Barotrauma: a cause of hemobilia.
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Barotrauma↗
Biomedical subjects
A Joshi
Publications and source records attributed to A Joshi.
Hydatid cyst of the tibia.
A case of hydatid cyst of the tibia, which manifested as a pathologic fracture is being reported. Pain and swelling of left lower limb with inability to bear the weight were the main features. Tender swelling was also noted at the upper and middle third of tibia. Open biopsy revealed the hydatid cyst wall and scolices of Echinococcus granulosus. Albendazole treatment was followed by curettage and bone grafting.
Adult↗
Endoscopic band ligation for non variceal bleed.
Endoscopic band ligation (EBL) is an infrequently used modality for treatment of non-variceal hemorrhage. We report the successful use of this technique for the management of bleed from blue rubber bleb nevus syndrome lesions and post polypectomy bleeding stalk.
Adolescent↗
Carcinoid tumor of bile duct.
We report a 38-year-old lady with carcinoid tumor of the extrahepatic biliary tract who presented with recurrent obstructive jaundice and previous surgery for suspected choledocholithiasis. MRCP revealed a large bile duct tumor extending from the confluence up to the superior aspect of the pancreas; this was completely excised, with bilio-enteric anastomosis. These tumors are characteristically slow growing and, therefore, are amenable to aggressive surgical excision, which offers the best chance of cure.
Adult↗
Achalasia cardia: A study of 113 patients managed with indigenous dilator.
BACKGROUND: Endoscopic dilatation of achalasia cardia is an effective nonsurgical management option. It requires costly pneumatic dilators which are used under fluoroscopic guidance. This study assesses the efficacy and safety of an indigenous pneumatic dilator used without fluoroscopic guidance. METHODS: Over a period of eleven years, 113 patients (69M, 44F) ofachalasia cardia underwent dilatation with indigenous pneumatic dilators without fluoroscopic guidance. The dilatation was performed under endoscopic vision. RESULTS: The procedure was successful in all patients. After six weeks following dilatation, there was significant improvement in the mean dysphagia score 3.63 + 0.61 to 0.53 + 0.93 (P<0.01). The response was still significant (0.78 + 1.03, P <0.05) at the end of one year. Excellent response with single dilatation was seen in 70.7% patients. After two dilatation sessions 92% of patients showed an excellent response. One patient had perforation. There was no mortality. CONCLUSION: Pneumatic dilatation under endoscopic vision without fluoroscopic assistance with the indigenous dilator is very effective and safe for short term treatment of achalasia carida.
Adolescent↗
Conscious sedation of pediatric dental patients using chloral hydrate, hydroxyzine, and nitrous oxide--a retrospective study of 382 sedations.
This retrospective study assessed the effectiveness and safety of chloral hydrate (55 mg/kg), hydroxyzine (1 mg/kg), and nitrous oxide in the sedation of 336 uncooperative pediatric dental patients over 382 sedation sessions, and identified variables associated with effectiveness including: sex, weight, age, and preoperative behavior of the patient; route and combinations of the sedative drugs; and sex of the operating and monitoring dentists. The operating and monitoring dentists rated the sedation session as either effective or ineffective and also as either heavy, moderate, light or poor. The mean age of the children was 2.6 years and mean weight was 14.1 kg. Seventy-four percent of the sedation sessions were deemed effective. Boys had more effective sessions (80.6%) than girls (65.1%) (P = 0.001). Also, the percentage of sedations rated as effective increased as the preoperative behavior was more positively rated (P = 0.001). Oral regimen of chloral hydrate alone or in combination with oral hydroxyzine was more effective (75.5%) than rectal administration of chloral hydrate alone (65.7%) (P = 0.09). There was no significant difference in effectiveness when chloral hydrate was administered orally alone or in combination with oral hydroxyzine. Sedation sessions rated effective had longer operative times, included more sextants of treatment, were more likely to include restorative treatment, and were less likely to include extractions than the ineffective sedations. Vomiting was the only complication reported, occurring in 8.1% of the sedations. Vomiting did not vary significantly with either route of administration or inclusion of hydroxyzine in the oral regimen. Pulse rates were significantly higher for children in the ineffective sedation sessions. This sedative drug regimen was deemed safe and effective for treating young and uncooperative pediatric dental patients.
Administration, Oral↗
Pathology of cardiac transplantation--the initial experience.
BACKGROUND: Cardiac transplantation has recently been started in India at the All India Institute of Medical Sciences, New Delhi. All transplants are monitored by right ventricular endomyocardial biopsies. This study describes our initial experience with the histopathological assessment of post-transplant endomyocardial biopsies. METHODS: Fifty-four endomyocardial biopsies from 8 transplanted hearts were reviewed. At least 3 haematoxylin-eosin and Masson trichrome stained sections were available on each biopsy. Special stains and immunohistochemistry were done as required. Biopsies were graded for rejection using the grading system of the International Society for Heart and Lung Transplantation. Infection, 'Quilty' effect, biopsy site, ischaemia and reperfusion injury were also assessed. RESULTS: There was no evidence of rejection in 34 biopsies. Eleven biopsies showed mild rejection. Only 9/54 biopsies from 4 of the transplant recipients had clinically significant grades of rejection. Biopsy sites were present in 13/54 biopsies. Ischaemia was present in the first biopsy after transplantation in 4 recipients. There was no evidence of viral or parasitic infection. 'Quilty' lesions were seen in 14/54 biopsies from 5 transplant recipients. Four of these 5 recipients had 'Quilty' lesions on more than 1 biopsy. CONCLUSIONS: The low rejection rate at our centre is consistent with reports from around the world. Endomyocardial biopsy has been a safe, convenient and useful method for diagnosing rejection and monitoring the postoperative course of cardiac transplants at our centre.
Adult↗
Day-case dental surgery.
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Ambulatory Surgical Procedures↗
Synchronous primary adenocarcinoma of small and large bowel.
Synchronous cancer of the small and large bowel is rare. We report a 45-year-old woman with synchronous primary cancer of the jejunum and descending colon who presented with intestinal obstruction.
Adenocarcinoma↗