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Biomedical subjects

B Kotecha

Publications and source records attributed to B Kotecha.

7 recordsLinked to original sources

Salivary duct carcinoma: report of a case and review of the literature.

Salivary duct carcinoma is a rare primary tumour of the salivary glands arising most frequently in the parotid gland. It has a male preponderance and occurs most often in patients over the age of 50 years. Its distinctive histological features include dilated ducts containing cells arranged in cribriform, papillary or solid patterns often with central necrosis and reminiscent of intraduct carcinoma of the breast. These features are associated with an obvious invasive component. It is an aggressive neoplasm and may metastasize widely, causing death in a high proportion of cases.

Carcinoma

Orbital cellulitis.

Orbital cellulitis is an emergency. It may cause blindness and progress to life-threatening sequelae such as brain abscess, meningitis and cavernous sinus thrombosis. Successful management is dependent upon urgent referral and immediate treatment. Although isolated eyelid erythema and swelling usually indicate primary infection anterior to the orbital septum, they may also be the first signs of an underlying frontal or ethmoidal sinusitis. The condition always requires emergency referral to both an ophthalmologist and otorhinolaryngologist.

Adult

Carcinoid tumour of the larynx: a case report and clinico-pathological review.

Carcinoid tumour of the larynx is a rare condition but one that is being increasingly recognised. We report the case of a 66 year old lady with an advanced malignant laryngeal carcinoid, metastasizing to the regional lymph nodes, thyroid and submandibular glands. Surgery is the treatment of choice in this condition--radiotherapy and chemotherapy being ineffective. Prognosis is poor, and most patients eventually die of distant metastases. The clinical, biochemical and histological findings are reviewed.

Aged

Pain relief after tonsillectomy in adults: intramuscular diclofenac and papaveretum compared.

A wide variety of surgical and pharmacological methods have been described in an attempt to reduce pain after tonsillectomy, with conflicting results. Opiates are still widely used, despite unwanted side-effects. Recently the non-steroidal anti-inflammatory drugs have been shown to be effective against a variety of post-operative pains. Diclofenac is effective in both children and adults in the relief of pain after tonsillectomy when administered rectally, but absorption is variable, and suppositories are not widely accepted in the UK. The present double-blind study compared a single intramuscular dose of diclofenac with papaveretum in adults undergoing tonsillectomy. Post-operatively, the patients who received diclofenac had less pain and started drinking significantly sooner than the control group. There were no undesirable side-effects. Intramuscular diclofenac is superior to papaveretum in the relief of pain in adults undergoing tonsillectomy.

Adolescent

The management of epistaxis in accident and emergency departments: a survey of current practice.

A short questionnaire on the subject of the management of epistaxis was sent to forty accident & emergency departments in two NHS regions. Thirty replies were received (response of 75%). It was found that all departments were involved in the initial management of epistaxis, but the extent of that involvement varied considerably. One of the most obvious factors contributing towards the degree of involvement was the liaison between the accident & emergency and the ENT departments. Three departments never referred patients to the ENT department for follow-up. Nine departments performed their own nasal cautery, but half of these did not use any form of local anaesthesia. Twenty-seven departments used various forms of nasal packing but, of these, two-thirds did not use any form of local anaesthesia. Twenty-three departments allowed patients to go home with a nasal pack in situ. The results of this survey are discussed and a guideline to the management of epistaxis in an accident & emergency setting is suggested.

Anesthesia, Local

Upper airway obstruction secondary to anticoagulant induced haemorrhage necessitating a tracheostomy.

The incidence of major haemorrhagic complications from oral anticoagulants is between 4.4% and 8.2%. Life-threatening haemorrhage is usually either intracranial or gastro-intestinal, but haemorrhage into the upper airways is a distinctly uncommon occurrence. We report the case of an elderly lady who developed an anticoagulant induced haemorrhage into the parapharyngeal area resulting in upper airway obstruction and necessitating an emergency tracheostomy.

Aged