PubMed Health⌕ Search

Biomedical subjects

T R Varma

Publications and source records attributed to T R Varma.

At least 19 recordsLinked to original sources
PubMed1992

Effect of stereotactic thalamic lesion on essential tremor.

The cause of essential (low-frequency) tremor is unknown and its relation to physiological (high-frequency) tremor is unclear. We assessed essential tremor in one patient before and after a stereotactic thalamic lesion. The procedure changed the size of the tremor in the right hand but not in the left. Persistence of a low-frequency component suggested that essential tremor was an additional feature superimposed on physiological tremor in this patient. The focus of essential tremor seems to be an autonomous central generator that is independent of physiological tremor mechanisms.

Adult↗
PubMed1991

Genital tuberculosis and subsequent fertility.

A successful pregnancy ending in live birth at term is very rare following genital tuberculosis, in spite of effective medical treatment for tuberculosis. The medical, surgical or combined treatments all are associated with relatively poor fertility outcome. In vitro fertilization and embryo replacement have been found to be successful in a few patients.

Adult↗
PubMed1991

Massive obstetric hemorrhage due to placenta previa/accreta with prior cesarean section.

There is a high association between anterior placenta previa, placenta accreta and previous cesarean section. We report three cases which illustrate the particular danger of massive hemorrhage posed by placenta previa/accreta in a scarred uterus. As the incidence of cesarean section continues to rise worldwide, the problem of placenta previa/accreta is likely to become more common. We emphasize the need for each obstetric unit to have a protocol for dealing with massive hemorrhage.

Adult↗
PubMed1991

An extraventricular colloid cyst: case report.

A case of a 33-year-old woman with a right fronto-parietal extracerebral lesion is reported. This lesion had all the features of a colloid cyst. Colloid cysts outside the third ventricle have been only rarely reported, but apparently never outside the ventricular system.

Adult↗
PubMed1989

Spinal arachnoiditis following subarachnoid haemorrhage.

Two cases of chronic adhesive spinal arachnoiditis following documented subarachnoid haemorrhage (SAH) are reported. Both cases progressed to severe spinal cord dysfunction with paraplegia. It is hoped that this case report will highlight this uncommon but extremely disabling complication of SAH.

Adult↗
PubMed1988

Ultrasound evaluation of amniotic fluid: outcome of pregnancies with severe oligohydramnios.

We studied a group of 247 patients out of 7725 patients who had an ultrasonic examination between 32 and 36 weeks gestation and were found to have oligohydramnios (amniotic fluid volume (AFV) less than or equal to 2.0 cm). We compared the features of labor and mode of delivery and perinatal outcome in this group with that of a normal control group of 247 patients who also had an ultrasonic examination between 32 and 36 weeks gestation and were found to have normal AFV (greater than 2.0 to less than 8.0 cm). The incidence of induction of labor, of elective cesarean section, of preterm delivery (less than 37 weeks' gestation) was significantly higher in the oligohydramnios group (study group) as compared with the incidence in the control group (P less than 0.05). The incidence of fetal distress in antenatal and intrapartum period, pH (less than or equal to 7.2), of low Apgar score (0-5), of intrauterine growth retardation (IUGR) (less than tenth centile) infants, of major fetal anomaly and perinatal mortality rate (PNMR) are significantly higher in the oligohydramnios group as compared with the incidence and PNMR in the normal control group (P less than 0.05). The ultrasonic finding of oligohydramnios should alert the clinician regarding the possibility of problems in labor and perinatal period.

Adult↗
PubMed1988

Ultrasonic assessment of ovulation in cyclofenil induced ovulatory cycles.

Graafian follicle growth was studied by ultrasound scanning during the peri-ovulatory period in 64 ovulatory cycles in 32 infertile patients on cyclofenil treatment, and compared with a control group of 32 patients with confirmed ovulatory cycles assessed on the basis of serum progesterone levels in the middle of the second half of the cycle. The mean maximum diameters of the leading follicles before ovulation were 21.9 +/- 0.6 (S.E.) mm and 24.4 +/- 0.5 (S.E.) mm, respectively for the cyclofenil group and the normal control group (P greater than 0.05). In 79% of the cyclofenil stimulated group and 83% of the spontaneous ovulation group, ultrasonic evidence of ovulation was present between 12 and 36 h after the initial increase in urine LH levels. Ultrasound scanning was found to be simple, and a quick method of monitoring graafian follicle development and ovulation on cyclofenil therapy and the cycles were comparable to the spontaneous ovulatory cycles as assessed on the basis of graafian follicle diameter, and the time of ovulation. Cervical score was not found to be useful to assess ovulation time in the cyclofenil treated group since 31.3% achieved a score of 10 or more on day -4, 93.8% within 24 h of ovulation and 24% on day 3 following the ovulation.

Cresols↗
PubMed1988

The relationship of increased amniotic fluid volume to perinatal outcome.

We studied a group of 135 patients with polyhydramnios diagnosed on the basis of ultrasonic findings (greatest vertical diameter of the liquor column greater than or equal to 8.0 cm) between 32 and 36 weeks gestation (study group). We compared the obstetric characteristics and perinatal outcome of the study group with a similar number who constituted our control group. The incidence of women aged 20 years or less was higher in the study group (8.9%) compared with 4.5% in the control group. Of the 135 patients who were diagnosed to have polyhydramnios ultrasonically, the clinical diagnoses prior to referral for ultrasonic scanning, were, suspected large for date fetuses in 34 patients (25.2%), clinically suspected polyhydramnios in 28 (20.7%), gestational diabetes in 21 (15.6%) and insulin dependent diabetes in 6 (4.4%) compared with 13.3%, 5.2%, 3.0% and 0.7%, respectively in the control group (P less than 0.05). Preterm delivery occurred in 11.1% in the study group compared with the incidence of 6.7% in the control group. The incidence of fetal distress, low Apgar Score, macrosomic infants, major fetal anomalies, gross and corrected perinatal mortality rate and admission to special/intensive care nursery was significantly higher in the study group compared with that of the control (P less than 0.01). We found ultrasonic examination is a reliable technique to assess the amount of amniotic fluid volume and it alerts the clinician to possible future problems in pregnancy, labor and neonatal period.

Adult↗
PubMed1988

Virilization due to a rare ovarian tumor in a postmenopausal woman.

A 60-year-old postmenopausal woman presented with evidence of hirsutism, alopecia and mild virilization. Clinical examination and biochemical abnormalities suggested that the source of androgen excess was ovarian, and an ovarian tumor was confirmed and removed at laparotomy followed by normal endocrine profile in the postoperative period.

Female↗
PubMed1988

The effect of mesterolone on sperm count, on serum follicle stimulating hormone, luteinizing hormone, plasma testosterone and outcome in idiopathic oligospermic men.

Two hundred fifty subfertile men with idiopathic oligospermia (count less than 20 million/ml) were treated with mesterolone (100-150 mg/day) for 12 months. Seminal analysis were assayed 3 times and serum follicle stimulating hormone (FSH) luteinizing hormone (LH) and plasma testosterone were assayed once before treatment and repeated at 3, 6, 9 and 12 months after the initiation of treatment. One hundred ten patients (44%) had normal serum FSH, LH and plasma testosterone, 85 patients (34%) had low serum FSH, LH and low plasma testosterone. One hundred seventy-five patients (70%) had moderate oligospermia (count 5 to less than 20 million/ml) and 75 patients (30%) had severe oligospermia (count less than 5 million/ml). Seventy-five moderately oligospermic patients showed significant improvement in the sperm density, total sperm count and motility following mesterolone therapy whereas only 12% showed improvement in the severe oligospermic group. Mesterolone had no depressing effect on low or normal serum FSH and LH levels but had depressing effect on 25% if the levels were elevated. There was no significant adverse effect on testosterone levels or on liver function. One hundred fifteen (46%) pregnancies resulted following the treatment, 9 of 115 (7.8%) aborted and 2 (1.7%) had ectopic pregnancy. Mesterolone was found to be more useful in patients with a sperm count ranging between 5 and 20 million/ml. Those with severe oligospermia (count less than 5 million) do not seem to benefit from this therapy.

Adult↗
PubMed1988

Outcome of pregnancy after infertility.

Pregnancy following a period of infertility was considered to be an increased risk for the fetus. During a period of 3 years (1983-85), 748 couples were seen at this infertility clinic; 515 women (68.9%) conceived, and were followed up and studied prospectively. Fifteen of these women moved out of the area. We analysed the results of pregnancies for the remaining 500, (Group 1) and compared them with the outcome for the total obstetric population (Group 2) during the same period. Mean age at conception in the infertility group (Group 1) was 31.8 (+/- 2.7, 2 SD) years, as compared with 23.7 (+/- 2.9, 2 SD) in the total hospital obstetric population (Group 2) (p less than 0.05). The incidences of spontaneous abortion for the two groups (8 and 6.2%) did not differ (p greater than 0.05). However, the incidence of ectopic pregnancy was higher (3.0%) in Group 1 than in Group 2 (1.5%) (p less than 0.01). The incidence of pre-existing hypertensive vascular disease (7.7%) complicating pregnancy and multiple pregnancy (4.1%) was significantly higher in Group 1 than in Group 2 (1.5% and 1.4% respectively), (p less than 0.01). The incidences of induction of labor (29.5%) and elective operative delivery (10.6%) were higher in Group 1 (p less than 0.01). The incidences of infants with birth weight below the tenth centile (12.9%), of fetal distress in labor (14.6%) and a low Apgar score (0-5) (9.5%), were higher in Group 1, but there was no difference in the perinatal mortality rate between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Spontaneous↗
PubMed1988

Ovarian hyperstimulation syndrome. A case history and review.

For the past two decades, significant advances have been made in the treatment of anovulation. The use of therapeutic agents for induction of ovulation, however, has given rise to several adverse reactions, the most important and serious of such complications being the ovarian hyperstimulation syndrome (OHSS), which can be fatal. It is characterized by gross ovarian enlargement, ascites, pleural effusion, hemoconcentration and thromboembolic disorder, which are potentially lethal conditions. The main pathogenic mechanism is considered to be increased capillary permeability, especially of the ovarian vessels, causing acute body fluid shift from the intravascular compartment to the peritoneal and pleural cavities. An experimental model of OHSS suggests that prostaglandins mediate this increased capillary permeability and transudation. Management is based on the concept of the pathogenic mechanism and includes maintenance of intravascular volume by plasma volume expanders, reduction of capillary permeability and prevention of thromboembolic complications. Surgical intervention is indicated only in cases of ovarian torsion or rupture and should be as conservative as possible.

Adult↗
PubMed1987

Infertility.

Explore the source record for details and available documents.

Adult↗
PubMed1987

Outcome of pregnancy following investigation and treatment of infertility.

We studied 500 women who conceived after investigation and treatment for different infertility problems and compared the outcome of the 5 infertility groups (Group 1 to 5), the ovulatory dysfunction (Group 1), male infertility (Group 2), A.I.D. (Group 3), tubal surgery and IVF (Group 4) and no treatment (Group 5) with the outcome in the hospital group during a period of 3 years. The incidence of abortion in Group 3 is significantly higher (13.8%), the incidence of ectopic pregnancy is significantly higher in Group 4 (21.7%) as compared with the incidence in the hospital group (P less than 0.01). The rate of pre-existing hypertension and gestational diabetes is significantly higher in all the 5 infertility groups as compared with the incidence in the hospital group (P less than 0.05). The incidence of preterm labor in general is less in the infertility group as compared with the incidence in the hospital group (P greater than 0.05). The incidence of older women, multiple pregnancy, induction of labor, operative deliveries, fetal distress, low Apgar score, babies with birth weight below the tenth centile were higher in the infertility groups (P less than 0.05). But the perinatal mortality or major or minor fetal anomalies were not significantly different in the infertility groups as compared with the rate in the hospital groups (P greater than 0.05).

Abortion, Spontaneous↗
PubMed1987

Combined intrauterine and extrauterine gestation: a report of case history and review.

Combined intrauterine and extrauterine gestation is very rare. There is a higher maternal morbidity and fetal loss, due to delayed or missed diagnosis. We present a patient who was treated for primary infertility with ovulation induction agents, who presented later with combined intra- and extra-uterine gestation with successful outcome following delivery of a healthy male infant at 38 weeks gestation.

Adult↗
PubMed1987

Ultrasonic assessment of cervix in "at risk" patients.

One hundred seventy patients were considered to be at risk of cervical incompetence from their previous history. They were scanned serially from the first trimester to 36 weeks gestation. Of the 170, 105 patients (61.8%) were found to have defective cervix (the length of cervix, width of the cervix, and cervical canal at the level of the internal cervical os, and herniation of amniotic membrane with or without fetal parts into the cervical canal). Of the 105 patients diagnosed to have defective cervix (possible cervical incompetence), 22 patients (21%) aborted, 48 patients (45.7%) had to have cervical cerclage, 26 patients (24.8%) had preterm delivery and the remaining 9 patients (8.5%) had no problems during pregnancy. The remaining 65 patients (38.2%) did not have ultrasonic evidence of cervical incompetence and 3 aborted and only 2 patients delivered between 35 and 37 weeks gestation while 60 patients delivered between 37 and 42 weeks gestation. These 65 patients would have had cervical cerclage on the basis of the clinical history alone, but in only 6, cervical cerclage was inserted.

Abortion, Habitual↗