Publications by authors named "Sandeep Singh Rana"

13 Publications

  • Page 1 of 1

Comparison of right ventricular outflow tract gradient under anesthesia with post-operative gradient in patients undergoing tetralogy of Fallot repair.

Ann Pediatr Cardiol 2021 Jan-Mar;14(1):18-25. Epub 2020 Oct 19.

Department of Cardiothoracic and Vascular Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Background: Intra-cardiac repair for tetralogy of Fallot has some degree of residual right ventricular outflow tract (RVOT) obstruction. However, the measurement of this gradient intra-operatively might get affected by the depth of anesthesia which is important for the long-term outcome.

Aims: The primary aim was to compare intraoperative RVOT gradient post repair under two different anesthetic depths of 1% and 2% end-tidal sevoflurane. The secondary objective was to follow up the changes in RVOT gradient till 1 month postoperatively. Design: Observational study. Setting : Advanced Cardiac Centre of PGIMER, Chandigarh.

Methods: Following intracardiac repair, RVOT gradient was measured directly by placing needle into the right ventricle and pulmonary artery at sevoflurane 1%, and subsequently, at 2% end.tidal concentration while maintaining hemodynamic stability. These gradients were also measured using transesophageal echocardiography (TEE) (ClinicalTrials.gov NCT03234582).

Results: Twenty-one patients were included in this study that had intra-cardiac repair, of which pulmonary annulus was preserved for 15 cases. Mean RVOT gradients measured invasively and by TEE at end-tidal sevoflurane concentration of 1% and 2% were not significantly different (6.67 ± 4.16 mmHg vs. 6.76 ± 3.82 mmHg, > 0.05 invasively and 13.01 ± 7.40 mmHg vs. 12.53 ± 7.11 mmHg, > 0.05 by TEE, respectively). RVOT gradient measured by trans-thoracic echocardiography (TTE) postoperatively at the time of extubation and during follow-up at 1 month showed significant reduction (11.37 ± 6.00 mmHg, < 0.05 and 9.23 ± 4.92 mmHg, < 0.01 respectively). Six patients who underwent repair with transannular patch had significant pulmonary regurgitation (PR) following surgery, with no significant change in PR severity or RVOT gradient on increasing anesthetic depth.

Conclusions: Postoperative RVOT gradient was not altered by changing depth of anesthesia provided systemic blood pressure was maintained. One month postrepair RVOT gradients were significantly reduced as compared to the intraoperative values.
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http://dx.doi.org/10.4103/apc.APC_147_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7918014PMC
October 2020

Extraction of bioactive compounds from Psidium guajava leaves and its utilization in preparation of jellies.

AMB Express 2021 Mar 1;11(1):36. Epub 2021 Mar 1.

Department of Biotechnology, Vignan's Foundation for Science, Technology and Research, Vadlamudi, Andhra Pradesh, 522213, India.

Psidium guajava L. (guava) is predominantly grown throughout the world and known for its medicinal properties in treating various diseases and disorders. The present work focuses on aqueous extraction of bioactive compounds from the guava leaf and its utilization in the formulation of jelly to improve the public health. The guava leaf extract has been used in the preparation of jelly with pectin (1.5 g), sugar (28 g) and lemon juice (2 mL). The prepared guava leaf extract jelly (GJ) and the control jelly (CJ, without extract) were subjected to proximate, nutritional and textural analyses besides determination of antioxidant and antimicrobial activities. GJ was found to contain carbohydrate (45.78 g/100 g), protein (3.0 g/100 g), vitamin C (6.15 mg/100 g), vitamin B3 (2.90 mg/100 g) and energy (120.6 kcal). Further, the texture analysis of CJ and GJ indicated that both the jellies showed similar properties emphasizing that the addition of guava leaf extract does not bring any change in the texture properties of jelly. GJ exhibited antimicrobial activity against various bacteria ranging from 11.4 to 13.6 mm. Similarly, GJ showed antioxidant activity of 42.38% against DPPH radical and 33.45% against hydroxyl radical. Mass spectroscopic analysis of aqueous extract confirmed the presence of esculin, quercetin, gallocatechin, 3-sinapoylquinic acid, gallic acid, citric acid and ellagic acid which are responsible for antioxidant and antimicrobial properties.
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http://dx.doi.org/10.1186/s13568-021-01194-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7921237PMC
March 2021

Postoperative hemodynamics after high spinal block with or without intrathecal morphine in cardiac surgical patients: a randomized-controlled trial.

Can J Anaesth 2021 Feb 9. Epub 2021 Feb 9.

Department of Cardiothoracic and Vascular Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Purpose: There is some evidence for the use of intrathecal morphine as a means to provide prolonged analgesia in selective cardiac surgical patients; however, the hemodynamic effects of intrathecal morphine are not well defined. This study was designed to study the effect of intrathecal morphine on hemodynamic parameters in cardiac surgery patients.

Methods: In a prospective, double-blind study, 100 adult cardiac surgical patients were randomized to receive either intrathecal 40 mg of 0.5% hyperbaric bupivacaine alone (intrathecal bupivacaine [ITB] group, n = 50) or intrathecal 250 µg of morphine added to 40 mg of 0.5% bupivacaine (intrathecal bupivacaine and morphine [ITBM] group, n = 50). Hemodynamic data, pain scores, rescue analgesic use, spirometry, and vasopressor use were recorded every four hours after surgery for 48 hr. The primary outcome was the incidence of vasoplegia in each group, which was defined as a cardiac index > 2.2 L·min·m with the requirement of vasopressors to maintain the mean arterial pressure > 60 mmHg with the hemodynamic episode lasting > four hours.

Results: Eighty-seven patients were analyzed (ITB group, n = 42, and ITBM group, n =45). The incidence of vasoplegia was higher in the ITBM group than in the ITB group [14 (31%) vs 5 (12%), respectively; relative risk, 2.6; 95% confidence interval [CI], 1.0 to 6.6; P = 0.04]. The mean (standard deviation [SD]) duration of vasoplegia was significantly longer in the ITBM group than in the ITB group [8.9 (3.0) hr vs 4.3 (0.4) hr, respectively; difference in means, 4.6; 95% CI, 3.7 to 5.5; P < 0.001].

Conclusion: Intrathecal morphine added to bupivacaine for high spinal anesthesia increases the incidence and duration of vasoplegia in cardiac surgery patients.

Trial Registration: www.clinicaltrials.gov (NCT02825056); registered 19 June 2016.
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http://dx.doi.org/10.1007/s12630-021-01937-zDOI Listing
February 2021

Image analysis to quantify the browning in fresh cut tender jackfruit slices.

Food Chem 2019 Apr 7;278:185-189. Epub 2018 Nov 7.

Department of Food Process Engineering, National Institute of Technology, Rourkela, Sundergarh, 769008, Odisha, India.

Changes in physicochemical properties of fresh cut tender jackfruit during storage is depend on its colour. Colorimeter measurements are best for the samples with homogeneous colour. However, for samples with non-homogenous colors or large sizes (like fruits and vegetables), the colorimeters are inappropriate and inaccurate. The aim for this study is to quantify the amount of browning in fresh cut tender jackfruit slices by using image analysis technique and justify the results by comparing them with existing techniques like sensory examination, enzyme activity, and colorimeter. It can be concluded from the results that browning in fresh cut tender jackfruit slices increase rapidly in control and normally packed samples. Correlation coefficient as high as 0.963, represent that image analysis system is an accurate and highly consistent method to quantify the colour of fruits and vegetables.
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http://dx.doi.org/10.1016/j.foodchem.2018.11.032DOI Listing
April 2019

Variation in properties of tender jackfruit during different stages of maturity.

J Food Sci Technol 2018 Jun 26;55(6):2122-2129. Epub 2018 Mar 26.

Department of Food Process Engineering, National Institute of Technology, Rourkela, Rourkela, Odisha 769008 India.

This research was conducted on two varieties of tender jackfruit [hard (HV) and soft variety (SV)]. The tender jackfruit was divided into four stages (i.e. Stage 1, 2, 3 and 4) and their physical, mechanical, chemical and textural properties were determined for both the varieties. Physical properties like weight, length, diameter, geometric mean and arithmetic mean diameter were increases with increase in size for both the varieties. There was a significant increase in TSS in both the varieties (HV: 1.5 ± 0.02 to 5.1 ± 0.03; SV: 2.7 ± 0.05 to 7.1 ± 0.05 Brix) from stage 1 to 4 because of ripening of fruit. The hardness, fracturability and springiness increases with maturity but on the counterpart, there is a decrease in adhesiveness, cohesiveness, chewiness and gumminess. The nutritional properties and the energy (kj) values were inevitable increases whereas vitamins content was decreases from stage 1 to 4 in both the varieties. The measured properties will be helpful in planning, design and fabrication of post-harvest processing equipment for tender jackfruits.
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http://dx.doi.org/10.1007/s13197-018-3127-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5976596PMC
June 2018

Management of Accidental and Iatrogenic Foreign Body Injuries to Heart- Case Series.

J Clin Diagn Res 2017 Mar 1;11(3):PE01-PE04. Epub 2017 Mar 1.

Ex Senior Resident, Department of Cardiothoracic and Vascular Anaesthesiology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India.

Accidental and iatrogenic foreign body injuries to heart require immediate attention and its timely management is cornerstone to the life of an individual. We describe in detail five cases of Accidental and iatrogenic foreign body injuries to heart encountered between January 2013 and July 2016. Our series included the following: needle stick injury to the right atrium (1 case) retained catheter fragments in the distal main pulmonary artery (1 case), right ventricle injury during catheterisation study (1 case), right ventricle injury during permanent pacemaker lead placement (1 case), device migration in atrial septal defect closure (1 case). Foreign bodies were removed from the cardiac cavities when the patient presented with features of infection (1 case), cardiac tamponade (2 case), anxiety (1 case), and haemodynamic instability (1 case). The management of accidental and iatrogenic foreign body injuries to heart requires immediate attention. Foreign bodies in the heart should be removed irrespective of their location and symptomatology. Asymptomatic foreign bodies diagnosed immediately after the injury with associated risk factors should be removed; asymptomatic foreign bodies without associated risks factors or diagnosed accidentally after the injury also need surgical intervention to allay fears of anxiety in patient and their relatives, to prevent any late complications and also for medico-legal purpose.
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http://dx.doi.org/10.7860/JCDR/2017/23847.9336DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5427375PMC
March 2017

Multiple intrathoracic hydatids.

Asian Cardiovasc Thorac Ann 2010 Feb;18(1):88-9

Department of Cardiovascular and Thoracic Surgery, Military Hospital (CTC), Golibar Maidan, Pune, India-411040.

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http://dx.doi.org/10.1177/0218492309355197DOI Listing
February 2010

Solitary intrapulmonary nodular amyloidoma.

Asian Cardiovasc Thorac Ann 2009 Jun;17(3):329-31

Department of CT Surgery, Military Hospital (CTC), Pune, India.

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http://dx.doi.org/10.1177/0218492309105243DOI Listing
June 2009

Intrapericardial teratoma presenting as recurrent pericardial tamponade: report of a case.

Surg Today 2009 29;39(8):700-4. Epub 2009 Jul 29.

Department of Cardiovascular and Thoracic Surgery, Military Hospital (Cardiothoracic Centre), Golibar Maidan, Pune, India.

Intrapericardial teratomas are rare after infancy. An accurate diagnosis can only be made with a high index of suspicion. Most of the time, a mediastinal teratoma ruptures/perforates the pericardial cavity, thus causing either pericardial effusion or life-threatening tamponade. These factors emphasize the importance of an early surgical excision even for extrapericardial locations. This report presents the case of a 16-year-old girl with intrapericardial teratoma who presented with cardiac tamponade which is a rare complication of this rare tumor with only eight cases reported so far beyond infancy. This patient presented with recurrent tamponade, and underwent multiple procedures of pericardiocentesis and developed pyopericardium and polyserositis. This intrapericardial teratoma was not detected by imaging modalities.
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http://dx.doi.org/10.1007/s00595-008-3903-7DOI Listing
September 2009

A rare cause of hypertension in children: intrathoracic pheochromocytoma.

Pediatr Surg Int 2008 Jul 6;24(7):865-7. Epub 2008 May 6.

Department of Cardiovascular and Thoracic Surgery, Military Hospital (Cardiothoracic Centre), Golibar Maidan, Pune, India.

Mediastinal pheochromocytomas account for only a small fraction of mediastinal tumors. Most commonly, these tumors are located in posterior mediastinum. Increasing number of cases of pheochromocytomas is being reported from middle mediastinum. Excision of mediastinal paraganglioma is often hazardous because of its rich blood supply and tendency to involve surrounding structures. It can be a big challenge to manage asymptomatic cases of pheochromocytoma intraoperatively. It is imperative that these patients receive adequate alpha adrenergic and if necessary beta adrenergic blockade. Adequate preoperative preparation with alpha and beta blockers may not prevent serious intraoperative hypertension. We report a case of posterior mediastinal pheochromocytoma which was biochemically active preoperatively. We review the presentation, diagnosis and management of intrathoracic pheochromocytomas including cardiac pheochromocytomas.
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http://dx.doi.org/10.1007/s00383-008-2165-1DOI Listing
July 2008

Internal jugular venous catheter malposition.

J Cardiothorac Vasc Anesth 2007 Jun 11;21(3):465-7. Epub 2006 Sep 11.

Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

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http://dx.doi.org/10.1053/j.jvca.2006.06.005DOI Listing
June 2007

Some more about intrapericardial teratomas in perinatal period.

J Pediatr Surg 2006 Apr;41(4):877-8; author reply 878

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http://dx.doi.org/10.1016/j.jpedsurg.2006.02.023DOI Listing
April 2006