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S Vashisht

Publications and source records attributed to S Vashisht.

At least 37 records · Page 2Linked to original sources
PubMed1991

Normal endoscopic pancreatogram in an Indian referral hospital.

A total of 101 normal pancreatograms were analysed in a major referral hospital in India in an attempt to establish normal standards of pancreatic ductal morphology in Indian population. Ductal position, course, caliber, length and variations of anatomy were analysed. Most often (39%) ampulla was seen at the level of second lumbar vertebra, commonly (54%) within 30-39 mm from the lateral margin of right side of corresponding vertebral body. Most common ductal course (21.78%) was ascending-horizontal-horizontal type. Mean ductal diameters in the head, body and tail of the pancreas were 2.63, 1.95, 0.99 mm in individuals aged less than or equal to 40 yr and 3.31, 2.34, 1.23 mm in those greater than 40 yr, respectively. A significant (r = 0.46; P less than 0.001) increase in ductal size was seen between less than or equal to 40 yr and after 40 yr of age. Mean ductal length was 16.10 and 16.58 cm in subjects less than or equal to 40 yr of age and greater than 40 yr respectively. Duct of Santorini was visualised in 6.6 per cent subjects.

Adolescent↗
PubMed1991

Congenital biliary cysts in Indian adults.

Only one report of congenital biliary cysts has been described so far from India, and that was in children. We present our experience with 22 adult Indian patients with this condition. The main presenting symptoms were abdominal pain, icterus, and fever, and the classical triad of jaundice, pain, and abdominal mass was seen in only one patient. The mean age of presentation was 25.5 +/- 10.1 yr, and females predominated (82%). Type Ia cysts (fusiform choledochal cyst) were the commonest. Intrahepatic cysts were seen in four patients; three of these were associated with extrahepatic biliary ductal cysts (type IVa). Internal drainage procedures performed elsewhere in six patients were followed by recurrent cholangitis, necessitating excision of the cyst. Hence, the preferred operation for congenital biliary cysts is cyst excision and hepaticojejunostomy.

Adolescent↗
PubMed1990

Caroli's syndrome: a heterogeneous entity.

We report our experience with nine adult patients (six females, three males) with Caroli's syndrome. Most of these patients were young (mean age 27.0 yr), and had presented at a mean interval of 12.1 yr after the onset of symptoms. Recurrent abdominal pain was the most common symptom, present in eight of nine patients. Mild jaundice (serum bilirubin 1.8-4.2 mg/dl) and raised serum alkaline phosphatase (18-36 King-Armstrong units) were the only other significant findings. Ultrasound proved to be a good screening test. However, the diagnosis was confirmed on cholangiography. Six of nine patients had associated extrahepatic biliary cysts (type IVa). The operative management was directed mainly at excising the extrahepatic cysts and draining the biliary tree, and was met with satisfactory results.

Abdominal Pain↗
PubMed1989

Primary sclerosing cholangitis in India.

Six patients with PSC have been diagnosed and followed up at a centre in Northern India for periods up to 4 years. They all presented with cholestatic jaundice and cholangitis, but one of them subsequently presented with variceal haemorrhage. Cholangiographic features were the most characteristic and included irregular narrowing and segmental dilatation of the biliary radicles giving them a beaded appearance. Treating them was most frustrating. Two of them died of hepatic encephalopathy, others have also continued to be sick during the follow-up.

Adrenal Cortex Hormones↗
PubMed1989

Radiologic approach to choledochal cysts.

Choledochal cysts, being uncommon and having a nonspecific presentation, require a high index of suspicion for their diagnosis. In this series of 11 patients, the correct diagnosis was established in all using a combination of real-time ultrasound (US) scanning (9 positive) and endoscopic retrograde cholangiopancreatography (ERCP; 10 positive). Real-time US is suitable as the initial imaging modality and ERCP is complementary.

Adolescent↗
PubMed1989

Duodenoscopic sphincterotomy in a northern Indian hospital.

In a 36-month period, 154 duodenoscopic sphincterotomies (DS) were performed on 120 patients in a Northern Indian hospital. The major indication for DS was choledocholithiasis (95.8%), the rest being done for indications like papillary stenosis, periampullary carcinoma and the sump syndrome. Seven patients (5.8%) had significant associated medical illnesses. An adequate sphincterotomy was achieved in 91.6% of patients, with successful stone extraction in 95.3% of them. Overall clearance of the common bile duct (CBD) was thus achieved in 87.5% of the patients subjected to DS. Two patients (1.7%) died after undergoing DS, and six (5%) experienced early complications that necessitated emergency operation in two of them (1.7%). DS appears to be the treatment of choice for the management of choledocholithiasis in the postcholecystectomy patient as well as in the patient with gallbladder in situ who has cholangitis or jaundice or associated medical illness that may constitute a high risk for surgery.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1988

Chronic calcific pancreatitis: clinical profile in northern India.

Twenty three patients with chronic calcific pancreatitis of the tropics in Northern India were prospectively studied. All had pancreatic calcification and ERCP changes typical of chronic pancreatitis, the most predominant being ductal dilatation which was detected in all patients by both ERCP and by ultrasonography. Pain was present in 19 (83%) patients and diabetes in 11 (48%) patients. Exocrine pancreatic dysfunction was uncommon, steatorrhoea being present in only 9% of patients. Ten of the 11 patients with diabetes required insulin for control and one case was able to be controlled by an oral antidiabetic agent. Two patients developed ketoacidosis during acute episodes of pancreatitis, 3 patients had peripheral neuropathy and one patient had visual changes. Recurrent severe pain was the reason for operation in 7 patients. All had a lateral pancreaticojejunostomy. In order to obtain an objective assessment of pain, a scoring system was developed to grade its severity according to its intensity, frequency and consequences. Six patients who preoperatively had a pain score of 15 or more (out of a maximum score of 24) attained significant relief after the surgery. We feel this scoring system may provide an easy objective assessment of pain in the subsequent follow-up of these patients.

Adolescent↗
PubMed1985

Optic nerve hypoplasia: clinical and ultrasonographic study.

The ocular and systemic features of 11 cases of optic nerve hypoplasia were analysed, with particular reference to visual function and associated anomalies of the central nervous system. Schizencephaly, noted in one of the cases, is reported for the first time in association with optic nerve hypoplasia. The role of ultrasonography in the diagnosis and qualitative evaluation of optic nerve hypoplasia is highlighted.

Adult↗
PubMedDate not supplied

Duodenoscopic sphincterotomy for acute suppurative cholangitis.

Fifteen patients (eight males, seven females; age range: 23-76 years) presenting with acute suppurative cholangitis underwent endoscopic retrograde cholangiography and sphincterotomy within 1-10 days of hospitalization. Cholangitis was due to common duct stones in all patients; all but one of them had their gall-bladders in situ. All of them had fever, jaundice, abdominal pain, leucocytosis and deranged liver function while 26.6% were in shock, 13.3% in coma and 40% in azotaemia. Cardiac or other associated diseases caused 21% of the patients to be high risk candidates for surgery. An adequately sized sphincterotomy was done in 14 (93.3%) patients; in eight of them it was immediately followed by a successful stone extraction while in another four patients either the stone passed out spontaneously (one patient) or was retrieved by a repeat basketing. Thus, the common bile-duct was cleared of stones in 80% patients. Of 14 patients with satisfactory sphincterotomy, 11 (73.3%) had a dramatic clinical improvement, two (14.3%) had a somewhat delayed benefit and one patient died due to unrelieved cholangitis. Ten patients subsequently underwent elective cholecystectomy while three patients continue to have their gall-bladders in situ. There has been no recurrence of biliary tract symptoms in these 13 patients during the subsequent 3-26 months (mean follow-up: 15.1 months). It is concluded that urgent duodenoscopic sphincterotomy is rewarding in patients with acute suppurative cholangitis when it is performed early.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMedDate not supplied

Laparoscopy assisted hemi-colectomy for ileo-caecal tuberculosis.

Laparoscopy assisted hemicolectomy for ileo-caecal tuberculosis is being evaluated the world over. Several procedures are performed laparoscopically, including the laparoscopic hemicolectomy, for benign and malignant diseases. Abdominal tuberculosis is one of the commonest causes of intestinal obstruction in India. We have evaluated the role of laparoscopic resection of ileocaecal tuberculosis and successfully performed the procedure in five patients. The clinical profiles of patients and operative procedure are discussed in this article with a brief review of the literature.

Adult↗
PubMedDate not supplied

Association between incidence of lipoprotein(a) positivity and coronary heart disease.

Serum samples from 167 (109 male, 58 female) hospital based staff as controls and 760 (596 male and 164 female) clinically documented patients of coronary heart disease (CHD) were subjected to 3.75% polyacrylamide gel electrophoresis for lipoprotein profile and the presence of lipoprotein(a) [LP(a)], which is reported to be an independent risk factor for CHD. Serum total cholesterol, triglyceride and ratio of the electrophoretically separated LDL/HDL lipoprotein fractions were also evaluated. The significant observations are (i) a large proportion of both male and female CHD patients showed the presence of LP(a) as compared to controls, (ii) The incidence of LP(a) positivity was found to be independent of sex and age in controls. Female patients however showed marginal increase (p < 0.05) with age. Male patients of < 40 years demonstrated three times higher incidence of LP(a) presence as compared to their female counterparts, (iii) Comparison of LP(a)+ and LP(a)- patients for serum lipid levels did not show any significant difference. It is inferred that LP(a) positivity may be independent of these lipid variables.

Adult↗
PubMedDate not supplied

A pancreaticographic study of malnutrition-related diabetes mellitus.

Pancreatic involvement is considered to be the hallmark of malnutrition-related diabetes mellitus (MRDM). Of the 2 subgroups of the disease, fibrocalculous pancreatic diabetes (FCPD) is characterized by pancreatic calcification. The nature of pancreatic abnormalities in MRDM have not been studied extensively in Indian patients. The present study was designed to compare pancreatic abnormalities (exocrine and endocrine) including endoscopic retrograde pancreaticography in patients with FCPD and protein deficient pancreatic diabetes (PDPD), in relation to controls. Ten patients each of FCPD and PDPD were studied with regard to clinical features, biochemical exocrine and endocrine pancreatic responses, C-peptide response, islet cell antibody, and pancreatographic changes. Five normal pancreatograms were taken as control. Clinical and biochemical features in patient with FCPD and PDPD were as follows: pain in 8 and 2 patients, respectively; the mean duration of diabetes was similar in both groups (62.28 +/- 71.92 months V. 72 +/- 50.9 months); and faecal fat excretion and insulin requirements were comparable in both groups. The main pancreatic duct was dilated in 6 of 10 patient with FCPD and only 1 of 10 with PDPD on ultrasonography. On pancreatography the duct was dilated in 9 of 10 patients with FCPD and only 1 of 10 patients with PDPD. The number of side branches was reduced in all cases with MRDM; in those with FCPD, these were stunted and dilated while in PDPD side branches are thin and spastic. We conclude that pancreatic ductal changes involving the main duct and side branches are more frequent in patients with FCPD as compared to those with PDPD.

Adolescent↗
PubMedDate not supplied

The missing eyeball--CT evaluation (a case report).

A case of blow out fracture of the medial wall and floor of the orbit with herniation of the eyeball into the ethmoid sinus diagnosed on CT scan is reported. To the best of our knowledge there is no previous report of prolapse of eyeball into the ethmoid sinus.

Adult↗