Publications by authors named "Atul Rana"

7 Publications

  • Page 1 of 1

Visceral scalloping in pancreatic ascites: An uncommon manifestation of pancreatitis.

Pleura Peritoneum 2020 Mar 26;5(1):20200101. Epub 2020 Feb 26.

Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Scalloping of visceral organs like liver and spleen can cause certain peritoneal diseases. It has usually been described with pseudomyxoma peritonei and peritoneal carcinomatosis. Occasionally, it has also been described with certain benign conditions like peritoneal tuberculosis. We describe visceral scalloping in setting of pancreatic diseases. We believe that pancreatic fluid collections exert significant pressure on the visceral organs to result in scalloping of the visceral surfaces.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1515/pp-2020-0101DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7469503PMC
March 2020

Reduction of intra-abdominal pressure after percutaneous catheter drainage of pancreatic fluid collection predicts survival.

Pancreatology 2020 Jun 20;20(4):772-777. Epub 2020 Apr 20.

Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India. Electronic address:

Objective: Intra-abdominal hypertension (IAH) can adversely affect the outcome in patients of acute pancreatitis (AP). Effect of percutaneous drainage (PCD) on IAH has not been studied. We studied the effect of PCD on IAH in patients with acute fluid collections.

Material And Methods: Consecutive patients of AP undergoing PCD between Jan 2016 and May 2018 were evaluated for severity markers, clinical course, hospital and ICU stay, and mortality. Patients were divided into two groups: with IAH and with no IAH (NIAH). The two groups were compared for severity scores, organ failure, hospital and ICU stay, reduction in IAP and mortality.

Results: Of the 105 patients, IAH was present in 48 (45.7%) patients. Patients with IAH had more often severe disease, BISAP ≥2, higher APACHE II scores and computed tomography severity index (CTSI). IAH group had more often OF (87.5% vs. 70.2%, p = 0.033), prolonged ICU stay (12.5 vs. 6.75 days, p = 0.007) and higher mortality (52.1% vs. 15.8%, p < 0.001). After PCD, IAP decreased significantly more in the IAH group (21.85 ± 4.53 mmHg to 12.5 ± 4.42 mmHg) than in the NIAH group (12.68 ± 2.72 mmHg to 8.32 ± 3.18 mmHg), p = <0.001. Reduction of IAP in patients with IAH by >40% at 48 h after PCD was associated with better survival (63.3% vs. 36.7%, p = 0.006).

Conclusion: We observed that patients with IAH have poor outcome. PCD decreases IAP and a fall in IAP >40% of baseline value predicts a better outcome after PCD in patients with acute fluid collections.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.pan.2020.04.012DOI Listing
June 2020

Ascites in acute pancreatitis: not a silent bystander.

Pancreatology 2019 Jul 9;19(5):646-652. Epub 2019 Jun 9.

Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address:

Background & Aim: Ascites in patients with acute pancreatitis (AP) is understudied although recent literature hints at its evident role in the final outcome. This study was planned to study the characteristics of ascites in patients of AP and its effect on the disease course and outcome.

Methods: Consecutive patients of AP were studied and patients with or without ascites were evaluated for the baseline parameters and severity assessment. Ascites was quantified and fluid analyzed for its characteristics. Intraabdominal pressure (IAP) was monitored. The various outcome parameters were compared between the two groups of patients with and without ascites.

Results: Of the cohort of 213 patients, 82 (38.5%) developed ascites. Ascites group had significantly higher rates of organ failure (p = 0.001), necrosis (p=<0.001) and higher severity assessment scores. The ascites group had significantly longer hospital and ICU stay and higher ventilator days compared to the non-ascites group. Mortality was also higher in the ascites group (34.1% vs 8.45; p = 0.001). Majority of patients with ascites had moderate to gross ascites (75.6%), low serum ascites albumin gradient (87.8%) with low amylase levels (71.9%). Sub-group analysis in ascites group showed that patients with fatal outcome had higher rates of moderate to gross ascites, higher baseline IAP and lower reduction in IAP after 48 h. Moderate to gross ascites and grades of intra-abdominal hypertension (IAH) were significant predictors of mortality (AUC - 0.76).

Conclusion: AP patients with ascites have a more severe disease with poorer outcome. Higher degrees of ascites and IAH grades are significant predictors of mortality.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.pan.2019.06.004DOI Listing
July 2019

Endoscopic Ultrasound-Guided Tissue Acquisition: Techniques and Challenges.

J Cytol 2019 Jan-Mar;36(1):1-7

Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, India.

Endoscopic ultrasound-guided fine needle aspiration (EUS FNA) has made pathological diagnosis of pancreatic neoplasms, diseases involving lymph nodes at various mediastinal and abdominal sites, gastrointestinal submucosal lesions, perirectal lesions, adrenal lesions, and mediastinal masses easy. EUS-guided FNA is a multistep procedure that involves assessment of proper clinical indication, correct selection of FNA needles, and adoption of evidence-based techniques for tissue sampling. EUS FNA is done by needles that are available in different sizes, mainly 25, 22, and 19-gauge needle. The need of onsite cytopathologist, dependence on histology/core biopsy occasionally to get a diagnosis, and inability to reliably assess for molecular markers are important limitations of EUS FNA. EUS-guided fine needle biopsy (FNB) that samples the core of tissue is an exciting new development in the field of diagnostic EUS. FNB needles are expensive than FNA needles, and although the initial results are encouraging, more studies with robust evidence proving their superiority beyond any doubt are needed before they can be widely used.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/JOC.JOC_146_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343389PMC
February 2019

Blisters on the sun-exposed area: as a clue for underlying hepatitis C virus infection.

Postgrad Med J 2019 02 16;95(1120):108-109. Epub 2018 Nov 16.

Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/postgradmedj-2018-136181DOI Listing
February 2019

Symmetrical peripheral gangrene: A rare complication of plasmodium falciparum malaria.

Trop Parasitol 2015 Jul-Dec;5(2):130-2

Department of Medicine, RNT Medical College, Udaipur, Rajasthan, India.

Malaria, the most important of the parasitic diseases of humans, is transmitted in 108 countries containing 3 billion people and causes nearly 1 million deaths each year. With the re-emergence of malaria various life-threatening complications of malaria have been observed. Unarousable coma/cerebral malaria, severe normochromic, normocytic anemia, renal failure, pulmonary edema/adult respiratory distress syndrome, hypoglycemia, hypotension/shock, bleeding/disseminated intravascular coagulation (DIC), hemoglobinuria and jaundice are few of the common complications of severe malaria. Symmetrical peripheral gangrene (SPG) has been reported as a rare complication of malaria. We report a rare and unique case of Plasmodium falciparum malaria complicated by DIC, severe normocytic normochromic anemia, and SPG.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/2229-5070.145592DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4557154PMC
December 2015

A curious case of hourly attacks of disabling episodic spontaneous hypothermia with hyperhidrosis.

Indian J Dermatol Venereol Leprol 2015 Mar-Apr;81(2):185-6

Department of Dermatology, Venereology and Leprosy and Department of Neurology, R. N. T. Medical College, Udaipur, Rajasthan, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/0378-6323.152292DOI Listing
December 2015