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Biomedical subjects

S K Mehta

Publications and source records attributed to S K Mehta.

At least 73 records · Page 4Linked to original sources
PubMed1992

Optimal number of biopsy specimens in the diagnosis of carcinoma of the oesophagus.

The study evaluated 48 patients with carcinoma of the oesophagus to assess the optimal number of biopsy specimens required to obtain the highest yield. Eight specimens were obtained from each patient and two specimens were placed serially in each of four vials. The first vial provided a positive diagnosis in 95.8% of cases. The addition of two more specimens (second vial) increased the yield to 97.9% and the fifth and sixth specimens increased the positive yield to 100%. There was no statistically significant difference in the yield according to the site and the type of growth.

Adult↗
PubMed1992

Evaluation of radical treatment of carcinoma esophagus using a combination of external beam and intracavitary irradiation.

Twenty five patients with squamous cell carcinoma arising from the middle third of the esophagus were treated radically, with external radiation, to a dose of 55-60 Gy. All patients had lesions less than 6 cm in length with no extra-esophageal spread on computed tomography scan. Eleven of these patients received additional intracavitary radiation to a dose of 12 Gy, 1 cm from the source axis in two sessions of 6 Gy each, a week apart. There was no significant difference in the relief of dysphagia and survival among these receiving and those not receiving intracavitary radiation. Addition of intracavitary radiation to radical external radiation was associated with significant complications like stricture and fistulae formation, which accounted for the poor results.

Brachytherapy↗
PubMed1992

Fatal pulmonary arterial hypertension complicating noncirrhotic portal fibrosis.

A 25-yr-old female with noncirrhotic portal fibrosis underwent a lienorenal shunt for variceal bleed. Ten years after shunt surgery, she presented with progressive breathlessness, and severe pulmonary arterial hypertension was detected, to which she subsequently succumbed. Autopsy revealed classical plexogenic pulmonary arteriopathy.

Adult↗
PubMed1992

Ingestion of strong corrosive alkalis: spectrum of injury to upper gastrointestinal tract and natural history.

We have prospectively studied 31 patients who ingested strong alkalis for location, extent, severity, and outcome of the injury to the upper gastrointestinal tract. Alkalis ingested were sodium hydroxide (n = 28) and potassium hydroxide (n = 3). The injury was assessed within 36 h of alkali intake by endoscopy or surgery, or at autopsy. Symptoms and signs did not give a reliable forecast of the extent and severity of injury. The corrosive burns were classified as grade 2a in six patients, grade 2b in eight, and grade 3 in 17. The esophagus was injured in all patients, the stomach in 93.5%, and the duodenum in 29.6%. Acute complications occurred in 32.3% of the patients and death in 12.9%; all but one of such patients had grade 3 burns. All patients with 2a injury recovered without sequelae. Four of the eight patients with grade 2b injury and all survivors of grade 3 injury developed esophageal or gastric cicatrization, or both, which needed endoscopic or surgical treatment. We find endoscopy is not only a safe and reliable tool for diagnosis in such patients, but also is of importance in treatment and prognosis. We conclude that ingestion of strong alkalis is a very serious condition that inflicts severe contiguous injury to the esophagus and stomach and results in high morbidity and mortality.

Adolescent↗
PubMed1992

Cimetidine therapy and duodenal candidiasis: role in healing process.

Patients with Candida colonization and invasion were studied in 20 duodenal ulcer (DU) patients, 10 non-ulcer dyspepsia (NUD) cases and 10 controls with non-gastroenterological disorders. Of 20 DU patients, Candida albicans was cultured from duodenal aspirates of 6 (30%) DU patients and pseudohyphae, indicating invasive form, were present in two (10%) prior to treatment. NUD patients and controls had positive Candida culture in 3 (30%) and 1 (10%) cases respectively; pseudohyphae were found in none. Six DU patients (30%) failed to heal with 4 weeks of cimetidine therapy; all six showed invasion of duodenal ulcer mucosa with Candida on histology. The pseudohyphae form of Candida was always found to be associated with non-healing of DU. Candidal invasion is associated with failure to respond to, H2-receptor antagonist therapy.

Candidiasis↗
PubMed1991

Radiation-induced proctosigmoiditis. Prospective, randomized, double-blind controlled trial of oral sulfasalazine plus rectal steroids versus rectal sucralfate.

In a prospective study, 37 consecutive patients with radiation-induced proctosigmoiditis were randomized to receive a four-week course of either 3.0 g oral sulfasalazine plus 20 mg twice daily rectal prednisolone enemas (group I, N = 18) or 2.0 g twice daily rectal sucralfate enemas plus oral placebo (group II, N = 19). The two groups were comparable with respect to demographic features, duration of symptoms, and clinical and endoscopic staging of the disease. Fifteen patients in group I and 17 in group II completed the trial. At four weeks, both groups showed significant clinical improvement (P less than 0.01 for group I and P less than 0.001 for group II) and endoscopic healing (P less than 0.01 for group I and P less than 0.001 for group II). When the two groups were compared, sucralfate enemas showed a significantly better response as assessed clinically (P less than 0.05), although endoscopically the response was not statistically different (P greater than 0.05). We conclude that both treatment regimens are effective in the management of radiation proctitis. Sucralfate enemas give a better clinical response, are tolerated better, and because of the lower cost should be the preferred mode of short-term treatment.

Administration, Oral↗
PubMed1991

Corrosive acid-induced esophageal intramural pseudodiverticulosis. A study of 14 patients.

Esophageal intramural pseudodiverticulosis (EIP) is a rare disease, characterized by multiple, small flask-shaped diverticula in the esophageal wall, and best demonstrated on single-contrast barium examination. Though the condition is often associated with reflux esophagitis, Candida esophagitis, and esophageal dysmotility, corrosive-acid injury is not a commonly recognized cause. In a radiological study involving 59 patients with sequelae of corrosive-acid injury of the upper gastrointestinal (GI) tract, evaluated over a 5-year period, 14 cases (23.7%) of EIP were found. Esophageal stricture was a constant association; the diverticula tended to involve either the entire length of the stricture or its upper part. There was, however, no correlation between the length of the stricture and number of diverticula (p greater than 0.05). Endoscopic dilatation resulted in relief of dysphagia, and the diverticula regressed in number of disappeared altogether. Our experience suggests that EIP is a common sequelae of esophageal acid injuries, and that diverticula tend to form at the site of initial contact between acid and susceptible esophageal mucosa. Stricture dilatation leads to reduction or total disappearance of the diverticula.

Acids↗
PubMed1991

Changing pattern of peptic ulcer in India. An endoscopic study of 1,188 ulcer patients.

Earlier studies have described a profile of peptic ulcer different in developing and developed countries. In a prospective endoscopic study in India over 5 years and 8 months involving 5,948 patients with upper gastrointestinal symptoms, we detected peptic ulcers in 1,188. There were 920 patients with duodenal ulcer (DU), 185 with gastric ulcer (GU), and 83 with combinations of the two. The male to female ratio was 4.2:1. About half the ulcers were in patients age greater than or equal to 40 years. Of the 223 (18.7%) patients with peptic ulcer complications, gastrointestinal bleeding was the most common (12.7%) and gastric outlet obstruction was less common (6.2%). Endoscopic evidence of duodenal bulb deformity was seen in 74.4% of DU patients. A comparison of these results with data from previous Indian studies suggests a changing trend of peptic ulcer with respect to age and sex distribution, the ratio between DU and GU, and complications of peptic ulcer. The profile of peptic ulcer in north India today is similar to that seen in Western countries four to five decades ago. We discuss possible factors responsible for this change.

Adult↗
PubMed1991

Variations in cytotoxicity and isoenzyme patterns of uncloned and cloned cultures of axenic Entamoeba histolytica.

Five clones of axenic Entamoeba histolytica (HMI) grown as discrete colonies in semisolid agar medium were adapted in liquid medium and labelled as HMI-C121, HMI-C131, HMI-C143, HMI-C144 and HMI-C145. The clone HMI-C121 was more cytotoxic to the cultured Baby Hamster Kidney (BHK) cells while all other clones were significantly (P less than 0.001) less cytotoxic as compared to the cloned HMI-C121 and uncloned E. histolytica (HMI). The uncloned Indian axenic E. histolytica (KCG:0986:11) as well as E. histolytica (NIH:200) cultures were significantly (P less than 0.001) less cytotoxic to cultured BHK cells. No difference in the electromobility of maleate NADP oxidoreductase (ME) or glucophosphate isomerase (GPI) isoenzyme in the lysates of all the cloned and uncloned cultures of E. histolytica was observed. The clones HMI-C121, HMI-C131, HMI-G143 and HMI-C144 had three bands of hexokinase (HK) while all uncloned cultures and one of clones, HMI-C145 had only two bands. Though cloned and uncloned cultures had a single PGM band, the relative electromobility (rf) of phosphoglucomutase (PGM) for clone HMI-C131, HMI-C143 HMI-C144 was relatively less (rf 0.075) and these were also significantly (P less than 0.001) less cytotoxic to BHK cells as compared to clone HMI-C121. It is felt that axenic E. histolytica culture consists of several populations (clones) and expression of isoenzymes pattern or cytotoxic potentials would depend upon the population which predominantly multiples and outgrows other populations in the culture system.

Animals↗
PubMed1991

High dose rate intracavitary therapy in advanced carcinoma esophagus.

Nine patients with advanced squamous cell carcinoma of the middle third of the esophagus were treated by high dose rate intracavitary therapy. The dose delivered was 12 Gy in two sessions at 1 cm from the center of the source. All nine patients were alive after 9 months. Six months after treatment, 4 patients had strictures which were dilated. At the end of nine months, 6 patients had dysphagia, four of whom had strictures and two had recurrence which was treated by further intracavitary irradiation. Intracavitary radiation using high dose rate, remote controlled afterloader has a significant role in palliation in patients with advanced esophageal carcinoma and avoids intubation.

Brachytherapy↗
PubMed1991

Post traumatic facial paralysis--a review.

A retrospective analysis of 23 cases of post-traumatic facial nerve injury has been done. Majority of the cases had a conductive or a mixed deafness. The Schirmer's test has been considered to be one of the main indicators to determine the site of injury. The mastoid segment of the facial nerve was found to be injured in 52% of the patients. The surgical approach in patients with post-traumatic facial nerve paralysis should be transmastoid. This can be combined with a middle fossa approach in patients with a positive Schirmer's test.

Facial Nerve↗
PubMed1991

Effect of instant preparation of betel nut (pan masala) on the oral mucosa of albino rats.

Paste made out of an instant betel nut preparation was painted into the oral cavity of 21 albino rats on alternate days for a period of six months. Biopsies were taken from the oral mucosa at the beginning of the study and every two months there after and compared histopathologically with those obtained from a control group of 14 albino rats. Mild to moderate loss of nuclear polarity and increase in keratoses, parakeratoses, inflammatory cell infiltration and vascularity were noted when compared to the control group. The increase in mitotic figures was statistically insignificant and no definite changes in pigmentation or atypical cells were seen. These findings suggest the possibility of mild leukoplakia. Submucosal collagen increased steeply and steadily throughout the study period and at the end of six months, 88.23 per cent of biopsies showed thickened and condensed sub-mucosal collagen, indicating submucous fibrosis.

Animals↗