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P Lal

Publications and source records attributed to P Lal.

At least 19 recordsLinked to original sources
PubMed2003

Transurethral resection of the prostate as catheter-free day-care surgery.

OBJECTIVE: To evaluate the feasibility of transurethral resection of the prostate (TURP) as catheter-free day-care surgery. PATIENTS AND METHODS: The study comprised 64 patients (mean age 62.4 years) with a mean (range) American Urological Association symptom score of 21.4 (9-31) and prostate volume (by ultrasonography) of 32.8 (17-50) mL, and with no significant comorbidity. The patients were admitted on the morning of the surgery and, under brief spinal anaesthesia, underwent standard TURP. After surgery the urethral catheter was removed as soon as the effluent was clear. The patients were discharged after they could pass urine freely and with a good stream. RESULTS: The mean duration of catheterization after TURP was 7.15 h; 59 patients (92%) had their catheter removed within 10 h (mean duration 6.42 h). There were no major complications during or after TURP. After removing the catheter, no patients required its reinsertion for failure to void or for clot retention. The mean hospital stay after TURP was 10.7 h and 98% of patients were discharged within 23 h of surgery. CONCLUSION: TURP can be conducted safely in a day surgery setting in patients with mild to moderate benign prostatic enlargement and no coexisting medical illness.

Aged↗
PubMed2002

Results of radiotherapy with, or without, salvage surgery versus combined surgery and radiotherapy in advanced carcinoma of the hypopharynx.

There is considerable controversy surrounding the optimum treatment of advanced hypopharyngeal cancers. Curative radiotherapy with surgical salvage in reserve is an accepted protocol as is also a combined treatment of surgery and radiotherapy. The present study is a retrospective analysis of the survival results of 195 cases treated in a single centre. The combined surgery and radiotherapy group comprised a greater number of pyriform fossa and post-cricoid tumours whereas, the curative radiotherapy group had a higher proportion of posterior pharyngeal wall tumours. Actuarial two-year disease-free survival rates were significantly better with combined treatment when results of stage III and IV lesions (164 patients) of all sites are taken together, as compared to those obtained with curative radiotherapy without salvage (p = 0.000) or radiotherapy with surgical salvage for residual/recurrent tumours (p = 0.0021).

Adult↗
PubMed2001

Postcoital vaginal laceration in a patient presenting with signs of small bowel perforation: report of a case.

Postcoital vaginal rupture or tear is a well-known entity to the gynecologist, albeit unusual; however, such cases are rarely encountered by the general surgeon. The index case is reported to highlight the rare situation wherein a middle-aged woman underwent laparotomy for a suspected small bowel perforation, which revealed a vaginal tear as the cause of pneumoperitoneum. This case emphasizes the importance of taking a gynecological history and performing a gynecological examination when the clinical diagnosis is uncertain.

Coitus↗
PubMed2001

Bacteriology of burn wounds--the first three years in a new burn unit at the Medical College Chandigarh.

A retrospective study was conducted at Government Medical College and Hospital, Chandigarh to analyse the bacterial isolates from the wounds of patients admitted to the Burns Unit and to determine the sensitivity pattern of the commonly cultured organisms over a 3-year period from May 1997 to May 2000. A total of 336 samples were analysed, with 293 positive samples yielding 324 isolates. The isolates obtained from the culture of wound swabs were single in the majority of cases (78.0%). Pseudomonas was the most commonly cultured organism (54.2%) followed by Staphylococcus aureus (20.8%). Isolation of other organisms was uncommon by comparison. No isolates of beta-hemolytic streptococci or diptheroids were encountered.

Bacteria↗
PubMed2001

Squamous cell carcinoma arising from a congenital duplication cyst of the esophagus in a young adult.

Squamous cell carcinomas arising from the congenital anomalies in the esophagus are rare. One such case of an 18-year-old man, with an associated history of ventricular septal defect, who developed an epithelial malignancy within the duplication cyst extending to involve the lower third of esophagus is presented here. He responded well to radical treatment using concurrent chemo-irradiation, and continues to be free of disease after a follow-up of 14 months.

Abnormalities, Multiple↗
PubMed2001

Management of retinoblastoma with radiation.

OBJECTIVE: To evaluate the role of radiation therapy in the management of retinoblastoma. DESIGN: Retrospective analysis. METHOD: From January 1993 to March 1994, one hundred and eleven children (150 eyes) of retinoblastoma were referred for radiotherapy. The diagnosis was based on clinical examination and ocular ultrasonogram for both the eyes. The radiation treatment policy involved 40 Gy in 20 fractions over 4 weeks delivered with sedation for children under 1 year of age, 36 Gy in 9 fractions over 3 weeks under ketamine anesthesia for 1-4 years of age and for >4 years of age, a dose of 50 Gy in 25 fractions over 5 weeks. The initial tumor regression was evaluated by A and B mode ultrasonography and/or CT scan. RESULTS: The age distribution ranged from two months to six years (median - 20 months). Bilaterality was observed in 39 out of 111 cases (35%). The male to female ratio was 1.8:1. Eighty two of the 111 children were treated by definitive external beam radiation to one or both eyes. Fifteen cases received adjuvant radiotherapy after enucleation, and 14 had extensive disease for which palliative radiotherapy was offered. We observed a complete response in 54% of cases, partial response in 32%, and none in 14% of cases. Forty per cent (40%) eye survival was documented at the end of 28 months. The complication rate encountered was about 15%. CONCLUSION: Radiotherapy is an effective modality of treatment in significant number of patients with retinoblastoma. However, it requires appropriate fractionation, precise colimation and careful immobilization with general anesthesia.

Child↗
PubMed2000

C282Y mutation and hepatic iron status in hepatitis C and cryptogenic cirrhosis.

BACKGROUND: Increased iron deposition in liver is seen in both primary and secondary hemochromatosis. However, it is not uncommon to see significant iron deposition in a liver biopsy, explant, or autopsy specimen without any significant clinical risk factor. Because of the discovery of the candidate gene (HFE) for hereditary hemochromatosis, we may now be able to screen high-risk patient populations for the abnormal mutation (C282Y). MATERIALS AND METHODS: In this study we analyzed the livers of 50 transplant patients with a diagnosis of either hepatitis C cirrhosis or cryptogenic cirrhosis for the prevalence of the more common C282Y mutation of the HFE gene and correlated the findings to hepatic iron concentration. RESULTS: Of the 26 cases of hepatitis C cirrhosis, 3 were found to be heterozygous for the C282Y mutation. Of the 22 cases of cryptogenic cirrhosis, 1 was found to be heterozygous for the C282Y mutation. Stainable iron was increased in hepatitis C cirrhosis (76.9%) as compared to cryptogenic cirrhosis (50%) (P =. 05). Of the 3 heterozygotes with hepatitis C cirrhosis, 2 showed hepatic iron concentrations of 3+ and 4+, and 1 showed 1+. CONCLUSIONS: We conclude that patients with hepatitis C have an increased tendency to accumulate iron in the liver, and mutations in the HFE gene play a minor role in hepatic accumulation of iron in these patients.

Amino Acid Substitution↗
PubMed2000

Primary CNS lymphoma: an audit of cases treated over a nine year period and review of the literature.

Primary CNS lymphoma is a rare tumor comprising around one percent of all brain tumors. This report is an audit of eight cases [5 males, 3 females, age range: 17-55 years] which were accrued over nine years. All patients underwent surgical decompression, followed by radical Radiotherapy [RT]. Five out of eight patients received adjuvant chemotherapy in the form of CHOP or PCV. Of the patients who relapsed two received CHOP as a salvage therapy, one received PCV therapy and lomustine with intrathecal methotrexate. At a median follow up of 16 months [range 1 to 39 months] the two year disease free survival and overall survival were 13 percent and 38 percent respectively, which is in accordance with the literature. High dose RT to whole skull with boost therapy is indicated for all the cases. However, the role of chemotherapy and the appropriate regime needs to be defined with certainty.

Adolescent↗
PubMed2000

Difficulties of the staff posted for intensive pulse polio immunization in Delhi.

Forty three staff members present on 18 booths for intensive Pulse Polio Immunization were interviewed anonymously during the first round of the programme on 24th October, 1999 to find out their problems likely to affect successful implementation of the programme. The observation revealed some of the problems such as long distance between residence and the booth (46.5%), difficulty in locating the booth (72%), lack of training (90.7%), improper meals (69.7%) and lack of toilet facilities (37.2%). Suitable modifications should be made in light of the observations to secure full support of the staff for success of the programme.

Adult↗
PubMed1999

Dermatofibrosarcoma protuberans metastasizing to lymph nodes: a case report and review of literature.

Dermatofibrosarcoma Protuberans (DFSP) is an uncommon cutaneous soft tissue tumor. It is locally invasive and is known to recur. Metastases are rare and occur most commonly to the lungs. Metastasis to lymph nodes is extremely rare with only a few case reports in literature. The management strategy for such lymph node metastases remains controversial because of rarity of the condition. We report a case of DFSP of the lower limb with definite inguinal node secondaries managed by loco-regional surgery. We recommend that block dissection of lymph nodes should be performed in all cases with secondaries. J. Surg. Oncol. 1999;72;178-180.

Adult↗
PubMed1999

Accessory limbs associated with spina bifida - a second look.

An accessory limb associated with spina bifida was already reported by the authors. We had then described it as a result of a very early splitting of the limb bud arising from the paraxial mesoderm. We have subsequently seen three other such cases, which are described in this report as well as a review of five other cases in the literature. It is proposed that the growth of the accessory limb occurs from a mesodermal blastema that is a result of de-differentiation from Schwann cells.

Abnormalities, Multiple↗
PubMed1999

Presurgical serum albumin levels predict survival time from glioblastoma multiforme.

To determine whether serum albumin levels, before first surgery, predict time until death, 24 glioblastoma multiforme patients newly diagnosed at Ohio State University and Cleveland Clinic Foundation Hospitals between 1993 and 1995 were followed until 1996. Patients with presurgical serum albumin levels below 3.4 mg/dL survived an average (median) of 62 days (95% confidence interval (CI): 34, 135 days) after surgery. Those with serum albumin levels of at least 3.4 mg/dL survived an average of 494 days (95% CI: 241, 624 days). The association between serum albumin level and time until death persists when adjusted for demographic and treatment variables using Cox proportional hazards regression. Adjusted hazard ratios, by quartile of presurgical serum albumin level, are: 1.0, 1.2, 0.1, 0.1 (P-value for trend test = 0.007). In addition to providing a prognostic indicator, presurgical serum albumin levels can be used to evaluate the success of randomization of clinical trials for glioblastoma multiforme therapies. Our findings are consistent with results seen for tumors at other sites. We speculate that our results may be attributable to an association between low serum albumin levels and physiological events associated with angiogenesis.

Female↗
PubMed1999

Carcinoma of the penis metastasizing to the dorsal spine. A case report.

Carcinoma of the penis tends to have a predictable route of spread by direct invasion and by regional lymphatic involvement to the inguinal group of lymph nodes. Blood-borne distant spread is rare, last to occur, and is seen in 1-3% of cases. Metastasis to the spine is even rarer. We encountered one such case who presented with spinal metastasis, as documented by the whole body bone scan, and this was later followed by involvement of the inguinal nodes. This case is unique in its site of metastatic presentation as well as its pattern of presentation.

Aged↗
PubMed1999

AIDS-related apprehensions among nursing students of Delhi.

Students from a nursing school of Delhi were surveyed anonymously using a self-administered questionnaire to explore various AIDS-related apprehensions and their possible reasons. The observations revealed that, majority of the students and their families/friends feared that these students were at risk of contracting HIV infection while providing routine patient care. A large number of students also opined that they would feel uncomfortable while talking, hugging, shaking hands, and sharing a room with an HIV positive person. The main reasons for their apprehensions were unsatisfactory anti-AIDS campaigning by the government, non-availability of sufficient protective measures in the health care settings, inadequate professional education related to prevention of HIV infection, and increase in HIV transmission following false sense of security due to excessive condom promotion. Findings of the study imply imparting factual knowledge addressing the concerns and removing misconceptions which influence attitudes and willingness of the nursing students to provide care to the HIV positives/AIDS patients, facts regarding efficacy of various preventive measures, and provision of counselling services in the event of exposure.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Congenital H-type urethroanal fistula.

A case of congenital urethroanal fistula with a normal anterior urethra in a male child is reported. The fistula was demonstrated between the prostatic urethra and anorectum. This anomaly is usually associated with an atretic anterior urethra and has been variously described as a variant of a urethral duplication by some authors, and of an anorectal malformation (ARM) by others. We conclude that its rightful classification is as a variant of ARM in which the fistula is a result of persistence of the cloacal duct and corresponds to the anorecto-vestibular fistula with a normal anus (perineal canal) in a female.

Humans↗