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Biomedical subjects

N K Chadha

Publications and source records attributed to N K Chadha.

8 recordsLinked to original sources
PubMed2006

A multivariate analysis of the factors predicting hearing outcome after surgery for cholesteatoma in children.

OBJECTIVE: To explore factors influencing hearing outcomes in children treated by canal wall up (CWU) and canal wall down (CWD) mastoid surgery. METHODS: Retrospective cohort study including three units in Bristol and Bath, UK. Ninety consecutive children underwent cholesteatoma mastoid surgery, with the first procedure between 1998 and 2001; minimum follow up was three disease-free years. RESULTS: The CWU and CWD cohorts significantly differed in pre-operative stage and hearing. After disease eradication, air conduction (AC) thresholds changed by +4.0 dB (95 per cent confidence intervals (95% CI) -2.0, 10.1) in the CWD group and -5.3 dB (95% CI -9.3, 1.3) in the CWU group (p=0.029). Using multiple linear regression to account for cohort differences, AC thresholds were increased by: pre-operative AC threshold (p<0.0001), initial ossicular stage (p=0.013), and CWD-surgery (p=0.005). CONCLUSION: Disease-free hearing was better with CWU-surgery, less initial ossicular damage, and better pre-operative hearing. Worse initial disease increased the likelihood of CWD surgery. Wider use of ossiculoplasty in the CWU cohort (51 per cent vs 5 per cent) may partially explain the superior results.

Adolescent↗
PubMed2005

Adjuvant antiviral therapy for recurrent respiratory papillomatosis.

BACKGROUND: Recurrent respiratory papillomatosis is a condition characterised by benign papillomatous (wart-like) growths in the upper airway. It can affect both adults and children causing airway-obstruction and voice change. Treatment usually involves repeated surgical debulking of the papillomata, and several agents have been proposed as adjuvants to surgical debulking. These include antivirals, administered systemically or injected into the lesions. OBJECTIVES: To assess the effectiveness of antiviral agents as adjuvant therapy in the management of recurrent respiratory papillomatosis in children and adults. SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 3, 2004), MEDLINE (January 1966 to November 2004), and EMBASE (January 1985 to November 2004) in December 2004. We checked reference lists of articles, contacted pharmaceutical companies and contacted leading experts in the field for further studies. SELECTION CRITERIA: All randomised controlled trials. DATA COLLECTION AND ANALYSIS: One hundred references were identified from the searches. Twenty-five were appropriate for retrieval and assessed for eligibility by the authors. None met the inclusion criteria. MAIN RESULTS: No controlled trials were identified. AUTHORS' CONCLUSIONS: There was insufficient evidence from controlled trials on which to base reliable conclusions about the effectiveness of antiviral agents as adjuvant therapy in the management of recurrent respiratory papillomatosis. Further research is required before any specific antiviral adjuvant therapy can be recommended.

Adult↗
PubMed2004

How much do healthcare professionals know about informed consent? A bristol experience.

BACKGROUND: It is important that healthcare professionals have a thorough knowledge of consent practice. The purpose of this study was to compare understanding against the agreed standards found in consent guidelines and UK case law. METHOD: Twelve 'true or false' questions testing knowledge of the consent process were completed by 118 healthcare professionals from the United Bristol Healthcare NHS Trust. The questions addressed areas of fundamental importance, difficult clinical situations, and common consent dilemmas. The answers were marked against pre-validated answers determined using published guidelines and case law. Results were analysed for differences between pre-determined population sub-groups. RESULTS: A 100% response rate was achieved. Significant areas of weakness were identified including the role of consent forms, Gillick competence and mentally-ill patients. Performance was generally better by medical staff, those in surgical specialties, and more junior doctors. For example, 30.9% of doctors versus 62% of non-doctors (p=0.05) thought, incorrectly, that if an adult is unable to provide consent for an emergency procedure, the patient's next of kin must sign the consent form. Doctors also demonstrated a greater understanding of Gillick case law and scored significantly higher than non-doctors (68% vs. 48.5%, p=0.027). CONCLUSIONS: National guidelines and case law provide the gold standard for ideal consent practice. Many healthcare professionals have either not read these documents or are unable to reliably recall them. Improvements in knowledge and practice could be possible with further education, particularly targeting those most closely involved in the consent process

Clinical Competence↗
PubMed2004

Portable method for the determination of snoring site by sound analysis.

It has been shown that computerized sound frequency analysis can be used to distinguish between different snoring sites. The aim of this study was to investigate whether a portable recording method using audiotapes and digital minidisc formats could produce waveforms similar to a computer recording. The snores of 12 subjects in their natural sleep were recorded onto audiotape, minidisc and directly onto a computer. For each snorer and recording method 30 snore samples were analysed and their power ratio was calculated indicating the relative amount of sound below and above a set frequency. It was found that the power ratios from audiotape recordings were significantly different to those from computer recordings for all snoring sites (p = 0.0007), whereas there was no significant difference between minidisc and computer recordings (p = 0.41). These results indicate that it would be possible to base a portable snore analysis system for site determination on minidisc, but not on audiotape recordings.

Adult↗
PubMed2004

The role of septal deviation in adult chronic rhinosinusitis: a study of 500 patients.

Septal deviation is a common finding and its role in the pathogenesis of chronic rhinosinusitis remains uncertain. The aim of this study was to assess the impact of septal deviation in the region of the ostiomeatal complex with regards to sinus disease, as staged by the Lund-Mackay scoring system in a group of adult patients with symptoms of chronic rhinosinusitis. Five hundred consecutive patients who had undergone CT scanning of the paranasal sinuses for possible chronic sinus disease between Sept. 2002 and Dec. 2003 were recruited. Septal deviation at the ostiomeatal complex on coronal CT scan was evaluated using Radworks diagnostic 5.1 software (Applicare Medical Imaging BU). There were 219 patients with CT positive sinus disease. 281 of the patients had normal sinus CT scans (control group) and were therefore patients with rhinitis rather than rhinosinusitis. Our study showed no significant difference between the chronic rhinosinusitis group and the control group with regards to septal deviation. Nor were we able to demonstrate any correlation between the severity of septal deformity at the ostiomeatal complex region and the severity of sinus disease or OMC disease.

Adult↗
PubMed2003

Social networks of old people in India: research and policy.

This article presents a comparative analysis of the available research on the social networks of older persons in India. Most of this research has been done in North Indian cities. The research foci of the available studies include network size, core networks and beyond, life course changes in networks, impacts of residency in old-age homes, gender differences, and joint and nuclear family residence. This research is discussed in terms of its policy implications. Because the research demonstrates that social networks are important for the welfare of older Indians, one can conclude that social policy that encourages the maintenance of robust networks throughout the life course may be worth pursuing. One aspect of policy is discussed. The analysis of the relationship between social network and gender suggests that current policies that can be seen as supporting gender inequality in terms of property may have a negative impact on the networks of older women.

Aged↗
PubMed1997

Intergenerational solidarity.

Family is that thread which links multiple generations together through a system of shared beliefs, norms, values and cultural traditions. Intergenerational ties fulfil many functions within a family. Besides transmission of appropriate information regarding behaviour, life styles, and values, these ties help reduce marginalization between different generations, and are a source of support and identity for each individual. The knowledge of ageing and the development of positive attitudes towards old age contribute to the improvement of intergenerational relations, combat stereotypes that promote ageism and develop a more realistic outlook towards one's own ageing process.

Aged↗