Journal Of The Indian Medical Association[JOURNAL]
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200 papers
Tuberculosis and anaesthesia.
Chandra A, Banavaliker JN, Bhatnagar A
J Indian Med Assoc · 2013 Mar · PMID 24592759
Anaesthesiologists and other healthcare workers have been at risk for nosocomial infection with tuberculosis for many years, however the advent of effective infection control techniques and the development of antibiotics...
Anaesthesiologists and other healthcare workers have been at risk for nosocomial infection with tuberculosis for many years, however the advent of effective infection control techniques and the development of antibiotics for Mycobacterium tuberculosis have decreased the risk of nosocomial infection. The risk of transmission of tuberculosis from patients to healthcare workers is a neglected problem in many developing and underdeveloped countries as they lack the resources to prevent nosocomial transmission of tuberculosis. Patients with active tuberculosis can present with problems related to tuberculosis or unrelated problems like trauma to anaesthetist for various surgeries. An attempt has been made to highlight the precautions to be taken and the risk that the anaesthesiologists are at while getting these patients operated. A detailed pre-operative examination and investigation is essential. The various drug interactions, side-effects of antituberculous drugs should be considered pre-operatively. The patients coinfected with HIV and tuberculosis have a higher risk of developing tuberculosis should be kept in mind.
Neuropsychiatric manifestations and their outcomes in chronic hypocalcaemia.
Maiti A, Chatterjee S
J Indian Med Assoc · 2013 Mar · PMID 24592758
Hypocalcaemia is an established cause of neurological and psychiatric disease with numerous clinical manifestations. The aim of the study was to determine the outcome of severe neuropsychiatric manifestations of chronic...
Hypocalcaemia is an established cause of neurological and psychiatric disease with numerous clinical manifestations. The aim of the study was to determine the outcome of severe neuropsychiatric manifestations of chronic hypocalcaemia after correction of calcium levels. Clinical and laboratory data of 22 patients seen between 1999 and 2009 were retrospectively analysed. Calcium, magnesium, phosphorus, albumin and parathormone values were measured in all cases. All patients except infants under one year of age had computed tomography (CT) scans of the head. Most patients (n = 19; 86%) presented with generalised tonic clonic convulsions while three had seizures with psychiatric manifestations. Movement disorders were present in 4 patients and one had candida meningitis. Nineteen of the 22 patients had primary hypoparathyroidism of which one had associated mucocutaneous candidiasis. One had pseudohypoparathyroidism and two had vitamin D deficiency. All patients improved with calcitriol and calcium treatment. Twelve of the 14 patients with convulsions could be taken off anticonvulsants. Hemiballismus disappeared in one patient and choreiform movements disappeared in one patient and dystonia in two patients. Psychiatric manifestations improved but did not disappear in the three patients who had them. Adult patients with seizures or neuropsychiatric manifestations should have calcium levels checked. Seizure disorders due to chronic hypocalcaemia had excellent prognosis on correction of serum calcium levels. Movement disorders improved markedly. Psychiatric manifestations did not improve substantially on correction of serum calcium levels.
Assessment of insulin resistance in non-diabetic hypertensives in Eastern India.
Pal J, Shrivastav A, Goswami D … +5 more , Mukhopadhaya JD, Karmakar PS, Sengupta P, Chatterjee S, Biswas NM
J Indian Med Assoc · 2013 Mar · PMID 24592757
To assess prevalence of insulin resistance in non-diabetic hypertensive patients in eastern part of India, a case-control study was undertaken among 112 patients of hypertension without diabetes mellitus or ischaemic hea...
To assess prevalence of insulin resistance in non-diabetic hypertensive patients in eastern part of India, a case-control study was undertaken among 112 patients of hypertension without diabetes mellitus or ischaemic heart disease and 76 age and sex matched controls. Anthropometric measurements (height, weight, waist circumference) were done and fasting blood sugar and fasting insulin levels were estimated. Among 112 patients, 50.9% (n = 57) have fasting hyperinsulinaemia, whereas in control population 12% had hyperinsulinemia (p < 0.001). Mean waist circumference was higher in hypertensive patients compared to control. No statistical difference of body mass index between cases and control found. In this study prevalence of fasting hyperinsulinaemia, considered as a surrogate marker for insulin resistance, was 50% in hypertensives. Body mass index was not associated with insulin resistance or hypertension.
Psychotherapeutic intervention with hypnosis in 554 couples with reproductive failure.
Vyas R, Adwanikar G, Hathi L … +1 more , Vyas B
J Indian Med Assoc · 2013 Mar · PMID 24592756
The objective of this study was to establish the efficacy of psychotherapeutic intervention including hypnotherapy in couples with "unexplained" reproductive failure. The study was based on a prospective clinical model s...
The objective of this study was to establish the efficacy of psychotherapeutic intervention including hypnotherapy in couples with "unexplained" reproductive failure. The study was based on a prospective clinical model set at a Trust Hospital. The couples with reproductive failure reported for treatment. Over a period of 28 years, 554 couples without any anatomical or physiological anomaly were studied. Psychotherapeutic intervention with indirect and direct hypnosis was added to the standard protocol for investigation and therapy of infertile couples. Several stressors were identified. Stress of barrenness was seen in 100% of women. Other stressors of marital life were identified. Hypnotherapy was targeted at general stress relief initially and, towards the specific stressor/s subsequently. The results were judged as success in terms of occurrence of pregnancy. The success rate was 71.67%. There could not have been a double blind study. However, 349/554 came after failing elsewhere. They had the same success rate ie, 70%. A persistent, unprecedented high success rate establishes that "unexplained" reproductive failure is psychodynamically triggered, is reversible with psychotherapy that includes hypnosis. The study explains causation in terms of psychosomatic stress. When that is alleviated with hypnotherapy, there are remarkable results.
Chest roentgenography in tuberculous cervical lymphadenopathy.
Bhattacharyya SK, Mandal P, Sarkar S … +3 more , Shamim S, Sit NK, Ghoshal AG
J Indian Med Assoc · 2013 Mar · PMID 24592755
The primary site of infection in tuberculous cervical lymphadenitis is lungs, from where bacilli reach gland through circulation. This study was done in the department of chest medicine, NRS Medical College, Kolkata, and...
The primary site of infection in tuberculous cervical lymphadenitis is lungs, from where bacilli reach gland through circulation. This study was done in the department of chest medicine, NRS Medical College, Kolkata, and was designed to find out chest x-ray abnormalities in apparently chest asymptomatic confirmed tuberculous cervical lymphadenitis without associate disease. The diagnosis of tuberculous cervical lymphadenitis was confirmed by fine needle aspiration cytology and/or smear for acid-fast bacillus, and chest x-ray (PA view) was done in all confirmed cases (n = 183). Normal chest x-ray was found in 132 cases (72.13%) and abnormal chest x-ray in 51 cases (27.87%). Pulmonary infiltration, the commonest radiological finding was detected in 32 cases (17.49%), hilar enlargement in 17 cases (9.29%), right paratracheal opacity in 2 (1.09%), obliteration of costophrenic angles in 3 cases (1.64%) and miliary mottling in one case (0.55%). Upper zonal predominance of lung parenchymal infiltrations was noted in 12.57% and right lung involvement in 16.39%. Single zone was affected in 9.84% cases and multiple zones were involved in 7.65% cases. We observed right hilar enlargement in 6.56%, left hilar lymphadenopathy in 4.37% and bilateral hilar lymphadenopathy in 2.73% cases. We concluded that routine chest x-ray PA view should be done in all tuberculous lymphadenitis before categorisation and starting of treatment.
Demographic profile and outcome analysis of a paediatric intensive care unit in a paediatric hospital in Kolkata.
Saha TK, Bose K, Sorkar UK … +1 more , Chatterjee MK
J Indian Med Assoc · 2013 Mar · PMID 24592754
A prospective observational study was performed to know the profile and outcome of paediatric Intensive care unit admitted patients. Paediatric intensive care unit admitted patients are mostly male (65%), suffering from...
A prospective observational study was performed to know the profile and outcome of paediatric Intensive care unit admitted patients. Paediatric intensive care unit admitted patients are mostly male (65%), suffering from critical respiratory (36%) and CNS diseases (35.4%). The survival at paediatric intensive care unit was 37.5% (25% were mechanically ventilated). Successful mechanical ventilation was done for 45 days. Major cause of mortality was sepsis with multiorgan dysfunction. Commonest organism Isolated from blood was Klebsiella pneumoniae (38%). Most Gram-negative organisms were sensitive only to carbapenems, some were sensitive only to polymyxin B. All staphylococci were resistant to vancomycin.
A cross-sectional study of prevalence of overweight and obesity among bus drivers and conductors of North-West Karnataka Road Transport Corporation (NWKRTC) in Belgaum Division, Belgaum.
Joshi BA, Joshi AV, Katti SM … +2 more , Mallapur MD, Karikatti SS
J Indian Med Assoc · 2013 Mar · PMID 24592753
Obesity has become a major chronic disorder affecting a large population more than any other disease in the world. To study the prevalence of overweight and obesity among bus drivers and conductors of North-West Karnatak...
Obesity has become a major chronic disorder affecting a large population more than any other disease in the world. To study the prevalence of overweight and obesity among bus drivers and conductors of North-West Karnataka Road Transport Corporation (NWKRTC) in Belgaum, and to compare the prevalence of overweight and obesity among them the study had been undertaken in Belgaum. Randomly selected 365 drivers and 370 conductors were personally interviewed using predesigned, pretested structured questionnaire. Physical examination was done to measure height, weight, waist circumference and hip circumference. Body mass index was measured to assess overweight and obesity. Waist circumference and waist hip ratio were used to assess central obesity. Summary figures like rates were calculated. Chi- square test was used to test the difference of prevalence between drivers and conductors. The study showed that in drivers 43.3% were overweight, 22.2% were obese and 23.8% were having a waist circumference > or = 102 cm. Among conductors 28.1% were overweight, 16.2% were obese and 18.1% were having a waist circumference of > or = 102cm.The prevalence of over-weight and obesity was high among drivers compared to conductors. Drivers were also more centrally obese than conductors.These differences were found to be statistically significant. Considering the high prevalence of overweight and obesity among drivers and conductors, necessary preventive measures need to be promoted.
International Women's Day.
Ghoshal AK
J Indian Med Assoc · 2013 Mar · PMID 24592752
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Gynandroblastoma: a rare ovarian tumour with an unusual clinical presentation.
Shanthala PR, Saldhana P, Upadhyaya K
J Indian Med Assoc · 2014 Feb · PMID 25935975
Gynandroblastoma is a rare ovarian mixed sex cord stromal tumour with very few cases reported in literature. These tumours are considered to be potentially malignant. Here a case of gynandroblastoma occurring in a 30-yea...
Gynandroblastoma is a rare ovarian mixed sex cord stromal tumour with very few cases reported in literature. These tumours are considered to be potentially malignant. Here a case of gynandroblastoma occurring in a 30-year female is reported who gave history of irregular menstrual bleeding and pain abdomen, there were no signs of virilisation. Computed tomography scan showed a left adnexal mixed density pelvic mass suggesting malignant ovarian tumour. Histological study revealed, the tumour was composed of mixed sex cord elements with predominantly intermediate differentiated Sertoli-Leydig cell component and a second adult type granulosa cell component.
Bilateral hip and knee arthroplasty in ochronotic arthritis.
J Indian Med Assoc · 2014 Feb · PMID 25935974
No effective medical treatment is available for the treatment of ochronotic arthritis which is a manifestation of long standing alkaptonuria. A patient of long standing alkaptonuria progressing to debilitating ochronotic...
No effective medical treatment is available for the treatment of ochronotic arthritis which is a manifestation of long standing alkaptonuria. A patient of long standing alkaptonuria progressing to debilitating ochronotic arthritis of both hip and knee jointswith severe deformities has been described. He was successfully treated with bilateral total hip and knee arthroplasty with an excellent four-year follow-up. The occurrence of severe osteoporosis in this condition and the importance of advocating surgery before development of severe deformities of the joints to improve the outcome of surgery has been highlighted in this article.
Biliary colic with dilated common bile duct: simple "sheepish" problem?
Ashdhir P, Sharma SS, Sharma G
J Indian Med Assoc · 2014 Feb · PMID 25935973
A 40-year-old man, resident of a rural area of Rajasthan state of India presented with recurrent biliary colic and fever since last 2 years. Examination was normal and investigations revealed a dilated common bile duct w...
A 40-year-old man, resident of a rural area of Rajasthan state of India presented with recurrent biliary colic and fever since last 2 years. Examination was normal and investigations revealed a dilated common bile duct with elevated alkaline phosphatase. Magnetic resonance cholangiopancreatography revealed a dilated biliary system without any evident cause. Patient was subjected to endoscopic retrograde cholangioancreatography and it demonstrated biliary dilatation with a linear filling defect in lower common bile duct, further sphinicterotomy was done and a live Fasciola hepatica was extracted using a biliary basket.
Proximal femoral focal deficiency revisited: a case report.
Mehta S, Rajaram S, Bhaskaran S … +1 more , Goel N
J Indian Med Assoc · 2014 Feb · PMID 25935972
Proximal femoral focal deficiency (PFFD) is a rare anomaly with an estimated incidence of < 0.2/ 10,000 births. The aetiology of PFFD is unknown though various agents have been implicated including anoxia, ischaemia, mec...
Proximal femoral focal deficiency (PFFD) is a rare anomaly with an estimated incidence of < 0.2/ 10,000 births. The aetiology of PFFD is unknown though various agents have been implicated including anoxia, ischaemia, mechanical or thermal injury. Herein is reported a case of a 22-year-old primigravida who delivered a baby with PFFD. This patient had developed high grade fever and had undergone ischiorectal abscess drainage at 7 weeks of gestation; maternal hyperthermia combined with anoxic injury might have been contributory factors in the causation of this disorder. So, it is of prudent importance to do prenatal targeted ultrasonography in patients who develop febrile illness in early pregnancy.
Disseminated intra-abdominal hydatid disease: surgical management.
Padhy BP
J Indian Med Assoc · 2014 Feb · PMID 25935971
Hydatid disease is a common parasitic disease of liver. Rupture of aliver hydatid into the peritoneal cavity, either spontaneous or iatrogenic (during surgery) leads to widespread dissemination and is a difficult problem...
Hydatid disease is a common parasitic disease of liver. Rupture of aliver hydatid into the peritoneal cavity, either spontaneous or iatrogenic (during surgery) leads to widespread dissemination and is a difficult problem to manage. Surgical management along with long term antihelminthic treatment offers the only hope for such cases. A case of disseminated intra-abdominal hydatid disease and its management has been reported.
Eosinophilic ascitis, an unusual presentation of eosinophilic gastro-enteritis.
Singh PS, Kushwaha SR
J Indian Med Assoc · 2014 Feb · PMID 25935970
Eosinophilic ascitis is probably the most unusual and rare presentation of eosinophilic gastroenteritis and is generally associated with the serosal form of eosinophilic gastroenteritis. It is characterised by eosinophil...
Eosinophilic ascitis is probably the most unusual and rare presentation of eosinophilic gastroenteritis and is generally associated with the serosal form of eosinophilic gastroenteritis. It is characterised by eosinophilic infiltration of any or all layers of the gut wall and may involve any segment of the gastro-intestinal tract. Peripheral eosinophilia may or may not be present. A case of eosinophilic ascitis that developed eight weeks postpartum in a 30-year-old young female has been reported. She presented with gastro-intestinal symptoms, ascitis and right sided pleurar effusion. Bood counts, ascitic fluid analysis and bone marrow examination showed evidence of eosinophilia. On high index of suspiscion, she was evaluated for eosinophilic gastroenteritis and treated with oral steroid (prednisolone). She responded well with satisfactory recovery.
Travelling in aeroplane with medical conditions.
Singal KK, Singal N, Sharma RG … +1 more , Gupta P
J Indian Med Assoc · 2014 Feb · PMID 25935969
Air travel has become so common these days that about one billion people travel in one year. A few number of the persons travelling by air have suffered or are suffering from one or more medical conditions which may incr...
Air travel has become so common these days that about one billion people travel in one year. A few number of the persons travelling by air have suffered or are suffering from one or more medical conditions which may increase risk to passenger himself. There may be additional risk to copassengers, crew of aircraft or safety of aircraft may be compromised. The present article evaluates different medical conditions from pregnancy to cardiovascular diseases in relation to the air travel.
Role of sentinel lymph node biopsy in early breast cancer.
Patel NS, Sisodia VK, Vadher SH
J Indian Med Assoc · 2014 Feb · PMID 25935968
Current literature has suggested that sentinel lymph node biopsy may replace axillary dissection as the nodal staging procedure of choice in early breast cancer. The aim of this study is to evaluate the effectiveness and...
Current literature has suggested that sentinel lymph node biopsy may replace axillary dissection as the nodal staging procedure of choice in early breast cancer. The aim of this study is to evaluate the effectiveness and accuracy of sentinel lymph node biopsy using methylene blue dye in predicting axillary nodal status in early breast cancer with clinically impalpable axillary lymph nodes. In the period between June 2005 and May 2009, 50 patients with early breast cancer and clinically impalpable axillary lymph nodes, underwent sentinel lymph node biopsy using methylene blue dye followed by completion of axillary dissection in the same setting after taking a written consent from the patients. Of the included 50 patients, sentinel lymph node biopsy was successful in 48 patients (96.0%). Accuracy of sentinel lymph node biopsy was 95.8%, sensitivity was 90.0%, false negative rate was 6.7%, negative predictive value was 93.3%.
Effect of anti-oxidant on tear film in patients suffering from diabetes mellitus.
Dutta S, Islam MN, Chakroborty S … +4 more , Mondal A, Bandopadhay R, Gayen S, Ranjan A
J Indian Med Assoc · 2014 Feb · PMID 25935967
To study the effects of anti-oxidant on tear film parameters in patients with diabetes mellitus, a total of 100 patients of diabetes mellitus with defective Schirmer test and tear film break-up time were enrolled in this...
To study the effects of anti-oxidant on tear film parameters in patients with diabetes mellitus, a total of 100 patients of diabetes mellitus with defective Schirmer test and tear film break-up time were enrolled in this study and they were given vitamin C (1000 mg/day) and vitamin E (400 IU/day) for 30 days. Schirmer test and tear break-up, time were re-examined after 1 month. There was significant improvement in values for Schirmer test (p < 0.001) and tear break-up time. Oxidative stress has an influence on how diabetes mellitus affects various systems of body. This study clearly depicted im- portant roles of vitamins C and E in improving the well-being of the ocular surface.
Recurrent headache in children.
Dalal P, Singh J
J Indian Med Assoc · 2014 Feb · PMID 25935966
Headache is a common symptom in paediatric hospital practice, the causes may be primary or secondary. A study was conducted in department of paediatrics from May 2005 to February 2007 in order to find out common causes f...
Headache is a common symptom in paediatric hospital practice, the causes may be primary or secondary. A study was conducted in department of paediatrics from May 2005 to February 2007 in order to find out common causes for recurrent headache in children. A total of hundred children in age range of 3-14 years were included in the study. Children with secondary headache were excluded from the study. Various clinical characteristics were studied and based on these, types of headache were categorised using International Headache Society criteria. The most common type of headache observed was migraine (46%) followed by tension headache (31%), psychogenic headache (8%), mixed migraine and tension headache (7%) and other non-specific recurrent headaches (8%). There was clear cut female preponderance in adolescent patients having migraine. Tension headache is becoming a matter of concern in paediatric age group probably due to more competitive and stressful environment.
Biceps tendon sheath effusion as a diagnostic clue to rotator cuff pathology.
Yadav PK, Shah B, Shende A … +1 more , Rajesh S
J Indian Med Assoc · 2014 Feb · PMID 25935965
The objective of this study was to evaluate the role of biceps tendon sheath effusion detected on ultrasound as a diagnostic clue to rotator cuff pathology. Despite being the most common cause of shoulder pain in adults...
The objective of this study was to evaluate the role of biceps tendon sheath effusion detected on ultrasound as a diagnostic clue to rotator cuff pathology. Despite being the most common cause of shoulder pain in adults early sonographic changes of rotator cuff tendinopathy are easy to miss. A total of 31 patients out of whom 27 had unilateral shoulder pain and 4 had bilateral complaints under- went ultrasonographic examination of shoulder joint using high frequency linear array transducer. Any fluid surrounding the long head of biceps tendon was noted followed by a careful search for any associated sonographic abnormality involving the rotator cuff. Eighteen out of the 35 had presence of fluid in their biceps tendon sheath. Twelve had presence of both biceps tendon sheath effusion and rotator cuff pathologies. Among 17 patients, who had no fluid in their biceps tendon sheath, only 2 had rotator cuff involvement whereas rest 15 had neither biceps tendon sheath fluid nor rotator cuff pathologies. A significant association was found between presence of fluid in long head of biceps tendon sheath and rotator cuff pathologies. Thus the most common finding observed in association with the presence of fluid around the long head of biceps tendon sheath in this study was tendinosis of rotator cuff. On ultrasonography simple presence of fluid around the long head of biceps tendon sheath demands careful examination of rotator cuff.
New onset paediatric epilepsy in 1-5 years age group children--approach to management in a tertiary care centre with newer anti-epileptic levetiracetam.
Barik KL, Paul UK, Bhattacharyya AK … +3 more , Adhikary A, Agarwal G, Rana KS
J Indian Med Assoc · 2014 Feb · PMID 25935964
Epilepsy is a common paediatric neurologic disorder that is difficult to manage in a substantial portion of children, highlighting the continued need for more effective and better tolerated drugs. A multicentric study wa...
Epilepsy is a common paediatric neurologic disorder that is difficult to manage in a substantial portion of children, highlighting the continued need for more effective and better tolerated drugs. A multicentric study was conducted from August, 2011 to July, 2013 using levetiracetam (LEV) in newely diagnosed epilepsy in 122 young children of 1-5 years age group to find its role in practical scenario depending upon the knowledge from prior literature available. It has been demonstrated effective as adjunctive therapy as well as monotherapy for new-onset partial seizures and generalised tonic-clonic seizures (GTCS) but it acts better as adjunctive therapy than the monotherapy. When LEV was used as adjunctive therapy 15.4% children with partial seizure were seizure-free as compared to 11.12% in GTCS and when LEV was used as monotherapy 16.17% children with partial seizure were seizure-free as compared to 15.38% in GTCS. When LEV was used as add on therapy 16.67% children < 2 years were seizure-free as compared to 17.85% in > 2 years. When LEV was used as monotherapy 25.00% children < 2 years were seizure-free as compared to 18.18% > 2 years. So, it was found more efficacious in partial group of seizures than the GTCS variety. It also shows more efficacy in older age group (> 2 years) than the younger ones (< 2 years). Somnolence and behavioural changes were noted as ad- verse effects in a few cases. So, LEV is an important addition to the treatment of paediatric epilepsy.
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