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Biomedical subjects

M K Goenka

Publications and source records attributed to M K Goenka.

72 records · Page 4Linked to original sources
PubMed1990

Controlled trial of twice a day versus once a day cimetidine therapy for duodenal ulcer.

A randomized controlled trial was carried out to compare the efficacy of conventional 400 mg twice daily dose of cimetidine with single bedtime 800 mg dose, in 40 patients with endoscopically proven duodenal ulcer. At repeat endoscopy after four weeks of therapy, complete ulcer healing was achieved in 78% of patients on twice daily dosage and 79% of patients on single daily dosage. A more convenient single nocturnal dosage of cimetidine is as effective in the treatment of duodenal ulcer as a twice daily dosage in the Indian population.

Adult↗
PubMed1990

Management of foreign bodies in the upper gastrointestinal tract.

Records of 55 consecutive patients who had ingested foreign bodies were reviewed retrospectively. Foreign bodies were located in the esophagus, stomach and duodenum in 25, 27 and 3 patients respectively. Eleven of these passed through the entire gastrointestinal tract spontaneously and uneventfully. Endoscopic extraction was successful in 36 patients while 8 needed surgical removal of the ingested object. Only one death was encountered. We conclude that using simple guidelines, foreign body ingestion can be managed with a low incidence of complications and mortality.

Adolescent↗
PubMed1990

Gastrointestinal bleeding in malaria.

Hematological alterations are frequent in patients with malaria. However, these rarely manifest clinically, except for symptoms due to anemia. Two cases with gastrointestinal hemorrhage as a complication of malaria are reported.

Animals↗
PubMed1990

Endoscopic sclerotherapy during pregnancy.

Pregnancy in patients with portal hypertension is an uncommon occurrence. Hence, there are no clear guidelines for management of variceal bleed during pregnancy. Moreover, the outcome of variceal sclerotherapy, particularly its effect on conception, as well as its safety and efficacy when used during pregnancy, is not known. We have treated four patients of portal hypertension during pregnancy with sclerotherapy. Two of them presented to us before conception, were put on sclerotherapy for variceal bleed, and conceived while on sclerotherapy schedule. Two other patients were started on sclerotherapy during pregnancy when they presented with variceal bleed. Sclerotherapy with absolute alcohol was effective in control of variceal bleed as well as obliteration of varices in pregnant patients. There was no untoward effect on mother or fetus. The mean number of sessions and volume of alcohol required for variceal obliteration were 6.5 and 42.0 ml, respectively. Variceal sclerotherapy does not interfere with conception and successful pregnancy, and is safe as well as effective during pregnancy.

Adult↗
PubMed1989

The emergence of colonic diverticulosis in urbanised Indians. A report of 23 cases.

Of a total of 969 barium enemas performed over a three year period, 23 (2.4%) showed colonic diverticulosis. The mean age of the patients was 58 years and the commonest site involved was the sigmoid colon. All the patients were urbanised and were obligatory vegetarians. Six (25%) of the patients had a complication of the disease and three of them required surgery. The possible relationship of the disease with socio-economic changes is highlighted.

Aged↗
PubMed1989

Upper gastro-intestinal mucosal changes in patients with chronic renal failure.

A prospective study was undertaken to determine the radiological, endoscopic and histological changes of upper gastro-intestinal mucosa in patients with end-stage renal failure and the effect of haemodialysis. Of the 30 patients studied, 28 (93%) had presented with upper gastrointestinal symptoms. Abnormal findings on upper gastrointestinal endoscopy were observed in 66.7% patients. These comprised oesophagitis (23.3%) gastritis (30%), duodenitis (33.3%) and peptic ulcer (6.7%). Histological study of the mucosal tissue biopsy in 24 patients showed oesophagitis, gastritis and duodenitis in 12.5%, 45.8% and 37.5% respectively. Ten patients were re-evaluated after institution of haemodialysis therapy for a minimum of one month. Though there was a significant improvement in gastrointestinal symptoms (p less than 0.05), there was no effect on endoscopic changes. The study documents a high incidence of mucosal inflammatory changes rather than that of ulcer disease in chronic renal failure.

Adolescent↗
PubMed1989

Tube esophagogram: a better radiological technique for evaluation of esophageal diseases.

Forty-six patients with suspected esophageal disease were studied by tube esophagography. This was performed by positioning a rubber tube in the proximal esophagus, followed by swallowing of high density barium suspension and insufflation of air through the tube. Comparison in 20 cases showed superiority of tube study over conventional double contrast barium, with alteration in diagnosis in six cases and additional information in 14 cases. Tube esophagogram is a safe, simple and valuable adjunctive technique leading to accurate and definitive radiological diagnosis of esophageal disease.

Barium Sulfate↗
PubMedDate not supplied

A comparative evaluation of sclerosants for esophageal varices: a prospective randomized controlled study.

The aim of this prospective randomized controlled study was to find a safe and effective sclerosing solution for endoscopic injection sclerotherapy in the treatment of esophageal variceal bleeding. Ninety consecutive patients with portal hypertension and variceal bleeding were randomized to receive sclerotherapy with 5% ethanolamine oleate, 3% sodium tetradecyl sulfate, or absolute alcohol at an interval of 3 weeks. Sixty-four patients who received more than three sessions were analyzed. All three agents were found to have similar success and complication rates (p greater than 0.05). However, absolute alcohol required fewer sessions (p less than 0.01) and lesser amounts (p less than 0.01) to produce successful variceal sclerosis and had the added advantage of low cost and easy availability.

Adult↗
PubMedDate not supplied

Outcome of injection sclerotherapy using absolute alcohol in patients with cirrhosis, non-cirrhotic portal fibrosis, and extrahepatic portal venous obstruction.

In order to assess the comparative efficacy and safety of endoscopic injection sclerotherapy in patients with portal hypertension of different etiology, i.e., cirrhosis, non-cirrhotic portal fibrosis, and extrahepatic portal venous obstruction, 87 patients with variceal bleeding were initiated on sclerotherapy using absolute alcohol. There was no significant difference in the success rate of sclerotherapy as well as in the number of sessions and volume of alcohol required for variceal obliteration between the three groups. Major complications included esophageal ulcers (30.0%), symptomatic strictures (18.6%), and interval re-bleed (17.1%) with similar complication rates for the three groups (p greater than 0.05). There was no difference between patients with Child's class A cirrhosis compared with classes B and C together with respect to efficacy and complications of sclerotherapy. Fifty patients (25 cirrhosis, 11 non-cirrhotic portal fibrosis, and 14 extrahepatic portal venous obstruction) with complete variceal obliteration were followed up for a mean period of 16.5 months. Sixteen patients (32%) had variceal recurrence, but bleeding due to recurrent varices occurred in only one case. There was no difference among the three groups for overall variceal recurrence, although recurrence tended to be somewhat later in extrahepatic portal venous obstruction (9.4 +/- 4.0 months) compared with that in cirrhosis (5.1 +/- 3.6 months) and non-cirrhotic portal fibrosis (4.8 +/- 2.6 months).

Adolescent↗
PubMedDate not supplied

Evaluation of fibronectin as a marker of malignant ascites.

The aim of the study was to assess the accuracy of fibronectin, a glycoprotein, for the diagnosis of malignant ascites and to compare it with conventional parameters. Ascitic fluid samples from 50 patients, 25 with intra-abdominal malignancy and 25 without it were analysed for total protein concentration, fluid/serum protein ratio, glucose concentration, leucocyte count, pH, fibronectin concentration (by ELISA) and for malignant cell cytology. Twenty-two of the 25 patients with ascites and intra-abdominal malignancy had documented peritoneal metastases in group A. The 25 patients with non-malignant ascites constituted group B. Mean values of ascitic fluid fibronectin, for groups A and B were 538 +/- 46 micrograms/mL and 60 +/- 4.92 micrograms/mL, respectively (P less than 0.001). Within the group with malignant ascites, patients who had positive malignant cytology (n = 12) exhibited a significantly higher ascitic fluid fibronectin concentration than patients with negative cytology (P less than 0.05). While mean ascitic fluid protein concentration showed a significant difference (P less than 0.01) between the two groups, there was no difference in respect to ascitic fluid pH, glucose concentration and leucocyte count. Malignant cell cytology was positive in 54.5% of group A patients with no false positive report in group B. The diagnostic accuracy for differentiating malignant from non-malignant ascites was 100% for a fibronectin value of greater than or equal to 110 micrograms/mL as compared with 78.7% for ascitic fluid protein concentration greater than or equal to 0.5 g/dL, 57.4% for leucocyte count greater than or equal to 1000/mm3, 59.6% for pH less than 7.45 and 78.7% for malignant cell cytology.

Abdominal Neoplasms↗
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

Abdominal cocoon in a male: rare cause of intestinal obstruction.

Abdominal cocoon, which is characterised by encasement of bowel by a fibrous membrane, is a rare cause of intestinal obstruction. It occurs primarily in females with only three cases reported earlier in males. We report a male patient presenting with small bowel obstruction and detected to have abdominal cocoon at surgery. Incision of thick membrane and lysis of adhesions led to relief of obstruction without any recurrence.

Adult↗
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↗