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Biomedical subjects

I H Bangash

Publications and source records attributed to I H Bangash.

7 recordsLinked to original sources

Cortical evoked potentials in the ruptured anterior cruciate ligament.

The sensory role of the intact and ruptured anterior cruciate ligament was studied by the use of cortical evoked potentials during arthroscopy. This showed a response from the intact ligament in four patients that was reproducible. This response was consistent with those obtained from stimulation of the ipsilateral posterior tibial nerve. No response was elicited from either the femoral or tibial stump of ruptured ligaments using the same technique in six patients who had ruptured their anterior cruciate ligament (two femoral and four mid-substance ruptures). We believe that this demonstrates that there is no functional nervous tissue within the anterior cruciate ligament after rupture.

Anterior Cruciate Ligament↗

Common peroneal nerve palsy following knee arthroscopy.

We report the case of a 43-year-old woman who underwent knee arthroscopy. Postoperatively, she developed a lesion of the common peroneal nerve, which was confirmed by neurophysiological studies. Exploration showed the nerve to be in continuity and externally undamaged. At review 17 months later, there was incomplete recovery. We believe this lesion was caused by a traction injury related to patient positioning, which has not been reported previously.

Adult↗

Conduction velocity in the forearm segment of the median nerve in patients with impaired conduction through the carpal tunnel.

Conduction velocity, in the forearm segment of the median nerve, has been investigated in a group of patients with carpal tunnel syndrome. Motor conduction velocity was reduced below 50 m/s in 18% of the sample. Although a correlation between severity of compression and forearm motor conduction velocity was demonstrated, it was weak (r = 0.51) and slow forearm velocities occurred in some patients who had only a minor abnormality at the carpal tunnel itself. In patients with uncomplicated carpal tunnel syndrome, slow motor conduction in the forearm segment of the median nerve was accompanied by only a small reduction (approx. 5 m/s) in mixed nerve conduction velocity. By contrast, in patients whose abnormality at the carpal tunnel was accompanied by evidence of a more widespread sensorimotor neuropathy, mixed nerve conduction velocity was reduced in parallel with the change in motor conduction velocity.

Adult↗

Portal and systemic haemodynamic response to acute and chronic administration of low and high dose isosorbide-5-mononitrate in patients with cirrhosis.

Oral isosorbide-5-mononitrate (Is-5-Mn) was given in doses of 10 and 40 mg acutely and chronically (twice daily for four weeks), allowing a nitrate free interval to 25 patients with cirrhosis. Both 10 mg and 40 mg Is-5-Mn reduced the hepatic venous pressure gradient acutely and chronically, without evidence of tolerance. This was achieved by a reduction in the wedged hepatic venous pressure. The effect on mean azygos blood flow was variable with no significant mean change seen acutely or after chronic use with either dose. The variability was dependent not on the dose used but on the initial azygos flow; the flow in patients with initially low values increased and those with high azygos flows decreased after nitrate challenge. The development of the porto-collateral flow seems an important parameter in predicting haemodynamic response to Is-5-Mn.

Adult↗

Portal and systemic haemodynamic action of N-acetylcysteine in patients with stable cirrhosis.

The effects of intravenous N-acetylcysteine on hepatic and systemic haemodynamics were investigated in 11 patients with stable cirrhosis (eight alcohol; two primary biliary cirrhosis; one cryptogenic). N-acetylcysteine administration had no effect on the mean heart rate or mean arterial blood pressure despite a significant fall in systemic and pulmonary vascular resistance. Cardiac index increased but estimated liver blood flow and portal venous pressure did not change significantly. Administration of N-acetylcysteine resulted in increased oxygen delivery to the tissues because of the increased cardiac index but this was not accompanied by a rise in either arteriovenous oxygen extraction ratio or mean tissue oxygen consumption. Therefore N-acetylcysteine administration seems to confer no haemodynamic benefit to patients with cirrhosis.

Acetylcysteine↗

Hysterical conversion reactions mimicking neurological disease.

Seven children with illnesses diagnosed as hysterical conversion reactions (HCRs) were treated at our institution over a period of nine months. They all had neurological symptoms that included one or more of the following: paralysis, headache, seizures, and episodic blindness. All patients but one were misdiagnosed as having an organic disease prior to our final diagnosis. Five children were treated with medications for presumed organic illnesses. In all of these children a diagnosis of HCR was made on the basis of their history and neurological examination findings. They all recovered or began recovery within a few days of having HCR diagnosed, and none of them had had a relapse three to 11 months after the diagnosis of HCR was made. We believe, and there is ample evidence in the literature, that a positive diagnosis of HCR in childhood can be made when neurological manifestations cannot be explained on an anatomic and physiological basis. Although absence of an obvious organic cause is a helpful clue, exhaustive exclusion of all possible organic causes is not necessary for the diagnosis of HCR.

Adolescent↗

Hyperdensity on CT after seizure: a pitfall.

A 12-year-old boy had a hyperdense area corresponding to a gyral pattern on an enhanced CT brain scan within 12 hours of his last seizure. The hyperdense area disappeared on a subsequent enhanced CT scan after he was seizure free for about 48 hours. The hyperdense area was in a location (mesial frontal lobe) predicted by the interictal physical exam findings and the seizure type recorded on video-EEG monitoring. We postulate that the CT abnormality was due to transitory increase of regional cerebral blood flow and vascular permeability.

Carbamazepine↗