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Biomedical subjects

R P Tripathi

Publications and source records attributed to R P Tripathi.

17 recordsLinked to original sources
PubMed1995

The failed thoracocentesis.

How often do we consider a differential diagnosis of diaphragmatic hernia in cases of failed thoracocentesis? How many of us remember that omental fat in the chest can behave in a fluid manner, layering along the chest wall, resulting in the misinterpretation of a decubitus view. A case is presented of a diaphragmatic hernia that was missed on conventional chest radiographs resulting in CT having to be performed. A high degree of suspicion is mandatory to reach the final diagnosis. Radiographs could be used more effectively and CT avoided.

Adult↗
PubMed1994

MRI (magnetic resonance imaging) spectrum of epilepsy.

In 361 patients with strong clinical suspicion of secondary epilepsy magnetic resonance imaging (MRI) was performed. Three hundred and forty-five patients revealed a positive study. Maximum number of patients (28.3%) were in the age group of 2 to 12 years without any significant sex predilection. More than 70% patients presented with generalised seizures. MRI revealed definite evidence of tuberculoma in 98, neurocysticercosis in 86, tumour in 60 and cerebrovascular accident in 23 patients. There were 78 patients in miscellaneous group which included patients with magnetic resonance (MR) diagnosis of generalised or focal atrophy, demyelinating disease, hydrocephalus with or without basal exudates, calcification and disappearing lesion. In 16 patients MR was found to be within normal limits.

Adolescent↗
PubMed1993

Surgical treatment of brachial plexus injuries.

Ninety-nine consecutive patients with brachial plexus injuries were operated upon over a period of 8 1/2 years. Among them, 70% sustained traction injuries. The surgical procedures included neurolysis in 35, excision of a lateral neuroma in six and interfascicular sural nerve grafting in 27 patients. In 25 patients, after an exploration, no further surgical procedure was carried out. In four patients, an intercosto-musculocutaneous anastomosis, and in two a trapezius muscle transplant were carried out. Just over two-thirds (68%) of the patients were operated upon 6 months after the injury. Water soluble contrast myelography was performed in 60 patients. These included patients where a root injury had been diagnosed clinically or electrophysiologically. MRI was performed in 14 patients to visualize root avulsions and distal lesions. Operative confirmation of MRI findings were obtained in more than 85% of patients. While an early improvement was seen in patients where only a neurolysis was required, at longer follow-up, gratifying results were recorded even in patients with interfascicular grafts of 6-8 cm length. All 49 patients who came for follow-up and in whom a definitive surgical procedure had been carried out improved. Of these patients, 61% showed near normal or satisfactory functional recovery. The other patients were followed for periods of less than 1.5 years and may show further improvement with time.

Adolescent↗
PubMed1992

Magnetic resonance imaging in occult spinal dysraphism.

A prospective study was carried out in 100 cases of suspected occult spinal dysraphic anomalies with Magnetic Resonance Imaging in order to determine its diagnostic efficacy as the initial imaging modality. MR imaging provided accurate preoperative information in 91 out of 92 cases (98.9%). Some of the unusual and interesting findings in the series were: presence of intrinsic cord abnormality in 19 out of 21 cases (90.4%) with a normal plain radiograph, 4 cases of diastematomyelia with a dermoid in the dorsal and lumbar region associated with syringohydromyelia, intradural fibrous/glial bands, syringohydromyelia/myelomalacia of the conus with tethered cord syndrome having a normally placed conus, and myelocystocele. It is concluded that MRI is an excellent primary diagnostic tool, together with a plain radiograph, for complete preoperative evaluation of mid-line spinal anomalies.

Adolescent↗
PubMed1992

Undescended testis: evaluation by magnetic resonance imaging.

We describe our experience of prospective magnetic resonance imaging (MRI) study in patients of undescended testis, with a 1.5 T equipment using body coil. There were thirty two patients, aged 1.5 to 14 years with a mean age of nine years. Surgical follow up was obtained for thirty one patients. We were able to indicate the position of 26 testes in 22 patients and absence of five testes in three patients. MRI was falsely positive and negative for five and two testes, respectively. Testicular tissue at ectopic site was identified by presence of characteristic signal intensity pattern, mediastinum testis and its location along empty spermatic canal in cases of inguinal testis either singly or in combination. MRI was able to detect atrophic changes in four testes, confirmed on surgery. The study concludes that MR imaging is useful in the localization and tissue characterization of a non palpable testis. However, it is not sensitive enough for complete exclusion of the diagnosis of an undescended testis. Thus a surgical or laproscopic exploration may be needed further in selective cases for the management of patient.

Abdomen↗
PubMed1991

Magnetic resonance imaging in childhood epilepsy.

One hundred and seventy children of chronic seizures with strong clinical suspicion of an underlying intracranial lesion as its cause were studied by Magnetic Resonance Imaging (MRI). Maximum number of patients were between 6-12 years, males outnumbering females. Structural abnormalities were seen in 158 of the 170 patients. The study revealed tuberculoma as the commonest lesion in this series (n = 64) followed by cysticercosis (n = 27). Three patients were seen to have glioma. An interesting finding was disappearing lesion in 6 children. MRI proved to be an excellent modality in demonstrating and characterising the intracranial lesion.

Brain Diseases↗
PubMed1982

A psychiatric study of amputees.

Psychiatric manifestations were studied in 72 amputees in the post-operative period. All were right handed. Besides phantom limb phenomena, which were observed in nearly four-fifths of the cases and are described in another paper, nearly two-thirds had psychiatric symptoms inthe form of depression (45 patients), anxiety (38), crying spells (38), insomnia (34), loss of appetite (23), suicidal ideas (21) and psychotic behaviour (2). Right arm amputees had phantom phenomena and insomnia significantly more often than left. Nearly one-fifth of the cases were diagnosed as having psychotic depressive reactions, two-fifths as having depressive neurosis and two, both with right upper limb amputations, as schizophrenic.

Adolescent↗
PubMed1982

Phantom limb: a phenomenological study.

Phantom limb phenomena during the post-operative period were studied in 72 amputees. All were right handed. Phantom limb was present in 86.1 per cent of the cases, significantly more commonly amputation of the right arm. Nearly half of the phantoms developed within the first 24 hours and another quarter in the next 24 hours, appearing earlier in lower limb amputees. Movements in the phantom were felt by three-quarters of the cases, an incidence unaffected by site or side of amputation. Telescopy was present in nearly two-thirds and phantom limb pain in over two-thirds, significantly more commonly in the upper limb amputees but uninfluenced by the side of amputation. Thirty-one of the patients dreamed that their limbs were intact.

Adolescent↗
PubMedDate not supplied

Adenosine deaminase activity in pleural fluid--a diagnostic test of tuberculous pleural effusion.

Adenosine deaminase (ADA) activity in pleural fluids was studied in 47 patients with pleural effusion of different etiology. Patients were divided into two groups: Group I - Tuberculous pleural effusion (21 patients): Group II - Non tuberculous effusion (26 patients) and these included malignant pleural effusion (9 cases), synpneumonic pleural effusion (9 cases) and transudative pleural effusion (8 cases). The mean ADA activity was 64.67 IU/L +/- 21.68 in group I and 6.99 +/- 3.69 in Group II. Increased mean pleural fluid ADA activity in tuberculous pleural effusion was highly significant (p < 0.001) when compared with pleural effusion of non-tuberculous etiology. Based on lowest value of ADA activity found in tuberculous pleural effusion (30 IU/L), the test has a sensitivity and specificity of 1.

Adenosine Deaminase↗