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Biomedical subjects

R Raman

Publications and source records attributed to R Raman.

At least 109 records · Page 6Linked to original sources
PubMed1993

Profuse epistaxis: an argument for conservative medical management.

A review of 10 years' experience of all patients with profuse epistaxis requiring hospitalisation in a tertiary care centre in India is presented. There were 106 patients among which only 72% of cases had associated medical illness. Hypertension (44%) and bleeding diathesis (11%) were found to be the most frequently associated aetiological medical conditions noted in this study. Although there is controversy regarding the optimum treatment in profuse epistaxis in literature, our experience suggests that it can be successfully managed with conservative medical management alone and surgical intervention with its potential complications may not be necessary in most cases.

Adolescent↗
PubMed1992

Medical management of pseudocyst of the auricle.

Four male patients with pseudocyst of the auricle were successfully treated with oral corticosteroids. This condition is an asymptomatic, non-inflammatory, cystic swelling, usually located in the scaphoid or triangular fossa of the anti-helix which if untreated, leads to deformity of the pinna. All successful methods of treatment described in the literature so far have been invasive. All four patients in the above series responded to oral steroid therapy alone.

Adult↗
PubMed1992

Laryngeal stridor in myasthenia gravis.

Two patients with laryngeal stridor secondary to myasthenia gravis are reported. The cause of bilateral abductor weakness in myasthenia is discussed; anticipation of the stridor in myasthenic patients is highlighted.

Adult↗
PubMed1992

Maxillary sinus fusariosis in immunocompetent hosts.

We report the first known cases of Fusariosis of maxillary sinus with granuloma and oro-antral fistula in two immunocompetent hosts. Fusarium solani was demonstrated in the direct microscopic examination and isolated in heavy growth from the biopsy materials. Both these patients were successfully treated with oral ketoconazole (200 mg daily) for three weeks followed by a Caldwell-Luc operation. Ketoconazole was continued for two months post-operatively.

Adult↗
PubMed1992

Alterations in oropharyngeal flora in patients with a nasogastric tube: a cohort study.

OBJECTIVE: To determine whether or not the presence of a nasogastric tube causes a change in the bacterial flora in the oropharynx. STUDY DESIGN: Cohort (prospective) design with concurrent control. SETTING: General Surgical and Ear, Nose, and Throat Units of a tertiary care hospital. PATIENTS: Sixteen patients with and 14 patients without a nasogastric tube. INTERVENTIONS: Patients scheduled to undergo surgery under general anesthesia with endotracheal intubation were eligible for inclusion in the study. From these patients, a study cohort of 16 consecutive patients who were to have nasogastric tube intubation and 14 patients who were not to have nasogastric intubation were enrolled. All patients had a high oropharyngeal swab taken for bacteriologic culture just before surgery. The swab of the oropharynx for culture was repeated after 48 to 72 hrs. The type of organism grown was identified and compared between and within the two groups. RESULTS: There was a significant increase in the frequency of colonization of the oropharynx by pathogenic Gram-negative bacteria after 48 to 72 hrs of nasogastric intubation in comparison with the preintubation level (p < .01) as well as in comparison with the group that did not have nasogastric intubation (p < .001). The pathogens included Pseudomonas, Klebsiella, Proteus and Escherichia coli. There was also a tendency for suppression of normal flora. There was no significant change in the flora of the control group of patients who did not have nasogastric intubation. The two groups were comparable with respect to age, gender, severity of underlying illness, and use of prophylactic perioperative antibiotics. CONCLUSIONS: The presence of nasogastric tubes in patients predisposes to colonization by Gram-negative pathogenic bacteria within 48 to 72 hrs.

Adult↗
PubMed1992

Mapping of brain tumor metabolites with proton MR spectroscopic imaging: clinical relevance.

Brain tumor metabolism was studied with hydrogen-1 magnetic resonance spectroscopy and positron emission tomography with fluorine-18 fluorodeoxyglucose in 50 patients. N-acetylaspartate (NAA) was generally decreased in tumors and radiation necrosis but was somewhat preserved at neoplasm margins. Choline was increased in most solid tumors. Solid high-grade gliomas had higher normalized choline values than did solid low-grade gliomas (P < .02), but the normalized choline value was not a discriminator of tumor grade, since necrotic high-grade lesions had reduced choline values. Serial studies in one case showed an increase in choline as the glioma underwent malignant degeneration. Choline values were lower in chronic radiation necrosis than in solid anaplastic tumors (P < .001). In two cases studied before and after treatment, clinical improvement and a reduction in choline followed therapy. Lactate is more likely to be found in high-grade gliomas, but its presence is not a reliable indicator of malignancy.

Adolescent↗
PubMed1992

Effects of radiation on hearing in patients with malignancies of head and neck.

Patients with normal hearing at the start of radiation were tested for hearing during (30 GY) and at the end of radiation therapy (45-60 GY) in order to determine if there was any alteration in their pure tone hearing thresholds. A significant increase in the hearing threshold was found at high frequencies at the end of therapy. At the end of the course of radiation, clinical findings suggestive of middle ear changes due to radiation were seen in 33% of the ears. Patients whose ears are included in the field of radiation may have to be forewarned to expect a loss in their acuity of hearing, especially those whose professional life may depend on it.

Adolescent↗
PubMed1991

Mammalian sex chromosomes. III. Activity of pseudoautosomal steroid sulfatase enzyme during spermatogenesis in Mus musculus.

Parallel to the inactivation of the X chromosome in somatic cells of female, the male X in mammals is rendered inactive during spermatogenesis. Pseudoautosomal genes, those present on the X-Y meiotically pairable region of male, escape inactivation in female soma. It is suggested, but not demonstrated, that they may also be refractory to the inactivation signal in male germ cells. We have assayed activity of the enzyme steroid sulfatase, product of a pseudoautosomal gene, in testicular cells of the mouse and shown its presence in premeiotic, meiotic (pachytene), and postmeiotic (spermatid) cell types. It appears that, as in females, pseudoautosomal genes may escape inactivation in male germ cells also.

Animals↗
PubMed1991

Obliterative otosclerosis.

An analysis of 420 consecutive cases of obliterative otosclerosis seen in the Christian Medical College Hospital, Vellore is presented. The proportion of truly obliterative otosclerosis is 33.09 per cent (139 ears). Our male to female ratio in truly obliterative otosclerosis is 1.48:1, while in the non-obliterative group it is 1.34:1. The mean age at onset in the obliterative group was 19.14 while in the non-obliterative group it was 25.60. This is statistically significant (P less than 0.001). The age at presentation was 25.90 in the obliterative group while in non-obliterative group it was 30.86; this is also statistically significant (P less than 0.001). However the time interval between the age at onset and the age at presentation is not statistically significant.

Adolescent↗
PubMed1991

Aetiological profile of paediatric laryngeal stridor in an Indian hospital.

The case records of 180 infants and children with stridor were reviewed to note their clinical profile. We found that cases of acute stridor outnumbered cases of chronic stridor. The aetiology was congenital in 32.2% and acquired in 67.8%. Laryngomalacia (19.4%) was the commonest congenital cause. Laryngotracheobronchitis and diphtheria were the commonest infectious causes (35%). Tracheostomy was performed in 25% of cases, the most frequent indication being bilateral abductor paralysis. The problems peculiar to developing countries that influence the clinical status of a child in stridor are discussed.

Adolescent↗
PubMed1991

Effect of nasogastric tubes on the nose and maxillary sinus.

OBJECTIVE: To estimate the proportion of patients who develop radiologic evidence of maxillary sinus inflammation among those who are maintained on nasogastric (NG) tubes after major surgery. DESIGN: Prospective case series. SETTING: Patients were drawn from the general surgical and ear, nose, and throat units of a tertiary care hospital. METHOD: All patients undergoing major surgery with or without a concurrent tracheostomy, in whom an NG tube was retained for greater than or equal to 48 hrs, were examined clinically and radiologically for evidence of maxillary sinus inflammation. RESULTS: Sixty-five patients were studied. Twenty patients had a concurrent tracheostomy and 45 patients were without tracheostomy. Only 10% of the patients in the tracheostomy group developed radiologic evidence of sinus inflammation, as compared with 50% in the nontracheostomy group (p less than .05). The proportion of patients who developed clinical evidence of rhinitis was about 75% in either group. However, none of the patients in the study had clinical evidence of maxillary sinusitis. There was no correlation between the age of the patient, sex, use of broad-spectrum antibiotics, or duration of NG intubation with the onset of sinus inflammation. CONCLUSIONS: The presence of NG tubes predisposes to nasal and maxillary sinus inflammation. Sinonasal symptoms of clinical sinusitis may not be present even when radiologic evidence of inflammation is evident. In patients with tracheostomy, the frequency of maxillary sinus inflammation is significantly lower than in those patients without tracheostomy.

Adult↗
PubMed1991

Mammalian sex chromosomes. IV. Replication heterogeneity in the late replicating facultative- and constitutive-heterochromatic regions in the X chromosomes of the mole rats, Bandicota bengalensis and Nesokia indica.

The karyotypes of Nesokia indica and Bandicota bengalensis are identical except for their sex chromosomes, which are much larger in Nesokia due to additional constitutive heterochromatin (C.H.). Replication patterns of their sex chromosomes were studied employing 3H-Tdr autoradiography and BrdUrd-FPG staining techniques. Though the "conservative" part of both early- and late-replicating X chromosomes revealed identical replication patterns in most cells, deviant patterns of only the late replicating X chromosome were encountered in approximately 10% cells. Surprisingly, these late-X variants were similar in the two species. The sex chromosome-associated C.H. segments replicated late in S-phase and, in females, the homologous heterochromatin replicated asynchronously--the later replicating one was predominantly associated with the late X. These results suggest structural and functional conservation of the X chromosomes as well as the possible influence of facultative heterochromatin (F.H.) on the replication of associated C.H. in these two species.

Animals↗
PubMed1991

Chronic suppurative otitis media: complicated versus uncomplicated disease.

To determine prognostic factors in patients with chronic otitis media who develop suppurative complications, we performed a retrospective study of all patients with chronic suppurative otitis media who underwent mastoid surgery between the years 1981 and 1989. Patients who developed complications were compared with those who did not with respect to six prognostic variables. The results indicated that patients with complications were younger (p less than 0.001), had shorter duration of ear discharge (p less than 0.001), were more likely to have pars tensa perforations (p less than 0.05), and had a higher degree of mastoid sclerosis in the operated and contralateral ears (p less than 0.001). The presence of cholesteatoma and the sex of the patient were of no prognostic value. Bacteriology of CSF and pus specimens from patients who developed intracranial complications mostly revealed mixed flora (62.9%). Proteus species was the most frequent isolate (34%) and anaerobes were present in 21.3% of specimens. Mastoid abscess occurred in more than half the patients in the complicated group. Brain abscess (57.4%) was the most frequent intracranial complication. On the basis of our findings we recommend that risk factors in patients with chronic suppurative otitis media be identified early to enable effective measures to be taken to eradicate the disease.

Adolescent↗
PubMed1991

Nasofacial conidiobolomycosis.

A case of Nasofacial Zygomycosis in a 15-year-old male patient from South India is reported. This patient had typical thickening of the nasofacial mucosa and the skin overlying it. The diagnosis was confirmed with fungal cultures. Although initially good response to treatment with potassium iodide was achieved, later the response was unsatisfactory, probably partly due to irregularity in treatment. Treatment with sulphamethoxazole--trimethoprim and prednisolone combination has resulted in remarkable improvement.

Adolescent↗