Biomedical subjects
Publications and source records attributed to V Singh.
The clinical and histopathological profile is presented of 145 patients with abdominal tuberculosis studied prospectively over a period of 5 years. The study highlights the role of various investigations and therapeutic response in this condition.
Eighty-seven patients underwent endoscopic sphincterotomy (ES) for common bile duct (CBD) stones. Out of these, 66 patients had post-cholecystectomy CBD stones and 21 had CBD stones with gall bladder 'in situ'. In post-cholecystectomy group, 15 patients had 'T' Tube 'in situ'. The presenting symptoms in the post-cholecystectomy group were: pain abdomen, jaundice and cholangitis in 51, 20 and 11 patients respectively. The fifteen patients with 'T' tube used to experience pain after clamping of 'T' tube. Those with gall bladder 'in situ' had cholangitis in 12 and jaundice only in 9 patients. CBD clearance was achieved in 80 patients (91.95%). The sphincterotomy cut had to be extended in 19 patients. There was no mortality following sphincterotomy. Nine patients (10.3%) had minor complications such as bleeding (4), cholangitis (3), pancreatitis and impaction of Dormia basket in one patient each. Thus ES is a safe and effective treatment for CBD stones with or without gall bladder/'T' tube 'in situ'.
Infections of the lower reproductive tract are common in Indian women of reproductive age. Hospital-based cytologic screening was undertaken on 63,265 women. The smears were examined for the presence of specific infections, such as Candida, herpes simplex virus, human papillomavirus, Trichomonas vaginalis (TV) and Chlamydia. This paper highlights the prevalence of TV infection in inflammatory cervical smears. Among the various infections detected, the rate of TV infection was the highest (5.1%). On further analysis the rate of TV infection showed an increasing trend up to the age of 49 years; an inverse association was observed with the educational status of the women. The prevalence was high in women with clinical signs (vaginitis, 6.9%) and low in those with a prolapsed uterus (1.2%) as compared to a normal cervix. These observations reveal the need for providing proper counseling and education on sexual behavior and genital hygiene besides treatment to control and prevent these infections.
A patient presenting with hematemesis was detected to have a 3 cm sized pedunculated polyp in the gastric antrum. A snare polypectomy was performed. Histopathology of polyp revealed it to be benign submucosal stromal tumor.
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BACKGROUND/AIMS: Derangement of liver functions in obstructive jaundice has been known to influence surgical outcome. The pattern and time frame of liver function recovery in patients with surgical obstructive jaundice undergoing a bilioenteric anastomosis has not been comprehensively defined in human beings. METHODOLOGY: Fifty patients of obstructive jaundice who underwent a bilioenteric anastomosis had their liver function evaluated done by biochemistry (pre-operatively and postoperatively on day 1,4,7 and 6 weeks) and radionuclide mebrofenin scan (preoperatively and 6 weeks postoperative). RESULTS: The results have shown a constant and significant decline in serum bilirubin levels by day 4 (p=0.04), however the decline in serum levels was not uniformly progressive in 54% patients. The decline in serum alkaline phosphatase levels has been constant and progressive reaching significant levels by day 4(p=0.01). Serum transaminases showed an initial rise followed by a rapid fall, again achieving significant levels by day 4 (p=0.003 & 0.009). Serum albumin decreased on day 1 itself but remained static after that. On isotope scanning hepatic uptake showed uniform improvement with 92% of patients having achieved a normal uptake after 6 weeks. Gastrointestinal excretion of the isotope however was still delayed in 26% patients at 6 weeks. Almost all these patients had an abnormal bilirubin level decline in the immediate postoperative period. CONCLUSIONS: Hepatic functional recovery has been seen to start immediately following bilioenteric anastomosis and has usually completed itself by 6 weeks. Patients who show an abnormal recovery pattern based on bilirubin levels need to be observed for a longer time.
BACKGROUND: Omeprazole, a H+/K+ ATPase inhibitor, has been shown to reduce gastric bicarbonate secretion in cats. However, there has been no study on the effect of omeprazole on bicarbonate secretion in patients with duodenal ulcer (DU). METHODS: Fifteen men with duodenal ulcer (mean age 38 years, range 22-57) were included. Baseline gastric acid output, bicarbonate secretion, and parietal and nonparietal secretions were estimated before and after omeprazole therapy (20 mg/day) for four weeks. RESULTS: Omeprazole administration did not significantly alter bicarbonate secretion (3.3 [1.2] vs 2.4 [0.4] mmol/h), though there was significant reduction in gastric acidity (44.2 [6.6] vs 20.7 [4.6] mmol/L, p < 0.01). CONCLUSION: Omeprazole reduces acid secretion but does not affect gastric bicarbonate secretion in patients with DU.
BACKGROUND: Alterations in the size and shape of liver occur in a wide variety of conditions. Liver span can be estimated by using clinical, radiological or radioisotopic methods. Chest dimensions may alter the liver span. METHOD: We evaluated the liver span in 51 healthy individuals by clinical, radiological and radioisotopic methods and its relation with chest dimensions. RESULTS: The liver span by clinical, radiological and radioisotopic methods was 10.8 +/- 1.1 cm, 12.6 +/- 1.5 cm and 13.6 +/- 1.7 cm, respectively. Liver span varied with clinical and radiological or radioisotopic method and it correlated with height of chest cage and subcostal angle in these individuals. CONCLUSION: The liver span varies with the method used and it is correlated with chest dimensions.
A large waterborne epidemic of hepatitis E occurred in the city of Saharanpur (Uttar Pradesh, India) between December 1992 and April 1993. A random survey was conducted in the affected area of Saharanpur. Source of water supply, number of family members, number and characteristics of affected persons were noted. Blood, stool and water samples were collected. The incidence of hepatitis was 14% in the affected area of the city. A total of 3682 individuals were affected with the disease. Attack rate for adults was significantly higher than the children aged < 15 years (17% vs 7%; p < 0.0001). Among the adults, the attack rate was higher for males than females (23% vs 12%; p < 0.0001). The incidence of hepatitis was greater in persons using the municipal water supply (17%) as compared to hand pump (0.9%) or tubewell water (0%). There was a single peak in the epidemic. Of the 56 fresh cases, 38 (64%) occurred within two weeks, 14 within 2-4 weeks and 4 within 4-6 weeks of index cases. Serologic markers for acute hepatitis A, B and C were absent. IgM anti-HEV was positive in 20 out of 24 sera tested. Immune electron microscopy detected 27-34 nm virus-like particles (VLPs) in 2 of 8 stool specimens and in 1 of 3 water samples. The epidemic occurred due to leakage of municipal water supply pipes passing through the sewerage holes. A large waterborne epidemic of hepatitis E resulted due to contaminated water supply. VLPs were detected in water. Adults and males were commonly affected. There was no person-to-person spread.