Biomedical subjects

D S Sethi

Publications and source records attributed to D S Sethi.

23 records · Page 2Linked to original sources

PubMed1992

Migrating foreign bodies in the upper digestive tract.

Migrating foreign bodies in the aerodigestive tract are not so uncommon. Two cases of penetrating and migrating extraluminal foreign bodies in the upper aerodigestive tract are presented. Both patients had ingested fish bones. Fish bones are the commonest of bones to be ingested. Sharp and pointed fish bones are more likely to penetrate extraluminally. A high index of suspicion is necessary to institute early treatment. A CAT scan is invaluable in locating the foreign body especially with regards to surgical landmarks at exploration. Early surgical intervention avoids life-threatening complications.

Adult↗

PubMed1991

Parapharyngeal abscesses.

Fifty-five patients with deep neck infections treated consecutively over a period of six and a half years between January 1983 and July 1989 were reviewed. Nine of these patients had abscesses localized to the pharapharyngeal space and form the basis of this study. The aetiology of the parapharyngeal abscess was odontogenic in two patients and remained unknown in the other seven. Five patients had associated systemic disease; four were diabetics and one patient had non-Hodgkin's Lymphoma. High dosage intravenous antibiotics directed towards the causative micro-organisms, airway control and early surgical intervention was the mainstay of treatment. All patients underwent open surgical drainage of the parapharyngeal abscess within 24 h of admission. Bacteriology results showed Klebsiella sp. to be the dominant micro-organism cultured in four patients. Morbidity was low; seven patients had no post-operative complications and were discharged from the hospital between 7-24 d (mean 12.9 d). There were two deaths. Early open surgical drainage remains the most appropriate method of treating parapharyngeal space infections; it avoids life threatening complications with rapid recovery.

Abscess↗

PubMed1991

Retropharyngeal abscess--the foreign body connection.

Retropharyngeal abscesses have been described to be more common among children especially under the age of three or four years and oropharyngeal infection have been implicated as a common etiological factor. However, this series reveals that retropharyngeal abscesses are more commonly seen in adults in our local population. Regional trauma resulting from an ingested foreign body is the leading cause of retropharyngeal abscess in this series. Twenty-three patients seen consecutively between January 1983 and June 1989 at the Department of Otolaryngology, Singapore General Hospital were reviewed retrospectively. Factors such as age, sex, racial distribution, presenting symptoms and signs, methods used to arrive at diagnosis, therapy and complications were studied and analysed. A lateral radiograph of the neck was the single most valuable investigation in the evaluation of the retropharyngeal space. Retropharyngeal and retrotracheal width were measured in 210 normal lateral neck radiographs to establish a normal range in our population. Retropharyngeal widening greater than 5 mm and retrotracheal widening greater than 15 mm was considered significant and was noted in all 23 patients. Regional trauma resulting from an ingested foreign body was the cause of the retropharyngeal abscess in thirteen (56.5%) patients.

Abscess↗

PubMedDate not supplied

Endoscopic management of orbital apex lesions.

Lesions of the orbital apex often present a diagnostic dilemma. Clinical assessment and imaging studies are helpful but a tissue biopsy is often required. The morbidity associated with transcranial approaches to the orbital apex may outweigh the benefits of obtaining a biopsy by these routes. Fine needle aspiration cytology of orbital apex lesions can be performed but there are disadvantages with this method. We describe a transnasal endoscopic technique to biopsy the orbital apex. The technique was used successfully to obtain a tissue diagnosis in six patients with orbital apex lesions. This enabled commencement of definitive treatment. There were no significant complications. The transnasal approach to the orbital apex using the endoscopes is reliable. Endoscopes provide excellent illumination, magnification, and a panoramic view of the operative field.

Adenocarcinoma↗

PubMedDate not supplied

Bronchodilator effect of terbutaline aerosol in asthmatic: comparison of two spacer devices.

The degree of bronchodilation achieved with aerosolised bronchodilators may partly depend on correct usage of a particular inhaler device. The effect of two puffs of 0.25 mg each of terbutaline aerosol using either of two spacer devices--a tube spacer and conical spacer with inhalation valve (Nebuhaler)--in a randomised manner were compared in 20 patients with bronchial asthma. All participants (11 male, 9 female) aged 16 to 50 years had clinically stable baseline airway obstruction responsive to bronchodilators. The maximum per cent increase of PEFR and FEV1 were significantly higher after inhalation via Nebuhaler than tube spacer (44.93 +/- 21.15% vs 26.67 +/- 13.17%; 74.0 +/- 17.87 vs 47.65 +/- 15.74% respectively, p less than 0.01). The increase noted at each time interval was significantly higher and more sustained with Nebuhaler. In terms of bronchodilator effect Nebuhaler had definite advantage over tube spacer in our study. There were no significant changes in pulse rate nor in blood pressure.

Administration, Inhalation↗