Biomedical subjects

G Kurian

Publications and source records attributed to G Kurian.

22 records · Page 2Linked to original sources

PubMedDate not supplied

Crohn's disease in rheumatology clinic--an Indian experience.

BACKGROUND: Prevalence of Crohn's disease (CD) among patients with rheumatic illnesses in India is grossly under estimated, especially when it has overtaken that of Ulcerative Colitis in the West. AIM: To study the frequency of histologically unequivocal CD amongst clinically suspected patients with enteropathic arthropathy and to ascertain if the arthritics with CD have any independent clinical predictor. SETTINGS AND DESIGNS: Retrospective datasheet analysis from a Rheumatology clinic of a large tertiary care centre. MATERIALS AND METHODS: Patients of suspected enteropathic arthropathy were studied by ileocolonoscopy and segmental colonic biopsy for histological evidence of Crohn's disease and followed up. STATISTICAL ANALYSIS: Logistic regression analysis was done to find out any clinical predictor of histologically proven CD. RESULTS: Fourteen of the twenty-nine patients studied had histologically confirmed CD. Those with CD were younger than those without (34.7 yr vs 41.6 yrs, p=0.057). The CD group also had significantly higher number of people with loss of weight (12 vs 1), fever (11 vs 0), perianal fistula (4 vs 0), abdominal pain (8 vs 2), history of dysentery (4 vs 0) and uveitis (6 vs 1) (p=0.00002, 0.00001, 0.026, 0.013, 0.026 & 0.01 respectively). However logistic regression analysis of the most relevant ones among these, namely, loss of weight, fever, and perianal fistula showed loss of weight as only independent predictor of CD in this subset of patients (p=0.03 with odds ratio of 28). CONCLUSION: Presence of significant loss of weight in an Indian patient with clinically suspected enteropathic arthropathy is an independent predictor of CD.

Adult↗

PubMedDate not supplied

Intraoperative enteroscopy in obscure gastrointestinal hemorrhage.

Forty three patients were diagnosed to have obscure gastrointestinal hemorrhage (OGH) between January 1987 and April 1996. Pre-operative diagnostic investigations were useful in localizing the site of bleeding in 28 patients (65.1%). These included small bowel enema (n = 12), erythrocyte tagged scan (n = 8), Meckel's scan (n = 2) and selective visceral angiography (n = 7). Following complete evaluation all patients underwent exploratory laparotomy. At laparotomy 31 patients were found to have gross lesions. Intraoperative enteroscopy (IOE) could detect lesions in 9 of the remaining 12 patients.

Adult↗

PubMedDate not supplied

Eosinophilic gastroenteritis--an Indian experience.

Eosinophilic gastroenteritis is an uncommon disorder with varied presentation. Records of 7 patients (6 men) with eosinophilic gastroenteritis, presenting to a large referral hospital over a 10-year period, were analyzed. The patients were young adults (mean age 32 years) with short duration (median 2 months) of illness. Symptoms included abdominal pain and vomiting (100%), weight loss (57%), diarrhea (43%) and abdominal distension (43%). Peripheral eosinophilia was present in all the patients. The diagnosis was made at duodenal (2 patients) or cecal (1) biopsy or surgical full-thickness jejunal biopsy (4). Three patients had predominantly mucosal disease (Klein type I), whereas two patients each had predominantly muscular (type II) and submucosal (type III) disease. Surgical resection was curative in one patient with type II disease. The other six responded to prednisolone, with complete resolution in one patient.

Adult↗

PubMedDate not supplied

Diagnosis and management of gastrointestinal angiodysplasia.

Eighteen patients with gastrointestinal angiodysplasia were seen in a single surgical unit over a period of 8 years. The mean age at onset of symptoms was 33 years. The average duration of symptoms was 54 months (range 2 days-16 years). Three patients had gastric angiodysplasia, two had colonic angiodysplasia, both diagnosed endoscopically preoperatively. The remaining patients required further investigation, which included small bowel enema (SBE), erythrocyte tagged scan (ETC), selective visceral angiography and intraoperative enteroscopy (IOE). SBE was useful but not diagnostic in 3, ETC in 3 and angiography in 5. Four patients required IOE for a diagnosis. Follow up of 17 months is available on all patients. Four had recurrence of symptoms. One required re-exploration and resection of 3 feet of small bowel and right hemicolectomy, another is on hormonal therapy and maintaining normal haemoglobin. Two others are asymptomatic on oral iron therapy.

Adolescent↗