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Biomedical subjects

A C Anand

Publications and source records attributed to A C Anand.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Impact of hepatitis C virus infection in renal transplant recipients.

OBJECTIVES: The impact of hepatitis C virus (HCV) infection on the success of renal transplant is controversial. We assessed the effect of HCV infection on graft and patient survival in renal allograft recipients. METHODS: We retrospectively analyzed medical records of renal allograft recipients who were transplanted between June 1990 and March 2004. Patients were divided into those positive and negative for anti-HCV antibody. Graft and patient survival were compared between the groups. RESULTS: Of 126 patients studied (median age 34.5 years, range, 16-60; 111 men), 35 were positive for anti-HCV antibody. In seven patients, the antibodies were detected for the first time after renal transplant. Mean patient and graft survival duration in the anti-HCV negative group was longer (55 [SD 2] months [95% CI, 51-58]) than in the anti-HCV positive group (50 [SD 4] months [95% CI, 43-58]) (p< 0.05). Twenty-two patients died - 8 (22.8%) in the anti-HCV positive group and 14 (15.3%) in the negative group. In the anti-HCV positive group, infections were the cause of death in 5 patients and 3 patients died of liver cell failure. In the anti-HCV negative group, corresponding figures were 13 and one. CONCLUSION: HCV infection is a bad prognostic indicator for patient and graft survival duration in renal transplant recipients. Infections are the commonest cause of death in renal transplant recipients.

Adolescent↗
PubMedDate not supplied

The anatomy of an epidemic (the final report on an epidemic of multidrug resistant enteric fever in eastern India).

Two hundred and forty two patients of enteric fever were treated at Command Hospital (EC) Calcutta, during the period 1989-90. The mean age of the patients was 28.4 (range 2-60) years and 119 (49.2%) of them were males. Fever (100%), headache (55%), diarrhoea (25.2%), intestinal bleeding (2.9%) and icterus (3.7%) were the main presenting features. Blood cultures were positive in 216 (%) patients. A majority of the isolates were found to be resistant to all four commonly used drugs for enteric fever i.e. chloramphenicol, ampicillin, cotrimoxazole and furazolidone. The commonest phage type found in the resistant strains was 51 (biotype-1). Two plasmids of 14 and 120 kd size were detected in the resistant strains but not in the sensitive strains. Clinical response to gentamicin was not satisfactory in spite of all strains showing in vitro sensitivity. Ciprofloxacin proved to be a safe and effective drug for the treatment of multidrug resistant enteric fever.

Adolescent↗
PubMedDate not supplied

Analysis of symptomatic patients after cholecystectomy: is the term post-cholecystectomy syndrome an anachronism?

Of 171 patients who were followed-up prospectively for 2.8 years after cholecystectomy, 31 developed postcholecystectomy symptoms, 24 of them being mild to moderate and 7 severe. Symptomatic patients mostly had functioning gall bladders preoperatively and longer duration of symptoms prior to cholecystectomy. The causes of postcholecystectomy symptoms could be identified in all of them except 9 patients who were labelled as having "essential dyspepsia". The symptoms in the latter syndrome as well as in other conditions diagnosed in the symptomatic postcholecystectomy patients appeared unrelated to the absence of gallbladder. Hence, we feel the term postcholecystectomy syndrome is an anachronism and should be redefined.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMedDate not supplied

Gall bladder dysmotility in diabetes mellitus--an ultrasound study.

Fifty two diabetic patients and 15 healthy control subjects were prospectively studied for their gall bladder function by ultrasound examination. The fasting gall bladder volume (FGBV) was calculated by using ellipse formula from the dimension of gall bladder shadow seen on ultrasound screen in two different cuts. The contractility of gall bladder was measured by calculating post prandial ejection fraction (EF) of the gall bladder. The mean FGBV and EF in 52 diabetic patients was found to be 20.7 +/- 10.7 cc and 47.5 +/- 20.1%, which was not significantly different from that in normal controls. Age, sex, obesity, diabetic control and presence of dyspeptic symptoms had no impact in FGBV and EF. Diabetic symptoms had no impact in FGBV and EF. However, diabetics with longer duration of disease had poorer gall bladder contractility (p < 0.05). Patients with autonomic neuropathy (AN) had significantly larger FGBV but normal contractility. Our results suggest that (a) long standing diabetics may have poor gall bladder emptying predisposing to gall stone formation (b) patients with autonomic neuropathy have reduced tone of fasting gall bladder but normal contractility.

Adult↗
PubMedDate not supplied

Impact of the site of arterial anastomosis on the risk of biliary complications after liver transplantation.

Biliary complications are an important cause of morbidity after orthotopic liver transplantation (OLT). It has been suggested that the denervation of recipient bile duct and the sphincter of Oddi may contribute to biliary complications. Recipient bile duct and the sphincter of Oddi receive its regulatory innervation through the nerve plexus around the gastroduodenal artery (GDA). These nerves are likely to be severed if recipient hepatic artery is divided at or proximal to the origin of GDA during arterial anastomosis of OLT (proximal arterial anastomosis). This study was carried out to determine the impact of the site of arterial anastomosis on the incidence of biliary complications. A total of 331 transplants by a single surgeon (JACB) were analysed. Patients with Roux-en-Y choledochoduodenostomy were excluded. Biliary complications were noted in 16.9% patients during first three months after transplantation. Incidence of biliary complications in patients with proximal and distal arterial anastomosis was found to be 17.2% and 12.9% respectively (ns). We conclude that the site of arterial anastomosis as an index of sphincter of Oddi denervation does not significantly influence the incidence of biliary complications.

Adult↗