Browsing by Author "Patel Ashvin K."

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Endomyocardial fibrosis and eosinophilia
(British Heart Journal, 1977) Patel Ashvin K.; D'Arbela Paul G.; Somers Krishna
Absolute eosinophil counts were assessed in 15 African patients with proven endomyocardial fibrosis. Though the mean eosinophil count in patients with endomyocardial fibrosis was higher compared with the normals reported from Kampala (1-13 vs 0.72X10(9)/1), the absolute range was comparable. A high percentage of patients with endomyocardial fibrosis had malarial parasites, high malarial antibody titres, hookworms, or strongyloides, but the correlation of eosinophilia to various parasitic infections was poor. Both eosinophilia and parasitic infections are common in the tropics and they effect patients with endomyocardial fibrosis no more than the population at large. Other aetiological factors, genetic, environmental, and immunological, are felt to be important in the causation of endomyocardial fibrosis in Uganda and evidence for this is reviewed. Though there is a similarity in pathological features, African endomyocardial fibrosis is a distinct entity from Löffler's endocarditis and cardiac lesions seen in eosinophilic leukaemia or reactive eosinophilia. There is no hard evidence to suggest that African endomyocardial fibrosis is a variant of Löffler's endocarditis caused by parasitic infections via eosinophilia.
Familial Cases of Endomyocardial Fibrosis in Uganda
(Br Med J - The BMJ, 1971) Patel Ashvin K.; Ziegler John L.; D'Arbela Paul G.; Somers Krishna
This report describes nine cases of endomyocardial fibrosis occurring in four families. All patients came from Rwanda or South-western Uganda, and five had tropical splenomegaly syndrome as well. It seems likely that genetic as well as environmental factors are operative in the aetiology of endomyocardial fibrosis.
Survival after first presentation with endomyocardial fibrosis
(British Heart Journal, 1972) D'Arbela Paul G.; Mutazindwa T.; Patel Ashvin K.; Somers Krishna
Forty-six cases of necropsy endomyocardial fibrosis are analysed and presented with the objective of determining their prognosis after first symptoms of the disease. Survival from first symptoms ranged from 12 days to 12 years and 2 weeks, the mean survival being 24 months. The commonest mode of termination was by progressive myocardial failure, very frequently associated with acute respiratory events - either pulmonary oedema, bronchopneumonia, or pulmonary infarction. Un-explained sudden deterioration and collapse probably due to a terminal acute dysrhythmia was the second most important immediate cause of death. Patients with sole left-sided endomyocardial fibrosis run a higher risk of succumbing to acute pulmonary oedema. Protection by development of severe right-sided endomyocardial fibrosis, organic tricuspid regurgitation, or pulmonary hypertension was therefore a relative advantage, and if other un-expected complications were excluded, survival time was increased. The role of the continuing myocardial destructive process in determining survival rate is discussed.