Biomedical subjects

S Akhtar

Publications and source records attributed to S Akhtar.

206 records · Page 12Linked to original sources

PubMedDate not supplied

Frey's syndrome following submandibular gland excision: an unusual postoperative complication.

Gustatory sweating and flushing, or Frey's syndrome, is a fairly common complication following surgery or injury to the parotid gland and is thought to be caused by aberrant nerve regeneration. A similar condition has been reported in the literature following surgery to the submandibular region. Since this was first described in 1934, only 7 subsequent cases of submandibular sweating and flushing have been reported. We present a case of a 52-year-old female who underwent excision of the left submandibular gland as a result of chronic sialadenitis. Twelve months following surgery, symptoms indicative of Frey's syndrome were experienced in the operative region. A review of the aetiology and treatment of the condition is described.

Female↗

PubMedDate not supplied

Bilateral vocal cord paralysis following radiation therapy for nasopharyngeal carcinoma.

Cranial nerve palsies are uncommon late sequelae of radiation therapy. We present a rare case of bilateral vocal cord paralysis secondary to radiation-induced recurrent laryngeal nerve paralysis. The exact mechanism accounting for radiation-induced nerve damage is unknown. The complication may occur years following radiation therapy thus making a causal relationship difficult. As there is no treatment available, the therapy should aim to improve the functional impairment produced by the nerve involved.

Carcinoma↗

PubMedDate not supplied

New experimental model of acute renal failure and sepsis in rats.

BACKGROUND: A rat model of acute renal failure (ARF) with sepsis (ARF+S) was developed to simulate the clinical syndrome of hypercatabolic illness in patients with ARF. METHODS: Sepsis was created by ligation and needle puncture of the cecum; ARF was created by left renal artery clamping and contralateral nephrectomy. RESULTS: Two studies were performed. In study 1, rats with sham surgery, sepsis, ARF, and ARF+S were examined for 48 hours. During the first 24 hours after surgery, ARF and ARF+S rats displayed increased urea and ammonia nitrogen appearances and abnormal plasma amino acid levels. These abnormalities were exaggerated in ARF+S rats. In study 2, sham, ARF, and ARF+S rats were injected with sodium bicarbonate or normal saline. During the first 24 hours after surgery, the ARF and ARF+S rats showed an increase in urea nitrogen appearance to 210% and 293%, respectively, of sham values, which was greater than the levels that have been previously reported. Sodium bicarbonate treatment did not influence nitrogen output. CONCLUSIONS: Rats with ARF+S may be a useful model for studying catabolic patients with ARF. The lack of effect of sodium bicarbonate on nitrogen balance merits additional study.

Acute Kidney Injury↗

PubMedDate not supplied

The concept of identity: developmental origins, phenomenology, clinical relevance, and measurement.

The aim of this paper is a thorough explication of the concept of identity. We have synthesized the scattered psychiatric and psychoanalytic literature on the topic to shed light on the historical origins, development, phenomenology, clinical relevance, and methods of assessing identity. Our review revealed that: (1) The concept of identity has persisted over eight decades. (2) Identity originates in the earliest interplay of the infant's temperament with the mother's attitude, gains structure from primitive introjections, refines itself through later selective identifications, acquires filiation and generational continuity in passage through the Oedipus complex, and arrives at its more or less final shape through synthesis of contradictory identifications and greater individuation during adolescence. It remains subject to further refinements during young adulthood, midlife, and even old age. (3) A cohesive identity comprises a realistic body image, subjective self-sameness, consistent attitudes, temporality, gender, authenticity, and ethnicity. (4) Disturbance of identity suggests psychopathology, with greater identity disturbance being associated with more-severe conditions (e.g., severe personality disorders, multiple personality, psychosis). (5) Clinical and psychometric assessment is therefore relevant and might indicate treatment strategies and outcome expectations. Findings from the literature are elucidated, and areas needing further research are identified.

Adolescent↗

PubMedDate not supplied

Comparative evaluation of intraocular pressure changes subsequent to insertion of laryngeal mask airway and endotracheal tube.

AIMS: To evaluate the intraocular pressure and haemodynamic changes subsequent to insertion of laryngeal mask airway and endotracheal tube. SUBJECTS AND METHODS: The study was conducted in 50 adult patients. A standard general anaesthesia was administered to all the patients. After 3 minutes of induction of anaesthesia baseline measurements of heart rate, non-invasive blood pressure and intraocular pressure were taken following which patients were divided into two groups: laryngeal mask airway was inserted in group 1 and tracheal tube in group 2. These measurements were repeated at 15-30 second, every minute thereafter up to 5 minutes after airway instrumentation. RESULTS: A statistically significant rise in heart rate, systolic blood pressure, diastolic blood pressure and intraocular pressure was seen in both the groups subsequent to insertion of laryngeal mask airway or endotracheal tube. Mean maximum increase was statistically more after endotracheal intubation than after laryngeal mask airway insertion. The duration of statistically significant pressure responses was also longer after endotracheal intubation. CONCLUSION: Laryngeal mask airway is an acceptable alternative technique for ocular surgeries, offering advantages in terms of intraocular pressure and cardiovascular stability compared to tracheal intubation.

Adult↗

PubMedDate not supplied

The role of vitamin A in enhancing humoral immunity produced by antirabies vaccine.

We tested the effects of vitamin A supplementation on the antibody titre of 40 healthy volunteers (age range: 10-35 years), who had received a complete course of antirabies vaccine (5 injections over 30 days). After determining the baseline serum vitamin A status of 80 volunteers, 20 pairs were matched for serum vitamin A level, body mass index, age, sex and socioeconomic status. One person from each pair was randomly assigned to an experimental or control group. The experimental group received vitamin A and antirabies vaccine. Controls received only the vaccine. The experimental group had significantly greater (2.1 times) serum antirabies titre than controls. This finding is an important step towards improving the economy of dosage of antirabies vaccines.

Adolescent↗

PubMedDate not supplied

A matched case-control study of risk factors for neonatal tetanus in Karachi, Pakistan.

BACKGROUND: Previous studies have identified various risk factors for neonatal tetanus (NNT) in rural areas of Pakistan. The present matched case control study was conducted to further evaluate these risk factors in an urban setting. AIM: The study was carried out to identify risk factors for NNT in Karachi. MATERIALS AND METHODS: Patients of NNT (n = 125) diagnosed from January 1998 to February 2001 were recruited through a surveillance system of Expanded Programme on Immunization (EPI). Two neighbourhood controls (n = 250) were matched for each case for gender and date of birth of the case. STATISTICAL ANALYSIS: Conditional logistic regression was performed to assess the independent effect of factors associated with NNT. RESULTS: The final multivariable model identified subsequent application of substances on the umbilical cord (adjusted matched odds ratio [adj. mOR] = 5.1 [2.7-9.7]), home delivery (adj. mOR = 1.8; 95% CI: 1.1- 3.1) and illiterate mother (adj. mOR = 1.6; 95% CI: 1.0- 2.0) as risk factors for NNT after adjusting for other variables in the model. Population attributable risk per cent (PAR %) for subsequent cord application was 69% and PAR % for home delivery was 31%. CONCLUSION: Health planners, while formulating control strategies through immunization programmes should also take into account the impact of post-delivery practices, such as 'subsequent cord application' along with pre-delivery practices. Health awareness regarding appropriate post-delivery practices should be promoted and counselling of pregnant women for giving preference to health care setting for delivery is also crucial.

Case-Control Studies↗

PubMedDate not supplied

Vitamin E in the treatment of tardive dyskinesia.

In a double-blind placebo controlled trial, the efficacy of Vitamin E in the treatment of tardive dyskinesia (TD) was studied in 32 patients. After a two week wash-out phase a baseline (0 week) TD rating was assessed on the tardive dyskinesia rating scale (TDRS). Subsequently, the patients entered a four week treatment phase during which 17 patients received capsules of vitamin E (600 mg) and 15 patients received identical placebo capsules. In the first week the patients received 1 capsule daily which was then increased to two capsules per day from the second to the fourth week. All patients were rated on the TDRS at the end of each week. The baseline TDRS score in the vitamin E group was significantly higher than the placebo group. This was hence adjusted and the results were then subjected to analysis of co- variance. The TDRS score after four weeks treatment was significantly lower in the vitamin E group as compared to the placebo group (p = 0.03).

Adult↗