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Biomedical subjects

I Kamal

Publications and source records attributed to I Kamal.

At least 19 recordsLinked to original sources
PubMed2006

The role of endobronchial electrocautery in the management of malignant airway obstruction.

Bronchoscopy has evolved well beyond a simple look-see examination, with new interventional techniques becoming more commonly employed. So-called interventional bronchoscopy implies the use of bronchoscopy as a therapeutic, in addition to diagnostic, tool. We present 2 cases to illustrate the utility of one such interventional technique, tumour ablation by endobronchial electrocautery and snaring, in the management of airway obstruction by tumour. This procedure, performed via a flexible bronchoscope under local anaesthesia can spare patients time-consuming, expensive treatments with their attendant morbidity, and in some cases can be life-saving. There is minimal morbidity associated with this technique. It is anticipated that interventional bronchoscopy will continue to revolutionise management of such conditions in the future, and become a necessary facility in all pulmonary medicine units.

Aged↗
PubMed2004

Troponin testing: beware pulmonary embolus.

Serum troponin estimation is widely used in the diagnosis and management of coronary syndromes, but it is possible to be misled by a positive result unless it is put carefully into clinical context. The serum troponin can be positive in pulmonary embolus and carries prognostic significance. A case report is presented and a review of the relevant literature.

Aged↗
PubMed2001

Normal standard curve for acoustic pharyngometry.

Pharyngeal size, compliance, and the dynamic behavior of the upper airway are important factors in the production of obstructive sleep apnea. Assessment of the upper airway for possible site(s) of obstruction is one of the keys to a successful management of the condition. Acoustic pharyngometry has the potential for localizing such sites, however, standardizing the operating technique and producing a standard normal curve is a prerequisite before exploring the potential of this equipment. A total number of 350 normal volunteers (271 males and 79 females) were examined by acoustic pharyngometry and a coefficient of variance of 5% to 7% was obtained from each of them. Mean and standard deviation of pharyngeal area at each point of X-axis (distance) was obtained and analyzed statistically to produce a general standard curve. Using special techniques during examination, the oropharyngeal junction and glottis were located, and thus a mapped acoustic pharyngogram was produced. Mean pharyngeal area was 3.194 cm(2) in males (SD 0.311) and 2.814 cm(2) in females (SD 0.331). Mean glottic area was 1.06 cm(2) in males (SD 0.119) and 0.936 cm(2) in females (SD 0.108). A minimal pharyngeal area is probably needed as a "golden standard" to evaluate patients with obstructive sleep apnea.

Acoustics↗
PubMed2000

Anterior rectal duplication: a diagnostic challenge.

The authors present an anterior rectal cyst in a 14-month-old girl. This rare variant of rectal duplications presented with recurrent urinary infections. The diagnosis was challenging in view of the multiple differential diagnoses to be considered. Magnetic resonance imaging appeared to be the most accurate preoperative investigation. The cyst was removed uneventfully by partial excision and mucosal ablation. An awareness of this variant can lead to early diagnosis and curative resection.

Failure to Thrive↗
PubMed1999

Hypertension following minor trauma: a rare presentation of pheochromocytoma.

The diagnosis of pheochromocytoma (Pheo) can be challenging due to the variety of potential presentations of this infrequent tumor. A 16-year-old boy presented with hypertension and sudden abdominal pain after minor blunt abdominal trauma. Both computer tomography (CT) and magnetic resonance (MR) scanning identified a right suprarenal mass, and raised the possibility of a Pheo. This diagnosis was confirmed through urine catecholamine testing and (131)I metaiodobenzylguanidine (MIBG) scanning. An extra-adrenal Pheo was successfully resected. The presentation of Pheos is quite variable, and patients may often be essentially asymptomatic. Pheo should be considered in hypertensive pediatric patients with a history of blunt abdominal trauma.

Abdominal Injuries↗
PubMed1999

Esophageal aperistalsis following fundoplication in a patient with trisomy 21.

Gastrointestinal abnormalities are frequent in patients with Down syndrome (DS), gastroesophageal reflux (GER) being prominent among them. A 10-year-old boy with DS presented with progressive daily vomiting and an upper gastrointestinal study documenting reflux. A laparoscopic Nissen fundoplication was performed uneventfully. Postoperative inability to take solids was noted and a contrast study showed a tight gastroesophageal junction and poor peristalsis. Persistent symptoms were not alleviated by esophageal dilatation, despite a relaxing lower esophageal sphincter. Esophageal manometry documented complete esophageal aperistalsis. A percutaneous endoscopic gastrostomy was placed and the patient required long-term tube feeds. Esophageal aperistalsis is a rare condition in DS, likely superimposed on GER. Fundoplication may adversely affect the already abnormal esophageal motility in these children. Esophageal manometry preoperatively will identify motility disorders and assist in selecting the best management for these patients.

Child↗
PubMed1999

Unusual findings in the inguinal canal: a report of four cases.

Masses in the inguinal canal other than hernias are rare occurrences, and their preoperative diagnosis requires a high index of suspicion. A soft, partly reducible groin mass in a 3-month-old boy proved to be a cystic lymphangioma within the inguinal canal. A 15-month-old female who presented with an irreducible inguinal mass was found to have a neuroblastoma metastasis in the groin. An irreducible groin mass in a 6-year-old female proved to be an inguinal canal epidermal inclusion cyst. A 14-year-old female presented with a painful groin swelling that represented an incarcerated hemorrhagic ovarian cyst. An awareness of the wide spectrum of entities other than the standard bowel, testicle, and ovary in the inguinal canal can help to identify uncommon pathologies preoperatively.

Adolescent↗
PubMed1999

Esophageal atresia: primary repair of a rare long gap variant involving distal pouch mobilization.

This report describes a rare type IIIb variant of long gap pure esophageal atresia treated with delayed primary repair. Preoperative imaging showed a distal pouch with a unusually long tapering end, and a 5-vertebral body gap. Delayed exploration with mobilization of the distal pouch allowed for successful primary repair without the need of myotomy. The characteristic radiological appearance of this rare variant enables its preoperative recognition and warrants attempting primary repair with a good expectation of success.

Adult↗
PubMed1999

The hazards of vinyl glove ingestion in the mentally retarded patient with pica: new implications for surgical management.

OBJECTIVE: To report experience with the treatment of complications of vinyl glove ingestion in mentally retarded patients with pica. DESIGN: A retrospective case series. SETTING: Two university-affiliated hospitals. PATIENTS: Five mentally retarded patients, 4 with a history of pica, who were admitted for the management of complications resulting from the ingestion of vinyl gloves. MAIN OUTCOME MEASURES: Type of complication, treatment and operative outcome. FINDINGS: The patients ranged in age from 26 to 46 years. One patient died while awaiting surgical consultation of massive gastrointestinal bleeding from a large gastric ulcer caused by a vinyl glove bezoar (VGB). Four VGBs were removed surgically. Endoscopic removal was difficult or impossible because the gloves had become hardened and matted. CONCLUSIONS: VGB should be considered in institutionalized mentally retarded people with a history of pica when they present with gastrointestinal symptoms. VGBs should be removed directly by laparotomy, gastrotomy or enterotomy. Endoscopic removal is not recommended.

Adult↗
PubMed1998

Calcified catheter "cast": a rare complication of indwelling central venous catheters in infants.

Peri-catheter calcification is an unusual and previously unreported complication of central venous (CV) catheterization in infants. A 1. 9 Fr Silastic CV catheter was placed in a term infant for administration of total parenteral nutrition and antibiotics following intra-abdominal sepsis. The catheter was removed, without complication, at a later date after another septic episode. Imaging studies performed in the investigation of a possible intra-abdominal abscess revealed a cylindrical density within a clot in the inferior vena cava (IVC). The density was presumed to be a retained catheter fragment. Further investigation indicated total occlusion of the IVC. Surgical exploration of the IVC revealed only a calcified thrombus. This case represents a rare and previously unreported complication of CV catheterization in infants. Diagnosing this condition on radiographic evidence alone can be difficult. It is hoped that awareness of the potential for this complication will avoid unnecessary invasive procedures in the future. We also suggest a high level of clinical suspicion and routine Doppler ultrasound investigations to detect IVC thrombosis when indwelling CV catheters are used in infants.

Anti-Bacterial Agents↗
PubMed1996

Traumatic gastric transection: a case report.

This report documents the first known pediatric survivor of seat-belt-associated gastric transection. An 11-year-old boy presented with abdominal ecchymoses after a motor vehicle accident. Physical and radiological examination determined the need for abdominal exploration. During the operation, a near-complete transection of the stomach was found, which was repaired by primary anastomosis. After an initially unremarkable recovery period, gastric stasis and pyloric obstruction developed. Radiologically and endoscopically, this was determined to be secondary to a traumatic distal vagotomy. Neither gastric transection nor traumatic vagotomy had been reported previously in the pediatric population with abdominal seat-belt injuries. This report demonstrates an exceptionally rare seat-belt-related injury, and its unusual postoperative complication. It also emphasizes the significance of the "seat-belt sign" in the assessment of motor vehicle-related blunt abdominal trauma, and outlines potential problems associated with the wearing of adult-designed lap belts by pediatric passengers.

Anastomosis, Surgical↗
PubMed1995

Perinatal management of nasopharyngeal teratoma.

Nasopharyngeal teratoma is a rare benign entity, with most of the published literature represented by sporadic case reports. We present a recent case of a 23-year-old woman found to have elevated maternal serum alpha-fetoprotein and ultrasound findings of a fetal cystic mass in the mandibular region. The infant had a large nasopharyngeal teratoma protruding from the oral cavity making airway access extremely difficult. The presence of severe coexisting cardiac anomalies and respiratory disease led to death in the neonatal period. This report and the review of the literature stress the importance of recognizing suggestive prenatal data and preparing for perinatal management including maintenance of fetal oxygenation and aggressive early provision of an adequate airway.

Abnormalities, Multiple↗
PubMed1992

Traditional birth attendant training: sharing experiences.

The experiences in TBA training in five countries are contrasted. Successful training must impart improved skills to the TBAs and follow-up that both provides continuing support and meets the self-interest of the TBAs. The preference of mothers for services of TBAs is explained.

Education, Nursing↗
PubMed1981

The "nylon T" intrauterine device: surface area versus copper adjunct.

A study to evaluate the relative effect of copper ions and increased surface area added through the wiring of the stem of the inert "T" device was performed. The experimental design was set up to test a hypothesis that the effectiveness of a copper device is a result of the increase in surface area of the IUD and not a result of the copper itself. Ninety-eight TCu 200 mm2 devices were stripped of their copper wire and rewound with a "nylon" thread of the same length, caliber and surface area. the devices were then repacked and gas sterilized. The 98 "nylon T" devices were fitted early in 1977 and followed up for 2 years. The major finding was that the replacement of copper wire on the "copper T" device by a "nylon" thread, "nylon T", had shown a comparable antifertility effect.

Adult↗
PubMed1976

Pregnancies in the presence of copper intra-uterine devices. Hysterosalpingographic studies.

Two copper-bearing intrauterine devices--the Cu-7 and Cu-T-200--were investigated to determine why contraceptive failures occur with these devices. For this investigation, 155 multiparous women were followed up for at least 24 months after IUD insertion (T-Cu-200 in 75 cases and the Cu-7 in 80 cases). Three women using the T-Cu-200 and 5 women using the Cu-7 became pregnant during the first year. Hysterosalpingographic findings are presented for 8 of these cases and for 2 additional cases (one with each device) who became pregnant during the second year of follow-up. These indicate that uterine abnormalities and disproportions between the uterine cavity's shape and size and that of the device are the primary reasons for device displacement and partial fundal coverage leading to contraceptive failures.

Copper↗