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Biomedical subjects

B N Bhatnagar

Publications and source records attributed to B N Bhatnagar.

At least 19 recordsLinked to original sources

Healing process in the ureter: an experimental study in dogs.

OBJECTIVE: This study set out to describe the basic milestones in the pattern of healing in the ureter in order to understand why problems in healing arise when the ureter is severed, usually through anastomotic leakage or stricture formation. METHOD: Transection and anastomosis of the ureter were performed on dogs. The anastomotic segment was removed at days 6, 14, 21 and 42. Mucopolysaccharide levels, collagen content and breaking strength were measured on these samples and on anatomically similar segments from normal dogs. A minimum of five observations were carried out at each time point. The mean values of the estimations in various groups were compared. Differences were considered significant at p < or = 0.05. RESULTS: Mucopolysaccharide levels peaked at day 6 and then fell gradually to near normal (p > 0.05) by day 42. The collagen content rose to a maximum at day 14 and then fell to near normal levels (p > 0.05) by day 21. Breaking strength rose gradually to peak by day 21 and then fell to reach day 6 level (> 0.05) at day 42. At no time point did it reach anywhere near normal value. Full healing in the ureter takes at least six weeks. CONCLUSION: The healing process in the injured ureter is different to that in other tissues. It is probable that clues to anastomotic healing problems of the ureter lie in the paradoxical pattern of collagen formation.

Anastomosis, Surgical↗

Nonresective alternative for the cure of nongangrenous sigmoid volvulus.

PURPOSE: Recurrence in sigmoid colon volvulus is a very vexing problem, because it occurs after all types of treatment including a resection of the sigmoid. A nonresective procedure that prevents recurrence in the long term has been devised and tried during the period 1968 to 1992. METHODS: The procedure involves extraperitonealization of the whole sigmoid colon via a left paracolic gutter incision in a manner akin to an extraperitonealized colostomy and placing it in the left half of the infraumbilical abdominal wall. This article presents a study of 84 patients who underwent this operation and who were followed-up. Some very useful practical points for ensuring the success of the procedure are also presented. RESULTS: The subjects comprised 58 male and 26 female patients, aged 10 to 81 (median, 60) years. The operating time ranged from 40 to 70 (median, 50) min. The operative mortality (9 percent) and morbidity of the procedure including cardiopulmonary complications (7 percent), incidence of small-bowel obstruction (1 percent), and incisional hernia formation (2.3 percent), were reasonably low. The incidence of wound-healing problems was significantly (P < 0.02) reduced in the 1980s and 1990s. Seventy-six patients were available for follow-up ranging from 0.5 to 25 (mean+/-standard error, 6.671+/-0.573; median, 6) years. Forty-eight patients were followed-up for five or more years. No patients developed recurrence of volvulus during the entire follow-up period. CONCLUSIONS: This nonresective, recurrence-free procedure provides a cure for nongangrenous sigmoid volvulus. It may be performed safely, even in relatively poor-risk patients, with acceptably low morbidity and mortality rates.

Adolescent↗

Complications of TUR of the bladder neck in the female. A study of 238 procedures.

Transurethral resection of the bladder neck in the female is unpopular because of complications and indifferent results. This retrospective study of 238 procedures (carried out over the period 1940-72) documents the various complications and shows that the fears generally held are exaggerated. Most complications are of moderate incidence and can be easily and satisfactorily managed. The incontinence rate (4.7% in this study) can be further reduced by selection of cases after careful urodynamic evaluation and avoiding certain types of cases. It is related more to the type of patient than to the procedure itself.

Adolescent↗

Ileo-sigmoid knotting: a clinical study of 11 cases.

Ileo-sigmoid knotting is an uncommon lesion that has a high mortality (27.3% in this study). This is due to the rapidly deteriorating systemic disturbances that can follow gangrene involving both the ileal and sigmoid loops (63.6% of cases had gangrene of both loops in this series). Isolated gangrene of the sigmoid colon is uncommon. The recommended treatment consists of resection and anastomosis of the small bowel, and a Mikulicz type exteriorisation of the gangrenous sigmoid. However, Hartmann's procedure is recommended when gangrene has extended down to the upper rectum.

Adult↗

Incontinence following transurethral resection of the bladder neck in the female.

Incontinence is an unwelcome complication of transurethral resection (TUR) of the bladder neck in the female. A computerised analysis of 238 procedures performed during the period 1940 to 1972 was carried out to assess the morbidity due to this complication and to evaluate possible predisposing factors. Initially 15.2% of patients were incontinent but 70% of these soon became continent without further treatment. The remaining 4.7% were treated by surgical or other measures. The incidence of incontinence was unrelated to the amount of tissue removed or to the number of operations, but was significantly lower when the operation was done for polypi of the bladder neck and significantly higher in patients with a cystocele or urethrocele. It seems possible to reduce the incidence of incontinence by careful selection of cases.

Adolescent↗

Blood coagulation profile in patients with acute diffuse peritonitis.

Coagulation studies conducted on 42 patients with acute peritonitis of varying etiology revealed statistically significant prolongation of kaolin cephalin clotting time, decrease of platelets and elevation of plasma fibrinogen and serum fibrinogen degradation products. The relationship of the coagulopathy to bacterial invasion of peritoneal cavity was indicated by the absence of significant change in KCCT, prothrombin time, and bleeding time in patients with sterile peritoneal fluid. The results suggest a process of insidious defibrination intricately superimposed on the hypercoagulable state in these patients.

Acute Disease↗