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Biomedical subjects

P Puri

Publications and source records attributed to P Puri.

299 records · Page 17Linked to original sources

Necrotising fasciitis of the orbit: early recognition and treatment a key to success.

PURPOSE: To report a case of necrotising fasciitis which was managed successfully with timely intervention. CASE REPORT: A 77-year-old lady diagnosed as having narcotizing fasciitis of the orbit based on the clinical picture and microbiology report is presented. Early recognition of the condition followed by timely surgical intervention in the form of surgical debridement and subsequent exenteration led to a favorable prognosis. DISCUSSION: Necrotising fasciitis is a fulminant synergistic infection. It spreads along facial planes causing necrosis of the overlying skin. Management of this condition includes both medical treatment and surgical debridement. Early intervention is of vital importance to save the patient's life as septicemia often leads to death within 24-96 hours. CONCLUSIONS: Early recognition and treatment are the key to successful management of cases with necrotising fasciitis of the orbit.

Aged↗

Non-cirrhotic portal fibrosis in children.

BACKGROUND AND OBJECTIVES: Non-cirrhotic portal fibrosis (NCPF) is an infrequent cause of portal hypertension in children. We report 11 children with NCPF, from among 338 with portal hypertension, seen over 6.5 years. METHODS: The diagnosis was based on patent splenoportal axis on ultrasonography and/or splenoportal venography and liver biopsy showing no evidence of cirrhosis or other diagnosis, in children with portal hypertension. Those with variceal bleed were managed with endoscopic sclerotherapy and/or shunt surgery. RESULTS: The median age was 11 years (range 5 to 14), and 8 were boys. Presentation was with variceal bleed in 6, lump in left upper abdomen in 5 (though all children had splenomegaly) and esophageal varices on endoscopy. The median spleen enlargement was 8.5 cm; 8 also had hepatomegaly. Hypersplenism was present in 7, and two had developed ascites after bleed. Of 6 children presenting with bleed, variceal obliteration was achieved on sclerotherapy (average 5.6 sessions) in 4 while two underwent shunt surgery for associated hypersplenism. After median follow up of 57.5 months (range 12-78) all are alive and well. CONCLUSION: NCPF is an uncommon cause of portal hypertension in Indian children. Presentation with variceal bleed is less common than in adults; sclerotherapy is effective.

Adolescent↗

Bilateral glaucomatocyclitic crisis in a patient with Holmes Adie syndrome.

A patient with pre-existing bilateral tonic pupils presented with simultaneous bilateral glaucomatocyclitic crisis. Deep tendon reflexes were absent although they were documented to be present 6 years ago. A possibility of a progressive autonomic dysfunction in both these conditions is discussed.

Adie Syndrome↗

Tissue glue aided lid repositioning in temporary management of involutional entropion.

PURPOSE: To evaluate the efficacy of the use of tissue glue in temporary management of involutional entropion. METHODS: Ten consecutive patients aged 68-74 years presenting senile entropion were included in the study. Lid repositioning as to achieve a slight ectropion was done by application of cyanoacrylate glue in the lower lid crease using a 20-G cannula. Patients were followed at 1 day, 7 days and finally at 14 days. Assessment of correction and, if absent, duration of correction was recorded. Any other ocular or dermatological complications of the application were also recorded. RESULTS: All the patients had successful correction at day 1. In two patients adhesions broke at day 6, in one patient at day 7, in 3 at day 9 and 2 at day 11. Two patients maintained correction at 2 weeks. No ocular or dermatological reactions were noted. CONCLUSIONS: Tissue glue aided lid repositioning is an effective method for temporary management of involutional entropion.

Aged↗

Comparative study to evaluate the efficacy of surgical and conservative techniques for apexification in young permanent teeth with open apices.

The Study was conducted to compare and evaluate the effectiveness of surgical and conservative approach for apexification. Twenty-four non-vital permanent maxillary anterior teeth were selected for this study. The teeth selected were having wide apical foramen and definite radiolucent periapical area. Twelve teeth were treated under conservative method and another 12 teeth with surgical method using 'Renew' (A radioopaque calcium Hydroxide paste). The patient were recalled after 1 1/2, 3, 4 and 6 Months. The results of the study indicated that Calcific bridge formation is rapid in teeth treated with conservative technique. However, periapical repair is accelerated in teeth treated by surgical technique, though the results are comparable at the end of 6 months, So the conservative approach is preferred as it saves surgical trauma. In conservative technique, 75% of the teeth showed calcific bridge formation and 100% showed decrease in periapical radiolucent area by 3.56 mm (mean) after 6 months. In surgical technique the radiographic evidence of calcific bridge formation was noticed in 54.51% of teeth after 6 months. However in 100% of teeth there was decrease in periapical radiolucent area by 3.53 mm (mean) after 6 months.

Calcium Hydroxide↗