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Biomedical subjects

Sunil Kumar

Publications and source records attributed to Sunil Kumar.

61 records · Page 4Linked to original sources
PubMedDate not supplied

Treatment of appendiceal mass: prospective, randomized clinical trial.

BACKGROUND: Appendiceal mass may be treated in several ways. However, no randomized trial has been conducted to find the best option. OBJECTIVE: To compare the three most commonly used methods for treating appendiceal mass. METHODS: Over a three-year period, 60 consecutive patients with appendiceal mass were randomly allocated to three groups: Group A--initial conservative treatment followed by interval appendectomy six weeks later; Group B--appendectomy as soon as appendiceal mass resolved using conservative means; Group C--conservative treatment alone. Short-term outcome measures included operative time, operative difficulty, postoperative complications, length of hospital stay, and duration of time away from work. Long-term outcome measures were: number of hospital visits made, presence of severe incisional pain, scar appearance, and patients with recurrent appendicitis. RESULTS: Baseline characteristics were comparable in the three groups. In patients in Group A, operative time was less, adhesions were encountered less frequently, the incision had to be extended less often and post-operative complications were fewer, as compared to Group B. Patients in Group C had the shortest hospital stay and duration of work-days lost; only 2 of 20 patients in this group developed recurrent appendicitis during a follow-up period of 24-52 (median 33.5) months. CONCLUSION: Of the three treatment modalities compared, conservative treatment without subsequent appendectomy appears to be the best.

Abdominal Pain↗
PubMedDate not supplied

Prevalence of Helicobactor pylori in patients with perforated duodenal ulcer.

It is believed that Helicobacter pylori (H. Pylori) plays an important role in the causation of peptic ulcer. However, its role in duodenal ulcer perforation (DUP) has not been investigated extensively and the results are conflicting. The aim of this study was to determine the prevalence of H. pylori in patients with DUP patients as compared to normal healthy volunteers (NHV). Eighty-six consecutives patients with DUP and 30 NHV were included in the study. The NHV, drawn from the Surgery outpatient, were subjected to upper gastrointestinal (UGI) endoscopy and multiple gastric mucosal biopsies. Gastric mucosal biopsies among patients with DUP were obtained during laparotomy by passing a biopsy forcep through the perforation site. Biopsy specimens were put in urea broth for the rapid urease test (RUT), brucella broth (used as a transport medium) for culture and 10% formalin for histopathology. The results were analysed as the percentage of positive cases. The mean (+/-SD) age of patients with DUP (39.4+/-15.5 years) and of the NHV (36.0+/-13.9 years) were comparable (p= 0.290). Sixty-one (70.9%)patients with DUP had used NSAIDs prior to perforation. Only 7 patients with DUP (8.14%) had a past history of symptoms of duodenal ulcer and had been treated for it. A positive history of smoking, alcoholism and tobacco use was present in 68 (78.9%), 59 (68.6%) and 41(47.7%) patient with DUP, respectively. No culture was positive. Histology was positive for H. pylori in 29 patients with DUP and in 2 (6.7%)NHV. RUT was positive for H. pylori in 43(50%) patients with DUP and 5 NHV (16.7%). The present study documented a markedly higher association of H. Pylori infection with perforated duodenal ulcer.

Adolescent↗
PubMedDate not supplied

Tropical calcific pancreatitis presenting as kwashiorkor.

Tropical clacific pancreatitis can be accompanied by varying degrees of malnutrition but full-blown kwashiorkor is an extremely rare presentation. We report the case of a 10-year-old male who presented with clinical features of severe kwashiorkor. He had extensive pancreatic clacification and exocrine pancreatic deficiency. The child was treated with pancreatic enzyme replacement, and enteral nutrition supplemented with vitamins and micronutrients. Following therapy, he started gaining weight, the skin changes partly disappeared and his hair resumed its normal black colour.

Calcinosis↗
PubMedDate not supplied

Hemoperitoneum as a first manifestation of HCC with bleeding from ruptured aberrant vessel: a case report.

A young man presented with a history of abdominal pain and distension for 4 days. Diagnosis of spontaneous hemoperitoneum was made after clinical examination, abdominal USG and a diagnostic peritoneal tap. Emergency laparotomy revealed massive hemoperitoneum with extensive bilobar hepato-cellular carcinoma (HCC). A ruptured aberrant vessel communicating between the intercostal vessel and HCC in the liver had caused massive hemoperitoneum.

Adult↗
PubMedDate not supplied

Infected pseudocyst in tropical pancreatitis presenting as psoas abscess.

Infected pseudocyst as a consequence of tropical pancreatitis presenting as psoas abscess is unusual. We report a 40-year-old man who presented with pain in the right lumbar region. CT and MRI of the abdomen revealed pancreatic pseudocysts with abscess formation in the psoas muscle and evidence of chronic calcific pancreatitis. He was managed by percutaneous drainage of the abscess along with antibiotics and other supportive measures.

Adult↗