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1.
Artículo en Inglés | IMSEAR | ID: sea-156259

RESUMEN

The reuse of medical devices marked as ‘single use’ by manufacturers has been going on for several decades. The process has been rationalized and legislated in the West as well as in Japan. However, the practice continues in an unregulated manner in India due to a paucity of guidance from the Food and Drug Administration in India. We trace the evolution of reuse policies, look at the prevalent practices in the Indian and international contexts, analyse the available Indian literature and address the ethical and economic implications of reuse. We also suggest some guidelines which may be adopted to formulate policies.


Asunto(s)
Ahorro de Costo , Equipo Reutilizado/economía , Equipo Reutilizado/normas , Equipo Reutilizado/estadística & datos numéricos , Equipos y Suministros/economía , Equipos y Suministros/normas , Equipos y Suministros/estadística & datos numéricos , Humanos , India , Esterilización/economía , Esterilización/normas , Esterilización/estadística & datos numéricos
3.
Artículo en Inglés | IMSEAR | ID: sea-65519

RESUMEN

Polycystic liver disease with severe symptoms is difficult to treat. We report a 35-year-old man with advanced disease, who had a successful outcome after resection and fenestration.


Asunto(s)
Adulto , Quistes/cirugía , Hepatectomía , Humanos , Hepatopatías/cirugía , Masculino
5.
Artículo en Inglés | IMSEAR | ID: sea-64248

RESUMEN

OBJECTIVE: Isolated gastric varices (IGV) are rare and are believed to be associated with left-sided portal hypertension. We studied patients presenting with bleeding from IGV and compared them with those bleeding from both esophageal and gastric varices. METHODS: A retrospective analysis of 14 patients with bleeding from IGV was carried out. Portovenography findings (pattern of collateralization and natural shunts) in these patients were compared with a matched group of 69 patients with both esophageal and gastric varices. RESULTS: Of 14 patients with IGV, 2 had isolated splenic vein thrombosis and 12 had generalized portal hypertension. Portovenograms in 11 of the latter 12 revealed predominantly 'left-sided' collateralization in 8 patients as compared to 17 of 69 (25%) patients with esophageal and gastric varices (p = 0.004); natural shunts were seen in 6 of 11 cases and 15 of 69 (22%) patients in the two groups, respectively (p = 0.05). Abdominal devascularization operation gave good short- and long-term control of bleeding. CONCLUSIONS: Contrary to belief most patients with isolated gastric varices may have generalized portal hypertension rather than splenic vein obstruction as the cause and hence should be treated by a more extensive procedure than just splenectomy. The IGV could be a result of predominant collateralization to the retroperitoneal area (left-sided collateralization and natural shunts) rather than the usual pattern to the azygos system which results in esophageal varices.


Asunto(s)
Várices Esofágicas y Gástricas/epidemiología , Femenino , Hemorragia Gastrointestinal/epidemiología , Humanos , Hipertensión Portal/epidemiología , India/epidemiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
6.
Artículo en Inglés | IMSEAR | ID: sea-65596

RESUMEN

BACKGROUND: Early decompression is needed in the Budd-Chiari syndrome (BCS) to prevent liver dysfunction and death. AIMS: To study the technical difficulties during surgery and the results of surgery for BCS. METHODS: Retrospective review of nine patients operated on between 1994 and January 1998 for BCS--1 for uncontrolled fundal variceal bleed and 8 for chronic BCS. Isolated hepatic vein block was found in 5, inferior vena cava (IVC) block in 1 and a combination in 3 patients. Preoperative liver biopsies did not reveal cirrhosis in any patient. Portacaval shunt (3), portorenal shunt (2), mesocaval shunt (1), mesoatrial shunt (2) and devascularisation (1) were the operations performed. RESULTS: In 3 patients, side-to-side portacaval shunt was not possible because of caudate lobe hypertrophy (1), aberrant right hepatic artery (1) and presence of IVC stent (1); they required portorenal (2) or interposition mesocaval (1) shunts. Both mesoatrial shunts were unsuccessful. Devascularisation was effective in controlling the acute bleed. There was no intraoperative death. Postoperatively there were 3 deaths. Of the 6 survivors, 5 are asymptomatic over a mean follow up of 19.7 months. CONCLUSIONS: Side-to-side portacaval shunt is effective in the management of BCS; results with the mesoatrial shunt are disappointing.


Asunto(s)
Adulto , Síndrome de Budd-Chiari/cirugía , Femenino , Humanos , Hipertensión Portal/cirugía , Masculino , Derivación Portosistémica Quirúrgica , Estudios Retrospectivos , Resultado del Tratamiento
7.
Artículo en Inglés | IMSEAR | ID: sea-65576

RESUMEN

A 22-year-old man with homozygous sickle cell disease presented with recurrent fever, right upper quadrant pain and jaundice. Liver biopsy confirmed the diagnosis of hepatic sickling crisis; the symptoms responded to hydroxyurea therapy. Hepatic vasocclusive crisis can diagnosed on liver biopsy, and need not be a diagnosis of exclusion.


Asunto(s)
Adulto , Anemia de Células Falciformes/patología , Colangitis/patología , Diagnóstico Diferencial , Humanos , Hígado/patología , Masculino
10.
J Postgrad Med ; 1997 Jan-Mar; 43(1): 21-2
Artículo en Inglés | IMSEAR | ID: sea-115685

RESUMEN

A middle aged male patient presented with gradual distension of the abdomen. Imaging modalities showed classical features of pseudomyxoma peritoneii which was confirmed by aspiration cytology. Details of the case are described and relevant literature is reviewed.


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Neoplasias Peritoneales/patología , Seudomixoma Peritoneal/patología
11.
Artículo en Inglés | IMSEAR | ID: sea-65354

RESUMEN

A 30-year-old man presented with acute acid-peptic symptoms. Endoscopy and radiological studies revealed generalized thickening of gastric folds with multiple superficial ulcerations and infiltration of the distal stomach simulating gastric neoplasm. Endoscopic biopsies revealed acute gastritis with foveolar hypertrophy with numerous Helicobacter pylori. The symptoms and endoscopy findings resolved completely with combination triple-drug therapy for H pylori.


Asunto(s)
Adulto , Diagnóstico Diferencial , Gastritis/diagnóstico , Infecciones por Helicobacter/diagnóstico , Helicobacter pylori , Humanos , Linfoma/diagnóstico , Masculino , Neoplasias Gástricas/diagnóstico
13.
Artículo en Inglés | IMSEAR | ID: sea-64204

RESUMEN

Fibrolamellar hepatocellular carcinoma, a histological variant of hepatocellular carcinoma, distinct pathological and clinical features and a better prognosis than other types of hepatocellular carcinoma. We report here a patient who was treated on successful surgically.


Asunto(s)
Adulto , Carcinoma Hepatocelular/cirugía , Femenino , Hepatectomía , Humanos , Neoplasias Hepáticas/cirugía , Pronóstico
14.
Artículo en Inglés | IMSEAR | ID: sea-64401

RESUMEN

Endoscopic variceal sclerotherapy, though a safe and effective therapy for esophageal varices, is not devoid of local and distant complications. We report a patient with postnecrotic cirrhosis and diabetes mellitus who developed a splenic abscess while on a sclerotherapy program. The abscess may have been a consequence of retrograde thrombosis of the portal venous system or of bacteremia following sclerotherapy.


Asunto(s)
Absceso/etiología , Várices Esofágicas y Gástricas/terapia , Hemorragia Gastrointestinal/terapia , Humanos , India , Masculino , Persona de Mediana Edad , Escleroterapia/efectos adversos , Enfermedades del Bazo/etiología
17.
Artículo en Inglés | IMSEAR | ID: sea-64949

RESUMEN

Use of vascular occlusion techniques during hepatic resection has besides decreasing blood loss improved the feasibility of surgical extirpation of large hepatic tumors. We report successful use of this technique to resect a large hepatoma in the right lobe of the liver. The hemodynamic and biochemical changes in the perioperative period are documented.


Asunto(s)
Colecistectomía , Hepatectomía/métodos , Arteria Hepática/cirugía , Conducto Hepático Común/cirugía , Humanos , Ligadura , Neoplasias Hepáticas/cirugía , Masculino , Persona de Mediana Edad , Vena Porta/cirugía
19.
J Postgrad Med ; 1992 Jul-Sep; 38(3): 119-23
Artículo en Inglés | IMSEAR | ID: sea-115986

RESUMEN

The pectoralis major myocutaneous (PMMC) flap or its modification was used in 19 cases after resectional surgery for malignancy of the oral cavity with minimal morbidity and no mortality. The resection as well as reconstruction was done by the same team consisting only of general surgeons. The final functional and cosmetic results were satisfactory. The pectoralis major myocutaneous flap is a hardy flap and can be performed with relative ease even by those not specialised in plastic surgery. This makes it an important tool for a general surgeon practicing in a country like India with its high incidence of head and neck malignancy.


Asunto(s)
Adulto , Femenino , Cabeza/cirugía , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Masculino , Persona de Mediana Edad , Cuello/cirugía , Músculos Pectorales , Servicio de Cirugía en Hospital , Colgajos Quirúrgicos
20.
J Postgrad Med ; 1991 Oct; 37(4): 228B, 229-30
Artículo en Inglés | IMSEAR | ID: sea-115781

RESUMEN

A forty-year-old male patient was admitted with acute intestinal obstruction, plain X-ray abdomen and chest revealing air fluid levels on the right side of chest. A successful operation was carried out and the patient made an uneventful recovery. Obstructed Morgagni's Hernia is an uncommon case and hence the presentation.


Asunto(s)
Enfermedad Aguda , Adulto , Hernia Diafragmática/complicaciones , Humanos , Obstrucción Intestinal/etiología , Masculino
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