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Biomedical subjects

D K Bhargava

Publications and source records attributed to D K Bhargava.

At least 37 records · Page 2Linked to original sources

Heterotopic gastric and pancreatic tissue in large bowel.

Heterotopic gastric and pancreatic tissues rarely involves large bowel. We report the case of a 30-yr-old man who presented with lower gastrointestinal bleeding. The barium enema showed an ulcerated mass lesion at the splenic flexure. Colonoscopy revealed a polypoid ulcerated lesion at the splenic flexure. The resected specimen, on histological examination, showed a polypoid lesion lined by gastric mucosa. The base of the polyp also showed ectopic pancreatic tissue. The patient recovered completely after surgery.

Adult↗

Endoscopic injection treatment of non-variceal bleeding lesions of upper gastro-intestinal tract.

Endoscopic injection of actively bleeding non variceal lesions with polidocanol was performed in 15 patients. Eleven of them had associated diseases. Haemostasis was achieved in 12 (80%). Three of them rebled. However, bleeding stopped by reinjection in two and spontaneously in one patient. No significant local or systemic complication was observed. This therapy avoided emergency surgery in 12 of 15 patients. Thus endoscopic injection treatment can be utilized for managing bleeding due to non variceal lesions.

Adult↗

Lipids changes in alcoholic & non-alcoholic cirrhotics.

Fasting plasma samples from 29 patients of cirrhosis were analysed for cholesterol and triglycerides and their lipo-protein fractions. The patients included 11 alcoholic cirrhotics consuming over 130 g/day of absolute ethanol and 18 non-alcoholic cirrhotics. The difference in lipid values between the two patient groups was not significant except that VLDL cholesterol was raised in alcoholic cirrhotics (P less than 0.05). However, in comparison to normal healthy controls, the values were significantly altered. The dietary intake, in the two groups showed no difference, except that non-alcoholic cirrhotics consumed more animal proteins. Low intake of exogenous fat and reduced synthesis of endogenous cholesterol in cirrhotic patients seemed to influence the total lipid values.

Adult↗

Sclerotherapy after variceal hemorrhage in noncirrhotic portal fibrosis.

Sixty patients with variceal bleeding due to noncirrhotic portal fibrosis were treated by repeated endoscopic injection sclerotherapy. During each session, the varices were injected with a mean volume of 14.4 ml of 1% polidocanol intravariceally. This decreased rebleeding, as evidenced by a reduction in mean bleeding risk factor and transfusion requirement. Difference between pre- and post-sclerotherapy parameters were significant (p less than 0.001). Variceal obliteration was achieved in 53 (88%) patients. The mean sclerotherapy sessions required for eradication were 8.43 (SD = 2.41). Minor complications related to the procedure occurred in 12% of patients. Cumulative survival for 5 yr was 86%. Survival was significantly related to Child's status, being 97.5% for Child's A and 64% for Child's B patients. Recurrence of varices occurred in 15% of patients after a mean interval of 19 months. We conclude that endoscopic sclerotherapy is an effective method of treatment for variceal bleeding due to non-cirrhotic portal fibrosis, and is a reasonable alternative to surgery.

Adult↗

Colorectal adenomas in a tropical country.

The objective of this study was to demonstrate the existence of colorectal adenomas in India and compare the findings with those reported elsewhere. Seventeen (2.06 percent) adenomas were detected among the 824 colonoscopic examinations conducted from 1978 to 1987. Synchronous malignant tumors were present in 3 (17.6 percent) of the 17 patients. Thus, though adenomas exist in India, they are relatively uncommon to western countries.

Adenoma↗

Spontaneous massive gastrointestinal hemorrhage in patients with pancreatitis.

Spontaneous massive gastrointestinal hemorrhage occurring in patients with pancreatitis is an uncommon and difficult clinical problem, especially in a tropical third world country where the underlying causes of pancreatitis and facilities for its diagnosis and management are different from those in the developed West. Of 7 such cases seen by us in 3 years, 2 were due to hemosuccus pancreaticus, 2 were due to gastric variceal hemorrhage consequent to splenic vein obstruction, and one each due to contiguous pancreatic inflammation involving the duodenum, an aneurysmal bleed from the left gastric artery and a pseudocyst rupturing into the transverse colon. A fiberoptic endoscopic examination was helpful in all the 7 cases and delineated the cause of bleeding, whereas angiography, performed in 4 patients contributed little to management. The mortality rate was 14%. It is suggested that a timely endoscopic examination during active bleeding, which may be repeated if necessary, is extremely rewarding in the diagnosis and management of such patients and often obviates the necessity of angiography which is a time-consuming and cumbersome investigation in a critically ill patient and facilities for which are usually not available in most third world country hospitals.

Adult↗

Serodiagnosis of intestinal tuberculosis by enzyme immunoassay and soluble antigen fluorescent antibody tests using a saline extracted antigen.

The efficacy of enzyme-linked immunosorbent assay (ELISA) and soluble antigen fluorescent antibody (SAFA) tests in the diagnosis of intestinal tuberculosis was compared using saline extracted surface antigen of M. tuberculosis H37Ra. Of the 24 proved cases of intestinal tuberculosis ELISA detected positivity in 92% compared with 83% detected by the SAFA test. The 2 tests showed a strong correlation with each other and yielded a clear cut difference between patients and controls, although there was some degree of overlap.

Enzyme-Linked Immunosorbent Assay↗

Enzyme linked protein-A: an ELISA for detection of IgG antibodies against Mycobacterium tuberculosis in intestinal tuberculosis.

Enzyme linked protein-A has been used to develop an enzyme-linked immunosorbent assay (ELISA) to detect circulating IgG antibodies to Mycobacterium tuberculosis. The specific binding of protein-A to IgG fractions through Fc receptors, makes the test more specific for detection of total IgG antibodies. The ELISA system has been used for detection of circulating antibodies to M. tuberculosis H37Ra in 22 patients with histologically proven intestinal tuberculosis and 88 healthy controls, in addition to 7 diseased controls. The ELISA has been found to be a sensitive test as it was positive in all 22 patients with intestinal tuberculosis. Its specificity was 85% in Indian controls and 97% in Norwegian controls. The test is easy to perform and may be recommended for the serological diagnosis of intestinal tuberculosis.

Antigens, Bacterial↗

Serodiagnosis of intestinal tuberculosis by the soluble antigen fluorescent antibody test (SAFA test).

The diagnosis of intestinal tuberculosis can only be established by the tissue obtained during surgery or endoscopy. We investigated the role of the soluble antigen fluorescent antibody (SAFA) test with the possibility that it may prove to be a valuable technique for the serodiagnosis of intestinal tuberculosis. The sera of 38 patients and 60 control subjects were studied. Mycobacterial saline extract was used as an antigen in the test. Thirty-two (84%) of 38 patients with intestinal tuberculosis yielded positive values (fluorescence coefficient greater than 3). Among the control subjects a false positive result was observed in only one patient who had eosinophilic enteritis. Patients with intestinal tuberculosis had a significantly higher level of antibodies than patients with non-tuberculous intestinal disease and healthy subjects. These results suggest that this technique may be used for the diagnosis of intestinal tuberculosis and in differentiating it from other non-tuberculous intestinal diseases.

Adolescent↗