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Cholecystoduodenocolic Fistula: An Unexpected Intraoperative Finding, a Surgical Challenge

International Journal of Clinical Medicine 2016年第4期7卷 261-264页

作者： Gulzar Ahmad Bhat Rahul Jain pawan lal Gen. & Minimal Access Surgery Lok Nayak Hospital Maulana Azad Medical College New Delhi India

The bilioenteric fistulas, first described in 1890 by Courvoisier, are found in 0.15% - 8% of biliary tract operations. Combined fistulas involving the gallbladder, duodenum and colon are extremely rare. We presented a case of 38 year female who presented to our OPD with complaints of pain right upper abdomen for seven months in whom a cholecysto-duodenocolic fistula (Figure 1 & Figure 2) was found during surgery which was repaired primarily. Gallstone disease is a common problem in hepatobiliary system and may rarely present as cholecysto-enteric fistula. The most common type of biliary enteric fistula is Cholecystoduodenal fistula (70%). Cholecysto-duodeno-colic (CDC) fistula is a rare complication of cholelithiasis. The standard treatment of IBF is cholecystectomy and repair of the fistulous opening. Although very rare a cholecystoduodenocolic fistula should be kept as a possibility when there are adhesions between GB, duodenum and colon. Conversion to open surgery should be considered early when the anatomy is not clear to prevent iatrogenic injury.

关键词： Fistula Cholecystectomy Cholecystoduodenocolic Fistula

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Evaluation of Outcome of Ureteroscopic Pneumatic Lithotripsy in Single Lower Ureteric Calculus and Its Association with CT Parameters

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Open Journal of Urology 2019年第10期9卷 153-161页

作者： Rahul Bhatia Tariq Hameed pawan lal Lovenish Bains Gaurish Sawant Haraesh Maranna Department of Surgery Maulana Azad Medical College New Delhi India

Objective: To evaluate the outcome of ureteroscopic pneumatic lithotripsy in single lower ureteric calculus and correlate its success with different CT parameters like HU, size of calculus and hydrnephrosis, if present. Patients and Methods: This study was conducted from October 2017 to March 2019 in Department of General Surgery, Maulana Azad Medical College, New Delhi. 30 patients (out of which 6 were excluded due to spontaneous passage of calculus), with single lower ureteric calculus were chosen and the outcome of URSL was compared with respect to CT parameters of Size, HU and Hydronephrosis and intra-operative clearance of calculus. Results: Success rate of URSL in single lower ureteric calculus was found to be 75%. Lower HU (774.12 ± 212.85) was associated with higher success rate. Similarly smaller size of calculus (9 ± 2.1) mm was associated with success group. Patients with gross hydronephrosis had a poor outcome of URSL. Lower urinary tract infection (8.33%) was the most common complication. Conclusion: Patients with small size calculus, low HU and absence of hydronephrosis have a better outcome of URSL.

关键词： Computed Tomography (CT) Ureteroscopic Lithotripsy (URSL) Hounsfield Unit (HU) Hydronephrosis (HDN)

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Ethnobotany and phytopharmacology of Pinus roxburghii Sargent:a plant review

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Journal of Integrative Medicine 2013年第6期11卷 371-376页

作者： pawan Kaushik Dhirender Kaushik Sukhbir lal Khokra Institute of Pharmaceutical Sciences Kurukshetra University

Traditional medicine is a blend of information gathered over generations from various communities and cultures. Pinus roxburghii Sargent （Pinaceae） commonly known as ＂chir pine＂ is widely used in traditional and folkloric systems of medicine. The all parts of the plant are believed to possess medicinal qualities in Ayurvedic and Unani systems of medicine. In these traditional systems of medicine, the plant is used to heal many diseases, including afflictions of the eyes, ears, throat, blood, and skin. The plant parts are rich in various bioactive compounds such as a-pinene, abietic acid, quercetin and xanthone. Resin acids and flavanoid form a major portion of these bioactive compounds. This review presents examples of traditional medicinal uses for P. roxburghii, and subsequently explores the current understanding of the chemical, pharmacological, and biochemical properties of the extracts and the main active constituents found in each tissue of the plant. Clinical trial information is also included where available. Careful evaluation of these data may be helpful for scientists and researchers to discover and evaluate the specific chemical entities responsible for the traditional medicinal uses of P. roxburghii.

关键词： Pinus roxburghii Sargeant phytochemistry pharmacology ethnopharmacology review

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