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Biomedical subjects

M Rohatgi

Publications and source records attributed to M Rohatgi.

At least 19 recordsLinked to original sources
PubMed1996

Management of metastatic Wilms tumor: an eleven year experience.

During the last 11 years, 101 patients of Wilms tumor were seen. Of these, 13 patients had metastatic disease at onset while 24 patients presented with relapse at a latter date. Seven patients have been cured, all had favourable histology. The risk factors associated with relapse were found to be unfavourable histology, lymph node involvement, age more than 6 years, diffuse spill, capsular and vascular invasion, and aneuploidy. Of the 18 patients who had relapsed, 14 were found to be aneuploid. Judicious use of various therapeutic options like radiotherapy to metastatic sites, second look surgery, resection of pulmonary metastasis and use of cis-platinum, VP-16 and Ifosfamide as "alternative chemotherapy protocols" were used to achieve cure in these advance cases.

Child↗
PubMed1993

The optic nerve in children with craniosynostosis. A pre and post surgical evaluation.

Optic nerve (ON) damage especially from papilloedema can be prevented with timely detection. The detailed ocular and radiographic status of 33 unoperated craniosynostosis (CS) was documented prospectively; the ON was also assessed by flash VER and A-scan echography for ON thickness. Fluorescein angiography (FA) was done for all suspected and early papilloedemas. ON involvement diagnosed in 10/33 showed highly significant correlations with multiple suture synostoses (p = 0.004) and exorbitism (p < 0.001). VER latency was increased in all 5 ON atrophies; and also in 1/5 papilloedemas without atrophic changes, urgent surgery in which reversed VER changes, and vision later improved from 6/60 to 6/9. FA was valuable for confirming the clinical diagnosis of the earliest papilloedemas; the FA also returned to normal with immediate therapy along with reversal of the clinical picture. ON echography especially helped in monitoring regression of disc oedema. Ours seems the first report especially in CS where a critical follow-up of all above parameters in 21 operated/33 could objectively establish the role of each investigation in conjunction with careful clinical monitoring especially of the ON head. Such comprehensive evaluation should help reduce the blindness often seen in such children.

Adolescent↗
PubMed1992

Single-system cecoureterocele.

A rare case of single system cecoureterocele associated with ipsilateral dysplastic kidney in a 4-year-old girl is reported. The preoperative radiological and endoscopic investigations identified ureterocele but not its cecal extension. The latter was diagnosed only during the transvesical surgery. Complete cure of her symptoms was achieved following staged procedures comprising of right ipsilateral nephroureterectomy followed by combined transvesical and transurethral deroofing of the cecoureterocele, excision of ureteric stump and its extension in the bladder and repair of the detrusor. This is the second case report in English language literature of single-system cecoureterocele.

Cecal Diseases↗
PubMed1992

Role of ultrasound guided percutaneous antegrade pyelography (USPCAP) in the diagnosis of obstructive uropathy.

Ultrasound guided percutaneous antegrade pyelography (USPCAP) was performed in 6 cases between 1 month and 8 years age, presenting with obstructive uropathy. The procedure in this age group was characterized by (i) ease of performance without sedation in the neonates and with sedation in older children, and (ii) use of smaller needles and catheters. The procedure enabled delineation of the intimate anatomy of complicated urological abnormalities such as obstructed duplex system, primary megaureters, posterior urethral valves, prune belly syndrome, obstructive hydronephrosis and vesicoureteric reflux. Percutaneous renal puncture may be established rapidly using ultrasonic guidance in severely ill pediatric patients with obstructive uropathy. B-mode ultrasonography has proved to be rapid, accurate and free of radiation hazards, making it applicable to children with little or no sedation. Guided by ultrasound, percutaneous antegrade pyelography should be considered in the few, selected children with obstructive uropathy when the diagnosis is critical for management and difficult with the usual imaging procedures.

Child↗
PubMed1991

Cloverleaf skull--a severe form of Crouzon's syndrome: a new concept in aetiology.

This is a study of 6 patients of cloverleaf skull (CLS) who were treated between 1980 and 1988. All of them had mild to severe degree of craniofacial dysostosis of Crouzon type with variable degrees of exorbitism (pseudoexophthalmus), raised intracranial pressure and mental retardation. All except one patient had maternal H O fever and/or drug intake during the first trimester or toxaemia of pregnancy. The skull X-ray showed typical CLS with expanded middle cranial fossa, foreshortened anterior and posterior fossae and honey-comb appearance in the occiput. Preoperative CT scan revealed generalized hydrocephalus in older patients but only cystic dilatation of the temporal horns in younger infants. The best treatment results were observed in the youngest infant, 7 weeks old, following morcellation cranioplasty, duroplasty, orbital decompression and delayed V.P. Shunt. Fronto-orbital advancement procedure gave satisfactory results in older infants except in those with severe craniofacial stenosis. A delayed CSF shunt is only indicated for progressive postoperative hydrocephalus. Immediate survival was 100% and late 50%. The deaths were due to complications of hydrocephalus. Survival was better in those having less severe Crouzon Syndrome irrespective of the type of surgical treatment. However, timely CSF shunt surgery played an important role in the long term survival, improvement of I.Q., and ultimate shape of head. The study suggests that CLS is a severe malformation of Crouzons disease due to teratogenic damage in the first trimester of pregnancy causing developmental aberration of primary mesenchyme of the neurocranial capsule and base of the skull. The cystic dilatation of the temporal horns is the earliest sign of hydrocephalus and occurs secondary to disturbed growth of the cerebral capsule.

Cerebrospinal Fluid Shunts↗
PubMed1991

Presence of embryotoxic factor in the sera of neonates affected by myelomeningocele: a study on chick embryo.

An experimental study on chick embryos was conducted where 0.02 mL of serum, taken from five neonates (1 to 7 days of age) with myelomeningocele was injected separately into the fertile white leghorn eggs, at zero hour of incubation. A total of 150 experimental and 135 control eggs were injected. It was observed that the embryos of chick exposed to experimental serum had an increased frequency of embryonic death and/or gross abnormalities as compared with the control group (chi 2 = 32.07; P less than .001). The anomalies observed were those of neural tube, gastrointestinal system, and musculoskeletal system. In addition, there was a generalized growth retardation among experimental embryos. These malformations are probably due to an embryotoxic factor, which is present in the serum of the baby with myelomeningocele and has been transmitted transplacentally.

Animals↗
PubMed1990

Echo-Doppler assessment of cardiac status in conjoined (thoraco-omphalopagus) twins.

Cardiac status was assessed noninvasively in a case of thoraco-omphalopagus conjoined twins by two-dimensional and Doppler echocardiography which showed completely separate hearts and major arteries and veins. The twins were successfully separated surgically, without preoperative invasive cardiac investigation. Echocardiography can provide an accurate assessment of cardiac status in conjoined twins and may obviate the need for cardiac catheterization.

Echocardiography↗
PubMed1989

Multicystic kidney in association with hepatoblastoma--a case report.

In the absence of functional renal tissue on the right side, differentiating between a liver tumor and a renal tumor, both clinically and on routine imaging, is difficult. This clinical dilemma is highlighted here in a case report of a 2 year old girl with hepatoblastoma occurring in association with multicystic kidney. To our knowledge no other such case has been reported so far.

Carcinoma, Hepatocellular↗
PubMed1989

Isolated ileal-loop endorectal pull-through: a new approach in the management of complicated Hirschsprung's disease.

The isolated ileal-loop endorectal pull-through was performed on two patients with Hirschsprung's disease complicated by disuse atrophy of the distal colon. In both patients there was not only a short length of the proximal ganglionic colon, which could not be safely pulled down to the perineum, but also nonavailability of the distal aganglionic colon, which had to be resected for nonfunctioning disuse atrophy. This technique allowed a safe endorectal pull-through with primary anal anastomosis, and also prevented complications like frequent watery diarrhea, steatorrhea, malabsorption of vitamins A, D, and K, and pernicious anemia frequently observed following popular surgical procedures for long-segment and total colonic aganglionsis.

Anal Canal↗
PubMed1988

Mesenteric lipoma.

Explore the source record for details and available documents.

Child, Preschool↗
PubMed1987

The presence of intersexuality in patients with advanced hypospadias and undescended gonads.

We studied 20 patients with advanced degrees of hypospadias and undescended testes for the presence of an intersex disorder. A comprehensive clinical, cytogenetic, endocrinological and surgical evaluation was performed. All patients were found to have an intersex disorder, including 10 with male pseudohermaphroditism and 10 with a gonadal/genetic intersex disorder. In the latter group 4 patients had mixed gonadal dysgenesis, 3 had dysgenetic male pseudohermaphroditism, 1 had the 46XX male syndrome, 1 had true hermaphroditism and 1 had Klinefelter's syndrome. Genetic and gonadal intersex disorders were more frequent in patients with a unilateral undescended testis and perineal hypospadias.

Child↗