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Biomedical subjects

B Ram

Publications and source records attributed to B Ram.

At least 19 recordsLinked to original sources
PubMed2002

Does flying after myringoplasty affect graft take rates?

Flying at altitude soon after myringoplasty may theoretically have an adverse effect on graft take rates owing to variation in external air pressure, together with suboptimal Eustachian tube function, causing graft displacement. We wished to assess the effect of flying after myringoplasty by comparing success rates of patients flying within a week postoperatively (n = 37) with a control group (n = 37) by carrying out a retrospective, controlled cohort study. The primary outcome measure was graft success, defined as a 100% closure at first outpatient follow-up (2.5 months). Our results showed that there was no difference in early graft success rates between the flying group (32/37: 86%) and non-flying group (29/37: 78%)(P = 0.32; 95% CI of difference: -9% to 27%). In conclusion, flying at altitude in a pressurized environment within a week of myringoplasty does not adversely affect early operative success.

Adolescent↗
PubMed2001

Value of nasal endoscopy and probing in the diagnosis and management of children with congenital epiphora.

BACKGROUND: Congenital nasolacrimal obstruction is usually the result of failure of canalisation of the distal end of the nasolacrimal duct. The most common outcome is spontaneous resolution, but some children do require surgical treatment by probing. Probing is a blind procedure with a recognised failure rate. METHODS: In 52 lacrimal systems of 40 children nasal endoscopy was combined with a "stepwise" systematic probing in an attempt to improve the outcome and reduce the number of repeat procedures. RESULTS: Combined nasal endoscopy and probing improved the understanding of outflow obstruction in young children. The success of the procedure depended upon the level of the obstruction within the outflow system. Formation of a false passage was seen in six cases (15%). The probe was rerouted under direct visualisation in these cases to form a functioning passage. Reasons for failure were identified in those who did not have a successful outcome and only one repeat procedure was required. CONCLUSION: Using nasal endoscopy the area of lacrimal outflow obstruction at the lower end of the nasolacrimal duct can be observed directly and it is possible to guide the progress of probing under direct vision. This gives better information about the nature of the obstruction, minimises the formation of false passages, and allows a wider range of treatment options under a single anaesthetic.

Algorithms↗
PubMed2001

Combined risk factors contributing to cerebral venous thrombosis in a young woman.

Cerebral venous thrombosis is a rare condition affecting predominantly adolescents or young adults. The presentation is often non-specific, and delay in diagnosis is common. The otolaryngologist may be consulted about the radiological findings of lateral sinus thrombosis and mastoid changes. The association of congenital thrombophilia with unusual presentations of venous thrombosis, especially in young individuals is now well documented. We present a case of lateral and sagittal sinus thrombosis complicated by cerebral venous infarction in a girl with protein C deficiency and masked mastoiditis. Unusual forms of venous thrombosis, including cerebral venous thrombosis may develop in association with a single risk factor for thrombosis, but additional risk factors should be sought especially when thrombosis presents in very young individuals. This case draws attention to the multi-causal nature of cerebral venous thrombosis in young adults, and highlights the issue of masked mastoiditis. A coordinated approach by otolaryngological and haematological teams is recommended in such cases.

Adolescent↗
PubMed2000

The technique of nasendoscopy in the evaluation of nasolacrimal duct obstruction in children.

Epiphora in infancy is most commonly the result of failure of canalisation of the nasolacrimal duct and most cases resolve spontaneously within 12 months. Lacrimal probing is the standard operative treatment when conservative expectant management fails. While this carries a high success rate, it does not reliably localise the site of obstruction, can create a false passage and may induce traumatic stenosis in the lacrimal passages. Nasendoscopy in conjunction with the lacrimal probing overcomes these problems as the procedure is performed under direct vision. The precise site of opening of the nasolacrimal duct is ascertained, the nature of obstruction established and the risks of false passage creation minimised. We report this technique of endoscopic assessment of lacrimal probing, and the outcome results of twenty such procedures performed on thirteen children.

Child, Preschool↗
PubMed2000

Endoscopic endonasal ligation of the sphenopalatine artery.

Internal maxillary artery ligation for persistent posterior epistaxis is traditionally performed via the transantral approach. Although usually effective in controlling the bleeding it carries significant risks, including damage to the infraorbital nerve, damage to dentition and oro-antral fistula formation. The alternative procedure of endoscopic ligation of the sphenopalatine artery at its exit from the sphenopalatine foramen avoids the morbidity associated with the transantral approach. The technique we describe involves the use of standard FESS instruments and a Ligge Clip applicator. This operation is well within the capability of the Otolaryngologist/Rhinologist experienced in endoscopic sinus surgery.

Arteries↗
PubMed1999

Surgical simulation: an animal tissue model for training in therapeutic and diagnostic bronchoscopy.

A series of surgical simulation exercises has been developed using an animal model to allow trainees to practise basic instrument handling and develop psychomotor skills in bronchoscopy, without risk to patients. A pig model was found to be most suitable. After suitable preparation the model can be used for diagnostic and therapeutic exercises in bronchoscopy, including lavage, biopsy and the removal of various foreign bodies. The model is a safe, inexpensive and convenient means of bronchoscopic training for otolaryngology trainees. For the trained specialist who has to remove bronchial foreign bodies infrequently, the model is a useful way of maintaining skills.

Animals↗
PubMed1998

Verrucous carcinoma of the maxillary antrum.

Verrucous carcinoma is a distinct variant of well differentiated squamous cell carcinoma. Its occurrence in the maxillary antrum is rare. Only three cases have previously been documented. We present a case report of verrucous carcinoma in the maxillary antrum and a review of the literature.

Aged↗
PubMed1998

Focal myositis of the sternocleidomastoid muscle.

Focal myositis is an unusual inflammatory lesion of skeletal muscle. It usually affects the extremities, but can present rarely in the head and neck region. We present a case of an elderly woman with focal myositis of the sternocleidomastoid muscle and review of the previous literature on this subject.

Aged↗
PubMed1998

Lipomatosis of the minor salivary glands.

Lipomatosis has not previously been reported in minor salivary glands. Its occurrence in the parotid gland is well recognized. We present the first reported case of lipomatosis of the minor salivary glands in the nasal cavity. We also review the tumours of the minor salivary glands, lipomas and lipomatosis of the parotid, and the few reported cases of lipomas of the sinonasal tract.

Adult↗
PubMed1994

Systemic diseases in age related cataract patients.

Age related cataract is the most common cause of blindness in the world. Most of these patients are elderly and are likely to have various associated systemic diseases. Higher mortality has been reported in patients undergoing cataract surgery. In order to determine the prevalence of associated systemic disease, we carried out a large eye camp based study in 6103 age related cataract patients. Seventeen percent of our patients had systemic problems. Pulmonary disease was seen in 4.3%, cardiovascular disease and hypertension in 4.1%, diabetes mellitus in 3.8%, skin disorder in 1.4%, orodental disease requiring tooth extraction in 3%, and other diseases were seen in 0.4% of the cases. Seventy eight patients (1.27%) had significant systemic complications post-operatively, 46% of whom required hospitalization in a tertiary care center. Thus, all patients undergoing cataract surgery should be evaluated for associated systemic diseases to prevent morbidity and mortality in the preoperative, operative and postoperative period.

Adult↗
PubMed1993

Emerging patterns of child-spacing in Canada.

This study used data from the 1984 Family History Survey conducted by Statistics Canada to examine recent trends and patterns of child-spacing among currently married women. Life table and proportional hazards estimates show that Canadian women, particularly those in younger age groups with higher education and longer work experience, start having children late, but have subsequent children rather quickly. This suggests that such women tend to complete childbearing within a compressed time period.

Adolescent↗
PubMed1991

High prevalence & heterogenicity of thalassaemias in Orissa.

High incidence of alpha thalassaemias (estimated from detection of Hb Bart's from cord blood), Hb constant spring (CS) and high A2 beta thalassaemia trait (estimated from normal adult subjects) were detected in 12.6, 15 and 8 per cent people of coastal Orissa (with less than 5% tribal population) respectively. Quantitation of Hb Bart's suggest that the alpha thalassaemia could be any of the genotypes such as, -alpha/alpha alpha, -alpha/-alpha, --/alpha alpha and alpha alpha/alpha alpha cs. Both heterozygotes and homozygotes for Hb CS were identified.

Fetal Blood↗
PubMed1990

Immigrant fertility patterns in Canada, 1961-1986.

"This paper has examined the fertility of immigrants who arrived in Canada at various periods in the recent past. Cumulative and current fertility measures derived from 1961, 1971, 1981 and 1986 censuses have indicated that immigrants tend to have children at a lower rate during the periods when they are immigrating, but at a higher rate after immigrating. However, once they have resided in the host country for a certain length of time, their fertility may either converge with that of the native-born population or may become even lower." (SUMMARY IN FRE AND SPA)

Americas↗
PubMed1989

Gonadotrophin stimulation in children with abnormal sexual development.

Plasma levels of testosterone were measured by radioimmunoassay before and after 3 days' administration of human chorionic gonadotrophin (HCG) 2,000 IU/d in 34 prepubertal boys (6 normal, 3 with anorchia, 5 with micropenis, 8 with cryptorchidism, 6 with hypogonadotrophic hypogonadism and 6 with hypospadias). The increase in plasma testosterone value ranged from 2.4 nmol/l to 10.5 nmol/l in normal boys. There was negligible (P greater than 0.05) response in boys with anorchia compared with normal children. Subjects with micropenis showed subnormal response (P greater than 0.05). Children with cryptorchidism showed a normal increase in testosterone levels (P greater than 0.05), but in those with hypogonadotrophic hypogonadism and hypospadias the increase was variable (1.2 - 8.8 nmol/l) (P greater than 0.05). Although the HCG stimulation test is not diagnostic in the majority of the sexual disorders, it appears to be sensitive for diagnosing anorchia.

Adolescent↗
PubMed1989

Asthma: a provincial study.

To identify factors contributing to increased mortality and morbidity we prospectively evaluated 200 consecutive adult (greater than 17 years) asthmatic presentations (105 patients) referred to Gisborne Hospital over a 28 month period between 1985 and 1987 using a modified protocol adapted from previous national studies. In the moderate asthmatic group (113 presentations, 56%), 6% failed to use beta agonists prior to admission and 43% were not on regular steroid inhaler therapy. No patient had a crisis plan although 45 (22.5%) had received oral steroid therapy before admission. Poor drug compliance was twice as common in the Maori. Fifty-eight percent of patients were on regular long term oral theophylline whereas 48 (43%) patients with moderate and severe asthma were not on corticosteroid inhalers. We conclude that patient education and more liberal use of steroid inhalers have the greatest potential for improving morbidity and mortality.

Administration, Inhalation↗