PubMed Health⌕ Search

Biomedical subjects

D K Bhasin

Publications and source records attributed to D K Bhasin.

At least 19 recordsLinked to original sources
PubMed1997

Transhiatal oesophagectomy for benign obstructive conditions of the oesophagus.

BACKGROUND: Transhiatal oesophagectomy is an accepted approach for the treatment of carcinoma of the oesophagus. However, experience of this technique in benign diseases is limited. METHODS: Transhiatal oesophagectomy was done in 29 patients for benign oesophageal conditions including corrosive stricture (21), achalasia of the cardia (four), tuberculosis (one), mediastinal fibrosis (one), Crohn's disease (one) and peptic stricture (one). Dysphagia was the predominant symptom in all patients; strictures had all previously been dilated repeatedly. The stomach was used as an oesophageal substitute in 24 patients; in five with a scarred stomach due to damage by a corrosive agent, oesophagocoloplasty was performed. Resection and reconstruction were done in one stage in 25 patients; four with poor nutritional status had a two-stage procedure. RESULTS: There was no perioperative death. Complications encountered were recurrent laryngeal nerve palsy (six patients) which was mostly transient, anastomotic leak (seven) and stenosis (eight). Postoperative function of the intrathoracic stomach was satisfactory. CONCLUSION: Transhiatal oesophagectomy is a safe and satisfactory procedure for benign obstructive conditions of the oesophagus.

Adolescent↗
PubMed1996

Hepatic amyloidosis presenting with severe intrahepatic cholestasis.

Systemic amyloidosis presenting with jaundice is rare. A case of primary amyloidosis presenting with severe intrahepatic cholestasis is reported. The patient had hepatomegaly, ascites, and a markedly elevated serum alkaline phosphatase level. He had a rapid downhill course resulting in death. Autopsy showed evidence of amyloidosis involving multiple organs, including the liver, kidney, and heart.

Adult↗
PubMed1996

Primary sclerosing cholangitis: an experience from India.

Primary sclerosing cholangitis (PSC) is considered to be rare in India. The aim of the present study was to investigate the incidence, clinical profile and outcome of PSC seen in a tertiary care centre. Over a period of 10 years (July, 1984-June, 1994) 18 patients of PSC were diagnosed at cholangiography (14 patients by endoscopic retrograde cholangiopancreatography, two patients by percutaneous transhepatic cholangiography and two patients by both methods). The presence of secondary causes, such as choledocholithiasis, biliary tract surgery, congenital biliary tract anomalies, cholangiocarcinoma and pancreatic diseases, were excluded. These patients were evaluated retrospectively with respect to their clinical presentation, radiological findings, presence of associated idiopathic ulcerative colitis (IUC), treatment instituted and outcome. The mean (+/- s.d.) age at diagnosis of PSC was 39.0 (+/- 16.1) years with a male:female ratio of 1.57:1. Nine (50%) patients had associated IUC. The diagnosis of the IUC preceded that of PSC in all but one case. Fifteen (83.3%) patients had cholestatic jaundice at presentation, while three (16.7%) patients had asymptomatic rise of alkaline phosphatase. Three (16.7%) patients had recurrent cholangitis and five (27.8%) patients developed portal hypertension during the course of the disease. At cholangiography, intrahepatic radicles were involved in all and extrahepatic radicles in 12 (66.6%) cases. Patients were managed with steroids (n = 7), colchicine (n = 3), ursodeoxycholic acid (UDCA; n = 2) and methotrexate (n = 1), along with symptomatic measures. Mean duration of follow up available in 11 (61%) patients was 20.1 months (range: 1 month-8 years). Four (36.4%) patients died. Steroids and colchicine did not have any effect while the one patient on UDCA and one on methotrexate showed improvement. In conclusion, in India PSC does not seem to be a rare entity. Its clinical profile and outcome are somewhat similar to those seen in Western countries.

Adult↗
PubMed1996

Emphysematous gastritis.

Emphysematous gastritis is a rare infectious disease of the stomach. A patient with fatal emphysematous gastritis associated with empyema thoracis is reported. The diagnosis was suspected as a result of a plain skiagram of the abdomen and was confirmed on CT scan of the abdomen.

Adult↗
PubMed1996

Pancrease divisum: five years' experience in a teaching hospital.

AIM: To study the frequency and significance of pancreas divisum. METHODS: Retrospective analysis of all pancreatograms carried out between July 1989 and June 1994. RESULTS: The 809 pancreatograms performed included 207 in patients with pancreatitis (acute 74, chronic 133), 330 with biliary disease, 238 with obscure abdominal pain and 34 with pancreatic malignancy. Of these, 30 patients (3.7%) were diagnosed to have pancreas divisum - 26 had type I variant, one had type II variant and three had type III variant. Accessory papillary cannulation was attempted in 10 patients; 8 were successful, with dorsal ductography confirming pancreas divisum in all of them. Two of these 8 patients had changes of chronic pancreatitis in the dorsal duct. The frequency of pancreas divisum in patients with pancreatitis (19 of 207, 9.2%) was significantly higher than in patients with biliary diseases and those with obscure abdominal pain (11 of 568, 1.9%; p < 0.001). CONCLUSIONS: Pancreas divisum is not an uncommon condition in India and its frequency in patients with idiopathic pancreatitis is higher than that in patients with other abdominal conditions. It should be looked for in any case of idiopathic pancreatitis.

Biliary Tract Diseases↗
PubMed1995

A study of hepatitis delta virus infection in patients with acute and chronic liver disease from northern India.

To assess the prevalence of hepatitis delta virus (H delta V) in northern India, 204 adult patients with acute and chronic liver disease who were positive for hepatitis B virus (HBV) markers were screened for anti-H delta V antibody by enzyme-linked immunosorbent assay (ELISA). Anti-H delta V antibodies were positive in 29 (14.2%) patients. The incidence of H delta V infection was higher (21.4%) in patients with chronic liver disease when compared with those with acute viral hepatitis (10.7%) (P < 0.05). H delta V antibodies were positive in 16.6% of patients with fulminant hepatic failure (FHF) and in 25% of cases with hepatocellular carcinoma. Co-infections were significantly higher in acute hepatitis (80%), while superinfections predominated (66.7%) in chronic liver disease (P < 0.05). Our data show that H delta V is endemic in northern India and should be considered a major health problem.

Acute Disease↗
PubMed1995

Eosinophilic gastroenteritis presenting as acute intestinal obstruction.

Eosinophilic gastroenteritis is a rare disorder of the gastrointestinal tract. Three cases of eosinophilic gastroenteritis presenting as intestinal obstruction are reported. Two patients had stenotic lesions in the jejunum whereas the ileum was involved in the third. None had peripheral eosinophilia. All underwent resection-anastomosis of the bowel and are symptom-free at follow-up ranging from 8 months to 6 years.

Acute Disease↗
PubMed1995

Assessment of optimal dose of lactose for lactose hydrogen breath test in Indian adults.

To evaluate the possibility of using a 12.5 g or 25 g oral dose of lactose for hydrogen breath test for diagnosis of lactose intolerance instead of the usual 50 g dose. 35 patients with non-ulcer dyspepsia and an abnormal 50 g lactose breath hydrogen of more than 20 ppm over the base line were retested using 12.5 g and 25 g lactose. 32 (91.4%) and 15 (42.8%) of these 35 patients had an abnormal hydrogen breath test using 25 g (p = ns compared to 50 g dose) and 12.5 g (p < 0.001) lactose doses respectively. This study reveals that it may be possible to use a 25 g lactose dose instead of a 50 g dose for the lactose hydrogen breath test.

Breath Tests↗
PubMed1994

Distribution of digestive enzymes in gastrointestinal tract of young rhesus monkeys.

The distribution of different mucosal digestive enzymes along the gastrointestinal tract of young rhesus monkeys were studied by biochemical analysis of homogenized specimen from 13 different segments (i.e. stomach-fundus, body, antrum; small intestine-D1, D2, proximal, middle, distal; caecum; colon-ascending, transverse, descending and rectum), obtained from 6 monkeys of approximate age 8-12 months. The activity of all the enzymes was lowest in gastric mucosa rising through duodenum to peak in small intestine and declining towards the large bowel. There was no significant difference in levels of any of the enzymes between different parts of stomach or large bowel. This study suggests that like humans in rhesus monkeys maximum activity of digestive enzymes is present in small intestine and much less in gastric and large bowel mucosa.

Animals↗
PubMed1994

Colonic diverticulosis in India: the changing scene.

BACKGROUND: The prevalence of colonic diverticulosis has a wide geographic and ethnic variation and has been considered to be quite low in India. This study was aimed at determining the prevalence of colonic diverticulosis in northern India based on barium enema examination in symptomatic patients. METHODS: All barium enema examinations performed between January 1985 and December 1991 were reviewed for the presence of colonic diverticulosis. Clinical data of such patients were retrieved. RESULTS: 51 (3.2%) of 1610 barium enema studies showed colonic diverticulosis. The frequency of diverticulosis in barium studies increased from 0.3% among subjects in the third decade to 32.4% in patients above 60 years. Most patients were city dwellers, vegetarians and belonged to the upper socio-economic stratum. Twenty patients (39.2%) presented with a complication; the spectrum of such patients was no different from that reported from the West. While the sigmoid colon was the commonest site of diverticuli, there was a relative preponderance of right sided diverticuli as compared to the Western experience. Seven patients with complications required surgical treatment, while the rest were managed conservatively. CONCLUSION: Colonic diverticulosis and its complications are not rare in India and should be considered in the differential diagnosis of abdominal disorders.

Adult↗
PubMed1994

Evaluation of 14C-urinary excretion and its comparison with 14CO2 in breath after 14C-urea administration in Helicobacter pylori infection.

OBJECTIVES: 1) to estimate levels of 14C-urinary excretion in Helicobacter pylori-infected and noninfected patients after 14C-urea ingestion, 2) to compare 14C-urinary excretion and 14CO2 breath results with biopsy findings, and 3) to find out correlation between 14C-urinary excretion with 14CO2 breath results, if any. METHODS: Twenty-four-hour 14C-urinary excretion was measured in 26 patients of non-ulcer dyspepsia after oral administration of 5 microCi 14C-urea to each patient. One-mmol CO2 breath samples at baseline, 2, 5, 15, and 45 min were collected and 14C content measured. Four gastric biopsies were obtained endoscopically from each patient for histology, culture, Gram staining, and rapid urease test. RESULTS: 14C-urinary excretion in H. pylori-positive patients was 27.38 +/- 13.35% (mean +/- SD) as compared to 67.05 +/- 14.19% in H. pylori-negative patients. Five-, 15-, and 45-min 14CO2 breath values in H. pylori-positive cases were 0.07 +/- 0.041%, 0.063 +/- 0.041%, and 0.028 +/- 0.017% of administered 14C-urea/mmol CO2 exhaled, respectively, which were significantly higher (p < 0.001) from their corresponding values in negative cases. The 14C-urinary excretion data, when compared with biopsies results, discriminated well in 17 of the 18 H. pylori-positive cases, resulting in sensitivity of 94.4%, specificity 100%, and diagnostic accuracy 96.1%, whereas 15 min 14CO2 breath results were 100% accurate. Strong negative correlation between 14C-urinary excretions and 15 min 14CO2 breath was obtained (r = -0.717, p < 0.001). CONCLUSIONS: Measurement of 14C in 24-h urine and in 15-min breath sample may be employed as a cross confirmatory reliable technique for the detection of viable H. pylori colonization.

Adult↗
PubMed1993

Clinical evaluation of the effect of omeprazole, cimetidine, famotidine and ranitidine on histamine induced cutaneous wheal and flare response.

The effect of H2 receptor antagonists on immediate cutaneous response to allergens remain controversial. In the present study, the effect of 7-day administration of omeprazole, cimetidine, famotidine and ranitidine on histamine induced wheal and flare reaction was evaluated. A single blind randomized parallel group study with within patient comparison of responses was planned in non-ulcer dyspepsia patients eligible to receive H2 antagonists or omeprazole. None of the drugs produced any changes in the area of the wheal in comparison to respective baseline values. The area of flare was decreased by all the drugs and the percentage decrease in this parameter caused by omeprazole, cimetidine, famotidine and ranitidine was 2.4, 12.3, 20.2 and 13.2, respectively. Only famotidine caused a significant decrease in flare area (p < 0.05).

Adult↗
PubMed1993

Detection of Entamoeba histolytica antigens in stool in amebiasis.

BACKGROUND: Stool microscopy, the conventional method of diagnosing intestinal amebiasis, fails to detect Entamoeba histolytica in more than 30-40% of clinically suspected cases. Demonstration of parasite products in clinical specimens has been suggested as an alternative. However, the usefulness of demonstrating amebic antigen in the stools of clinical cases needs to be assessed. METHODS: A double-antibody sandwich enzyme linked immunosorbent assay (ELISA) using anti-trophozoite antibodies to capture E histolytica specific coproantigen(s) was carried out on stools obtained from 31 patients with microscopically confirmed non-dysenteric amebic colitis, 18 patients with intestinal parasites other than E histolytica and 41 apparently healthy subjects. RESULTS: The assay detected E histolytica specific coproantigen(s) in stools of 23 (74.2%) of 31 subjects with non-dysenteric amebic colitis, none of 18 with other parasitic infections and 1 (2.4%) of 41 apparently healthy subjects. CONCLUSION: Our results provide evidence for the presence of E histolytica specific coproantigen(s) in stool eluates from patients with amebic infection; this finding can be exploited for confirming ongoing amebic infection. However, the sensitivity of the assay needs to be improved by the use of relevant monospecific/monoclonal antibodies.

Animals↗
PubMed1992

Optimal number of biopsy specimens in the diagnosis of carcinoma of the oesophagus.

The study evaluated 48 patients with carcinoma of the oesophagus to assess the optimal number of biopsy specimens required to obtain the highest yield. Eight specimens were obtained from each patient and two specimens were placed serially in each of four vials. The first vial provided a positive diagnosis in 95.8% of cases. The addition of two more specimens (second vial) increased the yield to 97.9% and the fifth and sixth specimens increased the positive yield to 100%. There was no statistically significant difference in the yield according to the site and the type of growth.

Adult↗