G H Malkan

Publications (3)4.88 Total impact

• Article: Cholangiopathy associated with portal hypertension: diagnostic evaluation and clinical implications.

  G H Malkan, S J Bhatia, K Bashir, R Khemani, P Abraham, M S Gandhi, R Radhakrishnan
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  ABSTRACT: There are few studies of biliary changes due to portal hypertension. We ascertained the incidence of such changes on endoscopic retrograde cholangiography and determined the reliability of biochemistry, ultrasonography (US) and hepatobiliary radionuclide scan in detecting this type of cholangiopathy. Forty-two patients with portal hypertension were studied. Cholangiopathy was detected by cholangiography in 17 of 20 patients with extrahepatic portal venous obstruction. Abnormalities (mainly strictures and caliber irregularity) were seen in the common bile duct (5) and common hepatic duct (7) and in the right (8) and left (11) hepatic ducts (mainly dilatation). One of 11 patients with noncirrhotic portal fibrosis had a dilated right hepatic duct. Three of 11 patients with cirrhosis had pruned intrahepatic ducts. Eight patients with portal venous obstruction had elevated alkaline phosphatase levels; two had elevated bilirubin levels. US detected gallbladder varices (11) and choledochal varices (9) in patients with extrahepatic portal venous obstruction. Biliary abnormalities were detected on hepatobiliary scintigraphy in 16 of 17 patients. Cholangiopathy associated with portal hypertension occurs exclusively in patients with extrahepatic portal venous obstruction. It rarely leads to functional obstruction; jaundice does not occur in the absence of functional blockage. Elevated alkaline phosphatase level (after excluding bile duct calculi), presence of gallbladder varices on US, and abnormal radionuclide scans are reliable in detecting these lesions.
  Gastrointestinal Endoscopy 04/1999; 49(3 Pt 1):344-8. · 4.88 Impact Factor
• Article: Correlation of manometric and radiographic diagnosis in esophageal motility disorders.

  S J Bhatia, G H Malkan, P Ravi, P Abraham
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  ABSTRACT: Radiography and manometry are complementary investigations in the diagnosis of esophageal motility disorders. In most centers, however, manometry is not available and diagnosis is based on radiography alone. To correlate the findings on radiography in patients with esophageal motility disorders in whom a manometric diagnosis was available. Retrospective analysis of esophageal manometry and barium contrast studies of 138 patients, done for suspected motility disorders, over a period of two years. Manometry was abnormal in 111 (80.4%) cases [achalasia 87, scleroderma 6, non specific esophageal motility disorders (NEMD) 13, diffuse esophageal spasm (DES) 5]. Radiology was abnormal in 106 cases; the overall radiographic sensitivity was 73.9% (achalasia 87.4%, scleroderma 83.3%, NEMD 38.5%) and the positive predictive value was 75.5% (achalasia 95%, scleroderma 100%, NEMD 29.4%). Radiography has a high sensitivity and positive predictive value in esophageal motility disorders like achalasia and scleroderma but in DES and NEMD the two investigative modalities (radiography and manometry) do not correlate well.
  Indian Journal of Gastroenterology 11/1995; 14(4):124-7.
• Article: Antibody to hepatitis-C virus in multi-transfused thalassaemics--Indian experience.

  M B Agarwal, G H Malkan, A A Bhave, C Vishwanathan, V Billa, S R Dube, K Bajan, G C Rajadhyaksha, S H Shah
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  ABSTRACT: Twelve out of 72 (16.7%) multi-transfused patients with thalassemia major (age range: 7-22 years) were found to be positive for antibody to hepatitis-C virus (anti-HCV). Nine (75%) of these 12 cases were positive for hepatitis B core antibody (anti-HBc) and/or hepatitis B surface antibody (anti-HBs). Out of the remaining 60 patients (83.3%), 27 patients (45%) were positive for anti-HBc and/or anti-HBs, while six (10%) were HBsAg positive Anti-HCV positive patients had significant higher levels of liver enzymes than those who were negative (p < 0.01). S. Ferritin was also significantly higher in those with seropositivity for anti-HCV than those who were negative (p < 0.01). It is concluded that HCV (besides HBV) is a major problem in multi-transfused thalassemia major patients and routine pre-transfusion screening of blood for anti-HCV must be introduced in the blood banks.
  The Journal of the Association of Physicians of India 04/1993; 41(4):195-7.