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Biomedical subjects

S Sultan

Publications and source records attributed to S Sultan.

At least 19 recordsLinked to original sources
PubMed1999

Outcome of the first 100 femoropopliteal angioplasties performed in the operating theatre.

OBJECTIVES: To examine the factors influencing outcome and restenosis in an initial series of 100 infrainguinal angioplasties. DESIGN: Prospective study of angioplasties of the superficial femoral and popliteal arteries performed over a 42-month period. MATERIALS AND METHODS: One hundred consecutive angioplasties in 96 patients performed in the operating theatre between January 1993 and June 1996 were followed prospectively with clinical, ABI, and duplex assessment. Forty-four procedures were for disabling claudication and 56 for critical ischaemia. Stents were deployed in 30 limbs. RESULTS: Angioplasty was successful in 84 of 100 limbs. Cumulative patency of the entire group at 3, 6, 12 and 18 months was 78%, 60%, 53%, and 49% respectively, while excluding initial failures, gave patencies of 95%, 69%, 63%, and 58%, respectively. Claudicants with a 1-year patency of 64% did significantly better than patients with critical ischaemia (44% p < 0.05). Angioplasties performed during the initial 21 months had a 1-year patency of 42%, while those performed in the final 21 months had a 74% patency (p = N.S.). The patency for stented arteries was 66% vs. 49% for angioplasty alone (p = N.S.). The 2-year limb salvage rate was 91% in patents with critical ischaemia. Forty-six per cent of restenoses were asymptomatic. CONCLUSIONS: The results suggest that while angioplasty is useful in treating infrainguinal arterial disease, there is a learning curve, resulting in a high restenosis rate for occlusive and multilevel disease, while concomitant placement of stents may be beneficial.

Aged↗
PubMed1998

Popliteal aneurysms: a 10-year experience.

BACKGROUND: Popliteal aneurysms account for 70% of peripheral arterial aneurysms and, if untreated, pose a serious threat to the affected limb. Debate continues about the best form of treatment especially for asymptomatic lesions. METHOD: We reviewed the computer records and charts of patients seen at this department with a diagnosis of popliteal aneurysm over the last 10 years. Patients who had not been seen within the last year were followed-up through their G.P. RESULTS: Twenty-four patients (M 23/F 1) presented with 40 popliteal aneurysms. The mean age was 63.5 +/- 9 years. Symptoms were present in 23 of the affected limbs while 17 were asymptomatic. Thirty were treated surgically and 10 followed with regular ultrasound. The mean diameter of the repaired aneurysms was 3.3 +/- 1 cm. Aneurysms < 2 cm were more likely to be asymptomatic. No limbs were lost in patients undergoing elective repair of popliteal aneurysms. The secondary patency and limb salvage rates at 3 years were 84% and 96% respectively. Conservative management of asymptomatic lesions < 2 cm was not complicated by the development of symptoms. CONCLUSIONS: Elective repair of popliteal aneurysms by exclusion and bypass is a safe, effective and durable technique. Small asymptomatic lesions can be safely managed with close follow-up.

Aneurysm↗
PubMed1996

Potentiation of fluoxetine by aminoglutethimide, an adrenal steroid suppressant, in obsessive-compulsive disorder resistant to SSRIs: a case report.

1. The role of serotonin in the aetiology of obsessive compulsive disorder (OCD) has been established through considerable indirect evidence (Landry and Chouinard, 1990). The strongest evidence comes from the fact that drugs known to be serotonin-selective reuptake inhibitors (SSRIs) have been found to be useful in the pharmacotherapy of OCD (Landry and Chouinard, 1990). 2. The authors investigated a new treatment approach by adding an adrenal steroid suppressant to a SSRI, fluoxetine, in the case of a severe obsessive-compulsive patient who was drug-resistant to clomipramine and SSRIs. 3. We found that the combination of aminoglutethimide 250 mg qid and fluoxetine 40 mg die significantly improved the patient's condition. Moreover, during a four and a half year period, each time we tried to decrease either fluoxetine or the steroid suppressant, the patient started to relapse, suggesting that the adrenal steroid suppressant had a potentiating effect on the SSRI.

Aminoglutethimide↗
PubMed1996

Evaluation of ureteropelvic junction obstruction (UPJO) by diuretic renography.

Of 52 cases with 56 affected renal units having symptoms and signs suggestive of Ureteropelvic Junction Obstruction (UPJO) evaluated by conventional (F + 15) diuretic renography where frusemide is given 15 minutes post-injection of radiopharmaceutical m99TC.DTPA.F + 15, twelve (21%) showed a good clearance (group A), 16 (28%) showed partial (group B) and 28 (50%) a poor clearance pattern (group C) indicating a definite obstruction. A high flow (F-15) diuretic renography where frusemide is given 15 minutes prior to the radiopharmaceutical m99TC.DTPA, was done in 23 cases with 27 affected renal units. Eleven renal units showed a good clearance (group A). Of these, 7 (64%) showed a persistent good clearance, 3 (27%) converted to poor clearance and 1 (9%) to partial clearance pattern. Of 8 renal units in group B, 5 (63%) converted to poor clearance and two (25%) to good clearance on F-15 and one remained unchanged. All renal units which presented as poor clearance (group C) on conventional (F + 15) diuretic renography remained unchanged on high flow (F-15) diuretic renography. In majority of cases conventional (F + 15) renography gave a reliable assessment of the upper tract drainage, however, since equivocal group was resolved by the F-15 and the intermittent obstruction group was definitely diagnosed, high flow (F-15) diuretic renography was more conclusive in assessment as compared to F + 15.

Adult↗
PubMed1991

Treatment of Alzheimer's disease: hopes and reality.

The relative failure of symptomatic therapeutic trials for Alzheimer's disease using non-selective cholinergic agonists brings about the need for longitudinal studies with parallel designs aimed at disease stabilization, using trophic substances or amyloid suppressors.

Alzheimer Disease↗
PubMed1990

Antiepileptic drugs in the treatment of neuroleptic-induced supersensitivity psychosis.

1. Supersensitivity psychosis (SSP) has emerged as a potential side-effect of long term neuroleptic therapy similar to tardive dyskinesia. 2. Five schizophrenic patients with SSP and considered to be drug-resistant were treated with antiepileptic drugs. All 5 improved initially, and in three the improvement was maintained at follow-up. 3. The proposed mechanism of action of the antiepileptic drugs is through correcting a pharmacological kindling effect in the limbic system which results from chronic neuroleptic therapy.

Adult↗
PubMed1990

[Chylous ascites in cirrhosis. Retrospective study of 20 cases].

Chylous ascites is a rare complication of cirrhosis. We report 20 cirrhotic patients with chylous ascites seen between 1976 and 1989. Hepatocellular carcinoma was associated in 2 cases and, in 5 cases, chylous ascites followed surgery (portosystemic shunt in 4 cases). Chylous ascites was spontaneous in the 13 other cases. Prevalence of chylous ascites was 1.1 p. 100 in the cirrhotic population with ascites observed between 1983 and 1988. Chylous ascites, whether spontaneous or postoperative, was almost always refractory to medical treatment (16 of 18 patients). Treatment by Le Veen shunt was unsuccessful in 4 patients and lead to infection in 2 cases. Four of 6 patients treated by portocaval shunt died during the first postoperative month. Repeated paracentesis should be preferred, but this can be complicated by malnutrition. Seven of 10 alcoholic cirrhotics with spontaneous chylous ascites and 2 of 4 patients with postoperative chylous ascites died during the year following diagnosis. In view of this poor prognosis, hepatic transplantation should be considered early in selected patients.

Adult↗
PubMed1990

[Chylous ascites in adults: etiological, therapeutic and prognostic aspects. Apropos of 35 cases].

Chylous ascites is a rare disease which often poses difficult problems in diagnosis and management. We reported a series of 35 patients with chylous ascites, seen between 1976 and 1989. Diagnosis of chylous ascites was made on: (1) a milky appearance of ascites; (2) an ascitic concentration of triglycerides higher than in serum and higher than 1.5 mmol/l. Incidence was about 1/8 850 admissions. Cancers (mainly lymphomas and abdominal carcinomas), cirrhosis and retroperitoneal surgery accounted for more than 90 p. cent of cases. In all cases of cancer the tumor was extensive, and the prognosis was poor with a one year mortality rate of 80 p. cent. The two postoperative chylous ascites without cirrhosis were cured, after treatment with medium chain triglycerides in one case, and surgical repair in the other case. Chylous ascites in cirrhosis, spontaneous or after porto-systemic shunt, became refractory in 13 of 15 patients, and the one year mortality rate was high (69%).

Adult↗
PubMed1990

Treatment of supersensitivity psychosis with antiepileptic drugs: report of a series of 43 cases.

Supersensitivity psychosis has emerged as a potential side effect of long-term neuroleptic therapy that may be similar to tardive dyskinesia. Schizophrenic patients with supersensitivity psychosis and considered to be drug-resistant were treated with anti-epileptic medication. Forty-three separate trials were conducted on a total of 35 patients. Over half improved on clinical global impression, some of them considerably. We propose that antiepileptic drugs ameliorate supersensitivity psychosis and so-called "drug-resistant" schizophrenic patients by correcting a pharmacological kindling effect in the limbic system which results from chronic neuroleptic therapy.

Adult↗
PubMed1989

Use of prophylactic antibiotic in clean surgical cases--a prospective trial of various regimens.

In a randomised controlled prospective trial, different antibiotic regimens were evaluated as prophylaxis in wound infection following elective surgical procedures. Four hundred and four consecutive cases were divided in four groups. Two groups were allotted two different conventional postoperative antibiotic regimens while the fourth group received short term perioperative antibiotic; group one served as control. A higher frequency of postoperative wound infection was observed in the controls. Results showed reduction in gross infection in only group III where short term perioperative antibiotic was used. Combination of penicillin and streptomycin were not found effective, and low infection rate was observed with Cephamendole used perioperatively.

Anti-Bacterial Agents↗
PubMed1986

Renal bicarbonate handling in low birth weight infants during metabolic acidosis.

We studied the fractional excretion of bicarbonate (FE HCO-3) in 10 low birth weight infants aged 1-6 days during metabolic acidosis (base excess greater than or equal to -5 mEq/l) and during subsequent sodium HCO-3 infusion. The mean birth weight was 1,095 g; the mean gestational age was 29 weeks. The ability to decrease urine pH to less than 5.5 and FE HCO-3 to less than 1% during metabolic acidosis was not limited by low gestational age or birth weight. After HCO-3 therapy, all infants corrected their negative base excess, and plasma HCO-3 increased significantly. All infants with blood pH less than or equal to 7.22 or PaCO2 greater than or equal to 50 mm Hg had minimal or absent FE HCO-3. Infants with elevated PaCO2 and mild or absent acidosis also had complete HCO-3 tubular reabsorption. These results suggest that the HCO-3 tubular reabsorption is adequate during metabolic and/or respiratory acidosis in low birth weight infants.

Acidosis↗