Biomedical subjects
Publications and source records attributed to S B Mann.
22 Cases of bacillary positive leprosy with no apparent lesion in the oral cavity, soft or hard palate were studied for any evidence of pathological involvement. Granulomata were present in 11 (65%) out of 17 cheek biopsies studied. M. leprae were identified in four specimens only. 9 specimens (64%) out of 14 palate biopsies showed definite granulomata. M. leprae were seen in six specimens.
A case of Rhinoscleroma of the left maxilla and ethmoid with involvement of the orbital apex, in a female diabetic, is reported. The significance of the associated diabetes is discussed.
Eight cases of primary mycotic infection of paranasal sinuses with Aspergillus and Candida species encountered during July, 1979 to December 1981 are being presented. Their clinical, mycological and serological responses have been discussed. Aspergillus flavus was isolated from all the seven cases with aspergillosis and Candida albicans, along with C. tropicalis, was isolated from one case.
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Auditory evoked responses using BERA were studied in 30 newborn babies with plasma bilirubin > or = 15 mgm/dl and repeated after treatment of neonatal jaundice with bilirubin levels of < or = 10 mgm/dl. A few jaundiced babies (16.5%) showed absent BERA response at the initial/subsequent examination. After treatment, 3/30 babies showed absent wave form responses and 2 of these were clinically kernicteric. Jaundiced babies had prolonged wave peak latencies and inter peak latencies. Treated babies showed a tendency towards recovery in their BERA responses which were however not complete. Total plasma bilirubin value at the time of BERA examination and mean maximal bilirubin values had no correlation with the incidence and degree of BERA abnormalities.
Schwannomas in children are rare. A nine-year-old boy presented with swelling right side of face and proptosis for 4 months. CT scan showed a heterogenous mass in the right infratemporal fossa and extending to the posterior ethmoid. There was erosion of the bony walls of the infratemporal fossa. A biopsy through the sublabial approach was reported as schwannoma. The tumour was approached by Weber-Ferguson approach and excised in toto with complete relief of symptoms.
One should be aware that the measurement of hearing is really an evaluation of a child's behavioural responses in a controlled setting to the presentation of various acoustic stimuli. The determination of hearing loss in some children is an ongoing process and may require more than one test session. Difficult to test children should be evaluated with as many techniques as possible for accurate cross checking of test results. Flexibility, patience and understanding and persistence are the watch words of successful hearing testing with children. For the bulk of patients who require audiological assessment however, the test battery (BOA, IMPEDANCE & BSER) approach seems to be the best available present day approach coupled with long term follow ups and careful management.
In the present study BERA profile of 30 post-meningitic children was compared with 15 normal children of the same age and it was observed that 36.6% children in the age range of 6 months to 36 months were found to have varying degree of sensorineural deafness. Severe bilateral sensorineural hearing loss (> 80 dB) was observed in 6.6% children and moderate (40-80 dB) hearing loss in 30% of children. Abnormalities were bilateral in both the samples of children with severe hearing loss (> 80 dB) whereas among 9 children who had moderate hearing loss abnormalities were bilateral in one patient and unilateral in the remaining 8 children. A relationship between higher incidence of sensorineural deafness and younger age of children, and occurrence of seizures during meningitis were noted. But no relationship was observed with either sex, hydrocephalus, subdural effusion or with low CSF sugar and high CSF proteins.
A total of 1,670 school going children (urban 1030 and rural 640) in the age range of 12-14 years were screened for hearing loss during a survey conducted by the Department of Otolaryngology of the Postgraduate Institute of Medical Education & Research, Chandigarh. 6.31% of cases in the urban group were found to be having hearing loss as compared to 32.81% of cases in the rural group. Secretory otitis media was found to be the commonest cause of hearing impairment in both the urban and rural group accounting for 5.33% and 33.59% respectively.
PURPOSE: The aim of the present study was to determine the factors that make a patient of chronic suppurative otitis media more susceptible to the development of a complication. MATERIALS AND METHODS: A prospective study of 125 patients of both complicated and uncomplicated cases of chronic suppurative otitis media who underwent mastoid surgery was undertaken to study the percentage proportion of various complications and to correlate various variables, such as age, sex, duration of ear discharge, otoscopy, operative findings, state of pneumatization, and microbiology of the ear. RESULTS: It was found that patients with complicated ear disease had ear discharge for a shorter duration compared with those without complications. The difference was statistically significant (P < .05). There was no significant difference in the otoscopic findings in both the groups. At surgery, presence of granulation tissue was significantly seen in the group with complications (P < .05). Radiologically, degree of mastoid pneumatization had no significant difference in the two groups, except the presence of lytic lesion in patients more than 15 years of age in the group with complications. Bacteriological examination showed significant isolation of anaerobes in patients with complications (P < .01). CONCLUSION: A history of ear discharge for a short duration in a younger patient less than 15 years of age, the presence of anaerobes in the ear discharge, and granulation tissue at surgery increase the probability of development of a complication in patients with chronic suppurative otitis media.
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PURPOSE: To find a correlation between increasing levels of serum bilirubin and auditory brainstem responses (ABR) and to find the use of ABR as a bilirubin neurotoxicity marker. MATERIAL AND METHODS: A prospective study of 60 neonates in which ABR of hyperbilirubinemic neonates was compared with the normal neonates. All cases with abnormal ABR were studied for 6 months and after 1 month and 6 months a repeat ABR was performed. RESULTS: Brainstem conduction time was found to be prolonged from 5.12+/-0.26 to 5.83+/-0.14 in neonates with a mean serum bilirubin level of 16.6 mg/dL (12 mg/dL to 18 mg/dL), which was found to be additionally prolonged to 6.0+/-1.0 with an increase in mean serum bilirubin level to 21.98 mg/dL (P < .01). At first retest after 1 month, 33.33% of cases with a mean serum bilirubin level of 19.46 mg/dL and 80.00% with a mean serum bilirubin level of 15.97 mg/dL showed total recovery. After 6 months, three cases with mean serum bilirubin levels of 26.3 mg/dL and one case with a mean serum bilirubin level of 17.7 mg/dL failed to show any improvement. CONCLUSION: A positive correlation was found between increasing levels of serum bilirubin and brainstem conduction time (P < .01). ABR was found to be a very sensitive tool in picking up the earliest signs of neurotoxicity. Neonates with distortion of normal wave patterns on ABR were found to have poorer prognosis compared with those with delayed inter-peak (I-P) latencies.
PURPOSE: The aim of this study was to determine the relationship of HLA typing in patients with otosclerosis. MATERIALS AND METHODS: We used a prospective study in which HLA typing of 100 surgically confirmed otosclerosis patients were compared with age and sex matched normal individuals. RESULTS: HLA-A3, HLA-A9, HLA-A11, and HLA-B13 were found to be significantly higher (P < .05, .01, and .01, respectively). HLA-A9 and HLA-A11 were found to be higher (P < .01) in patients with a positive family history, indicating genetic heterogenicity. CONCLUSIONS: Higher values of HLA-A9, HLA-11, and HLA-B13 in patients with otosclerosis compared with normal individuals strongly suggests a genetic, HLA-related component.
Allergic fungal sinusitis is a comparatively new disease entity in paranasal sinus mycoses. It is not a very rare condition, but diagnosis is difficult to establish. Of 28 consecutive cases of allergic nasal polyposis during a 2-year period, 11 patients had allergic fungal sinusitis and the diagnosis was based on the presence of type I hypersensitivity, eosinophilic mucus without tissue invasion of fungi on histopathology and detection of septate hyphae on direct microscopy. On culture, Aspergillus flavus was isolated from nine patients and A. fumigatus and A. niger from one patient each. Among patients with allergic fungal sinusitis, five had asthma, four had proptosis, of whom two had impaired vision, and all 11 patients had nasal obstruction. Eight patients described a history of recurrence. All patients underwent surgical clearance of the diseased sinuses and were given post-operative topical steroids to prevent recurrence.
Recognizing the high incidence of paranasal sinus mycoses in north India, we analysed retrospectively the clinical, mycological and management aspects of 178 patients with proven disease attending our institute. On the basis of clinical, radiological, histopathological and mycological findings, the patients could be categorized into those with allergic (8), non-invasive (92) and invasive (78) disease types. Bony erosion without mucosal invasion by fungi was seen in 16 patients with non-invasive disease. Young men from rural areas were the most commonly affected. Rhinorrhoea with nasal polyposis (45.8%) and proptosis (46.4%) was the most common presentation. Concurrent involvement of the maxillary and ethmoid sinuses was common in these patients, whereas isolated sphenoid and frontal sinuses were involved in the invasive variety only. Orbital and intracranial extensions were detected in 100% and 13.2%, respectively, of patients with the invasive type of disease. Aspergillus flavus (79.7%) was the most common isolate. Surgical debridement and sinus ventilation were adequate for the effective management of the non-invasive disease. However, adjuvant medical therapy was included in treatment of the semi-invasive and invasive varieties of the disease. Itraconazole was found to be most useful in prevention of recurrence in the invasive type. Mortality was highest (33.3%) among patients with zygomycotic infection. Invasive fungal granuloma with orbital and intra-cranial invasion is a distinct entity in terms of its clinical course and treatment compared with non-invasive fungal sinusitis, and it needs to be treated aggressively with surgical excision and postoperative itraconazole.