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Biomedical subjects

N Malhotra

Publications and source records attributed to N Malhotra.

At least 19 recordsLinked to original sources
PubMed2006

Anesthetic management of a pregnant patient with dengue hemorrhagic fever for emergency cesarean section.

Dengue fever is the most common and widespread insect-borne viral infection worldwide. The most critical phase of this viral infection is the defervescent phase when the fever subsides but the patient develops life-threatening thrombocytopenia due to complement activation by viral antigens binding to platelets. We have outlined the anesthetic management of a 25-year-old primigravida with dengue hemorrhagic fever who needed to undergo emergency cesarean section. We also describe this illness in brief and compare the anesthetic management to that of preeclampsia and hemolysis, elevated liver enzymes and low platelet syndrome which this disease mimics.

Adult↗
PubMed2003

Immunomodulatory and cytoprotective role of RP-1 in gamma-irradiated mice.

RP-1 has been reported to provide protection against lethal gamma-irradiation in mice. The present study was undertaken to understand its mechanism of action, especially with respect to modulation of radiation-induced changes in immune cell function, plasma antioxidant potential, cell cycle perturbations, apoptosis in mouse bone marrow cells, and micronuclei frequency in mice reticulocytes. 2 Gy reduced mitogenic response of splenic lymphocytes significantly at 48 h. Pre-irradiation RP-1 treatment significantly countered the radiation-induced loss of splenocyte proliferation. RP-1 treatment, with or without radiation, suppressed macrophage activation as compared to control. Irradiation decreased plasma antioxidant status significantly (p < 0.05) at 1 and 2 h (4.8 +/- 0.224 and 4.9 +/- 0.057 mM Fe2+) as compared to control (6.29 +/- 0.733 mM Fe2+) that was countered by RP-1 pre-treatment significantly (p < 0.05). RP-1 and irradiation individually caused G2 delay in bone marrow cells. RP-1 pre-treatment augmented radiation-induced G2 delay and elicited significant (p < 0.05) recovery in S-phase fraction at 48 h in comparison to irradiated group. Radiation-induced apoptosis (3%) was significantly higher than the control. RP-1 pre-treatment further enhanced apoptosis frequency (7.2%) in bone marrow cells. RP-1 pre-treatment significantly (p < 0.05) reduced (1.23%) the radiation-induced MN frequency (2.9%) observed at 48 h post-irradiation interval. Since the radioprotective manifestation of RP-1 is mediated through multiple mechanisms, needs further investigation.

Animals↗
PubMed2003

Evaluation of umbilical cord serum therapy for persistent corneal epithelial defects.

AIMS: To evaluate umbilical cord serum therapy as a means of promoting the healing of persistent corneal epithelial defects. METHODS: Umbilical cord serum or autologous serum drops were used to promote the healing of persistent epithelial defects. The study design was a prospective randomised controlled clinical trial. 60 eyes of 59 patients were divided into two groups, 31 in the cord serum group and 29 in the autologous serum control group. Epithelial defects measuring at least 2 mm in linear dimension resistant to conventional medical management were included. Serial measurements of the size of the epithelial defects-namely, two maximum linear dimensions perpendicular to each other, and the area and perimeter was done at start of therapy and follow up days 3, 7, 14, 21. Rate of healing of the epithelial defects were measured as percentage decrease from the baseline parameter at each subsequent follow up. The data were analysed by the non-parametric Wilcoxon rank sum test using STATA 7.0. RESULTS: The median percentage decrease in the size of the epithelial defect was significantly greater in the cord serum group at days 7, 14 and 21 (p<0.05) when measured in terms of the area and perimeter. A greater number of patients showed complete re-epithelialisation with umbilical cord serum (n = 18) than with autologous serum (n = 11) (Pearson chi = 0.19). None of the patients reported any side effects or discomfort with either treatment. CONCLUSIONS: Umbilical cord serum leads to faster healing of the persistent corneal epithelial defects refractory to all medical management compared to autologous serum.

Adult↗
PubMed2002

Epidural anesthesia for cesarean section in a patient with Eisenmenger's syndrome.

Eisenmenger's syndrome is a complex combination of cardiovascular abnormalities and is defined as pulmonary hypertension at systemic pressure level with reversed or bi-directional shunt through an intracardiac or aortopulmonary communication. Patients with Eisenmenger's syndrome are at high risk for peripartum morbidity and mortality. Multigravid patients with this disease are therefore uncommon. We report the anesthetic management for cesarean section of a 27-year-old multigravid female at 35 weeks' gestation with Eisenmenger's syndrome. Titrated epidural anesthesia was administered with incremental doses of 2% lidocaine. Intraoperative course was uneventful except for an episode of hypotension immediately after delivery of the baby, which was managed successfully. We conclude that carefully titrated epidural anesthesia may be safe, appropriate, and effective for patients with Eisenmenger's syndrome for cesarean section.

Journal Article↗
PubMed2001

Hydatiform mole with coexisting live fetus in dichorionic twin gestation.

A case of dichorionic twin pregnancy was diagnosed in a 29-year-old, on routine ultrasound at 12 weeks. Subsequent ultrasounds for persistent vaginal bleeding at 16 weeks revealed molar placenta with viable fetus in both gestational sacs. The patient declined any invasive prenatal testing to confirm the karyotype of the fetus. The pregnancy was managed expectantly until 21 weeks, when she had a spontaneous abortion of twin fetuses and separate placentae with attached molar tissue. A final karyotype on cord blood samples confirmed 46XY and 46XX for both fetuses. Histopathology of molar tissue reported complete mole, with diploid chromosomal pattern on subsequent DNA flow cytometry. The clinical, ultrasound and chromosomal examination suggest that there has been a quadruplet pregnancy where two embryos developed into normal fetuses and other two degenerated to complete moles.

Abortion, Spontaneous↗
PubMed2001

Recurrent eclampsia in a woman with chronic pyelonephritis.

Pre-eclampsia associated with chronic pyelonephritis is not uncommon, but recurrent eclampsia in two successive pregnancies associated with chronic pyelonephritis is very rare. We present one such rare case where a patient had recurrent eclampsia with chronic pyelonephritis.

Adult↗
PubMed2001

Broad ligament hematoma causing fetal death in a case of fracture pelvis.

Although motor ventricular accidents complicates 6-7% of all pregnancies, the experience of pelvic fractures in near term gravid patients is limited. We present a unique case of fetal death caused by bilateral broad ligament hematomas following maternal pelvic fracture which improved our understanding of management of such cases.

Accidents, Traffic↗
PubMed2001

Ureteric calculi masquerading metastatic lymph nodes in a case of endometrial cancer.

Extensive pelvic lymph node metastasis in the absence of risk factors was noticed at surgical staging for endometrial cancer in a 55-year-old postmenopausal women. On exploration there was a dilemma as to the disappearing lymph nodes which subsequently proved to be asymptomatic ureteric calculi. The need to palpate the pelvic side walls at the time of surgery for endometrial cancer even in cases when no nodal enlargement is detected preoperatively is highlighted.

Adenocarcinoma↗
PubMed2001

Anesthetic management of patients with Takayasu's arteritis: a case series and review.

UNLABELLED: Takayasu's arteritis is a rare, chronic progressive panendarteritis involving the aorta and its main branches. Anesthesia for patients with Takayasu's arteritis is complicated by their severe uncontrolled hypertension, end-organ dysfunction resulting from hypertension, stenosis of major blood vessels affecting regional circulation, and difficulties encountered in monitoring arterial blood pressure. Takayasu's arteritis is an uncommon disease and previous descriptions of the anesthetic management of patients with this disease have been limited to isolated case reports in the anesthetic literature, mostly in women undergoing cesarean delivery. We present our experience in this series of eight patients for various emergency and elective surgical procedures and review their perioperative problems and management. IMPLICATIONS: This case series describes the anesthetic problems and management of patients with pulseless disease.

Adult↗
PubMed2001

Hemiagenesis of the thyroid associated with chronic lymphocytic thyroiditis.

The authors report a case of hemiagenesis of the left thyroid lobe indicated on Tc-99m pertechnetate scan and later confirmed on ultrasonography. The patient was clinically hypothyroid with a right-sided goiter. The cytopathologic diagnosis was made by fine-needle aspiration cytologic analysis, which indicated chronic lymphocytic thyroiditis in the right lobe of the thyroid gland. Later the patient's condition was stabilized with thyroxine replacement therapy. The association of hemiagenesis of the thyroid with chronic lymphocytic thyroiditis has not been reported in the literature.

Adult↗