Journal Of The Indian Medical Association[JOURNAL]
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200 papers
Acute presentation of idiopathic thrombocytopenic purpura in postmenopausal woman.
Goyal S, Longjam G, Maheshwari S … +1 more , Swaroop A
J Indian Med Assoc · 2013 Jun · PMID 24761502
A healthy 50 years old woman who had no past history of bruising or menometrorrhagia was admitted with complaints of cutaneous petechiae all over the body for 5 days and gum bleeding for 3 days. She presented with isolat...
A healthy 50 years old woman who had no past history of bruising or menometrorrhagia was admitted with complaints of cutaneous petechiae all over the body for 5 days and gum bleeding for 3 days. She presented with isolated thrombocytopenia, an otherwise unremarkable peripheral smear and physical examination showed evidence of bleeding consistent with low platelet count. After excluding other causes of thrombocytopenia, diagnosis of idiopathic thrombocytopenic purpura was made. She was given intravenous steroids and marked improvement in signs and symptoms was noted.
Gastric xanthoma with hyperplastic polyp: a case report.
Ashwini BR, Kiran T, Prakash G … +1 more , Radhika N
J Indian Med Assoc · 2013 Jun · PMID 24761501
Gastric xanthoma is uncommon lesion with a variably reported frequency. Hyperplastic polyps are commonest epithelial polyps in stomach. A rare case of simultaneous presence of xanthoma with hyperplastic polyp is reported...
Gastric xanthoma is uncommon lesion with a variably reported frequency. Hyperplastic polyps are commonest epithelial polyps in stomach. A rare case of simultaneous presence of xanthoma with hyperplastic polyp is reported. A 70-year-old female presented with dyspepsia and heartburn. Upper gastro-intestinal endoscopy showed multiple sessile small whitish polyps in stomach. Histopathological examination of the polyps-showed features of xanthoma with hyperplastic polyp in the mucosa with areas of intestinal metaplasia and occasional H pylori. There was no evidence of malignancy in the present case.
Clinical profiles and symptoms of childhood depression.
Aravind VK, Krishnaram VD
J Indian Med Assoc · 2013 Jun · PMID 24761500
The identification of depression poses significant clinical challenges to physicians, parents and teachers. Symptoms of depression may differ from those of the adult depression. Clinical depression varies in the nature a...
The identification of depression poses significant clinical challenges to physicians, parents and teachers. Symptoms of depression may differ from those of the adult depression. Clinical depression varies in the nature and intensity of its presenting symptoms. It may present with the cardinal symptoms of major depressive disorder. It often goes unidentified and undiagnosed when it presents as masked depression or depressive equivalents.
Myocardial infarction increases progressive visual field defects in well treated early primary open angle glaucoma--a prospective case control study.
Mondal L, Baidya K, Choudhury H … +1 more , Roy R
J Indian Med Assoc · 2013 Jun · PMID 24761499
The purpose of the study was to evaluate the progression of glaucomatous field damage in patients with stable primary open angle glaucoma after an attack of myocardial infarction. In this case control study, 62 open angl...
The purpose of the study was to evaluate the progression of glaucomatous field damage in patients with stable primary open angle glaucoma after an attack of myocardial infarction. In this case control study, 62 open angle glaucoma patients were selected and regularly followed up. Among 62 patients, 9 had an attack of myocardial infarction. The intra-ocular pressure and visual field progression of both the groups (myocardial infarction versus no myocardial infarction) were analysed. Three (33.3%) out of 9 patients who had suffered from myocardial infarction showed progressive visual field loss whereas only 9 (16.9%) out of 53 patients who did not suffer from myocardial infarction, showed progressive field changes. Both the groups had stable target intra-ocular pressure between 14 and 16 mm Hg. Myocardial infarction may adversely influence the progression of primary open angle glaucoma which is suspected to result from ischaemia induced neuronal loss and only control of intraocular pressure is not the only solution. We have to look for other drugs that prevents ischaemia induced neuronal damage.
Latex agglutination test (LAT) for the diagnosis of typhoid fever.
Sahni GS
J Indian Med Assoc · 2013 Jun · PMID 24761498
The efficacy of latex agglutination test in the rapid diagnosis of typhoid fever was studied and the result compared with that of blood culture. This study included 80 children suffering from typhoid fever, among which 4...
The efficacy of latex agglutination test in the rapid diagnosis of typhoid fever was studied and the result compared with that of blood culture. This study included 80 children suffering from typhoid fever, among which 40 were confirmed by blood culture isolation and 40 had possible typhoid fever based on high Widal's titre (a four-fold rise in the titre of antibody to typhi "O" and "H" antigen was considered as a positive Widal's test result). Eighty children, 40 with febrile illness confirmed to be other than typhoid and 40 normal healthy children were used as negative controls. The various groups were: (i) Study group ie, group I had 40 children confirmed by culture isolation of Salmonella typhi(confirmed typhoid cases). (ii) Control groups ie, (a) group II with 40 febrile controls selected from paediatrics ward where cause other than S typhi has been established, (b) group III with 40 afebrile healthy controls that were siblings of the children admitted in paediatric ward for any reason with no history of fever and TAB vaccination in the last one year, and (c) group IV with 40 children with high Widal's titre in paired sera sample. Widal's test with paired sera with a one week interval between collections were done in all 40 patients. Latex aggtutination test which could detect 900 ng/ml of antigen as observed in checker board titration, was positive in all 40 children from group I who had positive blood culture and in 30 children from group IV who had culture negative and had high Widal's titre positive. Latex agglutination test was positive in 4 children in group II and none in group III. Using blood culture positive cases as true positive and children in groups II and III as true negative, the test had a sensitivity of 100% and specificity of 96%. Latex agglutination test was found to be significantly sensitive (100%) and specific (96%) and could detect 75% more cases in group IV (possible typhoid cases). Thus latex agglutination test can be used for rapid diagnosis of typhoid fever though it cannot replace conventional blood culture required for isolation of organism to report the antibiotic sensitivity.
Distribution of certain risk factors among dyslipidaemic patients, morbid with first episode coronary heart disease.
Vinod RK, Shashikala M, Suresh KP
J Indian Med Assoc · 2013 Jun · PMID 24761497
The objectives of the study were to determine dyslipidaemia prevalence in first episode coronary heart disease cases and to determine the pattern of distribution of risk factors in this temporal relationship. This hospit...
The objectives of the study were to determine dyslipidaemia prevalence in first episode coronary heart disease cases and to determine the pattern of distribution of risk factors in this temporal relationship. This hospital based retrospective cohort study was conducted at Basaveshwara Teaching Hospital, Gulbarga, during January 2012. Data for the 3 year period (January 2005-December 2007) were collected from the case sheets of cardiac care unit admissions. Out of the 1,373 admissions to the cardiac care unit over the 36 months period, 462 case sheets were examined as these were the ones with first episode coronary heart disease aetiology. Also, lipid profile was available for 102 patients only and hence they were included in the study (n = 102). Only first episode coronary heart disease cases were considered. The labelling of dyslipidaemia was done according to the National Cholesterol Education Program Adult Treatment Panel III guidelines. Statistical analysis was done using Fisher-Exact, Chi-square and other appropriate tests. Dyslipidaemia was present in 67.6% of first episode coronary heart disease cases. Age, sex and occupational profiles were enumerated and cross-tabulated to examine their influence on dyslipidaemia. In this study, increasing age profile did not show an association with the propensity towards developing an abnormal lipid profile. Males showed a greater predisposition towards developing dyslipidaemia (70.8%). With respect to occupation, males involved in semi-skilled labour had a higher degree of lipid profile abnormality (87.5%). Dyslipidaemia among working women was higher (75%) when compared to housewives (40%). This association was found to be statistically significant (p = 0.025). History of diabetes, hypertension, alcohol and smoking habits were also considered for the analysis. Heart disease patients with history of diabetes showed a high prevalence of dyslipidaemia (100%), the association being statistically significant (p = 0.008). Lipid profiling among hypertensives showed an aberration, wherein the prevalence of an abnormal profile was lower (54.5%). This association was found to be statistically significant (p=0.05). The influence of alcohol consumption on lipid profile showed an unequivocal association in this study (63.6%), when compared with patients who did not consume alcohol (69.6%). However, an association for dyslipidaemia was forthcoming among smokers (73.7%). This study shows significant association of dyslipidaemia with diabeties, history of alcohol consumption and the working profile of a woman.
Study of C-reactive protein and C3 complement as acute phase reactants in unstable angina.
Sharma B, Gupta B, Sharma DK … +1 more , Talib VH
J Indian Med Assoc · 2013 Jun · PMID 24761496
Prevalence rates of coronary artery disease are reported to be very high in Asian Indians. Traditional risk factors alone fail to explain the high rates of coronary artery disease in Indians. Acute phase reactants C-reac...
Prevalence rates of coronary artery disease are reported to be very high in Asian Indians. Traditional risk factors alone fail to explain the high rates of coronary artery disease in Indians. Acute phase reactants C-reactive protein and C3 in Indian subjects with unstable angina were evaluated and compared them with suitable controls to test the hypothesis that a relationship exists between acute phase reactants and unstable angina. Forty cases of unstable angina and forty suitable controls were enrolled for the study. Cases of unstable angina had significantly increased level of CRP as compared to control group (p = 0.01098). Statistically significant difference was found between case and control groups in TLC (p = 0.0037) and ESR (p = 0.0368), TLC and ESR being more in case group as compared to control group. C-reactive protein was significantly correlated with TLC, ESR and C3 in case group and TLC and ESR in control group. C3 was significantly correlated with all the other three inflammatory markers. C-reactive protein, TLC and ESR in case group while no correlation was observed with any variable in control group. The present study concludes that a relationship exists between acute phase reactants studied and unstable angina.
Peripheral neuropathy in diabetes.
Majumder A, Chatterjee S, Maji D
J Indian Med Assoc · 2013 Jun · PMID 24761495
Peripheral neuropathy is common complication of diabetes. The prevalence of peripheral neuropathy among diabetic patients on the basis of loss of vibration sensation had been studied. Detailed clinical history of each pa...
Peripheral neuropathy is common complication of diabetes. The prevalence of peripheral neuropathy among diabetic patients on the basis of loss of vibration sensation had been studied. Detailed clinical history of each patient including age, gender, duration of diabetes, foot ulcer and biothesiometry was recorded in 211 diabetic patients between 20 and 80 years of age. It was observed that all patients under 30 years age (n = 8) felt vibration below 15 volts (no risk zone); 77% (24 out of 31) of the patients in the age group of 30-39 years were in the no risk zone, and 23% (n = 7) had mild peripheral neuropathy. Sixty per cent of the patients between 40 and 50 years (n = 44) were in the no risk zone, while 32% (n = 24) had mild peripheral neuropathy, 5% (n = 4) had moderate neuropathy and 3% (n = 2) had severe peripheral neuropathy. Amongst patients above 50 years of age, 31% (n = 31) were in no risk zone, 34% (n = 34) had mild peripheral neuropathy, 22% (n = 20) had moderate peripheral neuropathy and 13% (n = 13) had severe peripheral neuropathy. Of the patients with diabetes for less than 5 years, 58% had no neuropathy, and only 3% had severe neuropathy. Of the patients with diabetes for 5 to 15 years, 50% had no neuropathy, 30% had mild, and 10% had severe peripheral neuropathy. When patients with diabetes for over 15 years were studied, only 6% had no neuropathy and 19% had severe peripheral neuropathy. The study re-establishes that the severity of peripheral neuropathy increases with age and vibration perception decreses progressively with increased duration of diabetes. Vibration perception threshold testing helps to identify the high risk subjects who require special counselling and education to protect their feet.
Evaluation of oxidative stress and anti-oxidant status in essential hypertension.
Hendre AS, Shariff AK, Patil SR … +3 more , Durgawale PP, Sontakke AV, Suryakar AN
J Indian Med Assoc · 2013 Jun · PMID 24761494
The present study was planned to access the role of oxidative stress and anti-oxidant status in essential hypertension. Malondialdehyde is one of the by-products of lipid peroxidase and so extent of lipid peroxidation wa...
The present study was planned to access the role of oxidative stress and anti-oxidant status in essential hypertension. Malondialdehyde is one of the by-products of lipid peroxidase and so extent of lipid peroxidation was measured by estimating malondialdehyde levels, nitrite concentration was used as an index of nitric oxide synthesis and anti-oxidant status was measured in terms of total antioxidant capacity. One hundred and eighty cases with essential hypertension and 60 volunteers as healthy controls were selected for the study. The subjects under study were grouped as pregeriatric (35-50 years) and geriatric (51-65 years). These cases were further subdivided into group I (mild), group II (moderate) and group III (severe), depending upon the levels of blood pressure. The study results showed statistically significant increased levels of serum malondialdehyde in all the groups of essential hypertensive patients when compared to that of healthy controls (p < 0.001), whereas levels of serum nitric oxide and total anti-oxidant capacity were significantly decreased in all groups of essential hypertensive patients when compared to those of controls (p < 0.001). These clear findings of the present study focuses the attention towards an alteration in the status of oxidants and anti-oxidant parameters indicating an impact of free radical action in the pathogenesis of essential hypertension.
World Environment Day and its impact on pollution-free environment.
Ghoshal AK
J Indian Med Assoc · 2013 Jun · PMID 24761493
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India moving from iodine deplete to replete status--whether rural or urban.
Kaur J, Gupta S, Jaswal S … +2 more , Kaur H, Aggarwal N
J Indian Med Assoc · 2013 Mar · PMID 24592769
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Catastrophic presentation of lupus vasculitis in a young female.
Acharya S, Singh D, Gupta A … +2 more , Amale A, Mahajan SN
J Indian Med Assoc · 2013 Mar · PMID 24592768
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Swine flu H1N1--control it or it will go out of control.
Garg M
J Indian Med Assoc · 2013 Mar · PMID 24592767
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Case report of a small outbreak of epidemic dropsy.
Dhayal GL, Agarwal H, Mathur A … +7 more , Mathur S, Kishoria N, Jain S, Choudhary R, Sharma R, Bishnoi S, Mathur S
J Indian Med Assoc · 2013 Mar · PMID 24592766
Epidemic dropsy results from use of edible oils adulterated with Argemone mexicans oil. We report of the disease in a family caused due to sesame oil adulteration. Peculiarity to report this disease is that it occurred d...
Epidemic dropsy results from use of edible oils adulterated with Argemone mexicans oil. We report of the disease in a family caused due to sesame oil adulteration. Peculiarity to report this disease is that it occurred due to consumption of contaminated sesame seeds oil instead of mustard oiland secondly epidemic dropsy is also not very common in western Rajasthan. Five members of a family presented to the hospital with history of generalised body swelling, itching and marked cutaneous flush. Few of them also have shortness of breath, dry cough, palpitation, diarrhoea, vomiting and haemoptysis. On physical examination rashes, pallor and signs of cardiac failure were present in few patients. None of them had neurological symptoms and signs. After multiple interviews history of consumption of home made sesame seeds oil was explored in the family and the differential diagnosis of epidemic dropsy was made. Edible oil sample of the sesame seeds oil turned out to be positive for sanguinarine. Sanguinarine and dehydrosanguinarine are two major toxic alkaloids of Argemone oil, which cause widespread capillary dilatation, proliferation and increased capillary permeability. Leakage of the protein-rich plasma component into the extracellular compartment leads to the formation of oedema. There is no specific therapy. Removal of the adulterated oil and symptomatic treatment of congestive cardiac failure and respiratory symptoms, along with administration of anti-oxidants and multivitamins, remains the mainstay of treatment.
'Proptosis'--may be the only presenting feature of small cell lung cancer: a case report.
Ray A, Aich RK, Das C … +2 more , Sen P, Bhattacharaya J
J Indian Med Assoc · 2013 Mar · PMID 24592765
Orbital metastasis from solid tumours is an uncommon entity and lung, breast and nasopharyngeal cancers are the common sites causing such a metastasis. Proptosis as the only presenting feature without any symptom suggest...
Orbital metastasis from solid tumours is an uncommon entity and lung, breast and nasopharyngeal cancers are the common sites causing such a metastasis. Proptosis as the only presenting feature without any symptom suggesting lung as the primary site is very rare. Here is a report of a patient who presented with proptosis as the only complaint and subsequent investigations proved it to be due to small cell lung cancer metastasis and without metastatic spread to any other site.
Accidental carbon monoxide poisoning during yagya for faith healing--a case report.
Behera C, Millo TM, Jaiswal A … +1 more , Dogra TD
J Indian Med Assoc · 2013 Mar · PMID 24592764
A 20-year-old female and a 45-year-old male were found lying dead on the floor with frothand vomitus stain present over mouth, nose and face in a closed room. An earthen bowl with incomplete burnt woods, flowers, food ma...
A 20-year-old female and a 45-year-old male were found lying dead on the floor with frothand vomitus stain present over mouth, nose and face in a closed room. An earthen bowl with incomplete burnt woods, flowers, food materials, agarbati, etc, was also found lying near the body of the two deceased. The cause of death, established by autopsy and toxicological examination was carbon monoxide poisoning in both victims. The source of carbon monoxide was incomplete burnt woods used for yagya during puja (a faith healing practice) for bearing children.
Pulmonary nocardiosis--a rare case of pulmonary nocardiosis in an immunocompetent patient.
Makwana GE, Sinha M, Jain V … +1 more , Jaiswal A
J Indian Med Assoc · 2013 Mar · PMID 24592763
Nocardiosis is localised or disseminated infection caused by soil dwelling aerobic actinomycetes, which habitually enter through the respiratory tract. There has been an increase in the incidence of nocardia species infe...
Nocardiosis is localised or disseminated infection caused by soil dwelling aerobic actinomycetes, which habitually enter through the respiratory tract. There has been an increase in the incidence of nocardia species infections probably due to higher degree of clinical suspicion, aggressive diagnostic examinations, increased use of immunosuppressive treatments (chemotherapy agents and immunosuppressive agents) and the appearance of AIDS. Here we are presenting an atypical case of Nocardia asteroides in a 45-years-old immunocompetent female patient presenting with history of cough with scanty expectoration, haemoptysis and fever for 4 months. Clinical and radiological diagnostic consideration were tuberculosis and malignancy. Diagnosis of nocardiosis was confirmed microbiologically and the patient responded to cotrimoxazole.
Tuberculosis of upper dorsal spine causing respiratory distress due to tracheo-oesophageal compression: an unusual presentation.
Mehtani A, Jha A, Kanojia RK … +2 more , Sud A, Rath B
J Indian Med Assoc · 2013 Mar · PMID 24592762
A cold abscess causing tracheo-oesophageal compression is quite unusual. A case of a 5-year-old boy with caries spine of D3-D4 vertebrea with respiratory distress due to mediastinal cold abscess pressing over trachea is...
A cold abscess causing tracheo-oesophageal compression is quite unusual. A case of a 5-year-old boy with caries spine of D3-D4 vertebrea with respiratory distress due to mediastinal cold abscess pressing over trachea is being reported. Urgent costotransversectomy was done to decompress the cold abscess. There was immediate relief of airway compression which was evident from fall in airway pressure from 39 cm H2O to 29 cm H2O. The child was extubated on the 5th postoperative day and discharged on the 15th postoperative day in good condition.
Diabetes mellitus with pulmonary tuberculosis--a double trouble.
Kant S, Lata H, Natu SM … +2 more , Mishra AK, Verma NS
J Indian Med Assoc · 2013 Mar · PMID 24592761
Diabetic patients are often at a higher risk for developing several types of infections and infection does alter the handling of glucose by tissues. Pulmonary infections in diabetics are characterised by alteration in ho...
Diabetic patients are often at a higher risk for developing several types of infections and infection does alter the handling of glucose by tissues. Pulmonary infections in diabetics are characterised by alteration in host defence, in entire body and in the lung locally as well as in the function of respiratory epithelium and ciliary motility. Association between diabetes mellitus and pulmonary tuberculosis is well established, while the prevalence of tuberculosis is increased 4-5 times more among diabetics. Impairment of host defence plays an important role for changing the clinical, radiological and bacteriological presentation in diabetic patients. It is also reported by the various studies that hyperglycaemia favours the growth of tuberculosis bacilli. So the severity of tuberculosis appears more cirtical with the degree of hyperglycaemia and host defence activity. This overlap between the diabetic and tuberculosis epidemics could adversely affect global tuberculosis control efforts.
Tranexamic acid used before caesarean section reduces blood loss based on pre- and postoperative haemoglobin level: a case-control study.
Halder S, Samanta B, Sardar R … +1 more , Chattopadhyay S
J Indian Med Assoc · 2013 Mar · PMID 24592760
The objective of the study was to find out the efficacy and safety of tranexamic acid in reducing blood loss during and after the lower segment caesarean section based on pre- and postoperative haemoglobin level. A prosp...
The objective of the study was to find out the efficacy and safety of tranexamic acid in reducing blood loss during and after the lower segment caesarean section based on pre- and postoperative haemoglobin level. A prospective randomised, case-control, study was conducted on 100 women undergoing lower segment caesarean section. Fifty of them were given tranexamic acid immediately before the surgery and compared with 50 others to whom tranexamic acid was not given. Blood loss was measured up to two days. Haemoglobin level was estimated before caesarean section and two days after. Urine analysis, liver and renal functions were tested in both the groups. In this study, it was found that tranexamic acid reduced the quantity of blood loss from placental delivery to 2 days postpartum: 990 ml in the study group versus 1004 ml in the control group. The fall of haemoglobin was significantly less in the study group (1.214 g/dl) in comparision to control (1.7256 g/dl) (p < 0.0001). No complications or side-effects were reported in either group. No adverse neonatal outcome was also noted. Therefore tranexamic acid significantly reduced the amount of blood loss during and after the lower segment caesarean section and its use was not associated with any side-effects or complications. Tranexamic acid can be used safely and effectively in women undergoing lower segment caesarean section.
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