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Biomedical subjects

V Bhatnagar

Publications and source records attributed to V Bhatnagar.

At least 199 records · Page 11Linked to original sources
PubMedDate not supplied

Liver transplantation from living related donors: review of world experience and its implications for India.

Living related liver transplantation (LRLT) was made possible because of a better understanding of the anatomy of the liver and advances made in hepatic surgical techniques. It was developed to reduce the waiting period for pediatric recipients. In countries like Japan, which do not have brain stem death legislation, LRLT is the only modality available for treating end stage liver disease. The world experience has shown that LRLT has been successfully performed in a variety of conditions leading to acute and chronic liver failure not only in children, but in young adults as well. The initial results of LRLT appear to be better than liver transplantation from cadaveric organs in terms of graft survival and function. Donor safety has been of prime concern. LRLT has tremendous potential in India with or without the brain stem death legislation. Liver transplantation has not been performed in India although the need and expertise for it exists.

Adult↗
PubMedDate not supplied

Urinary continence following posterior urethral valves treatment.

This retrospective study discusses the incidence of symptomatic voiding dysfunction, the etiological factors and the changes with age and with increasing duration of follow up in 67 boys treated for posterior urethral valves and followed up for a period ranging from 1-21 years. Twenty three of the 67 patients (34.3%) had symptomatic voiding dysfunction; the commonest symptom being nocturnal enuresis with diurnal urgency and frequency. Data in this study suggests a definite decrease in the incidence of urinary incontinence as the patient grows older or as the duration of follow up after valve fulguration increases. A Tc-99m DRCG based uroflowmetry was available in 31 of the 67 patients at the time of this review and evidence of detrusor dysfunction was identified in 9 of the 31 patients on the basis of uroflowmetry. Of significance was the detection of detrusor dysfunction on uroflowmetry in 3 patients with a history of normal urinary control and urinary stream with persistent post treatment hydroureteronephrosis eventually culminating into renal failure. Imipramine therapy was given to 10 of the 17 patients with symptoms of urinary frequency, urgency and nocturnal enuresis with a significantly symptomatic improvement in 9 of these patients. Urinary incontinence, detrusor dysfunction and its effect on the upper tracts and renal function is a significant determinant of the long term outcome of the boys treated for posterior urethral valves and this paper emphasises on the need to carefully evaluate and treat this aspect of all valve patients.

Adolescent↗
PubMedDate not supplied

Transillumination for the diagnosis of pneumoperitoneum.

Transillumination of the abdomen with a cold fibreoptic light source was used for the rapid diagnosis of pneumoperitoneum in a sick premature infant with necrotising enterocolitis. The diagnosis was confirmed at laparotomy. The neonate survived the surgical procedure of resection and anastomosis of the perforated gut. Although additional diagnostic investigations such as X-rays and paracentesis of the abdomen were also positive in this case, transillumination of the abdomen proved to be a useful tool for early diagnosis. Transillumination thus is a valuable modality for early diagnosis of pneumoperitoneum, especially where facilities for in-house X-rays are not available.

Enterocolitis, Necrotizing↗
PubMedDate not supplied

Stone's enterostomy crushing clamp for modified Duhamel's procedure.

AIM: To evaluate the safety and advantages of the use of Stone's enterostomy crushing clamps in modified Duhamel procedure. MATERIAL AND METHODS: Prospective study at a tertiary care paediatric surgery centre between February 1994 through February 1998 involving all cases undergoing modified Duhamel procedure for Hirschsprung's disease. RESULTS: Twenty eight patients, ranging from 5 months to 14 years were included in the study. The clamp was found to be easier to apply, needed no extra pelvic dissection and there were no immediate or delayed complications. The children were more comfortable and could be mobilized out of bed sooner post-operatively. It is a much cheaper option than staplers. CONCLUSION: The Stone's enterostomy crushing clamp is a reasonably cheap, reusable, safe and effective alternative for the Kocher's clamp and stapling devices for modified Duhamel procedure.

Adolescent↗
PubMedDate not supplied

Congenital true pancreatic cyst: presentation and management.

Congenital true pancreatic cyst is a very rare cause of a cystic lesion of the pancreas comprising less than 1% of all pancreatic cysts. Most of these are reported in children less than 2 years of age. Described here is a case of congenital true pancreatic cyst in a 6 years old girl with the clinical, radiological and pathological details and the surgical treatment.

Child↗
PubMedDate not supplied

Generating finances for the chemotherapy of children with cancer.

BACKGROUND: To develop and evaluate a system of obtaining financial assistance for the treatment of children with solid tumours by involving individual members of society. METHODS: This prospective project was carried out at the Paediatric Solid Tumours Clinic of the Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi, from January 1994 to December 1998. Donor families were enlisted by talking to affluent people. Families who agreed to help in this effort were told that they could 'adopt' a child for the purpose of his/her treatment and that they should purchase the prescribed chemotherapeutic drugs and give them to the family of the affected child. Therapy was started once the drug was received at the hospital. This process was repeated at each subsequent visit. RESULTS: Of the 291 children with solid tumours registered at the clinic, 45 (15.5%) received financial assistance by this method. The proportion of children receiving financial assistance increased from 8.6% in 1994 to 23% in 1998. Of all those who received assistance, 20 (44.4%) have completed therapy and are surviving, 11 are still on therapy, 12 died and 2 decided to discontinue therapy because of progressive disease. CONCLUSIONS: The advantages of this system far outweigh its disadvantages. This method of generating finances for children with cancer can be recommended to all doctors treating such children.

Antineoplastic Agents↗
PubMedDate not supplied

The liver in choledochal cyst.

BACKGROUND/PURPOSE: Hepatic changes due to choledochal cyst have not been given due emphasis in the published literature. In this study the gross and microscopic appearance of the liver in patients with choledochal cyst have been correlated with clinical features, liver function tests and postoperative complications. METHODS: A retrospective evaluation of patients treated for choledochal cysts between January 1989-December 1998 was undertaken. The case records were reviewed and liver biopsies taken at surgery were analysed. RESULTS: The case records of 22 patients were reviewed (16 girls, 6 boys; mean age 4.6 years, range 1 month-10 years). The presenting features included jaundice (59%; 85.7% in < 1 year), abdominal pain (59%; 86.7% in > 1 years) and fever in 40.9% cases. A palpable abdominal mass and hepatomegaly was present in 32% cases. A type IV cyst was present in 1 case; all others had type I cysts (14 cystic and 7 fusiform). The liver looked grossly 'normal' in 16 and 'cirrhotic' in 6 cases. Liver biopsies were available for review from 5 of the 'cirrhotic' and 7 of the 'normal' looking livers. All the liver biopsies showed varying degrees of bile duct proliferation, cholestasis, parenchymal damage, inflammatory cell infiltration and pericentral fibrosis. Histological features of cirrhosis were evident in 6 cases (4 'cirrhotic' and 2 'normal' looking livers), 4 of these cases were infants. Liver function tests were deranged in 5 cases with histological features of cirrhosis and hepato-biliary scintigraphy showed obstructive features in 3 of these cases. There was an increased risk of postoperative complications in the cases with histological features of cirrhosis, 2 died from hepatic insufficiency and one each had transient ascitic and biliary leak. CONCLUSION: Liver histology showed significant changes in all the cases of choledochal cyst in whom it was studied; even normal looking livers showed evidence of significant changes. Presence of cirrhosis, more common in infants, correlated with jaundice, deranged liver function tests, obstructive features on hepatobiliary scintigraphy and a greater risk of postoperative complications.

Child↗