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Biomedical subjects

B C Sharma

Publications and source records attributed to B C Sharma.

86 records · Page 5Linked to original sources
PubMedDate not supplied

Diaphragm disease of duodenum following long-term NSAIDs use: endoscopic management.

We report our experience with endoscopic management of 3 men (aged 62, 63 and 65 years) with duodenal diaphragm disease following NSAID use for 5-15 years. In the first patient a 24 F through-the-scope balloon dilatation was attempted but failed; he subsequently underwent gastro-jejunostomy. The other two patients subsequently underwent radial incisions of the web with mixed cutting and coagulation current using a standard 5 F sphincterotome.

Aged↗
PubMedDate not supplied

Cholestatic liver injury due to ibuprofen.

Ibuprofen is a member of the propionic acid class of NSAID. We report a 35-year-old man with ibuprofen-induced acute severe cholestatic liver injury. He recovered after seven months.

Adult↗
PubMedDate not supplied

The treatment of sepsis in superficial burns: effect of 1% Silver Sulphadiazine.

One hundred patients with superficial burns were treated by the exposure method under ordinary ward conditions. Topical 1% Silver Sulphidiazine ("Flamazine") was used under controlled conditions. The exposure technique, with judicious local cleaning, resulted in spontaneous healing in 42% of cases. Topical "Flamazine" was used in 58% of cases. It was found to be soothing, giving patients instant relief of pain. It arrested crack and fissure formation with bleeding, especially in burnt areas in the neck and about major joints. It expedited healing; an astringent effect was also observed. It was concluded that the exposure technique, with topical "Flamazine", was beneficial in the treatment of superficial burns, obviating the routine daily bathing of the burnt.

Administration, Topical↗
PubMedDate not supplied

A "pull-out" technique for "cut down" operations.

It is a common experience that some patients continue to attend outpatient departments with their cut-down wounds long after their primary disease is cured. This is so because a cut-down is done usually in an emergency situation with poor aseptic rituals. More often than not the patient is in shock and in urgent need of fluids but his peripheral veins are collapsed. It is often found that the ligature used to tie off the vein is responsible for the persistence of infection. When it is removed and an associated abscess(if any) drained cure results. A new simple technique has been devised and described here for cut-down operations which overcomes the problem.

Humans↗
PubMedDate not supplied

Burns: early shaving and immediate skin-grafting of dorsum of the hand.

Fourteen men with deep dermal burns of the dorsum of the hand treated by early excision and primary skin grafting are presented. Satisfactory functional and cosmetic results within two to three weeks were obtained in ten patients and in five to six weeks in the remaining four. Three patients who refused surgery developed contractures. The procedure is recommended as a routine.

Burns↗
PubMedDate not supplied

Keloids: a prospective study of 57 cases.

Of the total 57 cases of keloids, 8 cases of massive keloids were treated by diathermy excision and immediate skin grafting; 35 keloids of ear lobule by intramarginal excision and post-operative local hydrocostisone; 7 presternal keloids by local corticoids alone and a miscellaneous group of 7 cases of keloids were treated by combination therapy. It is concluded that massive keloids with or without sinuses and keloidal contractures require surgery to improve appearance and function respectively. Ear lobule keloids are best treated by intramarginal excision and post-operative local hydrocortisone. Presternal keloids and small keloids elsewhere should be treated by intralesional injection of corticoids alone. Initial results of intramarginal excision with or without local corticoids were satisfactory. However it is too early to claim best result with this regimen, in the absence of long term follow up.

Adolescent↗
PubMedDate not supplied

Aetiology and dynamics of dyspepsia in Shimla: a study of 500 patients.

Dyspepsia is a frequent presenting symptom amongst patients attending medical clinics worldwide. However their aetiologies differ geographically. The present study was conducted to identify the aetiologies of dyspepsia of our centre and to determine their clinical characteristics. Five hundred consecutive patients presenting with dyspepsia were studied at our Institute. All patients underwent detailed structured questionnaire, stool examination, upper gastrointestinal endoscopy, ultrasound scan of upper abdomen and sigmoidoscopy when necessary. Among 500 patients, 34% suffered from essential dyspepsia, 28% had peptic ulcer, 19.2% had cholelithiasis, 10.8% had irritable bowel syndrome and 6% had gastro-oesophageal reflux. Significantly more patients with peptic ulcer experienced night paints, pain relief with food, milk, antacids or H2 receptor antagonists and periodic pain. In patients with essential dyspepsia, pain was continuous, mild to moderate in intensity, aggravated by food or alcohol, without relief with milk, antacids or H2 receptor antagonists and night pains were absent in them.

Adult↗
PubMedDate not supplied

Percutaneous transhepatic biliary drainage in the management of obstructive jaundice.

BACKGROUND: Percutaneous transhepatic biliary drainage (PTBD) has been employed for decompression of the obstructed biliary tract to palliate jaundice and pruritus and for the management of cholangitis. We present our data to review the indications, therapeutic results and associated mortality and complications of this procedure. We have also studied the effect of size of drainage catheters on the improvement in liver functions and procedure related complications. METHODS: PTBD was attempted in 41 patients (18 men, age 56 +/- 12 years; 23 women, age 55 +/- 11 years) with obstructive jaundice (37 malignant, 4 benign). RESULTS: PTBD was successful in 39 (95%) patients. Mean serum bilirubin and alkaline phosphatase concentration declined significantly (p < 0.000001 for both) after 1 week, however thereafter decline was slow. Complete relief of pruritus and cholangitis was noted in most patients. Major complications such as cholangitis, bile leak into the peritoneum, malfunction of drainage catheter, intraperitoneal haemorrhage and renal failure, occurred in 11 (28%) patients, 2 (5%) of whom died. Large catheters (> 10 Fr) were superior to small size catheters (< 10 Fr) in relief of jaundice and had lower catheter related cholangitis. CONCLUSIONS: We conclude that PTBD is useful for palliation of malignant obstructive jaundice with intractable symptoms and cholangitis. Catheters larger than 10 Fr should be used.

Cholangitis↗
PubMedDate not supplied

Normal limits of 14C-urea breath test.

BACKGROUND/AIMS: 14C-urea breath test has been widely used for diagnosis of Helicobacter pylori (H. pylori) infection. There is no general agreement on the cutoff values for determination of H. pylori negative subjects. We studied baseline values in subjects who were proved to be H. pylori negative and calculated the cutoff value of normalcy. A comparison of this test with other tests for diagnosis of H. pylori infection was also done. PATIENTS AND METHODS: 12 patients (mean age 34 +/- 14, range 22-65 years; 8 men) of non-ulcer dyspepsia were studied, who were proved to be H. pylori negative by rapid urease test, Gram's staining, histopathology and culture of gastric mucosal biopsies obtained four each from the antrum, body and fundus of the stomach. The controls included 12 patients (mean age 40 +/- 13, range 22-65 years, 9 men), who were positive for H. pylori on culture or combination of rapid urease test and histopathology or rapid urease test and Gram's stain. 14C-urea breath test was performed using 5 uCi of 14C-urea dissolved in 300 ml of water. Breath samples were collected once before ingestion of 14C urea and subsequently at 5, 15 and 30 minutes after ingestion and 14C-contents in the breath samples measured. Results were expressed as 14 CO2/mmol CO2 exhaled as percent of administered urea. RESULTS: The mean +/- SD 14-C value in H. pylori negative vs H. pylori positive patients at 5 minutes, 15 minutes and 30 minutes were found to be 0.003 +/- 0.003 vs 0.064 +/- 0.042 (p < 0.001), 0.002 +/- 0.001 vs 0.056 +/- 0.039 (p < 0.001) and 0.001 +/- 0.002 vs 0.041 +/- 0.026 (p < 0.001) respectively. The mean values of 14C-urea breath test were significantly lower in H. pylori negative patients as compared to H. pylori positive patients. Using receiver operating characteristic (ROC) analysis of the data, the cutoff values obtained were 0.01, 0.007 and 0.009 at 5 minutes, 15 minutes and 30 minutes respectively. CONCLUSIONS: 14C-urea breath test levels at 5, 15 and 30 minutes intervals are significantly lower in H. pylori negative patients as compared to H. pylori positive patients. This test has high sensitivity and specificity in detecting H. pylori infection.

Adult↗