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Rakesh Sinha

Publications and source records attributed to Rakesh Sinha.

15 recordsLinked to original sources
PubMed2006

Jejunal diverticulosis: sonographic diagnosis.

We report the sonographic appearance of jejunal diverticulosis in 4 cases. Jejunal diverticula appear as multiple peri-intestinal hypoechoic structures on sonographic examination. Many diverticula show communication with the bowel lumen. The diverticular neck formed by the prolapsed mucosal and submucosal layers can be seen as a parallel, echogenic structure traversing the bowel wall. Most diverticula also contain echogenic debris and air-related artifacts. Because jejunal diverticula may be encountered during a sonographic examination, sonologists should be aware of their sonographic appearance to prevent diagnostic errors.

Aged↗
PubMed2003

Laparoscopic excision of very large myomas.

STUDY OBJECTIVE: To evaluate the feasibility, complications, and conversion rate of laparoscopic excision of very large myomas. DESIGN: Prospective study (Canadian Task Force classification II-2). SETTING: Private endoscopy center. PATIENTS: Fifty-one women with at least one myoma larger than 9 cm. INTERVENTION: Laparoscopic myomectomy. MEASUREMENTS AND RESULTS: We removed 78 myomas laparoscopically in these 51 patients. Three patients had two myomas larger than 9 cm, three had two myomas between 5 and 9 cm (in addition to 1 > 9 cm), and one had three myomas between 5 and 9 cm (in addition to 1 > 9 cm). Mean number of myomas removed/patient was 1.53 +/- 1.17 (range 1-6); 12 women (23.5%) had multiple myomectomy. The largest myoma removed was 21 cm. Mean myoma weight was 698.47 +/- 569.13 g (range 210-3400 g). Mean operating time was 136.67 +/- 38.28 minutes (range 80-270 min). Mean blood loss was 322.16 +/- 328.2 ml (range 100-2000 ml). One patient developed a broad ligament hematoma, two developed postoperative fever, and one underwent open subtotal hysterectomy 9 hours after surgery for dilutional coagulopathy. CONCLUSION: Myomectomy by laparoscopy is a safe alternative to laparotomy for very large myomas.

Adult↗
PubMedDate not supplied

Laparoscopic myomectomy: enucleation of the myoma by morcellation while it is attached to the uterus.

STUDY OBJECTIVE: To evaluate the feasibility, blood loss, length of surgery, mean hospital stay, and complications of enucleation of a myoma by morcellation while it is still attached to the uterus and to compare the technique with the standard technique of laparoscopic myomectomy. DESIGN: Randomized study (Canadian Task Force classification II-2). SETTING: Private endoscopy center. PATIENTS: Forty-four patients with symptomatic myomas confirmed by ultrasound examination were included in the study from January 2000 through December 2001 and were randomized into two groups-A and B. The inclusion criteria were the presence of a uterus larger than 12 weeks (on bimanual examination), ultrasound confirmation of the presence of at least one myoma 7 cm or greater in size, and/or presence of three or more myomas greater than 5 cm in size. INTERVENTION: The technique of laparoscopic myomectomy by enucleation of a myoma by morcellation while it is still attached to the uterus was performed in all patients in Group A. The patients in Group B underwent laparoscopic myomectomy by the conventional technique of complete enucleation of the myoma followed by morcellation. MEASUREMENTS AND MAIN RESULTS: Forty-nine myomas were removed in group A and 35 in group B. The mean weight of the myomas removed in each patient was 600.5 +/- 369.1 g in group A (95% CI 452.83-748.17 g) and 584.2 +/- 411.1 g in group B (95% CI 404.05-764.45 g) (p = .706). The mean blood loss was 283.9 +/- 229.3 mL in group A (95% CI 192.20-375.72 mL) and 218.5 +/- 110.7 mL in group B (95% CI 169.96-267.04 mL) (p = .739), the mean hospital stay was 37.91 +/- 5.44 hours in group A (95% CI 35.74-40.10 hours) and 39.5 +/- 3.634 hours in group B (95% CI 37.91-41.09 hours) (p = .236). The mean length of surgery was significantly shorter in group A (97.7 +/- 27.06 min, 95% CI 86.88-108.54 minutes) as compared with that in group B (123 +/- 38.8 min 95% CI 106.93-140.57 minutes), (p = .013). CONCLUSION: Preliminary results suggest that laparoscopic myomectomy employing the technique of enucleation of a myoma by morcellation while it is still attached to the uterus is safe and efficient. It helps to overcome certain technical difficulties inherent in the standard technique of laparoscopic myomectomy. It may help to relax the inclusion criteria of patients with myoma for laparoscopic myomectomy based on the size of the myoma.

Adult↗
PubMedDate not supplied

Laparoscopic metroplasty for bicornuate uterus.

This is a case study of a 29-year-old nulliparous woman with a bicornuate uterus who had a poor obstetric history in whom we performed a laparoscopic metroplasty. She was advised to use barrier contraception for 3 months. A repeat hystero-laparoscopy performed 3 months later revealed a single large uniform uterine cavity without any adhesions. The patient had an incompetent cervical os after surgery and was advised to undergo cervical cerclage on conception.

Abortion, Habitual↗
PubMedDate not supplied

Multiple leiomyomas after laparoscopic hysterectomy: report of two cases.

We report on 2 cases of multiple leiomyomas arising in the pelvis after laparoscopic hysterectomy. One patient underwent laparoscopic myomectomy at 41 years of age and subsequently had a total laparoscopic hysterectomy for myomas 4 years later. Three years post-hysterectomy, she presented with pelvic masses that were removed laparoscopically and were leiomyomas on histopathologic examination. The other patient underwent supracervical hysterectomy for myomas with removal of a parasitic myoma from underneath the dome of the diaphragm. Eight months post-hysterectomy, she came to our office with a pelvic mass with a large myoma that was removed laparoscopically. Disseminated leiomyomas may occur after hysterectomy; and though various theories have been proposed to explain this remarkable entity, none has found universal acceptance. A thorough MEDLINE search did not reveal any reports of large pelvic masses of this size after hysterectomy or their management laparoscopically, and these are probably the first reported cases.

Abdominal Neoplasms↗
PubMedDate not supplied

Abdominal hernias: imaging review and historical perspectives.

Many eminent anatomists originally described abdominal hernias, some of which are still named after the original authors. In this article, the radiologic features of abdominal hernias are reviewed as imaged on x-ray, ultrasound, multidetector computed tomography, and magnetic resonance imaging. Recognition of the typical appearance of various types of abdominal hernias and associated adverse features such as bowel obstruction, perforation, strangulation, or volvulus formation can help in formulating an accurate diagnosis. A short biography of the scientists associated with eponymous hernias and their other important scientific contributions are also described.

Hernia, Abdominal↗
PubMedDate not supplied

Scimitar syndrome: imaging by magnetic resonance angiography and Doppler echocardiography.

We report magnetic resonance angiographic demonstration of both an anomalous pulmonary venous drainage and an anomalous systemic arterial supply in a patient with scimitar syndrome. Contrast-enhanced magnetic resonance angiography provides an excellent non-invasive diagnostic tool for demonstrating this complex congenital lesion in detail. A two-dimensional and colour Doppler echocardiography was also performed to show the anomalous venous drainage and to analyse the anomalous flow velocity pattern.

Adult↗
PubMedDate not supplied

Sarcoidosis presenting as acute bilateral parotid swelling.

A case of bilateral parotid swelling of short duration, which turned out to be sarcoidosis confirmed by fine needle aspiration cytology, is presented here. The patient also had asymptomatic bilateral hilar lymphadenopathy and dryness of the eyes suggesting sarcoid involvement of the lungs and lacrimal glands. Sarcoidosis of the parotids, although rare, should be considered in the differential diagnosis of acute bilateral parotid swelling. Clinico-radiological findings of multi-organ involvement suggest the diagnosis in such cases.

Biopsy, Fine-Needle↗
PubMedDate not supplied

Chronic necrotising pulmonary aspergillosis: a rare complication in a case of silicosis.

Chronic necrotising pulmonary aspergillosis (CNPA) is a rare complication of silicosis whose diagnosis requires a high index of suspicion as it mimics tuberculosis. We report a case of a 52-year-old male with a long history of silica dust exposure and progressively increasing dyspnoea for the past eight years, productive cough, fever, weight loss for past three months and hemoptysis for preceding three weeks. Based on the clinical, radiological and microbiological evidence, he was diagnosed to be a case of CNPA with aspergilloma complicating silicosis.

Aspergillosis, Allergic Bronchopulmonary↗