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Search Results: 1 - 10 of 304458 matches for " Gupta Pravin J. "
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Infrared coagulation: a preferred option in treating early hemorrhoids
Gupta, Pravin J.;
Acta Cirurgica Brasileira , 2004, DOI: 10.1590/S0102-86502004000100013
Abstract: background: the ideal therapy for hemorrhoids is always debated. for early grades of the disease, many different modalities of treatment have been proposed. some are effective but are more painful, others are less painful but their efficacy is not assured on long term. infrared photocoagulation has emerged as a new addition to the list. in this procedure, the tissue is coagulated by infrared radiation. during treatment, mechanical pressure and radiation energy are applied simultaneously to ablate the blood supply to the hemorrhoidal mass. methods: in the present retrospective study, the effect of infrared coagulation on patients with early grades of hemorrhoids is described. in a separate study, a comparison is made between infrared coagulation and rubber band ligation in terms of their effectiveness and discomfort. results: 212 patients were treated by infrared coagulation and were followed up for a period of 18 months. only 28 patients had persistence or recurrence of bleeding. overall ratio of comfort and patient satisfaction from pain and bleeding was quite satisfactory. the comparative study showed that though rubber band ligation is more effective, it is a more painful procedure. conclusion: these studies shows that infrared coagulation for hemorrhoids in early stages could prove to be a easy and effective alternative to conventional methods as it is quick, less painful and safe. the procedure can be repeated in case of recurrence and should be considered as the first choice in early hemorrhoids.
Consumption of red-hot chili pepper increases symptoms in patients with acute anal fissures. A prospective, randomized, placebo-controlled, double blind, crossover trial
Gupta, Pravin J.;
Arquivos de Gastroenterologia , 2008, DOI: 10.1590/S0004-28032008000200006
Abstract: background: red-hot chili pepper and other spices have been blamed for causing or exacerbating symptoms of anal pathologies like anal fissure and hemorrhoids. aim: to determine if consumption of chilies increases symptoms of acute anal fissures. methods: individual patients were randomized to receive capsules containing chili or placebo for one week in addition to analgesics and fiber supplement. patients were asked to note score for symptoms like pain, anal burning, and pruritus during the study period. after 1 week, cross over treatment was administered to the same group of patients with the same methodology and results were noted at the end of 2 weeks. results: fifty subjects were recruited for this study. forty three of them completed the trial (22 in the chili group and 21 in the placebo group). the daily mean pain score was significantly lower in the placebo group in the study period. score 2.05 in chili group and 0.97 in placebo group. there was a significant burning sensation experienced by the patients in the chili group (score 1.85 for the chili group vs 0.71 for the placebo group). patient?s mean recorded improvement score was significantly higher after taking placebo. eighty one point three percent patients preferred placebo while 13.9% preferred chilies. two patients had no preference. conclusion: consumption of chili does increase the symptoms of acute anal fissure and reduces patient compliance.
Resección de quiste pilonidal por radiofrecuencia: una mejor opción para la resección amplia y cicatrización con herida abierta
Gupta,Pravin J;
Revista Colombiana de Cirugía , 2006,
Abstract: background: despite a variety of surgical techniques proposed for the treatment of pilonidal disease, none of them has come to be recognized as an optimum modality. in the present study, the author describes a technique of sinus excision using a radiofrequency device. a separate study is conducted to compare the outcome of this technique with wide excision and open granulation procedure. materials and methods: of the 44 patients with sacro-coccygeal pilonidal sinus disease studied, 23 were randomly assigned to undergo wide excision and healing by open granulation (weg) and 21 patients for radiofrequency sinus excision (rse). a ellman radiofrequency generator was used for sinus excision. peri and postoperative events, complexity and outcome data were recorded. results: the significant differences in the two group weg and rse were as follows- mean hospital stay [47 hours versus 10 hours], period off work (29 days versus 8 days), mean analgesic requirement (39 tablets versus 15 tablets), time for complete wound healing (84 days versus 49 days). at the mean follow-up of 30 months, two patients from the wide excision and open granulation group and one patient from the radiofrequency sinus excision group developed recurrence. conclusion: this study shows that sinus excision with radiofrequency is a simple and swift procedure. it needs a short hospital stay and is associated with less postoperative pain and early resumption to work. based on our initial experience, it can be concluded that this procedure has a place in the treatment of pilonidal sinus disease.
Infrared coagulation: a preferred option in treating early hemorrhoids
Gupta Pravin J.
Acta Cirurgica Brasileira , 2004,
Abstract: BACKGROUND: The ideal therapy for hemorrhoids is always debated. For early grades of the disease, many different modalities of treatment have been proposed. Some are effective but are more painful, others are less painful but their efficacy is not assured on long term. Infrared photocoagulation has emerged as a new addition to the list. In this procedure, the tissue is coagulated by infrared radiation. During treatment, mechanical pressure and radiation energy are applied simultaneously to ablate the blood supply to the hemorrhoidal mass. METHODS: In the present retrospective study, the effect of infrared coagulation on patients with early grades of hemorrhoids is described. In a separate study, a comparison is made between Infrared coagulation and rubber band ligation in terms of their effectiveness and discomfort. RESULTS: 212 patients were treated by infrared coagulation and were followed up for a period of 18 months. Only 28 patients had persistence or recurrence of bleeding. Overall ratio of comfort and patient satisfaction from pain and bleeding was quite satisfactory. The comparative study showed that though rubber band ligation is more effective, it is a more painful procedure. CONCLUSION: These studies shows that Infrared coagulation for hemorrhoids in early stages could prove to be a easy and effective alternative to conventional methods as it is quick, less painful and safe. The procedure can be repeated in case of recurrence and should be considered as the first choice in early hemorrhoids.
Radiofrequency surgery: Novel techniques in the treatment of ano-rectal disease
Gupta Pravin J.
Acta Chirurgica Iugoslavica , 2006, DOI: 10.2298/aci0602023g
Abstract: Background: Radiofrequency surgery is a method of utilizing high frequency (3.8 to 4MHz) radio wave energy to incise, excise, or coagulate tissues. Radiofrequency (RF) is a relatively new modality that is being used for ano-rectal surgeries with increasing frequency. As the RF energy is applied, frictional heating of tissues results, with cell death occurring at temperatures between 60 and 1000 C. Objective- This paper discusses author’s clinical experience with radiofrequency for various ano-rectal pathologies namely hemorrhoids, anal fistula, anal polyps, sinuses and anal papillae. A Ellman dual frequency radiofrequency generator was used to carry out the procedures. This study is intended to be somewhat of a "how we do it" manual, explaining the principles of radiofrequency. Conclusion: Radiofrequency proctological procedures are simple to perform with many advantages over the more traditional techniques. The procedures take less operative time, the postoperative recovery is accelerated and the incidences of complications are negligible.
Resección de quiste pilonidal por radiofrecuencia: una mejor opción para la resección amplia y cicatrización con herida abierta Radiofrequency resection of pilonidal cyst: a better option for a wide resection and healing by open wound
Pravin J Gupta
Revista Colombiana de Cirugía , 2006,
Abstract: Antecedentes: A pesar de la variedad de técnicas quirúrgicas descritas para el tratamiento del quiste pilonidal, ninguna ha merecido reconocimiento como modalidad óptima. En el presente artículo el autor describe una técnica para la resección del quiste o seno pilonidal utilizando un aparato de radiofrecuencia. Actualmente se realiza un estudio aparte para comparar los resultados de esta técnica de resección amplia y cicatrización por granulación. Materiales y métodos: De 44 pacientes con enfermedad pilonidal sacrococcígea, 23 fueron aleatorizados para resección amplia y cicatrización secundaria por granulación y 21 a resección por radiofrecuencia. Se utilizó un aparato de Ellman generador de radiofrecuencia. Se analizaron los eventos perioperatorios, la complejidad y los resultados. Resultados: Las diferencias significativas entre los dos grupos fueron las siguientes: promedio de hospitalización (47 horas frente a 10 horas); período de incapacidad laboral (29 días frente a 8 días); promedio de requerimiento analgésico (39 tabletas frente a 15 tabletas); tiempo para cicatrización total (84 días frente a 49 días). En el seguimiento promedio de 30 meses, dos pacientes en el grupo de resección amplia y herida abierta para granulación y uno en el grupo de resección por radiofrecuencia presentaron recurrencia. Conclusión: El estudio muestra que la resección mediante radiofrecuencia es un procedimiento simple y ágil. Requiere una hospitalización corta y se asocia con menos dolor postoperatorio y más pronto retorno al trabajo. Con base en nuestra experiencia, se puede concluir que este procedimiento merece un lugar en el tratamiento de la enfermedad pilonidal. Background: Despite a variety of surgical techniques proposed for the treatment of pilonidal disease, none of them has come to be recognized as an optimum modality. In the present study, the author describes a technique of sinus excision using a radiofrequency device. A separate study is conducted to compare the outcome of this technique with wide excision and open granulation procedure. Materials and Methods: Of the 44 patients with sacro-coccygeal pilonidal sinus disease studied, 23 were randomly assigned to undergo wide excision and healing by open granulation (WEG) and 21 patients for radiofrequency sinus excision (RSE). A Ellman radiofrequency generator was used for sinus excision. Peri and postoperative events, complexity and outcome data were recorded. Results: The significant differences in the two group WEG and RSE were as follows- mean hospital stay [47 hours versus 10 hours], period off work (
Ligation and mucopexy for prolapsing hemorrhoids – a ten year experience
Pravin J Gupta, Surekha Kalaskar
Annals of Surgical Innovation and Research , 2008, DOI: 10.1186/1750-1164-2-5
Abstract: 616 patients (255 females) complaining of symptoms of hemorrhoids were included in the study. The hemorrhoids were suture ligated with an absorbable suture material under vision. Operating time, postoperative complications, time to return to work, and outcome of the procedure were analyzed. Follow-up was planned following discharge after 1 month, 6 months and after at least 1 year. Patient satisfaction was also assessed.The mean procedure time was 8 ± 0 minutes (range, 6–15 minutes), and the total admission period was 12 ± 4 Hours. Perianal thrombosis and skin tags were the commonest post-operative complications. The mean total analgesic dose and duration of pain control using analgesics was 19 ± 4 tablets, and 9 ± 3 days respectively.The postoperative follow up after 4 weeks revealed therapeutic success in 589 patients (95.6%), who presented with hemorrhoidal bleeding. Prolapse was no longer observed in 98% of patients and 96% patients experienced no pain after defecation. 93% patients completed the one-year follow-up and 89 percent of them were asymptomatic. The patient satisfaction scoring was 8.2% on visual analogue scale.Suture ligation and mucopexy of hemorrhoids is an easy-to-perform technique that is well accepted by patients and has good results for prolapsing hemorrhoids.Many therapeutic options exist for the treatment of symptomatic hemorrhoids; among them are dietary and lifestyle modifications and office treatment such as infrared coagulation, sclerotherapy, rubber band ligation, hemorrhoidal artery ligation, or various stapling and excisional procedures [1].We describe a simpler technique for the reduction of the size of the hemorrhoids with control of bleeding and prolapse, which we term as ligation and mucopexy of the hemorrhoids under vision. This technique is based on the fact that the hemorrhoidal vessels have a constant anatomical location. Usually, they penetrate the hemorrhoid pile in the base. A stitch that is put on the base of the hemorrhoid
Which treatment for anal fistula? Cut or cover, plug or paste, loop or lift
Gupta Pravin J.,Shalini Gupta N.,Heda P.S.
Acta Chirurgica Iugoslavica , 2012, DOI: 10.2298/aci1202015g
Abstract: Anorectal fistulas are common maladies. The challenge in therapy of perianal fistulas balances between the best possible cure and the preservation of continence. Complex fistulous disease challenges even the most experienced surgical specialists. The management options in these groups of patients are inadequate, with treatment often requiring multiple procedures, causing a risk for continued symptoms and fecal incontinence. This has lead to a serious search for newer and safer treatment options. Use of different types of setons and advancement flaps have their own advantages and pitfalls. Invasive methods with high rates of incontinence have given way to sphincter-sparing methods that have a much lower associated morbidity. Treatment with fibrin glue is an attractive option whenever continence might be endangered by operative procedures. Initial results with fistula plugs are promising but need further critical observations. Recently, the ligation of fistula tract had shown few promising results though it will be too early to comment on its long-term efficacy.
Radiofrequency fistulotomy: a better alternative for treating low anal fistula
Gupta, Pravin Jaiprakash;
Sao Paulo Medical Journal , 2004, DOI: 10.1590/S1516-31802004000400008
Abstract: context: wide varieties of approaches are employed in dealing with low anal fistula. however, the simple method of laying open the fistula tract (fistulotomy) is still considered to be the favored one. materials and methods: a modified approach to the procedure of fistulotomy is discussed. this study describes the procedure, which used a technique of radiofrequency surgery, and its outcome in 232 patients with low anal fistula. the patients were followed for a period of 15 months. results: the patients were discharged on the same day as the procedure. the mean period off work was four days. the average healing time recorded was 67 days. four wound complications in the form of premature closure of the external wound were noted, which required trimming of the edges. two of these wounds remained unhealed. the recurrence rate was 1.7%. conclusion: in this era when the emphasis is on criteria like the minimization of hospital stay, reduction of postoperative pain, early resumption of work and low and comparable recurrence rates, there is a future for the procedure of radiofrequency fistulotomy.
An Empirical Evaluation of LIKE Operator in Oracle
Manoj Kumar Gupta,Pravin Chandra
BVICAM's International Journal of Information Technology , 2011,
Abstract: In database systems, user makes query and that query will be responded by the DBMS. Generally, there are a variety of methods for computing the response of the given query. It is the responsibility of the query processor to transform the query as entered by the user into an equivalent query that can be computed more efficiently. Query optimization is the process to find a good strategy or best query evaluation plan for processing a query. In the today’s competitive environment, query optimization is one of the important criteria based on which one can compare the available commercial RDBMSs. The objective of this study is to discuss about techniques used by the Oracle for optimizing the queries and to present a comparative study of the various costs involve to execute the LIKE Operator based queries. This comparative study is based on empirical study done on Oracle 8i, Oracle 9i and Oracle 10g.
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