Journal Of The Indian Medical Association[JOURNAL]
Sun
200 papers
Minimal effective dose of mifepristone for medical abortion.
Kapoor G, Salhan S, Sarda N … +1 more , Aggarwal D
J Indian Med Assoc · 2014 Feb · PMID 25935963
The aim of this study is to compare the effectiveness of 100 mg versus 200 mg mifepristone along with misoprostol for medical abortion in gestation upto 56 days. This is a prospective controlled study. Eighty women seeki...
The aim of this study is to compare the effectiveness of 100 mg versus 200 mg mifepristone along with misoprostol for medical abortion in gestation upto 56 days. This is a prospective controlled study. Eighty women seeking medical abortion with a gestation up to 56 days were included in the study. The women were randomly allotted into two groups. They received 100 mg/200 mg mifepristone on day 1 followed by 800 mcg misoprostol two days later. Women who had not aborted completely by day 14, received a repeat dose of 400 mcg misoprostol and were evaluated on day 21 for completeness of the procedure. Five women in both the groups had incomplete abortion by day 14 (12.5%), while one woman in the test group had to undergo dilatation and evacuation on day 3 due to excessive bleeding. By repeating a second dose of misoprostol, all of them aborted completely and the complete abortion rates were markedly improved from 85% and 87.5% in the test and the control group, respectively to 97.5% and 100%, respectively. It may be concluded that 100 mg mifepristone is as effective as 200 mg and appears to be the lowest effective dose for medical abortion.
Post-traumatic seizure: a multicentric epidemiological study.
Bhattacharyya K, Mandal N, Paul UK … +3 more , Bhattacharyya AK, Sinharay K, Gantait K
J Indian Med Assoc · 2014 Feb · PMID 25935962
Post-traumatic seizure (PTS) is the development of recurrent seizures following head trauma and has a high clinical relevance. We tried to understand the epidemiology of PTS in a multicentric pro- spective study during t...
Post-traumatic seizure (PTS) is the development of recurrent seizures following head trauma and has a high clinical relevance. We tried to understand the epidemiology of PTS in a multicentric pro- spective study during the period May 2010 to April 2012. We included 320 patients excluding poor Glasgow coma scale (GCS) ie, <4 and history of previous epilepsy. At a median follow-up of one year, 49 patients (15.31%) developed PTS. Incidence of immediate, early and late onset seizures were 27 (8.4%), 14 (4.4%), 9 (2.8%) respectively. In this study incidence of PTS was high in patients of the age group 20-30 years, with road traffic accident, with poor GCS ie, < 9. High incidence of PTS was associated with x- ray findings of skull fracture and abnormal CT findings. Early use of anticonvulsants is ineffective in preventing early post-traumatic epilepsy.
Bronchiectasis in western India: clinical presentations and socio-economic burden.
Natarajan S, Rudrawar P
J Indian Med Assoc · 2014 Feb · PMID 25935961
Bronchiectasis is an abnormal permanent dilatation distortion and destruction of the airways with both pulmonary and extrapulmonary side-effects. The aim of the study was to find out the presenting features, aetiologies...
Bronchiectasis is an abnormal permanent dilatation distortion and destruction of the airways with both pulmonary and extrapulmonary side-effects. The aim of the study was to find out the presenting features, aetiologies and socioeconomic factors in patients of bronchiectasis. It is a prospective observational study comprising 53 patients over aperiod of two years. Aetiologies were determined using Kuppuswamy's socioeconomic scale. Number of exacerbations and mortality were noted. The age ranged from 14 to 80 years (mean: 43.33 ± 16.37 years). There were 35 males (66%) and 18 females (34%). Clubbing was seen in 58% cases (n = 31); 11% patients (n = 6) had haemoptysis. Bilateral involvement was seen in 64% cases (n = 34). Allergic bronchopulmonary aspergillosis and post-tuberculous sequelae were the commonest causes (n = 12, 23% each). The range of household medical expenditure in these patients varied from 6% to 47%. Lower the Kuppuswamy scale poorer the follow-up (p-value < 0.05). Multiple exacerbations were seen in all classes of patients (p-value 0.09). Death occurred in 4 patients. It is concluded that bronchiectasis is a chronic illness with significant morbidity and socioeconomic implications. Lower the socio-economic scale, poorer the compliance of therapy.
Role of laporoscopy-hysteroscopy in cases of infertility with pregnancy outcome.
Neerja, Jain K
J Indian Med Assoc · 2014 Feb · PMID 25935960
The study aims to analyse the role of hysteroscopy-laparoscopy in diagnosis and treatment of infertility with effect on pregnancy outcome. The study group comprised 200 patients of 20-30 years age (125 with primary and 7...
The study aims to analyse the role of hysteroscopy-laparoscopy in diagnosis and treatment of infertility with effect on pregnancy outcome. The study group comprised 200 patients of 20-30 years age (125 with primary and 75 with secondary infertility). Hysterosalpingography (HSG) was done in all. Diagnostic as well as operative hysteroscopy-laparoscopy if required were performed in the same sitting in cases who have already been treated for 6 months and did not conceive, with unexplained cause or with abnormal HSG findings. All cases were followed up till they conceived or up to 1 year. Fifty patients of unexplained infertility were used as control and given only folic acid 5 mg/day. HSG was normal in 102/200 (51%) and abnormal in 98/200 (49%) cases in form of fimbrial block in 48 (48.97%) out of 98, cornual block 25 (25.51%), peritubal adhesions 15 (15.31%), filling defect in uterus 10 cases (10.20%). Hysteroscopy was abnormal in 150/200 cases (75%) with uterine synechiae 58 (38.66%) out of 150, endometrial hypertrophy 22 (14.67%), endometrial polyps 20 (13.33%), submucus fibroids 20 (13.33%), atrophy 25 (16.66%) and malformations 5 (3.33%). Hysteroscopy surgery was performed in 70 (46.66%), alone in 14 and with laparoscopic procedures in 56 cases, with subsequent pregnancy rate of 35.71-42%. HSG missed the abnormalities in 58 cases (38.66%) which were diagnosed with hysteroscopy with difference in findings in 58 cases (38.66%). Operative laparoscopy was performed in 140 cases (70%), divided between adhesiolysis in 38(27.14%), tubal surgery in 53 (37.86%), electrocoagulation or excision of endometriotic nodule in 25(17.86%) and ovarian drilling for polycystic ovarian disease in 24(17.14%). The HSG missed 30(20%) abnormal tubal and peritubal findings which were diagnosed with laparoscopy. All cases were followed for one year. Subsequent pregnancy rate was 64 (45.71%) after laparoscopic surgery. The results were analysed by applying Chi-square test and calculating p-value at 1 df. Hysteroscopy-laparoscopy is diagnostic and therapeutic both for uterine, tubal infertility and ovarian abnormalities. They give an advantage in diagnosis and treatment of female infertility at the same sitting. As compared to HSG, it is more accurate in 25% cases and improves the rate of pregnancy to 35%-45% almost comparable to 56.52% in cases with normal hysteroscopy-laparoscopy findings.
Role of real-time PCR (RT-PCR) in rapid diagnosis of tuberculous mycobacteria in different clinical samples.
J Indian Med Assoc · 2014 Feb · PMID 25935959
The study was aimed for molecular detection of mycobacterial DNA in different clinical samples using real-time polymerase chain reaction (RT-PCR) system and rapid diagnosis of tuberculosis. A total of 508 clinical specim...
The study was aimed for molecular detection of mycobacterial DNA in different clinical samples using real-time polymerase chain reaction (RT-PCR) system and rapid diagnosis of tuberculosis. A total of 508 clinical specimens (blood 343, menstrual fluid 53, endometrial tissue 43, body fluid 36, pus from lymph nodes 18, sputum 8, urine 5 and semen 2) were included in this study. We extracted DNA using QIAamp DNA Mini Kit (QIAGEN, Germany) and performed real-time assay using Rotor-Gene Q machine from Corbett Research, Australia for specific amplification of IS6110 sequence of mycobacterial genome. The RT-PCR result was also compared with bacterial culture and acid-fast bacillus staining. RT-PCR assay showed positivity in 52 cases and negative in 456 cases. Corresponding positive results in culture and acid-fast bacillus staining methods were 49 cases and 24 cases respectively. The sensitivity and specificity of detecting Mycobacterium tuberculosis by RT-PCR were 93.87% and 98.69% respectively taking positive culture results as reference standards. The overall positive and negative predictive values were 88.46% and 99.34% respectively. RT-PCR is a useful diagnostic tool for rapid and sensitive detection of mycobacteria in different clinical samples. The easy processing, fast reporting and relative lack of contamination issues make it worthy as a possible replacement to time consuming culture techniques. Moreover, it has added advantage of quantification of mycobacterial DNA, hence bacterial load.
Holistic approach--relevance to global nations.
Murthy TG
J Indian Med Assoc · 2014 Feb · PMID 25935958
Abstract loading — click title to view on PubMed.
Medical education in India.
Prabhu V
J Indian Med Assoc · 2013 Apr · PMID 24475568
Abstract loading — click title to view on PubMed.
Bilateral acute foot drop following lumber disc herniation.
Dutta PP, Bhattacharyya R
J Indian Med Assoc · 2013 Apr · PMID 24475567
Abstract loading — click title to view on PubMed.
Role of microbiologist in infection control.
Chopra S, Mahajan G, Chopra M … +1 more , Mahajan S
J Indian Med Assoc · 2013 Apr · PMID 24475566
Abstract loading — click title to view on PubMed.
Gastric trichobezoar.
Bhattacharya J, Banerjee D, Maity C … +2 more , Das MK, Dutta S
J Indian Med Assoc · 2013 Apr · PMID 24475565
Abstract loading — click title to view on PubMed.
Strongyloides stercoralis hyperinfection syndrome in patients on prolonged steroid treatment: two case reports.
Koticha A, Kuyare S, Nair J … +2 more , Athvale A, Mehta P
J Indian Med Assoc · 2013 Apr · PMID 24475564
Two cases of Strongyloides hyperinfection have been reported who were on prolonged steroid therapy for frequent exacerbations of respiratory problems. One patient presenting with acute respiratory distress, rapidly deter...
Two cases of Strongyloides hyperinfection have been reported who were on prolonged steroid therapy for frequent exacerbations of respiratory problems. One patient presenting with acute respiratory distress, rapidly deteriorated, did not give any time for management and died whereas the second patient survived because of early diagnosis of hyperinfection due to Strongyloides stercoralis.
Postmortem evaluation of death in an inoperable case of ischaemic enterits with focal infarction.
Rao PU, Babu PS
J Indian Med Assoc · 2013 Apr · PMID 24475563
Now-a-days, medical profession is facing with repeated allegations of medical negligence; hence the doctors ought to be very careful in treating the patients and also in giving agreeable explanation in case of death to t...
Now-a-days, medical profession is facing with repeated allegations of medical negligence; hence the doctors ought to be very careful in treating the patients and also in giving agreeable explanation in case of death to the public. Here is a case of a 6 years old, male, Muslim boy brought to the department of forensic medicine, Rangaraya Medical College, Kakinada with the cause of death as severe shock, secondary to abdominal colic as per the treating paediatric surgeon. The parents and relatives alleged negligence by the treating doctors as the child was brought with the complaints of pain abdomen, vomiting and loose motion and if he was operated at an early time, definitely he might be survived with a false belief of pain abdomen due to appendicitis. Clinical correlation, postmortem findings and histopathological findings revealed the cause of death was due to ischaemic enteritis with focal infarction - whether amounted to medical negligence as alleged by parents.
Orocfacial digital syndrome type II -- Mohr's syndrome.
Dua H, Edbor A, Asudani B
J Indian Med Assoc · 2013 Apr · PMID 24475562
Orofacial digital syndromes are a heterogeneous group of rare malformative diseases, characterised by abnormalities of the oral cavity, maxillofacial region and digits. Orofacial digital syndromes are classified into ten...
Orofacial digital syndromes are a heterogeneous group of rare malformative diseases, characterised by abnormalities of the oral cavity, maxillofacial region and digits. Orofacial digital syndromes are classified into ten types with orofacial digital syndrome type II, Mohr's syndrome being transmitted as autosomal recessive disorder. Here a case of a full term, female, born by lower segment caesarean section weighing 2.800 kg with respiratory distress, cyanosis, poly and syndactyly is reported.
Phaeochromocytoma in pregnancy: safe vaginal delivery, is it possible?
Kapoor G, Salhan S, Sarda N … +2 more , Sarda AK, Aggarwal D
J Indian Med Assoc · 2013 Apr · PMID 24475561
Pheochromocytoma in pregnancy is rare (1 in 50,000 full term pregnancies). Recognition of the condition is central to improving outcome (maternal and foetal mortality is reduced from 58% and 56%, respectively to 2% and 1...
Pheochromocytoma in pregnancy is rare (1 in 50,000 full term pregnancies). Recognition of the condition is central to improving outcome (maternal and foetal mortality is reduced from 58% and 56%, respectively to 2% and 11-15%, respectively). An antenatal patient in third trimester diagnosed as pheochromocytoma has been described. Diagnosis of pheochromocytoma was confirmed by urinary VMA levels and demonstration of right adrenal mass on ultrasound. A multidisciplinary approach was used and the patient received antihypertensives for 10 days. Vaginal delivery was conducted under epidural analgesia and the patient was kept under close surveillance. She delivered a healthy baby girl weighing 2.5 kg. The intrapartum and the postpartum period were uneventful. Adrenalectomy was done at 6 weeks postpartum. Using multidisciplinary approach and individualised management decreases both maternal and foetal morbidity and mortality. Selected multigravidae cases and those with previous history of short uncomplicated labour, may be considered for vaginal delivery under epidural analgesia and with back up facilities available to manage hypertensive crisis.
Atypical presentation of live cysticercus larva in anterior chamber.
Yadav RY, Ghosh A, Sharma K … +1 more , Ahmad S
J Indian Med Assoc · 2013 Apr · PMID 24475560
A 25-year femalepresented at the eye OPD with the complaint of some white thing in her right eye. She had visual acuity of 6/18 in the right eye and 6/6 in the left one. Slit lamp examination showed she had a live larva...
A 25-year femalepresented at the eye OPD with the complaint of some white thing in her right eye. She had visual acuity of 6/18 in the right eye and 6/6 in the left one. Slit lamp examination showed she had a live larva actively moving in the anterior chamber of the right eye. The patient was started on oral steroid, topical moxifloxacin with steroid, cyclopentolate and planned for surgery. Exploration of lerva was done by visco-expressive method. Histopathology showed if to be a cysticercus lerva. Her visual acurity was 6/6 in the affected eye after one month.
Antibacterial resistance: an overview.
Kushwah A, Gandhe M, Patel P
J Indian Med Assoc · 2013 Apr · PMID 24475559
The development of antibiotics, represents one of the most important advances in the therapeutics both in control or cure of serious infections and in the prevention, treatment of infection complications. However as the...
The development of antibiotics, represents one of the most important advances in the therapeutics both in control or cure of serious infections and in the prevention, treatment of infection complications. However as the antibiotics are vastly overprescribed in OPD settings and the availability of these drugs without prescription, are facilitating the development of resistance, the present article outlines the causes and mechanisms of antibacterial resistance as well as simple preventive measures at various levels and future prospects.
Treatment of scorpion envenoming syndrome -- need for scientific magnanimity.
Murthy KR
J Indian Med Assoc · 2013 Apr · PMID 24475558
Scorpion envenoming syndrome results in a severe autonomic storm with a massive release of catecholamines, increased levels of angiotensin II, an increase in glucagon, cortisol, thyroid hormones; either suppressed insuli...
Scorpion envenoming syndrome results in a severe autonomic storm with a massive release of catecholamines, increased levels of angiotensin II, an increase in glucagon, cortisol, thyroid hormones; either suppressed insulin levels or hyperinsulinaemia (insulin resistance), hyperglycaemia; increased circulating free fatty acid levels. These hormonal alterations could be responsible for the pathogenesis of a variety of clinical manifestations. Under these conditions, scorpion envenoming syndrome with myocardial damage, cardiovascular disturbances, peripheral circulatory failure, respiratory and cardiac pulmonary oedema, and many other clinical manifestations resulting in a syndrome of fuel-energy deficits and an inability to use the existing metabolic substrates by vital organs causing multisystem organ failure and death. Based on animal experiments in which insulin administration reversed the metabolic and ECG changes induced by scorpion envenoming and treating the poisonous scorpion sting victims with insulin, we consider that insulin has a primary metabolic role in preventing and reversing the cardiovascular, haemodynamic, and neurological manifestations and pulmonary oedema induced by scorpion envenoming. Administration of insulin-glucose infusion to scorpion sting victims appears to be the physiological basis for the control of the metabolic response when that has become a determinant to survival. The mordality of treatment is continuous infusion of regular crystalline insulin at the rate of 0.3 U/g glucose and glucose at the rate of 0.1g/kg body weight/hour, with supplementation of potassium as needed and maintenance of fluid, electrolytes and acid-base balance is required. This treatment should be given at the earliest on admission and continued for the next 48-72 hours. Antiscorpion serum could also be given independently or along with insulin-glucose infusion.
A cross-sectional study of gynaecological morbidity among married women in field practice area of community health centre Rajapur, Gulbarga.
Hiremath LD, Tengelekar SG
J Indian Med Assoc · 2013 Apr · PMID 24475557
There is always concern about the healthcare of women during pregnancy and child birth and prevention of maternal mortality on priority. By contrast little attention has been given to the reproductive health of non-pregn...
There is always concern about the healthcare of women during pregnancy and child birth and prevention of maternal mortality on priority. By contrast little attention has been given to the reproductive health of non-pregnant women. There is always a relative neglect of gynaecological care which fails to appreciate the magnitude of the problem in the community. The objectives of the study were to assess the level of gynaecological morbidity among married women and to assess the magnitude of gynaecological problems in relation to their history, clinical examination and laboratory investigations. This study is one cross-sectional and the area selected was Rajapur village field practice area, MR Medical College, Gulbarga. Population of Rajapur is 5000 spread over nearly in 850 familes. Family was taken as unit for study purpose. Estimated married women were 580. The sample interval was taken as two. Sample size constituted 290 married women. The information was collected in pretested proforma, gynaecological examination and laboratory investigation were done at community health centre. In the present study gynaecological morbidity perceived by women was 81.37% (including menstrual problems). Disease per woman as perceived by woman was 2.48%, but gynaecological morbidity on clinical examination was 79.66%. Disease per woman on clinical examination was 1.57%. On laboratory investigations 24.24% women had inflammatory cells on microscopic examination of urine and 1.29% women were found to have blood VDRL reactive, on laboratory investigation done among the 231cases. Pap smear report showed out of 290 women, 162 (55.86%) showed inflammatory changes. Only one woman ie, 0.34% had neoplasia, but there were 22 (7.58%), 2 (0.68%) and 12 (4.13%) women had mild, moderate and severe dysplasia respectively. Trichomonas vaginitis was observed in 10 women (3.44%).
Role of gentian violet paint in burn wound management: a prospective randomised control trial.
Choudhary KN, Soni PP, Sao DK … +3 more , Murthy R, Deshkar AM, Nanda BR
J Indian Med Assoc · 2013 Apr · PMID 24475556
In tribal part of central India burn remains a major cause of morbidity and mortality. Burn management is carried out in conventional manner in most places. The study carried out at Chhatisgarh Institute of Medical Scien...
In tribal part of central India burn remains a major cause of morbidity and mortality. Burn management is carried out in conventional manner in most places. The study carried out at Chhatisgarh Institute of Medical Sciences, Bilaspur was Intended to evaluate the efficacy and outcome of 0.5% gentian violet paint local application over conventional dressing treatment of burn wound. The study encompasses 400 patients of burn of varied aetiology admitted in burn ward whose total body surface area of burn was 15% to 50%. The patients receiving conventional treatment were in group I (n=200), and those with gentian violet paint local application formed group II (n= 200). Although, fibrosis of the burn wound, hypertrophic scar were slightly higher in second group it was observed gentian violet paint local application, healed it in 6-8 weeks without severe sepsis and need for skin grafting. From the study it can be concluded that markedly inexpensive gentian violet paint is an useful alternative, for burn wound management.
Occurrence of complications in newly diagnosed type 2 diabetes patients: a hospital based study.
Gupta A, Gupta AK, Singh TP
J Indian Med Assoc · 2013 Apr · PMID 24475555
Type 2 diabetes is characterised by a long asymptomatic period of hyperglycaemia and many individuals with type 2 diabetes have complications even at the time of diagnosis. The purpose of present study was to study and c...
Type 2 diabetes is characterised by a long asymptomatic period of hyperglycaemia and many individuals with type 2 diabetes have complications even at the time of diagnosis. The purpose of present study was to study and compare the prevalence of complications at the time of diagnosis of type 2 diabetes in newly diagnosed asymptomatic and symptomatic patients. One hundred and five consecutive newly diagnosed cases of type 2 diabetes were selected for study based on fasting blood glucose level > or = 126 mg/dl. Individuals who were known diabetic, individuals presenting with acute complications were excluded from study. The prevalence rates of various complications in newly diagnosed diabetic patients were studied in both asymptomatic and symptomatic subjects and results were analysed statistically using test of proportion and Chi-square test. There were 40.95% of newly diagnosed diabetes patients who were asymptomatic. There was no significant difference between those having symptoms of diabetes and those without symptoms of diabetes with regard to age, sex, weight and hypertension. Occurrence of both microvascular and macrovascular complications were not different in the two groups studied. We also observed a very high prevalence of microvascular (32.55%) complications in asymptomatic newly diagnosed type 2 diabetes patients. Since 35.20% of cases in this study were below 50 years and various complications develop 10-20 years after onset of disease, this study suggests that screening for diabetes should commence at the age of 40 years in general population.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe