Biomedical subjects
Publications and source records attributed to J Maharaj.
A 23-year-old male patient who had no history of any previous medical illness was noted to have a widened mediastinum on chest X-ray undertaken as part of a routine medical evaluation. A computer tomographic (CT) scan confirmed the widened mediastinum to be due to a double superior vena cava (SVC). No further investigations were undertaken. The patient was noted to be well when re-assessed 3 years later.
OBJECTIVES: to evaluate the use of endovascular occlusion in the treatment of arterial trauma. METHODS: records of patients with penetrating arterial injuries treated by endovascular occlusive techniques were culled from the computerised database of the vascular service. RESULTS: the study period spanned 7 years. Forty-two patients were studied with injuries to the cervicofacial vessels (24), lower limb (16) and upper limb (1). 13 had an arteriovenous fistula. There were 4 failures. In 2 cannulation was not achieved and in 2 with A-VF distal vessel occlusion was impossible. Two patients developed complications. In the remainder, treatment was effective and durable. CONCLUSION: this treatment modality is effective and safe in the treatment of penetrating trauma in selected patients.
AIM: To examine stress in carers of the elderly who attended a solo family medical practice. METHOD: Eighty-seven carers were compared with 102 non-caregiving controls. Subjects were asked to complete survey questionnaires either in the surgery or at home. The General Health Questionnaire (CHQ) was used to assess psychological morbidity, the Relative Stress Scale as a measure of subjective burden and information was collected on activities of daily living and instrumental activities of daily living. RESULTS: No significant difference was found in GHQ scores, reflecting the high level of stress in this family practice sample (mean GHQ = 4.7, standard deviation = 6.2). Psychological morbidity in carers was associated with the provision of assistance with instrumental activities of daily living such as shopping, cooking and finances. CONCLUSIONS: We suggest that because carers often encounter specific challenges which may be amenable to intervention, general practitioners should familiarise themselves with these issues, determine the caregiving status of their patients and provide information about community services to carers.
The persistent sciatic artery is a rare anatomical anomaly of the lower limb vasculature. It may be noted incidentally, or it may present with limb ischaemia or aneurysmal degeneration. Management entails exclusion of the aneurysm and vascular reconstruction. A case of bilateral persistent sciatic artery aneurysms and a review of the embryological development, clinical features, and management are reported. The persistent sciatic artery (PSA) may result from an aberration in the development of the arterial supply to the lower limb. It is a rare anomaly, with sporadic cases reported in the literature, few of which have been angiographically documented. A report of a patient treated at King Edward VIII Hospital, Durban, is presented here.
Gastric tuberculosis is an uncommon clinical entity. Great difficulty is encountered in making the pre-operative diagnosis. Other chronic granulomatous conditions (Crohn's disease, sarcoidosis and isolated granulomatous gastritis) should always be considered. Surgery, with postoperative antituberculosis treatment, remains the main modality for accurate diagnosis and treatment.
An elderly patient presented with intermittent vomiting. The cause was a gastric tumour causing gastroduodenal intussusception. On excision and histological examination this was found to be a stromal tumour of uncertain malignant potential ('STUMP').
We report on five patients with Salmonella typhi spondylitis who were immunologically normal and had no prodromal gastrointestinal illness. The diagnosis was confirmed on blood cultures, Widal test, and needle biopsy of the spine. Appropriate antibiotic treatment resulted in a favorable outcome.