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Fecal Evacuation Disorder Among Patients With Solitary Rectal Ulcer Syndrome: A Case-control Study
( Atul Sharma ),( Asha Misra ),( Uday C Ghoshal ) 대한소화기기능성질환·운동학회 2014 Journal of Neurogastroenterology and Motility (JNM Vol.20 No.4
Background/Aims Data on frequency of fecal evacuation disorder (FED) among patients with solitary rectal ulcer syndrome (SRUS), hitherto an enigmatic condition, are scanty. Moreover, most such studies had limitations due to small sample size and lack of inclusion of healthy controls (HC). Methods Forty patients with SRUS underwent symptom assessments, sigmoidoscopy, anorectal manometry, defecography, balloon expulsion test (BET); endoscopic ultrasound (EUS) of anal sphincter complex was performed in a subgroup. Physiological tests (anorectal manometry and BET) were also performed in 19 HC. Results Patients with SRUS (26/40 male, age 37 [18-80] years) more often had FED than HC (10/19 male, age 43 [25-72] years) as shown by weight needed to expel the balloon (300 [0-700] g vs. 100 [0-400] g; P = 0.006), a trend towards abnormal BET (need of > 200 g weight for expulsion) (21/40 [53%] vs. 5/19 [26%], P = 0.058) and impaired anal relaxation (14/40 [35%] vs 2/19 [10.5%]; P = 0.048). Using Rome III criteria, most patients with SRUS reported having chronic constipation (36/40 [90%]) in spite of having normal (Bristol stool type IV, 21/40 [53%]) and diarrheal (types V, VI, VII, 6/40 [20%]) stool forms (Asian classification). SRUS patients more often (17/40 [43%]) had functional defecation disorder (Rome III criteria). Patients with SRUS with abnormal BET had thicker internal anal sphincter than those without (3.9 [3.4-7.0] mm vs 2.8 [2.0-4.0] mm; P = 0.01). Conclusions FED was commoner among patients with SRUS as evidenced by abnormal BET and sphincter relaxation. Those with abnormal BET had thicker internal sphincter on EUS than those without.
Alok Sharma,G.D. Reddy,Atul Kaushik,K.Shanker,R.K. Tiwari,Alok Mukherjee,Ch.V. Rao 한국생약학회 2007 Natural Product Sciences Vol.13 No.1
ethanolic (50% v/v) extracts of Carissa carandas (fruits) (Apocynaceae) and Microstylis wallichii(tubers) (Orchidaceae) were examined for anti-inflamatory and analgesic activities in experimental animals.Carissa carandas and Microstylis wallichii (50 - 200 mg/kg) caused a dose dependent inhibition of swellingcaused by carrageenin significantly in cotton pellet induced granuloma in rats (P < 0.05 to P < 0.001). There was asignificant increase in the analgesy meter induced pain in rats. The extracts of Carissa carandas and Microstyliswallichii resulted in an inhibition of stretching episodes and percentage protection was 16.05 - 17.58%respectively in acetic acid induced writhing.KeywordsCarissa carandas, Microstylis wallichii, pain, inflamation
( Divij Jayant ),( Atul Parashar ),( Ramesh Sharma ) 대한외상학회 2023 大韓外傷學會誌 Vol.36 No.4
Purpose: This study investigated the epidemiology, management, outcomes, and postoperative disabilities of degloving soft tissue injuries (DSTIs) treated at a tertiary care center in northern India. Methods: A prospective study of patients with DSTIs was conducted over 15 months. The type of degloving injury, the mechanism of injury, and any associated injuries were analyzed using the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 along with the management, outcomes, and disabilities at a 3-month follow-up. Results: Among 75 patients with DSTIs, the average age was 27.5 years, 80.0% were male, and 76.0% had been injured in traffic accidents. The majority (93.3%) were open degloving injuries. Lower limbs were affected most often (62.7%), followed by upper limbs (32.0%). Fractures were the most commonly associated injuries (72.0%). Most patients required more than two procedures, including secondary debridement (41.3%), split skin grafting (80.0%), flap coverage (12.0%), or vacuum-assisted closure (24.0%), while five patients underwent conservative management for closed degloving injuries. Postoperative complications included surgical site infections (14.7%) and skin necrosis (10.7%). Two patients died due to septic shock and multiple organ dysfunction syndrome. The mean length of hospital stay was 11.5±8.1 days, with injuries affecting the lower limbs and perineum requiring longer hospital stays. The mean WHODAS 2.0 disability score at 3 months was 19. Most patients had mild disabilities. Time away from work depended largely upon the site and severity of the injury. Approximately 75% of patients resumed their previous job or study, 14% changed their job, and 8% stopped working completely due to residual disability. Conclusions: DSTIs are common injuries in trauma and management is challenging. Although open DSTI are clinically evident at secondary survey, closed degloving injuries may be missed in the primary survey, necessitating a high index of suspicion, thorough clinical examination, and protocol-based management. Primary preventive strategies (e.g., road safety protocols, preplacement training, and proper protective equipment in industries) are also needed to reduce the incidence of these injuries.
Seneviratne, J.M.,Gupta, Atul K.,Pandey, Dinesh,Sharma, Indu,Kumar, Anil The Korean Society of Plant Pathology 2009 Plant Pathology Journal Vol.25 No.4
Genetic variation among the base isolates and monosporidial strains derived from these isolates of Tilletia indica- the causal agent of Karnal bunt (KB) in wheat, was analyzed by morphological, growth behaviors and RAPD-ISSR based molecular polymorphism. Genetic make up of fungal cultures vary among each other. The magnitude of variation in KBPN group is less (narrow genetic base) when compared to the other groups KB3, KB9 and JK (broad genetic base) reflecting that variability is a genetically governed process. The generation of new variation with different growth characteristics is not a generalized feature and is totally dependant on the original genetic make-up of the base isolate generating new monosporidial strains. Thus, it can be concluded that monosporidial strains derived from mono-teliosporic isolate, consists of genetically heterogeneous population. The morphological and genetic variability further suggests that the variation in T. indica strains is predominantly derived through the genetic rearrangements through para sexual means.
Sachin Yadav,Praveen Kumar Sharma,Sudhir Kumar Singh,Atul Abhishek Jha,Reethesh,Anurag Garg 소화기인터벤션의학회 2022 International journal of gastrointestinal interven Vol.11 No.3
In the modern era, endoscopic retrograde cholangiopancreatography (ERCP) and therapeutic endoscopic ultrasound (EUS) are increasingly being performed in day-care settings. The safety of these procedures in elderly admitted patients has been established in previous studies, but evidence for the safety of day-care ERCP/therapeutic EUS is limited. We retrospectively analyzed the outcomes of day-care ERCP/EUS in patients more than 80 years of age. All procedures were done under total intravenous anesthesia (ketamine- and propofol-based) and the intra-procedural and immediate postprocedural complications (within 6 hours) were noted. Thirty patients (24 male and 6 female) were enrolled. The most common indication for the procedure was choledocholithiasis (46.6%), followed by malignant stenosis (30.0%) and benign strictures (20.0%). One patient had transient desaturation during the procedure and two patients had hypotension. The dreaded complications of bleeding, perforation, or pancreatitis did not occur in any patients, and none required admission. In conclusion, day-care therapeutic ERCP/EUS is safe and cost-effective in the oldest old patients.
J.M.seneviratne,Atul K. Gupta,Dinesh Pandey,Indu Sharma,Anil Kumar 한국식물병리학회 2009 Plant Pathology Journal Vol.25 No.4
Genetic variation among the base isolates and monosporidial strains derived from these isolates of Tilletia indica- the causal agent of Karnal bunt (KB) in wheat, was analyzed by morphological, growth behaviors and RAPD-ISSR based molecular polymorphism. Genetic make up of fungal cultures vary among each other. The magnitude of variation in KBPN group is less (narrow genetic base) when compared to the other groups KB3, KB9 and JK (broad genetic base) reflecting that variability is a genetically governed process. The generation of new variation with different growth characteristics is not a generalized feature and is totally dependant on the original genetic make-up of the base isolate generating new monosporidial strains. Thus, it can be concluded that monosporidial strains derived from mono-teliosporic isolate, consists of genetically heterogeneous population. The morphological and genetic variability further suggests that the variation in T. indica strains is predominantly derived through the genetic rearrangements through para sexual means.
Sachin Yadav,Praveen Kumar Sharma,Sudhir Kumar Singh,Atul Abhishek Jha,Reethesh,Anurag Garg 소화기인터벤션의학회 2022 Gastrointestinal Intervention Vol.11 No.3
In the modern era, endoscopic retrograde cholangiopancreatography (ERCP) and therapeutic endoscopic ultrasound (EUS) are increasingly being performed in day-care settings. The safety of these procedures in elderly admitted patients has been established in previous studies, but evidence for the safety of day-care ERCP/therapeutic EUS is limited. We retrospectively analyzed the outcomes of day-care ERCP/EUS in patients more than 80 years of age. All procedures were done under total intravenous anesthesia (ketamine- and propofol-based) and the intra-procedural and immediate postprocedural complications (within 6 hours) were noted. Thirty patients (24 male and 6 female) were enrolled. The most common indication for the procedure was choledocholithiasis (46.6%), followed by malignant stenosis (30.0%) and benign strictures (20.0%). One patient had transient desaturation during the procedure and two patients had hypotension. The dreaded complications of bleeding, perforation, or pancreatitis did not occur in any patients, and none required admission. In conclusion, day-care therapeutic ERCP/EUS is safe and cost-effective in the oldest old patients.
Mantle Cell Lymphoma: A North Indian Tertiary Care Centre Experience
Das, Chandan Krushna,Gogia, Ajay,Kumar, Lalit,Sharma, Atul,Sharma, Mehar Chand,Mallick, Saumya Ranjan Asian Pacific Journal of Cancer Prevention 2016 Asian Pacific journal of cancer prevention Vol.17 No.10
Background: Mantle cell lymphoma (MCL) is an aggressive non-Hodgkin's lymphoma, with a pathognomonic chromosomal translocation t (11;14). Prognosis is uniformly dismal but there is a paucity of information on MCL from India. Materials and methods: We retrospectively analysed clinicopathological information on all treated patients with MCL at our centre. STATA 14.0 was used for analysis. Survival was assessed by Kaplan-Meier analysis and the Cox's proportional hazards method. Statistical significance was defined as a P value of < 0.05. Results: Fifty-one patients with MCL were reviewed. The median age at presentation was 57.0 years. Extranodal involvement was seen in 39.0 (74.0%) while bone marrow positivity at presentation was found in 27.0 (54.0%). Initial treatment was chemotherapy with or without rituximab. Patients receiving rituximab-based therapy (n = 24) had 5-year progression-free survival (PFS) of 21.0 (88.0%), compared with 14.0 (61.0%) for those not receiving rituximab (n = 23, P = 0.036). Twenty-three patients were alive with a median follow-up of 20.7 months (range 2.5-89.2). PFS at 1 and 2 years was 51.0% and 27.0%, and overall survival (OS) 78.0% and 72.0%, respectively. Use of more than 2.0 lines of therapy, use of bendamustine-rituximab, and high TLC (>10,000.0/cu.mm) significantly affected PFS. Conclusions: In our experience, MCL patients from north India have an early age at presentation. When treated with regimens including rituximab results in an improved response rate and PFS. This study provided comprehensive insights into the treatment of MCL in a developing country.