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D K Chitkara

Publications and source records attributed to D K Chitkara.

13 recordsLinked to original sources
PubMed2006

From the bench to the 'crib'-side: implications of scientific advances to paediatric neurogastroenterology and motility.

Paediatric gastrointestinal motility disorders may present in the neonatal period as the result of a congenital insult that occurred during embryonic development or as a manifestation of an abnormal genetic background. Functional gastrointestinal and motility disorders may also be acquired and present during childhood as the first presentation of a condition that can persist or re-occur throughout adolescence and adulthood. These disorders can have a significant psychological and financial impact on the lives of the affected children and their families. Recently, enteric neuroscience research has advanced the understanding of the pathogenesis and treatment of uncommon congenital or developmental gastrointestinal motility disorders such as Hirschsprung disease and chronic intestinal pseudo-obstruction. In addition, research has contributed to improvements in the understanding of more prevalent functional gastrointestinal disorders in children, such as chronic constipation and functional abdominal pain syndromes. The purpose of this review is to highlight these advances with particular regard to the clinical impact they have in the understanding and management of disorders in the field of paediatric neurogastroenterology and motility.

Animals↗
PubMed2005

Aerophagia in adults: a comparison with functional dyspepsia.

BACKGROUND: Aerophagia is a functional upper gastrointestinal disorder that has not previously been well described in a large patient group. AIMS: To describe the initial evaluation of patients who presented with symptoms of aerophagia at a tertiary medical centre. METHODS: A computerized search was used to identify all patients who were diagnosed with aerophagia at the Mayo Clinic, Rochester between 1996 and 2003 (n = 79). Individual medical charts were abstracted for information on the demographics, clinical features, co-morbid diagnoses, diagnostic workup and treatment. Information on presenting symptoms was also collected for a group of patients who were classified as having functional dyspepsia for comparison (n = 121). RESULTS: The median duration of symptoms in patients with aerophagia was 24 months. The most common symptoms were belching (56%), abdominal pain (19%), bloating (27%) and abdominal distension (19%). Patients with functional dyspepsia had a higher prevalence of reporting nausea, vomiting, early satiety, weight loss and abdominal pain (all P < 0.01, adjusting for age, gender and body mass index). Significantly more patients with aerophagia had anxiety (19%) than those with functional dyspepsia (6%, P < 0.01). CONCLUSIONS: Individuals with aerophagia experience prolonged upper gastrointestinal symptoms. Initial presenting symptoms appear to be distinctly different from those who have functional dyspepsia.

Abdominal Pain↗
PubMed2005

Aerophagia in children: characterization of a functional gastrointestinal disorder.

The purpose of this study was to describe presenting symptoms, diagnostic testing, treatments and outcomes in a group of children with a diagnosis of aerophagia. A computerized diagnostic index was used to identify all children between the age of 1 and 17 years diagnosed with aerophagia at a tertiary care medical centre between 1975 and 2003. Individual medical charts were abstracted for information on the demographics, clinical features, co-morbid diagnoses, diagnostic work up and treatment of children with aerophagia. Information on presenting symptoms was also collected for a group of children who were retrospectively classified as having functional dyspepsia for comparison (n = 40). Forty-five children had a diagnosis of aerophagia. The mean duration of symptoms in children with aerophagia was 16 +/- 5 months. The most common gastrointestinal symptoms were abdominal pain, distention and frequent belching. Children with functional dyspepsia had a higher prevalence of nausea, vomiting, abdominal pain and unintentional weight loss compared to children with aerophagia (all P < 0.05). In conclusion, aerophagia is a disorder that is diagnosed in neurologically normal males and females, who can experience prolonged symptoms. Although many children with aerophagia present with upper gastrointestinal symptoms, the disorder appears to be distinct from functional dyspepsia.

Adolescent↗
PubMed1997

Risk factors, complications, and results in extracapsular cataract extraction.

PURPOSE: To examine a large series of extracapsular cataract extractions (ECCEs) to determine the risk factors for posterior capsule rupture with vitreous loss (PCR + VL) and the complications and results of this cataract surgery technique. SETTING: North Riding infirmary, Middlesbrough, United Kingdom. METHODS: In this retrospective study, the records of 1552 patients who had ECCE performed by two surgeons were examined. Follow-up was 4 months to 4 years. The main outcome measures were the incidence of risk factors, PCR + VL, major and minor postoperative complications, and the visual outcome. RESULTS: Three hundred twenty-two cases were considered high risk for PCR + VL. In this group, the PCR + VL rate was 5.3%; it was 3.7% in the low-risk group and 4.0% overall. Visual acuity of 6/9 or better was achieved by 76% of all eyes. Postoperative complications were 3 cases of endophthalmitis, 4 of retinal detachment, and 1 of pseudophakic bullous keratopathy. In 323 eyes, loose or broken sutures were removed and in 175, a neodymium: YAG capsulotomy was performed because of posterior capsule opacification. CONCLUSIONS: The incidence of perioperative and postoperative complications was comparable with those reported in other series. Factors that increased the risk of PCR + VL included pseudoexfoliation, diabetes mellitus, and a traumatic etiology. Previous glaucoma surgery and axial myopia of greater than 26.0 mm did not increase the PCR + VL risk. Loose or broken corneal sutures was a common finding that could be reduced substantially by planned suture removal.

Cataract Extraction↗
PubMed1997

Effectiveness of topical diclofenac in relieving photophobia after pupil dilation.

PURPOSE: To test the effectiveness of topical diclofenac in relieving photophobia after pupil dilation. SETTING: Department of Ophthalmology, Newcastle General Hospital, Newcastle-upon-Tyne, United Kingdom. METHODS: Twenty healthy patients and volunteers from the outpatient ophthalmology clinic were enrolled in a prospective, double-blind, placebo-controlled comparison in which the patient's fellow eye served as a control. Photophobia after pupil dilation was tested subjectively using a visual analog scale and a neutralization scale at 30 minute intervals for 2 hours after instillation of topical diclofenac. RESULTS: Both tests show a statistically significant reduction in photophobia in the diclofenac-treated eyes at each time interval (P < or = .05). This difference was also considered clinically relevant. CONCLUSION: Topical diclofenac given at the time of pupil dilation significantly reduced photophobia. The mechanism of action is unknown and requires further evaluation.

Administration, Topical↗
PubMed1996

Secondary implantation of open-loop, flexible, anterior chamber intraocular lenses.

PURPOSE: To assess the results of implantation of secondary, open-loop, flexible, anterior chamber intraocular lenses (IOLs) and compare the findings with those of other published studies. SETTING: A combined ophthalmology and ear, nose, and throat hospital in Middlesbrough, Cleveland, England. METHODS: This retrospective study comprised 81 patients who had secondary implantation of a flexible, open-loop, anterior chamber IOL by the one surgeon. The incidence of postoperative complications was ascertained, and best corrected preoperative and postoperative visual acuities were compared. RESULTS: Two serious complications occurred: one severe loss of vision that is still under investigation and one retinal detachment that was repaired with good residual visual function. Of all 81 patients, 92.5% were within one Snellen line of their preoperative best corrected visual acuity. These results compare favorably with those of other published studies. CONCLUSION: Using an open-loop, flexible, anterior chamber lens for secondary implantation is still an acceptable way to treat aphakia. The poor reputation of these lenses is undeserved.

Adult↗
PubMed1996

Flexible open-loop anterior chamber intraocular lens implantation after posterior capsule complications in extracapsular cataract extraction.

OBJECTIVES: To analyze 50 cases of flexible open-loop anterior chamber intraocular lens (IOL) implantation after posterior capsule rupture and vitreous loss and compare the results with those of other published series. SETTING: North Riding Infirmary, Cleveland, England. METHODS: This retrospective study, with a follow-up between 3 and 81 months, comprised all patients who had a flexible open-loop anterior chamber IOL implanted because of significant posterior capsule problems during extracapsular cataract extraction. The incidence of postoperative complications and best corrected visual acuity results were determined. RESULTS: Three patients with cystoid macular edema achieved final best corrected visual acuity of 6/9 (20/30). There was one retinal detachment and one traumatic incision rupture with IOL loss 6 weeks postoperatively and subsequent retinal detachment and phthisis. Seventy-two percent achieved a best corrected visual acuity of 6/9 (20/30). CONCLUSIONS: Our results agree with those of other published series. Implantation of a flexible open-loop anterior chamber IOL as a primary lens is still an acceptable way of treating posterior capsule complications in cataract surgery.

Adult↗
PubMed1995

Anterior chamber aspirate cultures in small incision cataract surgery.

BACKGROUND: Anterior chamber aspirates on completion of extracapsular cataract surgery contain significant numbers of organisms, particularly coagulase negative staphylococci, an important cause of endophthalmitis. METHODS: Culture rates were compared in 50 patients after phacoemulsification surgery, which allows the possible benefits of a small, self sealing wound and maintenance of positive intraocular pressure, with a similar number of extracapsular cases. RESULTS: A culture positive rate of 20% and 24% respectively was found, an insignificant difference. CONCLUSION: Small incision surgery has no proved advantage over extracapsular surgery in terms of reducing the intraoperative bacterial inoculum. The significance of this result in terms of causation of endophthalmitis is discussed.

Anterior Chamber↗
PubMed1994

Lack of effect of preoperative norfloxacin on bacterial contamination of anterior chamber aspirates after cataract surgery.

Eighty patients undergoing routine standardised extracapsular cataract surgery with lens implantation were divided randomly into two groups in a prospective double blind study comparing effects of preoperative norfloxacin eyedrops with placebo on bacterial contamination of anterior chamber aspirates after surgery. Pathogenic organisms were identified from 19 (24%) of the aspirates. The most commonly isolated organisms were coagulase negative Staphylococcus species. There was no statistical difference between the norfloxacin treated and placebo groups. This study demonstrates that routine use of topical preoperative antibiotics to eliminate the entry of bacteria into the eye during surgery is debatable.

Anterior Chamber↗
PubMed1992

Titanium tetrachloride burns to the eye.

We present eight cases of chemical burns of the eyes from titanium tetrachloride, an acidic corrosive liquid. However it causes severe chemical burns which have a protracted course and features more akin to severe alkali burns. Injuries related to titanium tetrachloride should be treated seriously and accordingly appropriate management is suggested.

Adult↗