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Biomedical subjects

S K Mehta

Publications and source records attributed to S K Mehta.

At least 109 records · Page 6Linked to original sources

Endoscopic management of chronic organoaxial volvulus of the stomach.

Endoscopic correction of the chronic organoaxial volvulus of the stomach was attempted in seven cases of primary and three cases of secondary volvulus. Endoscopic correction was successful in six cases of primary volvulus and one case of volvulus secondary to duodenal carcinoma. This paper describes the details of the technique of endoscopic correction of gastric volvulus, and documentation of correction of the volvulus by barium meal study with a follow-up of 5-26 months.

Adult↗

Management of foreign bodies in the upper gastrointestinal tract.

Records of 55 consecutive patients who had ingested foreign bodies were reviewed retrospectively. Foreign bodies were located in the esophagus, stomach and duodenum in 25, 27 and 3 patients respectively. Eleven of these passed through the entire gastrointestinal tract spontaneously and uneventfully. Endoscopic extraction was successful in 36 patients while 8 needed surgical removal of the ingested object. Only one death was encountered. We conclude that using simple guidelines, foreign body ingestion can be managed with a low incidence of complications and mortality.

Adolescent↗

Gastrointestinal bleeding in malaria.

Hematological alterations are frequent in patients with malaria. However, these rarely manifest clinically, except for symptoms due to anemia. Two cases with gastrointestinal hemorrhage as a complication of malaria are reported.

Animals↗

Evaluation of different methods for detection of Helicobacter pylori in patients with gastric disease.

Endoscopic gastric antral biopsy specimens (133) from 92 dyspeptic patients with endoscopically evident gastritis (34; including one patient with dual pathology) gastric ulcer (13), duodenitis (17; including one patient with dual pathology) duodenal ulcer (29) and 41 subjects of non ulcer dyspepsia (NUD) with endoscopically normal upper gastrointestinal tract were examined for H. pylori by stained smear, various urease tests, culture and histopathology. Crushed tissue smear stained by Gram's method using carbol fuchsin counterstain proved to be the simplest and a reliable technique. Up to 4 h urease broth + ve test correlated well with smear and culture. Positive association of H. pylori with disease was considered when at least two of the above methods were suggestive. Significantly higher positivities were observed in gastritis (61.7%), gastric ulcer (84.6%), duodenitis (58.8%) and duodenal ulcer (82.8%) patients, as compared to NUD subjects (46.3%). Severe histopathological lesions were frequently associated with multiple bacteriological test positives.

Adult↗

Acute colitis in renal transplant recipients.

Gastrointestinal complications constitute an important cause of morbidity and mortality in renal transplant recipients. The present communication is based on our experience with 10 living related donor kidney transplant recipients who suffered from severe acute colitis in the posttransplant period. A specific etiological factor was detected in only one (atypical mycobacteria). Six patients succumbed to the illness in the acute stage, thus highlighting its seriousness. Various factors involved in etiology have been discussed, and early therapeutic intervention emphasized.

Acute Disease↗

Endoscopic sclerotherapy during pregnancy.

Pregnancy in patients with portal hypertension is an uncommon occurrence. Hence, there are no clear guidelines for management of variceal bleed during pregnancy. Moreover, the outcome of variceal sclerotherapy, particularly its effect on conception, as well as its safety and efficacy when used during pregnancy, is not known. We have treated four patients of portal hypertension during pregnancy with sclerotherapy. Two of them presented to us before conception, were put on sclerotherapy for variceal bleed, and conceived while on sclerotherapy schedule. Two other patients were started on sclerotherapy during pregnancy when they presented with variceal bleed. Sclerotherapy with absolute alcohol was effective in control of variceal bleed as well as obliteration of varices in pregnant patients. There was no untoward effect on mother or fetus. The mean number of sessions and volume of alcohol required for variceal obliteration were 6.5 and 42.0 ml, respectively. Variceal sclerotherapy does not interfere with conception and successful pregnancy, and is safe as well as effective during pregnancy.

Adult↗

The clinical spectrum of anomalous pancreatobiliary junction.

Anomalous junction of pancreatobiliary ducts (AJPB) is known to be associated with choledochal cyst and gallbladder cancer. This report describes our experience with eight patients with AJPB, six of whom were diagnosed at endoscopic retrograde cholangiography and two at transhepatic cholangiography. Four of the patients with AJPB had an associated congenital choledochal cyst, two had a normal biliary tree and one each had inspissated bile syndrome and cholangiocarcinoma. The last two associations have not been previously described. It is felt that the clinical spectrum of AJPB may unfold further with the widespread use of the cholangiographic techniques.

Adult↗

A modified technique of ultrasonically guided percutaneous transhepatic biliary drainage.

Ultrasonically guided percutaneous transhepatic biliary drainage was performed for palliative treatment in 31 patients and for pre-operative drainage in 21. The drainage was performed through a right intercostal approach with the ultrasound transducer placed in the midclavicular line without use of any specialized adaptor. No major complications were encountered. The main advantages of ultrasound guided drainage were (1) the rapidness of the procedure, (2) the negligible risk of puncturing blood vessels, and (3) the minimal exposure to radiation.

Adult↗

Contamination of an endoscope due to Trichosporon beigelli.

Trichosporon beigelli was isolated from the gastric aspirates of ten patients who had undergone endoscopy. Suspecting fungal contamination of the endoscopic equipment, samples from the biopsy channel, the water bottle, aspiration catheter and the tip of the endoscope were examined. Only the sample from the biopsy channel showed fungal elements on direct examination and grew Trichosporon beigelli. The original source for the fungus was an immunocompromised patient who had undergone endoscopy earlier. This episode occurred despite adherence to apparently adequate disinfection procedures for endoscopes. Because of the risk of cross-infection, especially in immunocompromised patients, it is imperative to take special steps to prevent fungal contamination of endoscopes.

Cross Infection↗

Effect of vitamin A deficiency on hepatic and intestinal drug metabolizing enzymes in rats.

Feeding of vitamin A-deficient diet to male weanling rats for 10 weeks caused significant reduction in the hepatic cytochrome P-450, cytochrome b5, aminopyrine N-demethylase and arylhydrocarbon hydroxylase activities. Contrary to this, the levels of these Phase I enzymes were found to be significantly elevated in all the 3 portions (proximal, middle and distal) of the intestine in deficient animals as compared to corresponding pair-fed controls. Of the Phase II enzymes studied, UDP-glucuronyltransferase showed a significant decrease whereas glutathione S-transferase showed a significant increase in vitamin A-deficient rat liver and small intestine. The study suggests that vitamin A deficiency causes an imbalance between the Phase I and phase II drug metabolizing enzyme systems which may decrease the capacity of the organism to withstand the neoplastic effects of chemical carcinogens in vitamin A deficiency.

Aminopyrine N-Demethylase↗

Clinical and epidemiological features of acute gastroenteritis associated with human rotavirus subgroups 1 and 2 in northern India.

Rotavirus was detected in 111 (15.9%) of 694 children who presented to our hospital with acute diarrhoea over a period of 45 months (1982-1985). Subgrouping for rotavirus was done on 87 children by ELISA using specific monoclonal antibodies to find out any differences in the epidemiology and clinical profile of the two subgroups. Twenty six (29.9%) were found to belong to subgroup 1 and 61 (70.1%) to subgroup 2. Diarrhoea, vomiting and fever were present in both the subgroups in the same frequency. However, the severity of diarrhoea was more in children having subgroup 2 infection. Rotavirus infection showed two peaks, one during the early months of summer and the other during the early months of winter of each year. During most of the study period, infection was predominantly with subgroup 2, except for a few months in 1983 and 1985 when a majority of children had infection with subgroup 1.

Child, Preschool↗

Pseudomyxoma peritonei. A report of three cases.

Pseudomyxoma peritonei is an infrequently encountered clinical entity which presents mainly with abdominal distension. We present here our experience with three such cases and emphasize on the aggressive combined operative and chemotherapeutic approach in this disease.

Adenocarcinoma, Mucinous↗