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Biomedical subjects

K Singh

Publications and source records attributed to K Singh.

787 records · Page 44Linked to original sources
PubMedDate not supplied

Evaluation of commercially available antacid tablets.

Antacids are commonly used for the treatment of acid peptic disease. There is a need to study the relative merits of various brands of antacids available commercially. Twenty three brands of antacid tablet preparations were evaluated with regard to their composition, cost, dispersion time, pH, neutralising capacity and time taken for neutralisation. The cost of various tablets ranged from Rs 0.13 to Rs. 1.48 per tablet and the dispersion time from 20 to 90 minutes. The pH of the dispersed tablet solution ranged from 5.7 to 9.5. The neutralising capacity varied between 8 to 169 meq/tablet and the neutralizing time between 20 and 45 minutes. The cost: neutralizing ratio was calculated and ranged from 102 to 9867 x 10(-3) Rs/meq. A scoring system with a maximum score of 12 has been devised. The study provides a guide for choosing a more potent, quick neutralising and low cost antacid preparation.

Antacids↗
PubMedDate not supplied

Long common channel syndrome as etiology of choledochal cysts and pancreatitis--two instructive cases.

The aetiology of choledochal cysts is controversial. The authors report two cases of Type I C and Type IV B choledochal cysts; both showing axial dilatation of the common bile duct and common hepatic ducts, single fusiform (Type IC) and multiple cysts of extrahepatic ducts only (Type IVB). Both had anomalous junction of the pancreaticobiliary ductal system as delineated on ERCP leading to the formation of a long common channel. Both these female patients presented in the third decade of life with 7-8 years history of repeated episodes of right upper abdominal and epigastric pain suggestive of pancreatitis. Similar pain was precipitated in both patients following ERCP with raised serum amylase. Hepatico-enterostomy gave lasting relief in both these patients.

Adult↗
PubMedDate not supplied

Management of learning disability in the general hospital.

Learning-disabled people need to use the same medical services as the rest of the population. Once referred to a general hospital their diagnosis and treatment must take into account any special needs generated by their disability. This article describes the way in which this can be achieved and the resource implications.

Adult↗
PubMedDate not supplied

Gastric stromal tumor: treatment by snare polypectomy.

A patient presenting with hematemesis was detected to have a 3 cm sized pedunculated polyp in the gastric antrum. A snare polypectomy was performed. Histopathology of polyp revealed it to be benign submucosal stromal tumor.

Aged↗
PubMedDate not supplied

Clinical similarities and demographic differences between residency and private practice patients.

BACKGROUND: This study compared the clinical and demographic mix of patients at a family practice residency site in South Carolina to those from other regions and demonstrated the effectiveness of a computerized medical record in facilitating such analysis. METHODS: Patient visits to Richland Family Practice Center (RFP), the outpatient care site for the University of South Carolina School of Medicine, were retrospectively sampled for the period July 1992-June 1993. Data analysis used descriptive statistics and contingency tables. A time test comparing manual and computerized data retrieval was also performed. RESULTS: The patients seen were predominantly female (75.2%) and African-American (68%). RFP treated proportionately more federally funded and minority patients than did community-based physicians. The top five principal diagnoses at RFP were hypertension, diabetes mellitus, general medical examination, normal pregnancy, and acute upper respiratory infection; the top 20 principal diagnoses accounted for 51.3% of all visits. When compared to the top 20 diagnoses for all family and general practice physicians in the southern United States, considerable overlap was present, confirming clinical similarity between patient populations at residency and private practice sites. Computerized data retrieval was faster and more complete than manual data retrieval. CONCLUSIONS: Diagnoses encountered at RFP and reported by other family practice residencies generally parallel those documented in family practice in various geographic regions. However, residencies differ from private practices in that they care for more economically disadvantaged patients. Computerized medical records systems facilitate research within a residency program.

Adolescent↗
PubMedDate not supplied

Normal pancreatic duct morphology in a north Indian population.

Ninety three normal pancreatograms from a North Indian population were studied. The pancreatic duct (PD) was L-shaped in 47%, oblique in 5% and sigmoid in 11%. The mean length (SD) of PD was 18.2 (3.0) cm, being longer in males but not varying with age. The mean maximum diameters of PD in head, body and tail were 3.7 (0.8), 2.7 (0.6) and 1.7 (0.4) mm respectively. These did not vary with sex. The PD diameters showed a statistically significant increase with age but this variation does not appear to be of much practical importance.

Adolescent↗
PubMedDate not supplied

Primary duodenal tuberculosis diagnosed by endoscopic biopsy.

Tuberculosis involves the duodenum very rarely and is usually secondary to lymph node involvement. Endoscopic biopsy usually shows nonspecific changes necessitating laparotomy for confirmation of diagnosis and relief of obstruction. We report a case of duodenal tuberculosis diagnosed by endoscopic biopsy and treated successfully.

Adolescent↗
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Helicobacter pylori infection in patients with perforated duodenal ulcer.

AIM: Perforation is the commonest complication of duodenal ulcer. Helicobacter pylori is found in 95% patients with duodenal ulcer. However, there is paucity of reports on prevalence of H. pylori infection in patients with duodenal ulcer perforation. We, therefore compared the incidence of H. pylori infection in patients with duodenal ulcer perforation with the incidence in patients having complicated duodenal ulcers and non-ulcer dyspepsia. PATIENTS AND METHODS: The study was conducted on 45 patients (complicated duodenal ulcer 15, duodenal ulcer perforation 15, non-ulcer dyspepsia 15). Per-operative punch antral biopsies were taken in patients with duodenal ulcer perforation whereas endoscopic punch biopsies of antrum were taken in patients with non-ulcer dyspepsia. The criteria for H. pylori positivity was i) growth of H. pylori on culture, ii) combination of rapid urease test (RUT) and Giemsa staining, combination of RUT and Gram stain being positive for H. pylori. RESULTS: While 9 of 15 cases with complicated duodenal ulcer, 7 of 15 cases with non-ulcer dyspepsia were positive for H. pylori, none of the patients with duodenal ulcer perforation tested positive for H. pylori (p < 0.000). All patients with perforated duodenal ulcer had histological gastritis (H. pylori -ve). Fourteen of 15 patients (9 H. pylori +ve, 5 H. pylori -ve) with complicated duodenal ulcer and 9 of 15 patients (7 H. pylori +ve) with non-ulcer dyspepsia had histological gastritis. CONCLUSION: Patients with duodenal ulcer perforation do not have H. pylori infection. H. pylori negative patients of duodenal ulcer may have more predilection for perforation.

Adolescent↗
PubMedDate not supplied

Effect of omeprazole on gastric bicarbonate secretion in patients with duodenal ulcer.

BACKGROUND: Omeprazole, a H+/K+ ATPase inhibitor, has been shown to reduce gastric bicarbonate secretion in cats. However, there has been no study on the effect of omeprazole on bicarbonate secretion in patients with duodenal ulcer (DU). METHODS: Fifteen men with duodenal ulcer (mean age 38 years, range 22-57) were included. Baseline gastric acid output, bicarbonate secretion, and parietal and nonparietal secretions were estimated before and after omeprazole therapy (20 mg/day) for four weeks. RESULTS: Omeprazole administration did not significantly alter bicarbonate secretion (3.3 [1.2] vs 2.4 [0.4] mmol/h), though there was significant reduction in gastric acidity (44.2 [6.6] vs 20.7 [4.6] mmol/L, p < 0.01). CONCLUSION: Omeprazole reduces acid secretion but does not affect gastric bicarbonate secretion in patients with DU.

Adult↗
PubMedDate not supplied

Liver span--a comparative appraisal of various methods.

BACKGROUND: Alterations in the size and shape of liver occur in a wide variety of conditions. Liver span can be estimated by using clinical, radiological or radioisotopic methods. Chest dimensions may alter the liver span. METHOD: We evaluated the liver span in 51 healthy individuals by clinical, radiological and radioisotopic methods and its relation with chest dimensions. RESULTS: The liver span by clinical, radiological and radioisotopic methods was 10.8 +/- 1.1 cm, 12.6 +/- 1.5 cm and 13.6 +/- 1.7 cm, respectively. Liver span varied with clinical and radiological or radioisotopic method and it correlated with height of chest cage and subcostal angle in these individuals. CONCLUSION: The liver span varies with the method used and it is correlated with chest dimensions.

Adult↗
PubMedDate not supplied

Routes of transmission in the hepatitis E epidemic of Saharanpur.

A large waterborne epidemic of hepatitis E occurred in the city of Saharanpur (Uttar Pradesh, India) between December 1992 and April 1993. A random survey was conducted in the affected area of Saharanpur. Source of water supply, number of family members, number and characteristics of affected persons were noted. Blood, stool and water samples were collected. The incidence of hepatitis was 14% in the affected area of the city. A total of 3682 individuals were affected with the disease. Attack rate for adults was significantly higher than the children aged < 15 years (17% vs 7%; p < 0.0001). Among the adults, the attack rate was higher for males than females (23% vs 12%; p < 0.0001). The incidence of hepatitis was greater in persons using the municipal water supply (17%) as compared to hand pump (0.9%) or tubewell water (0%). There was a single peak in the epidemic. Of the 56 fresh cases, 38 (64%) occurred within two weeks, 14 within 2-4 weeks and 4 within 4-6 weeks of index cases. Serologic markers for acute hepatitis A, B and C were absent. IgM anti-HEV was positive in 20 out of 24 sera tested. Immune electron microscopy detected 27-34 nm virus-like particles (VLPs) in 2 of 8 stool specimens and in 1 of 3 water samples. The epidemic occurred due to leakage of municipal water supply pipes passing through the sewerage holes. A large waterborne epidemic of hepatitis E resulted due to contaminated water supply. VLPs were detected in water. Adults and males were commonly affected. There was no person-to-person spread.

Adult↗
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↗