Biomedical subjects
Publications and source records attributed to D M Purohit.
Morphologic evidence for calcium salts within the brains of severely stressed neonates at autopsy correlated to the mean daily parenteral dose of calcium gluconate (P less than 0.01). Survival analysis indicated that parenteral administration of calcium contributed a negative effect to predicted survival (P less than 0.05).
Over a 2 year period ending in April, 1981, 268 premature infants with birth weight below 1,750 gm underwent operation for a "hemodynamically significant" patent ductus arteriosus. Operations were performed in 13 centers participating in a collaborative study, which was primarily designed to evaluate the role of indomethacin in the management of patent ductus arteriosus. No patient died during the operations, which were done at a median age of 10 days. Eight infants (3%) died within 36 hours after operation. In only one was the death directly attributable to the operative procedure. Hospital mortality (23%) and postoperative morbidity, which included bronchopulmonary dysplasia, pneumothorax, and sepsis, were unrelated to birth weight, age at operation, and degree of preexisting pulmonary disease or preoperative treatment of the infant with indomethacin. Results indicate that surgical ligation is a safe and effective procedure for treating patent ductus arteriosus with large left-to-right shunting in small premature infants.
Parenteral calcium may augment the degree of calcification within brains of human neonates (p less than 0.01). This observation is supported by histochemistry, atomic absorption of ashed brain, selected area diffraction, and energy dispersive microanalysis. Survival analysis indicates that a standard replacement dose may have an adverse effect of severely stressed neonates (p less than 0.01). Nuclei within the optic-tract, circumferential pons and temporal lobe showed calcium salt deposits before other cytologic evidence of necrosis was discernible. Most calcification occurred in regions of ongoing necrosis primarily in the neuropil. But Purkinje cell and supraoptic neurons and apparent neurons from the fascia dentata, Ammon's Horn, were densely calcified in several brains. In those infants surviving longer periods both the neuropil and nuclei of glial scar stained for calcium salts.
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This is a case report of a tubular duplication with a clinical presentation as pseudoascites. It was treated surgically by stripping its mucosal lining.
A case of hemolytic disease of the newborn due to anti-Jsb is described. The immunohematologic status of the mother and her offspring is presented.
A newborn infatn developed gluteal necrosis and foot-drop associated with umbilical artery catheterization. Clinical course of the infant's illness illustrates that the etiology was multifactorial, being related to the site of catheter tip placement, hypotension, and infusion of hypertonic glucose and other drugs via umbilical catheter.
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Echocardiography is a useful means of determining whether or not to ligate the patent ductus arteriosus (PDA) in premature infants with respiratory distress syndrome and PDA. The magnitude of the left-to-right ductal shunt can be gauged by measuring the diameter of the left atrium (LA) and aortic root (AO) echocardiographically and by determining the LA/AO ratio. An increase in this ratio during weaning from assisted ventilation is an indication for ligation of the PDA. We recently used this criterion in treating 2 infants with respiratory distress syndrome and PDA.
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Twenty-seven infants with respiratory distress and hypoxemia of noncardiac etiology were treated with tolazoline. Thirteen infants had hyaline membrane disease and 14 had respiratory distress attributable to causes other than hyaline membrane disease. An immediate response to tolazoline, a rise in PaO2 of 15 torr or more within 15 min, was seen in 11 infants in the hyaline membrane disease group and in eight infants of the other group. Six infants in the hyaline membrane disease group and 11 infants in the second group survived. Tolazoline should be considered as a therapeutic adjunct in the management of hypoxemia which persists after optimal homeostatic and ventilatory support.
Extracorporeal membrane oxygenation (ECMO) is now an accepted therapy for neonatal respiratory failure due to reversible lung disease. There is a continued need to train ECMO team members using animal models. Hanford miniature swine are an appropriate model for this purpose because of the availability and size as well as anatomic and physiologic similarities to humans. This article describes training ECMO team members in venoarterial and venovenous bypass utilizing Hanford miniature swine.