Biomedical subjects
Publications and source records attributed to N A Barnard.
A case of actinomycosis arising within the masseter following extraction of a lower second molar is reported. The most likely cause was a needle tract infection from the planned administration of the local anaesthetic.
A patient is described with bilateral plunging ranulae which arose asynchronously and solely as cervical swellings. The diagnostic difficulties caused by the clinical presentation and the different treatment modalities are discussed.
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This paper describes the evolution and refinement, over a four-year period, of a simple technique for shaping and stabilising the bony component of a composite radial forearm free flap to reconstruct the mandible following segmental resection for neoplastic disease. The results of reconstruction in 30 consecutive patients are reported. The current method of adapting and stabilising the radial bony strut using a specially designed 32 hole osteosynthetic miniplate is described.
Sjögren-Larsson syndrome (SLS) is an autosomal recessively inherited disorder characterized by the triad of congenital ichthyosis, spastic diplegia or tetraplegia and mental retardation. SLS is also often associated with a variety of other anomalies, including signs that are of interest to optometrists and ophthalmologists. Two case histories are presented. Both patients exhibited maculopathies and uncorrected astigmatism. The reduced visual acuities in one case appeared to be caused at least partly by astigmatism and the associated astigmatic amblyopia.
Two hundred and ten consecutive 45-66-year-old patients underwent a routine eye examination and a decision was made whether to refer each patient on the basis of fundus appearance and other non-sphygmomanometric criteria. Blood pressure was then measured and the referral decision was reviewed. Of the 33 (15.7%) patients finally referred, only 5 (2.4%) would have been referred on the non-sphygmomanometric findings. It is suggested that optometrists include a protocol of blood pressure measurement as part of the eye examination routine.
A system has been implemented using a commercial database management program and a microcomputer for computerising pre-prosthetic surgery. Using selection criteria, clinical records can be added, edited/deleted, searched for, displayed on screen, generate consultation summaries and operative discharge letters to the referring consultant, general medical and general dental practitioners together with a synopsis of the clinical assessment and surgical admission. Surgical audit may be conducted on the records. This program will hold 30,000 clinical records. Such a system is beneficial for personal and departmental audit, epidemiological studies and research into the prevalence of surgical treatment and postoperative morbidity.
A review of the literature suggests that the oculocardiac reflex is part of a wider phenomenon involving any structure supplied by the trigeminal nerve. This can lead to potentially fatal complications in maxillofacial surgery. A review of the literature is discussed and two further cases are reported.
Visual conversion reaction (VCR) is a psychosomatic anomaly which occasionally manifests in children, most commonly in the form of reduced vision and visual field defects. Malingering or conscious simulation for secondary gain would appear to be rare in children but occasionally VCR and simulation coexist. A case history is presented of a 12-year-old child with behavioural and reading difficulties who manifested reduced vision most probably attributable to VCR and severe colour deficiency, which was best explained in terms of simulation or malingering.
Anthrax is a rare infection that is transmitted to humans from animals or animal products. In its cutaneous form it may produce lesions of the eyelids which can lead to cicatricization and ectropion. Exophthalmos, optic atrophy and panophthalmitis have also been reported. A case of anthrax affecting the eyelid of a patient seen by the author in Kabul, Afghanistan, is presented.
Congenital pit of the optic nerve is a rare condition which can lead to serous retinal detachment. A case history of a patient with a small pit of the optic nerve is presented and management by the optometrist is discussed.
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Visual conversion reaction (VCR) is a psychosomatic illness that will occasionally be seen by optometrists and ophthalmologists. This paper discusses some of the possible aetiologies and manifestations of the condition. Investigation and management of children with suspected VCR is discussed. Four case histories are presented in which signs of VCR included amblyopia, reduced accommodation and a deterioration in handwriting. The visual field defects presented include a static quantitative anomaly. Such a defect has not previously been reported.