Browsing by Author "Malhotra, V"

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    Abnormal growth patterns of the pelvic urothelium in the presence of renal calculi.
    (1975-06-01) Iyengar, B; Uma, K; Malhotra, V; Chandra, K
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    Aetiology of chronic diarrhoea in tropical children.
    (1999-01-28) Rastogi, A; Malhotra, V; Uppal, B; Aggarwal, V; Kalra, K K; Mittal, S K
    AIM: We studied the causes and presentations of chronic diarrhoea in post-weaned children. METHODS: Forty seven children (6 months to 12 years) with diarrhoea of more than 2 weeks duration were recruited and subjected to detailed clinical examination and investigations. RESULTS: Primarily on the basis of history, clinical examination and duodenal biopsy, children could be classified into 5 groups namely tropical enteropathy (46.8%), irritable bowel syndrome (10.6%), giardiasis (14.8%), celiac disease (6.8%) and non specific diarrhoea (21.8%). Children with tropical enteropathy improved with broad spectrum antimicrobial therapy, those with irritable bowel syndrome and non specific chronic diarrhoea with dietary interventions while children with celiac disease required definite withdrawal of gluten from diet.
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    Angio-access for haemodialysis--current perspective.
    (2001-07-08) Pareek, S K; Malhotra, V
    Vascular access for haemodialysis has seen many developments in recent times. Double lumen catheters introduced into wide bore veins have replaced the traditional Scribner shunt as temporary access thus reducing the complications and morbidity associated with it. Cuffed tunnelled internal jugular catheters and synthetic arteriovenous (AV) grafts usually made of polytetrafluoroethylene are the new additions to the vascular access armamentarium, but the AV fistula introduced in 1966 still remains the life-line for chronic haemodialysis patient. However, in elderly and diabetic patients, synthetic AV grafts are beneficial. The added advantage of synthetic grafts is short maturation time and multiple potential access sites. Access failure in 80% cases is due to venous stenosis and thrombotic episodes while infections or other complications are there in 20% cases. The complications of vascular access are not only a major cause of morbidity in haemodialysis patients but a major cost for the end stage renal disease programme. In western countries, access related morbidity accounts for almost 25% of all hospital stays for end stage renal disease patients and may contribute to as much as 50% of all hospitalisation cost. Access salvage includes prospective monitoring and treatment of outflow stenosis. The direct intra-access measure of blood flow by ultrasound dilution and duplex colour flow Doppler technique is the ideal method detecting venous outflow stenosis; however, conventional and digital subtraction angiography has an advantage, that total vasculature and blood flow may be visualised. The various treatment modalities for outflow stenosis include use of percutaneous transluminal angioplasty, stents and surgical correction. The lyses of secondary thrombosis can be done by surgical, medical and mechanical thrombolysis. The various methods being used to prevent graft stenosis include use of dipyridamole and radiation. The gene therapy holds promises for the future.
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    Angiofollicular lymph node hyperplasia (a case report with autopsy findings).
    (1984-01-01) Malhotra, V; Beohar, P C; Malik, R; Nigam, M; Naryanan, P S
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    Antemortem diagnosis of cardiac tuberculoma.
    (1998-01-16) Batra, R; Trehan, V; Salwan, R; Krishan, A; Nigam, M; Malhotra, V; Kaul, U A; Arora, R
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    Asymptomatic hepatocellular carcinoma with splenic metastasis--a case report.
    (1997-04-01) Jain, A K; Kumar, N; Misra, A; Puri, S K; Malhotra, V
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    Atypical TeratoidJRhabdoid Tumour of Brain
    (2003-04) Sidhu, Meena; Sakhuja, P; Malhotra, V; R, Gondal; Kumar, S
    Primitive neuroectodermal tumor (PNET) / medulloblastoma (MB) are the most commonmalignant central nervous tumors of the first decade of life. Atypical teratoid / rhabdoid tumor (ATT / RT) is a tumor of infancy and childhood although occasional cases have also been described in adults. ATT/RT has a characteristic histopathological, immunocytochemical and ultrastructural features. ATT /RT is a rare tumor, incidence of which remains to be defined with only hundred published cases. The present report docurilents the clinical features, histological and immunohistochemical findings of a case of ATT / RT.
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    Benign osteoblastoma of the lumbar spine.
    (1983-12-01) Kumar, S; Prakash, B; Singh, A K; Navlakha, R K; Malhotra, V
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    Brush cytology: an adjunct to diagnostic upper GI endoscopy.
    (2001-06-14) Patwari, A K; Anand, V K; Malhotra, V; Balani, B; Gangil, A; Jain, A; Kapoor, G
    Endoscopic brush cytology (EBC) was performed in antral and duodenal brushings of children subjected to upper GI endoscopy for the detection of H. pylori (Hp) and trophozoites of Giardia lamblia (Glt) in addition to routine endoscopic grasp biopsy (EGB). It was hospital based prospective study. EBC was performed in children subjected to upper GI endoscopy with a sheathed cytology brush. Mucosal brushings were collected from antrum, body of the stomach and second or third part of duodenum by gently rubbing the surface of the brush with the mucosal wall in all the directions, brush withdrawn and brushings performed on a glass slide. The smears were placed in 95% ethyl alcohol and later examined for Glt and Hp using Giemsa and Hematoxylin & Eosin stain. EGB was taken from antrum, body of the stomach and duodenum from sites other than those used for brushings. One hundred and seventy children between 1-13 years (median age = 5 years) were subjected to upper GI endoscopy for malabsorption (n = 94), recurrent abdominal pain (n = 49), failure to thrive (n = 16) and recurrent vomiting/regurgitation (n = 11) and EBC was performed in addition to routine EGB. Thirty five children (20.4%) were colonized by Hp, 14 (8.2%) were detected to have Glt and in 6 cases (3.5%) both Hp as well as Glt were detected. Out of 41 cases colonized by Hp, 24 cases (58.5%) were detected by EGB and 27 cases (65.8%) were detected by EBC. Out of 20 children in whom Glt were detected from their duodenum, the detection was by EBG in 12 cases (60%) and by EBC in as many as 19 cases (95%). Comparison of EGB and EBC suggested that detection rates with EBC were higher than EGB. Detection by EBC was significantly higher for Glt than Hp. There were no complications attributed to EBC and procedure time for endoscopy was not significantly prolonged. On the contrary, detection of Hp and particularly Glt in higher proportion of cases with the help of EBC was helpful in their appropriate management. Our results suggest that EBC is a safe and useful tool to enhance the value of diagnostic endoscopic procedure when used in combination with routine EGB.
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    Cardiac myxomas--a clinicopathological study.
    (1983-11-01) Beohr, P C; Malhotra, V; Khalilullah, M; Khanna, S K; Narayanan, P S; Gupta, M P; Rani, S
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    Choroid plexus carcinoma.
    (1996-05-01) Chopra, K; Iyer, S; Matta, S K; Gupta, A; Malhotra, V
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    Clinical implications of viral activity in dual infection with hepatitis B and C in chronic liver disease.
    (2002-05-21) Guptan, R C; Thakur, V; Malhotra, V; Sarin, S K
    BACKGROUND: There is limited information on the clinical and biochemical profile of chronic liver disease due to dual infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. There are variable reports on the severity of liver disease in dual infections. This is important, from clinical and therapeutic point of view. The present study analyzes liver disease in dual infections as compared to HBV and HCV infection present alone. MATERIAL AND METHODS: Out of 186 histologically proven non-alcoholic chronic liver disease patients, 30 (16.1%) were serologically diagnosed to be HBV and HCV dual infection (Group A, n=30). The clinical profile of these patients was compared with consecutively seen HBV related (Group B, n=30) and HCV related chronic liver disease (Group C, n=30) patients. Patients with dual infection were further grouped based on predominant HBV or HCV viral activity. RESULTS: Patients with dual infection were younger than those with chronic HCV infection (38.4 +/- 14.4 vs. 45.9 +/- 14.7 years, p < 0.05); with male predominance (p=0.06). Patients with chronic HCV infection more often presented with low-grade fever than dual infection group (60% vs. 30%, p < 0.05). Ascites and variceal bleeding were common presentations of HBV related cirrhosis. Patients with dual infection had significantly more deranged liver functions. The duration of illness was shorter in these patients compared with chronic HCV (2.9 +/- 1.6 vs. 7.3 +/- 1.4 year, p < 0.05). When patients with dual infection were subgrouped on HBV DNA and HCV RNA positivity, there was a tendency for increased biochemical derangement with active HBV infectionity. CONCLUSIONS: Our results highlight the fact that patients with HBV and HCV dual infection related chronic liver disease have a more aggressive course. There is a tendency for a more severe liver disease when HBV is active in the dual infection group.
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    Clinical spectrum of chronic liver disease in north Indian children.
    (1997-10-05) Dangwal, T R; Aggarwal, V; Malhotra, V; Baveja, U; Mittal, S K
    Recent advances in serodiagnosis of hepatotropic viruses have revolutionized the approach to diagnosis and understanding of chronic liver disease (CLD). There are few studies on CLD in children from India. The present study was planned to define the clinical spectrum of CLD in children, its histopathology and seroepidemiology. Forty children with clinical features satisfying the criteria for diagnosing chronic liver disease were studied. All underwent routine laboratory investigations, liver function tests and ultrasound scan of the abdomen. Liver biopsy, upper GI endoscopy and other special investigations were done wherever indicated. The most common presenting features were jaundice (70%), fever (67%), and abdominal distention (60%). On examination hepatomegaly and icterus (80% each) and splenomegaly (67%) were the commonest findings. Serum transaminases were raised in 62.5% of children while prothrombin time was prolonged in 75% patients. Oesophageal and/or gastric varices were seen in 13 out of 29 patients subjected to upper GI endoscopy. Hepatitis B surface antigen (HbsAg) was positive in 5 children (12.5%) while 3 (7.5%) tested positive for anti HCV antibody. The commonest histopathological diagnosis was infantile cholangiopathy (20%) followed by cryptogenic cirrhosis and idiopathic chronic active hepatitis (17.5% each). The study suggests that the incidence of chronic hepatitis B and C is rather low in childhood. However larger and longer studies are required to delineate the exact incidence of these conditions in childhood and their progression in adolescence and early adulthood.
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    Clinical, angiographic and histopathological predictors of restenosis after directional coronary atherectomy.
    (1995-05-01) Petkar, S; Gambhir, D S; Trehan, V; Nair, M; Gondal, R; Malhotra, V; Khalilullah, M
    Out of 127 directional coronary atherectomy (DCA) procedures done in our laboratory, there were 81 patients who had completed a minimum of six months of follow-up. To study the factors predisposing restenosis after successful DCA, we analysed the clinical and angiographic profile of the patients and the histopathological findings of the excised tissue in 44 patients whose complete follow-up data was available with us. The indication of DCA was an extremely eccentric significant stenosis located in the proximal or midsegment of a large vessel (> or = 3 mm size) in 97 percent of the cases. Angiographic restenosis, defined as more than 50 percent luminal diameter stenosis was absent in 24 (54.5%, Group A) and present in 20 (45.5%, Group B) patients. On univariate analysis, the factors which predisposed to restenosis were: (i) left anterior descending location, (ii) longer lesion length (9.6 +/- 3.1 mm vs 5.2 +/- 1.6, p < 0.01) and (iii) greater post-procedure residual luminal diameter stenosis (13.1 +/- 10.8% vs 4.3 +/- 6%, p < 0.01). No significant difference was found between the two groups for other variables like unstable angina, the location and the morphological characteristics of the lesion and the ratio of the vessel diameter to the size of the Atherocath. Histopathological examination of the retrieved tissue revealed the presence of media with or without external elastic lamina in 8 (33%) patients in Group A--without restenosis compared to only 1 (5%) patients in Group B--with restenosis (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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    Clinical, biochemical and histological profile of nonalcoholic steatohepatitis.
    (2001-09-26) Agarwal, S R; Malhotra, V; Sakhuja, P; Sarin, S K
    BACKGROUND: Nonalcoholic steatohepatitis (NASH) has often been described in obese women with diabetes and/or hyperlipidemia. We evaluated the clinical, biochemical and histological profile of NASH. METHODS: 52 patients with persistently elevated ALT (>40 IU/L) for >6 months with no history of significant alcohol consumption and negative serological work-up for hepatitis B and C and HIV were enrolled. Twenty-five patients were diagnosed as having NASH and their clinical, biochemical, and histological profile was evaluated. RESULTS: Of the 25 patients with NASH (mean age 33 years), 24 were men. Three were obese, seven had hyperlipidemia and two had impaired glucose tolerance. Thirteen patients presented with pain in the right hypochondrium, three with fatigue and weakness, and nine were asymptomatic. No patient had evidence of portal hypertension or liver cell failure. Mild elevation of ALT was the most common biochemical abnormality. Twenty-three of the 25 patients had ALT/AST ratio >1.0. Liver histology revealed macrovesicular steatosis in all, with mild inflammatory activity in the majority (70%). Fibrosis was seen in 12 patients-portal fibrosis in six, periportal fibrosis in three and bridging fibrosis in another three patients. None of the patients had features of cirrhosis. None of the factors was found to be associated with fibrosis except serum AST level, which was significantly higher in patients with fibrosis as compared to those without (89 [52] vs. 54 [18] IU/L; p<0.05). CONCLUSIONS: NASH is often seen in men, in the absence of obesity, diabetes and hyperlipidemia, and its severity is better assessed by liver histology than clinical assessment.
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    Colonoscopic polypectomy. North Indian experience.
    (1990-04-01) Kumar, N; Anand, B S; Malhotra, V; Thorat, V K; Misra, S P; Singh, S K; Chaudhary, A
    Colonoscopic snare polypectomy was carried out in 70 patients (40 children, 30 adults). There was a male preponderance in both the groups with a combined male: female ratio of 4.4:1. The majority of patients (85%) were aged 20 years or below. All patients presented with intermittent bleeding per rectum, ranging from 2 months - 6 years (mean 1.2 +/- 1.1 years) in children and 1-14 years (1.9 +/- 2.3) in adults. The majority of patients polyps were located in the rectum (73%) or in the rectosigmoid region (21%). Polyps were significantly more common in the rectum (80% vs 63%; P less than 0.01) and less frequent in the rectosigmoid (15% vs 30%; p less than 0.01) in children as compared to adults. A single polyp was present in 49 (70%) patients; 17 (24%) had 2-10 polyps, while 4 patients (2 children, 2 adults) had more than ten polyps. Most patients (94%) had polyps of less than 2 cm size. Histologically, the most polyps (91.5%) were of the juvenile variety; 39 (97.5%) children and 25 (83%) adults had this variety of polyp. The remaining 5 (17%) adults and one (2.5%) child had adenomatous polyps. The difference in the polyp histology between the two age groups was statistically significant (p less than 0.05). Only one patient (1.4%) had excessive bleeding following polypectomy. The present study suggests two important differences in the nature of polyps as compared to the West: 1) our patients were much younger, and polyps were rare after 40 years; and (2) histologically, the commonest polyps were of the juvenile variety (91.5%) while adenomatous polyps were rare (8.5%).
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    Comparative evaluation of bone marrow aspirate particle smears, imprints and biopsy sections.
    (1990-10-01) Sabharwal, B D; Malhotra, V; Aruna, S; Grewal, R
    Comparative evaluation of bone marrow aspirate particle smears, imprints and biopsy sections was done on 30 haematological problems. Core needle biopsy of the bone marrow is a safe and useful procedure. It is a valuable diagnostic aid for measurement of marrow cellularity, metastatic tumours and fibrosis. It should not be taken as a substitute for examination of the marrow by aspiration smear but is a complementary procedure which affords several advantages. Bone marrow biopsy was of maximum utility in myelofibrosis which was diagnosed on biopsy alone. There were three additional cases with normal bone marrow aspiration in which specific diagnosis could only be made from bone marrow biopsy sections. New methodologies i.e. plastic embedding and semi thin sections of undecalcified bone marrow, can be expected to improve the cytological details of tissue obtained by biopsy. Imprint preparations obtained from biopsy can be useful in patients of malignancy but we have found them to be of limited value except in cases of dry tap.
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    Cranial chordoma.
    (1991-02-01) Grover, A K; Mansharamani, G G; Jena, A; Dewan, R; Mehta, D K; Mathur, N N; Malhotra, V; Kumar, S
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    Current concepts in phototherapy.
    (1986-09-01) Ennever, J F; Malhotra, V
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    Disseminated mucormycosis.
    (1987-05-01) Banerjee, A; Malhotra, V; Mehta, V K; Malik, R; Beohar, P C; Narayanan, P S