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Dubey IB, Agrawal V, Jain BK. Five patients with emphysematous pyelonephritis. IRANIAN JOURNAL OF KIDNEY DISEASES 2011; 5:204-206. [PMID: 21525582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Accepted: 12/25/2010] [Indexed: 05/30/2023]
Abstract
Emphysematous pyelonephritis is an acute necrotizing infection of the renal parenchyma, resulting in presence of gas within either in the collecting system or perinephric space. We herein report our experience with 5 cases of emphysematous pyelonephritis in 2 men and 3 women managed by broad spectrum antibiotics, supportive measures including hemodialysis (2 patients), ureteral stenting (2 patients), surgical drainage of perinephric collection (1 patient), and control of diabetes mellitus (4 patients). Four patients were discharged after a mean hospital stay of 18 days. A nondiabetic male patient with a nonobstructed kidney died on the second postoperative day due to persistent septicemia despite nephrectomy. Emphysematous pyelonephritis is a potentially fatal disease requiring careful and prompt diagnosis and individualized rational therapy. Ureteropelvic stenting should be used for drainage of pent-up collections as a lifesaving measure through relieving the obstruction. Perinephric fluid collection should be drained either percutaneously or surgically.
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Joshi MK, Jain BK, Rathi V, Agrawal V, Mohanty D. Complete enteral migration of retained surgical sponge--report of two cases. TROPICAL GASTROENTEROLOGY : OFFICIAL JOURNAL OF THE DIGESTIVE DISEASES FOUNDATION 2011; 32:229-232. [PMID: 22332343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Garg PK, Jaswal V, Jain BK. Retroperitoneal benign mature teratoma. ACTA MEDICA INDONESIANA 2011; 43:206-207. [PMID: 21979287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Garg PK, Bhatt S, Kashyap B, George A, Jain BK. Genital filariasis masquerading as testicular torsio. J Vector Borne Dis 2011; 48:119-121. [PMID: 21715738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
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Dubey IB, Mohanty D, Jain BK. Diverse presentation of spontaneous rupture of urinary bladder: review of two cases and literature. Am J Emerg Med 2011; 30:832.e1-3. [PMID: 21570232 DOI: 10.1016/j.ajem.2011.02.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2011] [Accepted: 02/19/2011] [Indexed: 11/28/2022] Open
Abstract
The objective of the study was to highlight diagnostic dilemmas and suggest pointers toward early diagnosis of spontaneous rupture of urinary bladder based on case study of 2 patients diagnosed as a case of spontaneous rupture of urinary bladder. A 26-year-old man presented with painless progressive abdominal distension of 1-week duration. In absence of acute abdominal symptoms and signs, the diagnosis of chronic liver disease with ascites was entertained. Peritoneal fluid aspirate demonstrated high urea and creatinine levels. Computed tomographic (CT) scan of abdomen suggested urinary bladder rupture, which was further confirmed by CT cystogram. Another 34-year-old man presented with acute abdominal pain, hematuria, and features of peritonitis. There was no history of trauma. Foley catheterization revealed blood-stained urine. Ultrasonography abdomen suggested urinary bladder rupture, which was again confirmed by CT cystogram. Both patients made uneventful recovery after repair of bladder perforation. Spontaneous rupture of urinary bladder is extremely rare with only very few reports available in literature. High creatinine levels in the peritoneal fluid aspirate of the first patient and the blood-stained urine in the second patient were pointers toward possibility of urinary bladder rupture. Rupture of urinary bladder should always be considered in differential diagnosis of patients presenting with free fluid in abdomen/peritonitis, decreased urine output, hematuria and in whom increased level of urea/creatinine are detected in serum and/ or peitoneal fluid aspirate.
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Garg PK, Prasad D, Aggarwal S, Mohanty D, Jain BK. Acute intestinal obstruction: an unusual complication of mucocele of appendix. EUROPEAN REVIEW FOR MEDICAL AND PHARMACOLOGICAL SCIENCES 2011; 15:99-102. [PMID: 21381505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
A rare case of intestinal obstruction due to compression of ileocecal junction by mucocele of appendix is presented. Imaging with ultrasound or computed tomography (CT) is useful in establishing preoperative diagnosis. Avoidance of rupture of during appendicectomy is critical in preventing potential complication of pseudomyxoma peritonei.
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Prasad D, Mohanty D, Garg PK, Agarwal V, Jain BK. Adult intussusception: is associated bowel gangrene common? TROPICAL GASTROENTEROLOGY : OFFICIAL JOURNAL OF THE DIGESTIVE DISEASES FOUNDATION 2011; 32:45-49. [PMID: 21922856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Adult intussusception is a rare clinical entity in contrast to pediatric intussusception. Varied and non-specific clinical features, delayed presentation, and lack of awareness among attending surgeons to consider it as differential diagnosis complicates the clinical course of the disease. METHODS A retrospective study was conducted in a tertiary care teaching hospital in north India. Nine adult patients who presented with intussusception over a period of six years were analyzed. Their clinical profile, management and underlying pathology were studied. RESULTS Five out of nine patients had acute presentation while remaining four presented with subacute/chronic symptoms. Median duration of presentation was 8 days (range 2-180 days). Clinical diagnosis of intussusception was considered in only one patient. Ultrasonography clinched the diagnosis in all four patients who presented with subacute/chronic symptoms. Ileo-ileal intussusception was present in five patients, with one having associated jejuno-jejunal intussusception. Other four patients had ileo-colic intussusception. Seven of the 9 patients (77%) were found to have associated bowel gangrene. Resection of the bowel segment having intussusception was done in all patients. Five patients had associated benign intestinal pathology while idiopathic intussusception was present in four patients. CONCLUSION The patients presented in the series are distinct from cases reported earlier in literature in term of late presentation, manifesting as acute intestinal obstruction, high frequency of associated intestinal gangrene, and absence of associated intestinal malignancy. Patients presenting with features of intestinal obstruction and abdominal lump should be subjected to urgent imaging studies to examine the possibility of intussusception. The high frequency of bowel gangrene encountered in patients of adult intussusception mandates prompt surgical intervention soon after diagnosis.
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Jain BK, Arora H, Srivastava UK, Mohanty D, Garg PK. Insight into the management of non-traumatic perforation of the small intestine. J Infect Dev Ctries 2010; 4:650-4. [DOI: 10.3855/jidc.829] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2010] [Revised: 04/24/2010] [Accepted: 04/25/2010] [Indexed: 10/31/2022] Open
Abstract
Introduction: Management of non-traumatic perforation of the small intestine has always been a consideration for surgeons because of associated enormous morbidity and mortality. There is a paucity of data on the management of non-traumatic perforation of the small intestine. Methodology: A retrospective study was conducted which involved analysis of 192 patients treated for non-traumatic perforation of small intestine in a tertiary care teaching hospital in North India. The clinical profile and management of the patients were studied. Results: The most common cause of non-traumatic perforation of small intestine was typhoid (46.4%), followed by non-specific inflammation (39.2%), tuberculosis (12.8%) and malignant neoplasm (1.6%). Primary repair was the most frequent procedure (44.0%), followed by ileostomy (25.5%) and resection-anastomosis (19.3%). Superficial wound infection was the most frequent postoperative complication (46.8%), followed by wound dehiscence (31.3%). The wound infection rate was reduced significantly following delayed primary closure of skin incision. Enterocutaneous fistula/leak developed in 11.5% patients. Salvage ileostomy for post-operative intestinal leak resulted in a better survival rate as compared to conservative treatment (85.7% vs. 50.0%). The overall mortality rate was 16.6%. Conclusion: Operative procedures undertaken for the management of non-traumatic perforation of small intestine can be classified into two groups: procedures that leave an intestinal suture line inside the peritoneal cavity and procedures that do not. The no suture line-in procedure seems to be better option in adverse patient conditions.
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Mohanty D, Jain BK, Agrawal V, Gupta A. Cystic nephroma: a diagnostic dilemma. SAUDI JOURNAL OF KIDNEY DISEASES AND TRANSPLANTATION 2010; 21:518-520. [PMID: 20427881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Cystic nephroma (CN) is a rare benign neoplasm of kidney with excellent prognosis. An accurate pre-operative diagnosis differentiating CN from other cystic renal malignancies may be impossible by clinical and radiological examination, and histopathological examination provides the final diagnosis. This report describes two adult patients with large multi-locular cystic renal masses on imaging and the diagnosis of CN was clinched post-operatively by the honeycomb appearance of the cut specimen and the finding of multiple, non-communicating fluid filled cysts lined by cuboidal or flattened epithelial cells and absence of blastemal cells on microscopy. Tumor diameter on cross sectional imaging remains the key parameter for treatment decisions in renal neoplasms, with nephrectomy being preferred for larger lesions.
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Singh S, Mohanty D, Singh B, Jain BK. Enteric fever with gall bladder perforation. TROPICAL GASTROENTEROLOGY : OFFICIAL JOURNAL OF THE DIGESTIVE DISEASES FOUNDATION 2010; 31:48-49. [PMID: 20860229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Singh S, Jain BK, Mohanty D, Agrawal J, Mehta S. Ruptured ectopic pregnancy presenting as intestinal obstruction. Can J Surg 2009; 52:E99-E100. [PMID: 19680508 PMCID: PMC2724823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
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Mohanty D, Jain BK, Gupta A, Agrawal V. Chest wall abscess: an atypical presentation of isolated tuberculous liver abscess. ACTA BIO-MEDICA : ATENEI PARMENSIS 2009; 80:77-79. [PMID: 19705626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The incidence of hepatic tuberculosis is increasing with the resurgence of tuberculosis due to the emergence of multi drug resistant strains and to an increased prevalence of human immune-deficiency virus infection. In contrast, isolated tuberculous liver abscess (TLA) is extremely uncommon with a prevalence of 0.34% in patients with hepatic tuberculosis. We describe a case of isolated TLA in a 32-year-old immune-competent man, who presented with a painless lump in the right posterior chest wall. Fine needle aspiration revealed acid fast bacilli (AFB), computed tomogram of the thorax showed a hepatic abscess in the segments 6 and 7 communicating with the posterior chest wall. The presentation of TLA may be atypical and diagnosis remains elusive unless hepatic involvement is revealed by imaging and AFB is demonstrated in the aspirated pus or necrotic material. Open drainage of the superficial component of the abscess along with antituberculosis treatment resulted in the resolution of the abscess.
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Agrawal V, Joshi MK, Jain BK, Gupta A. Plasticobezoar-another new entity for Rapunzel syndrome. Indian J Pediatr 2009; 76:229-30. [PMID: 19129987 DOI: 10.1007/s12098-008-0236-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2007] [Accepted: 01/15/2008] [Indexed: 12/19/2022]
Abstract
Rapunzel syndrome- a form of trichobezoar occurs when a gastric trichobezoar extends beyond the pylorus into the bowel. We report two cases of Rapunzel syndrome, one of them caused by ingestion of plastic material, so as to name it as a 'Plasticobezoar'. To the best of our knowledge no Rapunzel syndrome due to this material has been reported so far.
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Mohanty D, Agrawal V, Jain BK, Gupta R, Rathi V, Gupta A. Osteomyelitis of the ribs: a strategy for prompt diagnosis and effective management. Trop Doct 2008; 38:239-41. [DOI: 10.1258/td.2008.070413] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Seven patients were treated for osteomyelitis rib (OR). Discharging sinuses and painful swellings were the presenting symptoms. An initial chest X-ray was unremarkable in all patients. Fine needle aspiration cytology and microscopy of pus did not reveal acid-fast bacillus in any patient. Computerized tomography (CT) of thorax was consistent with the diagnosis of OR in five patients. The patients underwent a subperiosteal excision of the affected part of the ribs or an excision biopsy of the unhealthy granulation tissue. Histopathological diagnosis was consistent with the diagnosis of tuberculosis (TB) OR in six patients. The patients received anti-TB drugs or appropriate antibiotics following surgery. All responded to treatment except one with a non-TB OR, who required further excision of the unhealthy rib ends. Inclusion of a CT of the thorax and an excision biopsy in the diagnostic process facilitates prompt diagnosis and effective management of OR.
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Jain BK, Mohanty D. Quality management in clinical practice: role of stakeholders. JOURNAL OF THE INDIAN MEDICAL ASSOCIATION 2008; 106:188. [PMID: 18712141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Agrawal V, Joshi MK, Jain BK, Gupta A. Unusual rectal stricture. TROPICAL GASTROENTEROLOGY : OFFICIAL JOURNAL OF THE DIGESTIVE DISEASES FOUNDATION 2008; 29:44-45. [PMID: 18564669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The aetiology of rectal stricture is varied, with malignancy being the commonest cause. We report the case of a 26-year-old man, from the state of Bihar, India, who presented with features of large bowel obstruction. Investigations revealed a rectal stricture. Biopsy from the affected site demonstrated non-specific inflammation. An anterior resection was carried out as it was not possible to convincingly rule out malignancy. Histopathological examination of the resected specimen reaffirmed the nonspecific inflammation. This case illustrates that long stricture of rectum my have a benign cause.
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Kumar S, Kumar R, Sharma SB, Jain BK. Effect of oral glutamine administration on oxidative stress, morbidity and mortality in critically ill surgical patients. Indian J Gastroenterol 2007; 26:70-3. [PMID: 17558069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To examine the effect of enteral administration of glutamine in patients with peritonitis or abdominal trauma. METHODS In a prospective, interventional, observer-blind, randomized clinical trial, 120 patients, aged 18-60 years, were randomized to receive either enteral glutamine 45 g/day for 5 days in addition to standard care (n=63; group A) or standard care alone (n=57; group B). Surgical intervention was done as needed. RESULTS The two groups were comparable for sex and severity of illness scores. Following treatment, serum malondialdehyde (MDA) levels in group A increased from 4.4 (8.0) to 7.2 (4.8) mmol/mL, whereas those in group B decreased from 3.9 (4.9) to 3.1 (5.0) mmol/mL; these changes were not statistically significant. Reduced glutathione levels increased from 0.03 (0.04) to 0.06 (0.12) mg/g Hb (p=0.032) after treatment in group A and from 0.03 (0.03) to 0.05 (0.04) mg/g Hb (p=0.001) in group B. Infectious complications were equally frequent in the two groups (group A: 44; group B: 37; p=0.571). Survival rate and duration of hospital stay were also comparable in the two groups. CONCLUSION Enteral glutamine supplementation offers no advantage in patients with peritonitis or abdominal trauma.
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Jain BK, Mohanty D. Surgery in the management of pyomyositis. JOURNAL OF THE INDIAN MEDICAL ASSOCIATION 2007; 105:400. [PMID: 18183663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Shrivastava UK, Jain BK, Kumar P, Saifee Y. A Comparison of the Effects of Diltiazem and Glyceryl Trinitrate Ointment in the Treatment of Chronic Anal Fissure: A Randomized Clinical Trial. Surg Today 2007; 37:482-5. [PMID: 17522765 DOI: 10.1007/s00595-006-3431-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2006] [Accepted: 12/02/2006] [Indexed: 10/23/2022]
Abstract
PURPOSE Anal fissure is a common problem affecting all age groups with an equal incidence in both sexes. Traditional surgical treatments, like manual anal dilatation or a sphincterotomy, effectively heal most fissures within a few weeks but such procedures may result in anal incontinence. In recent years, various medical therapies have been used for the treatment of chronic anal fissure without fear of incontinence. METHODS Ninety patients with a symptomatic anal fissure were randomly divided into three groups. Group I was treated with 2% diltiazem ointment, Group II was treated with 0.2% glyceryl trinitrate (GTN) ointment, and Group III was kept as the control group. The improvement in the signs and symptoms, the time taken for healing, and side effects were recorded in each group. The patients were followed up monthly and then every 3 months for any recurrence of fissure. Comparative evaluations of the three groups regarding an improvement in symptoms, progress in healing, appearance of side effects, and recurrence were made using the Tukey HSD test. RESULTS Diltiazem ointment was found to be superior regarding pain relief, fewer side effects, and late recurrence as compared with GTN ointment. CONCLUSION Diltiazem ointment (2%) and GTN ointment (0.2%) are both effective treatment modalities for chronic anal fissure, with diltiazem giving better patient outcome.
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Khandekar R, Sudhan A, Jain BK, Shrivastav K, Sachan R. Pediatric cataract and surgery outcomes in Central India: a hospital based study. ACTA ACUST UNITED AC 2007. [PMID: 17197734 DOI: 10.4103/0019-5359.29593] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND A review of pediatric cataract cases operated between January 2003 and March 2005 in the tribal belt of central India was carried out. AIM We present the profile of cataract cases in children <or=18 years and postoperative visual status in the eyes operated upon. SETTINGS AND DESIGN This was a retrospective medical record retrieval type of cohort study in a hospital setting. MATERIALS AND METHODS Pediatric ophthalmologists examined children and operated eyes with cataract. The personal profile, preoperative, intraoperative and postoperative details were noted. The surgical procedures included cataract extraction, intraocular lens implantation, posterior capsulorrhaxis and anterior vitrectomy in most of the cases. We evaluated the visual status of eyes with cataract before and 6 weeks after surgery. STATISTICAL ANALYSIS We used univariate type of parametric type of statistical analysis. RESULTS A total of 575 eyes of 502 children had cataract. Cataract in 65 children was bilateral and in 437 cases it was unilateral. Congenital cataracts were in 88 (17.5%) eyes. Traumatic cataracts were noted in 170 (33.9%) eyes. The proportion of cataract was higher in males than in females. Variation in 'number of cataracts' among different age groups was noted. Vision following surgery was more than 6/18 in 84 (16.4%) eyes. The vision could not be assessed in 256 (44%) eyes. CONCLUSION Improvement of child health care is needed for early detection of cataract in children. Role of rubella and trauma in childhood cataract should be investigated and addressed. Visual assessment and postoperative care should be further improved.
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Khandekar R, Sudhan A, Jain BK, Shrivastav K, Sachan R. Pediatric cataract and surgery outcomes in Central India: a hospital based study. INDIAN JOURNAL OF MEDICAL SCIENCES 2007; 61:15-22. [PMID: 17197734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND A review of pediatric cataract cases operated between January 2003 and March 2005 in the tribal belt of central India was carried out. AIM We present the profile of cataract cases in children <or=18 years and postoperative visual status in the eyes operated upon. SETTINGS AND DESIGN This was a retrospective medical record retrieval type of cohort study in a hospital setting. MATERIALS AND METHODS Pediatric ophthalmologists examined children and operated eyes with cataract. The personal profile, preoperative, intraoperative and postoperative details were noted. The surgical procedures included cataract extraction, intraocular lens implantation, posterior capsulorrhaxis and anterior vitrectomy in most of the cases. We evaluated the visual status of eyes with cataract before and 6 weeks after surgery. STATISTICAL ANALYSIS We used univariate type of parametric type of statistical analysis. RESULTS A total of 575 eyes of 502 children had cataract. Cataract in 65 children was bilateral and in 437 cases it was unilateral. Congenital cataracts were in 88 (17.5%) eyes. Traumatic cataracts were noted in 170 (33.9%) eyes. The proportion of cataract was higher in males than in females. Variation in 'number of cataracts' among different age groups was noted. Vision following surgery was more than 6/18 in 84 (16.4%) eyes. The vision could not be assessed in 256 (44%) eyes. CONCLUSION Improvement of child health care is needed for early detection of cataract in children. Role of rubella and trauma in childhood cataract should be investigated and addressed. Visual assessment and postoperative care should be further improved.
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Gautam A, Jain BK, Midha V, Sood A, Sood N. Prevalence of celiac disease among siblings of celiac disease patients. Indian J Gastroenterol 2006; 25:233-5. [PMID: 17090839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIMS To determine the prevalence of celiac disease (CD) in siblings of patients with this disease in Punjab, where wheat is the staple diet. METHODS Families of 80 patients with CD diagnosed as per modified ESPGAN criteria were offered family screening. Their siblings aged 2-15 years were tested for serum IgA anti-tissue transglutaminase antibody (anti-tTG) antibody. Those with positive or borderline test and some of those with negative test underwent endoscopic duodenal biopsy. Siblings with characteristics histological findings and showing improvement on follow-up were labeled as having celiac disease. RESULTS Of the 63 siblings of 48 index cases studied, 15 tested positive for anti-tTG; of these 13 had celiac disease. Three tested borderline for anti-tTG; none of them had CD. Of the 45 anti-tTG-negative subjects, two agreed to undergo biopsy; one of these had features of CD. Overall, 14 of 63 (22%) siblings had CD, including 8 who had no symptoms suggestive of CD. CONCLUSIONS CD is common among siblings of patients with CD in Punjab and may be asymptomatic.
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Sharma D, Gupta A, Jain BK, Agrawal V, Dargan P, Upreti L, Arora V. Tuberculous gastric perforation: report of a case. Surg Today 2004; 34:537-41. [PMID: 15170553 DOI: 10.1007/s00595-004-2745-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2002] [Accepted: 11/04/2003] [Indexed: 01/27/2023]
Abstract
A 21-year-old woman presented with a 2-day history of acute abdominal pain. Contrast-enhanced computed tomography (CT) showed a perforation in the lesser curve of the stomach. The patient suffered a bout of hematemesis, following which an endoscopy showed a bleeding blood vessel at the edge of the perforation. We performed an emergency distal gastrectomy, including the ulcer site. Histopathological examination revealed tuberculous granulation tissue and acid-fast bacilli in the ulcer. The patient was given antituberculosis therapy (ATT) postoperatively, and was well when last seen 1 year 5 months after surgery. We analyzed the clinical data of five cases of tuberculous gastric perforation (TGP), reported between 1948 and 2003, including our patient. The patients ranged in age from 21 to 45 years, with a mean age of 36.8 years (SD +/- 10.21), and a male to female ratio of 3 : 2. The diagnosis was confirmed by surgery or autopsy. Abdominal lymphadenopathy was present in all patients. Gastrectomy was performed in four patients, and two were given ATT. All four patients in the previous reports died of their disease.
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Jain BK, Dargan P. Possible scrotal violation by FNAC of testicular mass lesion. JOURNAL OF THE INDIAN MEDICAL ASSOCIATION 2004; 102:270. [PMID: 15636034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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