Biomedical subjects
Publications and source records attributed to R S Greval.
Of 175 throat swabs processed, anaerobes were isolated from 16 (9.14%) patients. Isolation of anaerobes from healthy controls was 2 out of 25 (8%). Peptostreptococci and Bacteroides species were the commonest isolates followed by Peptococci and Propioni-bacterium. All of these isolates were sensitive to Metronidazole. Clindamycin, Erythromycin and Tetracycline also showed good response.
A series of 300 cases of chronic suppurative otitis media encountered in Dayanand Medical College and Hospital, Ludhiana was surveyed for type specificity to determine latest trends of bacterial prevalence in Ludhiana. Punjab Pseudomonas, staphylococcus and proteus head the list. The problem of resistance is discussed in the present context.
An unusual case of an extensive radicular cyst, involving almost the entire body of the mandible, is presented. A localised tooth trauma in the remote past appeared to be the initiating factor. The pathology of the lesion stem from necrotic apical periodontitis. Histopathology confirms the type of dental cyst.
Sixty samples of smoking and chewing tobacco from subjects in and around Ludhiana, Punjab were tested for arsenic content. No significant difference between the two groups could be detected. The probable role of arsenicosis in neuropathy and liver disease in the Indian population is discussed.
Multiple dust allergy in a study of 100 patients of nasobronchial hypersensitivity has been demonstrated by skin testing in Chandigarh and successfully desensitised over a 3-year period. The results are discussed and the multiple factors involved postulated.
A clinical study of 90 cases of vernal keratoconjunctivitis was conducted to ascertain the efficacy of the local use of flurbiprofen and compare its effect with that of betamethasone. According to this study flurbiprofen was found to be effective in vernal keratoconjunctivitis, but less so than betamethasone. Because of the side effects due to prolonged use of steroids, it is recommended that topical flurbiprofen be tried first and in case it is ineffective, it should be replaced by betamethasone.
In a series of 4,366 patients screened at Ludhiana, Punjab, the incidence of hypothyroidism was of the order of about 20 per cent and of hyperthyroidism about 15 per cent in both sexes. The female-to-male ratio was a little over 3:1. These statistics conform broadly to conventional Western figures. The relevance of the thyroid function tests in detecting subclinical thyroid disorders in relation to other systems cannot be overemphasised.
The majority of patients with anaplastic thyroid carcinoma will achieve local tumour control with a combination of pre- and postoperative chemotherapy and radiotherapy. A few patients may even be cured with this regime. Chemotherapy alone for advanced thyroid carcinoma cannot, however, be routinely recommended. The chemotherapeutic agents in current use are discussed. Multimodality treatment remains the treatment of choice for undifferentiated thyroid carcinoma.
Congress grass (Parthenium hysterophorus) is a common weed growing wild in the urban and semiurban environs of North India. Cases of eczematous dermatitis caused by it generally escape clinical detection and are consequently wrongly diagnosed. An interesting case of Parthenium dermatitis treated with a high-dose course of desensitisation is presented to underscore the probability of the entity in obscure cases of contact dermatitis and eczema.
Presented is an update on the current role of intra-arterial chemotherapy in the management of advanced maxillary sinus cancer. The potential benefit of such chemotherapy is that it permits the delivery of a high concentration of the cytotoxic agent directly to the tumour tissue bed in an effort to maximize the cytotoxicity and minimize the side effects. In such circumstances it is feasible to omit mutilating surgery and treat under an organ-sparing protocol without compromising survival.
Two cases of acidophil adenoma of the pituitary causing sudden blindness from pituitary apoplexy are presented. The tumours had been clinically silent, without producing any symptoms of endocrine dysfunction. Radiological evidence was very conclusive. Transfrontal craniotomy with decompression resulted in quick and dramatic visual improvement. The interesting syndrome of clinical manifestations is discussed.
1) Ten per cent of cases of chronic maxillary sinusitis in a series of 50 cases treated in the ENT department of Dayanand Medical College, Ludhiana, were caused by anaerobic infection. 2) The causative anaerobic micro-organisms encountered were Peptostreptococcus and Clostridium species. 3) Treatment should, therefore, include metronidazole, especially in those cases refractory to conventional antibiotic therapy.
The lesser known manifestations of myxoedema encompass a wide spectrum of neurologic, psychiatric, endocrinologic and autoimmune pathology that mask obvious clinical diagnosis. Interesting head and neck presentations are discussed. The relationships with the Pendred and Down syndromes raise hereditary and genetic considerations.
From our study it is clear that lincomycin, given 300 mg intra muscularly daily in a single dose, is effective in a wide range of soft tissue infections especially those involving the head and neck region. An overall success rate of 88.8 per cent was observed in the 150 patients selected for the study. It is significant that in none of the subjects was any untoward reaction observed or reported. Hitherto all the previous systematic surveys on lincomycin appear to have been carried out on bone infections where, undoubtedly, lincomycin is highly effective. This pilot study furnishes an encouraging report on the successful treatment of soft tissue infections with parenteral lincomycin.
The clinical features, radiological findings, microscopic examination and treatment of a case of aneurysmal bone cyst have been discussed. The histopathological examination is the only way to confirm the diagnosis of this interesting bone lesion which rarely affects the jaws.
A study conducted on seventy-five cases of chronic maxillary sinusitis presenting at the E.N.T. Outpatients' Department of Dayanand Medical College, Ludhiana revealed the presence of fungi in 8 cases. The return fluids of proof puncture and antral lavage of the sinuses were subjected to standard extraction procedures. Methods of isolation and identification of the causal fungi are described. The role of fungi, particularly Aspergillus, as pathogen is discussed in the context of antibiotic and immuno-suppressive therapy and local predisposing factors.
An interesting case of odontogenic keratocyst of the maxilla, with its clinical, radiological and histopathological findings, is reported. Total cystectomy resulted in a complete cure. Its histogenesis is discussed.
The role of retinoids as chemopreventive agents in head and neck malignancies is briefly described. The hypotheses of mechanisms of cancer prevention are discussed. A strong case is made for extension of recent work in this field of preventive cancer chemotherapy.