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Biomedical subjects

S Bal

Publications and source records attributed to S Bal.

At least 19 recordsLinked to original sources
PubMed1991

Malignant insulinoma presenting with recurrent episodic loss of consciousness.

A 57 year old male presented with episodic behavioural abnormalities and loss of consciousness for 2 years. His fasting blood glucose was 20 mg/dl and corresponding insulin level 119 uU/ml. His EEG showed intermittent rhythmic delta activity. Abdominal CT scan revealed an enhancing mass in the tail of the pancreas and secondaries in the liver. After distal pancreatectomy, resection of the left lobe of the liver and chemotherapy, the hypoglycaemic spells subsided. Histopathology revealed an islet cell tumour with metastases in the liver. Episodic neurobehavioural dysfunction should alert towards the possibility of hypoglycaemia.

Humans↗
PubMed1990

A case of follicular small cleaved cell lymphoma with t(14;18) and t(8;11).

Follicular small cleaved cell lymphoma is a common B-cell lymphoma exhibiting a t(14;18)(q32;q21) chromosomal translocation, which has been found in most cases studied. In our case of follicular small cleaved cell lymphoma, the chromosome translocation 14;18 was observed. This case also exhibits a second consistent chromosomal translocation, t(8;11)(p21;q13), along with t(14;18).

Adult↗
PubMed1990

The drinking habits of Sikh, Hindu, Muslim and white men in the West Midlands: a community survey.

Men born in India but living in Britain have higher than expected treated prevalence rates of alcohol-related disorders. A community survey of random samples of 200 each of Sikh, Muslim and Hindu men and 200 white English-born men, matched for age, were interviewed using a structural questionnaire containing a retrospective drinking diary. Sikhs were most likely to be regular drinkers followed by whites and Hindus. The very few Muslim men who drank consumed the most alcohol on average. The frequently reported pattern of an inverse relationship between drinking and age was found for white men but not among Sikhs and Hindus. In both these groups older men reported consuming more alcohol than did young men. However, age was confounded with generation: heavier levels of consumption were reported by Sikhs and Hindus born in India than by Sikhs and Hindus born in Britain. Among regular drinkers Sikhs had higher average Alcohol Problem Scale Scores than did white men or Hindus. The highest average scores were recorded for the (few) Muslim regular drinkers (who also consumed the most alcohol). A clear association with religious observance was found for all three Asian groups and for the white men. No religious Muslims drank at all, and a relatively small proportion of the other groups who were regular church/Temple attenders drank regularly.

Adolescent↗
PubMed1990

Fine needle aspiration cytology as a preliminary diagnostic procedure for asymptomatic cervical lymphadenopathy.

Fine needle aspiration cytology (FNAC) was used as a preliminary diagnostic procedure in evaluating discrete, asymptomatic cervical lymphadenopathy of more than four weeks duration. Benign pathologies were encountered in 294/359 patients (82%); of these 86% had tuberculosis. Even in the elderly, a large number of patients (25/78) harboured tubercular lymph glands. FNAC obtained adequate material for cytologic diagnosis in 97.5% and had an overall accuracy rate of 97%. Malignancy was correctly diagnosed in 100%; in tuberculosis the accuracy rate of 96% with a 3.5% false negative results. FNAC is reliable as the initial evaluating procedure even in benign disorders; it is also cheap, speedy and easy to perform, with no complications, making it suitable for wider application in developing countries with scant resources.

Adenocarcinoma↗
PubMed1989

Near-total thyroidectomy for carcinoma of the thyroid.

There is controversy about the most appropriate treatment for patients with thyroid cancer. This study analyses our experience with 206 cases of thyroid cancer from an endemic goiterous area. There were 100 males and 106 females; patients presented at an earlier age with a short history. Thyroid cancers demonstrated an aggressive biological behaviour with an advanced stage at presentation (overt cancers in 51 per cent) and a relentless course with a mortality rate of 24.2 per cent for the well-differentiated tumours. Near-total thyroidectomy was performed in 126 patients. Multicentric foci of tumour were seen in 17.2 per cent of the well-differentiated cancers and 25.2 per cent of the cases of well-differentiated cancers who underwent near-total thyroidectomy developed loco-regional recurrence. Hemithyroidectomy was performed in 35 patients who refused completion total thyroidectomy at a second stage; 16.7 per cent of these patients developed a recurrence in the remaining contralateral lobe. Thus in our patients from an endemic goiterous area, near-total thyroidectomy is the treatment of choice particularly because of the frequent occurrence of follicular and anaplastic cancers (in 44.2 per cent) and because the course of the disease is more virulent.

Adenocarcinoma↗
PubMed1989

Intraperitoneal rupture of amoebic liver abscess.

A retrospective analysis of 23 cases of amoebic liver abscess with intraperitoneal rupture is presented. Group I consisted of 16 patients with clinical features of generalized peritonitis. Eight of these patients were treated surgically, and four died. Group II consisted of seven patients with features of localized peritonitis and all were treated conservatively. In all cases the diagnosis of liver abscess was established by liver scan or ultrasound examination; peritonitis was established either at operation or, in the conservatively managed group, by aspiration of pus from the peritoneal cavity. Amoebiasis was diagnosed by serology. Eight group I and all group II patients were managed conservatively by aspiration of the liver abscess, antibiotics and amoebicides. There were no deaths in this group. It is suggested that, if the diagnosis can be made early, conservative treatment offers the best chance of cure for patients of amoebic liver abscess with intraperitoneal rupture.

Adolescent↗
PubMed1989

A report of four cases of thyroid cancer occurring in thyrotoxicosis and review of the literature.

Four cases of thyroid carcinoma occurring in 140 cases of Graves' disease are presented herein. A standard workup of the patients was done to establish hyperthyroidism and all cases of cancer were diagnosed on receipt of histopathology. There were three cases of papillary carcinoma and one case of follicular carcinoma with one cancer being encountered in the 'cold' area of the thyrotoxic gland. The incidence of malignancy in thyrotoxicosis, however, was not found to be higher than that in other thyroid disorders.

Adenocarcinoma↗
PubMed1988

Squamous cell carcinoma of the thyroid.

Eight cases of squamous cell carcinoma of the thyroid are reviewed. The clinical features and natural history of our cases are presented. All tumours showed an aggressive biological behaviour. Two patients showed association with well-differentiated thyroid cancer. It is difficult to conclude whether these tumours are de novo occurrences or were a result of a complete replacement of a previously existing condition after a change in histologic character.

Adult↗
PubMed1988

Thyroid carcinoma in an endemic area presenting as solitary thyroid nodules.

A retrospective analysis of 66 cases of thyroid cancer presenting as a solitary thyroid nodule (STN) from an endemic area is presented herein. The workup included TSH estimation and radionuclide scanning and patients were divided into two groups. Group A included cases of STN carcinoma diagnosed histologically in patients clinically presenting as a benign STN. Of all the patients who presented with a benign STN, malignancy was found more frequently in 'cold' nodules (13.5 per cent), than in nodules with a different presentation on scintiscanning (0-9.5 per cent). Cancers occurred in 5 per cent of the females and in 19.5 per cent of the males. Group B included patients with overt signs of malignancy. In both groups, the clinical behaviour was determined by the stage at presentation according to TNM classification. TNM staging was found to be a good prognostic indicator, comparable to histopathology. Thus, locoregional recurrence and mortality were found to be higher in advanced T3 lesions and in Group B patients. On the basis of these findings it is suggested that STN cancers may either be an earlier stage of the disease or that the STN cancers in the two groups may be separate disease entities.

Adolescent↗
PubMed1988

Spontaneous regression of extramedullary plasmacytoma--a case report.

A case of extramedullary plasmacytoma in the soft tissues of the posterior chest wall of an 80-year old man is reported herein. Immunofluorescence study showed that the tumor cells produced IgG lambda. An M-component was also detected in the patient's serum by paper electrophoresis. Two months following the open biopsy done to establish diagnosis, the tumor underwent spontaneous regression and the M-component in the serum also disappeared. This is the first case report of spontaneous regression of an extramedullary plasmacytoma and the probable reasons for this spontaneous regression are discussed herein.

Aged↗
PubMed1988

Diagnosis and treatment of cystic disease of the thyroid by aspiration.

One hundred forty-one cases of euthyroid solitary "cold" and "uniform" nodules, each of which contained at least 3 ml of fluid obtained on aspiration, are presented. Sixty-three patients had complete disappearance of swelling after one aspiration. Seventy-eight patients were selected for surgery on the basis of cytologic findings of malignancy in the aspirated fluid (one patient), on the basis of recurrent cyst formation after one aspiration (17 patients; in these cases the incidence of malignancy was similar to that in solid, cold nodules), and on the basis of palpable tissue after aspiration that indicated a partially cystic lesion (60 patients). Surgicopathologic findings revealed six malignant lesions; all of these nodules were more than 3 cm in diameter. In percentage, 6.6% of the partially cystic and 2.5% of the purely cystic nodules were malignant. The color of the aspirated fluid did not add to the discriminant value of the aspirate. The identification of malignant conditions in thyroid cysts was handicapped by the yield of acellular material in three of five cases of malignant disease and in more than 50% of benign lesions. However, the study suggests that aspiration biopsy of cystic thyroid nodules when used in association with the above clinical criteria is a useful technique of selecting patients for operation and, by itself, is a safe and reliable means of treating the disorder.

Adult↗
PubMed1986

Carcinoma of the thyroid: differential behaviour in solitary and multinodular tumours.

One hundred and sixty-three cases of thyroid carcinoma were treated between 1979 and 1983. The cancers were classified as solitary nodules or carcinomas in multinodular goitres according to their clinical presentation. Analysis revealed a significantly higher incidence of T0/T1 in the solitary nodular carcinoma group (P less than 0.001) and a lower incidence of metastatic disease (P less than 0.05) compared with multinodular carcinoma. Survival for the T0/T1 subgroup of solitary nodular carcinoma was significantly better compared with the same subgroup of multinodular carcinoma (P less than 0.05).

Adult↗