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Biomedical subjects

R R Rai

Publications and source records attributed to R R Rai.

At least 37 records · Page 2Linked to original sources
PubMed1993

Endoscopic variceal ligation: an effective method of variceal obliteration.

Endoscopic variceal ligation was performed in 20 patients with portal hypertension of varied etiology. Variceal obliteration was achieved in 18 patients (90%) while recurrence of bleeding occurred in two patients (10%). The average number of bands required was four per patient and average number of sessions required for variceal obliteration was two. We found the procedure to be cheap, safe and effective in achieving early variceal obliteration.

Esophageal and Gastric Varices↗
PubMed1992

Endoscopic sclerotherapy: treatment of choice in patients less than 3 years old with extrahepatic portal vein obstruction.

Thirty-two children under 3 yr of age with extrahepatic portal vein obstruction were treated with endoscopic sclerotherapy. The group consisted of 22 males and 10 females, with a mean age of 1.96 yr (range 7 months to 3 yr). The procedure was well tolerated by all after premedication with intravenous diazepam. Esophageal varices were eradicated in all children after 4.45 sessions (+/- 1.12). Follow-up clinical and endoscopic evaluations have been carried out over a period of 9 months to 4 yr (mean 3.5 yr) after the patients were put on a sclerotherapy program. There was a significant reduction in number of bleeding episodes (60 vs. 8), mean blood transfusion requirement (2.19 vs. 0.31), and bleeding risk factor (0.09 vs. 0.008). There were a few minor conditions, such as transient dysphagia and esophageal ulcerations, in 14 patients (43.75%), which later responded to medical treatment. Perisclerotherapy bleeding, seen in six patients (18.7%), responded to repeat sclerotherapy. Recurrence of varices was encountered in two patients (6.25%); these were eradicated after reinstitution of sclerotherapy. Endoscopic sclerotherapy is the treatment of choice in patients of extrahepatic portal vein obstruction who are below 3 yr of age.

Child, Preschool↗
PubMed1990

Colonoscopy for investigation of unexplained rectal bleeding in a tropical country.

One hundred and forty four patients underwent colonoscopy to detect the cause of rectal bleeding. This was successful in either identifying the lesion or excluding the presume of lesions up to the cecum in 88.8% patients. The source of bleeding was diagnosed in 106 (73.61%) patients. Predominant lesions were nonspecific colitis and ulcers (62.26%), polyps (17.92%), cancer (8.49%), rectal varices (3.77%) and tuberculosis (1.88%). The remainder had other colonic conditions such as radiation colitis, ischemic colitis, vascular malformation, diverticulosis, right sided ulcerative colitis and pseudo-pancreatic cyst communicating with the descending colon. The majority (94.33%) of these lesions involved the left colon. Thus colonoscopic examination was useful in localizing the cause of rectal bleeding and the predominant lesions were differed from those reported in the western hemisphere.

Adult↗
PubMed1989

Needle aspiration of amoebic liver abscess.

OBJECTIVE: To determine the value of needle aspiration in uncomplicated amoebic liver abscess. DESIGN: Randomised case-control study with a minimum follow up of one year, comparing patients treated with drugs alone with those treated with additional needle aspiration. SETTING: Referral based gastroenterology clinic. PATIENTS: 39 Consecutive patients with amoebic liver abscess in the right lobe, of whom 37 completed the study. INTERVENTION: Metronidazole 2.4 g/day was given to all patients for 10 days. Needle aspiration of the abscess was performed in 19 patients on the day of admission to hospital. MAIN OUTCOME MEASURES: Abdominal pain, fever, anorexia, and hepatomegaly were measured. Erythrocyte sedimentation rate, serum aspartate, and alanine aminotransferase activities, and alkaline phosphatase activity were also measured. RESULTS: Clinical improvement was similar in both groups of patients. Improvement in haematological and biochemical variables and rates of healing of cavities were also similar. CONCLUSIONS: Chemotherapy with potent tissue amoebicidal drugs such as metronidazole is optimally effective in treating amoebic liver abscess, and in uncomplicated cases routine aspiration is not required.

Adult↗
PubMed1988

Chronic calcific pancreatitis: clinical profile in northern India.

Twenty three patients with chronic calcific pancreatitis of the tropics in Northern India were prospectively studied. All had pancreatic calcification and ERCP changes typical of chronic pancreatitis, the most predominant being ductal dilatation which was detected in all patients by both ERCP and by ultrasonography. Pain was present in 19 (83%) patients and diabetes in 11 (48%) patients. Exocrine pancreatic dysfunction was uncommon, steatorrhoea being present in only 9% of patients. Ten of the 11 patients with diabetes required insulin for control and one case was able to be controlled by an oral antidiabetic agent. Two patients developed ketoacidosis during acute episodes of pancreatitis, 3 patients had peripheral neuropathy and one patient had visual changes. Recurrent severe pain was the reason for operation in 7 patients. All had a lateral pancreaticojejunostomy. In order to obtain an objective assessment of pain, a scoring system was developed to grade its severity according to its intensity, frequency and consequences. Six patients who preoperatively had a pain score of 15 or more (out of a maximum score of 24) attained significant relief after the surgery. We feel this scoring system may provide an easy objective assessment of pain in the subsequent follow-up of these patients.

Adolescent↗
PubMedDate not supplied

Primary aortoesophageal fistula: presenting as massive upper gastrointestinal hemorrhage.

Primary aortoesophageal fistula is a rare cause of upper gastrointestinal bleeding. A six-year-old boy presented with massive upper gastrointestinal hemorrhage. Endoscopy revealed a submucosal bulge in the esophagus with an ulcer and clot at the top. Lateral skiagram of the chest showed a posterior mediastinal mass. CT scan of the chest revealed a ruptured aortic aneurysm into the oesophagus, confirmed the diagnosis. The patient succumbed to the illness before he could be subjected to definitive treatment.

Aortic Dissection↗