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Agrawal A.,Fortis Escorts Heart Institute
Transfusion and Apheresis Science | Year: 2014

Introduction: Pre-transfusion testing involves blood grouping (ABO and Rh) and major cross match (testing the recipient's serum/plasma against the donor's red blood cells) at 37. °C to detect IgG antibodies. In the western countries, type and screen policy is routinely followed. Aim: This study was conducted to assess implementation of type and screen policy in standalone blood banks in India and to assess compromise on blood safety, if any? Materials and methods: The study was carried out at the Standalone Blood Bank of North India during the period January 2012 to April 2012. Type and screen study was carried out in parallel to routine cross match using Column Agglutination Technology. Results: Total 354 patients were included in the study. 4 samples were positive on antibody screening. Cross match was incompatible in 1 case. No case was found with antibody screen negative but AHG cross match incompatible. Conclusion: This study concluded good safety level in high risk category patients. Type and screen policy can be implemented in Indian settings with no compromise on blood safety provided sufficient technical and infrastructural support is available at the centre. © 2014 Elsevier Ltd. Source

Bhatia M.,Fortis Escorts Heart Institute
Indian Heart Journal | Year: 2014

In ischemic heart disease, cardiac MRI, besides being the gold standard for evaluation of quantitative ventricular function, enables evaluation of myocardial wall thickness, T2-weighted imaging for myocardial edema and infarct quantification and transmurality. Delayed hyperenhancement sequences are highly predictive of scar formation, being associated with myocyte necrosis. The extent and transmurality of delayed hyperenhancement has prognostic implications and is inversely proportional to the degree of functional recovery after acute myocardial infarction. A greater transmural extent of infarction (eg, hyperenhancement involving >50% of the wall thickness) can predict regions that are less likely to improve in function after therapy. The ultimate focus of MRI in ischemic heart disease is in diagnosis, quantification of myocardium at risk, salvageable myocardium, perfusion defects and differentiation of viable myocardium from non viable myocardium to enable prognostication. Copyright © 2013, Cardiological Society of India. All rights reserved. Source

Iyer P.U.,Fortis Escorts Heart Institute
Indian Journal of Pediatrics | Year: 2015

Admission of infants and children with cardiac disease to the neonatal (NICU) and pediatric ICU (PICU) is ever increasing in India (30–50 % of all admissions). The commonest indication for admission to the NICU or PICU is acute deterioration of cardiac disease. This includes: acute heart failure, hypercyanotic spells, arrhythmias, pericardial tamponade and sick cardiac neonates who need urgent intervention. Other increasingly frequent indications for ICU admission include heart failure with concomitant chest infection and impending respiratory failure and, severe cyanotic heart disease with various stroke syndromes. It is thus essential that a pediatrician be comfortable with the ICU management of such children and that low cost ICU modalities be utilized in order to reach out to as many children as feasible. It is heartening that there is renewed interest in inexpensive therapies like noninvasive ventilation and therapeutic hypothermia. © 2015, Dr. K C Chaudhuri Foundation. Source

Bhatia M.,Fortis Escorts Heart Institute
Indian Heart Journal | Year: 2014

Myocarditis is an important cause of sudden death in young adults where infectious diseases, in previously healthy patients, account for the majority of cases. Cardiac MR imaging offers an extremely versatile, comprehensive and accurate tool for evaluation of morphological and functional abnormalities, pericardial effusion, myocardial tissue characterization for myocardial edema, hyperemia and capillary leak by myocardial early gadolinium enhancement and necrosis and fibrosis by late gadolinium enhancement besides enabling non invasive follow up with significant inter-observer consistency, and quantitative accuracy. © 2014, Cardiological Society of India. All rights reserved. Source

Sachdeva A.,Fortis Escorts Heart Institute
Journal of Association of Physicians of India | Year: 2015

Cardiopulmonary interactions or effects of spontaneous and mechanical ventilation (MV) were first documented in the year 1733. Stephen Hales showed that the blood pressure of healthy individual fell during spontaneous inspiration and he later went on to discover the ventilator. A year later Kussmaul described pulsus paradoxus (inspiratory absence of radial pulse) in patients with tubercular pericarditis. Echocardiography can help to diagnose a wide variety of cardiovascular diseases and can guide therapeutic decisions in patients on mechanical ventilation. © 2015 Journal of The Association of Physicians of India. All Rights Reserved. Source

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