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Biomedical subjects

U Dutta

Publications and source records attributed to U Dutta.

32 records · Page 2Linked to original sources

Accidental swallowing of a gold cast crown during orthodontic tooth separation.

Accidental swallowing of a gold cast crown that became loose after separation with brass wire for orthodontic band placement, is reported. The intervention to remove the ingested crown subsequent to its location in the GI tract on immediate radiographic examination of chest and abdomen included endoscopic examination. Since the crown had past distal to the duodenum it was decided to keep a watch on its movement by daily radiographic examination. The crown passed with excreta on the 5th day uneventfully. Literature on ingestion of foreign bodies of dental origin is reviewed. Possible emergencies and their management is discussed.

Adolescent↗

Severe duodenal candidiasis in a patient with IgA deficiency and T cell defects.

Candida albicans was found to repeatedly colonise and invade the duodenal ulcer base in a 45 years old otherwise healthy patient receiving H2 receptor antagonists for a prolonged period. He had no delayed hypersensitivity to Candida skin test, and had T cell deficiency, abnormality in T cell blast transformation, defective macrophage migration inhibition factor (MIF) and IgA hypogammaglobulinemia. When treated with ketoconazole alone his ulcer healed completely. Ulcer scar biopsy and aspirates revealed no Candida and anti candidal antibodies disappeared from his serum. His T cell blastoid transformation, MIF and skin DTH to Candida were restored to normal levels, but IgA levels remained unchanged. Thus H2 receptor antagonists probably caused abnormalities in T helper cells leading to lymphokine unresponsiveness and subsequently loss of cellular immunity to candidal antigen. This combined with prior IgA immunodeficiency resulted into severe invasive candidiasis.

Candidiasis↗

Blocking of the hepatic vein outflow by neointima covering a wallstent across a membranous stenosis of the inferior vena cava.

A 31-year-old man presented with idiopathic membranous obstruction of the suprahepatic inferior vena cava (IVC) and was treated by balloon dilation and placement of a Wallstent. The patient improved markedly. However, he developed obstruction of the hepatic vein outflow secondary to neointima formation over the stent that covered the hepatic vein ostia. The patient died of liver failure and septicemia. We believe that this is the first report of such a serious complication.

Adult↗

Double blind controlled trial of effect of cisapride on gastric emptying in diabetics.

AIMS: Diabetic gastroparesis is a common complication seen in 20-50% of patients due to autonomic neuropathy involving vagal supply. Cisapride, a specific gastrointestinal cholinomimetic agent may thus be effective. METHODS: Fifty-one diabetic patients (age 12-65 years) of disease duration > 5 years were assessed for symptomatic gastroparesis, other diabetic complications and glycemic control. Gastric emptying time (GET) was estimated using a solid meal method (99mTc labeled rice based idli) and patients randomized to receive either cisapride or placebo for a period of 2 weeks. Cisapride was administered in a dose of 10 mg TID. GET and symptom scores were reassessed on the therapy after 2 weeks. RESULTS: Twenty nine of 51 (56.8%) patients had gastroparesis. Mean GET in the gastroparesis group was 141 +/- 66 minutes compared to 24.53 +/- 10 minutes in the non gastroparesis group (p < 0.01). GET decreased by 72% amongst the patients who received cisapride compared to 23% in the placebo group (p < 0.001). Symptom scores also improved in the cisapride group; no adverse effects were noted. CONCLUSIONS: Cisapride improves the symptom score and the solid gastric emptying time in patients suffering from diabetic gastroparesis.

Adolescent↗

Pleural involvement by Salmonella senftenberg: a report of two cases.

Non-typhoidal serovars of salmonella are an unusual cause of pleuropulmonary infections. We report two patients with empyema caused by Salmonella senftenberg. One patient had associated diabetes and gall bladder carcinoma, and infection was acquired in hospital. Both patients responded well to parenteral antibiotics.

Anti-Bacterial Agents↗

Reversible portal hypertension due to tuberculosis.

Presentation of abdominal tuberculosis with portal hypertension is rare. We report a 25-year-old man with portal hypertension due to compression of the portal vein by tuberculous lymph nodes at the hepatic hilum. After antitubercular therapy, features of portal hypertension disappeared as the nodes regressed.

Adult↗

Common variable immunodeficiency in an adult.

Primary immunodeficiency syndromes are rarely diagnosed among adults. In this report, we describe a young male who had common variable immunodeficiency. He was treated with intravenous immunoglobulin and, on follow up, has been free of opportunistic infections.

Adult↗

Endocrine cell carcinoma of gall bladder.

Primary neuroendocrine carcinoma of the gall bladder is rare. We report a 70-year-old woman with a gall bladder mass and liver metastases; fine-needle aspiration cytology from these revealed neuroendocrine carcinoma. There was no evidence of any other primary site. The patient was treated symptomatically; she died within a month of discharge from hospital.

Aged↗

Pneumobilia--clue to an unusual cause of diarrhea.

A 65-year lady presented with diarrhea and weight loss of six months duration. Initial evaluation suggested that malabsorption was the possible underlying mechanism for the diarrhea. Work up for the common etiologies of malabsorption was non-contributory. Presence of pneumobilia raised the suspicion of a bilio-enteric fistula, which was subsequently confirmed on barium enema and endoscopic cholangio-pancreaticography to be a cholecystocolic fistula. At surgery, a fistulous tract from the fundus of the gallbladder was found to be communicating with the hepatic flexure. Fistulectomy with cholecystectomy resulted in prompt relief of symptoms. Cholecystocolic fistula (CCF) is a rare biliary fistula with diverse presentation.

Aged↗

Severe acute bleeding from portal colopathy controlled by somatostatin: a case report.

Portal hypertensive colopathy (PHC) is a recently described entity in patients with portal hypertension which can cause even life-threatening lower gastrointestinal bleeding. In contrast to variceal bleed, there is no standardized treatment for the control of bleeding from these lesions. We report a case of alcoholic cirrhosis with portal hypertension, in whom bleeding from colonic angiodysplasia-like lesions was effectively controlled by somatostatin infusion.

Acute Disease↗