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H Parmar

Publications and source records attributed to H Parmar.

44 records · Page 3Linked to original sources

Randomised controlled study of orchidectomy vs long-acting D-Trp-6-LHRH microcapsules in advanced prostatic carcinoma.

Safety and efficacy of a slow-release formulation of D-Trp-6-luteinising-hormone-releasing-hormone (D-Trp-6-LHRH) microcapsules were compared with orchidectomy in the initial treatment of advanced prostatic carcinoma. 41 patients were randomly assigned to D-Trp-6-LHRH and 38 to orchidectomy. Suppression of testosterone and reduction in prostatic acid phosphatase levels were similar in both groups. 87% of patients in the D-Trp-6-LHRH group and 81% in the orchidectomy group responded to treatment or showed no deterioration. Side-effects related to the decrease in testosterone were similar in both groups. 3 patients given D-Trp-6-LHRH had a disease "flare" in the first ten days of treatment which resolved completely when testosterone fell to castrate levels. Results of psychological assessment were similar in both groups before treatment, and on follow-up there was a weak trend towards decreased psychological morbidity in the hormone group. The slow-release preparation of D-Trp-6-LHRH microcapsules offers an important alternative in the management of advanced prostatic carcinoma.

Aged↗

Rehabilitation.

Explore the source record for details and available documents.

Nursing↗

Imaging findings in a giant hepatic artery aneurysm.

A rare case of relatively asymptomatic giant hepatic artery aneurysm of atherosclerotic aetiology is presented. The importance of imaging findings in the diagnosis of this condition and the differential diagnosis including the pertinent literature on the topic is discussed.

Adult↗

Magnetic resonance arthrography in recurrent anterior shoulder instability as compared to arthroscopy: a prospective comparative study.

AIM: To evaluate the accuracy of magnetic resonance (MR) arthrographic imaging in the diagnosis of glenoid labral and ligament tears in recurrent shoulder instability. SETTINGS AND DESIGN: Prospective, comparative study at a tertiary care centre. MATERIAL AND METHODS: Patients with three or more episodes of anterior shoulder dislocation were enrolled in the study. They were subjected to magnetic resonance arthrography (MRA) for delineation of abnormalities. The findings obtained at MRA were compared with those found at arthroscopy and surgical exploration. RESULTS: MRA detected glenoid tears in all 22 patients with 20 (90%) patients having antero-inferior tears, 3 (14%) patients had superior labral involvement and 2 (10%) patients had posterior labral abnormality. On arthroscopy, antero-inferior, superior and posterior labral tear were found in 21 (95%), 5 (22%) and 7 (32%) patients respectively. MRA showed a sensitivity of 95%, and a specificity of 100% for the detection of the antero-inferior labral tears. The sensitivity of MRA for the detection of superior, middle and inferior glenohumeral ligament tear was 83%, 80% and 86% with a specificity of 100%, 71% and 93% respectively. MRA was 100% sensitive for the detection of rotator cuff injuries and detection of bony lesions like Hill-Sach's and bony Bankart's lesion. CONCLUSIONS: MRA is a sensitive and specific modality for evaluation of anterior shoulder instability.

Adolescent↗

Improving the sensitivity of cervical cytologic screening. A comparison of duplicate smears and colposcopic examination of patients with cytologic inflammatory epithelial changes.

During a ten-month period, 264 cervical cytologic specimens were submitted in duplicate to two separate cytology laboratories. An attempt was made to perform colposcopy on all 45 patients reported as having an abnormality by either laboratory. All but one patient with a cytologic diagnosis of cervical intraepithelial neoplasia (CIN) underwent colposcopy, as did 68% of the patients with a diagnosis of nondysplastic atypia (inflammatory epithelial changes [IEC]). Five cases of histologically verified CIN were found by colposcopic study of patients with a cytologic diagnosis of CIN; two additional cases were found by colposcopic study of patients with a cytologic diagnosis of IEC. On the assumption that patients not colposcoped were not systematically different from the others with IEC, the screening sensitivities for both laboratories and for cytology followed by colposcopy of IEC cases were estimated. A statistically significant improvement in screening sensitivity was achieved by colposcopic examination of patients with IEC. This conclusion was tempered by a Bayesian analysis that suggested that some of the apparent improved sensitivity could be due to falsely positive biopsy reports. Despite potential benefits, it is premature to recommend universal colposcopic examination of patients with cytologic reports of inflammatory epithelial changes.

Cervix Uteri↗

Colposcopy of patients with cytologic inflammatory epithelial changes.

Of 3,308 cervical cytologies performed at a university health service between September 1986 and September 1987, 371 were reported as showing inflammatory epithelial changes (IECs). Colposcopy was offered to all patients with this diagnosis and was actually performed on 200 (54%). Of these women, 44 had an atypical transformation zone; of the 33 who were biopsied, 23 had histologic diagnoses ranging from human papillomavirus (HPV) infection (4 cases) to grade III cervical intraepithelial neoplasia (CIN; 4 cases). Most biopsies showed CIN I. In our clinic, the 95% confidence limits for the histologic diagnosis of HPV or CIN in women with a cytologic diagnosis of IEC are 8.5% to 23.5%. Colposcopic examination of women with IEC may be able to detect patients with CIN who are missed by standard cytologic screening. Concerns about a potential bias from false-positive histology reports must be resolved before such an approach can be recommended.

Biopsy↗