Hereditary angioedema is a rare disorder characterized by quantitative or qualitative deficiency ... more Hereditary angioedema is a rare disorder characterized by quantitative or qualitative deficiency of complement C1 esterase inhibitor. We report a family whose members presented with recurrent angioedema and abdominal pain; the diagnosis was confirmed by quantitative assay of C1 inhibitor. The index patient was treated with danazol and was relieved.
We describe a patient with protein C deficiency who presented with subacute intestinal obstructio... more We describe a patient with protein C deficiency who presented with subacute intestinal obstruction due to ischaemic small bowel stricture. The patient also had left sided ileofemoral thrombosis. Venous thrombosis at unusual sites especially if associated with deep vein thrombosis of lower limb warrants a thorough screen for underlying thrombophilia. This, however, is a rare cause for ischaemic small bowel stricture.
Background: A need was felt to have a simple scoring system for the objective assessment of hospi... more Background: A need was felt to have a simple scoring system for the objective assessment of hospitals for preparedness for donation after brain death (DBD). Materials and Methods: Eighteen tertiary care transplanting hospitals in India were scored on 20 parameters (Seth-Donation of Organs and Tissues [S-DOT] score). An independent observer scored each parameter as 2, 1, or 0 with a maximum score of 40. The loopholes in organ donation (OD) were addressed by monthly interactions and hospitals re-assessed at 6 months by the same observer. Statistical analysis was performed with the Wilcoxon signed-ranks test. Results: The median S-DOT score at baseline was 13.5 (range 3–33). On correlating baseline score with donations over preceding 4 years, 1 hospital with score >30 (good) had 17 donations, 8 hospitals with a score 15–29 (satisfactory) had 19 donations, whereas none of the 9 hospitals with score <15 (unsatisfactory) had a donation. After 6 months, S-DOT score improved for all hospitals to a median of 23.5 (range 4–37) with a median increase of 6.7 (range 1–22), P < 0.001. Four hospitals with a score >30 had 6 donations, 9 hospitals with score 15–29 had 7 donations whereas none of the 5 hospitals with score <15 had any donation. Conclusion: S-DOT score may be a useful tool for the objective assessment and improvement of hospitals on best practices in DBD. A score of >30 was frequently associated with OD, while a score <15 could consistently identify hospitals that did not have any donation.
Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 1997
A nonoperative method of palliation was used in four patients with malignant obstructive jaundice... more A nonoperative method of palliation was used in four patients with malignant obstructive jaundice in whom biliary endoprosthesis could not be placed endoscopically. A guide wire was manipulated through the lesion by a percutaneous transhepatic route and retrieved from the duodenum through an endoscope. A 10 Fr stent was then passed through the endoscope over the guide wire across the stricture. The procedure was successful in all four patients, with no complication.
Tropical gastroenterology : official journal of the Digestive Diseases Foundation
We present here a patient of congenital non-obstructive focal dilatation of intrahepatic biliary ... more We present here a patient of congenital non-obstructive focal dilatation of intrahepatic biliary radicles (Caroli's disease). The peculiar configuration of dilated intrahepatic biliary channels with central portal vein radicles was picked up sonologically as the 'central dot' sign. Awareness of this sign allows an accurate diagnosis without resorting to more invasive and expensive investigations.
The family of a 48-year-old female with brain death requested for directed donation of a kidney t... more The family of a 48-year-old female with brain death requested for directed donation of a kidney to her brother. Failure to comply with the wishes of the family due to medical reasons resulted in the withdrawal of consent for the donation of all organs. The status of deceased directed donation is discussed and a checklist suggested for the same in India.
Hereditary angioedema is a rare disorder characterized by quantitative or qualitative deficiency ... more Hereditary angioedema is a rare disorder characterized by quantitative or qualitative deficiency of complement C1 esterase inhibitor. We report a family whose members presented with recurrent angioedema and abdominal pain; the diagnosis was confirmed by quantitative assay of C1 inhibitor. The index patient was treated with danazol and was relieved.
We describe a patient with protein C deficiency who presented with subacute intestinal obstructio... more We describe a patient with protein C deficiency who presented with subacute intestinal obstruction due to ischaemic small bowel stricture. The patient also had left sided ileofemoral thrombosis. Venous thrombosis at unusual sites especially if associated with deep vein thrombosis of lower limb warrants a thorough screen for underlying thrombophilia. This, however, is a rare cause for ischaemic small bowel stricture.
Background: A need was felt to have a simple scoring system for the objective assessment of hospi... more Background: A need was felt to have a simple scoring system for the objective assessment of hospitals for preparedness for donation after brain death (DBD). Materials and Methods: Eighteen tertiary care transplanting hospitals in India were scored on 20 parameters (Seth-Donation of Organs and Tissues [S-DOT] score). An independent observer scored each parameter as 2, 1, or 0 with a maximum score of 40. The loopholes in organ donation (OD) were addressed by monthly interactions and hospitals re-assessed at 6 months by the same observer. Statistical analysis was performed with the Wilcoxon signed-ranks test. Results: The median S-DOT score at baseline was 13.5 (range 3–33). On correlating baseline score with donations over preceding 4 years, 1 hospital with score >30 (good) had 17 donations, 8 hospitals with a score 15–29 (satisfactory) had 19 donations, whereas none of the 9 hospitals with score <15 (unsatisfactory) had a donation. After 6 months, S-DOT score improved for all hospitals to a median of 23.5 (range 4–37) with a median increase of 6.7 (range 1–22), P < 0.001. Four hospitals with a score >30 had 6 donations, 9 hospitals with score 15–29 had 7 donations whereas none of the 5 hospitals with score <15 had any donation. Conclusion: S-DOT score may be a useful tool for the objective assessment and improvement of hospitals on best practices in DBD. A score of >30 was frequently associated with OD, while a score <15 could consistently identify hospitals that did not have any donation.
Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 1997
A nonoperative method of palliation was used in four patients with malignant obstructive jaundice... more A nonoperative method of palliation was used in four patients with malignant obstructive jaundice in whom biliary endoprosthesis could not be placed endoscopically. A guide wire was manipulated through the lesion by a percutaneous transhepatic route and retrieved from the duodenum through an endoscope. A 10 Fr stent was then passed through the endoscope over the guide wire across the stricture. The procedure was successful in all four patients, with no complication.
Tropical gastroenterology : official journal of the Digestive Diseases Foundation
We present here a patient of congenital non-obstructive focal dilatation of intrahepatic biliary ... more We present here a patient of congenital non-obstructive focal dilatation of intrahepatic biliary radicles (Caroli's disease). The peculiar configuration of dilated intrahepatic biliary channels with central portal vein radicles was picked up sonologically as the 'central dot' sign. Awareness of this sign allows an accurate diagnosis without resorting to more invasive and expensive investigations.
The family of a 48-year-old female with brain death requested for directed donation of a kidney t... more The family of a 48-year-old female with brain death requested for directed donation of a kidney to her brother. Failure to comply with the wishes of the family due to medical reasons resulted in the withdrawal of consent for the donation of all organs. The status of deceased directed donation is discussed and a checklist suggested for the same in India.
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