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Biomedical subjects

M K Goenka

Publications and source records attributed to M K Goenka.

At least 37 records · Page 2Linked to original sources
PubMed1996

Pancrease divisum: five years' experience in a teaching hospital.

AIM: To study the frequency and significance of pancreas divisum. METHODS: Retrospective analysis of all pancreatograms carried out between July 1989 and June 1994. RESULTS: The 809 pancreatograms performed included 207 in patients with pancreatitis (acute 74, chronic 133), 330 with biliary disease, 238 with obscure abdominal pain and 34 with pancreatic malignancy. Of these, 30 patients (3.7%) were diagnosed to have pancreas divisum - 26 had type I variant, one had type II variant and three had type III variant. Accessory papillary cannulation was attempted in 10 patients; 8 were successful, with dorsal ductography confirming pancreas divisum in all of them. Two of these 8 patients had changes of chronic pancreatitis in the dorsal duct. The frequency of pancreas divisum in patients with pancreatitis (19 of 207, 9.2%) was significantly higher than in patients with biliary diseases and those with obscure abdominal pain (11 of 568, 1.9%; p < 0.001). CONCLUSIONS: Pancreas divisum is not an uncommon condition in India and its frequency in patients with idiopathic pancreatitis is higher than that in patients with other abdominal conditions. It should be looked for in any case of idiopathic pancreatitis.

Biliary Tract Diseases↗
PubMed1995

Hepatic involvement culminating in cirrhosis in a child with disseminated cryptococcosis.

A 7-year-old child had unusual manifestation of cryptococcosis; liver and lymph node involvement predominated. There was evidence of cryptococcal hepatitis, extrahepatic biliary obstruction, and subsequent cirrhosis of the liver. Despite widespread dissemination, underlying immune disturbance was not evident. The patient was treated with two courses of amphotericin and 5-flucytosine.

Amphotericin B↗
PubMed1995

A study of hepatitis delta virus infection in patients with acute and chronic liver disease from northern India.

To assess the prevalence of hepatitis delta virus (H delta V) in northern India, 204 adult patients with acute and chronic liver disease who were positive for hepatitis B virus (HBV) markers were screened for anti-H delta V antibody by enzyme-linked immunosorbent assay (ELISA). Anti-H delta V antibodies were positive in 29 (14.2%) patients. The incidence of H delta V infection was higher (21.4%) in patients with chronic liver disease when compared with those with acute viral hepatitis (10.7%) (P < 0.05). H delta V antibodies were positive in 16.6% of patients with fulminant hepatic failure (FHF) and in 25% of cases with hepatocellular carcinoma. Co-infections were significantly higher in acute hepatitis (80%), while superinfections predominated (66.7%) in chronic liver disease (P < 0.05). Our data show that H delta V is endemic in northern India and should be considered a major health problem.

Acute Disease↗
PubMed1995

Eosinophilic gastroenteritis presenting as acute intestinal obstruction.

Eosinophilic gastroenteritis is a rare disorder of the gastrointestinal tract. Three cases of eosinophilic gastroenteritis presenting as intestinal obstruction are reported. Two patients had stenotic lesions in the jejunum whereas the ileum was involved in the third. None had peripheral eosinophilia. All underwent resection-anastomosis of the bowel and are symptom-free at follow-up ranging from 8 months to 6 years.

Acute Disease↗
PubMed1995

Pancreatic ascites and pleural effusion treated by endoscopic pancreatic stent placement.

Usefulness of endoscopic pancreatic stents in the management of pancreatic ascites and pleural effusion has been evaluated only recently. We report a patient with alcoholic pancreatitis who presented with ascites and pleural effusion and had a pancreatic duct disruption in the body area on pancreaticography. A 5 F stent was placed across the disruption with rapid subsidence of both ascites and pleural effusion. The stent was removed after 12 weeks and there has been no recurrence during a follow-up period of 9 months.

Alcoholism↗
PubMed1995

Colovesical fistula complicating colonic diverticulosis.

Two cases of colovesical fistulae secondary to colonic diverticulosis are reported. Urinary symptoms were the prominent presenting features. Barium enema was helpful in documenting the fistulae, which cystoscopically was not localised. Definitive treatment included resection of the fistula and the diseased segment of the intestine. Both patients are well on follow-up. Diverticulosis coli should be considered in the differential diagnosis of colovesical fistulae even in tropical countries.

Aged↗
PubMed1995

Isolated esophageal tuberculosis.

Isolated esophageal tuberculosis is very rare. We report a patient who presented with history of retrosternal pain and dysphagia and on investigation was found to have a smooth esophageal mass. Endoscopic biopsy showed epitheloid cell granuloma with necrosis suggestive of tuberculosis. CT scan of the thorax showed no involvement of adjacent structures. The patient responded to antitubercular therapy.

Adult↗
PubMed1994

Fungal colonization of untreated peptic ulcer.

AIM: To evaluate the relationship between Candida and peptic ulcer. METHODS: One hundred consecutive patients with untreated peptic ulcer (81 with duodenal ulcer and 19 with gastric ulcer) were studied using histopathology, culture and fungal serology. Twenty subjects with non-ulcer dyspepsia were taken as controls. RESULTS: Forty seven patients (47%) with peptic ulcer were colonized by Candida as compared to 3 patients (15%) with non ulcer dyspepsia (p < 0.05). Confluent growth of Candida on culture of gastric aspirate or biopsy from ulcer edge was a more sensitive method for diagnosis of peptic ulcer-associated candidiasis than histological examination. There was no significant difference in the prevalence of Candida isolation in relation to age or sex of the patients, smoking habit and alcoholism. Large ulcers (> 2 cm) were, however, more often colonized by Candida (75%) than smaller ones (43%) (p < 0.05). Candida albicans was the commonest species isolated (60%). Invasive candidiasis was associated with Candida agglutinin titer of 1:128 in 81% of cases. CONCLUSION: Candida colonization rate in peptic ulcer is significantly higher than in non-ulcer dyspepsia.

Adolescent↗
PubMed1994

Colonic diverticulosis in India: the changing scene.

BACKGROUND: The prevalence of colonic diverticulosis has a wide geographic and ethnic variation and has been considered to be quite low in India. This study was aimed at determining the prevalence of colonic diverticulosis in northern India based on barium enema examination in symptomatic patients. METHODS: All barium enema examinations performed between January 1985 and December 1991 were reviewed for the presence of colonic diverticulosis. Clinical data of such patients were retrieved. RESULTS: 51 (3.2%) of 1610 barium enema studies showed colonic diverticulosis. The frequency of diverticulosis in barium studies increased from 0.3% among subjects in the third decade to 32.4% in patients above 60 years. Most patients were city dwellers, vegetarians and belonged to the upper socio-economic stratum. Twenty patients (39.2%) presented with a complication; the spectrum of such patients was no different from that reported from the West. While the sigmoid colon was the commonest site of diverticuli, there was a relative preponderance of right sided diverticuli as compared to the Western experience. Seven patients with complications required surgical treatment, while the rest were managed conservatively. CONCLUSION: Colonic diverticulosis and its complications are not rare in India and should be considered in the differential diagnosis of abdominal disorders.

Adult↗
PubMed1993

Role of infectious agents in exacerbations of ulcerative colitis in India. A study of Clostridium difficile.

Fifty patients with idiopathic ulcerative colitis--25 with acute exacerbation of the disease (Group I) and 25 in quiescent phase (Group II)--were studied. None of the patients had a history of recent exposure to antimicrobial drugs or hospitalization. Evidence of infection with protozoal and bacterial agents and/or presence of Clostridium difficile toxin was demonstrated in eight (32%) patients in group I and one (4%) patient in group II (group I vs. group II, p < 0.05; chi 2 test with Yate's correction). In five of the six patients with demonstrable Clostridium difficile toxin in the stool, one patient with Entamoeba trophozoites, and another with Salmonella infection, the exacerbation responded clinically and endoscopically to specific antimicrobial therapy. Another two patients who had Entamoeba histolytica cysts in the stool had no change in their clinical status with metronidazole. We conclude that infectious agents are responsible for some of the exacerbations in patients of ulcerative colitis in a tropical country like India, where careful microbiologic examination is in order in every acute exacerbation of this disease. This contrasts with the findings in developed countries.

Acute Disease↗