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Biomedical subjects

S A Nanivadekar

Publications and source records attributed to S A Nanivadekar.

At least 19 recordsLinked to original sources
PubMed1996

Esophageal tuberculosis with intramural pseudodiverticulosis.

Esophageal tuberculosis is rare, and its association with intramural pseudodiverticulosis is not widely appreciated. We report a patient with dysphagia who proved to have esophageal narrowing, mediastinal lymphadenopathy, and intramural pseudodiverticulosis. Results of endoscopy and biopsy were nonspecific, but biopsy of the supraclavicular node showed histology consistent with tuberculosis. The patient experienced a dramatic response to antitubercular therapy, with resolution of the esophageal narrowing, mediastinal lymphadenopathy, and esophageal intramural pseudodiverticulosis.

Adult↗
PubMed1996

Gallbladder varices: diagnosis in children with portal hypertension on duplex sonography.

We established the prevalence of gallbladder varices (GBVs) as seen on duplex sonogram of children with portal hypertension. Fifty-five consecutive children with portal hypertension underwent duplex sonographic examination by an experienced sonologist who was blinded to clinical presentation. Forty children had extrahepatic portovenous obstruction (EHPVO), 12 had cirrhosis, and three had noncirrhotic portal hypertension. GBVs were seen on sonography in 10 of 40 children with EHPVO (25%), two of 12 children with cirrhosis (16.6%), and no children with noncirrhotic portal hypertension. Sonographic findings of GBVs were confirmed on duplex sonographic imaging. Among patients with EHPVO, GBVs did not correlate with size of esophageal varices, number of sessions of sclerotherapy, presence or absence of gastric varices, portal gastropathy, or splenorenal shunt placement. In cirrhotic patients, GBVs did not correlate with Child Pugh grade. Children with EHPVO have a higher incidence of developing GBVs. The clinical significance of GBVs is their propensity to bleed during biliary surgery; thus, the operating surgeon should be made aware of them.

Child↗
PubMed1996

Esophageal dilation in pediatric patients using balloon along the side of the endoscope.

Balloon dilation is an effective modality of treatment for esophageal strictures. As standard through-the-scope balloons do not pass through the biopsy channel of pediatric endoscopes, we have developed a technique by which these balloons can be used in pediatric patients by passing them alongside the endoscope. We report our experience of dilation in four patients using this technique.

Catheterization↗
PubMed1996

Achalasia cardia dilatation using polyethylene balloon (Rigiflex) dilators.

OBJECTIVE: Results of 20 dilatation sessions in 15 patients with achalasia cardia were assessed to determine the safety and efficacy of polyethylene balloon achalasia dilators (Rigiflex). METHODS: All patients underwent an initial dilatation by inflating a 30 mm balloon to 9 psi for one minute. Need for subsequent dilatations was assessed on symptom assessment; 35 mm balloon was used for repeat procedure. RESULTS: Overall success rate was 93.3%. The 30 mm balloon achieved a satisfactory result in 73.3% and the 35 mm balloon in 75% of the remainder. Only one patient needed surgery. No short-term complications were observed. The only late complication encountered over an average follow-up period of 16.2 months was gastroesophageal reflux in two patients. CONCLUSIONS: Dilatation using Rigiflex dilators is a safe, effective and simple procedure for treating patients with achalasia.

Adolescent↗
PubMed1996

Asymptomatic spinal tuberculosis presenting as esophageal stricture.

Esophageal tuberculosis is rare and is usually due to secondary extension from contiguous structures. We report a patient who presented with dysphagia and was found to have esophageal stricture. Endoscopic biopsy was not suggestive of malignancy or tuberculosis. CT scan of the thorax revealed involvement of the fourth thoracic vertebra with paratracheal lymphadenopathy. The patient responded to anti-tubercular therapy.

Adult↗
PubMed1995

Comparison of gastric mucosal blood flow in normal subjects and in patients with portal hypertension using endoscopic laser-Doppler velocimetry.

OBJECTIVE: To compare gastric mucosal blood flow (GMBF) in normal subjects with that in patients with portal hypertension with or without portal hypertensive gastropathy (PHG). METHODS: GMBF was measured by endoscopic laser-Doppler velocimetry in 20 gastroscopically normal subjects and 30 patients with portal hypertension with or without PHG. The effects of breath-holding (vasomotor reflex), submucosal epinephrine and sublingual isosorbide dinitrate were also studied. RESULTS: In normal subjects, GMBF on the greater curvature was (mean +/- SD) 9.5 +/- 1.3 V and on the lesser curvature, 9.1 +/- 1.9 V. Breath-holding caused a reduction in GMBF by 57.1 +/- 13.7%, submucosal epinephrine reduced it by 41.5 +/- 21.5% and sublingual isosorbide caused a rise of 25.8 +/- 15.2%. The GMBF on the greater and lesser curvature respectively in patients with mild PHG (7.7 +/- 1.2 V and 7.7 +/- 0.8 V) and those with severe PHG (6.5 +/- 3.5 V and 6.3 +/- 2.2 V), was significantly less than that in normal subjects (p < 0.05 and p < 0.001 respectively). Vasomotor reflex was blunted in patients with mild and severe PHG (23.3% +/- 20.3 and 23.1% +/- 17.7 respectively, p < 0.001). Responses to submucosal epinephrine and sublingual isosorbide were similar to those recorded in normal subjects. CONCLUSIONS: Patients with portal hypertension have significantly reduced GMBF and significantly attenuated vasomotor reflex in the gastric vascular bed as compared to normal subjects.

Adult↗
PubMed1995

Effect of a short course of indomethacin on gastric mucosal blood flow using endoscopic laser-Doppler velocimetry.

OBJECTIVE: To assess the effect of a short course of indomethacin on gastric mucosal blood flow (GMBF). METHODS: Patients with musculo-skeletal pain of recent origin and were prescribed a short course of therapy with indomethacin (25 mg tid for 7 days) were studied Baseline measurements of GMBF were carried out using endoscopic laser-Doppler velocimetry prior to starting indomethacin. At sites on the antrum, incisura, lesser and greater curvatures, and fundus. GMBF measurements were repeated after indomethacin therapy, as above and also on sites of erosions, it any. RESULTS: Baseline GMBF at sites on the antrum, incisura, greater and lesser curvatures, and fundus were (mean) 8.6, 7.9, 8.8, 8.5 and 8.7 volts, respectively. Post-therapy values did not differ from the corresponding baseline values (8.7, 8.5, 8.6, 8.6 and 8.3 volts, respectively). However, ten of the 16 patients developed gastric mucosal erosions and the mean GMBF on these sites of erosion was significantly reduced (6.6 +/- 1.3 volts, p < 0.05). CONCLUSIONS: A short course of indomethacin therapy produces a patchy decrease in blood flow in the gastric mucosa and erosions were seen in these areas.

Adult↗
PubMed1994

Burning sensation in the throat--should it be named caloripharyngeus?

A burning sensation in the throat is often complained of by patients, but this symptom has been neglected in the literature. To emphasize its importance, should we give the name 'caloripharyngeus' to the symptom of burning in the throat? A preliminary study of 30 patients with the sensation of burning in the throat is presented in this study. Of the patients studied 73.33 per cent had hyperacidity detected for the first time. Reflux was presented in only one patient; four patients showed oesophagitis in the lower one-third of the oesophagus; 90 per cent of the patients responded to antacids. We suggest that one of the causes of burning in the throat is a referred sensation due to hyperacidity.

Adolescent↗
PubMed1994

Esophageal involvement in pemphigus vulgaris.

Twenty five patients with pemphigus vulgaris were prospectively studied for esophageal involvement by endoscopic examination. Eighteen (72%) had esophageal involvement; the majority of the lesions were bullae. Histological examination showed acantholysis of the cells and exuberant inflammation.

Acantholysis↗