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Biomedical subjects

A Gnanapragasam

Publications and source records attributed to A Gnanapragasam.

7 recordsLinked to original sources
PubMed1979

Intralesional steroids in conservative management of subglottic stenosis of the larynx.

Subglottic stenosis after prolonged endotracheal intubation is a well recognised complication, especially with the advent of intensive resuscitative techniques. Although prevention is the best cure, once the management has been established it should be conservative in the first instance, especially in the case of children. The successful treatment of four cases with this complication is reported. The treatment consisted of intralesional injection of Triamcinolone Acetonide Aqueous Suspension (Kenacort A), dilatation with gum elastic bougies, bronchoscopy and very limited surgical correction in one case. A brief reference is made to the etiological factors and to the mechanism of action of steroids in scar tissue.

Adult↗
PubMed1978

Topical cocaine/adrenaline combination in intransal surgery--is it necessary?

Topic adrenaline with cocaine has been used commonly for intranasal vasoconstriction to facilitate surgery and to control haemorrhage. Pharmacologically the drug combination is known to be a potentially dangerous interaction. This investigation studied whether either drug could be used separately rather than in combination, to achieve the same purposes. One hundred cases were randomized into four groups using 1:1000 Adrenaline, 5% Cocaine, 10% Cocaine and 5% Cocaine/1:1000 Adrenaline as the topical vasoconstriction regimes. The results showed that the vasoconstrictor effect was not significantly different within the four groups; topical 1:1000 Adrenaline resulted in more haemorrhage compared to the other three regimes; comparing the other three regimes the blood loss was not significantly different. The conclusion is that the Adrenaline/Cocaine mixture has no advantage and its potentially dangerous interaction makes it unnecessary and unjustified. Topical 5% Cocaine is recommended because it achieves the aims with the least side-effects.

Administration, Topical↗
PubMed1977

Oesophageal involvement in epidermolysis bullosa.

Epidermolysis bullosa dystrophica causing oesophageal stricture in two males of a family of 4 siblings--2 females and 2 males, and whose parents are not related, is reported. The stricture was treated with repeated dilatations and oral prednisolone on and off with complete success. A brief comment is also made with regards to the pathology and management of this condition.

Child, Preschool↗
PubMed1975

Bilateral symmetrical maldevelopment of external and middle-ear cleft with pharyngeal and soft palate defects.

An unusual combination of first and second arch anomlies is presented. This has resulted in absent middle and external ears with gross naso- and oropharyngeal defects. A brief reference is made to the embryology of this region to explain the anatomical and functional defects. Vascular abnormality during the peri-gestational period is suggested as a possible cause and a conservative line of treatment has been followed with good result.

Audiometry↗