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Biomedical subjects

S Suri

Publications and source records attributed to S Suri.

At least 19 recordsLinked to original sources

Double pigtail cystogastric stent in the management of pancreatic pseudocyst.

We describe placement of a double pigtail cystogastric stent in 5 patients with pancreatic pseudocyst using real-time ultrasonography and fluoroscopy as guidance techniques. This was done as a two-step procedure. First, a transgastric drainage catheter was placed for a period of six days. All the patients continued to have high drainage output and the cyst size decreased, as seen sonographically. Simultaneous barium meal and sinogram were then done to measure the distance between the posterior gastric wall and the cyst. A polyurethane double pigtail stent of appropriate size was then introduced to achieve cystogastric drainage. The cyst resolved in all the patients by four weeks to six weeks, when the stent was removed endoscopically. There was no recurrence of pseudocyst during follow-up for 6 months to 13 months. None of the patients suffered any complication. Cystogastric drainage using a double pigtail stent is an easy and safe alternative to surgical cystogastrostomy.

Adult

Takayasu arteritis in India.

Takayasu arteritis is the commonest cause of renovascular hypertension in India. The clinical and radiological features, complications and course of 83 patients (51 females, 32 males) seen during the period from 1972-1990 are described in this study. The age of the patients ranged from 5 to 53 years with the mean +/- SD of 26.9 +/- 9.7. Hypertension (n = 50) and the related symptom of headache (n = 40), dyspnea (n = 24), and giddiness (n = 20) were common at presentation. Twelve patients were in congestive cardiac failure. The symptoms of activity with fever and arthralgia were present in only 16% contrary to reports from Japan and Mexico. Abnormal arterial pulses and bruit over abdominal (37%) or extra abdominal great arteries (25%) were useful clinical clues to suspect Takayasu arteritis. Rapid sequence intravenous urography was a sensitive screening procedure and predicted correctly the presence of renovascular disease in 80% of the patients. The diagnosis was confirmed on aortography in 72. In the rest, the clinical features and autopsy findings confirmed the same. The four patterns of the disease based on the anatomical extent of involvement were recognised. These were: type I (n = 8) with involvement of aortic arch and its branches, type II (n = 25) descending thoracic and abdominal aorta type III (n = 46) combination of I and II and type IV (n = 4) pulmonary artery in addition to any of the above.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Vanishing CT lesions in epilepsy.

Experience with computed tomography (CT) in patients with epilepsy has drawn attention to specific type of cerebral lesions widely prevalent in this part of the world. The lesions disappear spontaneously while patients receive only anticonvulsant therapy. The exact nature of these lesions is not yet understood. One-hundred and twenty-two such patients (M 77; F 45) were studied. Their age ranged from 3 to 57 (mean 21.8 +/- 12.7) years. Seizures were partial motor in 86 (70.5%), generalised tonic clonic in 31 (25.4%), complex partial in 4 and atonic in one case. Postictal hemiparesis was seen in 6 patients who completely recovered within 5 min to 7 days. One hundred patients underwent EEG examination. It was abnormal in 84 cases; 40 patients showed localisation which correlated with CT findings. Plain CT showed low attenuation lesions in all cases. Morphology on contrast enhancement was ring lesion in 50 (40.9%), disc lesion in 47 (38.5%), target lesion in 3 (2.5%), mixed lesion in 2 (0.8%), no enhancement in 18 (14.8%) and a speck with oedema in 2 (0.8%) cases. All lesions were cerebral, present at cortical-subcortical junction. The first follow-up scan was performed in 78 (63.9%) patients within 6-12 weeks. It showed complete disappearance of the lesion in 47 (60.3%) cases. Reduction in size of the lesion and surrounding oedema was observed in 24 (30.8%) cases. The follow-up scans in these 24 cases revealed disappearance of lesion in 11 cases and almost complete resolution of the lesion with a remaining speck in 13 cases. Cerebrospinal fluid (CSF) was normal in 95 out of 100 cases in which it was performed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Ultrasound-guided fine needle aspiration cytology of carcinoma involving the intra-abdominal oesophagus.

Ultrasound-guided fine needle aspiration cytology (FNAC) of carcinoma of the intra-abdominal oesophagus was attempted on 21 patients with a 21 G spinal needle using a percutaneous anterior epigastric approach. The results were compared with those of endoscopic biopsy and brush cytology. The ultrasound-guided FNAC had a positive yield in 20/21 (95.2%) compared with 18/21 (85.7%) for endoscopic biopsy and 18/21 (85.7%) for brush cytology (P greater than 0.59). The combination of US-guided FNAC with endoscopic biopsy and the brush cytology achieved a positive yield in 21/21 (100%) whereas combining endoscopic biopsy and brush cytology produced a positive yield of 19/21 (90.5%). Two patients developed temporary epigastric pain. We recommend US-guided FNAC as a safe and effective technique that can be used alone or as an adjunct to endoscopic procedures for the diagnosis of carcinoma of the intra-abdominal oesophagus.

Abdomen

Computed tomography of the abdomen with fat density oral contrast medium.

A 12.5% corn oil-emulsion (COE) was tested as an oral contrast agent for abdominal computed tomography (CT) examinations in 100 patients. The results were compared with those obtained from another group of patients who received a conventional, high-density, oral contrast agent (2-3% iodinated solution). There was no statistically significant difference in the subjects' tolerance to the two agents (P greater than 0.05). There was, however, a significant improvement in image quality with COE (P less than 0.05). Gastrointestinal tract discrimination, and mucosal and mural visualisation was of higher quality with fat density oral contrast medium than with the high-density contrast agent. These data suggest that COE should be considered for routine use as an alternative to conventional high density oral contrast agents in upper abdominal CT.

Contrast Media

Reliability of skinfold calipers as a tool for measuring body fat in human beings.

Triceps skinfold thickness measured in ten adults aged 19 to 50 yr by a Holtain skinfold caliper, was compared with subcutaneous fat thickness obtained on cross-sections of the left upper arm by computerized axial tomography (CAT). The thickness of subcutaneous fat was measured on CAT scan film directly with the inbuilt computer graphic technique. The measurements taken on CAT scan film were found to be significantly higher (by 21-45%; P less than 0.001) than those by the skinfold calipers. Our findings suggest that skinfold calipers may not be very accurate tools for the assessment of body fat in human beings. Therefore, its use in the determination of body composition, for which great precision is required calls for re-thinking.

Adipose Tissue

Ultrasound in choledocholithiasis.

Twenty-five patients of obstructive jaundice due to choledocholithiasis, were prospectively evaluated by ultrasonography and cholangiography. Ultrasound could demonstrate choledocholithiasis in 10 patients (40%). Choledocholithiasis in non-dilated ducts could be demonstrated only in one patient. All cases were diagnosed by cholangiography. Ultrasound, though an accepted modality of choice for diagnosing cholelithiasis, has a limited role in the diagnosis of choledocholithiasis. Ultrasonography (USG) is the screening modality of choice to distinguish obstructive from non-obstructive jaundice. It is highly accurate in the diagnosis of cholelithiasis but its role in detection of choledocholithiasis is less clear. Choledocholithiasis complicates 10% of all cases of cholecystitis and occurs in 2-4% of postcholecystectomy patients. The present study deals with the diagnostic value of USG in cases of choledocholithiasis subjected to USG prior to cholangiography and surgery.

Adult

Modified ultrasound-guided percutaneous transgastric drainage of pancreatic pseudocysts.

We describe a modified ultrasound-guided transgastric drainage technique for pancreatic pseudocysts. Using a water-filled stomach to improve visualization, we have successfully drained pseudocysts in ten patients. This report also describes the use of a stiffening cannula to assist transgastric catheter placement. We emphasize the value of constant real-time tracking of the dilator and guidewire to ensure correct positioning of the drainage catheter.

Adolescent

An epidemic of dengue haemorrhagic fever and dengue shock syndrome in Delhi: a clinical study.

Twenty-four cases of dengue haemorrhagic fever/dengue shock syndrome were studied in Delhi in the months of September and October, 1988. The majority of these cases were boys aged 6-10 years. Classical symptoms of dengue (fever, headache, aesthesia, myalgia) occurred in all the patients. Digestive symptoms (nausea, vomiting, anorexia, abdominal pain and hepatomegaly) were also common. Haemorrhagic manifestations were present in 41.7% of the cases. Of these, 90% had gastrointestinal haemorrhages. Shock occurred in 17 cases (70.8%). Thrombocytopenia and prolongation of coagulation profile were found in 62.5% of cases. Three patients (12.5%) who presented with encephalopathy died. The other 21 patients recovered after an average period of 2-8 days.

Child

Ultrasonic variables in the diagnosis of intrauterine growth retardation.

Ultrasonic biparietal diameter (BPD), femur length, abdominal circumference, femur length/abdominal circumference ratio, estimated fetal weight, ponderal index, estimated fetal length were measured within 72 h of delivery of 30 small-for-date (SFD) and 174 non-SFD newborns. Evaluation of each ultrasound variable in the antenatal diagnosis of SFD fetus was assessed. Abdominal circumference and estimated fetal weight were the best predictors in confirming SFD in 73.3 and 76.6 per cent respectively, followed by BPD (63.3%). Other variables (femur length, femur length/abdominal circumference ratio, estimated fetal length and ponderal index) were less accurate in diagnosis of SFD babies. For all variables studied negative predictive value was high (almost 90% or above). However, positive predictive value for abdominal circumference and estimated fetal weight were satisfactory. This study demonstrates the usefulness of abdominal circumference and estimated fetal weight in recognising SFD. It also shows that various growth variables could be used to rule out the diagnosis of IUGR with reasonable accuracy (negative predictive value greater than or equal to 90).

Female

Ultrasound guided pancreatic ductography.

Thirteen patients underwent ultrasound guided percutaneous pancreatic ductography during a one year period. In nine cases the procedure was performed after failure of endoscopic retrograde pancreatography (ERP) and in four patients ERP was not attempted. Under ultrasound guidance a 22 gauge needle was inserted into the pancreatic duct through a vertical transgastric route. After aspiration of 10-15 ml of pancreatic juice, contrast medium was injected into the pancreatic duct. Opacification was successful in 12 (92%) patients. No significant complications were encountered. The usefulness of the procedure in our country is highlighted.

Cholangiopancreatography, Endoscopic Retrograde

Ultrasonic intrauterine growth curves.

Intrauterine growth was studied by serial ultrasonic measurements of biparietal diameter (BPD), femur length (FL) and abdominal circumference (AC) in 241 normal low risk obstetric patients. These measurements were used to construct normal ultrasonic fetal weight and length curve. The data correlate well with the already established, postnatal weight and length curves after 28 weeks of gestation. The fetal ponderal index curve was compared with postnatal ponderal index curves available. Antenatal recognition of fetal weight, length and ponderal index can be used to evaluate pregnancies at risk for altered fetal growth.

Birth Weight