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Biomedical subjects

P Mandhan

Publications and source records attributed to P Mandhan.

7 recordsLinked to original sources
PubMed2004

Sigmoidoscopy in children with chronic lower gastrointestinal bleeding.

OBJECTIVE: This study was done to assess the role of rigid sigmoidoscopy in diagnosis and prognosis of children with chronic and minor lower gastrointestinal bleeding. METHODS: Retrospective review of the clinical notes of children under 15 years of age with minor and chronic lower gastrointestinal bleeding who had rigid sigmoidoscopy and biopsy between October 1998 and April 2002 at Liaquat Medical College Hospital, Hyderabad, Pakistan. Demographic data, clinical presentation, morbidity, sigmoidoscopic and histopathological findings were analysed to determine the role of rigid sigmoidoscopy in the management of rectal bleeding in children. RESULTS: A total of 229 sigmoidoscopic examinations were carried out in 207 children with a mean age of 6 years. Seventy-seven per cent (160) of children were symptomatic for a year or more. Causes of bleeding were juvenile colorectal polyps (155 cases; 75%), non-specific proctitis (38 cases; 18%), solitary rectal ulcer (seven cases; 3.5%), lymphoid nodular hyperplasia (six cases, 3%) and foreign body (betel nuts) impaction (one case; 0.5%). Polyps were mostly in the rectosigmoid region and solitary in 136 (88%) children. All polyps were removed by rigid sigmoidoscopy. Histological examination of 137 polyps revealed juvenile type in 136 (99%) cases and low-grade dysplastic changes in one patient. Non-specific proctitis (n = 38) was confirmed histologically in 92% (n = 35) of cases and it was self-limiting in 86% of cases. Other findings include solitary rectal ulcer in seven, lymphoid nodular hyperplasia in six and telangiectasic (pyogenic) granuloma in one patient. CONCLUSION: Rigid sigmoidoscopy was useful in diagnosis, treatment and prognostic evaluation of children with chronic and minor lower gastrointestinal bleeding. Final diagnosis was confirmed by histopathology.

Adolescent↗
PubMed2000

Outpatient pediatric surgery in a developing country.

OBJECTIVE: To access the prospects of daycare pediatric surgery in a developing country like Pakistan in view of economic advantages, parent's acceptability and utilization of hospital resources. METHODS: This prospective study was carried out in Karachi from 1st January 1994 to 31st December 1996 in three different private hospitals having optimum operating, anaesthetic and recovery facilities. Selection criteria included general fitness for surgical procedure, not requiring hospitalization, no associated congenital malformation and co-operative parents residing in Karachi. An evening before surgery, all patients were examined thoroughly and detailed instructions for pre-operative fasting and pre-medications were given to the family. Operations were carried out by same surgical team with different set of anesthetists. After surgery and recovery from anesthesia, the children were observed in a holding area adjacent to operating room till fully conscious and alert. Before leaving the hospital, the parents were briefed about post-operative care at home like feeding, ambulation and use of analgesics. A contact telephone number was also provided to the family for any difficulty or emergency. All patients were re-examined 36-48 hours post-operatively in clinic, for any problem at home and the parents were assessed for their attitude toward this modality. RESULTS: In 3-year period a total of 368 surgical procedures were carried out of whom 129 operations were done in children under 1-year of age and the youngest patient was one week old with a weight of 2.9 kg. The average age was 2.9 years and average weight was 13 kg. Male:female ratio was 3.6:1. The average operating time was 28 min, average anaesthesia time was 38 min and average recovery time was 17 min, which was not affected by the use of endotracheal tube. Majority of parents managed their children very well at home and only 17% of them called one of the surgeons to inquire about their apprehension at home and all were explained and satisfied. On an average 37% children required two doses of post-operative oral analgesia and 59% returned to normal activity after 24 hours. The overall incidence of complication was 3.6% and there were no deaths or major complications. Only one patient required post surgical hospitalization due to post-operative pneumonia. The mode of management was cost effective and also the parents appreciated the avoidance of hospitalization because of less disruption of their routine work at home and office. CONCLUSION: Based on the above experience, we recommended that a variety of common pediatric operations can be done safely as out patients in infants and children, with economic advantages, high parent's acceptability and better utilization of hospital resources without scarifying the quality of health services.

Ambulatory Surgical Procedures↗
PubMed1999

Recanalization of a portal-vein thrombosis and partial resolution of biliary cirrhosis following cholecystectomy for cholelithiasis in an infant.

Cholelithiasis in infants and children is unusual and is reputedly associated with underlying hemolytic disorders, total parenteral nutrition, ileal disease, and congenital anomalies of the biliary tree. We report a case of cholecystitis with pigmented stones in a 3-month-old infant associated with portal vein thrombosis (PVT) and biliary cirrhosis without the above-mentioned causes. Recanalization of the PV and partial resolution of the cirrhosis was observed following cholecystectomy. To our knowledge, cholelithiasis associated with PVT and cirrhosis in an infant has not been reported in the literature.

Biopsy, Needle↗
PubMed1998

Introducing the Internet to medical practitioners.

The benefits of using the Internet to medical practitioners are growing rapidly, as the Internet becomes easier to use and ever more biomedical resources become available on net. The Internet is the largest computer network in the world that connects millions of computers in a web and makes almost immediate communication possible, irrespective of the location of its users. There are various ways to be connected with Internet and once connected, it is easy to take advantage from this space of unlimited potentials. Several Internet applications are available today that will bring more information to the doctors' desk. Although, it is difficult to predict the future of medicine on the Internet, but the net has opened up many new possibilities for medical professionals, which were not available through previous technologies. It is now up to them to realize the Internet's full potential. A non-technical overview of Internet, a glimpse of electronically available information and the methods available to access, manipulate and disseminate biomedical data from the Internet are discussed. These methods are useful for beginners as well as beneficial for experienced physicians.

Communication↗
PubMed1994

Respiratory obstruction caused by lipoma of the esophagus.

A four-year-old boy presented with wheezing of 5 months' duration after a cold. During examination, an opacity was noted in the superior mediastinum, causing displacement of the trachea to the right. A barium swallow showed a mass in the wall of the esophagus, occupying the lumen, without causing any obstruction. Through further examination by computed tomography and magnetic resonance imaging, the mass was confirmed to be a lipoma in the wall of esophagus, causing displacement of trachea. The mass was removed via the transcervical approach, and the postoperative course was uneventful. Respiratory obstruction caused by a lipoma of esophagus in childhood had not been reported in the English language literature.

Child, Preschool↗