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Biomedical subjects

S Suri

Publications and source records attributed to S Suri.

At least 109 records · Page 6Linked to original sources

Ultrasound-guided fine needle aspiration cytology of carcinoma involving the intra-abdominal oesophagus.

Ultrasound-guided fine needle aspiration cytology (FNAC) of carcinoma of the intra-abdominal oesophagus was attempted on 21 patients with a 21 G spinal needle using a percutaneous anterior epigastric approach. The results were compared with those of endoscopic biopsy and brush cytology. The ultrasound-guided FNAC had a positive yield in 20/21 (95.2%) compared with 18/21 (85.7%) for endoscopic biopsy and 18/21 (85.7%) for brush cytology (P greater than 0.59). The combination of US-guided FNAC with endoscopic biopsy and the brush cytology achieved a positive yield in 21/21 (100%) whereas combining endoscopic biopsy and brush cytology produced a positive yield of 19/21 (90.5%). Two patients developed temporary epigastric pain. We recommend US-guided FNAC as a safe and effective technique that can be used alone or as an adjunct to endoscopic procedures for the diagnosis of carcinoma of the intra-abdominal oesophagus.

Abdomen↗

Computed tomography of the abdomen with fat density oral contrast medium.

A 12.5% corn oil-emulsion (COE) was tested as an oral contrast agent for abdominal computed tomography (CT) examinations in 100 patients. The results were compared with those obtained from another group of patients who received a conventional, high-density, oral contrast agent (2-3% iodinated solution). There was no statistically significant difference in the subjects' tolerance to the two agents (P greater than 0.05). There was, however, a significant improvement in image quality with COE (P less than 0.05). Gastrointestinal tract discrimination, and mucosal and mural visualisation was of higher quality with fat density oral contrast medium than with the high-density contrast agent. These data suggest that COE should be considered for routine use as an alternative to conventional high density oral contrast agents in upper abdominal CT.

Contrast Media↗

Reliability of skinfold calipers as a tool for measuring body fat in human beings.

Triceps skinfold thickness measured in ten adults aged 19 to 50 yr by a Holtain skinfold caliper, was compared with subcutaneous fat thickness obtained on cross-sections of the left upper arm by computerized axial tomography (CAT). The thickness of subcutaneous fat was measured on CAT scan film directly with the inbuilt computer graphic technique. The measurements taken on CAT scan film were found to be significantly higher (by 21-45%; P less than 0.001) than those by the skinfold calipers. Our findings suggest that skinfold calipers may not be very accurate tools for the assessment of body fat in human beings. Therefore, its use in the determination of body composition, for which great precision is required calls for re-thinking.

Adipose Tissue↗

Ultrasound in choledocholithiasis.

Twenty-five patients of obstructive jaundice due to choledocholithiasis, were prospectively evaluated by ultrasonography and cholangiography. Ultrasound could demonstrate choledocholithiasis in 10 patients (40%). Choledocholithiasis in non-dilated ducts could be demonstrated only in one patient. All cases were diagnosed by cholangiography. Ultrasound, though an accepted modality of choice for diagnosing cholelithiasis, has a limited role in the diagnosis of choledocholithiasis. Ultrasonography (USG) is the screening modality of choice to distinguish obstructive from non-obstructive jaundice. It is highly accurate in the diagnosis of cholelithiasis but its role in detection of choledocholithiasis is less clear. Choledocholithiasis complicates 10% of all cases of cholecystitis and occurs in 2-4% of postcholecystectomy patients. The present study deals with the diagnostic value of USG in cases of choledocholithiasis subjected to USG prior to cholangiography and surgery.

Adult↗

Modified ultrasound-guided percutaneous transgastric drainage of pancreatic pseudocysts.

We describe a modified ultrasound-guided transgastric drainage technique for pancreatic pseudocysts. Using a water-filled stomach to improve visualization, we have successfully drained pseudocysts in ten patients. This report also describes the use of a stiffening cannula to assist transgastric catheter placement. We emphasize the value of constant real-time tracking of the dilator and guidewire to ensure correct positioning of the drainage catheter.

Adolescent↗

An epidemic of dengue haemorrhagic fever and dengue shock syndrome in Delhi: a clinical study.

Twenty-four cases of dengue haemorrhagic fever/dengue shock syndrome were studied in Delhi in the months of September and October, 1988. The majority of these cases were boys aged 6-10 years. Classical symptoms of dengue (fever, headache, aesthesia, myalgia) occurred in all the patients. Digestive symptoms (nausea, vomiting, anorexia, abdominal pain and hepatomegaly) were also common. Haemorrhagic manifestations were present in 41.7% of the cases. Of these, 90% had gastrointestinal haemorrhages. Shock occurred in 17 cases (70.8%). Thrombocytopenia and prolongation of coagulation profile were found in 62.5% of cases. Three patients (12.5%) who presented with encephalopathy died. The other 21 patients recovered after an average period of 2-8 days.

Child↗

Ultrasonic variables in the diagnosis of intrauterine growth retardation.

Ultrasonic biparietal diameter (BPD), femur length, abdominal circumference, femur length/abdominal circumference ratio, estimated fetal weight, ponderal index, estimated fetal length were measured within 72 h of delivery of 30 small-for-date (SFD) and 174 non-SFD newborns. Evaluation of each ultrasound variable in the antenatal diagnosis of SFD fetus was assessed. Abdominal circumference and estimated fetal weight were the best predictors in confirming SFD in 73.3 and 76.6 per cent respectively, followed by BPD (63.3%). Other variables (femur length, femur length/abdominal circumference ratio, estimated fetal length and ponderal index) were less accurate in diagnosis of SFD babies. For all variables studied negative predictive value was high (almost 90% or above). However, positive predictive value for abdominal circumference and estimated fetal weight were satisfactory. This study demonstrates the usefulness of abdominal circumference and estimated fetal weight in recognising SFD. It also shows that various growth variables could be used to rule out the diagnosis of IUGR with reasonable accuracy (negative predictive value greater than or equal to 90).

Female↗

Ultrasound guided pancreatic ductography.

Thirteen patients underwent ultrasound guided percutaneous pancreatic ductography during a one year period. In nine cases the procedure was performed after failure of endoscopic retrograde pancreatography (ERP) and in four patients ERP was not attempted. Under ultrasound guidance a 22 gauge needle was inserted into the pancreatic duct through a vertical transgastric route. After aspiration of 10-15 ml of pancreatic juice, contrast medium was injected into the pancreatic duct. Opacification was successful in 12 (92%) patients. No significant complications were encountered. The usefulness of the procedure in our country is highlighted.

Cholangiopancreatography, Endoscopic Retrograde↗

Ultrasonic intrauterine growth curves.

Intrauterine growth was studied by serial ultrasonic measurements of biparietal diameter (BPD), femur length (FL) and abdominal circumference (AC) in 241 normal low risk obstetric patients. These measurements were used to construct normal ultrasonic fetal weight and length curve. The data correlate well with the already established, postnatal weight and length curves after 28 weeks of gestation. The fetal ponderal index curve was compared with postnatal ponderal index curves available. Antenatal recognition of fetal weight, length and ponderal index can be used to evaluate pregnancies at risk for altered fetal growth.

Birth Weight↗

Fetal ponderal index in predicting growth retardation.

Fetal ponderal indices were calculated by ultrasound examination and compared with the neonatal ponderal indices in 154 pregnancies. No significant difference was found between the prenatal and postnatal values of weight, length and ponderal indices of the entire sample as well as in babies with intrauterine growth retardation (IUGR). The fetal ponderal index had a sensitivity and specificity of 56.7 and 84.6 per cent respectively. These data suggest that fetal ponderal index could be used to rule out IUGR with reasonable accuracy (negative predictive value: 86%).

Birth Weight↗

Ultrasound in obstructive jaundice.

One hundred and twenty-five consecutive patients with obstructive jaundice were prospectively studied by ultrasonography to determine the level and cause of obstruction. These were diagnosed precisely in 80 (72%) and 52 patients (41.6%) respectively. The results were compared with cholangiography. The final diagnosis was established at surgery (97 cases) and fine needle aspiration cytology (28 cases). While US is an excellent screening modality in distinguishing obstructive and non-obstructive jaundice, cholangiography is still the gold standard for determining the precise anatomic level and cause of obstruction.

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↗

Cholangiographically guided aspiration cytology in the management of malignant biliary obstruction.

Fifteen patients with malignant biliary obstruction were subjected to fine needle aspiration cytology (FNAC) under fluoroscopic guidance. Fourteen (93%) of them were correctly diagnosed to have a malignancy at FNAC. Simultaneous with FNAC or at a later date, all the patients underwent percutaneous biliary drainage with a drop in serum bilirubin from a mean of 23.2 mg/dl to 8.5 mg/dl. Ten patients were subjected to exploratory laparotomy and biopsy at which the diagnosis of FNAC was confirmed in nine of them. The tenth patient with a negative yield at FNAC had a 1.0 cm cholangiocarcinoma. The usefulness of FNAC combined with biliary drainage as an alternative to surgery is highlighted.

Adenoma, Bile Duct↗