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Biomedical subjects

S Bajaj

Publications and source records attributed to S Bajaj.

At least 19 recordsLinked to original sources
PubMed1996

Percutaneous cardiopulmonary bypass-supported coronary angioplasty in patients with unstable angina pectoris or myocardial infarction and a left ventricular ejection fraction < or = 25%.

The objective of this study was to determine the acute and long-term results of percutaneous cardiopulmonary bypass-supported angioplasty in treating high-risk patients with unstable presentations and severely depressed left ventricular (LV) function (ejection fraction [EF] < or = 25%). One hundred seven consecutive patients with a mean LVEF of 19 +/- 3% were studied. Seventy-four patients (69%) had unstable angina, 60 (56%) had New York Heart Association class III or IV symptoms, 74 (69%) had recent (< 15 days) documented acute myocardial infarction, 103 (96%) had 3-vessel disease, and 58 (54%) had only 1 remaining patent artery. A total of 50 patients (47%) were deemed unsuitable for bypass surgery. Of 196 severe narrowings attempted in 166 coronary arteries, 193 (98%) were successfully dilated in 105 patients (98%), and there was no procedure-related mortality, Q-wave myocardial infarction, or urgent requirement for coronary bypass surgery. There were 5 in-hospital deaths (4.7%) and the remaining 102 patients have been followed for 24.5 +/- 1.3 (mean +/- SE) months. Twenty-three patients (21%) died between 1 and 23 months after the procedure. One- and 2-year survival free of cardiac death was 83% and 77%, respectively. Of the 79 surviving patients, 65 have survived event free of myocardial infarction and revascularization; event-free survival for 1 and 2 years was 76% and 69.5%, respectively. In the 64 patients in whom LV function was measured before and after the procedure, global EF increased from 20.6% to 29.3% (p < 0.001). Patients who remained event free had a greater improvement in LVEF than those who had a cardiac event during follow-up (p < 0.05). Thus, this study demonstrates the safety and efficacy of percutaneous cardiopulmonary bypass-supported angioplasty in the immediate treatment of high-risk unstable patients with multivessel coronary artery disease and severely depressed LV function.

Actuarial Analysis↗
PubMed1993

Magnetic resonance imaging of the brain in idiopathic hypogonadotropic hypogonadism.

Magnetic resonance imaging (MRI) of the pituitary, hypothalamus and olfactory sulci was performed in 40 patients with idiopathic hypogonadotropic hypogonadism (IHH). Twelve of these patients had an impaired sense of smell (Kallmann's syndrome). Sagittal and coronal imaging revealed no morphological abnormalities in the hypothalamic-pituitary region. On axial imaging rudimentary, hypoplastic or aplastic olfactory sulci were found in eight cases. All patients with olfactory sulcal abnormalities had associated hyposmia (one case) or anosmia (seven cases). Structural defects identifiable on MRI were present only in 20 per cent of patients with IHH.

Adult↗
PubMed1993

Coronary collateral circulation in the transplanted heart.

BACKGROUND: The concept that coronary collateral (CC) circulation can develop in cardiac transplant recipients (CTR) is controversial. Indeed, a decreased occurrence of CC in CTR has been previously reported. METHODS AND RESULTS: We reviewed 102 coronary angiograms in 73 CTR to evaluate the presence and significance of CC in denervated human hearts. These angiograms were compared with angiograms of 70 nontransplanted patients. Twenty-six CTR who had undergone at least two coronary angiograms, thus allowing comparative evaluations, form the basis for this study. Angiograms were analyzed using a modification of CC classification (Rentrop et al) from grade 0 for complete absence to grade 4 representing mature collateral with clear filling of epicardial vessels. Coronary artery disease was classified according to the scheme reported by Gao et al. For the purpose of this study, all type A lesions were grouped as large vessel disease (LVD), and types B1, B2, and C were collectively grouped as small vessel (epicardial) disease (SVD). The presence of CC circulation in all 73 CTR was grade 0, 7 (10%); grade 1, 41 (56%); grade 2, 33 (45%); grade 3, 30 (41%); and grade 4, 5 (7%). However, in control nontransplanted subjects grades 0, 1, 2, 3, and 4 were found in 47 (67%), 22 (31%), 4 (6%), 11 (15%), and 16 (20%) patients, respectively. The presence of mature collaterals (grade 4) in both groups were associated with type A lesions and was frequent in nontransplanted hearts. In contrast, grade 2 and grade 3 vascular channels probably representing CC with "myocardial blush" was more frequent in CTR and was mostly associated with small vessel coronary arteriopathy. CONCLUSIONS: These results suggest the presence of atypical CC in patients with cardiac allograft arteriopathy. It is speculated that this atypical form of CC with "blush pattern" may represent an angiogenic response to microvascular ischemia due to allograft coronary arteriopathy.

Adult↗
PubMed1992

Immediate and long-term results of delayed recanalization of occluded acute myocardial infarction-related arteries using coronary angioplasty.

Recent evidence suggests that late reperfusion of an occluded infarct-related artery after acute myocardial infarction (AMI) may convey a better prognosis. The clinical outcome of percutaneous transluminal coronary angioplasty (PTCA) as a means of mechanical reperfusion in this particular setting has not been clearly delineated. Ninety-seven patients with AMI underwent PTCA of the occluded infarct-related artery after the acute phase of the AMI (48 hours to 2 weeks, mean 8 +/- 4 days). The study consisted of 72 men (74%) (mean age 56.5 +/- 12 years) and 25 women. Seventy-seven patients (79%) had a Q-wave AMI and 20 patients (21%) a non-Q-wave AMI. Seventy-six patients (79%) had angina after AMI and 4 had previously undergone coronary bypass surgery. Clinical success was achieved in 85 patients (87%). Angiographic success was obtained in 90 of the 97 occluded arteries (93%) and was similar for all 3 major vessels: right coronary 97%, left anterior descending 93% and circumflex 85% (p = not significant). Major complications (AMI, emergency bypass and death) occurred in 3 patients (3.1%). Long-term follow up (3.7 +/- 0.8 years) revealed symptomatic recurrence in 20 (23%), whereas 51 (58%) remained asymptomatic. Most recurrences (16 of 20) were in the form of restenosis rather than reocclusion, with a high success rate for repeat dilation (93%). These results indicate that mechanical reperfusion of an occluded infarct artery, performing PTCA 48 hours to 2 weeks after AMI, has a high success rate, a low complication rate and low symptomatic restenosis.

Adult↗
PubMed1992

Isoniazid induced neuropathy in slow versus rapid acetylators: an electrophysiological study.

Clinical, biochemical and nerve conduction studies were performed in 100 cases of tuberculosis taking isonicotinic acid hydrozide (isoniazid) for more than 12 weeks. Electro-physiological studies were carried out in a similar number of normal age and sex matched controls. In 16 percent of cases an abnormality was documented in the motor nerve conduction velocity, amplitude and terminal latency of the common peroneal, ulnar and median nerves; of these, only two patients had objective evidence of neuritis. The occurrence of isoniazid neuropathy was found to be more in the fourth decade of life (10 of 16), in those who had taken the drug for over six months (13 of 16), and in 'slow' inactivators (10 of 16).

Acetylation↗
PubMed1991

Contrast computed tomography in epilepsy with special reference to intracranial ring or disc enhancing lesions.

We report the results of computed tomography (CT) in 170 patients who developed seizures. Localized signs could be demonstrated by neurologic examination in 23.5%. CT findings were normal in 64 patients (37.6%). The commonest abnormality was a focal ring or disc enhancing lesion in 66 patients (62.3%) followed by calcification (18 patients; 16.9%), cerebral atrophy (9; 8.5%), vascular lesions (7; 6.6%), tumours (4; 3.8%) and congenital hydrocephalus (2; 1.9%). The occurrence of abnormal CT was higher (74.3%) in patients with partial seizures.

Adolescent↗
PubMed1991

A prospective study of 14 cases of motor neuron disease.

Fourteen consecutive patients with motor neuron disease were studied during a period of one year. Seven patients were in the second decade of life, with eleven below the age of 40 years. Males accounted for 13 cases. Four had sustained some trauma in the past, one had poliomyelitis. Younger patients (average age 17.9 years) usually had an asymmetrical lower motor neuron lesion which was gradually progressive (the Norris score reached an average of 89.9 in a mean period of 36.9 months). A largely symmetrical distribution affecting both the upper and lower motor neurons and the lower cranial nerves with a rapidly downhill course (the Norris score fell to 80.3 in 12.9 months) were the features observed in older patients (average age 46.7 years). Cerebrospinal fluid protein was raised in four cases. Anti-neural antibodies were not demonstrable in any of the patients.

Adolescent↗
PubMed1989

Clinical profile and electrodiagnostic study of peripheral neuropathy.

A clinical analysis and electrophysiological study was performed in 40 cases of peripheral neuropathy. Motor nerve conduction velocity (MNCV) and electromyography (EMG) were also recorded in 20 healthy volunteers. Twelve cases were of diabetic neuropathy (DN), nine of Guillain-Barre syndrome (GBS), eight of idiopathic, six of leprous, three of toxic neuropathy and one each of acute intermittent porphyria (AIP) and carcinomatous neuropathy. The onset was insidious in a majority of the cases (70%), the presenting symptom being paraesthesia (27.5%). A variable sensory loss was the commonest finding (77.5%). Two patients each had evidence of cranial nerve involvement and affection of urinary bladder and bowel. In both DN and GBS there was a significant reduction in the MNCV especially in the peroneal nerves. In DN 41.6% had evidence of decreased motor unit potentials and 16.6% showed spontaneous fibrillatory activity. For GBS these figures were 77.7% and 8.3% respectively. The peripheral nerve involvement was variable in leprosy and the EMG was normal in all, but one case.

Adult↗
PubMed1989

A study on tropical splenomegaly syndrome and chloroquine prophylaxis.

Forty-two adults (22 males, 20 females) with tropical splenomegaly syndrome (TSS) were studied. Majority (88.1%) presented with complaints related to grossly enlarged spleen (greater than 10 cm). The duration of splenomegaly was 1 to 5 years in 54.8%. In 80.9% there was anaemia (Hb less than 10 g%). None of the patients had a macrocytic blood picture. Evidence of portal hypertension was observed in 56.7% and almost a similar number (58.1%) had raised intrasplenic pressure. The liver histology was entirely normal in only 8.8%. T-cell lymphopenia with B-cell lymphocytosis was a prominent feature. IgM values were raised in 73.8% and malarial antibody titres in 91.7% patients. Sixty-nine per cent of cases showed a distinct clinical and biochemical improvement after chloroquine chemoprophylaxis. Though a malarial origin in the development of TSS is favoured its precise aetiology is as yet speculative.

Adolescent↗
PubMed1986

Neuromyelitis optica: a case report from India.

A young Indian male was admitted for paraplegia of acute onset and with bilateral optic neuritis. The diagnosis of neuromyelitis optica was made. This is possibly the first case report of its kind from India.

Adult↗