Transthoracic electrical bioimpedence cardiac output: comparison with multigated equillibrium radionuclide cardiography.

Introduction: Thoracic electrical bioimpedance (TEB) for measuring cardiac output (CO) is being explored increasingly as an alternative to pulmonary artery catheter. The major advantage of this technology is that it is non-invasive and easy to perform. Several studies have compared it to thermodilution cardiac output using PA catheter, with variable correlation.

Non-invasive cardiac output by transthoracic electrical bioimpedence in post-cardiac surgery patients: comparison with thermodilution method.

Objective: Thoracic electrical bioimpedance (TEB) cardiac output (CO) is being explored increasingly as a non-invasive alternative to the pulmonary artery catheter (PAC). This study compared TEB-CO measured using a new instrument--NICOMON (Larsen & Toubro Ltd. India) with thermodilution (Td) CO in post-cardiac surgery patients.

Raised serum IgE levels in chronic inflammatory lung diseases.

Objective: To study the serum IgE response in nonallergic subjects with chronic inflammatory lung diseases.

Setting: Christian Medical College Hospital, Vellore.

Subjects: Twenty six patients with bronchiectasis, five with pulmonary mycosis referred from all over India and 30 healthy subjects.

Random plasma glucose and the glucose challenge test in pregnancy.

Background: The oral glucose tolerance test for detecting women with gestational diabetes is too complicated and prolonged for routine use. Similar and less time consuming screening tests have been proposed including random plasma glucose estimation and the glucose challenge test (blood glucose estimation one hour after a 50 g glucose load). However, in practice, correct timing of the blood sample, which is of critical importance in the interpretation of the results of these tests, is difficult to ensure.

Management of patients with mildly dysplastic cervical smears.

The management of patients with mild dysplasia on cervical smears remains controversial. Recent studies have shown that many harbor high grade squamous intraepithelial lesions (HSIL) and human papillomavirus (HPV) and warrant further evaluation rather than follow-up. This prospective study dealt with the evaluation of patients with mild dysplastic smears using colposcopy and directed biopsies with view to identifying HSIL/HPV and treating them.

alpha 1-Antitrypsin deficiency in Indian patients with chronic obstructive airways and other pulmonary diseases.

Objective: To determine alpha 1-antitrypsin (A1AT) deficiency in patients with chronic obstructive airways disease (COAD) and other pulmonary diseases.

Design: Observation study.

Subjects: 45 patients with COAD, 20 with bronchiectasis, 11 with pulmonary tuberculosis, 25 with chest malignancies and 42 healthy subjects.

False aneurysm following modified Blalock-Taussig shunt.

A nine month old infant with life threatening tracheal compression due to a Blalock-Taussig shunt aneurysm is described. Successful surgical management is discussed.

Single daily monitoring of periovulatory estradiol, progesterone, and luteinizing sera hormone levels in natural cycles useful for timing intrauterine insemination.

Single daily periovulatory serum levels of luteinizing hormone (LH), estradiol (E2), and progesterone (P) may be useful to predict the time of ovulation, since serum P is known to rise to 1000 pg/mL about 24 h after the LH surge. Intrauterine insemination (IUI) was performed based on the serum P level at the time of the LH surge; if sera P measures < 1000 pg/mL, then IUI is performed 36-40 h later; but if P is > or = 1000 pg/mL, IUI is performed 12-20 h later. The relationship of sera LH, E2, and P levels and follicular diameter were evaluated at the time of the LH surge and the day before in 40 women with cervical factor who conceived following a single IUI.

A prospective study in a southern Indian hospital on the prescription of medication during the lying in period following childbirth.

The awareness of the inherent risks attached to medication use during pregnancy is increasing. There is, however, a paucity of available following childbirth. We have conducted a prospective study in women who gave birth in hospital with the objective of analysing the use of medication in this lying in period.

Chest malignancies & serum immunoglobulin E.

Serum IgE levels were measured by the radioimmunoassay technique in the sera of 53 patients with neoplastic chest diseases. Forty seven patients had malignant chest tumours and another 6 had benign tumours or mediastinal cysts. They included 33 smokers and 20 non-smokers.

Clinical spectrum of pulmonary hydatidosis and raised serum IgE levels in the Indian southern peninsula.

Fifteen patients with surgically proven hydatid disease of the lung aged between 4 and 51 years were studied. The disease spectrum varied from single to multiple cysts of different sizes, with associated pyogenic chest infections or parasitic infestations of the gut. The serum IgE level varied widely in these cases and very high levels were found in 60% of the patients.

Mitral valve replacement for an annular submitral aneurysm of the left ventricle.

Successful surgical repair of an annular submitral aneurysm of the left ventricle in two patients is described. In both cases the diagnosis was made at surgery and they were treated successfully by transatrial closure of the aneurysm with Teflon felted sutures and mitral valve replacement. This is the first report of the use of mitral valve replacement for this condition.

Unruptured aneurysm of the sinus of Valsalva: a potential source of cerebrovascular embolism.

An unruptured aneurysm of the right sinus of Valsalva with intraluminal thrombus that displaced the right coronary artery ostium was diagnosed in a 30 year old Omani man who was investigated for uncontrolled grand mal epilepsy and residual left hemiparesis caused by occlusion of the right middle cerebral artery. Surgical intra-aortic closure of the aneurysm, which necessitated a saphenous vein graft to the right coronary artery, was successful. An aneurysm of the sinus of Valsalva is an unusual cause of a thromboembolic cerebrovascular accident.

Giant emphysematous bullae of the lung.

Emphysematous bullae may at times assume large proportions. We report a case of symptomatic giant bullae in a female which were removed surgically. The relevant literature has also been reviewed.

Ectopic ovary in the omentum.

At caesarean section the right ovary of a patient was found to be absent. There was an omental cyst that was excised and this was found to be an ectopic ovary. This case is reported because of its rarity.

Candida antibodies in amniotic fluid.

Amniotic fluid samples were tested for specific immunoglobulins against Candida albicans by indirect immunofluorescence. Nineteen of the 23 samples tested contained specific IgA while specific IgG antibodies were detected in only seven samples (P less than 0.01).

Interrupted aortic arch with tetralogy of Fallot. A report of an unsuccessful surgically treated case.

Interrupted aortic arch is a complete discontinuity of two segments of the aorta. Although associated with a number of conditions, it does not occur in association with pulmonary stenosis. We report a case unsuccessfully treated but from which we have learnt a lesson.

Cervical intraepithelial neoplasia and human papilloma virus infection.

Evidence of human papilloma virus (HPV) infection was sought in 50 patients with cervical intraepithelial neoplasia (CIN) and 50 controls. Cytologic, colposcopic and histopathological examinations were carried out in each one of them. Cytological evidence of HPV infection was found in 13 cases and two controls.

Surgical management of coarctation of aorta.

Between 1961 and 1988, 68 patients underwent operation for coarctation of the aorta. The average age of presentation of these subjects was higher than in other series. 7.

Colposcopy in the diagnosis of cervical neoplasia.

Two hundred and ninety one women were evaluated for cervical cancer by cytology and colposcopy. Of these, 152 patients underwent colposcopically directed biopsy for histological evaluation. Colposcopy and cytology were in agreement in 88 per cent of cases whereas colposcopy and histopathology were in agreement in 79 per cent of cases.

A bypass technique for aneurysms of descending aorta.

Uniformity of opinion does not exist regarding optimal surgical strategy for descending aortic aneurysms. We present a surgical technique for bypass during aortic cross clamp while operating on such aneurysms. Five patients have undergone surgery using this technique.

A randomized controlled trial of extra-amniotic ethinyloestradiol for cervical ripening in multiparas.

A double-blind randomized controlled trial was carried out to determine if ethinyloestradiol applied extra-amniotically would ripen the unfavourable cervix at term. Twenty five multiparas were given 150 mg ethinyloestradiol gel while 25 multiparas were given gel alone. There was no difference between the ethinyloestradiol and control groups in either mean change of Bishop score or the induction-to-delivery interval.

Valve replacement in the young patient with rheumatic heart disease. Review of a twenty-year experience.

During a 20-year period 303 young subjects between 9 and 20 years of age (mean, 16.2 +/- 2.72 years) with rapid and relentlessly progressive valvular disease from rheumatic fever underwent valve replacements.

Lack of evidence for seroconversion to human immunodeficiency virus in recipients of anti-D immunoglobulin containing HIV antibody.

Twenty nine Rh negative women who had received injections of anti-D (Rho) immunoglobulin preparations (from an Indian firm) contaminated with antibody to human immunodeficiency virus (HIV), were tested for seroconversion to HIV, 14-38 wk after injections. All 29 were negative for HIV antibody, indicating that infectious HIV or immunogenic concentrations of inactivated HIV were not present in the investigated immunoglobulin product.

Closed mitral valvotomy in the older subject. Results in 367 consecutive patients.

To determine the safety, efficacy, operative mortality, and long-term results, we reviewed 367 patients with mitral stenosis above the age of 40 who underwent mitral valvotomy. In this study, the majority of the subjects belonged to functional Class III and IV (97%) of the New York Heart Association (NYHA). Atrial fibrillation was associated in 38 percent and mitral valve calcification in 24 percent.