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Biomedical subjects

A Arora

Publications and source records attributed to A Arora.

At least 109 records · Page 6Linked to original sources
PubMed1992

Gastrointestinal endoscope disinfection practices in India: results of a national survey.

A questionnaire was sent to 435 endoscopy centers in the country to obtain information regarding current endoscopic disinfection practices. Of these, 133 (30.6%) centers responded. Adequate disinfection (a minimum exposure to 1% glutaraldehyde for 2 minutes) before the start of endoscopy sessions and between procedures was practised in 61 (46%) and 45 (34%) centers respectively. The proportion of centers practising adequate disinfection was similar among those performing < 1500 and > 1500 endoscopies/year (50% vs 36%; p = ns). Twenty two (17%) centers used some additional precautions in patients with hepatitis B virus infection or immunocompromised states. Two (1.5%) of the 133 centers performing upper GI endoscopies and eight (18%) of the 44 centers performing ERCP examinations reported occurrence of infections following these procedures. Allergic reactions to disinfectants were reported by five (4%) centers. We conclude that only about a third of the gastroenterology centers in the country are practising adequate endoscope disinfection routinely.

Cross Infection↗
PubMed1992

Diagnostic accuracy of IgM antibody detection in typhoid by a modification in Widal test.

Specific IgM antibodies were detected indirectly in sera of patients of typhoid by observing fourfold or more fall in the agglutinin titres after treatment of the serum with 2-mercaptoethanol (2-ME) for removal of IgM antibodies. Significant fall in titres was observed in 94 per cent patients of bacteriologically confirmed typhoid and 67 per cent patients in whom a diagnosis of typhoid was based only on a significant Widal test result. Patients of non-typhoid febrile illnesses showed either no fall or an insignificant fall in their titres. The detection of specific IgM antibodies by this simple modification of Widal test thus seems to enhance the sensitivity and specificity of the test.

Agglutination Tests↗
PubMed1991

Treating bleeding peptic ulcer with sustained achlorhydria.

A controlled randomized study and a subsequent prospective therapeutic trial have demonstrated the efficacy of an intensive therapy comprising hourly intravenous injections of 100 mg of cimetidine along with a continuous nasogastric infusion of a liquid antacid at the rate of 0.5 ml per minute in achieving achlorhydria and controlling bleeding in patients with bleeding peptic ulcer. We recommend that this regimen should be routinely employed for treating patients with bleeding peptic ulcer, at least in center that do not practise topical therapeutic modalities for control of bleeding.

Adult↗
PubMed1991

Case report: unusual CT appearances in a case of Budd-Chiari syndrome.

We describe a case of Budd-Chiari Syndrome due to hepatic venous blockage in which there were multiple space-occupying lesions on CT simulating tumour deposits. Ultrasound directed liver biopsy and laparoscopy proved these to be areas of haemorrhagic necrosis consistent with Budd-Chiari Syndrome without any evidence of malignancy. The CT finding of multiple large focal non-enhancing areas in liver does not always indicate tumour deposits in a patient suspected to have Budd-Chiari Syndrome.

Adult↗
PubMed1991

Laparoscopic features of the Budd-Chiari syndrome.

Twenty-three patients with Budd-Chiari Syndrome were examined by laparoscopy. The characteristic findings were a purple to dusky-blue lobulated surface of the liver, which was covered with whitish bead-like cysts and newly formed tortuous dilated veins. The rich network of blood vessels was also visible over the falciform ligament and peritoneal surface in the majority of patients. Ascites and splenomegaly were an added although non-specific diagnostic feature.

Adult↗
PubMed1991

The role of sustained achlorhydria in bleeding peptic ulcer.

Twenty-five patients with bleeding peptic ulcers were randomized to receive either ranitidine 50 mg 8 hourly i.v. (control group) or a continuous nasogastric antacid infusion at the rate of 0.5 ml/min along with an i.v. injection of cimetidine 100 mg/h (treatment group). Twelve patients were included in the control group and 13 in the treatment group. The mean gastric pH on therapy was significantly higher in the treatment group (7.88 +/- 0.37) than in the control group (5.00 +/- 0.55) (p less than 0.001), and the gastric pH was noted to be greater than 7 on 95% of the occasions in the treatment group and on 8.6% of the occasions in the control group. An overall control of bleeding was achieved in 92.3% of the patients in the treatment group and 50% of the patients in the control group (p less than .05). Thus, the failure of therapy was significantly more common in the control group than in the treatment group (p less than 0.05), and more patients of the control group had to undergo emergency surgery than that in the treatment group. None of the patients in the treatment group, but 16.6% of the patients in the control group, died during the study period in the hospital stay. We conclude that in patients with bleeding peptic ulcer an intensive medical therapy comprising hourly injections of cimetidine (or presumably of other H2 blockers) and continuous nasogastric antacid infusion can achieve sustained achlorhydria, better control of bleeding, and reduce the need for emergency surgery.

Adult↗
PubMed1991

Constrictive pericarditis masquerading as Budd-Chiari syndrome.

Budd-Chiari syndrome (BCS) and constrictive pericarditis (CP) share many common clinical features. Over the last year we encountered three patients in whom CP clinically mimicked BCS. Two of the three did not even have raised jugular venous pressure. One patient with severe jaundice and hepatic coma ultimately died. Liver biopsy features were not discriminating. The final diagnosis of CP was established by echocardiography, chest computed tomography (CT), or cardiac catheterization. We conclude that in all patients with apparent BCS and atypical features, a noninvasive test like echocardiography or chest CT should be done to rule out treatable illness like CP before embarking on such invasive procedures as liver biopsy for diagnosis.

Adolescent↗
PubMed1991

The effect of bile acids on the growth and adherence of Helicobacter pylori.

Bile reflux gastritis occurs in the absence of Helicobacter pylori (H. pylori). The aim of this study was to see if the bile acids cheno or ursodeoxycholic acid affected the growth or adherence of H. pylori in vitro. Twenty-seven strains growth were inhibited by 0.1% chenodeoxycholic acid whereas only 11 out of the 27 were inhibited by 0.1% ursodeoxycholic acid. Growth was totally inhibited by a combination of 0.05% chenodeoxycholic acid +0.05% ursodeoxycholic acid. Chenodeoxycholic acid was a more effective inhibitor of adherence in that the number inhibited and percentage inhibition were greater than with ursodeoxycholic acid. Bile salts might be useful in the treatment of H. pylori infection.

Animals↗
PubMed1991

Acute oral hypoglycemic ingestions.

We reviewed the poison center records of 48 consecutive reports of oral hypoglycemic exposure reported to the Rush Poison Control Center between January 1988 and December 1989. The average age of ingestion was 15.0 y (range 1 to 75 y). Twenty-three of the patients (48%) were male, while 25 (52%) were female. Twenty-nine patients ingested glyburide, 10 chlorpropamide, 6 glipizide, 2 tolbutamide, and 1 each for tolazamide and phenformin. One patient ingested both glyburide and tolbutamide. Sixteen cases (33%) involved coingestants. Accidental cause was the primary reason for ingestion in 33 cases (69%) with suicidal intent being mentioned in an additional 11 cases (23%). Thirteen patients (27%) were treated and released from a health care facility, while the same percentage of patients were admitted. There was no adverse effect in 24 patients (50%) while 9 patients (19%) had minor effects without residual disability. Only 2 patients (4%) experienced a major effect. No deaths were reported. We conclude that oral hypoglycemic ingestions generally have a successful outcome and there does not appear to be a significant difference whether a short/long acting agent or first/second-generation product was ingested.

Acute Disease↗
PubMed1991

Pneumatic dilatation is a satisfactory first-line treatment for achalasia.

The results of 124 pneumatic dilatations done in 92 patients with achalasia cardia were assessed. Relief of dysphagia and other symptoms was obtained in 90 (97.8%) patients--in 68 (73.9%) after one dilatation, in 16 (17.8%) after two dilatations and in six (6.5%) after three dilatations. Two patients who did not obtain relief after three sittings of dilatation underwent surgery and both became totally asymptomatic thereafter. Most of the patients successfully treated with pneumatic dilatation remained asymptomatic during a follow up of 6 months--5 years. The few who did become symptomatic (8.01%) within a year after pneumatic dilatation responded well to the same procedure when repeated. Immediate and late complications of pneumatic dilatation occurred in 3.3% and 4.35% of patients respectively and were all medically manageable. In our assessment, pneumatic dilatation is a simple, quick, safe and effective method for treating achalasia. It should be used as the primary mode of treatment and surgery should be offered only to those patients who fail to respond to at least three attempts at pneumatic dilatation.

Adolescent↗
PubMed1991

Circulating immune complexes in tuberculosis.

To examine whether any correlation exists between the levels of circulating immune complexes (CICs) and the activity of tuberculosis, CICs were measured in the sera of 75 patients with active tuberculosis and in 25 control subjects using polyethylene glycol method. The effect of drug treatment on the levels of CICs was also estimated in 25 patients. It was found that levels of CICs were elevated in most of the untreated patients (96%) of tuberculosis and the CICs levels fell to control values in 64% of patients at the end of treatment.

Antigen-Antibody Complex↗