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Rajeev Sharma

Publications and source records attributed to Rajeev Sharma.

At least 19 recordsLinked to original sources
PubMed2006

Spectrum of perforation peritonitis in India--review of 504 consecutive cases.

BACKGROUND/OBJECTIVE: Perforation peritonitis is the most common surgical emergency in India. The spectrum of etiology of perforation in Tropical countries continues to be different from its Western counterpart. The objective of the study was to highlight the spectrum of perforation peritonitis as encountered by us at Government Medical College and Hospital (GMCH), Chandigarh. METHODS: Five hundred and four consecutive cases of perforation peritonitis over a period of five years were reviewed in terms of clinical presentation, operative findings and postoperative course retrospectively at GMCH, Chandigarh. RESULTS: The most common cause of perforation in our series was perforated duodenal ulcer (289 cases) followed by appendicitis (59 cases), gastrointestinal perforation due to blunt trauma abdomen (45 cases), typhoid fever (41 cases) and tuberculosis (20 cases). Despite delay in seeking medical treatment (53%), the overall mortality (10%) was favourably comparable with other published series though the overall morbidity (50%) was unusually high. CONCLUSION: In contrast to western literature, where lower gastrointestinal tract perforations predominate, upper gastrointestinal tract perforations constitute the majority of cases in India. The increasing incidence of post-traumatic gastro-enteric injuries may be due to an increase in high speed motor vehicle accidents which warrant early recognition and prompt treatment to avoid serious complications and death.

Journal Article↗
PubMed2005

The management of large perforations of duodenal ulcers.

BACKGROUND: Duodenal ulcer perforations are a common surgical emergency, but literature is silent on the exact definition, incidence, management and complications of large perforations of duodenal ulcers. METHODS: The case files of 162 patients who underwent emergency laparotomy for duodenal ulcer perforations over a period of three years (2001 - 2003) were retrospectively reviewed and sorted into groups based on the size of the perforations - one group was defined as 'small 'perforations (less than 1 cm in diameter), another 'large' (when the perforation was more than 1 cm but less than 3 cms), and the third, 'giant'(when the perforation exceeded 3 cm). These groups of patients were then compared with each other in regard to the patient particulars, duration of symptoms, surgery performed and the outcome. RESULTS: A total of 40 patients were identified to have duodenal ulcer perforations more than 1 cm in size, thus accounting for nearly 25 % of all duodenal ulcer perforations operated during this period. These patients had a significantly higher incidence of leak, morbidity and mortality when compared to those with smaller perforations. CONCLUSION: There are three distinct types of perforations of duodenal ulcers that are encountered in clinical practice. The first, are the 'small' perforations that are easy to manage and have low morbidity and mortality. The second are the 'large' perforations, that are also not uncommon, and omental patch closure gives the best results even in this subset of patients. The word 'giant' should be reserved for perforations that exceed 3 cms in diameter, and these are extremely uncommon.

Adolescent↗
PubMed2004

A modified parasternal wire technique for prevention and treatment of sternal dehiscence.

BACKGROUND: Sternal dehiscence with or without mediastinitis is a devastating complication of median sternotomy. Various techniques of sternotomy closure including 'figure of eight' wire sutures, nylon bands, and custom-made titanium-H plates have been described. We have devised and tested a new method of sternal closure to prevent sternal wound complications in patients at high risk of sternal dehiscence. METHODS: 1336 patients underwent sternotomy for various cardiac operations from January 1996 to January 2002. Patients were divided into two groups. Group I consisted of 560 patients who did not have any high risk factors for sternal dehiscence and received a standard six wire closure. Group II comprised of patients at high risk of sternal dehiscence and were divided randomly into subgroup II A (n = 390), which included patients who had conventional sternal closure. While in subgroup II B (n = 386) patients had a modified parasternal wire closure according to the finalized protocol. RESULTS: Sternal instability was noticed in 1/560 and none had sternal dehiscence in group I, but 16/390 patients had sternal instability and 3/390 had sternal dehiscence in subgroup II A, whereas only one patient in high risk subgroup II B developed sternal dehiscence with mediastinitis and required a pectoral flap advancement for sternal closure. CONCLUSIONS: Use of modified parasternal wire closure in patients with a high risk of sternal dehiscence is a safe, effective, technically easily reproducible, as well as economical, method of preventing and treating sternal dehiscence.

Aged↗
PubMed2004

Surgical pearl: the safety pin as a better alternative to the versatile paper clip comedo extractor.

Acne vulgaris is a very common, chronic inflammatory disease of the pilosebaceous apparatus. The comedo extractor is the instrument primarily used for comedo extraction. There are many types of more costly instruments available, but extraction can be achieved with the help of a modified versatile paper clip and disposable syringes. The disposable syringe is a good option for acne surgery, but a safety pin has been found to be more effective than the clip comedo extractor for extracting the comedo. The safety pin can be regarded as a "two-in-one" instrument for piercing the lesion and for extracting the keratinous material from the pilosebaceous canals.

Acne Vulgaris↗
PubMed2004

Gastric and intestinal trichobezoar--a case report.

Trichobezoars can occur in young females usually with a history of some underlying behaviour disorder. An eighteen-year-old female presented with a fixed right upper quadrant mass. On investigation, a huge mass consisting of hair was found in the stomach, extending into the small intestine. The mass was removed in toto by a standard gastrotomy incision.

Adolescent↗
PubMed2003

Corrosive-induced gastric outlet obstruction.

Ten patients with gastric scarring and an outlet obstruction secondary to ingestion of corrosive substances were referred to our department for surgical management, between May 1999 and April 2003. Hydrochloric acid was the most common corrosive ingested (4 cases), although many were not aware of the nature of the ingested substance. An associated esophageal stricture was present in 5 cases (50%). All the patients initially underwent feeding jejunostomy, with definitive surgery performed at a later date. A partial gastrectomy was found to be the most satisfactory procedure, and was performed in 90% of the cases (9 patients).

Adult↗
PubMed2003

Annular atrophic plaques of skin (Christianson's disease).

Atrophic plaques with white borders are occasionally seen on sun-exposed areas of the skin. These patients are usually elderly and have solar elastosis. This condition is referred to as annular atrophic plaques of skin and we describe a typical case.

Aged↗
PubMed2003

Evoked electromyogram as a function of facial nerve.

Compound muscle action potentials were recorded bilaterally from alae nasi muscles following stimulation of facial nerve in 45 normal subjects in the age group of 20-30 years. Latency, amplitude and total duration of the compound muscle action potential were compared on both sides. A significant positive correlation between the three parameters with the highest for the amplitude was observed. Therefore it is suggested that amplitude is a better parameter for comparison while testing for side to side facial nerve integrity.

Action Potentials↗
PubMed2002

Laparoscopic cholecystectomy: an Indian experience of 1233 cases.

BACKGROUND: Laparoscopic cholecystectomy (LC) is a well-established procedure for symptomatic cholelithiasis in India, but there are few data available regarding the procedure and its related complications. PATIENTS AND METHODS: This paper represents a retrospective review of 1233 patients who underwent LC at Government Medical College and Hospital, Chandigarh, India, over 4 years (1997-2000). The case files of all these patients were analyzed for patient particulars, intraoperative findings, reason for any open conversion, postoperative stay, and mortality. RESULTS: The overall conversion rate was 7.06% (87 patients). The commonest cause of conversion was a frozen Calot's triangle (52 patients), followed by injury to the common bile duct (8 patients). The average postoperative stay in successful LC was 1.32 days. The overall mortality rate was 0.16% (2 deaths). The quality of life after LC was good to excellent in more than 90% of patients. CONCLUSIONS: Despite multiple hands in training, the complication rates of LC are within acceptable limits. The overall conversion rate has risen because of the increase in elective conversions, but the incidence of complications has come down because of a "no hesitation" policy in converting. In spite of multiple operators, LC is the procedure of choice for symptomatic cholelithiasis at our hospital.

Adolescent↗
PubMed2002

Splenic abscess.

Explore the source record for details and available documents.

Abdominal Abscess↗
PubMed1998

Efficient Learning of VAM-Based Representation of 3D Targets and its Active Vision Applications.

There has been a considerable interest in using active vision for various applications. This interest is primarily because active vision can enhance machine vision capabilities by dynamically changing the camera parameters based on the content of the scene. An important issue in active vision is that of representing 3D targets in a manner that is invariant to changing camera configurations. This paper addresses this representation issue for a robotic active vision system. An efficient Vector Associative Map (VAM)-based learning scheme is proposed to learn a joint-based representation. Computer simulations and experiments are first performed to evaluate the effectiveness of this scheme using the University of Illinois Active Vision System (UIAVS). The invariance property of the learned representation is then exploited to develop several robotic applications. These include, detecting moving targets, saccade control, planning saccade sequences and controlling a robot manipulator.

Journal Article↗
PubMedDate not supplied

Coexisting tuberculosis and carcinoma of the colon: a report of two cases and a review of the literature.

Tuberculosis and carcinoma of the colon rarely coexist. We report 2 such cases and review the available literature. Since the potential for misdiagnosis is high in such patients and a preoperative diagnosis of coexistence is usually not possible, important questions regarding the management of patient with a diagnosis of either colonic cancer on tuberculosis need to be addressed.

Adenocarcinoma↗
PubMedDate not supplied

Non-biliary mishaps during laparoscopic cholecystectomy.

BACKGROUND: The most important complications of laparoscopic cholecystectomy (LC) are biliary tract injuries. Non-biliary complications can be equally devastating, but have received less attention in literature. METHODS: The case files of 1748 patients who underwent LC over a period of seven years (1997-2003) in our department were retrospectively reviewed to identify non-biliary complications and their management. RESULTS: Nine patients (0.5%) sustained significant non-biliary injury while undergoing LC. The commonest was duodenal perforation during dissection of the Calot's triangle (3 cases). Other complications included diaphragmatic injury (2 cases), and small bowel injury while inserting the umbilical port, right external iliac artery injury during insertion of Veress needle, portal vein injury during dissection, and liver laceration while using a delivery system to extract the gall bladder (1 each). All these complications were detected and managed intra-operatively. During the same period, 10 patients sustained biliary injury. CONCLUSION: Intra-operative non-biliary injuries during LC occur as frequently as biliary injuries, and can be life-threatening and difficult to manage.

Adult↗