Biomedical subjects

Rajeev Sinha

Publications and source records attributed to Rajeev Sinha.

3 recordsLinked to original sources

PubMed2003

Subeschar clysis in deep burns.

Six hundred thirteen patients with deep burn of up to 50% total body surface area (TBSA) were treated with 0.25% povidone iodine subeschar clysis (PVP-SEC) in addition to surface application of povidone iodine + Neosporin in the form of "crust". The results were compared with those of 595 age, sex and percentage of burn, matched patients treated only by "crust application". The quantitative bacterial count showed significantly less incidence of infection on the 7th and 8th days post treatment (P<0.001). The organisms identified were predominately Staphylcocous aureus and Pseudomonas aeroginosa. Significantly more number of patients, with burns up to 50% TBSA, could be grafted within 20 days in the SEC group. The graft acceptance rate in this group was 90%.

Adult↗

PubMedDate not supplied

Acute cholecystitis and laparoscopic cholecystectomy.

OBJECTIVE: To determine whether laparoscopic cholecystectomy (LC) should be the procedure of choice in treating acute cholecystitis. METHOD: A prospective study was conducted over a 4 1/2-year period. There were 187 patients with acute cholecystitis out of 1020 patients with gallbladder disease who required cholecystectomy. These patients were divided into three groups based on the time interval between the onset of pain and the time patients sought medical attention: Group 1, < 3 days; Group 2, 3 to 7 days; Group 3, > 7 days. All the patients underwent LC after a comprehensive preoperative workup. The parameters analyzed included operating time, hospital stay, and conversion rate. The comparison was made among the various groups and with those who had elective LC. RESULTS: One hundred twenty patients (64.17%) presented for treatment within 3 to 7 days of the onset of an attack. Empyema of the gallbladder was seen in 106 (56.68%) patients and phlegmon of the gallbladder in 42 (22.46%) patients. Group 3 patients had an operative time of 56.2 min as opposed to 18.5 min in Group 1 and 17.5 min in the elective LC group. The conversion rate in Group 3 was 19.5% versus 3.8% in Group 1 and 3.48% in the elective LC group. The complication rate was 7.3% in Group 3, 3.8% in Group 1, and 3.7% in the elective LC group. CONCLUSION: Acute cholecystitis is better managed by laparoscopic cholecystectomy, except in the patients presenting with a gallbladder phlegmon later than 7 days after the onset of the attack.

Acute Disease↗

PubMedDate not supplied

Laparoscopic repair of small bowel perforation.

OBJECTIVES: For years, limiting operative wound sepsis and its resultant morbidity in patients with small bowel perforations has been a major headache for surgeons. The present study was intended to extend the benefits of minimally invasive surgery to traumatic and typhoid small bowel perforations, in terms of assessing its feasibility and limiting wound sepsis. METHODS: Twenty-five patients (20 with typhoid ileal and 5 with traumatic small bowel perforation) presenting within 96 hours of the catastrophe were included in the study. All were explored laparoscopically, and the perforation repaired by intracorporeal suturing. RESULTS: Time of operation varied from 45 minutes to 92 minutes. Two patients developed port-site infection. None of the patients developed postoperative fistula, and no mortalities occurred. Postoperative hospital stay was between 7 days and 10 days. CONCLUSION: Benefits of minimally invasive surgery can be safely and efficaciously extended to select patients with small bowel perforation in terms of limiting sepsis-related wound complications.

Abdominal Injuries↗