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Biomedical subjects

M P Sharma

Publications and source records attributed to M P Sharma.

138 records · Page 8Linked to original sources
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Inflammatory pancreatic masses.

An epigastric lump was found in 24 out of 55 cases of acute pancreatitis. Phlegmon was seen in 18, pseudocysts in five and abscess in one. These lumps present difficult diagnostic and management problems. Close monitoring of the signs and symptoms should serve as a guideline for rational medical or/and surgical management, especially in our country.

Abscess↗
PubMedDate not supplied

Amoebic liver abscess.

Sonography is a major advance in the diagnosis of ALA. Identification of amoebic antigen in the pus is a specific immunodiagnostic test. Medical therapy with a single drug (metronidazole) is adequate in most instances. Routine needle aspiration or surgical drainage are not indicated. The abscess cavity may take up to 18 months for resolution and demonstration of such a lesion does not warrant repeated therapy unless clinical evidence of recurrence is present. Recurrences are rare. Clinical and laboratory evidences of poor prognosis are being identified, and may guide the treatment modality to be selected.

Humans↗
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Sonographic signs in portal hypertension: a multivariate analysis.

A prospective case controlled study was conducted to evaluate the value of real time ultrasound in establishing the diagnosis and the etiology of portal hypertension. Patients attending the outpatient department of a tertiary care centre were included. There were 324 consecutive patients with portal hypertension due to cirrhosis (n = 229), non cirrhotic portal fibrosis (NCPF: n = 64) and extrahepatic portal venous obstruction (EHPVO: n = 31). During this period, 146 patients with dyspepsia, 35 with splenomegaly and 32 with ascites due to varied causes served as negative and positive controls. Real time ultrasonography using a 3.5 MHz linear array scanner was performed in a fasting state in all subjects. Portal and splenic vein diameter greater than 10 mm, splenomegaly, hepatic and splenic hilar collaterals were suggestive of portal hypertension. Non visualization of the portal vein which was replaced by a cavernoma had a diagnostic accuracy of 98% in EHPVO. Splenic infarcts and absence of ascites were features of non cirrhotic portal hypertension (NCPF and EHPVO). Sonography had an overall diagnostic accuracy of 80%. A stepwise logistic regression with multivariate analysis using discriminate function showed that collaterals at the hepatic and splenic hilum, hepatomegaly, ascites and splenic infarcts were independent markers to differentiate cirrhotic from noncirrhotic causes of portal hypertension. The discriminate equation generated had a mismatch of 9.8%. Correlations between the sonographic signs demonstrated that the variceal grade correlated positively with the presence of splenic hilar collaterals and the liver size inversely correlated with presence of ascites. It was concluded that real time ultrasonography is an accurate method to establish the presence and etiology of portal hypertension.

Adult↗
PubMedDate not supplied

Gall bladder dysmotility in diabetes mellitus--an ultrasound study.

Fifty two diabetic patients and 15 healthy control subjects were prospectively studied for their gall bladder function by ultrasound examination. The fasting gall bladder volume (FGBV) was calculated by using ellipse formula from the dimension of gall bladder shadow seen on ultrasound screen in two different cuts. The contractility of gall bladder was measured by calculating post prandial ejection fraction (EF) of the gall bladder. The mean FGBV and EF in 52 diabetic patients was found to be 20.7 +/- 10.7 cc and 47.5 +/- 20.1%, which was not significantly different from that in normal controls. Age, sex, obesity, diabetic control and presence of dyspeptic symptoms had no impact in FGBV and EF. Diabetic symptoms had no impact in FGBV and EF. However, diabetics with longer duration of disease had poorer gall bladder contractility (p < 0.05). Patients with autonomic neuropathy (AN) had significantly larger FGBV but normal contractility. Our results suggest that (a) long standing diabetics may have poor gall bladder emptying predisposing to gall stone formation (b) patients with autonomic neuropathy have reduced tone of fasting gall bladder but normal contractility.

Adult↗
PubMedDate not supplied

Long term follow-up of amebic liver abscess: clinical and ultrasound patterns of resolution.

A prospective study was undertaken to evaluate the clinical and sonographic patterns of resolution in amebic liver abscess (ALA). There were 146 patients of ALA attending the gastroenterology clinic of a tertiary care centre of whom 25 died. Of the remaining 121 patients, 107 were followed up for 20.9 +/- 11.4 months. 14 (11.3%) patients were lost to follow up before complete disappearance of the cavity. Complete disappearance of the cavity was seen in 84 (78.5%) and a reduction in volume to 50% at entry in 23 (21.5%). Abdominal pain, fever and hepatomegaly were the predominant forms of clinical presentation. On ultrasound, there were 121 cavities in 107 patients. The most frequent type of lesion was solitary, (96%) round cavity (80.4%) in the right lobe of liver (85%). Clinical and hematological parameters of resolution occurred rapidly (3.2 +/- 2.9 months). Sonographic resolution took much longer (9.6 +/- 6.8% months) in the 84 patients. The remaining 23 patients are on follow up. Three pattern of resolution were observed: Type I--where complete disappearance of the cavity occurred within 3 months (29.8%), Type II--where a gradual reduction and disappearance of the cavity occurred (64.3%) and Type III--where a rapid reduction till 25% of original cavity size remained and then a delayed resolution occurred (5.9%). There were no relapses in the patients on follow up. Factors that influenced healing time included the size of the abscess cavity at admission, hypoalbuminemia and anemia. The type of clinical presentation, nature of therapy, number or location of abscesses and time for clinical resolution did not influence the resolution time. None of the variables studied influenced the pattern of resolution. We conclude that rapid clinical resolution is common in patients with ALA. Sonographic resolution may be delayed and does not warrant additional or prolonged therapy.

Adolescent↗
PubMedDate not supplied

Primary bronchogenic carcinoma: clinical profile of 279 cases from mid-west Rajasthan.

The present retrospective study was undertaken to study the clinical profile of primary bronchogenic carcinoma seen during last eight years in a teaching hospital. Out of a total of 279 diagnosed cases, 86% were males with an average age of 57 years, smoking was the risk factor in 81.6%. Forty percent of female patients were smoker with a significant overlap in use of smoking objects. Twenty four (8.8%) patients were less than 40 years of age at the time of diagnosis. Average duration of illness was 4.5 months. Weight loss (77%) and fever (34%) were the commonest general symptoms. Other chest symptoms include cough (68%), dyspnoea (59%), chest pain (22%), hemoptysis (20%) and dysphagia (6%). Fiberoptic bronchoscopy (FOB) (75%) and fine needle aspiration cytology (FNAC) (74.8%) were found to be the most efficient diagnostic procedures. Histologically, squamous cell carcinoma, adenocarcinoma, large cell carcinoma and small cell carcinoma were seen in 42%, 20%, 18% and 14% cases, respectively. Six percent patients showed malignant cells only and marked as unclassified. Radiologically, obstructive pneumonitis was the commonest presentation (59.5%) followed by mass lesion (31.8%) and rib destruction (5.1%). Inspite of its limitation, this study for the first time reports lung cancer pattern from mid-west Rajasthan.

Carcinoma, Bronchogenic↗
PubMedDate not supplied

Antibodies to Cag A protein are not predictive of serious gastroduodenal disease in Indian patients.

OBJECTIVE: The present study was aimed at assessing the predictive utility of anti-Cag A antibodies in differentiating patients of duodenal ulcer (DU) and non ulcer dyspepsia (NUD) from asymptomatic controls in a developing country. METHODS: Sera from 120 subjects were tested for antibodies to Cag A using the immunodominant portion of a recombinant 37.5 kDa fusion protein by ELISA, in endoscopically proven cases of DU and NUD and healthy controls. RESULTS: The observed optical density (OD) in DU and NUD patients was 1,947 and 1,960 respectively, which was higher than that observed in controls (p < 0.01), but there was no difference in the anti-Cag A antibody titers between DU and NUD patients. CONCLUSION: Anti-Cag A antibodies do not seem to discriminate duodenal ulcer patients from non ulcer dyspepsia in the Indian population.

Adult↗
PubMedDate not supplied

Benign cystic peritoneal mesothelioma in a man.

Benign cystic mesothelioma of the peritoneum is uncommon and usually occurs in women. We report this condition in a man, who was treated successfully by surgical excision of the tumor.

Diagnosis, Differential↗