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Biomedical subjects

P Sen

Publications and source records attributed to P Sen.

At least 19 recordsLinked to original sources
PubMed2006

Water precautions and ear surgery: evidence and practice in the UK.

BACKGROUND: Patients are traditionally advised to refrain from exposing their ears to water after most otological procedures. However, recent evidence suggests that water does not adversely affect the outcome for children with tympanostomy tubes. The evidence behind the potential harmful effects of water on the outcome of other otological procedures is scarce. OBJECTIVE: The study was done to determine the current practice of otolaryngology consultants in the UK on the advice given to patients regarding swimming, diving and bathing in soapy water after myringotomy and tympanostomy tube insertion, mastoidectomy and myringoplasty. METHOD: Questionnaire based survey mailed to 382 members (consultants only) of the British Association of Otolaryngologists--Head & Neck Surgeons in the UK. RESULTS: A total of 195 responses were received (reply rate 51 per cent). In all, 95.6 per cent of the respondents allowed their patients to swim after insertion of tympanostomy tubes, with 32.9 per cent insisting on the use of earplugs until extrusion of the tympanostomy tubes. However, 61.6 per cent of the respondents restricted diving in these patients. In comparison, the respondents were more conservative with water precautions following myringoplasty and mastoidectomy. More than half the respondents recommended earplugs for bathing after all three operations. CONCLUSION: This study reveals current national practice among UK otolaryngologists. There is no general consensus in post-operative advice following otolaryngological procedures, indicating a need for national guidelines.

Baths↗
PubMed2006

Ectopic meningioma: a case report with a literature review.

Ectopic (extradural) meningiomas that do not originate from either the optic fascicle or the intracranial meninges are exceedingly rare. A patient with an ectopic meningioma in the external auditory canal and mastoid was treated in our unit. The world literature of the last 20 years was reviewed.

Audiometry, Pure-Tone↗
PubMed2006

Does the slow compression technique of hyperbaric oxygen therapy decrease the incidence of middle-ear barotrauma?

OBJECTIVE: To note the incidence of middle-ear barotrauma following standard and slow compression during hyperbaric oxygen therapy (HBOT). The standards used were: (1) less than 40 per cent of the cohort should develop barotraumas, and (2) the incidence of barotrauma following the slow technique should be less than that caused by the standard technique. DESIGN: Prospective clinical audit. MATERIAL AND METHODS: Forty-two consecutive patients who received either standard compression or slow compression HBOT were included. Pre- and post-treatment otoscopy (graded according to a modified Teed's scale), tympanometry, audiometry and subjective ear complaints were compared between the groups and also compared with the set standard. RESULTS: Significantly less middle-ear barotrauma was noted when using the slow compression technique compared with the standard compression technique (p < 0.05). The incidence of barotrauma when using standard compression failed to meet the set standard of less than 40 per cent. CONCLUSION: The slow compression method of HBOT proved to be both safe and superior to the standard compression technique.

Adult↗
PubMed2006

A systematic review of the role of proton pump inhibitors for symptoms of laryngopharyngeal reflux.

. Proton pump inhibitors are currently used widely for the treatment of laryngopharyngeal reflux. . This systematic review assessed the efficacy of proton pump inhibitors in the treatment of symptoms of laryngopharyngeal reflux. . Outcome measures used to assess efficacy of proton pump inhibitors included endoscopic laryngeal signs and pH recordings. .Only two small randomized-controlled trials included patients with objective evidence of reflux in the 24-h ambulatory oesophageal pH monitoring. . Pooled analysis of these two randomized-controlled trials failed to show any effect in favour of treatment with proton pump inhibitors. .Further randomized-controlled trials are required to ascertain the role of proton pump inhibitors in the treatment of laryngopharyngeal reflux.

Anti-Ulcer Agents↗
PubMed2005

Surgical interventions for pharyngeal pouch.

BACKGROUND: A pharyngeal pouch is an out-pouching or pocket that develops from the posterior wall of the pharynx just above the entrance to the oesophagus (gullet). Pouches may give rise to difficulty in swallowing, sensation of a lump in the throat or of food sticking in the throat and may lead to troublesome regurgitation of food. Food may enter the pouch rather than passing down the oesophagus and this and regurgitation may result in weight loss, hoarseness of voice and/or recurrent chest infections. The management of patients with a pharyngeal pouch may be either conservative or surgical. The surgical management can be further divided into two broad categories: endoscopic and open procedures. In the first half of the twentieth century an open surgical approach to the pouch was most frequently used, and remains common in some parts of the world. In recent decades endoscopic procedures (where the approach is made through the mouth) have become popular. The superiority of one approach over another has yet to be clearly demonstrated. OBJECTIVES: To assess the effectiveness and safety of open and endoscopic surgical procedures for the management of a pharyngeal pouch. SEARCH STRATEGY: We searched the Cochrane Ear, Nose and Throat Disorders Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library Issue 3, 2004, MEDLINE (1966 to 2004) and EMBASE (1974 to 2004). Reference lists of all identified trials and previous reviews were searched for additional trials. Further electronic searches for key authors identified were made. There were no language restrictions. The date of the last search was September 2004. SELECTION CRITERIA: We sought to identify all randomised controlled trials (RCTs) comparing two or more interventions. DATA COLLECTION AND ANALYSIS: Three reviewers assessed the eligibility of trials for inclusion in the review, based on pre-determined criteria. MAIN RESULTS: No trials were identified which fulfilled the criteria. AUTHORS' CONCLUSIONS: There is no evidence from high quality randomised controlled trials to demonstrate the effectiveness of endoscopic compared with open procedures for pharyngeal pouch. There is no good evidence to establish whether one endoscopic procedure is superior to another.

Diverticulum↗
PubMed2004

Calcium binding protein 1 of the protozoan parasite Entamoeba histolytica interacts with actin and is involved in cytoskeleton dynamics.

Blocking expression of EhCaBP1, a calmodulin-like, four EF-hand protein from the protozoan parasite Entamoeba histolytica, resulted in inhibition of cellular proliferation. In this paper we report that EhCaBP1 is involved in dynamic changes of the actin cytoskeleton. Both endocytosis and phagocytosis were severely impaired in cells where EhCaBP1 expression was blocked by inducible expression of the antisense RNA. In wild-type cells both actin and EhCaBP1 were found to co-localize in phagocytic cups and in pseudopods. However, in antisense-blocked cells the phagocytic cup formation is affected. Analysis of the staining patterns in the presence and absence of actin dynamics inhibitors, jasplakinolide and cytochalasin D suggested that EhCaBP1 and polymerized F-actin co-localize on membrane protrusions. Direct interaction between soluble EhCaBP1 and F-actin was further demonstrated by a co-sedimentation assay. A variant of EhCaBP1 did not bind F-actin showing the specificity of the interaction between EhCaBP1 and actin. There is no significant change in the kinetics of in vitro polymerization of actin in presence of EhCaBP1, indicating that EhCaBP1 does not affect filament treadmilling. In addition, using atomic force microscopy; it was found that filaments of F-actin, polymerized in presence of EhCaBP1, were thinner. These results indicate that EhCaBP1 may be involved in dynamic membrane restructuring at the time of cell pseudopod formation, phagocytosis and endocytosis in a process mediated by direct binding of EhCaBP1 to actin, affecting the bundling of actin filaments.

Actins↗
PubMed2004

Endoscopic stapling of pharyngeal pouch.

The relatively new technique of endoscopic stapling in the surgical management of pharyngeal pouch has gained widespread popularity over the last few years. The technique seems to be the procedure of choice as it is easier and quicker to perform and has a lower morbidity compared with open techniques. We present here an overview of the current evidence provided by a literature search performed by Ovid MEDLINE on literature published between January 1993 and May 2003 on endoscopic stapling of pharyngeal pouch. Several case series have been reported on various aspects of the surgery. The modifications in technique, peri-operative care, success rate, complications and recurrence are summarized, based on observational analytical case series. There were no randomized controlled trials comparing this approach to any other endoscopic or open surgical techniques for pharyngeal pouch.

Esophagoscopy↗
PubMed2004

A case of recurrent erythema multiforme and its therapeutic complications.

INTRODUCTION: We report a patient with recurrent erythema multiforme (recurrent EM) who developed iatrogenic Cushing's syndrome due to prolonged corticosteroid use. CLINICAL PICTURE: The patient had been treated with multiple courses of oral and intramuscular prednisolone over a 10-year period to suppress his recurrent and episodic symptoms. This resulted in the development of iatrogenic Cushing's syndrome with secondary adrenal suppression and steroid-induced osteoporosis. TREATMENT: The patient was treated with continuous acyclovir therapy in addition to azathioprine. This combination controlled his disease and enabled us to stop his requirement for high-dose prednisolone. OUTCOME: The patient responded well to this treatment regimen and has been in remission to date. CONCLUSION: This represents a severe case of recurrent EM and the side effects associated with years of chronic high-dose steroid usage. We discuss the therapeutic options to aid physicians in treating this disabling condition.

Adult↗
PubMed2003

Ménière disease patient information and support: which website?

Management of Ménière's disease remains problematic. Many different therapies are available, with variable success. Ménière's patients frequently research the Internet for information about the disease and to make contact with other patients. Internet websites providing this information have grown in number vastly in the past few years. This paper aims to identify the best websites available for Ménière's patients. Using Internet search engines the top 50 websites were evaluated a Website Global Scoring and Evaluation Proforma. From the above the top ranking 15 websites were identified.

Humans↗
PubMed2001

Simulation of flux lines with columnar pins: bose glass and entangled liquids.

Using path integral Monte Carlo we simulate a 3D system of up to 1000 magnetic flux lines by mapping it onto interacting bosons in (2+1)D. With increasing temperatures we find first order melting from an ordered solid to an entangled liquid signaled by a finite entropy jump and sharp discontinuities of the defect density and the structure factor S(G). For a particular density of strong columnar pins the crystal is transformed into a Bose glass phase with patches of crystalline order disrupted by the trapped vortices at the pinning sites but with no overall positional or orientational order. This glassy phase melts into a defected entangled liquid through a continuous transition.

Journal Article↗
PubMed2001

Quantum-fluctuation-induced spatial stochastic resonance at zero temperature.

We consider a model in which the quantum fluctuation can be controlled and show that the system responds to a spatially periodic external field at zero temperature. This signifies the occurrence of spatial stochastic resonance where the fluctuations are purely quantum in nature. Various features of the phenomenon are discussed.

Journal Article↗
PubMed2001

Selective impairment of protein kinase C isotypes in murine macrophage by Leishmania donovani.

Leishmania donovani, an obligate intracellular parasite resides and multiplies within macrophage of the reticuloendothelial system. The intracellular signalling mechanism involved in the impaired oxidative response in leishmaniasis has not yet been clearly established. Generation of superoxide anion (O2-) is supposed to be the first line of host defence during microbial invasion. We found a substantial inhibition of superoxide anion generation in parasitized macrophages, which was just the reverse in case of macrophages challenged with Lipophosphoglycan (LPG) deficient attenuated leishmanial parasite UR-6. The generation of O2- essentially needs the prior activation of protein kinase C (PKC) mediated phosphorylation events. Our study proposed that phosphorylation of 67, 54, 47 and 36 kDa proteins was attenuated during infection. This was supported by PKC activity study, where Ca-dependent PKC activity was inhibited but, Ca-independent PKC activity was enhanced. This result was further confirmed by using isotype specific pseudosubstrate inhibitors of Ca-dependent PKC beta and Ca-independent PKC zeta. Application of beta-pseudosubstrate could not alter the Ca-dependent PKC activity but zeta-pseudosubstrate inhibited the Ca-independent PKC activity in infected macrophages. Our immunoblot analysis with specific antibody against PKC beta and PKC zeta isotypes showed down regulation of PKC beta-II expression with concomitant induction of PKC zeta. Such inhibition of Ca-dependent PKC beta was reversed in macrophages treated with UR-6. Taken together, our observations revealed that infection with L. donovani selectively attenuates both the expression and activity of Ca-dependent PKC beta.

Animals↗
PubMed2001

Recovering maxillofacial trauma patients: the hidden problems.

This longitudinal study highlights the psychological and functional problems that can result from maxillofacial trauma. This is the first study to report outcome at one year. A total of 147 patients admitted for surgery following facial trauma were recruited over a seven-month period. Three questionnaires were used to record patient-derived levels of dysfunction: the Hospital Anxiety Depression scale, a modified University of Washington Quality of Life questionnaire and five non-validated facial trauma items. At one year 46 patients (31%) responded. Although there were significant improvements in scores from pre-operatively to one year, with all patients being discharged from outpatient follow-up, there was a substantial level of subjective symptomatology. Most notable was the level of anxiety and depression, which were present in 30% of the sample at both time points. Health-care professionals tend to underestimate the long-term effects of maxillofacial trauma. To improve patient care, greater appreciation of these problems is required at the time of initial management.

Adaptation, Psychological↗
PubMed2001

Initial study to assess the effects of topical glyceryl trinitrate for pain after haemorrhoidectomy.

BACKGROUND: Postoperative pain remains the most dreaded part of haemorrhoidectomy in the minds of both patients and doctors. It may delay patient discharge, recovery, and return to work. Glyceryl trinitrate has been used successfully in the treatment of anal fissures. We investigated its topical use in the management of pain after haemorrhoidectomy. METHOD: Twenty patients were entered into a double-blind trial and randomised into two groups. Group A (n = 10) applied glyceryl trinitrate ointment (0.2% twice daily) to the perianal area following surgery, and Group B applied a placebo ointment. They applied the ointment for up to 42 days after surgery, or until they felt it necessary to stop the treatment. Patients scored their daily anal pain using a visual analogue scale. Six weeks after surgery, patients were reviewed by an independent observer. RESULTS: The total pain score was calculated for each patient. The median score for Group A was 50.65; the median score for Group B was 73.50. There was no significant difference in pain scores between both groups, even when aberrant results were ignored. 20% of patients in each group complained that the ointment caused headache. CONCLUSION: The results suggest that topical glyceryl trinitrate ointment may not significantly reduce postoperative pain following haemorrhoidectomy. Meta-analysis would provide a more definitive answer.

Administration, Topical↗
PubMed2000

Quantum phase transitions in the Ising model in a spatially modulated field.

The phase transitions in the transverse field Ising model in a competing spatially modulated (periodic and oscillatory) longitudinal field are studied numerically. There is a multiphase point in absence of the transverse field where the degeneracy for a longitudinal field of wavelength lambda is [(1+sqrt[5])/2](2N/lambda) for a system with N spins, an exact result obtained from the known result for lambda=2. The phase transitions in the Gamma (transverse field) versus h(0) (amplitude of the longitudinal field) phase diagram are obtained from the vanishing of the mass gap Delta. We find that for all the phase transition points obtained in this way, Delta shows finite size scaling behavior signifying a continuous phase transition everywhere. The values of the critical exponents show that the model belongs to the universality class of the two dimensional Ising model. The longitudinal field is found to have the same scaling behavior as that of the transverse field, which seems to be a unique feature for the competing field. The phase boundaries for two different wavelengths of the modulated field are obtained. Close to the multiphase point at h(c), the phase boundary behaves as (h(c)-h(0))(b), where b is also lambda dependent.

Journal Article↗