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Anil C Anand

Publications and source records attributed to Anil C Anand.

5 recordsLinked to original sources
PubMed2005

Symptomatic portal system thrombosis in soldiers due to extended stay at extreme altitude.

BACKGROUND: With induction of Indian Army to heights over 5000 m above mean sealevel (MSL), several new complications of long-term stay at extreme altitude have come to light. The authors' experience with soldiers who developed symptomatic portal system thrombosis (SPST) is described here. METHODS: Clinical data were prospectively collected between April 1998 and April 2003, on all patients hospitalized for SPST from high-altitude areas (HAA, >3000 m above MSL) and those from non-high-altitude areas (NHAA). Site of thrombosis was confirmed by imaging and included splenic, portal, superior mesenteric, or inferior mesenteric vein thrombosis. Patients were investigated to rule out known predisposing factors and prothrombotic conditions. RESULTS: A total of 37 cases of SPST were seen during the study period, of which 26 were from HAA. Mean age of cases from HAA was 27 +/- 4.6 years and all were male. Mean stay at high altitude was 11.7 +/- 6.2 months. First symptom was pain in abdomen in almost all the cases, later followed by gastrointestinal bleeding and fever in 14 each, and vomiting in 19. Clinical examination showed ascites (81%), splenomegaly (76.9%), and hepatomegaly (69.2%). Diagnosis was made by imaging scans (23 cases) and on surgery in three cases. A known prothrombotic state was detected in five cases from HAA and in eight cases from NHAA (P < or = 0.01). Ultrasound Doppler scan picked up collaterals as early as 12-45 days after onset of symptoms. CONCLUSIONS: Extended stay at HAA may be a risk factor for development of symptomatic portal system thrombosis.

Adult↗
PubMed2005

Jaundice in malaria.

Jaundice is not an unusual accompaniment of malaria. It can occur due to intravascular hemolysis, disseminated intravascular coagulation, and, rarely, 'malarial hepatitis'. Although the primary schizogony of the malarial parasite always leads to the rupture of the infected hepatocyte, alteration of the hepatic functions is uncommonly recorded due to this event. Histologically, the hepatitis or the actual inflammation in the liver has never been demonstrated. Nonetheless, the term 'malarial hepatitis' (MH) has been used in the literature to describe the occurrence of hepatocellular jaundice in patients with Plasmodium falciparum infection. The authors' own data and review of the literature indicate that it is not an uncommon entity. In endemic areas, jaundice is seen in approximately 2.5% of patients with falciparum malaria. It also appears to be a heterogeneous syndrome and one can recognize two clinical subsets. In one group there was an acute, virulent presentation with coma, renal failure and in some cases even hemorrhagic manifestations. It is only in this setting that jaundice signified a 'severe' disease as noted by the World Health Organization action program. This presentation is often confused with acute viral hepatitis and acute hepatic failure in non-endemic areas, but can be clinically differentiated.

Animals↗
PubMed2002

Stroke at high altitude: Indian experience.

UNLABELLED: Stroke is a common medical emergency. There is limited knowledge about stroke at high altitude. We present the clinical profile of 30 cases of stroke at high altitude seen at our center between November 1998 to July 2000. A detailed neurological and systemic examination was carried out. Cases were investigated with blood counts, lipid profile, cardiac evaluation, and CT scan/MRI. Coagulation parameters were studied in some cases. Strokes formed 13.7/1000 of hospital admissions from high altitude area, compared to 1.05/1000 in nonhigh altitude area. All our cases from high altitude area were males (serving soldiers of armed forces). Their mean high altitude stay was 10.2 months, and they were all located at heights greater than 4270 m. Age ranged from 22 to 48 years (mean 33.4 yr). Except for smoking (in four cases), they had no preexisting risk factors. Twenty-two cases were of ischemic stroke, 2 of intracerebral hemorrhage, 4 of TIA/RIND (transient ischemic attack/reversible ischemic neurological deficit), and 2 had cerebral venous thrombosis. Out of 30 cases, 28 were of "stroke in young" (<45 yr) and were compared with cases in the same age group from nonhigh altitude areas. Polycythemia with Hb ranging from 16.2 to 22 g.dL(-1) was seen in 21 of these 28 cases (75%). Protein C and S deficiency was found in 1 case in each group. CT scan showed massive infarcts involving at least 50% of one cerebral hemisphere in 12 cases. Multiple infarcts were seen in one case. CONCLUSION: Long-term stay at high altitude is associated with higher risk of stroke. Although all types of stroke were seen, ischemic stroke was the commonest. Massive infarcts were common. Polycythemia was an important risk factor.

Adult↗