Publications by authors named "G Avasthi"

34 Publications

Methotrexate-induced liver cirrhosis in a patient of psoriasis.

J Assoc Physicians India 2012 May;60:47-8

Department of Medicine, SPS Apollo Hospitals, Ludhiana.

Methotrexate has been used for many years to treat refractory psoriasis. A case of methotrexate induced cirrhosis is being presented to emphasize the importance of strict adherence to published criteria for patient selection, monitoring of cumulative drug dosages, and the performance of serial liver biopsies.
View Article and Find Full Text PDF

Download full-text PDF

Source
May 2012

Healing of solitary rectal ulcers with multiple sessions of argon plasma coagulation.

Dig Endosc 2010 Apr;22(2):107-11

Department of Gastroenterology, SPS Apollo Hospitals, Ludhiana, Punjab.

Background: Solitary rectal ulcer syndrome (SRUS) is an uncommon disorder of evacuation. Management of bleeding ulcers is usually unsatisfactory with conventional treatment. Argon plasma coagulation (APC) has been reported to control bleeding; however, it has not been shown to result in ulcer healing. The aim of the present study was to: (i) to investigate the efficacy and safety of APC in controlling bleeding from SRUS; and (ii) to study its efficacy in the healing of ulcer/s.

Methods: Twenty-four patients with bleeding SRUS diagnosed on clinical, colonoscopic, and histological findings were randomized to receive either standard care alone (12 patients) or to undergo multiple sessions of APC in addition (12 patients). All patients were followed up to determine ulcer healing.

Results: Twenty-four patients with a mean duration of symptoms of 12.6 +/- 4.8 months were included. Bleeding was controlled with one (n = 5) or two sessions (n = 7) of APC. Reduction in size and depth of ulcer was noted. Eight out of 12 patients who received APC had complete healing of ulcers after four to eight sessions, carried out 2-4 weeks apart. The remaining four patients had a reduction in size and depth of ulcers compared to their pretreatment appearance. All patients were advised to have a high intake of fluids, fiber and laxatives, and to undergo biofeedback and behavior modification therapy in addition to the treatment.

Conclusions: APC controls bleeding in patients with SRUS and it also improves the healing of these ulcers.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/j.1443-1661.2010.00941.xDOI Listing
April 2010

High pharyngoesophageal strictures after laryngopharyngectomy can also be treated by self-expandable plastic stents.

Gastrointest Endosc 2010 Jun 9;71(7):1304-7. Epub 2010 Apr 9.

Department of Gastroenterology, Sahara Hospital, Lucknow 226010 (UP), India.

Background: Permanent dysphagia occurring after laryngectomy or laryngopharyngectomy can usually be treated by periodic dilation. Occasionally, however, conservative treatment is insufficient, and patients require long-term tube feeding. We describe 4 cases with stricture after laryngopharyngectomy who underwent insertion of self-expandable plastic stents (SEPSs) across the stricture for treatment of dysphagia.

Objective: The aim of this study was to evaluate the role of SEPSs in postlaryngopharyngectomy strictures.

Design: An interventional study of management of 4 patients of dysphagia after laryngopharyngectomy with SEPSs.

Setting: Medical gastroenterology unit in a tertiary care hospital.

Patients: Four patients with dysphagia after laryngopharyngectomy.

Interventions: SEPS placement and removal after 3 months.

Main Outcome Measurements: Improvement in dysphagia.

Methods: Four patients with dysphagia after laryngopharyngectomy underwent dilation of stricture followed by SEPS placement for 3 months.

Results: Three patients had grade IV, and 1 grade III dysphagia. Endoscopy showed stricture at 10 to 14 cm from the incisors. Stricture was dilated up to 15 mm on 3 occasions, 2 weeks apart. A silicone Polyflex stent was placed across the stricture and removed after 3 months. No dysphagia recurred after 2 months. No significant complications were noted.

Limitations: Small sample size.

Conclusions: SEPSs dilate postlaryngopharyngectomy strictures and prevent restenosis even after removal.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.gie.2009.12.050DOI Listing
June 2010

Healing of a bleeding solitary rectal ulcer with multiple sessions of argon plasma.

Gastrointest Endosc 2010 Mar;71(3):578-82

Department of Gastroenterology, SPS Apollo Hospitals, Punjab, India.

Background: Solitary rectal ulcer syndrome (SRUS) is an uncommon disorder of evacuation. Management of bleeding ulcers is usually unsatisfactory with conventional treatments. Argon plasma coagulation (APC) has been reported in case reports to control bleeding; however, it has not been shown to result in ulcer healing.

Objective: To investigate the efficacy and safety of APC in controlling bleeding from SRUS and to study its efficacy in eventual healing of ulcers.

Design: A randomized, controlled trial of the management of 24 consecutive patients with SRUS.

Setting: The gastroenterology unit at 2 tertiary care hospitals.

Patients: Twenty-four patients with bleeding SRUS.

Main Outcome Measurements: Control of bleeding and endoscopic healing of SRUS.

Methods: Twenty-four patients with bleeding SRUS, whose diagnoses were based on clinical, colonoscopic, and histologic findings, were randomized to receive either standard care only (12 patients, biofeedback therapy [BT] group) or multiple sessions of APC in addition to BT (12 patients, APC group). All patients were advised to intake a high level of fluids and fibers, laxatives, biofeedback, and behavior modification therapy in addition to the treatment. Patients were followed to determine whether ulcers healed.

Results: Twenty-four patients with symptoms that lasted 12.6 +/- 4.8 months were included. Bleeding was controlled in all 12 patients in the APC group, but only in 5 of 12 patients in BT group. We also made the following observations about healing of the ulcers: 8 of 12 patients in the APC group had complete healing of their ulcers after 4 to 8 sessions, whereas in the BT group, ulcers healed in only 2 of 12 patients.

Conclusions: APC controls the bleeding in patients with SRUS and also improves the healing of these ulcers.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.gie.2009.10.038DOI Listing
March 2010

Homocysteine--risk factor for ischemic stroke?

Indian J Physiol Pharmacol 2009 Jan-Mar;53(1):34-8

Department of Biochemistry, Dayanand Medical College & Hospital, Ludhiana 141 001.

The present study was undertaken to compare the homocysteine levels in patients of ischemic stroke with controls. Our study included 117 patients of ischemic stroke and 101 controls. The mean homocysteine levels in patients with ischemic stroke were 16.80 +/- 6.71 micromol/L while in controls it was 12.30 +/- 4.68 micromol/L, the difference being statistically significant (P < 0.01). The increased homocysteine levels in patients with ischemic stroke are independent of diabetes mellitus, age and sex. The homocysteine levels were higher in hypertensive subjects than non-hypertensive (P < 0.05).
View Article and Find Full Text PDF

Download full-text PDF

Source
November 2009
-->