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Biomedical subjects

R Kochhar

Publications and source records attributed to R Kochhar.

At least 127 records · Page 7Linked to original sources
PubMed1989

Cholangiographically guided aspiration cytology in the management of malignant biliary obstruction.

Fifteen patients with malignant biliary obstruction were subjected to fine needle aspiration cytology (FNAC) under fluoroscopic guidance. Fourteen (93%) of them were correctly diagnosed to have a malignancy at FNAC. Simultaneous with FNAC or at a later date, all the patients underwent percutaneous biliary drainage with a drop in serum bilirubin from a mean of 23.2 mg/dl to 8.5 mg/dl. Ten patients were subjected to exploratory laparotomy and biopsy at which the diagnosis of FNAC was confirmed in nine of them. The tenth patient with a negative yield at FNAC had a 1.0 cm cholangiocarcinoma. The usefulness of FNAC combined with biliary drainage as an alternative to surgery is highlighted.

Adenoma, Bile Duct↗
PubMed1989

Pseudomyxoma peritonei. A report of three cases.

Pseudomyxoma peritonei is an infrequently encountered clinical entity which presents mainly with abdominal distension. We present here our experience with three such cases and emphasize on the aggressive combined operative and chemotherapeutic approach in this disease.

Adenocarcinoma, Mucinous↗
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

Delta hepatitis infection in north India. A preliminary report.

There is a paucity of data on occurrence of delta hepatitis in India. We here present our preliminary data showing that delta coinfection and superinfection occur quite frequently in our set up. The coinfection rate was found to be 15% and superinfection rate 26.6% in the initial screening of 69 patients of acute and chronic liver disease.

Adult↗
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

Association of Candida with carcinoma of esophagus.

Twenty-five patients with carcinoma of the esophagus (group I) and 25 patients suffering from non-ulcer dyspepsia with normal endoscopy (group II) were studied to know the incidence of isolation of Candida from their esophagus. Endoscopic brushings were taken from the esophagus in both groups and studied by smear examination and culture. Fungal organisms could be detected in 75% of cases of group I and 32% of cases of group II by culture techniques, and 45.8% and 12% respectively by smear examination. The difference was statistically significant (p less than 0.05) for both the techniques. Candida albicans was the commonest species isolated. No correlation was found between Candida agglutination titres and density of Candida growth on culture. We conclude that an association exists between carcinoma esophagus and the occurrence of Candida in the esophagus.

Candida albicans↗
PubMed1989

Ultrasonography in non-cirrhotic portal hypertension: correlation with splenoportography.

Real time sonography followed by splenoportography was performed in 38 cases with non-cirrhotic portal hypertension. Eleven of these cases, in whom porto-systemic shunt surgery was done, were also evaluated by real time sonography post-operatively. The ultrasound findings correlated well in 37 cases (98%) with splenoportography. All the post-operative cases also revealed a patent portosystemic shunt on sonography. Ultrasonography, a valuable, non-invasive, initial investigation of portal hypertension, may thus be used as the only investigation to distinguish intra- from extra-hepatic obstruction and to evaluate patency of surgically created porto-systemic shunts. Invasive portography may be performed only if surgical treatment is anticipated.

Adolescent↗
PubMed1989

Ingestion of corrosive acids. Spectrum of injury to upper gastrointestinal tract and natural history.

We have prospectively evaluated 41 patients who ingested acid for location, extent, severity, and outcome of the injury to the upper gastrointestinal tract. The injury was assessed within 36 h of acid intake by endoscopy or surgery, or at autopsy. Symptoms and signs were unreliable in predicting the extent and severity of injury. The degree of burns was classified as follows: grade 0 in 2 patients, grade 1 in 3, grade 2 in 16, and grade 3 in 20. Esophageal injury was seen in 87.8% of the patients, gastric injury in 85.4%, and duodenal injury in 34.1%. All patients with grade 0, 1, and 2a injury recovered without sequelae. Acute complications occurred in 39.1% of the cases, and death in 12.2%. It is significant that all such patients had grade 3 burns. Five of the 8 patients with grade 2b injury and all survivors of grade 3 injury developed esophageal or gastric cicatrization, or both, which subsequently needed endoscopic or surgical treatment. We find that endoscopy is not only the tool of choice for diagnosis in such cases but also aids in deciding upon treatment and prognosis. We conclude that acid injury of the upper gastrointestinal tract is a very serious condition that affects the esophagus and stomach equally and results in high morbidity and mortality.

Accidents, Home↗
PubMed1989

Upper gastrointestinal endoscopy in infants and children.

Fibreoptic endoscopy is a highly efficient diagnostic tool which is now being increasingly used in pediatric age group also. However, certain special considerations like the use of special instruments, use of general anesthesia in younger children and various indications of diagnostic and therapeutic endoscopy need to be clearly emphasized. Over a period of 24 months, 132 children underwent upper gastrointestinal endoscopic examination in our section. Diagnostic endoscopy was carried out on 102 occasions and therapeutic on 162 occasions. Most of the children below 3 years of age required general anesthesia for the procedure. Children above 3 years of age could be managed by intravenous diazepam and pentazocine. The commonest cause of upper gastrointestinal bleed in children was variceal (60.6%) followed by erosive gastritis (27.2%). In children with recurrent abdominal pain no underlying cause was detected at endoscopy. Injection sclerotherapy was found to be a safe and effective mean for control of variceal bleed and most of the foreign bodies ingested by children and still lying proximal to 2nd part of duodenum could be successfully retrieved endoscopically.

Child↗
PubMed1989

Pneumatic dilatation in achalasia.

Pneumatic dilatation of achalasia cardia was performed on 22 patients using Rider-Moeller bag under fluoroscopic control-during a three year period. The diagnosis was established at barium study and endoscopy. A total of 28 dilatations were performed on 22 patients. Sixteen patients required a single dilatation, five required another sitting while one patient had to be dilated thrice. Surgery was not required in any patient. There was a single complication in the form of an intramural leak which could be successfully managed conservatively. Our short term follow up results reiterate the consensus that pneumatic dilatation should be the initial form of management in these cases.

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↗
PubMed1988

Non-surgical treatment of jejunogastric intussusception.

Three cases of retrograde jejunogastric intussusception who were managed endoscopically are described. The diagnosis was made by means of endoscopy in one case and contrast radiology of the stomach in the other two. Endoscopic management consisted of reduction of the intussusception, followed by placement of a feeding tube deep in the intussuscepting segment. The patients responded very well and surgery could be avoided in all of them.

Adult↗
PubMed1988

Fine-needle aspiration cytology of rectal tumors.

This report describes the application of fine-needle aspiration cytology to rectal tumors and metastatic deposits in the rectovesical pouch using a short proctoscope and an 8-cm long fine needle.

Biopsy, Needle↗