Amniotic fluid volumes in normal pregnancies.
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Aminohippuric Acids↗
Biomedical subjects
S I Shah
Publications and source records attributed to S I Shah.
Long-term follow-up of mitral paraprosthetic regurgitation by transesophageal echocardiography.
Paravalvular regurgitation (PVR) is an uncommon complication of mitral valve replacement (MVR). Although severe PVR is almost always repaired immediately when recognized during surgery, there are little data available on the management of patients with mild and moderate PVR. This study includes eight patients with mild (n = 6) and moderate (n = 2) PVR identified by transesophageal echocardiography at the time of MVR who were treated conservatively. Clinical and echocardiographic follow-up was obtained at a mean of 16.3 months. Two of six patients with mild PVR at the time of MVR and two of two patients with moderate PVR at the time of MVR deteriorated clinically and echocardiographically over time. We suggest that moderate PVR should be corrected at the time of valve-replacement surgery, if this can be performed without high operative risk. Mild PVR should probably also be repaired, if this can be performed at low risk, because some will progress. Patients left with mild PVR after surgery, or patients in whom PVR is recognized only after surgery, should be followed up carefully with serial clinical and echocardiographic examinations.
Echocardiography, Transesophageal↗
Spontaneous subcutaneous temporal emphysema.
The presence of air in the temporal regions is an uncommon presentation of spontaneous pneumomediastinum. As terminal alveoli rupture, air dissects along bronchovascular shafts. Usually, air travels either in a superior or inferior direction. Thus, extensive spontaneous subcutaneous emphysema accompanied by both cervical and retroperitoneal emphysema is rarely encountered. We present an unusual case of spontaneous pneumomediastinum, pneumoretroperitoneum, and cervical and facial emphysema presenting as bilateral painless temporal swelling. To our knowledge, this association has not been reported. Treatment involves observation for potentially life-threatening sequelae.
Adult↗
Photorefractive keratectomy for myopia with a 6-mm beam diameter.
BACKGROUND: Earlier studies have reported clinical outcomes for up to 2 years following photorefractive keratectomy (PRK) using a 5.0-mm treatment zone with the Summit excimer laser. We present results of PRK using a 6-mm ablation zone with the same laser. METHODS: Forty-five eyes of 45 patients underwent excimer laser PRK for correction of myopia using a 6-mm excimer laser beam diameter. Attempted corrections ranged from 1.50 diopters (D) to 6.00 D. Data on outcomes of uncorrected visual acuity, spectacle-corrected visual acuity, predictability, corneal haze, subjective glare/halo effects, and patient satisfaction with the procedure were analyzed over a follow-up period of 6 months. RESULTS: All patients obtained a postoperative uncorrected visual acuity of at least 20/40; 28 eyes (62%) achieved at least 20/20. Postoperative spectacle-corrected visual acuity was at least 20/20 in all patients; no patients lost more than one Snellen line of spectacle-corrected visual acuity. Twenty-eight patients (62.2%) achieved within +/-0.50 D of the attempted correction; 40 patients (84.4%) achieved within +/-1.00 D. Mean spherical equivalent refraction was -4.99 D preoperatively and +0.44 D at 1 month, +0.04 D at 3 months, and +0.09 D at 6 months. At 6 months, 40 eyes (88.9%) were graded as clear, 4 eyes (8.9%) as having trace subepithelial haze, and 1 eye (2.2%) as having mild subepithelial haze. The mean glare/halo index for all of the patients was 0.59 on a scale of 0 to 5. Mean subjective patient satisfaction was 4.68 (on the same scale). CONCLUSIONS: Clinical outcomes following excimer laser PRK for myopia using a 6-mm treatment zone are encouraging. Postoperative subjective glare/halo were minimal, suggesting an optical advantage in using the larger ablation zone.
Adult↗