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Biomedical subjects

R K Shah

Publications and source records attributed to R K Shah.

At least 19 recordsLinked to original sources
PubMed2006

Effect of rehabilitation facility location on outcomes in head and neck surgical patients.

The objective of this study was to determine the significance of in-hospital rehabilitation facility vs. distant rehabilitation facilities in the outcomes and complications of post-operative head and neck surgical patients. Retrospective review of head and neck surgical patients was conducted over a 5-year period at a tertiary care medical centre. Fifty patients met criteria for this study (35 males, 15 females). Forty-two patients had a primary squamous cell carcinoma and eight patients had other primary malignancies of the head and neck. Thirty-two patients were placed in an in-hospital rehabilitation facility and 18 patients were placed in distant rehabilitation facilities (average distance 40.9 miles). Seventeen patients (34%) had complications including infection/drainage (seven patients), fistula (six patients), pneumonia (two patients), wound dehiscence (two patients) and other minor complications. The difference complication rate among the two groups was not statistically significant (37.5% in-hospital rehabilitation, 27.8% distant rehabilitation; P=0.496). The rate of hospital re-admission was not statistically significant (25% in-hospital rehabilitation patients, 16.7% distant rehabilitation patients; P=0.505). The average length of stay of patients without complications was 18.5 days (SD=5.8) for in-hospital rehabilitation and 12.9 days (SD=17) for distant rehabilitation. This difference was not statistically significant (P=0.346). In summary, one-third of post-operative head and neck surgical patients developed complications while in a rehabilitation facility. The length of stay, hospital re-admission rate and frequency of complications does not correlate with the proximity of the rehabilitation facility to the hospital where the patients received their surgery.

Aged↗
PubMed2005

Improvement of the quality of whole wheat bread by supplementation of xylanase from Aspergillus foetidus.

The possible use of xylanase from Aspergillus foetidus MTCC 4898 as a bread improver was tested in whole wheat bread. The partially purified xylanase was used as an additive at 12 U/g during mixing of wheat flour. The effects of xylanase addition on the fermentation stage and the final bread quality were analyzed. Remarkable decrease (11%) in water absorption and increase in dough rising (28.5%) were noticed. Final moisture content of the bread was higher (40.5%) than control (32.3%). Improvements in volume (53%) and specific volume (56%) were also significant. Sensory evaluation indicated better flavour, taste, softness and overall acceptability. Texture profile analysis confirmed the rheological changes. Firmness was decreased by more than four folds. Improvements in cohesiveness and decline in springiness and gumminess were observed.

Aspergillus↗
PubMed2005

Treatment of fracture dislocation of talus by primary tibiotalar arthrodesis (Blair fusion).

We present a retrospective clinical and radiological study of eight patients who underwent primary Blair tibiotalar arthrodesis for Hawkins' grade III fractures of the neck of talus. The average age of the patients was 23 years and the average follow-up, was 2 years. Results were good in six patients, fair in one and poor in one. It is concluded that the displaced talar fractures with late presentation are challenging to treat and Blair fusion is a reasonable procedure.

Adult↗
PubMed2005

Mid-frequency sensorineural hearing loss: aetiology and prognosis.

OBJECTIVES: An audiometric finding of mid-frequency sensorineural hearing loss (MFSNHL), or a U-shaped pattern, is uncommon. The objective of this study is to investigate the aetiology and prognostic significance of MFSNHL. DESIGN: Tertiary academic referral centre-based retrospective case review and review of audiograms to determine the prevalence of this audiometric finding. METHODS: Patients with a pure tone threshold average at 1, 2, and 4 kHz at least 10 dB greater than the average at 0.5 and 8 kHz were included in this study; 35 patients met these criteria. The mean age of the patients was 34.6 years old (range 4-71 years). Twelve patients (33 per cent) were under 18 years of age. Serial audiograms were obtained for 14 patients. The notes were reviewed for any pertinent otologic history, subsequent diagnoses, management and disease course. RESULTS: The prevalence of MFSNHL in this practice setting is less than 1 per cent. The average hearing threshold in the mid-frequencies was 44 dB, which was 17 dB and 20 dB lower than at 0.5 Hz and 8 kHz, respectively. The pure tone average (0.5, 1, 2 kHz) was 40 dB. Sixteen patients (44 per cent) required amplification. Of all patients, 22 had hereditary hearing loss, eight had idiopathic hearing loss, and five adults had vestibular schwannomas. CONCLUSIONS: MFSNHL is an infrequent audiometric finding. The great majority of these cases are of presumed hereditary or idiopathic aetiology, although 22 per cent of adults had vestibular schwannomas. This series presents the causes and prognosis of this audiometric pattern.

Adolescent↗
PubMed2004

Surgical Implant Generation Network (SIGN) intramedullary nailing of open fractures of the tibia.

We treated 36 open tibial fractures (32 patients) by primary intramedullary nailing and debridement and treatment of open wounds. There were 13 grade I, 14 grade II and 9 grade III according to Gustilo-Anderson classification. After a minimum follow-up of 8 months, there were two cases of superficial infection and one of deep infection. Thirty-one fractures united within 6 months with a mean period to union of 22 weeks. There were four delayed unions and one non-union. There was a longer union time and a higher rate of delayed or non-union in the complex and/or comminuted grade IIIB fractures. Intramedullary nailing, with appropriate soft-tissue treatment, gives good results in the treatment of open tibial fractures.

Adolescent↗
PubMed2004

Acute pyogenic iliopsoas abscess in children in Nepal.

We describe a prospective study of twenty-four cases of acute pyogenic abscess of the iliopsoas in children treated conservatively and operatively. Eight patients were managed conservatively with antibiotics alone while sixteen others were managed operatively by open drainage. All made a complete recovery.

Acute Disease↗
PubMed2003

Improving primary orthopaedic and trauma care in Nepal.

PURPOSE: To evaluate the efficacy of training programmes for the village health practitioners aimed at improving primary orthopaedic and trauma care in our rural setting. MATERIALS & METHODS: Six year prospective study of training workshops in local health institutions was carried out using locally available manpower and materials. RESULTS: After 6 years the evaluation of this programme shows a significantly improved (p < 0.05) knowledge base and working skills after completion of training workshop. SUMMARY: To avoid unnecessary complications, effective primary health care provided by an appropriately trained person should be available at the peripheral level. This training programme seems successful in achieving this goal and hence needs adoption for wider use in Nepal.

Community Health Workers↗
PubMed2001

Optical-thermal simulation of tonsillar tissue irradiation.

BACKGROUND AND OBJECTIVE: Despite laser applications targetted toward tonsillar tissue, there has been no characterization of underlying optical and thermal events during laser irradiation of tonsillar tissue. STUDY DESIGN/MATERIALS AND METHODS: The optical properties of canine and human tonsils were determined at 805 nm (diode laser) and 1,064 nm (Nd:YAG laser). An optical-thermal simulation was developed to predict the temperature rise in irradiated human tonsils. RESULTS: The optical properties of human and canine tonsillar tissue are similar at both wavelengths. The optical-thermal simulation was validated and predicts that at 10 W and 1 minute of irradiation, the heat will be contained within the human tonsil. The diode laser causes more superficial heating than the Nd:YAG laser. CONCLUSIONS: The safety of irradiating human tonsils was shown. The diode laser is superior to the Nd:YAG laser because less heat affects collateral structures. The optical-thermal simulation detailed in this study can be used to predict the temperature rise in tissues undergoing irradiation.

Animals↗
PubMed2001

Pulsed-dye laser and retinoic acid delay progression of oral squamous cell carcinoma: a murine model.

OBJECTIVES/HYPOTHESIS: This study examined the role of the pulsed-dye laser (PDL) at 585 nm coupled with retinoic acid at therapeutic (5.0 mg/kg) and nontherapeutic (0.5 mg/kg) doses to delay the progression of cancer with a two-hit approach. The existing vasculature is selectively targeted by the laser, whereas retinoic acid inhibits future angiogenesis. STUDY DESIGN: Randomized, prospective study in a murine model. METHODS: Twenty-five athymic nude mice were inoculated with oral squamous cell cancers on six flank sites and randomly divided into five groups: 1) control subjects, 2) treatment with 0.5 mg/kg retinoic acid (RA 0.5), 3) treatment with 5.0 mg/kg retinoic acid (RA 5.0), 4) treatment with RA 0.5 + PDL, and 5) treatment with RA 5.0 + PDL. The PDL groups received irradiation after inoculation. The retinoic acid was administered daily. The tumors were counted and measured for 14 days. RESULTS: The control group developed visible tumors in 50% of the inoculation sites at 3 days compared with 3 days (RA 0.5) and 4 days (RA 5.0) for the retinoic acid groups and 9 days (RA 0.5 + PDL) and 10 days (RA 5.0 + PDL) for the laser treatment groups. There was no tumor growth until day 7 in the RA 5.0 + PDL group. The tumor volume was statistically different between the treatment groups. CONCLUSION: This study demonstrated the superiority of a single treatment with the PDL coupled with retinoic acid to delay the progression of cancer when compared with treatment with retinoic acid alone, thus introducing a novel strategy in cancer control.

Animals↗
PubMed2000

Optical-thermal simulation of human tonsillar tissue irradiation: clinical implications.

BACKGROUND AND OBJECTIVE: Mucosa intact laser tonsillar ablation is an alternative to conventional tonsillectomy. The efficacy of this procedure was demonstrated in canines, but establishing the safety of irradiating human tonsils is paramount. STUDY DESIGN/MATERIALS AND METHODS: An optical-thermal simulation of tonsillar tissue irradiation was previously developed, but the effect of varying parameters was not investigated. The tissue response to irradiation at 5-25 watts for 1 minute and 10 watts for 10 seconds to 162 seconds is simulated. RESULTS: At 15 watts and greater, the peak temperature is over 100 degrees C and the mucosal temperature is over 70 degrees C. At the depth of the tonsil, the temperature does not vary significantly. The peak temperature is at 1 mm. The radial temperature profile is not significantly altered by longer irradiation times. CONCLUSIONS: The optimal dosimetry parameters for irradiation of human tonsillar tissue at 805 nm with the MILTA technique is under 15 watts for approximately 1 minute.

Computer Simulation↗
PubMed1994

The Nepalese patuka in the prevention of back pain.

The patuka is a special piece of cloth worn around the waist by heavy workers and mountain porters in Nepal. An investigation was carried out to study its role in preventing pain in the back. Observations of intra-abdominal pressure and the lumbosacral compression force confirmed that the patuka might be responsible for the low incidence of back pain in those wearing it.

Abdomen↗
PubMed1993

A pilot survey of the traditional use of the patuka round the waist for the prevention of back pain in Nepal.

A pilot survey of 55 persons from the traditional patuka-wearing population in the central region of Nepal was conducted during May 1991 to study the significance of the traditional use of the patuka around the waist as related to the prevention of back pain. The hypothesis that a patuka functions like a spinal support and hence prevents back pain in the workers and porters in Nepal appears to be supported by the results of this epidemio-clinico-radiological pilot research. Hence its traditional use in Nepal appears to be justified on scientific grounds and it seems rational to recommend the use of this indigenous, simple and cost-effective spinal support to people facing the risk of back pain. However, only a broad epidemiological survey and/or double-blind study can establish reliably its role in clinical or ergonomic application.

Journal Article↗
PubMed1991

Appropriate management of femoral neck fractures in Nepal.

The management of femoral neck fractures in the Third World has always been a problem. Its management in Nepal reflects the level of available treatments for other orthopaedic conditions, as well as for medical care in general. The most successful methods of fracture treatment have remained the simple ones, consistent with the available resources. Adherence to this philosophy of management, carried out with attention to the needs of the people, reduces the incidence of iatrogenic complications. Six years of experience in the management of femoral neck fractures by traction, plaster, McMurray's osteotomy, modified Girdlestone's excision arthroplasty and Austin Moore prosthetic replacement have been reviewed, along with the relevant literature. Non-operative management has been found to be the most satisfactory method of treatment when related to the overall medical resources in Nepal.

Adult↗
PubMed1990

Ultrasonographically observed preterm grade III placenta and perinatal outcome.

Ultrasound studies of placenta were conducted in 270 singleton normal pregnancies. Women were enrolled between 31 and 34 weeks of gestation and were followed up for the outcome of pregnancy. Women with grade III placental maturity comprised the study group (n = 64) and those with grade I placenta were enrolled as control group (n = 206). Another 100 normal women were enrolled to note the prevalence of grade III placenta at term. There was an increased incidence of intrauterine growth retardation (6.20%) and fetal distress (7.8%) in the study group compared with the control group (nil), which was statistically significant. The incidence of low birth weight was also higher (34.37%) in the study group compared with the control group (22.33%). Three women in the study group developed preeclampsia at subsequent follow up visit but none in control group (P less than 0.01). Prevalence rate of grade III placenta at term was 28%. In view of these findings preterm grade III placenta is found to be a sensitive predictor of poor perinatal outcome.

Adult↗