Combined endoscopic and surgical modalities for percutaneous endoscopic gastrostomy placement in the setting of subtotal gastrectomy with a gastric pull up.
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Gastrectomy↗
Biomedical subjects
S Hasan
Publications and source records attributed to S Hasan.
Facio-cervical transfixion by a metallic rod: a case report.
Foreign bodies penetrating into the neck may cause extensive neurovascular and aerodigestive tract injuries. Facio-cervical transfixion by a metallic rod without such injuries is very rare. The patient presented in this article reported to our center 5 hours after the road traffic accident with impacted hollow metallic rod traversing through the tongue, pharynx, and neck after causing fracture to maxilla. Exploration under general anesthesia after tracheostomy resulted in an uneventful extraction of the metallic rod. Postoperatively, the patient recovered completely and had no neurologic deficits. [Editorial comment: This case report demonstrates an approach to an extremely difficult and potentially dangerous clinical problem. The authors decision to forego angiography is based on physical examination with evidence of palpable flow in the superficial temporal artery.]
Accidents, Traffic↗
Insight and schizophrenia.
Few clinical attributes, if any, have such a profound impact on the management of schizophrenia as that associated with lack of insight. Yet, despite its importance, the clinical correlates of lack of insight are poorly understood. In one present study of long-stay patients at a state facility, lack of insight showed modest associations with positive and negative symptoms and with diminished executive function on cognitive testing. Insight did not differ between patients receiving typical and atypical antipsychotic medications.
Adult↗
Abolition of feeding intolerance following ophthalmologic examination of neonates.
Administration of mydriatic medication and ophthalmologic examination have previously been associated with feeding intolerance, characterized by large retained gastric aspirates and abdominal distention. In an attempt to eliminate this problem, we instituted a policy of withholding feedings for four hours following ophthalmologic examination. A prospective series of 50 consecutive patients was then followed to determine the incidence of feeding intolerance 24 hours prior to and 24 hours following the examination. All infants had received cyclopentolate hydrochloride and phenylephrine hydrochloride prior to the examination. A critical review of the nursing notes revealed no increased incidence in feeding intolerance during the 24-hour period following examination. There were no cases of necrotizing enterocolitis during either period. This study provides evidence that the incidence of feeding intolerance following ophthalmologic examinations might be reduced by withholding feeding for four hours after the examinations.
Cyclopentolate↗
Mandibular metastasis from renal cell carcinoma. A case report.
Renal cell carcinoma (RCC) metastasizing to the mandible and subsequently spreading to oropharynx in a 62 year old man is reported. The patient presented with solitary mandibular lesion with hematuria, which on further investigation was diagnosed to be RCC with no other systemic involvement. Clinical manifestation of the mandibular metastasis from RCC is rarely seen. A case is reported and literature regarding extracranial head and neck metastasis by RCC is reviewed.
Carcinoma, Renal Cell↗
The challenging task of motivating leprosy workers.
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Attitude of Health Personnel↗
Botulinum toxin A for the treatment of achalasia.
Pneumatic balloon dilatation of the esophagus is one of the current recommended treatment for achalasia. This procedure is associated with risks such as esophageal rupture. Surgery and percutaneous gastrostomy tube placement has been performed in severely affected individuals. The Botulinum Toxin A (BoTxA) is widely used to treat neuromuscular conditions in which spasticity is of concern. We present four cases in which BoTxA was used as an alternative of treatment and in which less invasive modalities were unsuccessful. The patients received a total of 80 units of BoTxA, applied to the submucosa in doses of 20 units in each predetermined quadrants to the lower esophageal sphincter. All patients demonstrated improvement of their symptoms without side effects in this study.
Aged↗