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N Ananthakrishnan

Publications and source records attributed to N Ananthakrishnan.

81 records · Page 5Linked to original sources
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↗
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Gastrojejunocolic fistula following surgery for peptic ulcer.

This article aims to emphasize that gastrojejunocolic fistula following peptic ulcer surgery, though uncommon in the post vagotomy era, still continues to occur. We stress the changing trends in its epidemiology, aetiopathogenesis and treatment. The case records of 12 patients with gastrojejunocolic fistula (seen over a 15 year period) were reviewed. Details regarding clinical presentation, investigations and treatment were analyzed and the results compared with previous published series. All the 12 patients in this study had a short loop posterior retrocolic gastrojejunostomy as part of the primary peptic ulcer surgery. Diarrhoea and profound weight loss was present in all of them. Incompleteness of vagotomy was proved in all the six patients investigated for the same. The fistula was demonstrated in all of them on barium enema, while it was seen on upper GI endoscopy in 4. Eight patients were treated by a one stage resection and repair of fistula. A three stage procedure was performed in two.

Adult↗
PubMedDate not supplied

Helicobacter pylori infection in duodenal ulcer with gastric outlet obstruction.

One hundred and three patients were included in the study. Thirty seven had duodenal ulcer (DU) (Group I), 35 DU with gastric outlet obstruction (GOO) with presence of an active ulcer in the duodenum (Group II). Thirty one had DU with GOO but no active ulcer (Group III). Presence of H. pylori infection was determined by urease test, serology and/or histology. The prevalence of H. pylori in these groups was compared. Levels of Anti-H. pylori IgG antibody titres were also compared. The patients with duodenal ulcer (DU) were significantly younger (38 +/- 2 years) compared to those with established gastric outlet obstruction without ulcer (45 +/- 2 years) (P = 0.02). The prevalence of H. pylori infection in DU (95%), DU with GOO with ulcer (91%) and DU with GOO but no ulcer (90%) was not significantly different (p > 0.05). Anti-H. pylori IgG antibody titre levels were 72 +/- 6 EU/ml in Group III. The titre levels between Group I and Group III were significantly different (P < 0.05). The prevalence of H. pylori infection is high is patients with DU and is unaltered by gastric outlet obstruction. The presence or absence of an active ulcer with gastric outlet obstruction does not affect its association with H. pylori infection.

Adult↗