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S Dasarathy

Publications and source records attributed to S Dasarathy.

At least 37 records · Page 2Linked to original sources
PubMed1992

Prospective controlled study of post-transfusion hepatitis after cardiac surgery in a large referral hospital in India.

We studied the risk of post-transfusion hepatitis (PTH) in recipients of blood collected from voluntary donors screened for HBsAg. Two hundred and fifty patients without any previous history of liver disease or transfusion were followed up for 12 months subsequent to cardiac surgery. Thirty-five of them had closed-heart surgery without receiving transfusion and served as controls. The remaining 215 patients received single-point transfusions (mean 4 +/- 2.4 units). None of the controls and 15 (6.9%) blood recipients developed PTH. Three (20%) patients had hepatitis-B-virus-induced hepatitis while the remainder (80%) had non A, non B (NANB) hepatitis. The number of units of blood transfused and surrogate markers for development of PTH (donor alanine aminotransferase, anti-HBc and anti-HBs antibody) were not associated with the occurrence of PTH (p greater than 0.05). Nine (60%) of the 15 patients developing PTH were asymptomatic. All the patients recovered from the PTH, except one who died of fulminant hepatitis. At the end of 1 year of follow-up, none of the patients had evidence of chronic hepatitis. Only three (25%) of the patients with NANB-PTH developed anti-hepatitis C virus (HCV) antibody during the follow-up. We conclude that the incidence of PTH in India is similar to other parts of the world and NANB virus was the major cause of the PTH. The absence of chronicity and lack of seroconversion to anti-HCV antibody in the majority of the patients after 1 year of follow-up may suggest the possibility of a NANB virus other than HCV as the major cause of PTH in India.

Adolescent↗
PubMed1992

A study of Helicobacter pylori in north Indian subjects with non-ulcer dyspepsia.

A prospective case control study was conducted in 50 patients with non-ulcer dyspepsia (NUD) and 10 age and sex matched controls to determine the prevalence of Helicobacter pylori in patients with NUD and to correlate symptoms, histology and presence of H pylori in gastric biopsies. Endoscopic biopsies from antrum and fundus were subjected to urease test and histological examination. On histology, H pylori was identified in 27 (54%) NUD patients and in one of 10 controls. Urease test was positive in 31 (62%) antral and 21 (42%) fundal biopsies in patients with NUD and in only one (10%) of 10 antral biopsies in the control group. On histology, gastritis was present in the antrum in 46 (92%) NUD patients and in the fundus in 40 (80%) cases; of these, 27 (54%) and 15 (30%) had H pylori in antral and fundal biopsies respectively. The severity of antral gastritis correlated with the density of H pylori (p < 0.05).

Adolescent↗
PubMed1992

Peritoneal tuberculosis: laparoscopic patterns and its diagnostic accuracy.

We report laparoscopic findings in 38 proven cases of peritoneal tuberculosis. The laparoscopic appearances can be classified into three types: thickened peritoneum with miliary yellowish white tubercles with or without adhesions (n = 25), only thickened peritoneum with or without adhesions (n = 8), and fibroadhesive pattern (n = 5). Biopsies were avoided from fibroadhesive lesions due to risk of complications. Visual diagnosis was accurate in 95% of patients. In comparison, in 27 (82%) of 33 patients, the examination enabled a histologic diagnosis to be made on the basis of typical granulomas. The combined use of guinea pig inoculation and culture isolated Mycobacterium tuberculosis in six (37.5%) of 16 patients. Mycobacteria were scarcely (3%) seen on histological sections. We conclude that, although target biopsy is an effective method of obtaining an early diagnosis of peritoneal tuberculosis, chemotherapy may be started on the basis of visual laparoscopic appearances alone.

Adult↗
PubMed1992

A prospective randomized study of the injurious effects of aspirin and naproxen on the gastroduodenal mucosa in patients with rheumatoid arthritis.

A prospective double-blind randomized placebo-controlled study was conducted to compare the injurious effects of aspirin and naproxen on the gastroduodenal mucosa. Patients with rheumatoid arthritis attending the immunology clinic of a tertiary care center were included in the study. Ninety consecutive patients were randomized to receive aspirin, naproxen, or placebo. Clinical evaluation was done every 2 wk. Upper gastrointestinal endoscopy, biopsies from the gastric antrum and duodenum for histological examination, and Helicobacter pylori studies were done at entry and after 2 months. The number of patients with dyspeptic symptoms was similar in the aspirin (12) and naproxen (9) groups. In both cases, however, it was higher (p less than 0.01) than in the placebo group (none). Naproxen was associated with a higher score of endoscopic abnormalities in the gastric body (0.6 +/- 1.3) than aspirin (0.2 +/- 0.6) or placebo (0.03 +/- 0.18). H. pylori was present in a similar proportion of patients in the three groups (33-43%). A greater fall in hemoglobin was observed with aspirin (0.35 +/- 0.48 g%) and naproxen (0.44 +/- 0.53 g%) than with placebo (0.09 +/- 0.4 g%). The present study suggests that aspirin and naproxen produce a similar degree of injury to the gastroduodenal mucosa.

Adult↗
PubMed1992

Evaluation of enzyme-linked immunosorbent assay using mycobacterial saline-extracted antigen for the serodiagnosis of abdominal tuberculosis.

The efficacy of enzyme-linked immunosorbent assay (ELISA) was evaluated in the sera of 215 individuals as a diagnostic aid in abdominal tuberculosis. The subjects had abdominal tuberculosis (group 1), intestinal disorders other than tuberculosis (group 2), cirrhosis of the liver (group 3), and peritoneal malignancy (group 4). Sera from patients of pulmonary tuberculosis and healthy volunteers (group 5) were also analyzed for enzyme activity and served as positive and negative controls. In patients with abdominal tuberculosis, the absorbance (OD) values were significantly higher than for the other groups and healthy volunteers (p less than 0.001). OD values were similar in abdominal and pulmonary tuberculosis (p greater than 0.05). Level above 0.7 (OD) in serum suggests tuberculosis with a sensitivity of 81%, specificity of 88%, and a diagnostic accuracy of 84%. These results suggest that ELISA may be used for the diagnosis of abdominal tuberculosis and in differentiating it from other nontuberculous abdominal diseases.

Adolescent↗
PubMed1992

Prospective randomized comparison of sodium tetradecyl sulfate and polidocanol as variceal sclerosing agents.

A prospective randomized controlled study was designed to evaluate differences in efficacy and complication rate between the two most commonly used sclerosing agents, sodium tetradecyl sulfate (STD) and polidocanol. Of 52 patients with esophageal variceal bleeding, 26 were randomized to receive sclerotherapy with 1.5% STD and 26 to receive 1% polidocanol at weekly intervals. Eradication of varices was achieved in 88% patients each of the STD and polidocanol group. There was no significant difference between patients injected with STD and polidocanol with regard to re-bleeding (27% vs. 15%) and mortality (11.5% in both). The use of STD, in contrast to polidocanol, was associated with a higher incidence of complications in terms of severe retrosternal pain (27% vs. 4%), deep ulceration (53% vs. 23%), dysphagia (88% vs. 46%), and stricture formation (27% vs. 8%). It was concluded that these two agents were similar in efficacy. However, polidocanol was superior due to a lower incidence of complications.

Adolescent↗
PubMed1991

Results of endoscopic variceal sclerotherapy: influence of etiology of portal hypertension and hepatic functional status.

In India 50% of patients with gastrointestinal bleeding bleed from esophageal varices. Causes of portal hypertension includes hepatic cirrhosis, non-cirrhotic portal fibrosis and extrahepatic portal obstruction. Endoscopic sclerotherapy is the treatment of choice to control continued active bleeding. Immediate hemostasis was not influenced by the etiology of portal hypertension. However, rebleeding episodes were lower, in extrahepatic portal vein obstruction than non-cirrhotic portal fibrosis and cirrhotic patients. Child's status significantly influenced recurrence of bleeding and mortality which was lower in child's A than B and lower in B than C irrespective of etiology. Results of long term sclerotherapy were also influenced by the etiology of portal hypertension and hepatic functional status. Sclerotherapy was most effective in patients of (EHO), than (NCPF) followed by cirrhosis of the liver.

Chi-Square Distribution↗
PubMed1991

Laparoscopic features of the Budd-Chiari syndrome.

Twenty-three patients with Budd-Chiari Syndrome were examined by laparoscopy. The characteristic findings were a purple to dusky-blue lobulated surface of the liver, which was covered with whitish bead-like cysts and newly formed tortuous dilated veins. The rich network of blood vessels was also visible over the falciform ligament and peritoneal surface in the majority of patients. Ascites and splenomegaly were an added although non-specific diagnostic feature.

Adult↗
PubMed1991

Gallbladder abnormalities in acute viral hepatitis: a prospective ultrasound evaluation.

We carried out a prospective case controlled study to evaluate the temporal sequence of sonographic abnormalities in acute viral hepatitis (AVH) and their resolution patterns. Correlations were established between the sonographic abnormalities and the clinical and biochemical profiles. Fifty-six patients within 2 weeks of onset of illness (37 within 1 week and 19 between 1 and 2 weeks) underwent real-time ultrasound at weekly intervals until clinical and biochemical resolution. Abnormal sonographic patterns were found in 55 of 56 (98.2%) patients. The wall thickness was abnormal (6.1 +/- 4.3 mm) in 55 (98.2%) cases, luminal abnormalities observed in 33 (58.9%) cases, and alterations in volume in 14 (25%) cases. Complete resolution took place in 53 (96.4%) cases by 12 weeks. A wall thickness of greater than 7 mm and abnormal luminal contents were more frequent in patients studied within 1 week of illness than later (p less than 0.05). No other correlations could be established between the different sonographic patterns and the clinical and biochemical profiles at any stage of the illness. We conclude that sonographic abnormalities are common in patients with AVH, with resolution as the rule with clinical recovery.

Acute Disease↗
PubMed1991

Laparoscopic & histological features of hepatocellular carcinoma.

Laparoscopic findings in 17 patients of proven hepatocellular carcinoma are reported. The laparoscopic appearance was of two types viz., solitary mass (in 12) and a multinodular lesion (in 5). Five patients with a solitary lesion involving the right lobe of the liver had associated satellite lesions. There was no evidence of cirrhosis in 8 (47%) patients. Ascites, peritoneal metastasis and splenomegaly were observed in 24, 12 and 17 per cent patients respectively. The commonest histological pattern seen was trabecular (65%) followed by anaplastic (17%), acinar (12%) and fibrolamellar (6%).

Aged↗
PubMed1990

Adenosine deaminase (ADA) in peritoneal tuberculosis: diagnostic value in ascitic fluid and serum.

Simultaneous determination of ascitic fluid and serum adenosine deaminase (ADA) activity was evaluated as a diagnostic aid in peritoneal tuberculosis. The ascites was due to peritoneal tuberculosis (group 1), cirrhosis of the liver (group 2), cirrhosis of the liver with spontaneous bacterial peritonitis (group 3), peritoneal malignancy (group 4), Budd-Chiari Syndrome (group 5) and miscellaneous conditions (group 6). Serum from patients of pulmonary tuberculosis and healthy volunteers was analysed for enzyme activity. In patients with peritoneal tuberculosis the ascitic fluid and serum ADA activity was significantly higher than for the other groups (P less than 0.001). Levels above 36 u/l in ascitic fluid and above 54 u/l in the serum suggest tuberculosis. The ascitic fluid/serum ADA ratio was also higher in patients with peritoneal tuberculosis than with other causes of ascites (P less than 0.01). A ratio of more than 0.984 was suggestive of tuberculosis.

Adenosine Deaminase↗
PubMed1990

Gallstone disease in north India: clinical and ultrasound profile in a referral hospital.

We studied the prevalence of gallstones in patients with upper abdominal pain, heaviness, or discomfort by ultrasound examination of the gallbladder. The actual ultrasound examination was performed by a clinical gastroenterologist blinded to the symptoms. Of 1,680 consecutive dyspeptic patients, 500 (29.8%) had gallstones. The gallbladder was contracted in 450 (91.2%), normal-size in 36 (7.2%), and distended in 8 (1.6%). Biliary colic was more frequently the presenting complaint in patients with a contracted gallbladder than in those with normal size gallbladder (p less than 0.001). Dyspepsia was more frequent in the presence of a normal size gallbladder than a contracted one (p less than 0.001). We conclude that ultrasonography of the gallbladder by the clinician has a high diagnostic yield, and the symptom complex has an excellent correlation with the sonographic appearance.

Adolescent↗
PubMed1990

Clinical profile of multiple amoebic liver abscesses.

Of 70 consecutive patients with amoebic liver abscess admitted over a 3 year period, 15 (21.4%) had multiple abscesses. This condition, like solitary abscess, was a disease of the 2nd to 5th decade with a male preponderance. Multiple abscesses were more frequently associated with fever, jaundice, upper abdominal pain, pneumonitis and tender hepatomegaly. The left lobe of the liver was always enlarged in patients with multiple abscesses and 86% of patients required drainage of an abscess cavity. The presence of more severe clinical course, jaundice and left lobe hepatomegaly should raise the suspicion of multiple abscesses. After confirmation of the diagnosis by imaging technique, the abscess cavity should be aspirated for quick relief and cure.

Adolescent↗
PubMed1989

Endoscopic injection treatment of non-variceal bleeding lesions of upper gastro-intestinal tract.

Endoscopic injection of actively bleeding non variceal lesions with polidocanol was performed in 15 patients. Eleven of them had associated diseases. Haemostasis was achieved in 12 (80%). Three of them rebled. However, bleeding stopped by reinjection in two and spontaneously in one patient. No significant local or systemic complication was observed. This therapy avoided emergency surgery in 12 of 15 patients. Thus endoscopic injection treatment can be utilized for managing bleeding due to non variceal lesions.

Adult↗
PubMed1989

Sclerotherapy after variceal hemorrhage in noncirrhotic portal fibrosis.

Sixty patients with variceal bleeding due to noncirrhotic portal fibrosis were treated by repeated endoscopic injection sclerotherapy. During each session, the varices were injected with a mean volume of 14.4 ml of 1% polidocanol intravariceally. This decreased rebleeding, as evidenced by a reduction in mean bleeding risk factor and transfusion requirement. Difference between pre- and post-sclerotherapy parameters were significant (p less than 0.001). Variceal obliteration was achieved in 53 (88%) patients. The mean sclerotherapy sessions required for eradication were 8.43 (SD = 2.41). Minor complications related to the procedure occurred in 12% of patients. Cumulative survival for 5 yr was 86%. Survival was significantly related to Child's status, being 97.5% for Child's A and 64% for Child's B patients. Recurrence of varices occurred in 15% of patients after a mean interval of 19 months. We conclude that endoscopic sclerotherapy is an effective method of treatment for variceal bleeding due to non-cirrhotic portal fibrosis, and is a reasonable alternative to surgery.

Adult↗
PubMedDate not supplied

Endoscopic sclerotherapy for portal hypertension due to extrahepatic obstruction: long-term follow-up.

Between 1982 and 1987, 43 patients with variceal bleeding due to extrahepatic portal obstruction were treated by repeated endoscopic injection sclerotherapy using 1% polidocanol intravariceally. This decreased rebleeding, as evidenced by a decrease in bleeding risk factor (BRF), mean transfusion requirement, and mean number of transfusions per patient per month of follow-up. Differences between pre- and postsclerotherapy parameters were significant (p less than 0.001). The varices were eradicated in 86% of patients. The mean sclerotherapy sessions required were 7.68 +/- 2.39 (SD). Complications were infrequent. Forty-three patients were followed from 5 to 68 months: cumulative survival was 97.7% and varices recurred in 16%. Sclerotherapy avoided a second operation in 21 postsurgical patients. Sclerotherapy for managing variceal bleeding due to extrahepatic portal obstruction is a reasonable alternative to surgery.

Adolescent↗