Browsing by Author "V.S. Chauhan"

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Biliary nitrate and risk of carcinoma of the gallbladder
(2004) V.K. Shukla; A. Prakash; V.S. Chauhan; S. Singh; Puneet
[No abstract available]
Enteric Perforation - Single-Layer Closure
(2004) V.K. Shukla; S.P. Sahoo; V.S. Chauhan; M. Pandey; A. Gautam
A hundred cases of enteric perforation, treated surgically by single- or double-layer closure, were studied prospectively. Mortality and morbidity rates were 10-18 and 37-42% and comparable in the two groups. The presence of preoperative shock was the single most important prognostic indicator observed in this study. Hence it is good closure of the perforation rather than single- or double-layer closure that determines the outcome in patients with enteric perforation.
Incisional hernia - Comparison of mesh repair with Cardiff repair: An university hospital experience
(2005) V.K. Shukla; R. Mongha; N. Gupta; V.S. Chauhan; Puneet
Background: Incisional hernia is a frequent complication of abdominal surgery. Various types of repair are recommended for incisional hernia. Suture and mesh repair are compared in the present study. Method: One hundred seventy one patients with incisional hernia underwent Cardiff repair (far and near sutures with reinforcement sutures) which was used as an open suture repair while onlay polypropylene mesh was used in the mesh repair technique. Result: Cardiff repair was performed in 116 patients with no mortality with recurrence in two patients with mean follow up of 7.1 years. Both these patients with recurrence had a defect measuring more than 10 cm in width. Mesh repair was carried out in 55 patients with no recurrence in mean follow up of 37 months. Seroma formation was noted in 7 (12.72%) with mesh repair as compared to 4 (3.44%) patients with Cardiff repair. Conclusion: We recommend Cardiff repair for primary and small to medium size incisional hernias. Onlay polypropylene mesh is ideal for tension-free hernia repair, recurrent incisional hernia and hernia defects wider than 10 cm. © Springer-Verlag 2005.
Lifestyle, reproductive factors and risk of gallbladder cancer
(2008) Vijay K. Shukla; V.S. Chauhan; R.N. Mishra; S. Basu
Introduction: Lifestyle and dietary habits play an important role in carcinogenesis. Carcinoma of the gallbladder is no different. The present study was carried out to evaluate the roles of lifestyle, menstrual and reproductive factors in gallbladder cancer. Methods : A prospective case-control study involving 78 newly-diagnosed cases of carcinoma of the gallbladder and 78 age- and gender-matched controls with cholelithiasis were investigated for their lifestyle history, with an emphasis on habits with chewing betel nut and tobacco, alcohol consumption and smoking. Besides this, female patients were investigated for their menstrual and reproductive factors. Odds-ratio and significance were calculated. Results: A Hindu preponderance was seen. About half of the patients with carcinoma of the gallbladder and gallstone were either illiterate or had a very low level of education (primary or below). Religion, education, family income, chewing of tobacco as well as smoking were comparable. But numbers of chewing tobacco and smoking per day differed significantly. Alcohol was consumed by 11.6 percent of carcinoma and 4.1 percent of gallstone patients. Lower age of menarche, higher number of pregnancies and higher age at menopause had a significantly increased risk of gallbladder carcinogenesis. A significant difference in carcinogenesis was seen in the postmenopausal women compared with the menopausal group. Conclusion: Carcinoma of the gallbladder was common in tobacco chewers. Females with lower age at menarche, higher number of pregnancies and childbirths and higher age at last childbirth had an increased risk of gallbladder cancer.
Magnetic resonance cholangiopancreatography in obstructive jaundice
(2004) M.D. Vaishali; A.K. Agarwald; N. Upadhyaya; V.S. Chauhan; O.P. Sharma; V.K. Shukla
Goals: To determine the ability of magnetic resonance cholangiopancreatography (MRCP) to diagnose the level and cause of obstruction in patients with obstructive jaundice. Background: The limitations of available imaging modalities have led to the increasing use of MRCP, which is a noninvasive and highly accurate technique in evaluating patients with biliary obstruction. Study: Thirty patients were included in this study. MRCP was done using a fat suppressed heavily T2 weighted fast spin echo sequence. The MRCP findings were confirmed on surgical exploration or clinical follow-up. Results: MRCP could correctly identify ductal dilatation and the level of obstruction in all cases, except one. All causes of obstruction, except three, were detected. It failed to detect a common bile duct calculus in a minimally dilated ductal system and misdiagnosed a case of focal chronic pancreatitis as carcinoma head pancreas and a small pancreatic head mass as cholangiocarcinoma. It had a sensitivity of 94.44%, specificity of 81.81%, positive predictive value of 89.47%, and negative predictive value of 90% for the detection of malignant causes. The overall diagnostic accuracy for detection of level and cause of obstruction was 96.3% and 89.65%, respectively. Conclusion: The high diagnostic accuracy of MRCP in evaluating patients with obstructive jaundice indicates that it has the potential to become the diagnostic modality of choice in such patients.
Sonocholangiometry: A simple method to detect residual stones after CBD surgery [1]
(W.B. Saunders Ltd, 2003) V.K. Shukla; V.S. Chauhan; R.C. Shukla; O.P. Sharma
[No abstract available]
The prevalence of pressure ulcers in hospitalised patients in a university hospital in India.
(2005) V.S. Chauhan; S. Goel; P. Kumar; S. Srivastava; V.K. Shukla
OBJECTIVE: To estimate the prevalence of pressure ulcers in hospitalised patients and any underlying or predisposing factors to ulceration. METHOD: This cross-sectional study took place in a university hospital in Varanasi, India. A total of 445 patients hospitalised in medical and surgical wards were examined in a single day for the number, site and grade of pressure ulcers. Haemoglobin, serum albumin and blood sugar levels of patients with pressure ulcers were recorded. RESULTS: The prevalence of pressure ulcers was high (4.94%). Anaemia, malnutrition and diabetes were important risk factors, while morbidity due to pressure ulcers in long-stay wards, such as neurology, was exceptionally high (40.9%). CONCLUSION: Pressure ulcers remain one of the most neglected aspects of health-care provision in India and identifying their associated risk factors at an early stage may go a long way in preventing their occurrence.
Thyroid surgery under local anaesthesia: An alternative to general anaesthesia
(2005) V.K. Shukla; S. Narayan; V.S. Chauhan; D.K. Singh
Background: Local Anaesthesia is now being accepted universally as a safe alternative to general anaesthesia for thyroid surgery. Aim: This study was carried out to compare the outcomes of patients undergoing thyroid surgery under local and general anaesthesia. Material and Methods: Hundred patients who underwent thyroid surgery for benign and malignant diseases under local and general anaesthesia from January 1996 and September 2003 were analysed. Patient characteristics analysed were age, sex, pathology lesion size, operating time, length of stay, cost and post operative complications. Results: Mean lesion sizes were 5.26 cms. and 6.33 cms. in local and general anaesthesia group respectively. Mean operating time was 41.6 minutes and 74.5 minutes in local anaesthesia and general anaesthesia group respectively. Mean cost incurred was Rs.2189.32 in local anaesthesia and Rs.5520.00 in general anaesthesia group. Mean length of hospital stay was 39.26 hours and 71.06 hours in local anaesthesia and general anaesthesia group respectively. Conclusion: Local anaesthesia is a safe alternative to general anaesthesia for patients undergoing thyroid surgery. Use of local anaesthesia has resulted in a decreased length of stay, cost and mean operating time, hence useful in a setup with limited anaesthesia time and increased work load.