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Biomedical subjects

M Bhandari

Publications and source records attributed to M Bhandari.

125 records · Page 7Linked to original sources
PubMed1983

Strictures of the penile urethra.

One hundred and eighty-seven patients with urethral strictures have been treated over a period of 2 1/2 years. In nearly 50%, strictures were confined to the penile urethra, involving the meatus, the fossa navicularis or varying lengths of the urethra up to the bulb. Of these, 95.3% were inflammatory in nature. Overall, 85.5% were managed with a single surgical procedure. The single-stage technique using a skin inversion pedicled flap was done in 15 cases and was found to be useful, with less morbidity than the staged procedure.

Adolescent↗
PubMed1983

Point of focus: poor genital hygiene and terminal urethral strictures.

Males attending the urology clinic with strictures of the terminal urethra were studied. Evident frank balanoposthitis, subpreputial calculi and infected urine in the preputial sac were seen in a sizable number, 35% of them were suffering from a second urethral stricture also, either in continuity over the whole length of the penile urethra or in the bulbomembranous area. Balanitis xerotica obliterans was responsible for those terminal urethral strictures in nearly 20%. All patients required terminal urethroplasty in addition to appropriate surgical procedures for other stigmata. Knowledge and sense of hygiene of the genitalia were lacking in most of the patients.

Adolescent↗
PubMed1979

Malignant pericystitis plastica.

A case of infiltrative bladder tumor presenting as diffuse perivesical and periureteral fibrosis is presented and termed malignant pericystitis plastica.

Aged↗
PubMed1977

Ileal replacement for gunshot injury of the ureter.

A case of gunshot injury of the upper third of the ureter is reported. The injury was managed by ileal replacement with complete conservation of the kidney, after an attempt at primary repair had failed. A survey of the literature has not disclosed any previous report of a gunshot injury of ureter being treated by this method. However, we recommend it only in cases where the conventional procedure of end-to-end repair fails.

Adult↗
PubMedDate not supplied

High pressure pulsatile lavage of contaminated human tibiae: an in vitro study.

OBJECTIVE: This study was designed to examine the effect of high pressure pulsatile lavage (HPPL) on bone destruction and propagation of bacteria in experimentally contaminated human tibiae. METHODS: Using an in vitro model, nine human tibiae from above-knee amputations were tested. A mid-diaphyseal tibial shaft fracture was created, and each end of the fracture was contaminated with bacteria (six tibiae with Staphylococcus aureus, three tibiae with Escherichia coli). The proximal end was designated as the control and the distal end was the test site. The test site was debrided by HPPL (seventy pounds/square inch, 1,200 milliliters/minute, 1,050 cycles/minute) with three liters of normal saline, whereas the control site did not receive any form of irrigation. Serial sections at increasing distance from the fracture site were cultured and the numbers of bacterial colony-forming units (CFUs) were determined at each level. The degree of macroscopic architectural change in each serial section was graded on an ordinal scale. RESULTS: Analysis of culture data revealed a reproducible pattern of bacterial propagation into the intramedullary canal. Peak bacterial seeding occurred at two to three centimeters from the fracture site (p = 0.023, Wilcoxon signed rank test). The degree of bone destruction varied proportionally with the depth into the canal and was found to be predictive of the extent of bacterial propagation determined by culture data. CONCLUSION: In an in vitro model of a contaminated fracture, HPPL resulted in bacterial seeding into the intramedullary canal and significant damage to the architecture of the bone. These observations might have clinical significance.

Bone and Bones↗
PubMedDate not supplied

Stone composition, metabolic profile and the presence of the gut-inhabiting bacterium Oxalobacter formigenes as risk factors for renal stone formation.

OBJECTIVE: To examine stone composition, metabolic evaluation and colonization of Oxalobacter formigenes as risk factors for renal stone formation. SUBJECTS AND METHODS: Eighty patients with renal stones and 70 healthy controls were enrolled in the study. Of the 80 patients, 48 were first-time stone formers (FSF) and 32 were 'recurrent' stone formers (RSF), recurrent indicating 2 or more episodes of stone formation. Stone analysis by X-ray crystallography, 24-hour urine metabolic profile and detection of O. formigenes-specific DNA by PCR were performed for each patient. Detection of O. formigenes was also performed on 45 and urinary metabolic profile on an additional 25 controls. RESULTS: Calcium oxalate monohydrate was the major component of stones, hyperoxaluria and hypocitraturia were the most common urinary abnormalities in the 80 patients, 46% of RSF patients had hypercalciuria. Urinary abnormalities were far less frequent in the controls, with the exception of hypocitraturia (40%). Of the urinary metabolites, only calcium levels were significantly different (p < 0.05) between FSF (6.50 +/- 4.08 mmol/24 h) and RSF (8.21 +/- 5.26 mmol/24 h) patients. Colonization of O. formigenes was higher in controls (62.2%) than in FSF (33.3%) or RSF (28%) patients, it was least in patients with more than 4 episodes (7%) of stone formation. CONCLUSION: The findings indicate that lack of colonization of O. formigenes may be an important risk factor for recurrence of stone formation (calcium oxalate monohydrate).

Adult↗
PubMedDate not supplied

Laparoscopic surgery for reflux esophagitis and paraesophageal hernia.

BACKGROUND: Laparoscopic surgery has become the standard for treatment of several abdominal diseases. We analyzed our data on laparoscopic treatment of reflux esophagitis and paraesophageal hernia. METHODS: Twenty patients (mean age 61 y; 14 men) - 18 with reflux esophagitis and sliding hiatus hernia, and two with paraesophageal and sliding hernia - were operated on using laparoscopy between March 1999 and March 2001. All patients were investigated by upper GI endoscopy, barium study and routine pre-operative work-up. Nineteen patients underwent a modified Nissen fundal wrap along with repair of the diaphragmatic crura; one patient had only crural repair with no fundal wrap. RESULTS: All procedures were completed laparoscopically. The mean operating time was 140 min (range 90 to 240). Eighteen patients were discharged on the third postoperative day and two on the fifth day. One patient had perforation of intrathoracic part of the esophagus during passage of an esophageal bougie; he presented with empyema 10 days after discharge and was treated by intercostal drainage. There were no other complications. All patients have been followed up on an outpatient basis for 3 months to 2 years. All are presently off acid-suppressive therapy. Seventeen patients are free of symptoms; two patients have gas bloat-like symptoms and one has occasional grade I dysphagia. CONCLUSIONS: Laparosopic surgery is a safe and effective method of treating esophagitis and paraesophageal hernia.

Adult↗
PubMedDate not supplied

Percutaneous ureterolitholapaxy: the best bet to clear large bulk impacted upper ureteral calculi.

OBJECTIVES: The outcome of treating impacted upper ureteral calculi by extra corporeal shock wave lithotripsy was less satisfactory than antegrade litholapaxy in our earlier experience. During a four year period (October 1988 to September 1992) 86 reno-ureteral units with impacted upper ureteral calculi were treated by percutaneous litholapaxy. We review our methods and results of this accumulated experience. METHODS: Moderate to severe proximal hydronephrosis on excretory urography or ultrasound was taken as evidence of impaction. Antegrade extraction was performed in a single stage, except in patients who presented with anuria, severe azotemia and urosepsis where the system was decompressed by initial nephrostomy drainage. RESULTS: 86 impacted upper ureteral calculi in 80 patients were treated by the percutaneous antegrade approach. Eleven were in a solitary functioning unit; 33% presented with moderate to severe renal failure. The average stone size was 256 sq mm. Associated renal calculous disease was present in 22 ipsilateral and 28 contralateral units. Total clearance was achieved in 74 units (86%) by antegrade litholapaxy alone. Adjunct ESWL (5) and ureteroscopy (4) rendered 96% of the units free; 3 units with recurrent calculi were salvaged by ESWL (2) and ureterolithotomy (1). Complications encountered in 17 (20%) patients were fewer in 13 (16%), ureteric perforation in 7 (9%), hematuria in 6 (7%) and ureteric stricture 1 (1%). Hospital stay was 5 days in uncomplicated cases; prolongation of stay (average 8.8 days) was necessitated in staged procedures (sepsis, renal failure), treatment of the contralateral unit or due to postoperative morbidity. The majority of the stones (80%) were of the calcium oxalate monohydrate variety. CONCLUSION: It is concluded that failing a retrograde manipulation, percutaneous ureterolitholapaxy offers the best bet to clear large bulk impacted upper ureteral calculi.

Adolescent↗