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Biomedical subjects

S Bhaskaran

Publications and source records attributed to S Bhaskaran.

17 recordsLinked to original sources

Continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis (CAPD) was used as renal replacement therapy in 55 patients for 666 patient months. Thirty five patients had Type II diabetes. They ranged in age from 1-83 years. Majority of the patients were above 50 years of age who could not be transplanted due to various comorbid conditions. The incidence of peritonitis was 1 episode every 20 patient months. Twenty five patients dropped out during the observation period. The major cause of drop-out was death due to underlying coronary artery disease. Three patients underwent renal transplantation.

Adolescent

Effect of proteolytic and glycolytic enzymes on a factor in Sorghum bicolor that induces mycelial growth in the smut fungus, Sporisorium reilianum.

Proteins obtained from seedling shoots and floral meristems of Sorghum bicolor (L.) Moench cv. NK 1210 induced mycelial growth in the smut fungus, Sporisorium reilianum in vitro. Proteins precipitated with trichloroacetic acid and ammonium sulfate were equally effective as inducers, although there were minor variations in the pattern of mycelial growth. Hydrolysis of the protein fraction with the proteolytic enzyme pronase E resulted in considerable reduction in the proteins' ability to induce mycelial growth. Digestion of the protein fraction with driselase, resulted in a slight enhancement of biological activity. The results suggest that amino sugar moieties in glycoproteins may act as inducers of mycelial growth in Sporisorium reilianum.

Edible Grain

A study of hepatitis B surface antigen positive patients on haemodialysis and following transplantation.

Of 1339 patients who entered the dialysis and transplantation program, 104 (7.77%) patients were HBsAg positive. On dialysis, 15 of 104 patients (14.42%) developed icteric hepatitis (serum bilirubin > 2 mg/d1) and 7 patients (6.73%) developed anicteric hepatitis (SGOT > twice the upper limit of normal--normal 5-40 IU); one patient died of hepatic failure. Sixty five patients underwent live related transplantation. Actuarial graft survival at the end of 1 year, 2 years and 6 years were 81.67%, 73.98% and 69.36% respectively, and there was no significant difference compared to the negative group. 8 grafts (12.31%) were lost due to patient death due to infection in the HBsAg positive group compared to 27 out of 390 (6.923%) HBsAg negative patients (x2 = 1.88 P > 0.1). Post transplantation hepatic dysfunction was seen in 7 out of 65 (10.77%) patients and two patients died of hepatic failure.

Actuarial Analysis

Mortality and morbidity associated with ophthalmic surgery.

BACKGROUND AND OBJECTIVES: To study the mortality and morbidity among the patients undergoing ophthalmic surgery under local or general anesthesia. MATERIALS AND METHODS: A retrospective analysis of all patients who underwent ophthalmic surgery at Sankara Nethralaya, Madras, India, between 1979 and 1988, was performed. Relevant details included the preoperative medical status of the patients (ASA status), type of surgical procedure, type of anesthesia, and intraoperative and postoperative complications. RESULTS: The overall mortality rate was 1.15 per 1000. There was a decrease in the mortality rate from 2.09 per 1000 in the first 5-year period to 0.37 per 1000 in the second 5-year period. The factors significantly associated with mortality were hypertension, presence of cardiac pacemaker, renal disease, duration of surgery, type of surgery, and physical status (American Society of Anaesthesiologists classification). CONCLUSION: Identifying the risk factors can help reduce the mortality in ophthalmic surgery.

Adult

Blood urea levels 30 minutes before the end of dialysis are equivalent to equilibrated blood urea.

The steady decline in blood urea during high efficiency hemodialysis is followed by a rebound phase after dialysis in which the level of urea rises to an equilibrium value (Ct + 30) that may be up to 20% higher than the immediate post dialysis (Ct) concentration. The artificially low urea concentration immediately after dialysis leads to an overestimate of the efficiency of the dialysis calculated by Kt/V if the true equilibrium blood concentration of urea is not used in the calculation by the single-pool urea kinetic model. The measurement of equilibrium urea concentration requires a blood sample approximately 30 min after hemodialysis, which is an encumbrance on dialysis patients. This study was undertaken to determine whether an intradialytic sample taken 30 min before the end of dialysis (Ct - 30) may be representative of the equilibrium sample, and to compare the Kt/V using the Ct - 30 and Ct + 30 samples. Thirty-six patients were studied and blood urea concentrations were measured half an hour before the end of dialysis (Ct - 30), at the end of dialysis (Ct), and half an hour after the end of dialysis (Ct + 30). Kt/V (Daugirdas method) was calculated using urea concentration 30 min before the end of dialysis (Kt/Vt - 30) and was compared with Kt/V calculated using equilibrium urea concentration (Kt/Vt + 30). There were no significant differences between the Kt/Vt - 30 and the KtVt + 30 (1.25 versus 1.22, p = 0.65). The correlation between Kt/Vt - 30 and Kt/Vt + 30 was excellent with r2 = 0.93, regression y = 1.05 x -0.033. Kt/Vt - 30 also compared favorably with the Kt/V double pool method (Kt/Vdp) described by Daugirdas (1.25 versus 1.19, p = 0.23). Using the Ct - 30 to calculate Kt/V by the percent urea reduction methods of jindal (Kt/Vpru) decreases the Kt/V value by 0.14 on average, but it remains significantly higher than the Daugirdas method. The authors conclude that calculations using urea concentration 30 min before the end of dialysis improves the accuracy of dose estimation in high efficiency dialysis, without inconveniencing the patient.

Female

Decrease in Staphylococcus aureus exit-site infections and peritonitis in CAPD patients by local application of mupirocin ointment at the catheter exit site.

OBJECTIVE: To evaluate the potential effectiveness of the application of mupirocin ointment at the catheter exit site in preventing exit-site infection and peritonitis caused by Staphylococcus aureus (SA). DESIGN: This prospective, historically controlled study was done on 181 peritoneal dialysis patients treated between 1 November 1996 and 1 November 1997. They were instructed to apply mupirocin at the catheter exit site daily or three times per week at the conclusion of their exit-site care (Study 1). The patients were not screened to determine whether they were SA carriers. The group's historical control was the infection data from the previous year among these patients. A second group of 70 patients, who started using mupirocin within a month after catheter implantation (1996-1997), was compared with a historical group of 118 patients (controls) who were on continuous ambulatory peritoneal dialysis (CAPD) for 1 year after in-patient implantation without mupirocin, (1990-1995) (Study 2). RESULTS: In the group of 181 patients (Study 1), application of mupirocin at the exit site led to a significant reduction in SA exit-site infections--21 versus 3 episodes (0.11 vs 0.01 episodes/patient/year)--and a significant reduction of SA peritonitis--35 episodes in the year preceding mupirocin versus 11 episodes during the year of mupirocin treatment (0.19 vs 0.06 ep/pt/yr). The same results were observed in Study 2: the incidence of SA exit-site infection was significantly lower in the mupirocin-treated group--17 episodes among the 118 nontreated patients versus 4 episodes among 70 patients using mupirocin (0.14 ep/pt/yr vs 0.06 ep/pt/yr, respectively). Similarly there were 20 episodes of SA peritonitis among 118 patients during their first year of CAPD versus 4 episodes in 70 mupirocin-treated patients (0.16 ep/pt/yr vs 0.06 ep/pt/yr, respectively). No adverse effects were observed among the patients treated with mupirocin. Overall peritonitis rates decreased from 0.87 to 0.48 ep/pt/yr (p < 0.01) in Study 1 and from 0.56 to 0.41 ep/pt/yr (p = NS) in Study 2. We observed no differences in the incidence of exit-site infection and peritonitis rates among patients applying mupirocin ointment at the exit site daily, compared to three times per week. CONCLUSIONS: Mupirocin application at the exit site significantly lowers the incidence of SA exit-site infections and peritonitis due to SA infections. Since SA infections are accompanied by significant morbidity and occasional mortality, this treatment may improve long-term survival of patients on CAPD.

Administration, Topical