PubMed Health⌕ Search

Biomedical subjects

N Ananthakrishnan

Publications and source records attributed to N Ananthakrishnan.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Combined x-ray diffraction and microchemical gallstone analysis in determining the sequential events in biliary lithogenesis.

Seventy-five gallstones were analyzed layer by layer by x-ray diffraction and microchemical techniques. Microchemical analysis showed that protein was present in 96% of stone nuclei. Application of x-ray diffraction analysis to biliary calculi revealed that cholesterol in three crystalline polymorphs and the three forms of calcium carbonate were the predominant crystalline components. "Cholesterol" and "mixed calculi" revealed differences in their composition. The value of the application of multiphasic qualitative analytical techniques to gallstones is discussed and the pattern of the probable sequence of events in the formation of "mixed" gallstones indicated. It appears that in this process of biliary lithogenesis epitaxy may play a significant role especially in the growth of calculi after formation of the nidus.

Bile Pigments↗
PubMedDate not supplied

Partial cholecystectomy in elective and emergency gall bladder surgery in the high risk patients--a viable and safe option in the era of laparoscopic surgery.

Partial cholecystectomy was performed in this Institute in fifteen patients in the last 8 years. Three were performed in cirrhotic patients with bleeding diathesis. The other indications were obscure anatomy, intraperitoneal adhesions, Mirizzi syndrome and poor general condition of the patient. None of these had any major morbidity in the immediate postoperative period. Partial cholecystectomy is a safe and viable option in a difficult situation.

Acute Disease↗
PubMedDate not supplied

Results of the Smead-Jones technique of closure of vertical midline incisions for emergency laparotomies--a prospective study of 403 patients.

The early and late results of the Smead-Jones (SJ) technique of closure of emergency vertical midline laparotomies was compared with other conventional methods of closure such as anatomical repair (AR), mass closure (MC) and single layer (SL) closure. Four Hundred and Three patients who underwent emergency laparotomy were studied prospectively. The results of SJ closure of laparotomy in them were compared with other techniques of abdominal closure. Ninety percent of patients with SJ were in wound class IV and at high risk of wound complications. It was seen that the overall infection rate for SJ at 12.4% was significantly less than all other types of closure. The wound dehiscence rate for SJ at 3.0% was the lowest. This protective effect of SJ against dehiscence was also seen in the presence of post operative chest infection and abdominal distension. The incisional hernia rate for SJ was also lowest (4%). The appearance of the scar was comparable to the other techniques of follow up. The present study concluded that the Smead-Jones techniques of laparotomy closure had very low incidence of early and late complications and was superior to other conventional methods of closure.

Abdomen↗
PubMedDate not supplied

Truncal vagotomy and gastrojejunostomy for chronic duodenal ulcer in India.

BACKGROUND: Insufficient information is available on long term results of truncal vagotomy and gastrojejunostomy since most previous series have relied on functional grading using the Visick scale which possibly both overdiagnoses and underdiagnoses complications. We used endoscopy to assess the results following truncal vagotomy and gastrojejunostomy as well as functional grading and compared them with published results of highly selective vagotomy. METHODS: Two hundred patients were reviewed (5-11 years after truncal vagotomy and gastrojejunostomy) by clinical examination and endoscopy. Completeness of vagotomy was assessed by estimation of the postprandial alkaline tide in the urine and gall bladder using ultrasonography. RESULTS: The ulcer recurrence rate was 15 (7%). Nine (60%) of the recurrent ulcers were asymptomatic and detected only on endoscopy. In all patients with recurrence, the urinary alkaline tide estimation revealed an incomplete vagotomy. Dumping was present in 12%, it was troublesome in 4%, occasional episodes of post-vagotomy diarrhoea in 6% (all in Visick grades I or II) and bile vomiting in 17% (affecting the lifestyle in only 5%). Recurrence and other complications were not related to the experience of the operating surgeon or the type of gastroenterostomy. There was no mortality. Overall, satisfactory long term functional results (Visick grades I and II) were found in 8% of patients. CONCLUSIONS: Truncal vagotomy and gastrojejunostomy still remains the best option in the surgical management of chronic duodenal ulcer. Long term results are good with a relatively low incidence of troublesome complications.

Adolescent↗
PubMedDate not supplied

Medical colleges in India.

Explore the source record for details and available documents.

Education, Medical, Undergraduate↗
PubMedDate not supplied

Role of histamine-2 receptor antagonists after simple closure of perforated duodenal ulcer--a double blind randomised, controlled study.

INTRODUCTION: Definitive surgery at the time of primary laparotomy for perforated duodenal ulcer is often deferred because of its increased morbidity. However simple closure alone is associated with a high rate of recurrence. In view of this H2 blockers have been administered along with simple closure to promote ulcer healing. Only 4 series have been published so far, all lacking either a control group or endoscopic follow up. The results are contradictory. AIMS: This study was done to assess the effect of administration of H2 blockers after simple closure on ulcer healing in a randomised, controlled, double blind fashion. METHODS: One hundred patients were entered in the study. Fifty patients randomly selected either received ranitidine or a placebo after simple closure. Follow up endoscopy was done at 1, 2 and 6 months. If persistence of ulcer was seen at 4 weeks, patients on placebo were converted to ranitidine and those on ranitidine were continued on the drug. RESULTS: Endoscopically assessed rate of persistent or recurrent ulcer at 4 weeks was 39% in the ranitidine group and 29% in the placebo group. At 6 months the corresponding figures were 33% and 30% respectively. The differences between the two groups were not significant. CONCLUSIONS: Ranitidine, therefore, does not appear to promote healing of a perforated duodenal ulcer after simple closure.

Administration, Oral↗
PubMedDate not supplied

Blood utilization in elective surgery--requirements, ordering and transfusion practices.

BACKGROUND: Preoperative over-ordering of blood is very common and leads to holding up of the blood bank reserve, ageing of the blood unit and wastage of blood bank resources. We evaluated the preoperative blood-ordering and transfusion practices for common elective general surgical procedures at a major Indian hospital. The principal aim of this study was to identify the surgical procedures where type and screen can be introduced and to formulate a maximum surgical blood-order schedule for those procedures where a complete cross-match appears mandatory. METHODS: Six hundred and eighty patients undergoing 21 different surgical procedures between April 1993 and March 1995 were studied. Blood-ordering and transfusion details were noted and the data used to calculate cross-matched to transfused ratio (C/T ratio), transfusion probability (%T) and transfusion index (Ti). The maximum surgical blood-order schedule was calculated using Mead's criterion. RESULTS: There was gross over-ordering of blood in 10 out of the 21 procedures studied. Three hundred and seventy (40%) of the cross-matches performed were unnecessary. Sixty per cent of the patients studied had blood loss of less than 10% of the total blood volume and 90% of the cross-matches performed for this group were unnecessary. Based on these data, the maximum surgical blood-order schedule was calculated for 11 common surgical procedures. CONCLUSION: This study shows that blood was over-ordered in 10 out of the 21 procedures studied. Implementation of the recommended maximum surgical blood-order schedule and introduction of type and screen for eligible surgical procedures is a safe, effective and economic solution to preoperative over-ordering of blood.

Blood Transfusion↗
PubMedDate not supplied

Prevalence of Helicobacter pylori infection in disorders of the upper gastrointestinal tract in south India.

BACKGROUND: Helicobacter pylori (H. pylori) is the most common human infection. Though most individuals are asymptomatic, H. pylori plays a key role in the aetiology of many upper gastrointestinal disorders. The prevalence of duodenal ulcer in south India is high but there are very few reports regarding the prevalence of H. pylori infection in various upper gastrointestinal disorders in south Indians. Therefore, we studied the prevalence of H. pylori infection in upper gastrointestinal disorders in south Indians. METHODS: Three hundred and thirty-five patients with various upper gastrointestinal disorders were included in the study. Seventy-five patients with no gastrointestinal disease based on symptoms and endoscopy were taken as controls. The H. pylori status was determined by the urease test, serology and histology and the prevalence compared between various upper gastrointestinal disorders, with controls and with one another. RESULTS: The prevalence of H. pylori was high in the patients and controls. Duodenal ulcer patients had a significantly higher prevalence compared to controls (p < 0.001) and those with other upper alimentary disorders. There was no significant difference between patients with other disorders and controls nor between each other (p > 0.05). CONCLUSION: The prevalence of H. pylori infection is high in south India. It is closely associated with duodenal ulcer. More population-based studies are required to evaluate the relationship of H. pylori with other disorders of the upper gastrointestinal tract.

Gastrointestinal Diseases↗
PubMedDate not supplied

A trial of various regimens of antibiotics in acute appendicitis.

A three year prospective randomised study was undertaken to study the efficacy of three regimens of antimicrobial drug combinations in reducing postoperative wound sepsis in acute appendicitis. Group A--Metronidazole and gentamicin; Group B--Metronidazole and ciprofloxacin; Group C--Metronidazole and cefotaxime. Randomization was done by drawing from a set of sealed envelopes. Antibiotics were started preoperatively once a presumptive diagnosis of appendicitis was made, provided there was no history of prior antibiotic usage. For simple appendicitis (normal or inflamed) two more doses were given postoperatively. For complicated appendicitis, duration of antibiotic treatment was four days postoperatively. All antibiotics were given intravenously to avoid variations in bioavailability. Wound was inspected daily till discharge and at 30 days post operatively or earlier if the patient had symptoms of wound infection. A total of 128 patients completed the study. Eighty nine were simple appendicitis while the rest were complicated. Twenty one developed wound infection. Out of 21, 13 occurred in group A, 5 in group B and 3 in group C. Individually, the difference in infection rates between group A and group C patients with simple appendicitis was statistically significant. Infection rates in all other groups were not statistically different. Cefotaxime and metronidazole combination had the lowest wound infection rate. Hence it is recommended for antibiotic prophylaxis.

Acute Disease↗