Publications by authors named "Modi P"
Background: Cooling of burns is one of the oldest therapies, yet there are concerns that excessive cooling may result in hypothermia.
Objectives: To determine the effects of surface cooling with a commercially available cooling blanket on the core temperatures of volunteers and to test the ability of the cooling blanket to reduce water evaporation from plastic containers. The null hypothesis was that rectal temperatures would not be reduced by surface cooling and that the cooling blanket would reduce evaporative water loss.
An 8-year-old boy with right flank pain was found on ultrasonography and intravenous urography to have hydronephrosis secondary to ureteropelvic junction obstruction with calculi in the lower pole of the right kidney and a fusion anomaly. Transperitoneal laparoscopic dismembered pyeloplasty and removal of calculi was carried out. The patient had uneventful recovery and is doing well at 6 months' follow-up.
View Article and Find Full Text PDFBackground: The immature heart has a much greater dependence than the adult heart on amino acid transamination in determining its ischemic tolerance. Compared with adult hearts, experimental models of the immature heart have quantified higher resting concentrations of free amino acids (AA) which are depleted by acute hypoxia. However, we have found no clinical studies that have looked at the free AA profile of the immature human heart or the effects of cyanosis, age, and pathology upon this.
View Article and Find Full Text PDFBackground: Retroperitoneoscopic surgery has become an established armamentarium in the hands of urologist. We present a simple and cost-effective technique that aids in the maintenance of pneumoretroperitoneum.
Methods: Between June 2003 and December 2004, 150 retroperitoneal nephrectomies were performed with maintenance of the pneumoretroperitoneum using our technique.
Objectives: To present our initial experience with laparoscopic ureteroneocystostomy in patients with traumatic disruption of the distal ureter owing to gynecologic procedures. Reconstructive laparoscopic procedures are still evolving.
Methods: Six patients with ureterovaginal fistula in whom endoscopic management had failed underwent laparoscopic ureteroneocystostomy with a psoas hitch between July 2003 and December 2004.
Thiazolidinediones in type 2 diabetes--have they lived up to expectations?
J Indian Med Assoc
June 2005
The thiazolidinediones have been in clinical use for the management of type 2 diabetes for the past five years. These agents reduce insulin resistance by acting as ligands that regulate gene expression related to the proliferation and differentiation of adipose tissue. Overall, data from several clinical studies suggest that their hypoglycaemic efficacy is slightly less than sulphonylureas and metformin but greater than acarbose and the glinides.
View Article and Find Full Text PDFObjective: To evaluate the metabolic effect of buccal spray insulin compared with subcutaneous regular insulin in patients with type 1 diabetes.
Research Design And Methods: This study compared plasma glucose, insulin, and C-peptide levels in 18 patients with type 1 diabetes treated with subcutaneous regular or buccal spray insulin on 2 consecutive mornings. On day 1, patients were treated with their usual subcutaneous regular insulin regimens.
Objective: To evaluate the pharmacodynamic and pharmacokinetic properties and the dose-ranging effects of an oral insulin spray in comparison with subcutaneous regular insulin.
Research Design And Methods: In this randomized, five-way, cross-over study, seven healthy volunteers were assessed under euglycemic clamp and received four different doses of oral spray and one dose of subcutaneous regular insulin.
Results: The time to maximum insulin concentration was shorter for oral insulin than for subcutaneous insulin (25.
Fibrin sealant treatment of splenic injuries during oesophagectomy.
Eur J Cardiothorac Surg
July 2005
The incidence of 'accidental' splenectomy during oesophagectomy varies from 4 to 42% and leads to an increase in sepsis, anastomotic leakage and mortality. Therefore, preservation of the spleen should be the aim of treatment whenever splenic injury occurs. We describe the use of fibrin glue delivered as a thin film by a spray applicator for rapid and definitive haemostasis of grades 1 and 2 splenic injuries in patients undergoing oesophagectomy.
View Article and Find Full Text PDFObjective: We designed a prospective, randomized, and controlled clinical trial to evaluate the efficacy and safety of achieving a mixed chimerism-associated tolerance protocol for recipients of living related donor (LRD) renal allografts.
Patients And Methods: Sixty-six consecutive patients were divided into two equal groups of 33 patients with end-stage renal disease. They were enrolled for transplantation after negative lymphocytotoxicity cross-matching (LCM).
Background: Oral insulin spray is a new, noninjectable method of insulin delivery. This system delivers an aerosol of uniform-sized droplets containing regular human insulin at a high velocity into the oropharyngeal cavity for local transmucosal absorption.
Objective: The purpose of this study was to compare the pharmacokinetic and pharmacodynamic properties of single-dose oral insulin spray and SC insulin injection in healthy subjects.
Dissecting intramural haematoma of the oesophagus (DIHO) is a rare condition, which has an excellent prognosis when managed conservatively. Awareness of this condition is vital to guide subsequent investigations and avoid inappropriate treatment or unnecessary surgical intervention. We describe an unusual case of massive DIHO causing left atrial compression presenting with pericarditic electrocardiographic changes and document the utility of endoscopic ultrasound/computed tomography to make the diagnosis.
View Article and Find Full Text PDFBackground: Experimental models have established numerous myocardial metabolic changes with chronic hypoxia and maturation. We conducted this study to specifically look at the effects of cyanosis, age, and pathology upon the basal metabolic state of the immature human heart.
Methods: One hundred and eighty-one pediatric patients (37 cyanotic, 144 acyanotic) undergoing open heart surgery were recruited.
Objective: Proof-of-concept study of evaluation of metabolic effect of novel oral spray insulin (Oralin) formulation at breakfast time in subjects with type 2 diabetes on multiple daily injections.
Research Design And Methods: This was an open-label, crossover, randomized study in (n = 23) subjects with type 2 diabetes on multiple daily injections. Subjects received each treatment, in random order, 3 to 7 days apart-a daily dose of SC injection (0.
Introduction: We designed a prospective, randomized clinical trial to evaluate the immune response to thymic and peripheral infusions of donor haematopoietic stem cells (HSCs) to create tolerance in recipients of cadaver renal allografts.
Method: We divided 24 patients into two equal groups. For group A, 350 ml of unfractionated bone marrow (BM) was aspirated from the anterior iliac crests of donor cadavers.
Myocardial metabolic changes during pediatric cardiac surgery: a randomized study of 3 cardioplegic techniques.
J Thorac Cardiovasc Surg
July 2004
Background: Blood cardioplegia and terminal warm blood cardioplegic reperfusion ("hot shot") reduce myocardial injury and improve metabolic recovery in hypoxic but not normoxic experimental models. However, there is little evidence of a benefit of either technique in pediatric clinical practice compared with crystalloid cardioplegia.
Methods: Pediatric patients undergoing cardiac surgery were randomized to receive intermittent antegrade cold crystalloid cardioplegia, cold blood cardioplegia, or cold blood cardioplegia with a hot shot.
The aim of this study was to determine the metabolic effect and the safety of a novel oral insulin spray (Oralin) formulation at breakfast-time in subjects with type 2 diabetes with suboptimal glucose control and maintained on a combination therapy of oral hypoglycemic agents (OHAs). This was an open-label, crossover, randomized study design in subjects (n = 21) with type 2 diabetes (glycated hemoglobin A1c >8.0%).
View Article and Find Full Text PDFDepleting intracellular taurine in heart cells improves their resistance to ischemia and reperfusion injury. The aim of this work was to see whether physiologically low levels of endogenous taurine also reflect a reduced vulnerability of the myocardium to cardiac insults. The myocardial concentration of taurine was measured during different stages of development and compared with vulnerability to ischemia and reperfusion injury in the rat and in pediatric patients undergoing cardiac surgery.
View Article and Find Full Text PDFBackground: Perioperative myocardial injury is determined by the ischemic duration, pathology, and preoperative myocardial status. Our aim was to evaluate pathology-related differences in troponin I (TnI) release, a sensitive and specific marker of myocardial injury, and its relation to clinical outcome after pediatric open heart surgery.
Methods: Troponin I was measured serially postoperatively in 133 children undergoing repair of atrial (ASD, n = 41) and ventricular septal defects (VSD, n = 46), and tetralogy of Fallot (TOF, n = 46).
Background: Cardiac troponin I (TnI) is a sensitive and specific marker of myocardial injury, but little is known about its release after complex congenital heart surgery. We investigated whether TnI correlates with early clinical outcome in neonates undergoing the arterial switch operation (ASO) for transposition of the great arteries (TGA).
Methods: Troponin I was measured serially up to 48 hours postoperatively in 31 neonates undergoing the ASO alone (simple TGA) and 9 neonates undergoing the ASO combined with other procedures (complex TGA) (eg, closure of a ventricular septal defect) and correlated with intraoperative and postoperative clinical parameters.
Background: There is little evidence in the literature on the benefits of cold blood cardioplegia in pediatric cardiac surgery. This study investigates the effects of cold crystalloid versus cold blood cardioplegia on myocardial metabolism, reperfusion injury, and clinical outcomes in patients undergoing ventricular septal defect (VSD) repair.
Methods: Patients were randomly assigned to receive antegrade cold (4 to 6 degrees C) St Thomas's I crystalloid (CCC) or blood (CBC) cardioplegia.
[Right heart failure in a patient with giant mediastinal dermoid cyst].
Ital Heart J Suppl
February 2002
This case report describes the management of a rare giant mediastinal dermoid cyst causing right heart compression and failure. The precise relationships with vital structures were preoperatively defined at transesophageal echocardiography and computed thoracic tomography. These allowed us to predict the likely diagnosis and therefore plan a limited surgical approach.
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