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Biomedical subjects

D Takkar

Publications and source records attributed to D Takkar.

At least 55 records · Page 3Linked to original sources
PubMed1995

Unexplained absence of both fallopian tubes with ovary in the omentum.

A rare case of unexplained absence of both fallopian tubes and ovaries from their normal position, resulting infertility is presented. On careful search an ectopic ovary containing dermoid cyst was found in the omentum. Possible mechanism and clinical significance of such a rare occurrence is discussed.

Adult↗
PubMed1995

Ruptured intracranial aneurysm complicating pregnancy.

Three cases of ruptured intracranial aneurysm during pregnancy are presented. Rupture occurred near term in all three cases. Simultaneous elective cesarean section and clipping of the aneurysm was performed in two cases. Successful maternal and perinatal outcome was achieved in all three patients. The diagnosis and management of the cases are described and discussed.

Aneurysm, Ruptured↗
PubMed1995

von Willebrand disease: a rare cause of puberty menorrhagia.

A 13-year-old girl with a family history of epistaxis presented with pubertal menorrhagia necessitating multiple blood transfusions. Her coagulation profile confirmed the diagnosis of Von Willebrand disease. The menorrhagia was controlled by cyclical use of oestrogen progestogen combination drugs. The important clinical implication of this case is that the patient with adolescent menorrhagia may have an underlying coagulation disorder, which can successfully be managed by hormones.

Adolescent↗
PubMed1994

Maternal and perinatal outcome in thyrotoxicosis complicating pregnancy.

In this report we describe 32 pregnancies complicated by hyperthyroidism cared for over a 7-year period at AIIMS, New Delhi. In 6 cases hyperthyroidism was diagnosed during pregnancy; others were diagnosed before conception and were on antithyroid therapy during pregnancy. For control of thyrotoxicosis thiourea derivatives, carbimazole (CMZ) and propylthiouracil (PTU), were both used. The dosage of antithyroid drugs could be decreased or stopped in the third trimester in only 28% cases, while 50% cases did not require any change in the dosage during gestation and 21% required an increase in dosage with advancing gestation to control thyrotoxicosis. Maternal and fetal complications included preterm labour (25%), PIH (22%), thyroid crisis (9%) and intrauterine growth retardation (13%). Thyroid status of neonates was found abnormal in 9% cases, including 1 case (3%) of neonatal thyrotoxicosis with goitre and 2 (6%) cases of neonatal hypothyroidism. One maternal death occurred due to thyroid storm. No case of stillbirth or perinatal death occurred in the present study. In our experience of 32 cases maternal and fetal complications are reported with increased frequency, requiring close surveillance of thyroid status to maintain euthyroidism and intensive fetal monitoring during pregnancy to achieve good maternal and perinatal outcome.

Adult↗
PubMed1994

Results of radical radiotherapy in carcinoma of the uterine cervix stage I-III.

A retrospective analysis is described of 271 diagnosed cases of carcinoma of the uterine cervix who were treated with radical radiotherapy between January 1987 and July 1988 at the Institute Rotary Cancer Hospital. The mean age at presentation was 49 years and 89% of the tumours were FIGO Stage II and III. The median duration of follow-up was 60 months. The early cases were treated with two intracavitary insertions of 34 Gy each to point A with a Selectron LDR intracavitary system, followed by 36 Gy external radiotherapy to the parametrium. Late stage disease was treated with 50 Gy of external radiotherapy, followed by a single intracavitary insertion of 30 Gy to point A. To compensate for the higher dose rate of the Selectron (180 cGy/h) a dose reduction factor of 15% was applied over the intracavitary dose. There were 2.5% and 4.7% of late Grade III bladder and bowel complications, respectively, requiring surgical intervention. There was no relationship between haemoglobin level at diagnosis and the development of late complications. The actuarial 5-year survivals were 65%, 63% and 35% for Stages I, II and III disease, respectively. This study from the Indian subcontinent shows the effectiveness of radiotherapy in Stages I, II and III carcinoma of the uterine cervix, with acceptable morbidity rates.

Actuarial Analysis↗
PubMed1994

Pregnancy with idiopathic thrombocytopenic purpura.

The management of ITP in pregnancy remains controversial, particularly with reference to labour management. Thirteen pregnancies in 9 women with ITP are analysed with respect to maternal and neonatal outcome. One pregnancy culminated in spontaneous abortion. Ten infants were born by vaginal delivery and two by Caesarean section. There were no maternal or perinatal deaths. Maternal morbidity was not increased significantly due to ITP and none of the infants had purpuric manifestations even with low platelet counts. It is concluded that the obstetric management of these patients should be individualised and should not be based on platelet count alone.

Adult↗
PubMed1994

Polycythemia associated with uterine fibroid.

Polycythemia has been observed to occur infrequently in association with uterine fibromyomas. Study of this case revealed polycythemia prior to surgery and remission was noted after myomectomy. The mechanisms proposed to explain polycythemia in such a tumor were revised.

Adult↗
PubMed1992

Hypothyroidism complicating pregnancy.

In this report we describe 26 pregnancies complicated by hypothyroidism cared for over 6.5 years at AIIMS, New Delhi. In 2 women hypothyroidism was diagnosed during pregnancy; others were diagnosed before pregnancy and continued to receive thyroxine replacement therapy throughout pregnancy. The thyroxine treatment needed readjustment in 7 (26.9%) pregnancies to maintain euthyroidism. Maternal complications included anaemia (23.0%), pregnancy induced hypertension (26.9%), postpartum haemorrhage (7.7%), intrauterine growth retardation (15.4%), postdatism (30.8%), and deficient lactation (19.2%). Perinatal mortality was 3.9%. No case of stillbirth occurred probably because of intensive fetal monitoring and timely termination of pregnancies on evidence of intrauterine fetal compromise. One neonatal death occurred due to fetal thyrotoxicosis. In these cases close surveillance during pregnancy is needed to maintain optimum thyroid hormone concentration, and intensive fetal monitoring is required to achieve a good perinatal outcome.

Adult↗
PubMed1989

Fetal foot length--a new parameter for assessment of gestational age.

Ultrasonographic measurement of fetal foot length, a new parameter, was correlated with the gestation age. One hundred and five ultrasonographic measurement of fetal foot length was performed between 13 and 42 weeks gestation. Comparison of linear regression of foot length versus gestational age demonstrated a strong correlation with an r2 value of 0.84 (P less than 0.001). Ninety-five percent confidence intervals at each week compared favorably with both biparietal diameter and femur length data. Mean foot lengths at each week of gestation compared favorably with data based on pathological specimens described in 1920 (Streeter GL: Weight, sitting height, head size, foot length and menstrual age of the human embryo. Contrib Embryol Carnegie Inst. 11: 143, 1920). Measurement of fetal foot length is of particular use when other parameters do not accurately predict gestational age, e.g. hydrocephalus, anencephaly, short limb dysplasia. It can also be used in conjunction with biparietal diameter and femur length in the management of patients with premature labor in order to patients with premature labor in order to accurately predict gestational age. Hence the present study demonstrates that the ultrasonographic measurement of foot length is a reliable indicator of gestational age.

Embryonic and Fetal Development↗
PubMed1981

Correlation between the serum norethindrone (NET) levels attained after insertion of a silastic implant releasing norethindrone acetate and the endogenous hormones particularly progesterone.

Six normally menstruating women were inserted each with a single silastic implant-D releasing norethindrone acetate (NETA). The levels of endogenous hormones, FSH, LH, E2 and progesterone, were estimated by radioimmunoassay (RIA) procedures in the control and treatment cycles. In addition, the levels of drug in the serum as norethindrone (NET) which is a major metabolite of NETA were also estimated by RIA procedures in the treatment cycles. In all, 12 treatment cycles were studied. In the initial treatment cycles (1st/2nd or 3rd), the serum NET levels were either 1 ng/ml or above. The LH and FSH showed either normal or suppressed mid-cycle peaks, but the progesterone levels were completely suppressed. In the sixth treatment cycles, the serum NET levels were either 0.5 ng/ml or below. The FSH and LH mid-cycle peaks were lower but distinct while the luteal progesterone levels were of normal ovulatory type. These studies lead us to the conclusion that a serum level of NET of the order of 1 ng/ml is required to bring about suppression of luteal progesterone, either as a result of direct action on the ovary or through suppression of pituitary gonadotropins. When the serum level falls to 0.5 ng/ml or below, the suppressive effect is removed and ovulatory pattern of progesterone returns.

Drug Implants↗