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Biomedical subjects

D Maharaj

Publications and source records attributed to D Maharaj.

At least 55 records · Page 3Linked to original sources
PubMed1998

Simple repair of fractured penis.

Though rare, fracture of the penis is associated with significant morbidity if early surgical repair is not carried out. A simple same-day surgical technique performed under local anaesthesia is presented that requires no pre-operative investigations. Careful clinical examination (rolling sign) is used to accurately identify the fracture site.

Adult↗
PubMed1995

Serum G-CSF levels in patients undergoing G-CSF/chemotherapy mobilized peripheral stem cell harvest and predictors of neutrophil and platelet recovery.

Granulocyte colony-stimulating factor (G-CSF)/Chemotherapy mobilized peripheral blood progenitors are an effective source of stem cells which affords rapid and complete hematopoietic engraftment after myeloablative chemotherapy regimens. The dose of G-CSF most commonly used for mobilization is 5 micrograms/kg. We measured G-CSF levels in patients with chemosensitive malignancies undergoing peripheral stem cell harvest to determine whether there was a relationship between serum G-CSF levels and the yield of CD34+ hematopoietic progenitors. Peripheral blood stem cells (PBSCs) were mobilized by chemotherapy followed by G-CSF (5 micrograms/kg) started 24 hours after completion of chemotherapy. PBSCs were collected by daily leukapheresis during G-CSF stimulation once the WBC had recovered to 1.0 x 10(9)/L, with 10 liters of blood processed using a Fenwall CS 3000. G-CSF levels were monitored daily before and after leukapheresis. CD34+ cells from daily leukapheresis collections were determined in 11 patients. Immunophenotyping analyses of CD34+ and non-CD34+ cells for surface antigens CD38+, HLA-DR, CD71+, CD61+ and CD42a+ were performed on these daily leukapheresis. The mean (SD) number of days to neutrophil recovery (NR: > or = 0.5 x 10(9)/L) after stem cell reinfusion was 9.2 (1.92). The corresponding values for platelet recovery (PR: > or = 20 x 10(9) L) were 8.1 (2.39) days. Using multiple regression analyses, the best predictors for NR were: last G-CSF (R2 = 0.21); last G-CSF and CD34+ (R2 = 0.67); last G-CSF, CD34+ and number of chemotherapy cycles (R2 = 0.72).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Management of peritonsillar abscess.

A prospective, randomized clinical trial was conducted on 60 patients with confirmed peritonsillar abscess to: (1) compare the safety and efficacy of permucosal needle aspiration with that of incision and drainage; (2) assess whether admission to hospital and treatment with intravenous antibiotics is necessary; (3) culture the pus obtained, in order to decide on a rational antibiotic regime. Of the 60 patients, 30 were randomized to the needle aspiration group, and 30 to the incision and drainage group. The initial success rate was 87 per cent (26 of 30 patients) with needle aspiration, and 90 per cent (27 of 30 patients) with incision and drainage. Two patients required hospital admission, for rehydration and intravenous antibiotics. The commonest organisms cultured were streptococci (62 per cent); 97 per cent of all patients responded to penicillin. This study indicates that most patients with peritonsillar abscess may successfully and safely be treated by permucosal needle aspiration, and oral penicillin, on an out-patient basis.

Adolescent↗
PubMed1990

Neonatal stridor. Five-year experience at King Edward VIII Hospital, Durban.

During the period January 1984-January 1989, 110 neonates were referred to the ENT clinic at King Edward VIII Hospital, Durban, with symptoms of upper airway obstruction. The medical records of these patients were reviewed in order to document the clinical presentation, diagnostic evaluation, pathological findings and therapeutic approach. All patients underwent a thorough clinical examination, postero-anterior and lateral chest radiography, soft-tissue lateral radiography of the neck and endoscopic evaluation. We outline our findings and briefly describe management. Of interest is the high incidence of vallecular cysts in this series (15%) compared with others.

Humans↗
PubMed1989

Improvement of platelet counts in steroid-unresponsive idiopathic immune thrombocytopenic purpura after short-course therapy with recombinant alpha 2b interferon.

In 13 patients with severe steroid-refractory idiopathic immune thrombocytopenia (ITP), a short course of recombinant alpha 2b interferon (IFN), given at a dose of 3 MU for 12 doses, caused a significant increase in platelet count in 11 patients. The rise in platelet count occurred following completion of the short course of IFN in 10 patients and occurred during therapy in one patient. Three patients showed an increase to normal platelet counts within 14 days of discontinuing the drug, eight showed a partial response, with a platelet count increase from 30 to 100 x 10(9)/L, and two patients showed minimal response. One complete responder relapsed at 5 months from initial response, and a further course of alpha 2b IFN caused a second prompt response with a rise of platelet count to supranormal levels. Short-course alpha 2b IFN can be recommended as a therapy for severe ITP. Responses are seen in splenectomized and nonsplenectomized subjects, and thrombocytopenia is not exacerbated during treatment.

Autoimmune Diseases↗
PubMed1989

Surgical experience with juvenile nasopharyngeal angiofibroma.

Our experience with 18 cases of juvenile nasopharyngeal angiofibroma (JNA) over a period of 9 years is discussed. All cases were managed surgically: 17 via a transpalatal approach and one case by a combined transpalatal, lateral rhinotomy, and transantral approach. In this series there were two recurrences following primary surgical procedures and these required a second procedure. There were no major complications and all 18 patients are alive. We believe that surgical excision should be the treatment of choice for JNA and that radiotherapy should be used adjunctively for cases wherein intracranial extension of the tumors prevents total excision.

Adolescent↗
PubMed1988

Hypocalcaemia in autoimmune haemolytic anaemia and pernicious anaemia.

A 71 year old woman presented with hypocalcaemia in association with autoimmune haemolytic anaemia and pernicious anaemia. The hypocalcaemia resolved only when the haemolytic anaemia and pernicious anaemia were successfully treated. The possible pathogenic mechanisms are discussed.

Aged↗
PubMed1987

Aluminium bone disease in patients receiving plasma exchange with contaminated albumin.

Aluminium balance studies were carried out on eight patients with various immunological disorders who were receiving plasma exchange with albumin solutions known to be contaminated with aluminium. Four patients with impaired renal function (creatinine clearance less than 50 ml/min) retained between 60% and 74% of the aluminium infused during a single plasma exchange. Transiliac bone biopsy specimens from three patients in this group had a high content of aluminium and showed histological evidence of current or previous bone disease related to aluminium. Two of these patients suffered intermittent bone pain. The main route of excretion of injected aluminium was in urine, only a small proportion of the total input being removed in the "plasma bag" during plasma exchange. The extent of aluminium retention and bone deposition was not reflected by the plasma aluminium concentration before or after plasma exchange. Treatment of five patients with intravenous desferrioxamine increased the plasma aluminium concentration and urinary output of aluminium in those with evidence of aluminium retention. These studies show that patients with poor renal function receiving treatment with albumin contaminated with aluminium retain the metal and deposit it in bone, where it may eventually cause aluminium bone disease. Plasma exchange should be used with caution in patients with renal impairment.

Adult↗
PubMed1987

Bacteriology in acute mastoiditis.

During the period from July 1979 to December 1979, the bacteriology of 35 consecutive patients undergoing surgery for acute mastoiditis was studied. The patients' ages ranged from 3 to 13 years. All patients presented with a purulent otorrhea and a postauricular subperiosteal abscess and were subjected to a mastoidectomy within 12 hours of presentation. Specimens were obtained intraoperatively from the mastoid cavity and, using appropriate technology, were cultured for aerobic and anaerobic organisms. Bacteria were isolated from specimens of 32 patients (91.4%); specimens from three patients (8.6%) yielded no growth. Aerobes alone were cultured from four patients (11.4%); six patients' cultures (17.1%) yielded only anaerobes; and 22 patients' cultures (62.8%) had both aerobic and anaerobic organisms. Thus, anaerobes were cultured from a total of 28 patients (80.0%).

Acute Disease↗
PubMed1987

Laryngopyocele (a report of two cases).

A laryngocele is an air-filled dilatation of the saccule of the larynx. An infected laryngocele is called a laryngopyocele. Our experience with two cases of laryngopyoceles are presented. Only 29 cases of laryngopyoceles have so far been reported in the literature (Illum and Nehen, 1980). Case one had a right-sided combined laryngopyocele and case two had a right-sided combined laryngopyocele and a left-sided combined laryngocele. Both our cases had their lesions excised via an external approach, as described by Yarington and Frazer (1966), with case two having a bilateral excision.

Cysts↗