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Biomedical subjects

K Sasidharan

Publications and source records attributed to K Sasidharan.

At least 19 recordsLinked to original sources

Chronic systemic (hepatosplenic) candidiasis in a patient with granulocytic sarcoma.

Chronic systemic (hepatosplenic) candidiasis (CSC) is a syndrome of invasive candidiasis characterized by fever without localizing signs or symptoms. It occurs predominantly in patients with acute leukemia, after prolonged severe neutropenia. We report a young woman who underwent extensive chemotherapy for granulocytic sarcoma of the ovary; CSC then developed in this patient. She was successfully treated with fluconazole and liposomal amphotericin B. Clinical presentation, diagnostic problems, and the current successful treatment with fluconazole and liposomal amphotericin B are discussed.

Adult↗

Ocular metastasis of choriocarcinoma.

Metastatic tumours of the eye commonly occur from primaries of the breast or lung. The prognosis is poor and the mean life expectancy is 6.5 months from diagnosis. Although metastatic tumours of the eye are not a rarity, ocular metastasis from choriocarcinoma has not been reported previously. We report a case of gestational choriocarcinoma with ocular metastasis.

Adult↗

Ureteroscopic lithotripsy using mini-endoscope and Swiss lithoclast: experience in 147 cases.

To evaluate the efficacy of a semirigid mini-endoscope and the Swiss Lithoclast compared with a conventional rigid endoscope and ultrasound, the results of transurethral ureteroscopic lithotripsy in 147 patients over a period of 30 months were analyzed according to the type of ureteroscope (rigid v semirigid) and energy (ultrasound v Lithoclast) used. In the initial 25 cases (Group I), a conventional rigid ureteroscope and ultrasound were used. The latter 122 patients (Group II) were subjected to ureteroscopic lithotripsy using a miniscope and the Lithoclast. The results were superior in Group II with respect to the overall success rate (p = 1.6 x 10[-2]), first-attempt success rate (p = 2.9 x 10[-4]), and the need for ureteral dilation (P = 1.0 x 10[-6]) compared with Group I. There were no major complications. Overall, minor complications (hematuria and urinary tract infection) were observed in 25% of the cases. Further, the results of ureteroscopic lithotripsy in Group II were comparable to those of SWL in situ for upper ureteral calculi and better than for those located in the iliac and lower ureter as reported previously. Our results demonstrate that the Swiss Lithoclast provides effective fragmentation of even hard and smooth stones without increasing the complication rate. This lithotripter is reliable, safe, and simple to operate. In addition, the cost of maintenance is almost nil.

Adolescent↗

Sonographic evaluation of operability of malignant cervical lymph nodes.

Infiltration of the carotid artery by malignant cervical nodes is considered to be a contraindication for radical neck dissection in many centers. Clinical examination alone is unlikely to provide information on the fixity of nodes to the carotid artery. We studied the role of ultrasonography as an adjunct to clinical examination in screening patients for neck dissection. Twenty-seven patients with clinical neck node metastasis were chosen for ultrasonography. All of them had surgery and the findings were correlated. The findings revealed that this procedure is effective in delineating involvement of carotid artery by neck nodes and in identifying false-positive and false-negative cases. Since the sample of patients studied was small, the study is continuing in order to accrue a larger sample.

Adolescent↗

Urethral rhinosporidiosis. Analysis of 27 cases.

An analysis of 27 cases of urethral rhinosporidiosis is presented. Only 11 cases have been previously reported. The disease is chronic and causes no systemic derangement. The key to diagnosis is its characteristic histology and diathermy excision provides the best treatment.

Adult↗

Coronary angiographic features in endomyocardial fibrosis.

Selective coronary cineangiography was performed in 24 patients with angiographic features suggestive of endomyocardial fibrosis (EMF). 8 patients had right ventricular disease, 2 had left ventricular disease and 14 had biventricular disease. The abnormal features found in the coronary arteries of these patients were: (a) vascular blush or neovascularity in 54.2% of patients and (b) localized ventricular filling from the region of the blush in 16.7%. Generalized tortuosity of the coronary arteries, considered to be a nonspecific change associated with ventricular enlargement and hypertrophy, was seen in 50%. This study lends support to one of the hypotheses which implies the role of mural thrombus in the evolution of the pathological lesion of EMF.

Adolescent↗

Early angiographic features of right ventricular endomyocardial fibrosis.

Right ventricular (RV) angiograms were done in 45 patients with left ventricular (LV) endomyocardial fibrosis (EMF). 34 patients had angiographic features compatible with the diagnosis of RV and LV EMF. 11 patients showed the angiographic features of EMF on the left side, but did not show the classical angiographic features on the right side. The RV angiograms of these 11 patients showed a disturbance of the normal parenchymal pattern along the septal margin, irregular small filling defects near the apex and the septal region and minimal tricuspid regurgitation. Biopsies from the RV taken from 2 of these patients during operation for mitral valve replacement had histological features compatible with the diagnosis of EMF on the right side also. This study demonstrates that the early angiographic features of RV EMF differ from those of well-established cases already described in the literature, and that it is possible to spot RV EMF well before the conventional features appear in RV angiograms.

Adult↗

A comparison of the clinical, haemodynamic and angiographic features in right ventricular endomyocardial fibrosis and Ebstein's anomaly of the tricuspid valve.

The clinical, haemodynamic and angiographic features of 18 patients with right ventricular endomyocardial fibrosis (RVEMF) and 8 patients with Ebstein's anomaly of the tricuspid valve (EATV) have been compared. Diagnosis was confirmed by selective angiography. The position of the tricuspid annulus was identified from selective right ventricular angiograms and confirmed by selective right coronary angiography. In 83% of RVEMF patients the tricuspid annulus was displaced to the left of the spine. A false impression of displacement of the tricuspid leaflet can thus be created. However, a tricuspid leaflet displaced away from the tricuspid annulus was found only in patients with EATV. A considerable overlap exists between the wide spectrum of clinical presentations of the two conditions. Helpful distinguishing features that favour EATV were, the presence of a scratchy diastolic murmur and polyphasic QRS complexes in the ECG. Atrial fibrillation in the ECG, and myocardial calcification or pericardial effusion, whenever present, favour RVEMF.

Adolescent↗