Biomedical subjects

Neera Aggarwal

Publications and source records attributed to Neera Aggarwal.

4 recordsLinked to original sources

PubMed2005

Fatal Burkholderia cepacia early prosthetic valve endocarditis: a very rare case and a review of the literature.

A 58-year-old woman who underwent mitral valve replacement and tricuspid valve repair developed severe acute systemic illness four weeks after surgery. Serial blood cultures grew Burkholderia cepacia at four to five days after incubation. Transthoracic echocardiography had confirmed a diagnosis of prosthetic valve endocarditis. The patient did not respond to empirical or culture-sensitive antibiotic therapy of endocarditis. Trimethoprim-sulfamethoxazole (TMP-SMX) therapy was only commenced at three weeks after the start of fever because of delayed presentation. Every effort should be made to identify this organism in the laboratory. When clinically indicated, early presumptive antibiotic therapy with TMP-SMX should be started.

Burkholderia Infections↗

PubMed2004

Amnioinfusion in thick meconium.

OBJECTIVE: There are conflicting reports regarding the results of amnioinfusion in the management of meconium passage in utero. This study was done to evaluate transcervical amnioinfusion for meconium stained amniotic fluid during labour. METHODS: 196 women at term in early labour with meconium were randomized to receive either transcervical intrapartum amnioinfusion with saline (96) or routine obstetrical care (100). Transcervical amnioinfusion of one liter saline infused over 30-45 minutes. End points were relief of decelerations, incidence of vaginal delivery, presence of meconium below the neonatal cords, and X-ray evidence of meconium aspiration. RESULTS: Amnioinfusion resulted in relief of decelerations in 75% of cases as compared to 7% in the control group. Eighty-eight percent of patients delivered vaginally as compared to 58% in the control group (p< 0.001). Neonatal outcome was significantly better in the infusion group. The incidence of meconium below the vocal cords was reduced from 48% to 17% (p< 0.004) using amnioinfusion with positive X-rays for meconium aspiration in only 12.5% versus 26% (p < 0.5). CONCLUSIONS: We concluded that transcervical intrapartum amnioinfusion is a safe, simple and inexpensive technique that reduces operative intervention and improves neonatal outcome, and is of tremendous relevance in developing countries.

Amniotic Fluid↗

PubMed2004

Bacterial vaginosis and vaginal anaerobes in preterm labour.

Maternal genital infections, particularly bacterial vaginosis has been implicated as a cause for preterm labour and adverse pregnancy outcomes. This prospective study aimed to study the association of bacterial vaginosis with preterm labour. The prevalence of bacterial vaginosis was studied in 60 women in preterm labour who had no recognisable cause for prematurity and in 60 term labour controls. Demographic factors, pregnancy outcome and reproductive history were also studied. Vaginal specimens for Gram-stain and culture were collected from posterior vaginal fomix and bacterial vaginosis was defined by evaluation of Gram-stained smear by Spiegel criteria. Bacterial vaginosis was diagnosed in 31.6% of women in preterm labour and in 15% of term labour controls ( p<0.05). In preterm labour group, preterm delivery occurred in 48 women (80%) out of which 18 women had bacterial vaginosis and term delivery occurred in only one woman with the condition. Anaerobes were significantly associated with bacterial vaginosis ( p<0.01) and were more common in women with preterm labour ( b>0.05). The results indicates that bacterial vaginosis has a significant association with preterm labour and adverse pregnancy outcome.

Adult↗

PubMedDate not supplied

Cytomorphology and histomorphology after thermal endometrial ablation. Early changes.

OBJECTIVE: Endometrial thermal balloon ablation is a recent technique for treatment of dysfunctional uterine bleeding. Although the histologic features of thermal injury to the endometrium have been documented, the cytologic features are not described in the literature. In this study, the cytomorphology of recent thermal injury was studied and correlated with histomorphology. STUDY DESIGN: The study consisted of 29 cases divided into 3 groups: (1) control group, hysterectomies without ablation; (2) specimen (in vitro) group, where ablation was carried out on the uteri in the immediate postoperative period; and (3) in vivo group, with intraoperative endometrial ablation. The cytotoxic effect of thermal injury was assessed by staining the smears for oxidative enzymes. RESULTS: The cytomorphologic features of in vivo thermal ablation were characteristic and composed of fragmented glands, numerous single cells with fuzzy cytoplasm and giant cells. Staining for dehydrogenases was absent from > 90% of endometrial cells in the in vivo cases as against 100% positivity in the control group. CONCLUSION: The cytomorphologic features described for the first time in this study can be applied to endometrial aspirate or brush smears to evaluate the efficacy of the technique and follow-up.

Catheterization↗