative period. The survival rate was 41 per cent.

Abscess↗
PubMedDate not supplied

Modification of aflatoxin B1-induced changes in certain mitochondrial enzymes and lipids by medroxyprogesterone acetate.

The effect of a single dose of 5 mg/kg body weight of aflatoxin B1 on rat liver mitochondrial enzymes, succinate dehydrogenase (SDH) and Mg++ adenosine triphosphatase (Mg++-ATPase) and on certain lipids were studies at various intervals of time from 3 to 24 hours. A significant decrease in the specific activity of SDH was observed after 6, 12, 18 and 24 hr treatment. The Mg++-ATPase activity remained unaffected up to 12 hr but appreciably decreased after, 18 and 24 hr of the treatment. The level of phospholipids and cholesterol were not altered after 3, 6 and 12 hr treatment, thereafter (18 and 24 hr) an increase was observed in both the lipids following the aflatoxin treatment. Medroxyprogesterone acetate (MPA) did not cause any alteration in the specific activities of these enzymes as well as levels of cholesterol and phospholipids. The treatment with MPA caused significant increase in contents of cytochromes P-450, b5 and activities of Arylhydrocarbon hydroxylase (AHH), UDP-glucuronyl transferase (UDP-GT) and NADPH-cytochrome C-reductase of hepatic microsomes. It was observed that pretreatment with medroxyprogesterone acetate (MPA) could significantly minimuze the depression caused in mitochondrial SDH and Mg++-ATPase activities by aflatoxin B1.

Aflatoxin B1↗
PubMedDate not supplied

Effect of medroxyprogesterone acetate on hepatic lipid profile of female rats under various states of nutrition.

The effect of medroxyprogesterone acetate (MPA) treatment on hepatic lipid profile was studied in female rats kept on protein-deficient diet, on normal restricted diet and on normal, ad libitum diet. A significant decline in total and free cholesterol levels was observed in rats kept on protein-deficient diet and on normal, restricted diet. However, protein-deficient animals exhibited a significant rise in the liver triglyceride level. In rats on normal, ad libitum diet only, MPA treatment resulted in elevated levels of triglycerides and increased esterification of cholesterol. This was mostly due to increased incorporation of acetate into esterified cholesterol and triglyceride as evident from studies using the labelled precursor. Total phospholipid content was found to be unaffected by MPA in all the groups suggesting that the drug and dietary protein level have no effect on hepatic phospholipid content.

Animals↗