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Biomedical subjects

Y Desai

Publications and source records attributed to Y Desai.

8 recordsLinked to original sources
PubMed1995

Arterial complications of the thoracic outlet syndrome.

OBJECTIVES: Arterial complications due to compression of the thoracic outlet are uncommon. The objective of this study was to review our fairly extensive experience with this problem with particular reference to its management. METHODS: Patients entered into the Vascular Clinic database were reviewed over an 11 year period. Twenty six records were found. In 24 patients the vasculopathy was caused by a cervical rib (complete in 15) and in two by an anomaly of the first rib. In all patients the basic arteriopathy was a fibrous structure with a post-stenotic aneurysm in 13. Seventeen presented with a fixed pulse deficit; 13 had a palpable aneurysm and 12 had distal embolisation. RESULTS: Two patients refused operation. In 22 with cervical rib, the rib was removed via a supraclavicular incision, an anterior scalenectomy was performed and the arterial pathology repaired on its merit, usually by vein graft replacement or bypass. In two with first rib anomalies these were resected by the transaxillary route. Twenty three patients have been followed for between 3 months and 10 years; 20 are cured and three have residual claudication. CONCLUSIONS: Our results show that simple excision of the cervical rib via the supraclavicular route together with vascular reconstruction is adequate. This is in disagreement with the view of those who advocate routine excision of the first rib in addition to cervical rib excision.

Adult↗
PubMed1995

Sphincter preservation for low rectal carcinoma--the Durban experience.

With the increasing interest in sphincter preservation in the treatment of low rectal carcinoma, we retrospectively reviewed the present surgical options--sphincter preservation with colo-anal anastomosis, and the radical abdominoperineal resection (APR). Seventeen patients had sphincter preservation with colo-anal anastomosis and 12 an APR; 53% of the sphincter preservation group survived, compared with 25% of those patients who had APR. We conclude that in selected cases sphincter preservation would not compromise the chance of cure and would save the patient from a permanent colostomy.

Anal Canal↗
PubMed1992

Ulcerative colitis in the Indian population of Durban.

This study on ulcerative colitis in the Indian population of Durban between 1983 and 1987 revealed an incidence of 2,7/100,000 per year. Patients tended to have clinically mild-to-moderate disease, with macroscopic examination showing moderate severity and either extensive or total involvement. No relationship was found between clinical, macroscopic and laboratory indices of severity and extent of disease. The only relationship between laboratory tests and severity was that patients with low albumin values were more likely to have clinically severe disease. Extra-intestinal manifestations were rare, but many patients had liver involvement and colonic strictures. Ulcerative colitis was diagnosed more frequently than tuberculosis of the bowel during the study period, and amoebic dysentery was rarely diagnosed.

Adolescent↗
PubMed1991

Gastric carcinoma in Durban's Indian population.

Histologically proven gastric carcinoma was studied to establish the incidence and pattern of the disease in the Indian population of Durban. The incidence in this population was found to be low, 6.9/100,000/year. Over a 7-year period (1980-1986) 115 patients were treated for gastric carcinoma at R. K. Khan Hospital. There was a male preponderance, and the average age at presentation was 56 years. The commonest presenting symptoms were dyspepsia and vomiting, and the majority of patients presented with advanced disease. Only a third underwent resection, a third had no treatment, and a third underwent palliative bypass or laparotomy only. The majority of patients who had a palliative bypass or no treatment died within 9 months. The 5-year survival rate for patients undergoing curative resection was 38% and for palliative resection 9%. To improve survival, emphasis must be on early diagnosis and it is recommended that any patient with dyspepsia who is over the age of 30 years should have an endoscopic investigation.

Adenocarcinoma↗
PubMed1990

Renal involvement in scleroderma.

Twenty four patients (20 females, 4 males; aged 10-65 years) with progressive systemic sclerosis have been analysed. Twenty three had proximal scleroderma (14 acrosclerosis, 9 proximal scleroderma). Two patients had CREST syndrome and two had incomplete CREST syndrome. Both patients with CREST syndrome had acrosclerosis; the two with incomplete CREST syndrome had proximal scleroderma. Cutaneous and vasospastic symptoms were the common initial symptoms. Two patients had pulmonary symptoms at the onset. Skin changes (24 cases), Raynaud's phenomenon (20), articular involvement (13) and upper gastrointestinal involvement (12) were the major manifestations during the course of the disease. Three patients had cardiac involvement. Another three had overlap syndrome. Two had clinically manifest renal involvement. Kidney biopsies were abnormal in 5 of 10 clinically normal patients. Three patients died, one each due to involvement of the heart and lung; in the third, the cause of death could not be ascertained.

Adolescent↗
PubMed1986

Staged below-knee amputations for septic peripheral lesions due to ischaemia.

Preservation of the knee joint is of paramount importance in lower limb amputation for ischaemia. Clinical predictors of healing are unreliable in patients with septic peripheral lesions due to ischaemia. Seventy-three patients in whom a below-knee amputation was considered likely to heal, based on the temperature and appearance of the skin and bleeding from skin and muscle flaps, were divided into two groups. Twenty-nine (Group A) had a primary below-knee (BK) amputation at the site of election with delayed primary skin closure, while 44 patients (Group B) initially had a guillotine BK amputation below the site of election, with elective amputation at the appropriate level once infection had been eradicated (4-5 days later). The groups were similarly matched with regard to level of occlusive arterial disease, nature of ischaemic lesions and operative risk factors. There was no significant difference in the overall operative mortality in Group A (6.7 per cent) compared with Group B (11.4 per cent) (P greater than 0.05). There was a significantly higher above-knee revision rate in Group A survivors (33.3 per cent) compared with Group B (7.7 per cent) (P less than 0.01) due to non-viability and uncontrolled sepsis of the BK amputation site. The presence or absence of a palpable femoral or popliteal pulse had no significant influence on healing in either group.

Amputation, Surgical↗