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Biomedical subjects

V K Anand

Publications and source records attributed to V K Anand.

At least 19 recordsLinked to original sources
PubMed1992

Inconsistencies in the correlation between loss of brain stem auditory evoked response waves and postoperative deafness.

This case underscores the difficulty of predicting postoperative hearing status from brain stem auditory evoked response (BAER) monitoring when wave I is preserved and all later waves are lost. During an operation involving the base of the skull, sudden and irreversible loss of all BAER waves beyond wave I occurred unilaterally. Wave I was preserved, with reduced amplitude and minimal latency shift. There was no permanent postoperative hearing sensitivity loss or speech discrimination loss.

Adolescent↗
PubMed1992

Lower respiratory tract infection in hospitalized children due to respiratory syncytial (RS) virus during a suspected epidemic period of RS virus in Delhi.

A study of 131 children below 5 years of age seeking hospitalization due to lower respiratory tract infections (LRTI), comprising 56 cases of bronchiolitis, 61 cases of bronchopneumonia, and 14 cases of other lower respiratory tract diseases showed significant occurrence of bronchiolitis in younger age groups (chi 2 = 79.21; P less than 0.001). Employing two rapid techniques, viz. immunofluorescent antibody technique (IFAT) and enzyme immunoassay (EIA) along with tissue culture, Respiratory Syncytial (RS) virus could be detected in higher percentage of bronchiolitis cases (54 per cent by both culture and IFAT, 70 per cent by EIA) compared to bronchopneumonia (36 per cent by both culture and IFAT, 49 per cent by EIA) and other LRTI cases (14 per cent each by culture, IFAT and EIA). The detection rate of RS virus was higher in the age group 0-6 months compared to the remaining age groups combined (7-60 months) in bronchiolitis cases irrespective of the technique employed while no such difference could be noted in bronchopneumonia. Eighteen (90 per cent) out of 20 specimens positive for RS virus by EIA, but negative by culture were found to be true positives as revealed by blocking test. In comparison to culture, sensitivities of IFAT, EIA, and EIA (by blocking test) were found to be 89, 94, and 94 per cent, respectively, while specificities of these techniques were found to be 92, 74, and 76 per cent, respectively. Higher detection rate of RS virus in the present study compared to earlier ones from India is attributed to application of EIA as well as selection of LRTI cases during a period of suspected epidemic of RS virus.

Age Factors↗
PubMed1992

Surgical considerations in tracheal stenosis.

From 1969 to 1990, 43 patients with tracheal stenosis were treated at the University of Mississippi Medical Center. Seventy-four percent of these patients (n = 32) had intrinsic tracheal stenosis, most frequently as a complication of prolonged endotracheal trauma. A total of 41 distinctly separate stenotic segments were identified in the 32 patients. The stenoses were considered moderate or severe in 33 (80%) of the 41 cases and the length of the stenotic segment was greater than 1 cm in 23 (56%) of the cases. An overall 70% success rate was achieved following 93 surgical procedures in this group. The concurrent presence of glottic/subglottic stenosis, multiple segments of stenosis, bilateral vocal cord paralysis, tracheoesophageal fistula, and a tendency to marked hypertrophic scar formation were found to be significant factors in the surgical management of this patient group.

Adolescent↗
PubMed1992

Intracranial complications of mucormycosis: an experimental model and clinical review.

The clinical course of patients with mucormycosis of the paranasal sinuses can be unpredictable and is often determined by intrinsic host factors. The degree to and mechanism(s) by which these factors influence a patient's ability to survive the disease are poorly understood. Extensions to orbital and intracranial structures occur in some patients with paranasal sinus mucormycosis despite aggressive treatment. Controversies persist over adequate antifungal regimen, the precise role of hyperbaric oxygenation, and the appropriate extent of surgical debridement. We have developed an alloxan-induced immunocompromised murine model of mucormycosis in mice. Deferoxamine iron chelation produced rhinocerebral mucormycosis in these animals when challenged intraethmoidally with Rhizopus spores. The implications of our experimental studies in the content of our clinical experience in managing patients with intracranial extensions of paranasal sinus mucormycosis are discussed.

Adult↗
PubMed1992

Multidrug resistant typhoid fever: therapeutic considerations.

Forty six blood culture positive cases were studied during the current outbreak of multidrug resistant typhoid fever (MRTF). The present outbreak was caused by E1 phage type and organisms were resistant to all commonly used drugs for the treatment of typhoid fever, viz., chloramphenicol (78%), co-trimoxazole (76%) and ampicillin (68%). Treatment failures with chloramphenicol (45.5%) corroborated well with in vitro resistance. No treatment failure was seen with chloramphenicol and ceftriaxone, when these drugs were used in cases infected with sensitive strains. Among the alternative drugs used in cases with in vitro sensitivity, successful clinical response was seen with ceftriaxone (4/4) and cefotaxime (8/9) as compared to cephalexin (3/5) or a combination of cephalexin and furazolidone (9/12).

Ampicillin Resistance↗
PubMed1991

Obstructive sleep apnea: a comparison of continuous positive airway pressure and surgical treatment.

Since earlier descriptions of the syndrome of obstructive sleep apnea (OSA), various treatment alternatives have included a variety of medical regimens, continuous positive airway pressure (CPAP), tracheostomy, and other surgical options. A lack of acceptable criteria for surgical intervention remains an important concern for the surgeon. in an attempt to resolve some of the controversies pertaining to various therapeutic modalities, we performed a retrospective analysis--from 1983 to the present--of posttreatment results in patients who underwent surgical therapy and those who were treated primarily with CPAP at this institution. Of 400 patients diagnosed with OSA, only 66 underwent surgical treatment, including uvulopalatopharyngoplasty. CPAP was the mainstay of treatment in the majority of our patients. Post-treatment data were available for 50 patients treated with CPAP and for 45 patients treated surgically. A comparative analysis of polysomnographic studies revealed superior cures with CPAP, although long-term compliance remains a significant problem. We advocate CPAP as initial therapy in patients with no clinically apparent causes for obstruction (e.g., nasal polyps, deviated nasal septum, or obstructive tonsillar hypertrophy) because of the predictability of success, and lower costs and complication rates. Long-term followup of OSA patients is indicated, regardless of treatment modality.

Female↗
PubMed1991

A clinical profile of multidrug resistant typhoid fever.

Fifty blood culture positive patients of typhoid fever were studied during the current outbreak of the disease for their clinical profile. In 39 (78%) cases the isolates of S. typhi were resistant to conventional drugs. Children below 2 years of age constituted 20% of the total cases and belonged exclusively to the group with multidrug resistant typhoid fever (MRTF). The clinical presentation seemed to mimic malaria, bronchopneumonia, meningitis, etc. Typhoid hepatitis was diagnosed in 2 cases with MRTF. Life threatening complications were seen in 28.2% patients and were observed exclusively in MRTF group.

Child↗
PubMed1990

Zygomatic approach to skull-base lesions.

A modification of the preauricular skull-base approach is described. After sectioning and downward displacement of the zygomatic arch, the coronoid process of the mandible is dissected and sectioned at its base. The temporal muscle, with its coronoid insertion, is then retracted upward. This approach provides direct and unobstructed access to the temporal and infratemporal fossae. Adequate vascularity of the temporal muscle is maintained. The exposure encompasses the internal carotid artery in the neck for vascular control. Extensive reconstruction is eliminated. The described technique was used in seven patients with lesions of the skull base. There was no operative mortality, and morbidity consisted of temporary restriction of mandibular opening in two patients.

Adult↗
PubMed1990

Serum immunoglobulins in leukaemia and malignant lymphoma.

The serum immunoglobulin levels were studied in 25 healthy control subjects and 23 cases of leukaemia (6 cases of acute lymphatic leukaemia, 5 cases of acute myeloid leukaemia, 2 cases of chronic lymphatic leukaemia and 10 cases of chronic myeloid leukaemia) and 17 cases of malignant lymphoma (13 cases of Hodgkin's lymphoma and 4 cases of non-Hodgkin lymphoma). The mean levels of IgG, IgA and IgM in 25 control subjects were 1573.56 +/- 91.45 mg/dl, 209.64 +/- 12.55 mg/dl and 109.81 +/- 10.03 mg/dl respectively, those in 23 cases of leukaemia were 1338.23 +/- 109.74 mg/dl, 195.53 +/- 20.72 mg/dl and 127.47 +/- 13.29 mg/dl respectively and those in 17 cases of malignant lymphoma were 996.99 +/- 99.50 mg/dl, 147.47 +/- 19.61 mg/dl and 129.35 +/- 19.95 mg/dl respectively. The mean levels of IgG and IgA were found to be decreased in cases of leukaemia with elevated levels of IgM, however, it was found to be insignificant (p less than 0.4). The mean IgG, IgA and IgM levels were found to be almost identical in different leukaemia irrespective of cytological types except in 2 cases of chronic lymphatic leukaemia which showed low levels of IgG and IgA. The mean levels of IgG and IgA were found to be significantly decreased in malignant lymphoma (p less than 0.02). IgM levels were found to be increased in 3 cases of non-Hodgkin lymphoma.

Acute Disease↗
PubMed1989

Modern presentations of Bezold's abscess.

The use of antibiotics in suppurative otitis media has greatly diminished the incidence of complications. Deep neck abscess arising from acute mastoiditis, a disease thoroughly described by Frederick Bezold early in this century, has become rare. In the last three years we have treated five cases of deep neck abscess of otogenic origin at our hospital. These cases exemplify Bezold's classic description in their site of origin in the mastoid process and route of spread in the neck. However, our contemporary examples differed in clinical setting, latency of onset, and bacterial cause. In four of the cases, delay in diagnosis occurred because of failure to recognize the disorder. Computed tomography has proved valuable in the anatomic diagnosis and surgical planning. Renewed familiarity with the clinical presentations and pathogenesis of this now uncommon condition may prevent delay in diagnosis and initiation of therapy.

Abscess↗
PubMed1989

Extrauterine mixed mesodermal tumour of ovary with heterologous element.

The ovary is very rare site of mixed mesodermal tumour. The present case occurred in postmenopausal woman aged 52 years, in right ovary with endometrioid carcinomatous component admixed with chondrosarcomatous component and squamous element. The patient was disease free at one year follow up, with no evidence of local recurrence and distant metastases and was treated post-operatively with combination therapy of radiotherapy and chemotherapy. The review of literature is discussed briefly, with its histogenesis and its differential diagnosis from immature teratoma, malignant teratoma, sertoli leydig cell tumour containing islands of cartilages and embryonal carcinoma of ovary.

Female↗
PubMed1989

Isolated Castleman's disease in the neck.

It can be difficult for the clinician to diagnose Castleman's disease when cervical lymphadenopathy is its only manifestation. The diagnostic challenge may be compounded by the presence of a profound fibrotic reaction secondary to multiple biopsy attempts that are frequently required to establish a diagnosis. Castleman's disease is a benign lymphoproliferative disorder and it most frequently involves the mediastinal lymph nodes. The recognition of an occasional variant of this disorder with a potential malignant course and its association with AIDS calls for a greater awareness of this disease among all clinicians.

Adult↗
PubMed1989

Xanthogranulomatous cholecystitis (XGC): a clinicopathological study of 21 cases.

Xanthogranulomatous Cholecystitis (XGC) is an uncommon inflammatory disease. In a retrospective analysis of 159 cholecystectomy specimens revealed 21 cases of diffuse and focal XGC with an overall incidence of 13.2 per cent. The age distribution was identical to those of traditional chronic cholecystitis with female predominance (M:F ratio 1:4). Gallstones were seen in 15 cases with marked thickening of the gall bladder on ultrasonography. In one case it falsely diagnosed as carcinoma on ultrasonographic examination, however, histopathologically it was turned out to be XGC. One case of XGC was associated with adenocarcinoma of gall bladder. The incidence of diffuse XGC was 5.66 per cent, whereas incidence of focal XGC was 7.54 per cent amongst chronic cholecystitis.

Adult↗
PubMed1989

Glycosylated haemoglobin(HbA1C) and serum protein bound hexose in diabetes mellitus.

Glycosylated haemoglobin (HbA1C) and serum protein bound hexose (SPBH) levels were estimated in 35 healthy control subjects and 35 diabetic subjects. The mean levels of SPBH in control subjects was 161.69 +/- 3.84 mg/dl. The SPBH levels in diabetic subjects were found to be increased (P less than 0.001). It was not influenced by age and sex of the patients, complications, type of diabetes and treatment received. HbA1C levels in control subjects were 5.33 +/- 0.38/dl. The HbA1C levels in diabetic subjects was found to be markedly elevated (11.95 +/- 0.46/dl) and was found to be highly significant (P less than 0.001). The levels were found to be on higher side in juvenile diabetics. A progressive linear correlation was observed between fasting blood sugar levels and concentration of SPBH and glycosylated haemoglobin concentration. A significant correlation was also observed between the levels of glycosylated haemoglobin and SPBH levels (P less than 0.05).

Blood Glucose↗