Browsing by Author "M. Ansari"

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Comparative assessment of imaging modalities in biliary obstruction
(Georg Thieme Verlag, 2006) V. Upadhyaya; D. Upadhyaya; M. Ansari; V. Shukla
Background: Many imaging modalities are available today for the evaluation of patients with suspected biliary obstruction including Ultrasonography, Computed Tomography and Invasive cholangiography. Magnetic resonance cholangiopancreatography is a relatively new technique, which has gained popularity because of its excellent diagnostic capabilities in the evaluation of biliary obstruction. Aims: The aim of the present study was to compare the diagnostic accuracy of Ultrasonography, Computed Tomography, Endoscopic retrograde cholangiopancreatography/ Percutaneous transhepatic cholangiography and Magnetic resonance cholangiopancreatography in assessing the level and cause of obstruction in patients with obstructive jaundice. Patients & Methods: One hundred patients with clinical and laboratory features suggestive of biliary obstruction were included in this study. At least two imaging modalities were used in each patient. The level and cause of obstruction was evaluated by each modality. The findings were corroborated with the operative and/or histopathological findings. Results: Magnetic resonance cholangiopancreatography showed the best results in detecting the cause of obstruction and was second only to Endoscopic retrograde cholangiopancreatography in detecting the level of biliary obstruction. Conclusions: With its excellent diagnostic capabilities, Magnetic resonance cholangiopancreatography has certainly carved a niche for itself in the non-invasive evaluation of the patient with obstructive jaundice.
Effect of glycaemic control on apoptosis in diabetic wounds.
(2005) N.K. Rai; Suryabhan; M. Ansari; M. Kumar; V.K. Shukla; K. Tripathi
OBJECTIVE: To study the effect of glycaemic control on apoptosis in chronic ulcers in diabetic patients and the differential roles of insulin and oral hypoglycaemic agents (OHAs). METHOD: Ten non-diabetic (group I) and 20 diabetic patients (groups II and III), with a wound of more than four weeks' duration, who were attending the wound clinic at University Hospital, Varanasi, India were recruited. The 10 patients in group 11 received insulin and the 10 in group III an oral hypoglycaemic agent; all had diabetic foot ulcers. Wound biopsy and other routine investigations were performed. Both DNA fragmentation and morphological changes under light microscopy (apoptotic index) were used as determinants of apoptosis. Different variables, including fasting and post-prandial blood sugar, serum low-density lipoprotein (LDL) and markers of microangiopathy, such as proteinuria and diabetic retinopathy, were compared with apoptosis. RESULTS: DNA fragmentation in groups I, II and III was 40.00 +/- 2.97, 45.26 +/- 3.21 and 60.8 +/- 3.13 respectively (p < 0.01). Near linear correlation was observed with blood sugar level, particularly post-prandial blood sugar (p < 0.05) and DNA fragmentation. DNA fragmentation was significantly correlated with serum LDL and proteinuria, and it was much greater in the OHA group than in the insulin group (p < 0.05). Similarly, in the diabetic patients with background retinopathy the DNA fragmentation was 46.50 +/- 3.42 (n=3) in the insulin group and 66.70 +/- 6.48 (n=4) in the OHA group (p < 0.05). CONCLUSION: There is a significant increase in apoptosis in diabetic wounds with poorly controlled blood sugar and microangiopathy. This increase was greater in patients on OHAs than those on insulin, and it contributes to delayed wound healing. Morphological markers do not appear to be a reliable index of apoptosis in the diabetic wound.
Primary retroperitoneal transitional cell carcinoma presenting as a dumb-bell tumour
(2009) S. Basu; M. Ansari; S. Gupta; Anand Kumar
We report a retroperitoneal transitional cell carcinoma arising from the primitive urogenital remnants of a 56-year-old married Indian woman. She presented with a huge cystic mass in the hypogastrium and right iliac fossa, which extended into the right thigh as a massive dumb-bell tumour. On exploration, it was found not to be arising from any known retroperitoneal structure. The mass was excised, and the histopathology confirmed transitional cell carcinoma with positive margins. Though she received postoperative chemotherapy with cyclophosphamide, adriamycin and cisplatin, she developed extensive local recurrence and hepatic secondaries, and succumbed to the disease after ten months of follow-up. We highlight the rarity of the disease, its atypical presentation as a cystic dumb-bell lump, its diagnostic challenges and aggressive behaviour, and review the literature on primary retroperitoneal transitional cell carcinomas.