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Biomedical subjects

S Shrivastava

Publications and source records attributed to S Shrivastava.

At least 109 records · Page 6Linked to original sources
PubMed1990

Initial experience with percutaneous transluminal angioplasty in the management of Takayasu's arteritis.

We have performed percutaneous transluminal angioplasty (PTA) for 15 arterial stenoses in 11 patients with Takayasu's arteritis. The lesions included tight, proximally located renal artery stenosis (12 stenoses; nine patients), localized abdominal aortic stenosis (two patients) and occluded left common iliac artery (one patient). Clinically successful dilatation was achieved in seven patients (10 stenoses) with renal artery stenosis, in both the patients with abdominal aortic stenosis and in the only patient with an occluded left common iliac artery. No complications related to the procedure were encountered. The follow-up period (n = 7) ranged between 1 and 16 months, mean follow-up period after renal angioplasty was 5 months and after abdominal aortic angioplasty was 12.5 months. Initial success has been maintained in both the patients with abdominal aortic stenoses and in four out of five patients with renal artery stenosis. Percutaneous transluminal angioplasty offers an attractive alternative for the management of stenosing lesions in Takayasu's arteritis with good short term results.

Adolescent↗
PubMed1989

Doppler echocardiographic assessment of transmitral gradients and mitral valve area before and after mitral valve balloon dilatation.

This is a comparative study of 60 sets of observations of mitral valve end-diastolic gradient, mean diastolic gradient, and mitral valve area obtained by Doppler echocardiography and cardiac catheterization. The studies were performed in 28 patients, 16 of whom underwent mitral valve balloon valvuloplasty. These 16 patients had studies performed before, immediately after valvuloplasty, and one week later. Thus 28 studies were performed before or without valvuloplasty (Group I) and 32 after valvuloplasty (Group II). The time interval between Doppler echocardiography and cardiac catheterization was less than 24 hours in 44 studies and 24 to 72 hours in 16 studies. In Doppler echocardiography the gradients were obtained by simplified Bernoulli's equation and the mitral valve area by pressure half-time method. There was excellent correlation between end-diastolic gradients (r = 0.96, p less than 0.001) and mean diastolic gradients (r = 0.92, p less than 0.001) measured by the two techniques. A statistically significant correlation also existed in the mitral valve area values (r = 0.53, p less than 0.005). On separate analysis Group I showed excellent correlation for all three variables (r values of 0.90, 0.87, and 0.82 for end-diastolic gradients, mean-diastolic gradients, and mitral valve area, respectively). Group II also showed excellent correlation of end-diastolic gradients (r = 0.80) and mean diastolic gradients (r = 0.87), but poor correlation of the mitral valve areas (r = 0.17; p = NS) by the two techniques. Doppler echocardiography can accurately measure transmitral gradients both before and after valvuloplasty.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

The heart in polymyositis-dermatomyositis.

Fourteen patients with polymyositis-dermatomyositis (PM-DM) underwent prospective cardiac assessment with non-invasive techniques. One patient had electrocardiographic evidence of Long-Ganong-Levine syndrome with multiple supraventricular premature beats. Echocardiographically one patient had late systolic prolapse of the posterior mitral leaflet and another had paradoxical movements of the interventricular septum. The study suggests that cardiac involvement is infrequent in PM-DM.

Adult↗
PubMed1989

Comparative Doppler evaluation of the monostrut and older convexo-concave Björk-Shiley mitral prosthetic valve.

Doppler echocardiography was performed in 104 patients with a Björk-Shiley prosthetic valve in the mitral position. Valves of size 25 mm and 27 mm were inserted in 39 and 65 patients, respectively. Each valve had two models; the older convexo-concave model (22 and 40, of 25 and 27 mm size, respectively). Inflow velocities were recorded using Doppler techniques and the gradients calculated using the Bernoulli principle. The area of the mitral valve was determined by the T1/2 method. Comparison of the two models for both sizes did not reveal any significant differences in either the gradients across the valves or the area of the valve. Trivial mitral regurgitation was detected in a higher percentage of monostrut valves (18% and 20% for the 25 and 27 mm older convexo-concave models and 59.9% and 52% for the 25 and 27 mm monostrut valve). We conclude that the newer monostrut model of the Björk-Shiley valve in the mitral position does not offer any additional haemodynamic benefit.

Adolescent↗
PubMed1989

Angiographic abnormalities of the morphologically left ventricle in the presence of Ebstein's malformation.

Cineangiography of the morphologically left ventricle was performed in 10 patients with Ebstein's malformation. The angiographic findings included left ventricular contour abnormalities (8), mitral valve prolapse (7) and global hypokinesia (5). Left ventricular abnormalities were present whether the left ventricle was normally placed or in mirror-image position in congenitally corrected transposition. Abnormalities of the morphologically left ventricle in Ebstein's malformation have received little attention in the past. Frequent occurrence of these abnormalities should make careful evaluation of the morphologically left ventricle mandatory in all patients with Ebstein's malformation.

Adolescent↗
PubMed1989

Diagnosis of pulmonary venous obstruction by Doppler echocardiography.

A 1 1/2-year-old female patient with atrial and ventricular septal defects and severe pulmonary arterial hypertension was found to have discrete stenosis of left upper and middle lobe pulmonary veins. The diagnosis was made by cross-sectional and Doppler echocardiography. The findings were confirmed at cardiac catheterization and operation. Pressure gradients across the pulmonary vein stenosis as obtained by Doppler echocardiography correlated well with those measured at cardiac catheterization.

Cardiac Catheterization↗
PubMed1989

Infective endocarditis following patch closure of ventricular septal defect: a cross-sectional Doppler echocardiographic study.

Cross-sectional and Doppler echocardiographic characteristics of infective endocarditis are described in six cases following patch closure of a ventricular septal defect. The patients presented to us with fever one to five months after surgery. Five of them also had congestive cardiac failure. Cross-sectional echocardiography showed large masses over the patch in all cases. Dehiscence of the lower end of the patch was identified in three of them, and, in two cases, the right sinus of Valsalva had ruptured into the right ventricle. Doppler detected turbulent flow in the right ventricle in five cases, and a continuous signal indicating an aorto-right ventricular communication in two cases. A signal indicative of aortic regurgitation was also found in the latter two cases. Staphylococcus aureus was cultured from the blood in three cases and Aspergillus was identified at autopsy in one. The echocardiographic findings were confirmed in three cases (one during surgery and two at autopsy). Dehiscence of the patch and large masses were associated with a poor prognosis.

Adolescent↗
PubMed1989

Pulmonary arterial anatomy in tetralogy of Fallot.

We have searched for any abnormalities of the pulmonary arteries visualized by angiography in 200 consecutive patients with tetralogy of Fallot. All the patients were studied by conventional right ventricular angiography in the right and left anterior oblique views. Thirty six patients (18%) showed a total of 61 pulmonary artery stenoses, 32 being severe (52%), 17 moderate (28%) and 12 mild (20%). Bifurcational stenoses were the most common (31), followed by stenosis of the main pulmonary trunk, the right or the left pulmonary arteries (22), combined central and peripheral stenosis (6), and isolated peripheral pulmonary artery stenosis (2). Nine patients showed segmental stenosis involving both the right and left pulmonary arteries and three of them had atresia of the left pulmonary artery. The detailed preoperative evaluation of obstruction within the pulmonary arterial pathways is essential in tetralogy of Fallot to ensure normalisation of the right ventricular pressure following total correction.

Adolescent↗
PubMed1989

Echocardiographic diagnosis of a left atrial thrombus in a patient with normal prosthetic mitral valve.

A 20-year-old male with a Björk-Shiley mitral valve prosthesis on optimal anticoagulation and antiplatelet drug therapy presented with systemic embolization 11 months after mitral valve replacement. Cross-sectional and Doppler echocardiography revealed a left atrial thrombus attached to the posterior wall of the left atrium and normal function of the prosthetic valve. The findings were confirmed at surgery.

Adult↗
PubMed1989

Fixed subaortic stenosis with congenital aneurysm of sinus of Valsalva--cross-sectional and Doppler echocardiographic diagnosis of a rare association.

A 13-year-old girl was diagnosed by cross-sectional and Doppler echocardiography to have the rare combination of congenital aneurysm of the right sinus of Valsalva rupturing into the right ventricular outflow tract and a discrete subaortic fibrous shelf with severe subvalvar stenosis, moderate aortic regurgitation and left ventricular dysfunction. The findings were confirmed at cardiac catheterisation and surgery.

Adolescent↗
PubMed1989

Echocardiographic assessment of infants born to diabetic mothers.

Echocardiography was carried out in 31 neonates (group 1) born to diabetic mothers and 37 control infants (group 2) matched for weight and gestational age. The interventricular septum was significantly thicker in group 1 babies (mean (SD) 4.77 (1.4) mm) compared with those in group 2 (2.5 (0.7) mm); in eight it was more than 5 mm, but had regressed in six over a period of three months. There was no significant difference between the two groups in the left ventricular internal dimension, right ventricular outflow tract, or size of the left atrium or the aorta. The left ventricular mass was significantly greater in infants born to diabetic mothers. The left ventricular contractility (judged by the percentage of shortening of the internal dimension and the ejection fraction) was significantly greater in group 1. No evidence of left ventricular outflow obstruction was found on pulse Doppler echocardiography in group 1.

Cardiomyopathy, Hypertrophic↗
PubMed1989

Detection of typhoid fever by Widal and indirect fluorescent antibody (IFA) tests. A comparative study.

Widal test is a conventional method for the detection of typhoid fever. However, it takes 18-24 hours to complete the test. In the present study indirect fluorescent antibody test has been compared with the Widal test using single serum specimens and was found to be rapid, sensitive and specific. Serum specimens from 41 culture proven cases of typhoid fever, 14 clinically suspected cases and 22 normal individuals were collected. Whereas Widal test detected 63.41% positive cases, IFA test detected 87.80% from among culturally proven typhoid cases. Among the clinically suspected cases of typhoid fever, IFA test detected 85.71% (28.57 + 57.14%) while Widal test detected only 57.13% (35.71 + 21.42%) positive cases out of above 14 cases.

Agglutination Tests↗
PubMed1989

Comparative efficacy of indirect haemagglutination test, indirect fluorescent antibody test and enzyme linked immunosorbent assay in serodiagnosis of typhoid fever.

In the present study three tests, viz. IHA, IFA and ELISA were compared for their sensitivity, specificity and predictive values in serodiagnosis of typhoid fever. One hundred and eleven sera samples comprising 41 culturally confirmed, 14 clinically suspected and 56 normal controls were tested. Among the three tests, ELISA was found to be the method of choice using single serum sample.

Antibodies, Bacterial↗