Search PubMed⌕ Search

Biomedical subjects

S John

Publications and source records attributed to S John.

301 records · Page 17Linked to original sources

Total anomalous pulmonary venous return in children and adults. Results of corrective surgery.

The operative technique and the early and long term results are described in twenty consecutive patients who have undergone corrective surgery for total anomalous pulmonary venous return over a 12 year period from 1967 to 1979. There was a 15 per cent early mortality which occurred only in children below the age of four. There have been no late deaths. All survivors are leading normal gainful lives. Nine of seventeen have been recatheterised. The abnormality when encountered in children and adults carries a more favourable prognosis than when encountered during infancy.

Adolescent↗

Use of aspirin as the sole antiplatelet agent following prosthetic valve replacement in rheumatic heart disease.

Aspirin was administered as the sole antiplatelet agent in 147 patients following valve replacement, who were at low risk for thromboembolism. Of these, 67 underwent mitral valve replacement (MVR), 61 aortic valve replacement (AVR) and 19 combined aortic and mitral valve replacement (DVR). The mean follow up period was 6.63 years (range 1-14 years). The incidence of thromboembolic episodes (TEE) in patients following MVR, AVR, and DVR was 0.41, 0.80 and nil respectively. The TEE free survival at the first year follow-up was 98.4%, 99.3% and 100% in patients following MVR, AVR and DVR respectively. Fatal intracranial haemorrhage was not encountered. Valve thrombosis in this patient population was not seen. In conclusion, aspirin as the sole antiplatelet agent appears to be safe and effective following prosthetic valve replacement in selected patients. Further studies involving larger number of patients are necessary to confirm these results.

Adult↗

Cancer associated with leprosy.

Eighty-seven leprosy patients with cancer, seen between 1960 to 1984, were studied. Cancer in patients with leprosy occurred in a younger age group compared to the general population. The most common type of malignancy seen among males was squamous cell carcinoma of the lower extremity while in hospital patient population it was cancer of head and neck. Among the females, carcinoma cervix was the most common as in the hospital patients. The types of malignancy occurring among leprosy patients was similar to that of the hospital patient population with the exception of an increase in incidence of squamous cell carcinoma of extremities.

Adult↗

Aortic valve replacement with concomitant open mitral valvotomy--early results and long term followup in 72 consecutive patients.

Experience with 72 consecutive subjects, who underwent aortic valve replacement with open mitral valvotomy is presented. Mean age was 30 years and history of rheumatic fever was forthcoming in 80%. 91.7% patients had aortic regurgitation--with or without aortic stenosis. 45% patients had pulmonary hypertension. Starr Edwards (51.4% and Bjork Shiley valves (45.8%) were commonly used. There were no early deaths. All patients were followed up for 1 to 19 years (mean = 9 years). There were 4 (5.5%) late deaths. 4.1% patients developed mild restenosis of the mitral valve over a mean period of 8 years and 1.04% developed mitral regurgitation mandating mitral valve replacement. A notable feature of this series is the low incidence of thromboembolism-free lives at upto 10 years followup despite receiving only aspirin in place of coumarin anticoagulation. We believe aortic valve replacement and open mitral valvotomy is a worthy alternative to double valve replacement in view of its zero hospital mortality, low late mortality, low incidence of restenosis, low thromboembolic episodes and the avoidance of coumarin anticoagulation.

Adolescent↗