Tracheostomy in the management of respiratory distress—A 10 years review

The role of 170 tracheostomies done over a period of 10 years (1982–1991) in the Department of Otorhinolaryngology at Silchar Medical College Hospital is analysed. Upper respiratory tract obstruction was found to be the commonest indication of operation. Most of the operations were carried out as an emergency and found to be a safe and life-saving procedure in the management of respiratory distress.     

Pyrimidinylpyrroloquinolones as highly potent and selective PDE5 inhibitors for treatment of erectile dysfunction

A series of N-pyrimidinylpyrroloquinolones were discovered as extremely potent and selective PDE5 inhibitors. Representative compounds demonstrated in vivo efficacy in dog erectile dysfunction models and are orally bioavailable.     

Biliary‐enteric bypass in unresectable malignant hilar biliary obstruction: Kwong Wah Hospital experience

Objective : To evaluate the efficacy of biliary‐enteric bypass in the palliation of malignant hilar biliary obstruction. Materials and Methods : Records of 19 patients from 1995 to 1998 were reviewed. There were 13 patients with cholangiocarcinoma and 6 patients with carcinoma of the gallbladder. Single biliary‐enteric bypass had been performed in 13 of the patients; the rest had more than one biliary‐enteric anastomosis. Results : The 30‐day mortality was 21% (4/19 patients). Bile leakage occurred in 2 patients, leading, in both, to fatality. Excluding the 30‐day mortality, the median survival of patients with carcinoma of the gallbladder and cholangiocarcinoma was 116 days (43–200) and 202 days (47–1207), respectively. The mean hospital stay was 31 days (13–59) and all patients were discharged with their symptoms relieved and a drop in bilirubin of at least two‐thirds their pre‐operative level. The late complication rate was 26.7% (4/15 patients). Conclusion : Biliary‐enteric bypass is effective in the palliation of symptoms of patients suffering from unresectable hilar biliary obstruction, although it carries considerable mortality and morbidity. Stenting, rather than surgery, should be considered for patients with unresectable gallbladder cancer.      

Nasal polyp : A clinico histological study

A total of 113 cases of nasal polypi from almost all age groups, having almost equal sex incidence, were subjected to clinico histological study, in an attempt to subgroup nasal polyp on etiological basis. History of allergic manifestations could not be elicited in most of the cases (65.5%). Ulceration with ciliated columnar and transitional epithelium were seen in good number of cases (93.8%). Infiltration of stroma by lymphocytes, plasma cells, macrophages, eosiniphils and mast cells Were plenty to moderate in number with almost equal frequency, although 22.1% of cases showed poor number of eosinophils and mast cells, while polymorphs in poor number were detected in 70.8% of cases. Stroma was severely or moderately oedematous in most of the cases. Presence of amyloid like material was noted in 80.6% of cases. Atypical mesenchymal cells were seen in plenty to moderate number in 36 3% of cases. Seventy six cases could be followed up, of whom 11 cases showed recurrence within 6 months. Histological picture in these cases didnot reveal mesenchymal cell atypicality as a factor for recurrence. The present study also could not catagorise the nasal polypi as allergic or nonallergic on the basis of gland histology and character of cellular infiltrate.     

Tuberculous meningitis in children

Between May 1988 and November 1992 the data from 52 patients with tuberculous meningitis (TBM) were noted down for their symptoms and signs, BCG vaccines, PPD tests; clinical, laboratory, radiologic and microbiologic findings. These data were discussed by means of literature knowledge. Cranial computed tomography (CT) demonstrated hydrocephalus (HC) in 98% of the patients. There was a statistically significant difference among the clinical stages on admission in respect to prognosis (P < 0.05). In addition, there was also a significant relationship between prognosis and HC (P < 0.05). However, we did not find any significant relationship between parenchymal involvement, basilar meningitis and prognosis (P > 0.05).