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Biomedical subjects

H H Ramadan

Publications and source records attributed to H H Ramadan.

At least 55 records · Page 3Linked to original sources
PubMed1993

Report of Pseudomonas aeruginosa sinusitis in a patient with AIDS.

Pseudomonas aeruginosa can cause infections in AIDS patients who frequently do not have the usual predisposing conditions such as neutropenia and intravenous drug use. The infections due to P. aeruginosa may be difficult to treat in AIDS patients. Sinusitis has been increasingly recognized as a complication in patients with AIDS. This article describes a case of recurrent P. aeruginosa sinusitis which, until recently, was rarely reported in AIDS.

AIDS-Related Opportunistic Infections↗
PubMed1993

Laryngeal tuberculosis: presentation of 16 cases and review of the literature.

Tuberculosis of the larynx was quite common in the past and usually associated with advanced pulmonary cavitations with an overall mortality of approximately 70% before the advent of chemotherapy. Its incidence was on the decline in the last two decades; however, it seems to be on the increase in the last few years. During the past 30 years, 16 patients with laryngeal tuberculosis were investigated at the American University of Beirut, Medical Centre. Around 20% of our patients had isolated laryngeal tuberculosis with no apparent pulmonary involvement. Four patients (25%) presented with stridor and had a tracheotomy performed for the relief of their upper airway obstruction. In contrast to earlier studies, our series showed great variations as far as location and appearance of the laryngeal lesions.

Adolescent↗
PubMed1992

Effect of wound infections on head and neck cancer.

There seems to be a consensus in the surgical literature that wound infections after surgery for cancer have a favorable effect on the course of certain malignant diseases. In a review of laryngeal cancer during a 10-year period, the recurrence rate was statistically lower in the group that suffered wound infections than in the group that did not have a wound infection.

Adult↗
PubMed1992

Management of an unusual presentation of foreign body aspiration.

Foreign body aspiration is a very common problem in children and toddlers and still a serious and sometimes fatal condition. We are reporting on a 2-year-old white asthmatic male who choked on a chick pea and presented with subcutaneous emphysema, and on chest X-ray with an isolated pneumomediastinum but not pneumothorax. On review of the literature an isolated pneumomediastinum without pneumothorax was rarely reported. This presented a challenge in management mainly because of the technique that we had to use in order to undergo bronchoscopy and removal of the foreign body. Apnoeic diffusion oxygenation was used initially while the foreign body was removed piecemeal, and afterwards intermittent positive pressure ventilation was used. The child did very well, and his subcutaneous emphysema and pneumomediastinum remarkably improved immediately post surgery.

Bronchi↗
PubMed1991

Use of prophylactic otic drops after tympanostomy tube insertion.

In a 1-year prospective study, 60 patients with chronic serous otitis media underwent bilateral tympanocentesis with tube insertion. The right ear was treated with dexapolyspectran (a solution consisting of polymyxin B sulfate, neomycin sulfate, sulfonamide, and hydrocortisone) intraoperatively and for 72 hours afterward, and the left ear served as the control. All patients were followed up at weekly intervals for the first month. Five (8.3%) out of 60 experimental ears had purulent otorrhea within the first 14 days after surgery, compared with eight (13.3%) out of 60 control ears. Statistical analysis showed no difference between the two groups.

Administration, Topical↗
PubMed1991

Some pathological and biochemical studies on experimental ascaridiasis in chickens.

During studying the pathogenicity of Ascaridia galli for young Ross-Broiler chickens fed with single doses of 100, 200 and 500 infective eggs, it was found that the infected chickens showed variable decreases in body weight gain and increases in the ratio of liver weight relative to body weight when compared with the control. Both decrease and increase was proportionally related with the number of infective eggs given to the chickens. Biochemical analysis of muscle and liver tissue of the previous groups of chickens showed a decrease in both glycogen and protein content and an increase in fat content of muscle and liver of infected chickens when compared with those of normal tissues. The decrease in the glycogen content due to ascaridiasis was mostly apparent in case of 500 egg dose and that of the protein content was noted with the egg doses of 200 and 500. Each of the three egg doses showed a significant increase in the fat content of the muscle and liver of infected chickens when compared with the control. After the sixth week of infection chickens fed with 500 eggs showed emaciation, loss of colour of combs and legs and of brightness of plumage, diarrhoea, drooping wings, ruffled feathers and a gradual loss of strength manifested by leg weakness. At autopsy, the small intestine showed external macroscopic lesions of haemorrhage and congestion. Intestinal obstruction with adult Ascaridia galli was also found in the infected birds.

Animals↗
PubMed1989

Is there a conductive type of presbycusis?

Many ears that manifest hearing losses caused by aging show combinations of atrophic change in the sensory cells, cochlear neurons, and stria vascularis. When it occurs in pure form, the loss of sensory cells produces an abruptly sloping high-tone threshold loss, the loss of cochlear neurons decreases the capability for speech discrimination, and the loss of strial tissue produces a flat threshold loss. There remains a fourth group of cases that have gradual sloping high-tone threshold losses for which a pathological correlate has not been identified. We performed a quantitative histologic study, using light microscopy on the temporal bones of such cases, and again could find no pathologic explanation. We believe that the findings of this study support the concept of an alteration in cochlear motion mechanics as the most probable cause for the gradually sloping high-tone hearing loss.

Age Factors↗
PubMedDate not supplied

Adenocarcinoma with simultaneous squamous carcinomas of the larynx.

BACKGROUND: Primary adenocarcinoma of the larynx is a rare neoplasm. The incidence is reported as less than 1% of all laryngeal neoplasms in multiple series. Simultaneous primary adenocarcinoma and a solitary squamous cell carcinoma of the larynx is even rarer and only one case has been found on review of the literature. METHODS: A case report of a 74-year-old man with a history of right-sided throat pain, odynophagia, and progressive hoarseness is presented with a review of the literature pertaining to this unusual case. RESULTS: The patient was found to have three distinctly separate laryngeal lesions on direct laryngoscopy. Histopathologic diagnosis of adenocarcinoma was made on one of the three biopsied sites with the other sites being squamous cell carcinoma. Following Combined radiotherapy and surgical treatment, the patient has remained free of disease. CONCLUSIONS: Adenocarcinoma of the larynx is an infrequent and lethal disease. This case report and a review of the literature demonstrate that aggressive surgical management is indicated, although still may not result in improved survival.

Adenocarcinoma↗
PubMedDate not supplied

The influence of elective neck dissection on neck relapse in NO supraglottic carcinoma.

INTRODUCTION: Mortality due to cancer in patients treated for squamous cell carcinoma of the supraglottic larynx is closely associated with regional relapse in the neck. Controversy exists relative to the most effective way to manage potential cervical metastases. METHODS: The records of 126 patients with carcinoma of the larynx treated between 1975 and 1986 were reviewed. Sixty-three patients with T2-4,NO squamous cell carcinoma of the supraglottic larynx are the subject of this report. Twenty-one patients underwent surgical resection of the primary tumor plus elective neck dissection while 42 patients underwent surgical resection of the primary tumor without neck dissection. Subsequent relapse in the neck was ascertained. RESULTS: The overall neck relapse rate was 31.7%. In patients treated with neck dissection, the relapse rate was 14.3%, while relapse in the patients who did not have neck dissection was 40.5%. Radiation therapy did not seem to make a significant difference in relapse rate in this patient population. CONCLUSIONS: We conclude that elective neck dissection decreases the neck relapse rates significantly in patients treated for NO supraglottic carcinoma.

Carcinoma, Squamous Cell↗
PubMedDate not supplied

What is the bacteriology of chronic sinusitis in adults?

PURPOSE: Recent advances in imaging and endoscopy has increased our awareness of chronic sinusitis. The teaching has been that chronic sinusitis is mainly caused by anaerobes; however, recent studies have found that the role of anaerobes is small, especially in children. MATERIALS AND METHODS: A prospective study was conducted on 76 adults who failed medical treatment for chronic sinusitis and were scheduled for endoscopic sinus surgery. Specimens were obtained on all 76 patients at the time of surgery and were sent for aerobic and anaerobic cultures. RESULTS: Anaerobic organisms were isolated in 7.6% of the cases, and aerobes were isolated in 76.3% of the patients. The most common aerobic organism was the Staphylococcus species, whereby resistance to the most commonly used antibiotics was 21.7%. CONCLUSION: All past studies on the bacteriology in adults were made before the era of endoscopic sinus surgery and the newer-generation antibiotics. According to our results, it seems there is a change in trend in the bacteriology of chronic sinusitis in adults.

Adult↗
PubMedDate not supplied

Fine-needle aspiration of head and neck masses in children.

PURPOSE: Head and neck masses in children are common. Suspicious or persistent masses are referred to the otolaryngologist who is faced with the dilemma of deciding which ones require surgical excision. Fine-needle aspiration (FNA) in adults helps distinguish lesions requiring excision from those that do not. Few reports exist of its use in children PATIENTS AND METHODS: Between January 1991 and December 1994, 67 FNAs were performed on children, 29 of which (43%) were for head and neck masses. Based on the FNA findings, 16 patients underwent surgery. RESULTS: In 13 patients, the final pathology was consistent with the FNA findings: granulomatous diseases (3), branchial cysts (3), acute/chronic lymphadenitis (3), thyroglossal cyst, hemangioma, Hodgkin's lymphoma, and Castleman's disease (one each). There was one misdiagnosis, no false positives, and two nondiagnostic specimens. Based on the results of FNA, surgery was not performed in the remaining 10 patients. The cytology was: cervical lymphadenopathy (7), abscess formation (1), lymphangioma (1), and leukemia (1). CONCLUSION: We conclude that FNA in an extremely useful tool in the management of head and neck masses in children. It is very well-tolerated by children, and we did not encounter any complications.

Adolescent↗
PubMedDate not supplied

Allergic mucin sinusitis without fungus.

Allergic fungal sinusitis (AFS) is a distinct clinical pathologic entity that has been recognized for over a decade. The hallmark of this process is eosinophilic allergic mucin with fungal hyphae on histopathology. We have identified a subset of patients who present with a clinical picture similar to that of AFS patients in which fungus could not be demonstrated pathologically or on culture. We present four cases of allergic mucin sinusitis without fungus. A comparison of the clinical presentation of this group of patients with those with AFS will be discussed. Both groups had nasal polyposis and a history of multiple sinonasal procedures. By contrast, the patients with allergic mucin sinusitis were older than the AFS group. All of the patients with allergic mucin sinusitis also had asthma. Treatment was the same for both groups of patients.

Adolescent↗
PubMedDate not supplied

Nonsurgical versus endoscopic sinonasal surgery for rhinogenic headache.

Headaches of sinonasal origin have been described lately. Terms such as middle turbinate syndrome have been used to describe this entity. The true incidence of this headache is unknown. A concha bullosa or a hypertrophied middle turbinate have been associated with these cases. Mucosal contact between the middle turbinate and the nasal septum or the lateral wall of the nose have been attributed as the cause of referred pain in the face. We present data on 23 individuals with refractory primary headache in the absence of any significant sinus symptoms. The duration of the symptoms of these individuals ranged between 4 and 13 years with a mean of 7.2 years. Fifteen patients agreed to undergo surgery, whereas eight refused surgery. After a mean of 23 months of follow-up, all those who did not have surgery continued to have pain that required excessive medications, whereas 60% of those who had surgery reported marked relief of their headaches. Those who had symptoms for less than 7 years had a greater chance of success (OR = 2). Sinonasal surgery seems to be helpful in alleviating primary headaches, especially in individuals whose duration of symptoms is less than 7 years.

Adult↗
PubMedDate not supplied

Correlation of allergy and severity of sinus disease.

Allergy is an important consideration in the evaluation of patients with rhinosinusitis. Several studies have addressed staging systems for rhinosinusitis based on the extent of disease present on computed tomography (CT) scanning. The severity and extent of sinus disease present on CT imaging helps guide decisions regarding medical and surgical treatment options. This study evaluates the severity of sinus disease in allergic and nonallergic patients. A total of 42 patients at our institution underwent both modified RAST and coronal sinus CT scan in the evaluation of their rhinosinusitis symptoms. A single, blinded staff neuroradiologist staged all 42 CT scans using the Lund-Mackay staging system. None of the patients had undergone sinus surgery. Age, sex, co-morbidities, asthma, smoking, RAST score, total IgE, and CT staging score were analyzed. Allergic patients were found to have a higher CT scan score (mean score = 12) when compared to nonallergic patients (mean score = 6), indicating more extensive sinus disease (p = 0.03). We conclude that allergy is a significant factor in the development of rhinosinusitis, and allergic patients are more likely to demonstrate advanced disease on CT scan when compared to nonallergic patients.

Adolescent↗
PubMedDate not supplied

Usefulness of computed tomography and magnetic resonance in fulminant invasive fungal rhinosinusitis.

Fulminant invasive fungal rhinosinusitis is an aggressive, destructive process most commonly affecting the immunocompromised host. Although frequently fatal, prognosis is related directly to early recognition and aggressive treatment. Various reports advocate computed tomography (CT) scanning as the study of choice in evalucating suspected invasive fungal disease, reserving magnetic resonance imaging (MRI) for select cases. Others report lack of correlation between CT and surgical or pathological findings. Our aim wasq to investigate the usefulness of CT and MR in the diagnosis of invasive fungal rhinosinusitis. We retrospectively reviewed four cases of biopsy-proven invasive disease. Correlations between radiographic, endoscopic, and surgical findings were investigated. Rhizopus species were detected in three cases and mixed Mucor and Aspergillus species in another. Superimposed bacterial sinusitis was confirmed in all cases. CT findings were nonspecific, revealing pansinusitis; no bone destruction or intracranial extension was noted. Mild orbital cellulitis was noted in one case. Anterior rhinoscopy revealed nonviable tissue in two patients. Nasal endoscopy later confirmed tissue ischemia in a third patient, whereas a final patient had normal findings on both exams. Nonspecific findings resulted in delay of diagnosis by 48-72 hours in two patients with presumed bacterial sinusitis. MR revealed intracranial extension in two patients and better represented intraoperative findings. In conclusion, CT findings in invasive fungal rhinosinusitis may be nonspecific and underestimate extent of disease. A high index of suspicion and early endoscopic examination with biopsy are mandatory for evaluation. MRI may better represent disease progression and should be considered early.

Adult↗