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Biomedical subjects

S Bhaskaran

Publications and source records attributed to S Bhaskaran.

At least 19 recordsLinked to original sources
PubMed1996

Continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis (CAPD) was used as renal replacement therapy in 55 patients for 666 patient months. Thirty five patients had Type II diabetes. They ranged in age from 1-83 years. Majority of the patients were above 50 years of age who could not be transplanted due to various comorbid conditions. The incidence of peritonitis was 1 episode every 20 patient months. Twenty five patients dropped out during the observation period. The major cause of drop-out was death due to underlying coronary artery disease. Three patients underwent renal transplantation.

Adolescent↗
PubMed1995

Effect of proteolytic and glycolytic enzymes on a factor in Sorghum bicolor that induces mycelial growth in the smut fungus, Sporisorium reilianum.

Proteins obtained from seedling shoots and floral meristems of Sorghum bicolor (L.) Moench cv. NK 1210 induced mycelial growth in the smut fungus, Sporisorium reilianum in vitro. Proteins precipitated with trichloroacetic acid and ammonium sulfate were equally effective as inducers, although there were minor variations in the pattern of mycelial growth. Hydrolysis of the protein fraction with the proteolytic enzyme pronase E resulted in considerable reduction in the proteins' ability to induce mycelial growth. Digestion of the protein fraction with driselase, resulted in a slight enhancement of biological activity. The results suggest that amino sugar moieties in glycoproteins may act as inducers of mycelial growth in Sporisorium reilianum.

Edible Grain↗
PubMed1994

A study of hepatitis B surface antigen positive patients on haemodialysis and following transplantation.

Of 1339 patients who entered the dialysis and transplantation program, 104 (7.77%) patients were HBsAg positive. On dialysis, 15 of 104 patients (14.42%) developed icteric hepatitis (serum bilirubin > 2 mg/d1) and 7 patients (6.73%) developed anicteric hepatitis (SGOT > twice the upper limit of normal--normal 5-40 IU); one patient died of hepatic failure. Sixty five patients underwent live related transplantation. Actuarial graft survival at the end of 1 year, 2 years and 6 years were 81.67%, 73.98% and 69.36% respectively, and there was no significant difference compared to the negative group. 8 grafts (12.31%) were lost due to patient death due to infection in the HBsAg positive group compared to 27 out of 390 (6.923%) HBsAg negative patients (x2 = 1.88 P > 0.1). Post transplantation hepatic dysfunction was seen in 7 out of 65 (10.77%) patients and two patients died of hepatic failure.

Actuarial Analysis↗
PubMedDate not supplied

The effect of small solute clearances on survival of anuric peritoneal dialysis patients.

OBJECTIVE: Primarily, to determine whether peritoneal small solute clearance is related to patient and technique survival among anuric peritoneal dialysis [continuous ambulatory (CAPD) and automated peritoneal dialysis (APD)] patients. A secondary goal was to describe the ability to attain Dialysis Outcomes Quality Initiative (DOQI) targets among anuric patients on peritoneal dialysis. DESIGN: Retrospective cohort study via chart reviews. SETTING: Peritoneal Dialysis Unit of Toronto Hospital (Western Division). PATIENTS: The study included 122 CAPD and APD patients between January 1992 and September 1997, with 24-hour urine volume less than 100 mL, or renal creatinine clearance (CCr) less than 1 mL/minute. Adequacy data were available for 115 patients. OUTCOME MEASURES: Mortality and technique failure (TF). Regression analysis was used to estimate the mortality and TF rate ratios (RR) for peritoneal Kt/V urea (pKt/V) and pCCr, adjusting for age, gender, diabetes, months of follow-up prior to anuria, albumin, transport status, coronary artery disease, cardiovascular disease, and peripheral vascular disease. RESULTS: Fifty seven per cent (51/89) of patients on CAPD and 81% (21/26) on APD had a weekly pKt/V > or = 2 and > or = 2.2, respectively (DOQI targets); whereas only 35% on CAPD (31/89) and 35% (9/26) on APD had a weekly pCCr > or = 60 U1.73 m2 and 66 L/1.73 m2, respectively. Median follow-up times among patients were 16.5 and 19.5 months pre- and postanuria, respectively. Patients with pKt/V > or = 1.85 experienced a strong decrease in patient mortality (RR = 0.54, p= 0.10); the effect was less pronounced for pCCr > or = 50 L/1.73 m2 (RR = 0.63, p = 0.25). No relationship was observed between pKt/V or pCCr and TF. CONCLUSION: Mortality was noticeably less frequent among patients with a pKt/V > or = 1.85 compared with those with a Kt/W < 1.85 (p = 0.10). Given the magnitude of the association, the failure to observe statistical significance relates to the size of the patient cohort. Our results imply that it is, in fact, possible to achieve DOQI targets among anuric patients on peritoneal dialysis.

Anuria↗
PubMedDate not supplied

Rate of decline of residual renal function in patients on continuous peritoneal dialysis and factors affecting it.

OBJECTIVE: We analyzed residual renal function (RRF) in a large number of new peritoneal dialysis (PD) patients to prospectively define the time course of decline of RRF and to evaluate the risk factors assumed to be associated with faster decline. STUDY DESIGN: Single-center, prospective cohort study. SETTING: Home PD unit of a tertiary care University Hospital. PATIENTS: The study included 242 patients starting continuous PD between January 1994 and December 1997, with a minimum follow-up of 6 months and at least three measurements of RRF. MEASUREMENT: All patients had data on demographic and laboratory variables, episodes of peritonitis and the use of aminoglycoside (AG) antibiotics, temporary hemodialysis, and number of radiocontrast studies. Adequacy of PD was measured from 24-hour urine and dialysate collection and peritoneal equilibration test using standard methodology. Further data on RRF was collected every 3 to 4 months until the patient became anuric (urine volume < 100 mL/day or creatinine clearance < 1.0 mL/min) or until the end of study in December 1998. OUTCOME MEASURE: The slope of the decline of residual glomerular filtration rate (GFR) (an average of renal urea and creatinine clearance) was the main outcome measure. Risk factors associated with faster decline were evaluated by a comparative analysis between patients in the highest and the lowest quartiles of the slopes of GFR, and a multivariate analysis using a stepwise option within linear regression and general linear models. RESULTS: There was a gradual deterioration of residual GFR with time on PD, with 40% of patients developing anuria at a mean of 20 months after the initiation of PD. On multivariate analysis, use of a larger volume of dialysate (p = 0.0001), higher rate of peritonitis (p = 0.0005), higher use of AG (p = 0.0006), presence of diabetes mellitus (p = 0.005), larger body mass index (BMI) (p = 0.01), and no use of antihypertensive medications (p = 0.04) independently predicted the steep slope of residual GFR. Male gender, higher grades of left ventricular dysfunction, and higher 24-hour proteinuria were associated with faster decline on univariate analysis only. CONCLUSION: Faster decline of residual GFR corresponds with male gender, large BMI, presence of diabetes mellitus, higher grades of congestive heart failure, and higher 24-hour proteinuria. Higher rate of peritonitis and use of AG for the treatment of peritonitis is also associated independently with faster decline of residual GFR. Whether the type of PD (CAPD vs CCPD/NIPD) is associated with faster decline of residual GFR remains speculative.

Adult↗
PubMedDate not supplied

Mortality and morbidity associated with ophthalmic surgery.

BACKGROUND AND OBJECTIVES: To study the mortality and morbidity among the patients undergoing ophthalmic surgery under local or general anesthesia. MATERIALS AND METHODS: A retrospective analysis of all patients who underwent ophthalmic surgery at Sankara Nethralaya, Madras, India, between 1979 and 1988, was performed. Relevant details included the preoperative medical status of the patients (ASA status), type of surgical procedure, type of anesthesia, and intraoperative and postoperative complications. RESULTS: The overall mortality rate was 1.15 per 1000. There was a decrease in the mortality rate from 2.09 per 1000 in the first 5-year period to 0.37 per 1000 in the second 5-year period. The factors significantly associated with mortality were hypertension, presence of cardiac pacemaker, renal disease, duration of surgery, type of surgery, and physical status (American Society of Anaesthesiologists classification). CONCLUSION: Identifying the risk factors can help reduce the mortality in ophthalmic surgery.

Adult↗
PubMedDate not supplied

Blood urea levels 30 minutes before the end of dialysis are equivalent to equilibrated blood urea.

The steady decline in blood urea during high efficiency hemodialysis is followed by a rebound phase after dialysis in which the level of urea rises to an equilibrium value (Ct + 30) that may be up to 20% higher than the immediate post dialysis (Ct) concentration. The artificially low urea concentration immediately after dialysis leads to an overestimate of the efficiency of the dialysis calculated by Kt/V if the true equilibrium blood concentration of urea is not used in the calculation by the single-pool urea kinetic model. The measurement of equilibrium urea concentration requires a blood sample approximately 30 min after hemodialysis, which is an encumbrance on dialysis patients. This study was undertaken to determine whether an intradialytic sample taken 30 min before the end of dialysis (Ct - 30) may be representative of the equilibrium sample, and to compare the Kt/V using the Ct - 30 and Ct + 30 samples. Thirty-six patients were studied and blood urea concentrations were measured half an hour before the end of dialysis (Ct - 30), at the end of dialysis (Ct), and half an hour after the end of dialysis (Ct + 30). Kt/V (Daugirdas method) was calculated using urea concentration 30 min before the end of dialysis (Kt/Vt - 30) and was compared with Kt/V calculated using equilibrium urea concentration (Kt/Vt + 30). There were no significant differences between the Kt/Vt - 30 and the KtVt + 30 (1.25 versus 1.22, p = 0.65). The correlation between Kt/Vt - 30 and Kt/Vt + 30 was excellent with r2 = 0.93, regression y = 1.05 x -0.033. Kt/Vt - 30 also compared favorably with the Kt/V double pool method (Kt/Vdp) described by Daugirdas (1.25 versus 1.19, p = 0.23). Using the Ct - 30 to calculate Kt/V by the percent urea reduction methods of jindal (Kt/Vpru) decreases the Kt/V value by 0.14 on average, but it remains significantly higher than the Daugirdas method. The authors conclude that calculations using urea concentration 30 min before the end of dialysis improves the accuracy of dose estimation in high efficiency dialysis, without inconveniencing the patient.

Female↗