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Biomedical subjects

N Deshmukh

Publications and source records attributed to N Deshmukh.

32 records · Page 2Linked to original sources
PubMed1991

Surgical treatment of pilonidal disease: comparison of three different methods in fifty-nine cases.

The surgical treatment of pilonidal disease at the Robert Packer Hospital from 1983 to 1989 was reviewed. During that period, 59 patients were operated on for definitive treatment of the disease. The different methods of treatment, namely excision and packing (28 cases), marsupialization (11 cases), and excision and primary closure (20 cases) were compared in terms of age and sex distribution, length of hospital stay, number of post-operative visits, time required for complete healing, complications, and recurrence rate. The operations were performed by surgical residents under the supervision of board-certified surgeons. The average time for complete healing was 21 weeks, 8 weeks, and 3 weeks, respectively, for the different methods. Recurrence rates were essentially nil for all methods. It was concluded that excision and primary closure is the superior method in the treatment of pilonidal disease. The relevant literature was reviewed and the surgical technique discussed.

Adolescent↗
PubMed1991

Modified Kraske approach for disease of the mid-rectum.

A modification of Dr. Paul Kraske's approach for removal of mid-rectal lesions has been used in 11 patients from 1977 to 1988 by the senior authors. Patients ranged in age from 56 to 89 yr, with an average of 67 yr. There were seven male and four female patients. Indications for surgery were as follows: villous adenoma (seven), carcinoid (one), recurrent dysplasia in a previous endoscopic polypectomy site (one), positive distal margin for neoplasm following low anterior sigmoid resection (one), and adenocarcinoma in one elderly poor-risk patient. All lesions were in the middle rectum (7-11 cm from the anal verge, average 9 cm). The postoperative stay ranged from 6 to 12 days with a mean of 8 days. The average follow-up for the 11 patients is 3 1/2 yr (1 month to 7 yr), with only one patient having a local recurrent lesion. There was no morbidity or mortality. We conclude that this modification of the Kraske approach offers a good alternative for excision of mid-rectal lesions in terms of technical ease, efficacy, safety, and patient tolerance. The modified Kraske approach is indicated in certain situations and should be a part of the surgeon's armamentarium.

Aged↗
PubMed1990

Obturator hernia: a difficult diagnosis.

We have presented the case of an elderly woman with severe kyphoscoliosis, osteoarthritis and left knee effusion who had symptoms and signs of intermittent intestinal obstruction. Operation showed a left-sided obturator hernia. In any elderly, debilitated, chronically ill woman, symptoms and signs of recurrent small-bowel obstruction (without a history of abdominal surgery or external hernias) and pain along the ipsilateral thigh and knee (Howship-Romberg sign) should raise suspicion for an obturator hernia. If the hernia is not palpable by physical examination, a CT scan of the pelvis and upper aspect of the thigh would confirm the diagnosis before operation and allow prompt treatment and better chance of patient survival.

Aged↗
PubMed1990

Saphena varix: a case report.

Saphena varix is a rare condition characterized by isolated distention of the saphenous vein immediately below the sapheno-femoral junction. The clinical significance of saphena varix lies in its differentiation from other conditions that cause a groin mass. A case of saphena varix is presented and methods for differentiating this unusual condition from other causes of groin masses are discussed.

Humans↗
PubMed1989

The lack of effect of pentoxifylline on random skin flap survival.

The effects of pentoxifylline on skin flap survival were studied in rabbits. A total of 40 rabbits had caudally based single-pedicle flaps measuring 4 x 14 cm raised on the mid dorsum of each animal. Twenty of these rabbits were given intraperitoneal injections of pentoxifylline in doses of 24 mg/kg per day beginning 48 hours prior to flap construction and continued daily for 7 days postoperatively. The remaining 20 control rabbits received intraperitoneal injections of saline in equal volumes as the experimental groups. At the end of 7 days, viable flap length was visually inspected and measured in all 40 rabbits. There was no significant difference in skin flap viability in rabbits treated with pentoxifylline compared to the control group.

Animals↗
PubMed1988

Hypogastric artery aneurysm causing microscopic hematuria.

Aneurysms of the hypogastric artery are rare. Most of the lesions are discovered incidentally but occasionally they produce urinary symptoms or rupture unexpectedly. We report a case of an isolated hypogastric artery aneurysm that caused painless microscopic hematuria. The natural history of these lesions and the surgical options are discussed briefly.

Aged↗
PubMed1988

All-terrain vehicle injuries. A review at a rural level II trauma center.

All-terrain vehicles (ATVs) have become a major source of morbidity and mortality with more than 600 deaths nationwide. Nearly half of those injured are children under 16 years. Twenty three ATV accidents were seen at the Guthrie Medical Center over a 30 month period ending in August 1986. Ten patients (43.5%) were under 16 years old. Of those injured who were older, alcohol was involved in 70 per cent of the accidents. Five accidents occurred on highways (21.7%), in spite of laws banning their use on public roads. Rollover type accidents and collisions were the most frequent mechanisms of injury (39% and 35%). Of 18 patients known not to have worn a helmet, 61 per cent sustained a closed head injury. In all, there were 88 injuries in 23 patients. Common injuries included lacerations (13), long bone fractures (13), renal contusions (11) and head injury (11). There were two deaths (8.7%), two cord transections with permanent disability, and a below-knee amputation. ATVs present a serious hazard to adult and children riders alike. Age limits, state licensing, safety programs, and protective equipment are all recommended as a means to reduce injury and death from recreational riding.

Accidents↗
PubMed1986

Actinomycosis at multiple colonic sites.

A case of actinomycosis affecting multiple sites in the colon, masquerading as diverticulitis, is presented. Final diagnosis was delayed until a tuboovarian abscess developed that required resection and was found to contain sulfur granules. Bacteriology, pathophysiology, and antibiotic treatment of abdominal actinomycosis is discussed. Difficulties in diagnosis are mentioned.

Abscess↗
PubMedDate not supplied

Carotid endarterectomy in patients with renal insufficiency: Should selection criteria be different in patients with renal insufficiency?

The objective of this study was to elucidate the relationship between outcomes from carotid endarterectomy (CEA) in patients with and without renal insufficiency. Carotid endarterectomy is one of the most commonly performed vascular procedures. The role of cardiac comorbidity in carotid endarterectomy has been extensively studied. The relationship between renal failure and surgical outcomes has also been studied for both coronary artery bypass grafting and lower extremity occlusive disease. However, the role of renal insufficiency in relationship to decision making regarding surgical intervention for carotid stenosis is not well defined. The authors hypothesized that the outcomes from CEA were negatively influenced by renal dysfunction. A retrospective review was made of consecutive CEAs performed at their institution from 1990 to 1995. Patients were grouped into 2 categories according to their renal function. Group A, 448 patients (90%) with creatinine level 1.8 mg/dL or less, and group B, 49 patients (10%) with creatinine levels more than 1.8 mg/dL. Data from patients on dialysis are presented but were excluded for the purpose of analysis. Included in the study were 497 patients with a mean age of 70 +/-8.9 and 74 +/-8.9 for groups A and B, respectively. Preoperative creatinine was 1.1 (+/-0.25) mg/dL for group A and 2.5 (+/-0.81) mg/dL for group B. Outcomes were as follows: perioperative cardiac events 5.4% vs 28.6%, stroke rates 2.7% vs 2.0%, and mortality rates 0.9% vs 8.2%, for groups A and B, respectively. At 60-month follow-up the stroke rates were 7.6% vs 6.1 %, and the mortality rates 22.8% vs 59.2%, for groups A and B, respectively. While patients with chronic renal insufficiency have no increased risk of perioperative or long-term neurologic events, perioperative and long-term mortality rates are significantly increased. This significant reduction in survival should prompt a more cautious application of CEA in patients with increased creatinine.

Aged↗