Browsing by Author "Francis, B"

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    Cellular and sub-chronic toxicity of hydroxyapatite porous beads loaded with antibiotic in rabbits, indented for chronic osteomyelitis
    (International Journal of Pharmaceutics, 2022-02) Vandana, U; Akhil, V; Suresh Babu, S; Francis, B; Sabareeswaran, A; Varma, HK; Mohanan, PV
    Bioceramics have emerged as a hopeful remedy for site-specific drug delivery in orthopaedic complications, especially in chronic osteomyelitis. The bioresorbable nature of bioceramic materials shaped them into a versatile class of local antibiotic delivery systems in the treatment of chronic osteomyelitis. Hydroxyapatite (HA) based bioceramics with natural bone mimicking chemical composition are of particular interest due to their excellent biocompatibility, better osteoconductive and osteointegrative properties. Although HA has been widely recognized as an efficient tool for local delivery of antibiotics, information regarding its subchronic systemic toxicity have not been explored yet. Moreover, a detailed investigation of in vivo subchronic systemic toxicity of HA is critical for understanding its biocompatibility and futuristic clinical applications of these materials as novel therapeutic system in its long haul. Evaluation of biocompatibility and sub-chronic systemic toxicity are significant determinants in ensuring biomedical device’s long-term functionality and success. Sub-chronic systemic toxicity allows assessing the potential adverse effects caused by leachable and nanosized wear particles from the device materials under permissible human exposure to the distant organs that are not in direct contact with the devices. In this context, the present study evaluates the sub-chronic systemic toxicity of in-house developed Hydroxyapatite porous beads (HAPB), gentamicin-loaded HAPB (HAPB + G) and vancomycin- loaded HAPB (HAPB + V) through 4 and 26-week muscle implantation in New Zealand white rabbits, as per ISO 10993–6 and ISO 10993–11. Analysis of cellular responses of HAPB towards Human Osteosarcoma (HOS) cell line through MTT assay, direct contact cytotoxicity, live/dead assay based on Imaging Flow Cytometry (IFC) showed its non-cytotoxic behaviour. Histopathological analysis of muscle tissue, organs like heart, lungs, liver, kidney, spleen, adrenals, intestine, testes, ovaries, and uterus did not reveal any abnormal biological responses. Our study concludes that the HAPB, gentamicin-loaded HAPB (HAPB + G) and vancomycin-loaded HAPB (HAPB + V) are biocompatible and did not induce sub-chronic systemic toxicity and hence satisfies the criteria for regulatory approval of HAs as a plausible candidate for
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    Coronary artery fistula in children and adults: A review of 25 cases with long-term observations
    (INTERNATIONAL JOURNAL OF CARDIOLOGY, 1997) Sunder, KRS; Balakrishnan, KG; Tharakan, JA; Titus, T; Pillai, VRK; Francis, B; Kumar, A; Bhat, A; Shankaran, S
    We studied 25 patients with coronary artery fistula between 1976 and 1994. Age ranged from 1 to 58 years. Twelve patients were symptomatic; seven had dyspnoea, four had angina, one had palpitation and one had syncope. Coronary artery fistula involved right coronary artery in 10, left coronary artery in 11 and both right and left coronary arteries in four. Coronary artery fistula drained into right ventricle in 11, right atrium in nine, pulmonary artery in four and left ventricle in two. The Qp/Qs ranged from 1.0 to 2.6 with a mean of 1.39+/-0.38. Five patients had associated cardiac anomalies. Two had atrial septal defects, one had patent ductus arteriosus, one had atresia of proximal right coronary artery and in one patient, the right coronary artery was arising from left coronary artery. Five patients underwent surgery without any operative mortality. Thirteen patients were followed-up medically for a mean period of 6.1+/-5.1 years. There were no complications related to coronary artery fistula during follow-up. In one patient coronary artery fistula closed spontaneously. Copyright (C) 1997 Elsevier Science Ireland Ltd.
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    Femoral neuropathy following cardiac catheterization for balloon mitral valvotomy
    (INTERNATIONAL JOURNAL OF CARDIOLOGY, 1999) Kuruvilla, A; Kuruttukulam, G; Francis, B
    Femoral neuropathy is a very rare complication of cardiac catheterization. We report an adult female who developed femoral neuropathy after undergoing cardiac catheterization through femoral vein for balloon mitral valvotomy. Neuropathy was confirmed by electromyography and nerve conduction studies and the patient showed spontaneous recovery over a course of 6 months. Use of prolonged digital pressure for post-procedural hemostasis is implicated as possible etiology. Such complications can be prevented by by minimising the procedural time, avoiding injury to the vessels and maintaining optimal posture of patient's thigh by limiting abduction and external rotation of hip. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.
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    Percutaneous mitral commissurotomy with the metal commissurotome: Acute and six month follow up results.
    (CIRCULATION, 2000) Bhat, A; Francis, B; Shankar, S; Kumar, AV; Titus, T; Tharakan, J
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    Percutaneous transvenous mitral commissurotomy using an Inoue balloon in children with rheumatic mitral stenosis
    (INTERNATIONAL JOURNAL OF CARDIOLOGY, 1997)
    Percutaneous transvenous mitral commissurotomy(PTMC) using the Inoue technique was performed in 557 patients with rheumatic mitral stenosis. Of these, 107 were children aged 10-18 years (mean+/-SD 14.5+/-2.3). All patients were symptomatic New York Heart Association (NYHA) Class II(n = 78) and Class III (n = 29). All were in sinus rhythm. Following PTMC, the mitral valve area (MVA increased from 0.73+/-0.18 to 1.7+/-0.53 cm(2) (P<0.001). There was a significant fall in mean transmitral gradient from 15.6+/-5.2 to 5.1+/-2.3 mmHg, and in mean pulmonary artery pressure from 41+/-15 to 28.4+/-10 (P<0.001). Cardiac tamponade developed in one patient. One patient developed severe mitral regurgitation requiring emergency mitral valve replacement. Five patients (4.7%) developed moderate mitral regurgitation. There was no mortality or cerebral embolism in any of the children. Four patients (3.7%) had oximetry evidence of atrial septal defect. Mean mitral valve area and transmitral gradient at 14 months mean follow up was 1.68+/-0.4 cm(2) and 6+/-3.5 mmHg, respectively, and were comparable to the immediate post-PTMC results. Two patients (1.8%) developed restenosis. The immediate haemodynamic results in children were compared to 450 adult patients who underwent PTMC in the same period. The outcome was similar in both groups. Children were found to have significantly higher pulmonary artery pressure compared to adults. We found that PTMC using an Inoue balloon is very effective and safe in children, and consider that it should be the procedure of choice for young patients with symptomatic rheumatic mitral stenosis. (C) 1997 Elsevier Science Ireland Ltd.