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Primary tuberculous appendicitis presented with caecal perforation:A case report

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Asian Pacific Journal of Tropical Medicine 2012年第10期5卷 834-836页

作者： Elamurugan TP Sivashanker M Suresh Kumar S Muthukumarassamy R vikram kate Department and Institution/Department of surgery Jawaharlal Institute of Postgraduate Medical Education and Research(JIPMER)PuducherryIndia

Gastrointestinal tuberculosis accounts for 3%of the extrapulmonary tuberculosis with ileocaecal region being the common site of involvement up to 75%.Primary involvement of appendix is very rare and accounts for only 0.6%to 2.9%of gastrointestinal tuberculosis in the absence tubercular focus *** pre-operative investigations usually give non-specific results. The diagnosis in most instances made only after *** we report a case of primary appendicular tuberculosis in a patient presented with caecal perforation.

关键词： Appendicular tuberculosis Intestinal tuberculosis Caecal peroration TB Abdomen

Risk factors for the development of colorectal carcinoma:A case control study from South India

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World Journal of Gastrointestinal Oncology 2016年第2期8卷 207-214页

作者： Santhana Krishnan Iswarya Kariyarath Cheriyath Premarajan Sitanshu Sekhar Kar Sathasivam Suresh Kumar vikram kate departments of preventive and social medicine jawaharlal institute of postgraduate medical education and researchPondicherry 605006India department of surgery jawaharlal institute of postgraduate medical education and researchPondicherry 605006India

AIM:To study the association of colorectal carcinoma(CRC) with diet,smoking,alcohol,physical activity,body mass index,family history and ***: All consecutive patients with CRC confirmed by histopathology diagnosis were included. Age(±5 years) and gender matched controls were selected among the patients admitted in surgery ward for various conditions without any co-existing malignancy. Food frequency questionnaire(FFQ) was developed and validated after pretesting by investigator trained in data col ection techniques. Cases and controls were interviewed ensuring privacy,in similar interview setting,with same duration of time for both cases and controls without any leading question. Biological variables like family history of CRC in first degree relatives,history of diabetes mellitus; behavioral factors like tobacco use both smoking and smokeless form,alcohol consumption and physical activity were recorded. Dietary details were recorded using a FFQ consisting 29 food items with seven categories. Analysis was done using appropriate statistical ***: Ninety-four histopathologically confirmed cases of CRC and equal number of age and gender matched controls treated over a period of two years were studied. Age distribution,mean age,male to female ratio,education level and socioeconomic status were similar in cases and controls. Intake of food items was categorized into tertile due to skewed distribution of subjects as per recommended cut off for consumption of food item. On univariate analysis red meat [OR=7.4(2.935-18.732)],egg [OR=5.1(2.26-11.36)],fish,fried food and oil consumption were found to be risk factors for CRC. On multivariate analysis red meat consumption of more than 2-3 times a month(OR=5.4; 95%CI:1.55-19.05) and egg consumption of more than 2-3 times a week(OR = 3.67; 95%CI:1.23-9.35) were found to be independent risk factors for the development of ***: Egg and red meat consumption found to be independent risk factors for C

关键词： Dietary factors Smoking Rectal cancer Redmeat Colorectal malignancy

Retrograde jejunogastric intussusception following Braun's jejunojejunostomy

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World Journal of Clinical Cases 2014年第1期2卷 24-26页

作者： Raj Gopal Thirthar Palanivelu Elamurugan Sunny Hage Rajakannu Muthukumarassamy vikram kate Department of Surgery Jawaharlal Institute of Postgraduate Medical Education and Research Puducherry 605006 India

Jejunogastric intussusception is a rare long term complication of Billroth Ⅱ gastrectomy. The case reported here is a 50 year old man with history of a Billroth Ⅱ gastrectomy and Braun's side-to-side jejunojejunal anastomosis who presented with hematemesis. On abdominal examination, there was a mass in the left iliac fossa. Computed tomography scan showed a retrograde jejunogastric intussusception across the gastrojejunostomy. On laparotomy, a retrograde intussusception of the distal jejunum through the jejunojejunal anastomosis and across the gastrojejunostomy with a gangrenous intussusceptum was found. The jejunojejunal anastomosis was taken down, the gangrenous segment was resected and bowel continuity was restored with two jejunojejunal anastomoses, proximal and distal to the gastrojejunostomy. The gastrojejunostomy was preserved. This case brings out an unusual type of retrograde gangrenous intussusception which occurred at two points of a previous anastomosis, i.e., jejunojejunostomy and gastrojejunostomy simultaneously, which could be managed with jejunal resection.

关键词： Retrograde Intussusception BillrothⅡgastrectomy Jejunojejunostomy

Effect of Frey's procedure on islet cell function in patients with chronic calcific pancreatitis

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Hepatobiliary & Pancreatic Diseases International 2018年第4期17卷 358-362页

作者： Ritesh Kumar Jaya Prakash Sahoo Biju Pottakat Sadishkumar Kamalanathan Pazhanivel Mohan vikram kate Sitanshu Sekhar Kar Jayakumar Selviambigapathya Department of Endocrinology Metabolism Jawaharlal Institute of Postgraduate Medical Education and Research(JIPMER)Pondicherry 605006India Department of Surgical Gastroenterology Jawaharlal Institute of Postgraduate Medical Education and Research(JIPMER)Pondicherry 605006India Department of Medical Gastroenterology Jawaharlal Institute of Postgraduate Medical Education and Research(JIPMER)Pondicherry 605006India Department of Surgery Jawaharlal Institute of Postgraduate Medical Education and Research(JIPMER)Pondicherry 605006India Department of Preventive and Social Medicine Jawaharlal Institute of Postgraduate Medical Education and Research(JIPMER)Pondicherry 605006India

Background: Frey’s procedure involves both drainage and resection of the pancreas in subjects with chronic calcific pancreatitis(CCP). The procedure may affect the pancreatic endocrine function after surgery. The present study was to evaluate the effect of Frey’s procedure on both beta and alpha cell function in CCP ***: Thirty CCP patients who underwent Frey’s procedure were included. According to the glycemic status, patients were divided into the diabetes mellitus(DM), prediabetes, and normal glucose tolerance(NGT) groups. Islet cell function was assessed before and 3 months after ***: At baseline, there was a significant difference in beta cell function among the three groups [NGT group 1.71(1.64–2.07) vs prediabetes group1.50(0.83–1.61) vs DM group 0.33(0.12–0.55), P < 0.0001], but the insulin resistance was not different among them. Post glucose hyperglucagonemia representing alphacell dysfunction during oral glucose tolerance test was present in all of them, but showed no significant difference [NGT group 0.15(0.06–0.31) vs prediabetes group 0.32(0.05–0.70) vs DM group 0.07(0.02–0.18), P = 0.20]. Frey’s procedure did not change beta cell function and insulin resistance. However, alphacell dysfunction deteriorated after surgery [0.10(0.03–0.27) vs 0.33(0.09–0.68), P = 0.004].Conclusions: Although Frey’s procedure does not affect the beta cell function and insulin resistance in CCP patients, the alpha-cell dysfunction deteriorates after surgery.

关键词： Beta-cell Diabetes mellitus Glucagon Insulin secretion sensitivity index Matsuda index

Standard triple versus levofloxacin based regimen for eradication ofHelicobacter pylori

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2013年第2期4卷 23-27页

作者： Raj Gopal Thirthar Palanivelu Elamurugan vikram kate Sadasivan Jagdish Debdatta Basu Department of Surgery Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India Department of Pathology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India

AIM:To compare the eradication rates for Helicobacter pylori(***) and ulcer recurrence of standard triple therapy(STT) and levofloxacin based therapy(LBT).METHODS:Seventy-four patients with perforated duodenal ulcer treated with simple closure and found to be *** infected on 3 mo follow up were randomized to receive either the STT group comprising of amoxicillin 1 g bid,clarithromycin 500 mg bid and omeprazole 20 mg bid or the LBT group comprising of amoxicillin 1 g bid,levofloxacin 500 mg bid and omeprazole 20 mg bid for 10 d *** *** eradication rates,side effects,compliance and the recurrence of ulcer were assessed in the two groups at 3 mo follow ***:Thirty-four patients in the STT group and 32 patients in the levofloxacin group presented at 3 mo follow *** eradication rates were similar with STT and the LBT groups on intention-to-treat(ITT) analysis(69% vs 80%,P = 0.425) and(79% vs 87%,P = 0.513) by per-protocol(PP) analysis *** recurrence in the STT and LBT groups on ITT analysis was(20% vs 14%,P = 0.551) and(9% vs 6%,P = 1.00) by PP *** and side effects were also comparable between the groups.A complete course of STT costs Indian Rupees(INR) 1060.00,while LBT costs only INR ***:*** eradication rates and the rate of ulcer recurrence were similar between the STT and *** LBT is a more economical option compared to STT.

关键词： Helicobacter pylori Eradication Peptic perforation Levofloxacin regime Randomized control trial Standard triple therapy

Rapunzel syndrome:A rare presentation with multiple small intestinal intussusceptions

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World Journal of Gastrointestinal Surgery 2013年第10期5卷 282-284页

作者： Bidarahalli Krishna Prasanna Kuppusamy Sasikumar Uppinakudru Gurunandan Gubbi Shamanna Sreenath vikram kate Department of Surgery Jawaharlal Institute of Postgraduate Medical Education and Research

Bezoars are usually confined to the stomach which is seen in individuals with psychiatric illness like trichotillomania,trichophagia and gastric *** standing bezoars may extend into the small intestine leading to a condition known as Rapunzel *** can be established by endoscopy,ultrasonography and computed tomography *** includes improvement of general condition and removal of bezoar by laparoscopic approach or *** consultation is necessary to treat and prevent *** report a case of Rapunzel syndrome in a 16-yearold girl with *** presented with history of epigastric mass for three months and recent onset of pain abdomen,vomiting and early *** of abdomen was showing distended stomach and endoscopy revealed *** laparotomy,stomach was distended with trichobezoar and there were multiple small intestinal *** and manual reduction of intussusceptions with the removal of trichobezoar with its tail was *** recovered completely after the procedure.

关键词： Rapunzel syndrome Trichobezoar Trichotillomania Intussusception

Isolated Full Thickness Jejunal Necrosis Following Sulphuric Acid Cocktail Ingestion – A Clinical Case Report—Isolated Corrosive Jejunal Necrosis

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Surgical Science 2011年第6期2卷 338-340页

作者： S. S. Pankaja George J. Valooran Sri Aurobindo Prasad Das L. Suvasini R. Aravind vikram kate Pankaj Kundra Departments of Surgery and Anaesthesiology Jawaharlal Institute of Postgraduate Medical Education and Research

Isolated involvement of the lower gastrointestinal tract with relative sparing of the oesophagus and the stomach is extremely rare following corrosive agent ingestion. We report a case of isolated full thickness jejunal necrosis following sulphuric acid cocktail ingestion. A 42 year old man presented with history of consuming 200ml of sulphuric acid mixed with alcohol, with suicidal intent. On exploration there were multiple, full thickness necrotic areas in the proximal jejunum with minimal congestion of the oesophagus, stomach and duodenum. Inversion of the jejunal necrotic areas with feeding jejunostomy was carried out. However postoperatively patient developed progressive pulmonary insufficiency with features of sepsis and expired on the nineteenth day following a bout of massive haematemesis. Corrosive agents when taken in considerable amount mixed with other fluids can lead to full thickness small bowel necrosis with relative sparing of the proximal gastrointestinal tract.

关键词： Corrosive Injury Acid Ingestion Bowel Necrosis