Biomedical subjects
Publications and source records attributed to C S Sharma.
An unusual combination of posterior hip dislocation with ipsilateral femoral neck and head fractures is reported. The femoral head migrated too far inferiorly in the posterior part of the thigh, making it different from the previously reported solitary case report of obturator hip dislocation associated with femoral neck and head fractures.
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This presentation deals with 110 surgically proven cases of abdominal tuberculosis in the pediatric age group. The protean clinical profiles and complications of the disease entity made the clinical diagnosis difficult; the investigations were also found non-pathognomonic. The most common type of pathology seen was adhesive variety followed by nodal type. Strictures of the small bowel were uncommon and hyperplastic variety was rarely seen in the present series. The pathogenesis relating to various varieties has been suggested based on the vast experience from a single institution.
The clinicopathological features of 75 children under the age of 12 years with teratomas are reviewed. Tumors arose in the following anatomic sites: sacrococcygeum (n = 49), ovary (n = 10), Testis (n = 5), oral cavity (n = 3), retroperitoneum (n = 2) and others (n = 6). Fifty five (74%) presented within the first year of life. Excluding the gonadal tumors, male-female ratio was 2:5. Majority of the tumors had only mature tissues. Such patients and those 9 patients in whom the histology was not specified, underwent excision alone and had 95% early survival rates. Five patients had admixture of mature and immature tumors. Nine patients had malignant tissues. Germ cell tumors containing only malignant component, but no mature or immature teratomatous tissues were excluded from the series. The patients with immature and malignant tissues underwent multimodal therapy including surgical excision, multiagent chemotherapy (VAC regimen) and at times radiotherapy. Mortality in patients with immature and malignant teratomas was 20 and 66.7%, respectively. Besides histology, the only factor which affected prognosis, especially in case of sacrococcygeal teratomas was the age at the time of presentation. Our experience highlights the importance of early recognition and complete surgical excision of teratomas in the pediatric age group.
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Congenital granular-cell myoblastoma is a rare jaw tumor presenting in the neonatal period. The differentiation between congenital epulis and granular cell myoblastoma is a controversial issue amongst pathologists. It is a benign swelling in which simple excision is the treatment of choice. Here we report two cases with a brief review of literature.
Congenital intraluminal esophageal diaphragm causing complete obstruction is a rare anomaly. By esophagoscopy, a complete membranous diaphragm was demonstrated, perforated, and excised. In the English language literature, this case represents the first report of an isolated membranous atresia at the lower end of the esophagus. A brief review of the world literature and the classification of membranous atresia of the esophagus is discussed.
Twenty seven cases of spontaneous gastro-intestinal perforation were treated from 1981 to 1990. Four perforations were in the stomach, 17 in the small bowel and seven in the large bowel. One of them had dual perforation, one in the stomach and another in the duodenum. The exact etiology remained obscure. Various factors observed were maternal obstetric complications, prematurity and perinatal asphyxia. Stress should be laid on early diagnosis by following up 'at risk neonates' thus, giving a better overall survival rate.
The fecundity of two hillstream fishes, Garra lamta and G. gotyla gotyla, is related to their total body length (L), total body weight (W), ovary length (X) and ovary weight (V). The relationships to L, W, X and V were all linear. The correlation coefficient values (r) showed that total body length and total body weight were the best indices in fecundity estimates in both fishes.
The management of fractures of the radial head is still a controversial subject. Fifty cases of radial head fractures have been treated by conservative means. These cases were immobilized in a plaster Paris cylinder cast for 3 weeks to restrict the movement of flexion and extension at the elbow, while encouraging supination and pronation movements from the very beginning. The cases have been evaluated and 43/50 have shown excellent results.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Problems in the management of abdominal tuberculosis in children are discussed with reference to 80 surgically proven cases. The protean clinical manifestation depends on the site and the extent of the disease and its complications. The clinical diagnosis is difficult because of the vague symptoms, non-specific signs, and non-availablity of specific diagnostic tests. The most common type of pathology seen in abdominal tuberculosis in the paediatrics age were adhesive variety followed by nodal type. Strictures of the small bowel are uncommon and hyperplastic variety is rarely seen in this age group. Response to the antitubercular drugs is excellent however, the post operative complications and mortality remain high.
During a period of two decades, 1972-1991, 303 patients with esophageal atresia and/or tracheo-esophageal fistula were treated at the department of Pediatric Surgery, SMS Medical College, Jaipur, India. More than half of our patients fall into Waterston's risk category C. To evaluate the improvement in our results, the patients were divided into four phases of 5 years each. Over the period of observation, the incidence of new cases as well as the number of associated anomalies has considerably increased. With time, more patients are being diagnosed and referred early for treatment. This has resulted in more patients being treated by primary repair with or without a gastrostomy. Extrapleural approach and single layer end-to-end anastomosis has been practised in all cases. Results have shown a steady improvement primarily because of early recognition, improved perioperative care and newer antibiotics. Although postoperative pulmonary complications and anastomotic leak have shown a decreasing trend, but the presence of severe associated anomalies, pulmonary complications and sepsis still remain the major killers in our set-up. Although our results may not match those from the developed countries, we have still come a long way, improving our overall survival rate of 4.6% in 1972-76 to 45.7% in 1987-91. Through the present article, we wish to highlight the practical problems faced in the management of these patients in underprivileged developing countries.