Prevalence of lower urinary tract symptoms (LUTS) and groin hernia increase with rising age. Straining in itself is an important aetiology of inguinal hernia. Posthernioplasty retention of urine is one of the most signif...Prevalence of lower urinary tract symptoms (LUTS) and groin hernia increase with rising age. Straining in itself is an important aetiology of inguinal hernia. Posthernioplasty retention of urine is one of the most significant complications. The aims of this study are to know the prevalence of signifi- cant LUTS in men > 50 years (n = 200) undergoing inguinal hernia surgery, to identify the high-risk patients for posthernioplasty urinary retention and to assess the role of peri-operative use of alpha- blocker in reducing the incidence of postoperative urinary retention in these patients. This study was performed at RKMSP Hospital, Kolkata from August 2005 to January 2008. All findings were docu- mented. Prevalence of significant LUTS above 50 years undergoing inguinal hernioplasty was found to be 48% (96 out of 200). Out of 96 patients who had International Prostate Symptoms Score>7, 48 patients had maximal urine flow (Qmax) < 10 ml/second and postvoid residual urine > 100 ml, 48 patients belonged to high risk group for postoperative retention of urine. Incidence of postoperative retention of urine among high risk group among tamsulosin users was only 3(12.5%) out of 24 patients and among tamsulosin non-users was 10(41.6%) out of another 24 patients. Therefore, we concluded that among male patients > 50 years of age (undergoing groin hernia surgery) prevalence of significant LUTS increases per decade. We also concluded that tamsulosin is important for alleviation of LUTS and is quite effective for prevention of postoperative retention of urine and helpful for early discharge of patients.
Sen K, Ghosh UC, Mukherjee AK
… +2 more, Ghosal A, Pandey UK
J Indian Med Assoc
· 2013 Feb · PMID 24003576
Adult onset Still's disease is a febrile illness of unknown aetiology, accounting for about 6% cases of fever of unknown origin. It was first described by Eric GL Bywater in 1971, and since then few case series have been...Adult onset Still's disease is a febrile illness of unknown aetiology, accounting for about 6% cases of fever of unknown origin. It was first described by Eric GL Bywater in 1971, and since then few case series have been reported from India and other parts of the globe. A case of adult onset Still's disease who presented with fever and polyarthralgia of 18 months duration with flare of joint symptoms during fever spikes has been reported.
Lupus vulgaris is the most common morphological variant of cutaneous tuberculosis accounting for approximately 59% of cases of cutaneous tuberculosis in India. We present a case of lupus vulgaris of external nose diagnos...Lupus vulgaris is the most common morphological variant of cutaneous tuberculosis accounting for approximately 59% of cases of cutaneous tuberculosis in India. We present a case of lupus vulgaris of external nose diagnosed early and treated with CAT-3 RNTCP regimen for six months without any nasal deformity except for a small scar over the dorsum of the nose. Patient followed up for one year after completion of the prescribed regimen, there being no recurrence of the lesion.
Anand R, Narula MK, Chadha R
… +2 more, Chander J, Jain M
J Indian Med Assoc
· 2013 Feb · PMID 24003574
Pleuropulmonary blastoma is a rare and aggressive malignant tumour that affects young children. A case of pleuropulmonary blastoma has been presented in a 9-year-old male child who was initially diagnosed and treated as...Pleuropulmonary blastoma is a rare and aggressive malignant tumour that affects young children. A case of pleuropulmonary blastoma has been presented in a 9-year-old male child who was initially diagnosed and treated as pulmonary tuberculosis. Computed tomography of chest revealed a large heterogeneously enhancing mass with calcification in left hemithorax and left pleural effusion. The mass was seen to invade mediastinum and left hemidiaphragm. Thoracotomy revealed unresectable tumour involving both lobes of left lung with invasion of mediastinum and left hemidiaphragm. Biopsy confirmed type II pleuropulmonary blastoma and the child was treated with chemotherapy and radiotherapy.
Association between chronic lung disease and peri-odontal infection has recently been reported. The microbiology of peri-odontal infection and lung infection is almost similar. The most direct means by which the oral inf...Association between chronic lung disease and peri-odontal infection has recently been reported. The microbiology of peri-odontal infection and lung infection is almost similar. The most direct means by which the oral infection might influence lung disease is by aspiration of dental plaque bacteria into the lower respiratory tract. In this case report we are presenting a patient who suffered recurrent lung infection. Intra-oral examination revealed the presence of chronic peri-odontitis, which was not treated before. On providing treatment for lung infection in addition to that for peri-odontal infection, there was no recurrence of lung infection.
Mandal PK, Bhattacharyya NK, Mookerjee SK
… +1 more, Chaudhuri B
J Indian Med Assoc
· 2013 Feb · PMID 24003572
The diabetic foot ulcer is one of the major complications of diabetes mellitus leading to prolonged hospital stay. Non-healing foot ulcers in diabetes may be due to peripheral neuropathy and/or vasculopathy. Non-healing...The diabetic foot ulcer is one of the major complications of diabetes mellitus leading to prolonged hospital stay. Non-healing foot ulcers in diabetes may be due to peripheral neuropathy and/or vasculopathy. Non-healing occurs following a trivial trauma due to loss of local immunity and increased infection by bacteria and fungus. Candida and mucormycosis are common fungal infection in diabetic foot ulcer. Squamous cell carcinoma in any non-healing ulcer is a common occurrence. But squamous cell carcinoma in non-healing diabetic foot ulcer is rarely reported. Here, mucormycosis in a diabetic foot ulcer which turned into squamous cell carcinoma is reported in a 62-year-old male with poor glycaemic control for last 21 years who presented with a non-healing ulcer of 8 months' duration over dorsum of left forefoot. Microbiological examination revealed presence of mucormycosis infection and histopathology of ulcer showed infiltrating well-differentiated squamous cell carcinoma. The clinicians and pathologists should be aware of these combinations because only eradication of mucormycosis may not cure the ulcer, rather presence of squamous cell carcinoma may be ignored that may be an immediate threat to the patient's life.
Backdraught is a type of explosion occurring in fire in closed spaces. The fire consumes all oxygen suddenly explodes when more oxygen is avaibable. Here a case is presented where death occurred as a consequence of backd...Backdraught is a type of explosion occurring in fire in closed spaces. The fire consumes all oxygen suddenly explodes when more oxygen is avaibable. Here a case is presented where death occurred as a consequence of backdraught related explosion. The inflammable substance in this case was firecrackers, which were stored in a closed room. The resultant blast was strong enough to sever both the upper limbs of one individual and cleave the other individual into two.
Hepatitis is a feature of many viral diseases usually resulting as a part of generalised infection which involves the liver. In contrast, there are at least five different hepatitis viruses (HAV to HEV) that primarily ta...Hepatitis is a feature of many viral diseases usually resulting as a part of generalised infection which involves the liver. In contrast, there are at least five different hepatitis viruses (HAV to HEV) that primarily target the liver in humans--called hepatitis viruses, whereas the role of sixth virus (HGV) is doubtful. Although symptoms produced are similar, these viruses differ greatly in their structure, mode of replication and transmission. The aim of this article is to bring out salient features of these viruses and approach towards their control/prevention, laying emphasis on HBV which has attained/ become one of major public health problems in India.
Yavagal ST, Amarkhed B, Halkati PC
… +4 more, Patted SV, Porwal SC, Ambar S, Patil R
J Indian Med Assoc
· 2013 Feb · PMID 24003569
Prehypertension as an entity has been given Importance after JNC VII report. The magnitude of this problem in India and the importance of recognising prehypertension is slowly growing and getting established. Under these...Prehypertension as an entity has been given Importance after JNC VII report. The magnitude of this problem in India and the importance of recognising prehypertension is slowly growing and getting established. Under these circumstances it was decided to study the prevalence of prehypertension in the city of Belgaum in Karnataka and the literature was reviewed. The objective of this study was to find out the prevalence of prehypertension in the urban population of Belgaum above thirty years of age. The urban population of Belgaum city was screened for prehypertension and hypertension by measuring blood pressure of all individuals aged 30 years and above. Blood pressure of 52196 persons was checked and the data was analysed. JNC VII criteria was used for defining hypertension, prehypertension and normal blood pressure. Among 52196 persons prehypertension was present in 41.1%, 67.1% were in the age group of 30-50 years. The prevalence was similar in both male and female population. Thirty-three percent of diabetic population had prehypertension. About 22.8% of prehypertensives were obese. Prehypertension is highly prevalent in urban population of India, more often seen in persons below 50 years of age. This study recognises the importance of detection of prehypertension and emphasises the need for mass education on life style modification to prevent the development of hypertension and its complications.
In India, institutionalisation of deliveries is happening at a fast pace. Evaluating the knowledge and practices of healthcare providers in these institutions is a priority in this current scenario. The objective of this...In India, institutionalisation of deliveries is happening at a fast pace. Evaluating the knowledge and practices of healthcare providers in these institutions is a priority in this current scenario. The objective of this study was to assess the knowledge and practices regarding essential newborn care and resuscitation among healthcare providers in Panchkula district of Haryana. A cross-sectional questionnaire based survey of healthcare personnel working in one district hospital, 2 community health centres, 5 primary health centres and 2 subcentres, each with at least 100 deliveries per year, was done. Fifty-eight medical personnel comprising of 27 staff nurses, 11 auxiliary nurse midwives, 15 doctors and 5 multipurpose health workers were interviewed. Of them, 33 (57%) had received training in newborn care, but only 9 (16%) knew all the initial steps of resuscitation. Twenty-eight (48%) had knowledge of positive pressure ventilation while 8 (13%) could provide chest compression or drugs during resuscitation. Thirty-three (57%) practiced holding the baby upside down after delivery. Early and exclusive breastfeeding including colostrum was advised by all. All practiced hand washing prior to delivery and kept the cord clean anddry. At least one danger sign was told to the mother at the time of discharge by 48 (83%). However, kangaroo mother care was rarely advised to mothers of preterm babies. It was found that majority of healthcare personnel had good awareness about breastfeeding and clean practices while conducting delivery. In contrast, knowledge about neonatal resuscitation and some aspects of essential newborn care was poor.
Tewary K, Singh VK, Singh SK
… +3 more, Tiwary P, Garg A, Joshi KK
J Indian Med Assoc
· 2013 Feb · PMID 24003567
Diabetes mellitus is a major public health problem worldwide, and it is a known risk factor for coronary artery disease. Younger population, a group which lacks epidemiological data on diabetes mellitus, the prevalence o...Diabetes mellitus is a major public health problem worldwide, and it is a known risk factor for coronary artery disease. Younger population, a group which lacks epidemiological data on diabetes mellitus, the prevalence of diabetes in them was investigated in the rural districts of north Bihar (India). Furthermore, the risk factors associated with diabetes mellitus in this younger population were also assessed. A total of 3957 subjects in the age group of 12-30 years from northern Bihar participated in the study. Data were obtained from history, random capillary blood glucose levels detected by glucometer and body mass index. Of the available 3955 results, glucometer identified 103 subjects (2.6%) as positives with the cut-off value of 150 mg/dl. Out of these, 12 (0.3%) were diabetic while 35 (0.88%) had impaired glycaemic control by intravenous blood sugar method. The random blood glucose levels varied from 53-391 mg/dl (mean and SD: 105.3 and 21.2). Amongst these subjects; only 103 (2.6%) were declared to be diabetic. The fasting and postprandial blood glucose levels for diabetic subjectes were 148.5 and 227.1 mg/dl respectively. The logistic regression evidenced that positive glucometer results was associated with age (> 25 years), sex (male), high BMI (> 18.5), high BP (> 120/80) and occupation. The increasing prevalence of diabetes in young may have adverse effects on nation's health and economy. Data from this study highlights the importance of early screening, diagnosis and management of diabetes mellitus.
Shrivastava MP, Chaudhari HV, Dakhale GN
… +3 more, Hiware SK, Solanke BP, Shinde A
J Indian Med Assoc
· 2013 Feb · PMID 24003566
To assess the adverse drug reactions to non-steroidal anti-inflammatory drugs through spontaneous reporting system in IGGMC&H, Nagpur and to analyse them using WHO assessment scales, an observational, prospective study w...To assess the adverse drug reactions to non-steroidal anti-inflammatory drugs through spontaneous reporting system in IGGMC&H, Nagpur and to analyse them using WHO assessment scales, an observational, prospective study was conducted in patients attending outpatient department, inpatient department and casualty of IGGMC and H Nagpur from 1st June 2005 to 31st May 2009. Data were collected by spontaneous adverse drug reactions reporting system. Among 2639 total adverse drug reactions reported, 336 (12.7%) were due to non-steroidal anti-inflammatory drugs. The non-steroidal anti-inflammatory drugs most frequently implicated with adverse drug reactions were ibuprofen (51.19%) followed by diclofenac (27.08%), paracetamol (6.55%), nimesulide (6.25%), aspirin (5.95%). The most commonly affected organ systems were skin and appendages and gastro-intestinal system. Maculopapular rashes were the most frequent skin Involvement. Non-steroidal anti-inflammatory drugs are the most frequently used drugs. As they are commonly associated with adverse drug reactions, their limited and careful use is needed. Considering their prominent role in therapeutics, close clinical observations are very important in minimising adverse drug reactions and demands need for vigilant surveillance of adverse drug reactions in patients, receiving established as well as newer non-steroidal anti-inflammatory drugs.
To analyse various cough and cold formulations available in the Indian market and to study their pharmacological rationale and cost effectiveness, a cross-sectional, observational study was carried out for evaluation of...To analyse various cough and cold formulations available in the Indian market and to study their pharmacological rationale and cost effectiveness, a cross-sectional, observational study was carried out for evaluation of the drugs listed in Current Index of Medical Specialities (CIMS) India, September 2010.The formulations were assessed for their total number, type of dosage form, number of constituents in each formulation, their pharmacological group and rationality. The total daily cost and its association with type of dosage form was analysed. Out of a total 1297 preparations evaluated, 94% were fixed dose combination. The mean number of constituents was 3.20 +/- 1.03. Liquid oral formulations were largest in number (64.4%). The formulations contained various antitussives (30.30%), expectorants (33.92%), antihistamines (71.09%), mucolytics (35.62%), decongestants (56.28%), bronchodilators (16.81%) and analgesics/antipyretics (31.30%). None of the preparation was listed in the Model list of Essential Medicines, WHO (March 2011) under section 25 of "Medicines acting on the respiratory tract". Only 2% of the preparations had pharmacological rationale for their use in cough and common cold; 9.6% were containing more than one ingredient of the same pharmacological group and 6.85% were containing both antitussive and expectorant having opposing action. Highest number of preparations (36.85%) was having cost of therapy of Rs 6-10 per day. Liquid oral dosage forms had significantly higher cost than solid dosage form (p < 0.0001) and topical nasal dosage forms had significantly higher cost than liquid (p < 0.03) and solid (p < 0.001) dosage forms. It is conducted that various cough and cold medicines available in Indian market lacked therapeutic rationale for their use, leading to wasteful expenditure.
Perinatal autopsy detects the cause of death and also finds the various types of congenital malformation involving one or more than one system. Congenital malformations are one of the leading causes of perinatal deaths a...Perinatal autopsy detects the cause of death and also finds the various types of congenital malformation involving one or more than one system. Congenital malformations are one of the leading causes of perinatal deaths and infant mortality. In the present study various visceral malformations were detected in perinatal autopsies and categorised them systemwise. The prospective study was conducted during the period of June 2007 to May 2009 consisting of 32 cases. Out of 32 perinatal deaths studied, 30 were stillborn and in 2 there were early neonatal deaths. In each case, an attempt was made to find out the congenital malformation in perinatal deaths and clinicopathological correlation was attempted after a detailed postmortem and histopathological study. Congenital malformations were seen in 10 cases which accounted for 31.2% of perinatal deaths. A total of 64 congenital malformations were observed in 10 cases. Malformations of the alimentary system (20.31%) were most common followed by genito-urinary system (18.75%), musculoskeletal system (17.18%) and central nervous system (9.37%). There were other 22 congenital anomalies. Two cases of harlequin icthyosis and one case each of Meckel Gruber syndrome, sirenomelia and twin reverse arterial perfusion syndrome were also seen. In many of the perinatal deaths, internal malformations were not suspected clinically. Thus, autopsy is an invaluable tool for detecting visceral malformations, adding to the clinical diagnosis and counselling the parents for subsequent pregnancy.
Juyal A, Variyani A, Sharma SC
… +2 more, Chauhan V, Maheshwari R
J Indian Med Assoc
· 2013 Feb · PMID 24003563
This prospective study was carried out in the orthopaedic department of a medical college to evaluate the accuracy of clinical diagnosis by knee arthroscopy. The reliability of clinical assessment (history and physical e...This prospective study was carried out in the orthopaedic department of a medical college to evaluate the accuracy of clinical diagnosis by knee arthroscopy. The reliability of clinical assessment (history and physical examination) was determined by comparing the initial pre-operative diagnosis with the postoperative diagnosis as determined by arthroscopy. The study group included 50 patients (50 knees) scheduled for arthroscopic surgery for suspected internal derangements of knees. The primary pre-operative diagnosis was fully correct in 16 cases (32%), partially correct in 16 cases (32%), and incorrect in 18 cases (36%), with an overall accuracy of 81%, sensitivity 82% and specificity 62%. The most common pre-operative diagnosis was medial meniscal tear and anterior cruciate ligament tear. The results of clinical assessment were comparable to the published reports. Though the present study suggests that the diagnostic value of arthroscopy is higher than clinical examination but it also makes it apparent that the two techniques complement each other and are more accurate when taken together than individually.