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Biomedical subjects

R B Zachary

Publications and source records attributed to R B Zachary.

At least 19 recordsLinked to original sources
PubMed1983

One man's burden.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMed1978

Preventable death in oesophageal atresia.

We report on experience gained in the treatment of 158 cases of oesophageal atresia presenting during a period of 10 years. The factors influencing mortality were analysed. During the period studied there was a slight improvement in survival, and this was probably due mainly to improved preoperative preparation of those babies undergoing primary repair. At best, 'staging' was thought to have had little influence on the survival of poor risk cases. Midwives, obstetricians, paediatricians, surgeons, and general practitioners did not do all that they could have done to prevent morbidity and mortality in these babies. At least one-third of the 79 deaths could have been prevented, and several deaths were caused solely by lack of awareness of the possible complications and associated abnormalities.

Community Health Services↗
PubMed1977

Urinary continence in open myelomeningocele.

In a consecutive series of 200 neonates having undergone surgery for open myelomeningocele, 24 of the 106 survivors at 10 to 12 years of age proved to be continent of urine. These figures included 11 children who had considerable neurological involvement. 4 children did not acquire urinary control until after the age of 5 years. Therefore, we consider early urinary diversion in children with myelomeningocele, even in the presence of neurological deficit, to be indicated only for the prevention of progressive deterioration in renal function. Incontinence of urine itself is not an indication for urinary diversion in the first decade of life.

Age Factors↗
PubMed1977

Open myelomeningocele--a ten-year review of 200 consecutive closures.

An unselected series of 200 consecutive closures of open myelomeningocele is reported with reviews of the survivors at 5 and 10 years. Assessment of the child's ability to fit into society can be made reasonably accurately at 5 years. Urinary tract problems in older children have not been so prominent as expected. Twenty-six out of 106 10-year-olds had normal micturition. Social problems seem likely to outweigh surgical ones in the teenage survivors.

Child↗
PubMed1976

Exomphalos and gastroschisis: a 10-year review.

Ninety-six cases of exomphalos or gastroschisis managed at The children's Hospital, Sheffield, during the period 1964-74 are analysed. There were 306 cases with minor lesions, 30 with major lesions, 27 with a ruptured exomphalos and only 3 with gastroschisis. The overall mortality rate was 46-9 percent. Survival could be closely correlated with the birth weight, the nature of the primary lesion, the presence or absence of liver within the sac and the presence and severity of associated congenital anomalies. A "scoring system" based on these criteria is proposed to predict the prognosis of an infant with an exomphalos.

Abdominal Muscles↗
PubMed1975

A study of the Indian valve for ventriculo-atrial shunts in the treatment of hydrocephalus.

Because of the high costs of importing commercially-available shunts, a hand-made ventriculo-atrial shunt was devised in India for the treatment of hydrocephalus. Modifications have been made to the original design and these shunts are now being produced commercially at a fraction of the cost of other available shunts. Hydrodynamic testing indicates that they compare favourably with the other shunts at present in use.

Cerebrospinal Fluid Shunts↗