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Biomedical subjects

I M Vora

Publications and source records attributed to I M Vora.

15 recordsLinked to original sources
PubMed1992

Rhinocerebral mucormycosis: an unusual case presentation.

Rhinocerebral mucormycosis is a rapidly fatal fungal disease which involves the nose, paranasal sinuses, orbit and central nervous system. The fungal infection is usually secondary to immunosuppression, diabetic acidosis, or antibiotic, steroid or cytotoxic therapy. It can also occur in patients suffering from burns, malignancy and haematological disorders. Current treatment consists of correction of the underlying disorder, repeated debridement of the wound in combination with intravenous amphotericin B. This paper describes our experience with a case of rhinocerebral mucormycosis. This is an unusual case in which mucormycosis was seen in a young female where no underlying cause was found. She responded to surgical debridement in combination with intravenous amphotericin B.

Adult↗
PubMed1992

Solitary rectal ulcer syndrome and colitis cystica profunda--a clinico-pathological review.

Twenty cases of solitary rectal ulcer syndrome (SRUS) and three cases of colitis cystica profunda (CCP) diagnosed between 1985 to 1990 were studied retrospectively. Clinical features, sigmoidoscopic findings and histopathology of the above lesions were reviewed. Haematoxylin and Eosin, Masson's Trichome, and high iron diamine Alcian blue staining was done in all the cases. Histopathologic examination helps in diagnosing the benign condition of the rectum viz. SRUS and CCP which are considered malignant clinically. Since an overlap of histopathological features were seen in SRUS and CCP, both can be considered as one entity, which has been highlighted in our study. Fibromuscular obliteration of lamina propria is the hallmark of the lesion.

Adolescent↗
PubMed1991

Spondylo-epiphyseal dysplacea tarda (a case report).

A rare case of disproportionate short stature suggestive of spondylo-epiphyseal dysplasia tarda is reported and relevant literature reviewed. It is emphasized that its radiological features show a marked similarity to ochronotic spine, with which it is therefore commonly mistaken. An indeterminate pigment was observed in the liver biopsy in this case with connective tissue disorder.

Dwarfism↗
PubMed1990

Ischemic bowel disease.

Twenty-five cases with ischemic bowel disease seen over a period of 4 years are presented. Of these, 20 cases presented with acute symptoms and five with chronic symptoms. In the majority of patients, the diagnosis was established at operation and on histopathology. Occlusive disease of the superior mesenteric artery was the commonest cause of acute ischemia. Non-occlusive ischemia was not observed in any case. All the patients were treated by resection and anastomosis of the involved bowel. Vascular procedures were not carried out in any. No planned second-look procedures were carried out. Of the 20 acute cases, eight patients died and three developed complications. One chronic case died and there were no other complications in this group. We suggest that ischemic bowel disease should be considered while dealing with cases presenting as acute abdomen or with chronic abdominal pain.

Acute Disease↗
PubMed1990

Adaptative changes in terminal ileum after total colectomy, mucosal proctectomy and straight ileo-anal anastomosis in chronic ulcerative colitis.

Total colectomy, mucosal proctectomy and straight ileo-anal anastomosis was performed in four adult patients with chronic ulcerative colitis (three males, one female; mean age 27.4 years). During a follow-up period of one to five years, all patients were continent, had spontaneous bowel evacuation (average 4-5 per day), and had normal bladder and sexual function. Sequential per rectal ileoscopies revealed loss of ileal folds and gradual transformation to a colonic type of mucosa. On barium studies, the anastomosed terminal ileum showed progressive ballooning and assumed a rectosigmoid appearance with complete disappearance of ileal characteristics. The histology showed a progressive transformation from ileal to colonic type of mucosa, with blunting and ultimate disappearance of villi, increasing goblet cell population, and increase in mononuclear cells in the lamina propria. Histochemical studies (high iron diamine and alcian blue stains) revealed a change from small intestinal to colonic mucin, progressing proximally from just above the anastomotic site. Two patients had a single recurrence with ileal histology resembling that of active ulcerative colitis; both responded to short term steroid therapy. The results of straight ileo-anal anastomosis compare well with Western reports of ileal reservoirs. Adaptative changes of 'colonisation' can be consistently demonstrated in the anastomosed ileum on follow-up; these start just above the anastomotic site and ascend proximally. The colonised ileum appears to be susceptible to the ulcerative disease.

Adult↗
PubMed1990

Morphological changes in esophagus following endoscopic sclerotherapy with 3% aqueous phenol.

Autopsy studies have shown that a majority of sclerosants presently used for endoscopic variceal sclerotherapy achieve their end result by a process of necrotizing inflammation of the esophageal wall followed by fibrosis and thrombosis, rather than bland thrombosis of varices. We have been using 3% phenol in water for variceal sclerotherapy and found it to be an effective sclerosant. To study the effect of this sclerosant on varices and the esophageal wall, autopsies were performed in 15 patients who died following sclerotherapy. Histopathological examination of sections from the esophagus showed (a) fresh thrombus in the varices immediately following injection, (b) intimal damage with medial sclerosis and superficial mucosal ulceration after one week, (c) organisation and recanalization with marked medial sclerosis at 3-4 weeks, and (d) complete obliteration of varices after 6-12 weeks. None of the patients was found to have esophageal necrosis, perforation or mediastinitis. Thus, 3% aqueous phenol appears to be an effective and safe sclerosant for variceal sclerotherapy.

Esophageal and Gastric Varices↗
PubMedDate not supplied

Colloidal bismuth subcitrate in non-ulcer dyspepsia.

The effect of colloidal bismuth subcitrate (De-Nol) on symptoms, Helicobacter pylori status and histological features was studied in 35 patients with non-ulcer dyspepsia. Pain (34 cases) and gas bloat (18) were the predominant symptoms. H pylori was present in 26 (74.3%) patients. Gastritis and duodenitis were present in 29 of 32 and 22 of 31 cases respectively in whom biopsies were available. Relief in symptoms after treatment was seen in 29 (82.8%) cases. Improvement in gastritis and duodenitis was noted in 60.8% and 58.8% respectively; over 70% of H pylori positive patients cleared the organism. These changes did not correlate with the relief in symptoms. We conclude that colloidal bismuth subcitrate is effective in the short term treatment of non-ulcer dyspepsia. It also clears H pylori infection and results in improvement of histological features.

Adult↗
PubMedDate not supplied

Nonfunctioning adrenocortical carcinoma.

The rarity of adrenocortical carcinoma prompted us to report a case who came with a history of swelling in the left flank associated with pain, weakness and loss of appetite. Ultrasonography revealed a left retroperitoneal mass which was removed by radical surgery along with the left kidney and spleen. On histopathological examination, a diagnosis of adrenocortical carcinoma was made. (Hough criteria score 2.97). The cells of the tumor were arranged in closely packed columns and cords supported by fibrovascular stroma. There was no evidence of metastasis.

Adrenal Rest Tumor↗
PubMedDate not supplied

Primary extrapancreatic gastrinoma.

Extrapancreatic gastrinoma is a rare clinical entity encountered in surgical practice. A patient was referred to us who had a history of recurring symptoms of peptic ulcer disease and ulcer perforation located at an unusual site. Serum gastrin levels were abnormally high. Scopy revealed multiple ulcers in the antrum and duodenum. A mass superior to the head of the pancreas was detected on USG, which later on found to be a separate mass on CT scan. The tumour was excised and confirmed on histopathology. Results of conservative surgery were found to be satisfactory.

Adolescent↗