Search PubMed⌕ Search

Biomedical subjects

B L Laddha

Publications and source records attributed to B L Laddha.

7 recordsLinked to original sources
PubMed2000

Pedicled omental transfer for limb salvage in Buerger's disease.

We performed pedicled omental transfer in 62 patients with Buerger's disease at the Department of Surgery, J.L.N. Hospital, Ajmer between January 1990 and December 1996. All were male and had evidence of limb ischaemia. Post-operative results in these patients consisted of relief of intermittent claudication in 92%, disappearance of rest pain in 94%, disappearance of limb coldness in 83%, disappearance of discolouration in 82%, and healing of ischaemic ulcers in 83%. Tissue oxygen saturation in the affected limb improved from a mean of 84.8+/-3.6% in the preoperative period, to 89+/-1.5% at 12 h, 93.1+/-1.8% at 72 h and 96+/-1.2% at the end of 2 months of follow-up. Claudication distance improved from a mean of 75+/-20 m in the pre-operative period to 1000+/-110 m at 2 months of follow-up in 57 of 62 patients. Major amputations were not required in any patient, thus conserving the limb. We conclude that pedicled omental transfer offers promising results in patients with limb ischaemia due to Buerger's disease.

Adult↗
PubMed1999

Trauma scoring in a developing country.

AIM OF STUDY: The aim of the study was to evaluate the efficacy of trauma scoring systems in a developing country. METHOD: Trauma Score (TS) and Trauma and Injury Severity Score (TRISS) were used to predict the survival of 462 trauma patients during the period January 1996 to July 1996. RESULTS: TS had a sensitivity of 53.9% and a specificity of 98.8% whereas TRISS had a sensitivity of 46% and a specificity of 98.7%. Significant differences in mortality were observed compared with the baseline Major Trauma Outcome Study (MTOS) norms (Z = 4.17, p < 0.001). CONCLUSION: Present injury severity instruments using MTOS coefficients do not accurately predict survival of trauma patients in a developing country, thus highlighting the need for developing new coefficients for trauma scoring in these countries.

Developing Countries↗
PubMed1998

Free versus pedicled omental grafts for limb salvage in Buerger's disease.

BACKGROUND: Buerger's disease is a disabling and progressive disease that affects young smokers with a variable and unpredictable course. Free or pedicled omental transfer are the possible modes of management for these patients, and these modes are compared in the present study. METHODS: Of the 43 patients who had Buerger's disease who were treated at the Department of Surgery, Jawahar Lal Nehru (JLN) Hospital, Ajmer, between January 1990 and December 1995, 15 patients underwent application of free omental grafts (group A); 28 patients underwent pedicled omental transplantation (group B). The clinical results obtained with the use of either technique were compared. RESULTS: There were no statistically significant differences in the relief of intermittent claudication (80% vs 82%), rest pain (82% vs 91%), coldness (83% vs 87%), discolouration (80% vs 82%), ulceration (75% vs 78%) and post-amputation ulcer healing (75% vs 86%) in the two groups (P > 0.05); but the time taken for the relief of intermittent claudication, rest pain and coldness was significantly less in group B. Major amputations were not required in both the groups. CONCLUSIONS: These findings suggest that the ultimate clinical benefits obtained with the use of either free or pedicled omental grafts in patients with Buerger's disease are similar, supporting a possible local action of the omentum.

Adult↗
PubMedDate not supplied

Choice of incision in surgical management of small bowel perforations in enteric fever.

Fifty six patients with typhoid enteric perforation who underwent operative treatment were randomly assigned to 2 groups. Twenty seven patients in group A underwent laparotomy via the Rutherford-Morrison incision while 29 patients in group B underwent the same procedure via a right paramedian incision. Surgical treatment consisted of two layer closure of the perforation with peritoneal lavage and tube drainage in all cases. Mean operating time in group A and group B was 45 +/- 10 minutes and 73 +/- 6 minutes respectively (p < 0.001). Postoperative wound dehiscence in group A and group B was observed in 2 and 11 cases respectively (p < 0.001). Incisional hernia developed in 8 patients in group B and none in group A (p < 0.01). Two patients in group A and 10 in group B developed adhesion-obstruction (p < 0.05). Differences in wound sepsis, pelvic abscess and mortality were not significant. Mean hospital stay in groups A and B was 12.4 days and 16.8 days respectively (p < 0.001). We conclude that in the presence of a confirmed preoperative diagnosis of typhoid enteric perforation, laparotomy via the Rutherford-Morrison incision may significantly reduce postoperative wound complications and morbidity without significantly altering the overall outcome.

Female↗