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365 results on '"Kothari, Shyam Sunder"'

39. Neurodevelopmental outcomes in children with cyanotic congenital heart disease following open heart surgery.

Author

Shakya, Samir, Saxena, Anita, Gulati, Sheffali, Kothari, Shyam Sunder, Ramakrishnan, Sivasubramanian, Gupta, Saurabh Kumar, Devagourou, Velayoudam, Talwar, Sachin, Rajashekar, Palleti, and Sharma, Shobha

Subjects
CARDIAC surgery, EVALUATION of medical care, PERIOPERATIVE care, LENGTH of stay in hospitals, SCIENTIFIC observation, CONGENITAL heart disease, VIDEOCONFERENCING, COMPARATIVE studies, CHILD psychopathology, LONGITUDINAL method, NEUROLOGIC examination, COVID-19 pandemic, CHILDREN
Abstract

Background : Neurodevelopmental abnormalities are common in congenital heart disease (CHD), more so in cyanotic CHDs. Perioperative factors have been known to affect neurodevelopmental outcomes. Aim : We aimed to determine the neurodevelopmental outcomes following open-heart surgery in cyanotic CHD. Methods : In this prospective observational study, eligible infants and children < 21 months with cyanotic CHD planned for open-heart surgery underwent preoperative neurodevelopmental assessment using Developmental Assessment Scale for Indian Infants (DASII) to look for any motor and/or mental delay. A second neurodevelopmental assessment was performed after 9 months ± 2 weeks of cardiac surgery. Follow-up DASII was conducted through interactive video conferencing in 23 of 60 patients due to COVID-19 pandemic. The univentricular and biventricular repair groups were compared in terms of their neurodevelopmental outcomes. Perioperative factors were compared between neurodevelopmental "delay" and "no delay" groups. Results: Of the 89 children enrolled, preoperative motor and mental delay were present in 29 and 24 children, respectively. Follow-up DASII could be performed in 60 children. At follow-up, motor delay was present in seven and mental delay in four children. Overall, there was a significant improvement in both motor and mental developmental quotient at follow-up. There was no significant difference in either motor or mental domains between univentricular and biventricular groups. Among the perioperative variables, only the postoperative length of stay in intensive care unit was significantly different between neurodevelopmental "delay" and "no delay" groups (P = 0.04). Conclusion : Neurodevelopmental delay occurred substantially among unoperated children with cyanotic CHD. The neurodevelopmental status improved significantly following open-heart surgery among the survivors. Delay was associated with length of stay in intensive care following cardiac surgery. [ABSTRACT FROM AUTHOR]

Published
2022
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45. Subaortic Membrane Excision: Mid-Term Results

Author

Talwar, Sachin, Bisoi, Akshaya Kumar, Sharma, Rajesh, Bhan, Anil, Airan, Balram, Choudhary, Shiv Kumar, Kothari, Shyam Sunder, Saxena, Anita, and Venugopal, Panangipalli

Published
2001

47. Efficacy and safety of propranolol in infants with heart failure due to moderate-to-large ventricular septal defect (VSD-PHF study) -- A prospective randomized trial.

Author

Ramakrishnan, Sivasubramanian, Ghati, Nirmal, Ahuja, Ramandeep Singh, Bhatt, Kinjal Niranjan, Sati, Hem Chandra, Saxena, Anita, and Kothari, Shyam Sunder

Subjects
PROPRANOLOL, TREATMENT effectiveness, RANDOMIZED controlled trials, RISK assessment, DESCRIPTIVE statistics, HOSPITAL care, STATISTICAL sampling, HEART failure, VENTRICULAR septal defects, BRONCHIAL spasm, LONGITUDINAL method, PATIENT safety, CHILDREN
Abstract

Aims: The utility of beta-blocker therapy in infants with heart failure (HF) due to significant left-to-right shunt lesions is not known. The study aimed to assess the efficacy and safety of propranolol in infants with HF due to moderate-to-large ventricular septal defect (VSD). Methods: The prospective randomized trial included 80 infants with HF and moderate-to-large VSD, randomly allocated to receive either conventional therapy alone (n = 40) or propranolol plus conventional therapy (n = 40). The primary endpoint was a composite of all-cause mortality, hospitalization for HF and/or chest infection, and referral for surgery. The secondary clinical outcomes were the individual components of the composite endpoint. In addition, the patients were followed up to detect safety outcomes, for example, bronchospasm, bradyarrhythmia, and worsening HF symptoms. Results: The addition of propranolol therapy to the conventional medications did not result in significant improvement in the primary composite endpoint (32.50% vs. 52.50%; P = 0.07). There was a trend toward improvement, but the study is underpowered for this important question. However, propranolol therapy significantly decreased the risk of hospitalization (12.50% vs. 32.50%; P = 0.03) and worsening of Ross HF class (5.41% vs. 28.21%; P = 0.01) as compared to conventional therapy (estimated number needed to treat = 5). Propranolol did not result in any significant safety concerns in these infants except bronchospasm in an infant. Conclusions: Propranolol therapy in infants with significant left-to-right shunt may prevent worsening in HF symptoms and hospitalization and is well tolerated. However, it does not reduce mortality or need for surgery. [ABSTRACT FROM AUTHOR]

Published
2021
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49. Abernethy malformation type 2: varied presentation, management and outcome

Author

Jain, Vishesh, primary, Sangdup, Tsering, additional, Agarwala, Sandeep, additional, Bishoi, Akshay Kumar, additional, Chauhan, Sandeep, additional, Dhua, Anjan, additional, Jana, Manisha, additional, Kandasamy, Devasenathipathy, additional, Malik, Rohan, additional, Kothari, Shyam Sunder, additional, Patcharu, Ravi, additional, Varshney, Abhimanyu, additional, and Bhatnagar, Veereshwar, additional

Published
2019
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