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Biomedical subjects

B Prakash

Publications and source records attributed to B Prakash.

At least 19 recordsLinked to original sources

Magnetic resonance evaluation of spinal dysraphism in children.

Magnetic resonance (MR) imaging of the spine was performed as the initial imaging technique in 20 children when spinal dysraphism was suspected clinically and plain radiographs showed spina bifida. The correlation with surgical findings indicated that MR provided accurate information preoperatively in all the cases. Some unusual observations in cases with spina bifida cystica and occulta are discussed. It is concluded that plain radiograph and MR complete the preoperative radiologic evaluation of cases with spinal dysraphism.

Adolescent

Intracranial aneurysms in India--microsurgical approach.

This is a retrospective study of 100 cases of intracranial aneurysms, treated in an Indian hospital, reflecting the special situation and experiences in our country. The incidence of subarachnoid haemorrhage due to ruptured aneurysm has been more or less the same as is reported from other parts of the world. The cases of recurrent haemorrhage resulting in poor clinical status are more common in our situation. Delayed referral and diagnosis were responsible for recurrent haemorrhage, increased morbidity and mortality. Forty two percent developed cerebral vasospasm within two weeks after the bleed. The use of a temporary clip on the parent vessel prevented the intraoperative rupture of the aneurysm while dissecting round about the aneurysm. Operative mortality was eight percent in the present series.

Humans

Tuberculous abscess of the brain stem.

Three cases of tuberculous abscess of the brain stem were treated with excision of the abscess supplemented with antitubercular therapy for 12 to 18 months. The lesions were frankly purulent and tubercle bacilli were demonstrated in the pus. A computed tomography scan demonstrated the site and extent of the lesion. Two of three patients developed the abscess during the course of antitubercular therapy for associated tubercular lesions. In spite of modern antitubercular treatment the abscess did not resolve and surgical excision had to be employed as a curative treatment.

Abscess

Human gnathostomiasis: infection with an immature male Gnathostoma spinigerum.

Gnathostomiasis, usually caused by larvae of Gnathostoma spinigerum, is a significant cause of morbidity in the Far East. We report a case of gnathostomiasis involving a male Thai residing in Kuwait who presented with acute pain in the right iliac fossa. A resection of the terminal ileum and cecum was performed. Microscopic examination showed a parasite in an eosinophilic abscess. The nematode was identified as an immature male G. spinigerum based on size, morphology, and distribution of cuticular spines.

Adult

Computer assisted analysis of wound infection in neurosurgery.

The effect of 10 variables on the development of postoperative infection in 536 clean elective neurosurgery patients was calculated using correlational, regression and discriminant analyses. The time of shaving the operation site, type of theatre ventilation and duration of operation were found to have a highly significant effect on the infection rate. The influence of season and age of patient was not evident on simple analysis, but both were found to be significant factors using regression analysis. The sex of patient, carriage of Staphylococcus aureus, airborne bacterial count, presence of bacteria in the wound and the use of prophylactic antibiotics did not have a significant effect on infection rates.

Age Factors

Surgical approach to large thalamic gliomas.

Fifteen cases of large thalamic gliomas were treated by laser surgery and CUSA under X8 magnification and subsequently they were subjected to radiotherapy. More than 50% of the tumours were located in the dominant hemisphere and therefore an interhemispheric approach was carried out to avoid disturbances of speech and field defects. Nine patients had astrocytomas grade II and the remaining six had astrocytomas grades III-IV. The quality and survival has been gratifying in the less malignant gliomas. The operative technique and use of Laser and CUSA is highlighted.

Adolescent

Temporal lobe lesions in head injury.

In cases of closed head injury temporal lobe lesions e.g. contusion, laceration, pulping, or intracerebral haematoma frequently result in an expanding process. These are frequently associated with an overlying subdural haematoma. Eighty five cases of such lesions from a consecutive series of 1,000 cases of head injury have been analyzed. The lesions are caused by severe injury resulting in loss of consciousness and skull fracture. Most of them are contre-coup lesions. Clinically they manifest themselves like any other acute or subacute intracranial hematoma. The majority of the patients have contralateral hemiparesis and pupillary abnormalities. Carotid angiography is valuable for diagnosis. These lesions are likely to be missed when exploratory burr holes are made or, are erroneously diagnosed as acute subdural haematoma or brain oedema. Smaller lesions, not showing progressive deterioration, may respond to conservative treatment. However, surgical decompression is essential in most cases A frontotemporal osteoplastic craniotomy or a large Scoville trephine hole is essential to deal with these lesions adequately.

Accidents, Traffic

Haemorrhage into pituitary adenomas.

Seventy cases of pituitary adenoma were analysed for evidence of haemorrhage. It was present in 18 cases. These are classified into four groups, acute, acute on chronic, chronic, and late sequelae of pituitary apoplexy, and an example of a patient in each group is given. The diagnosis and management are discussed.

Adenoma

Brain abscess and congenital heart disease.

The clinical features and management of 18 patients with congenital heart disease and a brain abscess are reviewed. Except for one patient all had cyanosis. All abscesses were large, containing at least 50-60 ml of pus, and mostly unilocular. Bilocular and multilocular abscesses were also encountered. The organisms cultured from the pus had little relation to the mortality. Tapping may be the final investigation, and is also the treatment of choice. The high mortality (50%) is attributed to the delay in referral of these patients to a neurosurgical unit.

Adolescent