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Biomedical subjects

R R Singh

Publications and source records attributed to R R Singh.

89 records · Page 5Linked to original sources
PubMed1987

Myocardial rupture following acute myocardial infarction.

Ten patients, eight males and two females, suffered myocardial rupture following acute myocardial infarction and required surgery. There were five ventricular septal ruptures, four papillary muscle ruptures and one free wall rupture. Ventricular septal rupture was suspected clinically by the appearance of a new systolic murmur, usually associated with a thrill at the left sternal border. A left to right shunt was confirmed by bedside oximetry using a Swan-Ganz catheter. The mean pulmonary to systemic flow ratio was 3.04:1. Following cardiac catheterization all patients underwent corrective surgery with or without aortocoronary bypass grafting. Three patients with inferior wall myocardial infarction died. Papillary muscle rupture was suspected clinically following the abrupt onset of hypotension with severe acute pulmonary edema accompanied by a new systolic murmur. The diagnosis was confirmed by cardiac catheterization. All underwent surgery for mitral valve replacement with or without aortocoronary bypass grafting. One patient died postoperatively of multiorgan failure. Free wall rupture was suspected clinically by the sudden onset of loss of consciousness, apnea, junctional bradycardia and severe hypotension leading to electromechanical dissociation. The diagnosis was confirmed by demonstrating a significant pericardial effusion by two dimensional echocardiography. Immediate surgery was performed. This patient is totally asymptomatic on no drug treatment six months following discharge. Ten patients underwent emergency surgery for myocardial rupture. Operative mortality was 40%. Patients with ventricular septal rupture associated with an inferior myocardial infarction had a poor prognosis.

Aged↗
PubMed1986

Sailocele of Stenson's duct (a case report).

A case of dilatation of Stenson's duct is described. This was associated with a non-functioning parotid gland. The dilated part was constantly fed by saliva from the accessory parotid gland (Sailocele). The unusual presentation prompted us to report this case. Dilatation of Stenson's duct should be considered in the differential diagnosis of cystic swellings in the soft tissues of the cheek.

Adult↗
PubMed1982

Control of the hyperglycemic response to hemorrhage in cats.

Rapid hemorrhage to 50 mmHg (1 mmHg = 133.322 Pa) mean arterial blood pressure led to a rise in blood glucose levels that reached a level of 500 mg% by 15 min and was then maintained with minor decreases for the full period of hemorrhage (90 min). From changes in hepatic glycogen levels it is estimated that glucose from 3.1 g of glycogen was released per kilogram of body weight over the 90-min period of hemorrhage. Bilateral adrenalectomy or hepatic denervation did not reduce the hyperglycemic response significantly although adrenalectomy tended to produce a lesser response. Removal of the adrenals and the hepatic nerves (surgically or selective hepatic sympathectomy using 6-hydroxydopamine) eliminated all but a very small hyperglycemic response which was of slow onset. Thus, the hyperglycemic response to hemorrhage is controlled by a redundant control system wherein either the adrenals or the hepatic sympathetic nerves can produce the response but elimination of both systems eliminates the response. The minor hyperglycemia that occurred with both systems eliminated shows that other hormonal changes known to occur during hemorrhage play, at most, a minor role in the direct stimulation of glycogenolysis during hemorrhage.

Adrenalectomy↗
PubMedDate not supplied

Traumatic pseudoaneurysm of the internal carotid artery presenting with oculosympathetic palsy.

BACKGROUND: Blunt internal carotid artery (ICA) injury is rare but undiagnosed can have disastrous clinical consequences. AIM: To report a late presentation of blunt ICA injury in a young male following a road traffic accident. RESULT: A 16-year-old male presented 11 days following a head injury with a unilateral Horner's syndrome. Imaging confirmed a pseudoaneurysm of the ICA. The patient was treated with anticoagulant therapy. CONCLUSION: Diagnosis of ICA injury requires a high index of suspicion and presentation with unusual neurological signs following blunt trauma to the head and neck requires prompt investigation.

Accidents, Traffic↗
PubMedDate not supplied

Designing a medical Web site.

BACKGROUND: A web site is a valuable shop window for any medical unit with something to sell or something to say. AIMS: The aim of this report is to outline the basic steps of web page design for the individual or unit with limited financial resources. METHODS: There are two ways of designing a web site. A reputable web design company can be employed, but this is usually expensive. Alternatively, a web site can be designed in-house using commercial software, following a few simple steps. The basic requirements are a personal computer, software that is available on most computers and access to a few peripheral items of hardware. An outline of the page design should first be put down on paper. This can be transferred to a computer file using a web page design program. This file is then sent to a server for publication on the World Wide Web (WWW). CONCLUSION: Designing and publishing a web page can take time and effort, but the rewards can be great and the results will reflect the message and motto of the unit.

Humans↗
PubMedDate not supplied

Defining small bowel strictures.

BACKGROUND: Strictures of the intestine can be difficult to detect despite current radiological techniques. AIM: To review our experience with a new Foley catheter technique. METHOD: Three cases are reviewed in which a Foley catheter was used to identify a fibrous stricture. RESULTS: A Foley catheter with an inflated 10ml balloon inserted through an enterotomy successfully identified the site of stricture in three cases of fibrous stricture obstruction. CONCLUSION: A Foley catheter inserted through an enterotomy is a useful method of identifying fibrous strictures.

Aged↗
PubMedDate not supplied

Bilateral recurrent laryngeal nerve palsy in systemic lupus erythematosus.

An unusual occurrence of bilateral recurrent laryngeal nerve palsy as an initial manifestation of systemic lupus erythematosus (SLE) is described. The patient had positive lupus anticoagulant (LAC) and high titers of anti-dsDNA antibody. She showed rapid improvement following intravenous pulse dexamethasone.

Adult↗
PubMedDate not supplied

Massive lower gastrointestinal bleeding as a presenting feature of Behcet's disease.

This reports a 27 yr old female Patient with seronegative polyarthritis who presented with lower GI bleeding and subsequently developed evidence of cutaneous vasculitis (palpable purpura) and orogenital ulcers. The cause of the GI bleeding was multiple ulcerations in the terminal ileum, cecum ascending colon and transverse colon. Continued and massive bleeding necessitated surgical resection of the involved segment of gut which on histopathological examination confirmed the presence of vasculities. This patient was thus diagnosed as having Behcet's disease. Although major GI bleeding is a rare manifestation of Behcet's disease with vasculitis of the gut, one must consider this possibility if the patient has multi-system involvement with evidence of vasculitis involving the skin in the form of palpable purpura.

Adult↗