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S K Acharya

Publications and source records attributed to S K Acharya.

136 records · Page 8Linked to original sources
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Pancreatic abscess: is there a role for conservative therapy?

Pancreatic abscess is a serious complication of acute pancreatitis and non-operative management has been reported to carry a mortality of nearly 100%. We present five patients with pancreatic abscess, who were successfully treated with antibiotics alone. All 5 patients had acute pancreatitis followed by prolonged fever and development of an abdominal mass. The diagnosis was confirmed in each of them by a contrast enhanced CT scan and an ultrasound guided aspiration of pus from the pancreatic mass. The choice of antibiotics was decided by the culture reports in two cases and by Gram's staining in the remaining three patients. We attribute the success of antibiotic therapy in our patients to early diagnosis by CT scan and guided aspiration as well as the absence of any unfavourable risk factors. This study suggests that a select group of patients with pancreatic abscess may be managed conservatively with antibiotics.

Abscess↗
PubMedDate not supplied

Gastrointestinal mucormycosis--an uncommon isolated mucormycosis.

BACKGROUND: Isolated mucormycosis of the gastrointestinal tract is uncommon, with only two case reports from India. OBJECTIVES: To study the clinicopathologic features of gastrointestinal mucormycosis in Indian patients. METHODS: Eight cases of isolated gastrointestinal mucormycosis, seen over six years (1992-97) are reviewed. RESULTS: Five of the patients were premature babies or infants, one was a 12-year-old boy, and two were middle aged. Symptomatology included vomiting, bloody diarrhea, upper gastrointestinal bleeding, abdominal lump and abdominal distention. All the neonates presented with intestinal perforation. The duration of symptoms was ten days or less in six cases. Mucormycosis was not suspected clinically in any patient. In six cases the diagnosis was established antemortem from resection or biopsy material. Only two patients received antifungal therapy and only one patient responded. CONCLUSIONS: Isolated gastrointestinal mucormycosis is not uncommon in India. Early diagnosis may be helpful in reducing the high mortality.

Child↗
PubMedDate not supplied

Evaluation of third generation anti-HCV enzyme immunoassays.

The Hepatitis C Virus (HCV) is a major cause of post transfusion hepatitis. The introduction of HCV antibody screening has reduced the risk of post transfusion hepatitis significantly. However, the test is yet to be used routinely in blood banks of several developing countries with limited resources. We have developed an Enzyme immunoassay using synthetic peptides. The test was compared to seven commercial tests available in the Indian market. The test was evaluated using a panel of 90 sera which were chosen from an earlier panel based on detection of HCV RNA by Reverse Transcription Polymerase Chain Reaction RT-PCR. In case of any discrepancy the sera were further analysed by Line immunoassay (LIA). The sensitivity of the in house EIA was 90%. The specificity of the commercial EIAs varied.

Hepacivirus↗
PubMedDate not supplied

Relative merits of ultrasonography, computed tomography and cholangiography in patients of surgical obstructive jaundice.

Fifty consecutive patients with surgical obstructive jaundice were evaluated prospectively with ultrasonography (US), computed tomographic scans (CT scan) and cholangiography-percutaneous transhepatic cholangiography (PTC) or endoscopic retrograde cholangio-pancreaticography (ERCP). The diagnostic accuracy of ultrasound in defining the level of obstruction was 86% as compared to 86% and 94.8% for CT scan and cholangiography, respectively. To measure the etiology of the obstruction, the accuracy of ultrasound, CT scan and cholangiography were 84%, 86% and 75%, respectively. The sensitivity of CT scans and cholangiography in the diagnosis of choledocholithiasis was 100%, 81.8% and 90%, respectively, whereas specificity was 97%, 100% and 100%, respectively. Sensitivity for a diagnosis of malignant disease was 100% for both US and CT scans whereas specificity was 90% and 81%, respectively. Ultrasonography as a single radiological investigation is sufficient in the evaluation of the majority of patients with surgical obstructive jaundice. CT scan and cholangiography should be done only when US gives equivocal findings or if concomitant therapeutic procedures like basketing and stenting are also planned.

Adolescent↗