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Nirmanmoh Bhatia Buddhadeb Dawn Tariq S. Siddiqui Marcus F. Stoddard 《Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital》2015,42(1):16-24
Determining aortic stenosis (AS) severity is clinically important. Calculating aortic valve (AV) area by means of the continuity equation assumes a circular left ventricular outflow tract (LVOT). The full impact of this assumption in calculating AV area is unknown. Predictors of noncircular LVOT shape in patients with AS are undefined.In 109 adult patients with AS who underwent multiplanar transesophageal echocardiography, we calculated AV area by means of the standard continuity method and by a modified method involving planimetric LVOT area.We found 54 circular, 37 horizontal-oval, 8 vertical-oval, and 10 irregular LVOTs. Area derived by direct planimetry correlated better with the modified than the standard continuity method (r=0.89 vs r=0.85; both P=0.0001). Valve areas of patients with mild, moderate, or severe AS by planimetry were more often mischaracterized with use of the standard than modified method (29 vs 18; P <0.0001). Horizontal-oval AV area derived by planimetry (1.28 ± 0.55 cm2) was underestimated by the standard method (1.05 ± 0.47 cm2; P=0.001), but not by the modified method. Congenital AV morphology and low cardiac index were the only multivariate predictors of horizontal-oval shape. Low cardiac index was the only predictor of noncircular shape.More than half our patients with AS had noncircular LVOTs. Using the modified method reduces mischaracterizations of AS severity. Congenital AV morphology and low cardiac index predict horizontal-oval or noncircular shape. These data suggest the value of direct LVOT measurement to calculate AS severity in patients who have congenital AV or a low cardiac index. 相似文献
3.
Girish S. Mishra Arpan Bhatia 《Indian journal of otolaryngology and head and neck surgery》2007,59(3):296-297
Dermatofibrosarcoma protuberance of head and neck is a rare neoplasm and accounts for less than one percent of Head and Neck Neoplasm. The objective of this report is to understand etiology, presentation, histopathologic identification and treatment option for this tumour. The goal of current report is to acquaint the clinician with presentation and treatment option for this disease. 相似文献
4.
Gayatri Vasudevan R. Chandra B. Vishnu Bhat B. D. Bhatia 《Indian Journal of Thoracic and Cardiovascular Surgery》1993,9(1):42-44
We present two cases of neonatal pleural effusion, a relatively rare condition, most commonly due to chylothorax. One had
bilateral hypoplastic lungs and the other suffered birth asphyxia. Both died before any treatment could be initiated. 相似文献
5.
There are very few reported cases of milk of calcium in the ureter. Its presence in the ureter is quite unusual and is the
subject of the present report. 相似文献
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Nitin Gupta Saurabh Varshney S. S. Bist Pratima Gupta Rajat Bhatia 《Indian journal of otolaryngology and head and neck surgery》2007,59(4):309-312
Retropharyngeal abscesses were fairly common in preantibiotic era but the advent of antibiotics has reduced the overall incidence
of these abscesses. They still continue to occur specially in developing world and carry significant morbidity and even mortality
if not managed properly. The prevalence of this abscess in the young children pose a bigger challenge, as the examination
of oral cavity is difficult. Emphasis is placed on the age, sex, type, and duration of symptoms, bacteriology, methodology
of diagnosis, therapy and complications. With proper antibiotic cover and surgical management, majority of patients today
survive without major residual squeal. Hereby we present a series of 15 cases of retropharyngeal abscess. 相似文献
9.
Bhabatosh Biswas Dipayan Ghosh Rupak Bhattacharjee Ashis Patra Subir Basuthakur Rajarshi Basu 《Indian Journal of Thoracic and Cardiovascular Surgery》2004,20(2):88-90
Introduction Hydatid cysts of the lung are quite frequent in our country. Some patients have additional cysts in the liver. Though most
of the liver cysts remain asymptomatic for long time, but may be symptomatic with increasing size. Surgical removal is the
treatment of choice for both lung & liver cysts. Aim of the study was to establish suitability of one stage surgery for pulmonary
& hepatic hydatid cysts.
Methods From 1996 through 2003 we operated on 216 pulmonary hydatid cysts, out of which 42 patients had hydatid cysts in the right
lung as well as in the right lobe of liver. Right thoracotomy was done to remove the lung hydatids followed by phrenotomy
to remove the liver cysts.
Results Right thoracotomy was done in 42 patients having hydatid cysts of lung & liver. In 36 patients, cysts were removed, bronchial
leaks were sutured & residual cavities were obliterated. Out of rest 6 patients, having dense adhesions or destruction of
pulmonary parenchyma, 4 had segmentectomy & 2 had lobectomy. Right phrenotomy was then done with radial incision above the
palpated liver cysts. Hydatid cyst was removed from liver. Cavity and remaining pericystic liver tissue was inverted with
sutures. Water seal chest drain & subdiaphragmatic drain were placed. Post operative albendazole was continued for 3 months
in the dose of 10–20 mg/kg with a gap of 2 weeks after each month. Post operative recovery was uneventful in most of the cases.
However, air leak continued for almost 3 weeks in 4 patients & 3 months in one patient. There was no death.
Conclusion Surgical management of pulmonary and hepatic hydatids with one stage right thoracotomy & phrenotomy is a suitable option.
It avoids additional laparotomy and thereby additional cost & hospital stay. Results are quite satisfactory. 相似文献
10.
Restless legs syndrome (RLS) is a disorder of motor activity with a circadian pattern, occurring frequently in patients with Parkinson's disease (PD). We sought to estimate the prevalence of RLS in Indian PD patients. One hundred twenty-six consecutive PD patients and 128 healthy age- and sex-matched controls were evaluated using a predesigned questionnaire. RLS was present in 10 of 126 cases of PD (7.9%) and 1 of 128 controls (0.8%, P = 0.01). PD patients with RLS were older than those without RLS (63.70 +/- 7.80 years vs. 57.37 +/- 10.04 years; P = 0.05) and had higher prevalence of depression (40% vs. 10.3%; P = 0.023). No demographic factors or factors related to PD correlated with the presence or severity of RLS. RLS is more common among patients with PD than controls. A greater medical recognition of this disorder is needed in view of available effective treatment. 相似文献