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Biomedical subjects

S K Sarin

Publications and source records attributed to S K Sarin.

At least 145 records · Page 8Linked to original sources
PubMed1986

Cholesterol and pigment gallstones in northern India. A prospective analysis.

Two hundred one consecutive patients with gallstone disease who had undergone cholecystectomy were analyzed to determine the relative frequency of occurrence of cholesterol and pigment gallstones and to identify distinguishing features of the two stone types. Cholesterol stones (CS) formed the majority (94%) of gallstones. There were no distinctive clinical, biochemical, or radiological features of CS or pigment stones (PS). However, CS were found significantly more often than PS (P less than 0.05) in multiparous women leading a sedentary life-style. Although multiplicity of gallstones was somewhat commoner with CS (P less than 0.05) and radiopacity with PS (P less than 0.05) as compared with the other stone type, these differences were certainly not discriminatory between CS and PS.

Adult↗
PubMed1986

A clinico-radiological reappraisal of intestinal tuberculosis--changing profile?

Intestinal tuberculosis is still common in developing countries. In 186 patients with intestinal tuberculosis, clinical features, radiological findings and complications were carefully recorded and compared with those from earlier studies with a view to study any possible changes after the liberal use of antitubercular drugs. Sixty two percent of the patients in the present series had had prior exposure to antitubercular drugs. The incidence of systemic symptoms like fever and anorexia, alternating diarrhoea and constipation, peritoneal and lymph node involvements and associated pulmonary lesions were less frequently observed. On the other hand, an indolent and complicated course with intestinal obstruction (47%) and lower gastrointestinal bleeding (5.5%) and frequent colonic involvement (19%) often necessitating surgical intervention appeared to have become more frequent than reported in earlier series. Awareness of these changes in the clinical profile of intestinal tuberculosis should be helpful in the diagnosis and management of the condition.

Adult↗
PubMed1986

Oesophageal ulceration after sclerotherapy--a complication or an accompaniment?

Forty eight patients with oesophageal varices were serially endoscoped over a period of 3 weeks for the presence of oesophageal ulcers after the first course of sclerotherapy with absolute alcohol. Post-sclerotherapy oesophageal ulcers were seen in 94% patients on day 1, in 69% patients at 1 week and in only 12.5% patients at the end of 3 weeks. A strong correlation (r = + 0.88) was observed between the incidence of ulceration and the amount of sclerosant injected. In fact, all patients who received 3 ml or more of the sclerosant showed development of oesophageal ulcers. It can be concluded that oesophageal ulcers are probably a necessary accompaniment of sclerotherapy and should not be considered an avoidable complication.

Adult↗
PubMed1986

Follow-up of patients after variceal eradication. A comparison of patients with cirrhosis, noncirrhotic portal fibrosis, and extrahepatic obstruction.

One hundred one patients, 54 with cirrhosis of liver, 31 with noncirrhotic portal fibrosis (NCPF), and 16 with extrahepatic obstruction (EHO), were followed up at monthly intervals for a mean (+/- SD) period of 17.9 +/- 4.8 months after achieving total variceal eradication with endoscopic sclerotherapy. Recurrence of esophageal varices was seen in 19 (18.8%) patients, 12 with cirrhosis and seven with NCPF, within a mean (+/- SD) period of 5.7 +/- 1.6 months. No patient with EHO showed recurrence. Three (2.9%) patients rebled from the recurred varices. Mean (+/- SD) number of sclerotherapy sessions and the amount of absolute alcohol required for eradication of recurred varices were 1.6 +/- 0.8 and 3.6 +/- 1.8 ml, respectively. Dysphagia and esophageal stricture were present in 15 (14.9%) patients with nearly similar frequency in patients with cirrhosis, NCPF, and EHO. Dysphagia in four patients with stricture improved without dilatation. While there were no deaths in patients with NCPF and EHO, 11 patients with cirrhosis died. There was significant (p less than 0.01) improvement in the liver status of surviving patients with cirrhosis after variceal eradication. It can be concluded that variceal recurrence and rebleeding are not major problems after sclerotherapy. Sclerotherapy probably helps in spontaneous improvement of the liver status of surviving cirrhotics and reduces long-term morbidity and mortality of patients with NCPF and EHO.

Adult↗
PubMed1986

Comparison of the two time schedules for endoscopic sclerotherapy: a prospective randomised controlled study.

To compare the efficacy and safety of one week versus three weeks interval treatment schedules of endoscopic sclerotherapy, injections were carried out in a prospective manner in 96 patients with variceal bleeding; 47 on a one week and 49 on a three weeks treatment schedule. Weekly endoscopic sclerotherapy eradicated oesophageal varices significantly (p less than 0.01) earlier (mean +/- SD 7.1 +/- 2.43 weeks) as compared with the three weeks regimen (mean +/- SD 14.86 +/- 4.86 weeks). The rebleeding rate was also significantly less (p less than 0.05) with weekly endoscopic sclerotherapy (8.5%) as compared with three weeks endoscopic sclerotherapy treatment (26.5%). The amount of alcohol and the number of endoscopic sclerotherapy courses required for complete variceal eradication did not differ significantly between the two groups. Patients undergoing weekly injections were seen to have significantly more oesophageal ulcers (p less than 0.01) as compared with the three weeks group, necessitating at times (23%) postponement of the procedure. There was, however, no difference between the two groups in the frequency of oesophageal stricture formation, dysphagia, retrosternal pain, and fever. Mortality was also similar in the two groups. It can be concluded that a weekly schedule of endoscopic sclerotherapy appears superior to a three weeks schedule.

Adult↗
PubMed1985

Repeated endoscopic sclerotherapy for active variceal bleeding.

Emergency endoscopic sclerotherapy (EEST) during continued moderate to severe bleeding was carried out using a flexible endoscope and absolute alcohol as a sclerosant in 38 patients with variceal bleeding. Portal hypertension was due to cirrhosis in 27, noncirrhotic portal fibrosis in eight, extrahepatic obstruction in two, and Budd-Chiari Syndrome in one patient. A technically adequate EEST could be carried out in 36 (95%) patients, with successful control of variceal bleeding in 35 (92%). Thirty-one episodes of rebleeding occurred in 12 (31.6%) patients. Twenty-nine (93.5%) of these episodes could be controlled with repeated EEST, giving an overall success of 87%. The new approach of repeating sclerotherapy on every rebleeding episode up to a maximum of three course within 24 hours, use of a wide bore injector, and certain other technical innovations were found safe and effective. The mean (+/- SD) amount of alcohol injected per patient was 9.23 +/- 3.3 ml and the mean (+/- SD) number of injections needed per patient were 6.0 +/- 3.07. Complications were minor, transient, and similar to conventional sclerotherapy. There were three deaths, two due to massive rebleeding and one due to hepatic encephalopathy. It can be concluded that EEST is technically feasible during active variceal bleeding and is an effective and relatively safe procedure. It can serve as the first line treatment in this group of patients.

Adolescent↗
PubMed1985

Subclinical encephalopathy after portosystemic shunts in patients with non-cirrhotic portal fibrosis.

Cerebral function was studied in patients with non-cirrhotic portal fibrosis who had no clinically detectable neurological abnormality, 14 before and 29 after a proximal lienorenal shunt operation. In each patient electroencephalography (EEG) and psychometric tests (the number connection test, construction of a five-pointed star and the reverse counting test) were performed. Psychometric tests were also done in an equal number of matched, healthy controls. Subclinical encephalopathy was diagnosed when any of these tests was abnormal. In the unoperated group the EEG was normal in all patients and there was no difference in the psychometric test results between patients and healthy controls. After portosystemic shunt operations, the EEG was abnormal in 10%, the number connection test in 38%, construction of a five-pointed star in 19% and the reverse counting test in 30% of the patients. Detection of subclinical hepatic encephalopathy in such a high proportion of operated patients with non-cirrhotic portal fibrosis suggests that the surgical procedure and its haemodynamic consequences per se could have been responsible.

Adolescent↗
PubMed1985

Endoscopic sclerotherapy using absolute alcohol.

To assess the efficacy of absolute alcohol as a sclerosant, endoscopic sclerotherapy was carried out using a conventional endoscope and an indigenously designed injector. Forty three patients with portal hypertension who had presented with history of variceal bleeding were included in the study. Portal hypertension was caused by cirrhosis in 30 (69.8%), non-cirrhotic portal fibrosis in eight (18.6%) and extra-hepatic obstruction in five (11.8%). Acute bleeding was successfully controlled in all 11 patients, seven with a fresh bleed and four who rebled while on endoscopic sclerotherapy regimen. All patients with fresh, recent, or old bleeding were treated with a weekly endoscopic sclerotherapy schedule. Reduction in variceal size of two or more grades was achieved in all 20 patients who had completed at least four endoscopic sclerotherapy courses with total eradication of varices in 16 (80%). The mean (+/- SD) number of endoscopic sclerotherapy courses and time required for variceal eradication was 6.06 (+/- 1.87) and 9.1 (+/- 4.69) weeks respectively. None of these patients has shown appearance of fresh varices in a follow up of 18.47 +/- 8.50 weeks (range six to 38 weeks). Six patients died; all deaths were caused by progressive hepatic encephalopathy. Complications usually seen were dysphagia, retrosternal pain and fever; these were mild and easily tolerated by the patients. Rebleeding occurred in four patients who had received less than four endoscopic sclerotherapy courses. Absolute alcohol appears to be an effective, safe, economical, and freely available sclerosant. advocate endoscopic sclerotherapy as the first line of treatment for acute variceal bleeding and recommend a weekly schedule for the early eradication of varices.

Adolescent↗
PubMed1984

Noradrenaline in upper gastrointestinal haemorrhage. A prospective, randomized, double blind controlled clinical trial.

The effect of noradrenaline (8 mg in 100 ml cold saline) gastric lavage was compared with that of cold saline alone in 42 patients with upper gastrointestinal haemorrhage in a prospective, randomized, double blind study. Fifty three per cent (11/21) of the patients given noradrenaline stopped bleeding within two hours of treatment compared with 14% (3/21) of those given saline alone. We suggest that noradrenaline gastric lavage is a simple, safe and effective method for controlling upper gastrointestinal haemorrhage and could be used with advantage in peripheral hospitals in tropical countries.

Adolescent↗