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1.
2.
Pankaj Kumar Mishra 《European journal of cardio-thoracic surgery》2006,29(5):861-2; author reply 862
3.
Dr. Menon Raj Gopal M.Ch. AlDelamie Taha FRCS Valliathu John FRCS Zacharias Sunny FRCS Lawati Al Adil FRCS Venkatraman M.Ch. 《Indian Journal of Thoracic and Cardiovascular Surgery》2006,22(3):173-177
Background Despite improving surgical techniques, treatment of heart valve disease in children remains controversial. Somatic growth
and adequate anticoagulation are of concern when children undergo valve replacement. We conducted this study to evaluate the
performance of valves in this age group.
Methods 42 children under the age of 13 years who underwent valve replacement were included in this study. Totally, 50 valves were
implanted in 42 patients: 48 were mechanical prostheses, two were bioprosthetic both in pulmonary position. 37 (74%) valves
were implanted in mitral position, 10 (20%) in aortic position, 1 (2%) in tricuspid position and 2 (4%) in pulmonary position.
Preoperatively, 14 (33,3%) patients were in New York Heart Association (NYHA) class IV, while 27 (64.2%) were in NYHA class
III.
Results There were 2 (4.7%) hospital deaths and 2 (4.7%) late deaths while 2 (4.7%) patients were lost to follow up. The mean follow
up period was 9.4 yrs. 35 (83.3%) patients are in NYHA Class I and free of all medications except warfarin. 3 (7.1%) patients
have undergone 5 successful pregnancies. The median INR was 2.23. Major thrombo-embolic episode occurred in 1 (2.3%) patient.
Conclusions In view of the problems of sizing, anticoagulation and need for re-operation at an early age, there is a reluctance to replace
valves in children. This study shows that despite these problems, valve replacement can be undertaken safely and successfully
in children, when repair has failed or not technically feasible. 相似文献
4.
OBJECTIVE: To analyse morbidity after completion total thyroidectomy compared with primary total thyroidectomy in a specialist thyroid surgery centre. DESIGN: Retrospective study. SETTING: Tertiary referral hospital, India. PATIENTS: Medical records of 143 patients who had total thyroidectomy between January 1990 and December 1999. 95 had primary thyroidectomies and 48 were completion thyroidectomies. MAIN OUTCOME MEASURES: Complication rate in both groups. RESULTS: The groups were comparable in respect of clinicopathological variables. Residual tumour was found in 19/48 (40%). After completion thyroidectomy, transient hypoparathyroidism and transient recurrent laryngeal nerve palsy were recorded in 8/48 (17%) and 2/48 (4%), respectively. No permanent hypoparathyroidism or permanent recurrent laryngeal nerve palsy was recorded in the completion thyroidectomy group. CONCLUSIONS: Completion thyroidectomy can be done with acceptable morbidity in a specialist thyroid surgery centre. Fear of increased morbidity after the procedure should not deter surgeon from doing this operation or referring the patients to a specialist centre. 相似文献
5.
A Girdhar B Mishra R K Lavania A K Bagga G N Malaviya B K Girdhar 《International journal of leprosy and other mycobacterial diseases : official organ of the International Leprosy Association》1989,57(2):472-475
Two infants, one 4 months old and the other 2 months old, having histologically confirmed indeterminate leprosy are reported. The route of infection, mode of transmission, and incubation period are discussed with reference to these two cases of infantile leprosy. 相似文献
6.
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
7.
8.
Simultaneous Quantification of an Enantiomer and the Racemic Compound of Ibuprofen by X-ray Powder Diffractometry 总被引:1,自引:0,他引:1
Purpose. An X-ray powder diffractometric method was developed for the simultaneous quantification of the relative amounts of the racemic compound (±) of ibuprofen (I) and S(+)-ibuprofen (II), when they occur as a mixture.
Methods. The X-ray powder diffraction patterns of I and II show pronounced differences. This formed the basis for the determination of the relative amounts of I and II when they occur as a mixture. X-ray lines with d-spacings of 14.41 and 4.37 Å were unique to I and II, respectively. Mixtures containing different proportions of I and II were prepared which also contained lithium fluoride (III) as an internal standard.
Results. A linear relationship was obtained when the intensity ratio (intensity of the 4.37 Å line of II/intensity of the 2.01 Å line of III) was plotted as a function of the weight fraction of II in the mixture. Similar results were obtained in the case of I. Using these standard curves, the weight fractions of I and II in 'unknown' mixtures were determined. The experimentally determined analyte concentration ranged between 98 and 104% of the true value. The relative error in the analyses of individual samples was < 10%. The minimum detectable weight fraction of I in II and II in I were 0.032 (3.2% w/w) and 0.034 (3.4% w/w), respectively. The minimum quantifiable weight fractions were 0.136 for I and 0.112 for II. Since the X-ray diffraction patterns of S(+)-ibuprofen and R(–)-ibuprofen are identical, the conclusions drawn regarding mixtures of I and II will also hold true in the quantitative analyses of mixtures of I and R(–)-ibuprofen. 相似文献
9.
Z. S. Meharwal N. Trehan V. M. Kohli V. K. Sharma R. R. Kasliwal A. Mishra V. Kohli A. Jayant 《Indian Journal of Thoracic and Cardiovascular Surgery》1992,8(2):88-91
Between November 1988 and February 1992, 416 patients required coronary endarterectomy for diffuse coronary artery disease.
This constitutes 16.19 per cent of all patients who underwent coronary artery bypass grafting during the same period. A total
of 528 endarterectomies were performed. Four-hundred and twenty-two endarterectomies were performed on right coronary system
and 106 endarterectomies were performed on left coronary system. One-hundred and twelve (26.92%) patients required more than
one endarterectomies.
The hospital mortality was 2.16 percent. 3.37 per cent of patients had perioperative infarction. Intraaortic balloon pump
was required in 1.92 per cent of patients. 5.77 per cent of the patients had significant arrhythmias. The patients have been
followed up for a mean period of 27 months. One-hundred and forty patients were evaluated by exercise multigated radionuclide
angiogram. One-hundred and thirty-four (95.71%) patients showed increase in ejection fraction as compared to preoperative
value. Six (4.29%) patients did not show any significant change while eight (5.71%) patients had fall in ejection fraction.
Postoperative coronary angiogram was done in 44 patients at a mean of 10 months. 89.59 per cent of grafts to the endarterectomised
vessels and 91.67% of grafts to nonendarterectomised vessel were patent. The difference between the two groups was not statistically
significant. 相似文献
10.
Khalid Irshad Samuel Millar Raj Velu Allan W Reid Edward B Diethrich Donald B Reid 《Journal of endovascular therapy》2007,14(2):198-207
PURPOSE: To report early clinical experience with virtual histology intravascular ultrasound (VH IVUS) in carotid endoluminal repair. TECHNIQUE: A 2.9-F, 20-MHz catheter that utilizes computer software to demonstrate the histological components of arteriosclerotic plaque was evaluated during carotid angioplasty and stenting. VH IVUS images were created following a pullback through the carotid stenosis and produced a color-coded map of the different histological constituents of the disease (dark green: fibrous, yellow/green: fibrofatty, white: calcified, and red: necrotic lipid core plaque). CONCLUSION: VH IVUS produces a color-coded map of the different histological components of artery plaque. It has the potential to predict how the plaque is likely to behave at the moment of endoluminal treatment. 相似文献