The diagnostic criteria for cystic fibrosis require the presence of 1 or more typical clinical features, a family history of cystic fibrosis, or a positive newborn screening test, plus laboratory evidence of the cystic f...The diagnostic criteria for cystic fibrosis require the presence of 1 or more typical clinical features, a family history of cystic fibrosis, or a positive newborn screening test, plus laboratory evidence of the cystic fibrosis transmembrane conductance regulator dysfunction. However the present case was an adopted baby with persistent pneumonia since birth, his health had been deteriorating rapidly. He was becoming very listless, malnourished, and the whole family had lost all hope of the baby's survival. Diagnosis early and effective management resulted in the baby being discharged after 15 days of hospitalisation with an improvement in clinical condition and increase in weight of the baby. We would like to stress on the fact that children who present with recurrent wheezing in combination with failure to thrive must be iInvestigated for cystic fibrosis in the initial workup.
Congenital malaria is the least known manifestation of malaria and a much neglected area of research. Most of the existing information is limited to case reports in children born to non-immune women. Congenital malaria c...Congenital malaria is the least known manifestation of malaria and a much neglected area of research. Most of the existing information is limited to case reports in children born to non-immune women. Congenital malaria can be acquired by transmission of parasitised maternal erythrocytes across the placenta due to microdamage. Congenital malaria has been documented for many years but it was previously thought to be uncommon especially in indigenous populations. Many gaps in knowledge remain. There is a need of considering congenital malaria as differential diagnosis even in low endemic areas, especially in countries where there is social practice of moving the pregnant woman to her native place for childbirth, which may be endemic for malaria. Physicians should judge each case individually, considering such factors as reliability of follow-up and access to medical care and advice accordingly.
Talikoti AT, Dinesh K, Deepak VD
… +2 more, Nanda A, Somasekharam P
J Indian Med Assoc
· 2013 Oct · PMID 24968500
Endotracheal intubation is sine quo non for safe conduct of general anaesthesia. Pregabalin, an anticonvulsant drug is being studied for control of haemodynamic response to laryngoscopy and intubation. Some authors have...Endotracheal intubation is sine quo non for safe conduct of general anaesthesia. Pregabalin, an anticonvulsant drug is being studied for control of haemodynamic response to laryngoscopy and intubation. Some authors have found that pregabalin 150 mg orally attenuates the haemodynamic response to laryngoscopy. The purpose of the present study was to compare injection lignocaine (preservative free) i.v. and oral pregabalin for attenuation of haemodynamic response to laryngoscopy and intubation. The study consisted of 60 patients of ASA class I, divided into two groups of 30 each. Group I received injection lignocaine (preservative free) 1.5 mg/kg i.v., 3 minutes prior to laryngoscopy. Group II received oral pregabalin 150 mg capsule 1 hour prior to induction. The parameters recorded were heart rate, systolic BP, diastolic BP, mean BP and rate pressure product was calculated at baseline before induction and at 1, 3 and 5 minutes following laryngoscopy. The data obtained was analysed using unpaired "t" test. Lignocaine was more effective than pregabalin in controlling the heart rate at one minute following laryngoscopy. Pregabalin was more effective than lignocaine in controlling diastolic blood pressure at 1, 3 and 5 minutes following laryngoscopy, and mean arterial pressure at land 3 minutes following laryngoscopy. There was no difference between two groups when systolic BP and rate pressure product were compared. Lignocaine (preservative free) thus, exerts better control over heart rate and pregabalin exerts better control over diastolic and mean blood pressure following laryngoscopy.
To study the role of oral misoprostol in the management of Incomplete abortion, 98 women with a clinical diagnosis of incomplete abortion and the uterine size < 12 weeks were recruited for this study. A single dose of 60...To study the role of oral misoprostol in the management of Incomplete abortion, 98 women with a clinical diagnosis of incomplete abortion and the uterine size < 12 weeks were recruited for this study. A single dose of 600 microg of oral misoprostol was given to these patients. If abortion was clinically complete at follow-up after 3 days, the woman was released from the study. If it was still incomplete, immediate suction and evacuation was performed. Percentage of successful abortion (success defined as no secondary surgical intervention needed) and adverse effects were observed. Success was achieved in 96 (97.96%) out of 98 cases. In 32.6% cases adverse effects were found. Misoprostol used orally in the management of incomplete abortion, forms an alternative treatment modality, particularly in resource poor set up. It is highly effective with little adverse effects.
Sudhir U, Kumar AT, Srinivasan G
… +2 more, Kumar RV, Punith K
J Indian Med Assoc
· 2013 Oct · PMID 24968498
Seizures are frequent in patients over 60 years. Often, there is an underlying causative disorder, which aids in the treatment of these patients. To study the aetiological profile of seizures in patients aged 60 years an...Seizures are frequent in patients over 60 years. Often, there is an underlying causative disorder, which aids in the treatment of these patients. To study the aetiological profile of seizures in patients aged 60 years and above, 100 elderly patients with seizures, attending medicine or neurology OPD or admitted under these departments for seizures were studied. A complete history and detailed examination followed by biochemical, haematological, serological tests and neuro-imaging were obtained. Additional studies including cerebrospinal fluid analysis, and toxicology tests were done as and when indicated. There was no gender difference noted in the type or in the aetiology of the seizures. Stroke (31%) was the most common cause of seizures, followed by metabolic derangements (19%). In 24% of the patients, no cause could be found. Infection caused seizures in a significant number of patients when compared to other studies in the literature. Generalised tonic clonic seizure was the most common type of seizure, again a finding differing from many previous studies. The fact that the population size was smaller and the majority of the patients were in the "younger elderly" ie, age group of < 75 years could have contributed to the differing result. The commonest aetiology of seizure in the elderly was found to be cerebrovascular accident and a significant number of patients were found to have an infectious cause for their seizures.
Viveki RG, Halappanavar AB, Joshi AV
… +2 more, Pujar K, Patil S
J Indian Med Assoc
· 2013 Oct · PMID 24968497
A new trend of admitting more and more senior citizens hailing from the Indian middle class background to old age homes is being observed in recent times. The objectives of this study were to study sociodemographic dimen...A new trend of admitting more and more senior citizens hailing from the Indian middle class background to old age homes is being observed in recent times. The objectives of this study were to study sociodemographic dimensions and common health problems of inmates of old age homes and to know various reasons for their admissions and their leisure time activities in old age homes. The present cross-sectional study was conducted during March and April 2010 in 4 different old age homes in and around Belgaum city, North Karnataka, by interviewing the inmates of old age homes using predesigned, pretested, structured questionnaire followed by thorough clinical examination and haemoglobin estimation by Sahli's method. The collected data was compiled and analysed using SPSS software version 14. Out of 73 elderly, 54 were females (74.0%). Majority were in the age group of 61-70 years (50.7%) and 56 were belonging to nuclear family (76.7%). Thirty-nine inmates were widow/widower (53.4%) and 42 were having no children (57.5%). Forty-seven inmates were admitted as there was nobody to take care of them (64.4%). Common health problems observed were locomotive/joint and muscle disorders (35.6%), hypertension (34.2%), diabetes mellitus (26.0%), respiratory disorders (23.3%), hearing loss (21.9%) etc. Forty-nine were having normal body mass index (67.1%) while 19.2% were underweight. Majority were having haemoglobin levels between 10-12 g/dl (58.9%). Old age homes definitely will enable the elderly to remain sociopsychologically healthy and lead active lives if effective medical and emotional support is given.
Philip NP, Singla SC, Chakravarti R
… +2 more, Singh Y, Toppo JN
J Indian Med Assoc
· 2013 Oct · PMID 24968496
To compare the diagnostic sensitivity of diffusion weighted images with that of conventional magnetic resonance imaging (MRI) techniques in patients presenting within 24 hours of onset of symptoms of acute cerebral ischa...To compare the diagnostic sensitivity of diffusion weighted images with that of conventional magnetic resonance imaging (MRI) techniques in patients presenting within 24 hours of onset of symptoms of acute cerebral ischaemia, a one year prospective study was conducted in the department of radiodiagnosis of Christian Medical College and Hospital, Ludhiana. Patients with signs and symptoms of cerebral ischaemia, presenting within 24 hours of onset were included in the study. MR imaging was performed with 1.5 Tesla system (Signa; GE Medical systems) with echoplanar capability. A total of 40 patients were studied, with majority (80%) in the 40-80 years age group; 52% of patients presented to the hospital after 12 hours of symptom onset. Eight patients presented within three hours of symptoms. In this group of 8 patients conventional MR was positive in only 5 patients (62.5%) while diffusion weighted imaging was positive in all 8 patients. The time of presentation is a crucial factor in determining the therapeutic options for a patient with stroke. Diffusion weighted imaging is more sensitive than conventional MRI in detecting cerebral ischaemic changes in patients presenting less than 24 hours from the onset of symptoms.
Endometrium is the mucosal layer of uterus. Throughout the reproductive age endometrium undergoes cyclical changes during each lunar month to prepare the uterus for implantation. Endometrium proliferates and regenerates...Endometrium is the mucosal layer of uterus. Throughout the reproductive age endometrium undergoes cyclical changes during each lunar month to prepare the uterus for implantation. Endometrium proliferates and regenerates during menstrual cycle. The most common cause of abnormal vaginal bleeding during a woman's reproductive years is dysfunctional uterine bleeding. Aim of this study was to compare endometrial thickness in regular and irregular menstrual cycles. A total of 111 patients with regular and irregular menstrual bleeding were selected. Age, duration of menstrual cycle, detailed menstrual history, endometrial thickness, difference in endometrial thickness before and after treatment were recorded. Endometrial thickness was recorded by ultrasonography. In patients with abnormal uterine bleeding, if endometrial thickness was less than 8mm first medical line of treatment was advised. If endometrial thickness was greater than 8mm, line of treatment depended on age and pattern of bleeding.
Chakrabarti S, Goswami BK, Paul PC
… +3 more, Sarkar S, Mondal S, Das S
J Indian Med Assoc
· 2013 Oct · PMID 24968494
There is a scarcity of clinical data in the field of aplastic anaemia from rural India. Present study was conducted in North Bengal Medical College to find out the clinicohaematological profile and the possible aetiologi...There is a scarcity of clinical data in the field of aplastic anaemia from rural India. Present study was conducted in North Bengal Medical College to find out the clinicohaematological profile and the possible aetiological factors in patients with aplastic anaemia. The study population (n = 83) included 21 children with male to female ratio 4.93:1. Weakness was present in all cases and pallor was present in 74.70% cases. Fever, bleeding episodes and localised infection were found in 55.42%, 48.19% and 27.71% cases respectively. There was no difference in clinical manifestations between children and adult except occurrence of fever (p = 0.0365). We identified possible aetiological factors in 32.53% cases as relevant drug intake in 10.84%, exposure to chemicals in 13.25% and hepatitis in 8.43% cases. We found low mean haemoglobin (3.81 +/- 1.71 g/dl), leucocyte and platelet (3.05 +/- 1.3 and 37.30 +/- 35 x 10(3)/cmm), neutrophil (30.28 +/- 21.76%) and high lymphocyte (67.27 +/- 22.50%) in peripheral blood. At the time of presentation, aplastic anaemia was moderate in 59.04% cases, severe in 48.19% cases and mild in 4.82% cases. We estimated the prevalence of aplastic anaemia in 4 districts of West Bengal including tea garden areas was 2.98/million populations per year. It was concluded that aplastic anaemia is a major non-malignant haematological disease in this part of India, and an increasing use of chemicals in agricultural and tea garden areas might be the responsible factor. Larger population based study is suggested.
Pregnancy is principally a phenomenon of maternal adaptation to the increasing demands of the growing foetus. Pregnancy causes many visible and invisible changes in human body and it represents one of the best example of...Pregnancy is principally a phenomenon of maternal adaptation to the increasing demands of the growing foetus. Pregnancy causes many visible and invisible changes in human body and it represents one of the best example of selective adaptation in terms of respiratory physiology. To evaluate the changes in dynamic pulmonary function tests in all three trimesters of pregnancy and compare the results between normal pregnant women (case group) and normal non-pregnant women (control group) and also to compare the results of the study with other studies, 50 subjects were selected and divided into two groups, non-pregnant women (n = 20, mean age = 26.5 +/- 2.69 years) and normal pregnant women of all three trimesters (n = 30, mean age = 24.84 +/- 3.00 years). Pulmonary function tests were done by medspiror. Significant decrease in all the parameters of pulmonary function tests like forced vital capacity, forced expiratory volume in one second, peak expiratory flow rate, maximum ventilation volume, were noticed in all trimesters of normal pregnant women as compared to normal non-pregnant women. The data suggest that there is alteration in pulmonary function tests in pregnant women. Continuous Monitoring of pulmonary function tests may prove to be of great value in maternal healthcare as cases of restriction and obstruction in lungs during pregnancy can be identified early and its deterioration can be prevented by proper management.
Chandla SS, Sood S, Dogra R
… +3 more, Das S, Shukla SK, Gupta S
J Indian Med Assoc
· 2013 Oct · PMID 24968492
There has been an increasing interest in pranayamic breathing exercises which have been known to improve the quality of life. Present study was conducted to find out the effect of Bhastrika and Anulom Vilom Pranayam and...There has been an increasing interest in pranayamic breathing exercises which have been known to improve the quality of life. Present study was conducted to find out the effect of Bhastrika and Anulom Vilom Pranayam and yogasana on heart rate variability, general well being, cognition and anxiety levels of the medical students. Ninety-six medical students were randomly divided into two groups. One group performed Bhastrika and Anulom Vilom Pranayam and the second Suryanamaskar for six weeks. The subjects were made to fill in PGI memory scale, Hamilton- anxiety scale and psychological general well being schedule and recording of heart rate variability parameters was done, before and after six weeks of pranayam practice. The results showed highly significant increase in high frequency (HF) components of heart rate variability and decrease in low frequency (LF) components and LF/HF inthe group practising pranayam. There was also highly significant improvement of cognition, general well being and anxiety as shown by the PGI memory scale, Hamilton- anxiety scale and psychological general well being schedule scores in this group. In the yogasana group no significant changes were observed in the heart rate variability, cognition and anxiety although psychological general well being schedule scores significantly improved after six weeks practice of yogasana. The study shows that practice of slow breathing type of pranayam for six weeks improves cognition, anxiety and general well being and Increases the parasympathetic activity. Whereas there was no effect of the yogasana on the above parameters except improvements in the general well being.
Jana TK, Giri S, Roy H
… +3 more, Kar M, Santra S, Das S
J Indian Med Assoc
· 2013 Oct · PMID 24968491
As in many cases long bones get available in fragments, so gender determination from short as well as robust bones like patella paid importance now-a-days. So far the literature reviewed such records are little in Indian...As in many cases long bones get available in fragments, so gender determination from short as well as robust bones like patella paid importance now-a-days. So far the literature reviewed such records are little in Indians especially from West Bengal. The present study is aimed to demonstrate the gender differentiability of different patellar anthropometric parameters viz, length, breadth, surface areas of articular surfaces, patellar Index, etc, amongst population of northern part of West Bengal in India. A total 46 intact patellae of which 23 belonged to males and 23 belonged to females, were taken out from human corps of 20 to 50 years of age group, brought for postmortem in the forensic department, NB Medical College, Sushrutanagar. Patellar vertical length, width, different measurements of the individual articular facet, angulations at the vertical ridge, patellar index and total surface area of the posterior surface and articular part, etc, were measured. In males patellar height, diameter, index, dry weight, articular surface area would be more than 3.75cm, 4.1cm, 108.23, 18g and 11.67cm2 respectively and values less than those will be for females. But in contrary angulation at the vertical ridge between medial and lateral articular facets will be more than 119.28 degrees in females, and less than for males. The results of this study revealed that we can determine sex of North Bengal population just by using the patellar measurements, when other long bones, skull and pelvis get not available, or fragmented. But there remains a scope for multicentric study throughout the India to validate the fact.
Isolated inferior oblique muscle palsy is the least common of all extra-ocular muscle palsies and very few reports are available in the literature. It can present a formidable therapeutic challenge to the ophthalmologist...Isolated inferior oblique muscle palsy is the least common of all extra-ocular muscle palsies and very few reports are available in the literature. It can present a formidable therapeutic challenge to the ophthalmologist, as treatment options need to be titrated on an individual basis. A patient of 60 years old of idiopathic right inferior oblique palsy who underwent an adjustable superior rectus recession in his left eye, with a satisfactory surgical outcome and symptomatic resolution of diplopia is reported.