Biomedical subjects
M K Biswas
Publications and source records attributed to M K Biswas.
Blood-saturated operating-room shoe covers.
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A case report of giant cell arteritis of the uterus and adnexa.
Giant cell arteritis of the uterus and adnexa is a rare disorder, which is generally asymptomatic and occasionally associated with temporal arteritis. The true clinical significance of this dramatic microscopic finding remains obscure, but arteritis of the uterus and adnexa may be associated with later development of giant cell arteritis elsewhere in the body.
Pregnancy outcome in patients with repeat visits to the labor observation area near term.
Patients whose pregnancies are near term and who repeatedly visit the labor observation area but are found not to be in labor and have no clear diagnosis for their complaints remain a source of concern for the obstetrician. In order to determine whether this is a population with special perinatal risks, such cases were reviewed over a 4-month period at Charity Hospital in New Orleans. Seventy-one patients were identified who had repeatedly visited the labor observation area near term. Compared with those in the general obstetrics population, these patients had a significantly increased risk of cesarean section for "failure to progress." Repeat visitors to the labor observation area should be viewed as having a high risk for later abnormalities of active labor. Careful management of labor abnormalities in such patients could theoretically lower their need for cesarean section.
Relative strength of a new suture technique for fascial closure.
In an attempt to decrease the risk of fascial dehiscence, a new suture technique for fascial closure is proposed, referred to as the "secured" stitch. The secured interrupted stitch is performed by taking a double bite of fascia at each traditional site of fascial puncture. Relative strength of the secured interrupted stitch in comparison with the simple interrupted stitch is determined in samples of fresh bovine fascia. A significantly greater force is required to disrupt fascia repaired with the secured stitch compared with a simple interrupted repair. The secured stitch may afford a greater degree of protection from fascial dehiscence.
Torsion of the gravid uterus. A report of two cases.
Two cases of 180 degree torsion of the term uterus occurred. Both patients recovered uneventfully.
High hepatitis B carrier rate among non-Oriental patients with acute salpingitis.
Hepatitis B surface antigen screening was performed on non-Oriental patients with the diagnosis of acute salpingitis. Six of 59 (10.17%) had hepatitis B surface antigenemia. We therefore recommend hepatitis B screening for all patients with salpingitis. The detection of covert hepatitis B helps to protect hospital staff and provides important information for the patient. Further, the administration of hepatitis B vaccine may be appropriate for those patients with acute salpingitis who are found to be hepatitis B surface antigen-negative.
Gonococcal chorioamnionitis associated with sepsis: a case report.
We present a case of gonococcal chorioamnionitis in a patient with intact membranes, which has not been previously reported. Evidence suggests that the spread of bacteria was transplacental.
The pregnant hepatitis B carrier: evidence favoring comprehensive antepartum screening.
The prevalence of hepatitis B surface antigen among 15,399 gravidas screened in the prenatal clinic at Charity Hospital of Louisiana in New Orleans was 0.88%. The race-specific prevalence was 0.56% for whites, 0.62% for blacks, and 8.8% for Orientals. Identifiable risk factors could not be found for approximately half of the hepatitis B surface antigen-positive women. Comprehensive antepartum hepatitis B screening is recommended, based upon the significant risk of perinatal transmission to the neonate and upon the failure of selective screening to identify the majority of maternal hepatitis B surface antigen carriers in our population. The cost-effectiveness of general antepartum screening compares favorably with current blood bank hepatitis screening costs.
Chronic hypertension in pregnancy.
The course and outcome of 169 pregnancies in 156 women with chronic hypertension were studied. Antihypertensive medications were given if the diastolic blood pressure exceeded 90 mmHg. A number of major associated medical problems were found. Left ventricular hypertrophy, a serum creatinine greater than 1.0 mg%, and a diastolic pressure greater than 100 mmHg at less than 20 weeks' gestation were high-risk indicators. The overall perinatal mortality was 28.4 of 1000 (versus hospital of 25.6 of 1000). Despite antihypertensive therapy, one-third of the patients developed superimposed preeclampsia. The poorest outcome occurred in patients with superimposed preeclampsia necessitating delivery at 27 to 34 weeks' gestation (perinatal mortality = 238 of 1000). Antepartum fetal heart rate testing was abnormal in 10% of the patients with intrauterine growth retardation occurring in 15%. The incidence of fetal growth retardation was fourfold higher (20 versus 5%) in patients treated with antihypertensive drugs, particularly methyldopa as a single agent. However, this may have been related more to the study design than to a detrimental effect of the drug. The perinatal outcome in this study is similar to the outcome of studies in which antihypertensive therapy was withheld. This indicates that controlling the blood pressure is merely one aspect of the management of chronic hypertension in pregnancy. Accurate dating, attention to associated medical problems, antenatal fetal assessment by ultrasound and heart rate monitoring, and carefully timed delivery are additional important factors.
A placebo-controlled comparative trial of various prenatal vitamin formulations in pregnant women.
The iron-delivery characteristics of three commercially available prenatal vitamin-mineral supplements were studied in a placebo-controlled, randomized cross-over comparison in 40 low-risk women during their second and third trimesters of pregnancy. Each formulation was ingested immediately after a standardized meal. The serum iron concentration was measured at one, three, and six hours after administration. With two of the supplements (Stuart-natal 1 + 1 and Stuart Prenatal tablets), the mean serum iron level at six hours was significantly higher than the mean level at three hours. In contrast, Materna gave the same mean serum level at three hours and at six hours. Calculations of the mean total number of milligrams of iron absorbed after a single dose were 5.7 for Stuart Prenatal, 5.2 for Stuartnatal 1 + 1, and 4.4 for Materna. The results from this study indicate that Stuartnatal 1 + 1, when administered correctly, does provide substantially more iron than the accepted daily requirement during pregnancy.
Pulmonary edema induced by betamimetic drugs.
We present six cases of pulmonary edema related to betamimetic (beta sympathomimetic amine) agents (three to ritodrine and three to terbutaline). The hemodynamic data from three patients suggest that this may be a form of noncardiogenic pulmonary edema. A seventh case, resulting in a maternal death, is included because of the association with ritodrine therapy and the instructive complications of invasive monitoring. We also propose an outline for the management of betamimetic-drug-induced pulmonary edema.
Treatment of smallpox with cytosine arabinoside.
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