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  Access statistics : Table of Contents
   1993| April-June  | Volume 39 | Issue 2  
 
 
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Objective structured clinical/practical examination (OSCE/OSPE).
N Ananthakrishnan
April-June 1993, 39(2):82-4
PMID:0008169870
  55,106 0 -
ORIGINAL ARTICLE
Everted plication--a modified technique in hydrocoele surgery.
OP Rohondia, SS Kowli
April-June 1993, 39(2):77-8
PMID:0008169868
In the present article, a new technique of surgery for hydrocoele is described. This technique involves combination of plication and eversion of tunica vaginalis sac. This surgical method was compared with the standard operative procedures-Jabouley's and Lord's (25 patients in each group). Our technique required less suture material (average knots required were 4). The risk of injury to epididymis or testis appeared to be less and time required for surgery was 10 min. Thus the technique appeared to be simple and safe, even when carried out by junior surgeon.
  22,740 188 3
CASE REPORTS
Status of neonatal intensive care units in India.
A Fernandez, JA Mondkar
April-June 1993, 39(2):57-9
PMID:0008169863
Neonatal mortality in India accounts for 50% of infant mortality, which has declined to 84/1000 live births. There is no prenatal care for over 50% of pregnant women, and over 80% deliver at home in unsafe and unsanitary conditions. Those women who do deliver in health facilities are unable to receive intensive neonatal care when necessary. Level I and Level II neonatal care is unavailable in most health facilities in India, and in most developing countries. There is a need in India for Level III care units also. The establishment of neonatal intensive care units (NICUs) in India and developing countries would require space and location, finances, equipment, staff, protocols of care, and infection control measures. Neonatal mortality could be reduced by initially adding NICUs at a few key hospitals. The recommendation is for 30 NICU beds per million population. Each bed would require 50 square feet per cradle and proper climate control. Funds would have to be diverted from adult care. The largest expenses would be in equipment purchase, maintenance, and repair. Trained technicians would be required to operate and monitor the sophisticated ventilators and incubators. The nurse-patient ratio should be 1:1 and 1:2 for other infants. Training mothers to work in the NICUs would help ease the problems of trained nursing staff shortages. Protocols need not be highly technical; they could include the substitution of radiant warmers and room heaters for expensive incubators, the provision of breast milk, and the reduction of invasive procedures such as venipuncture and intubation. Nocosomial infections should be reduced by vacuum cleaning and wet mopping with a disinfectant twice a day, changing disinfectants periodically, maintaining mops to avoid infection, decontamination of linen, daily changing of tubing, and cleaning and sterilizing oxygen hoods and resuscitation equipment, and maintaining an iatrogenic infection record book, which could be used to study the infection patterns and to apply the appropriate antibiotics.
  17,728 238 4
ORIGINAL ARTICLE
Bacterial pneumonias--evaluation of various sputum culture methods.
MP Verenkar, MJ Pinto, R Savio, N Virginkar, I Singh
April-June 1993, 39(2):60-2
PMID:0008169864
With an objective of improving diagnostic value of sputum in bacterial pneumonias, 50 uncomplicated 'community' acquired cases were studied using Gram staining of sputum along with bedside inoculation with/without dilution of the specimen. Gram staining of sputum samples collected before treatment revealed pneumococcal infection in 46% cases. The results were however inconclusive on samples sent by routine procedure involving logistic delay. Cultural analysis of sputum processed by three different techniques showed that bedside inoculation of sputum after dilution to be the most efficient technique yielding Streptococcus pneumoniae in 34% cases, Gram positive cocci in lesser number (20%), Gram negative rods (GNR) in 18% cases. Sputum samples processed bedside without dilution yielded a lower number of pneumococci and other Gram positive cocci (24% & 16% cases respectively). Routine processing of sputum, involving logistic delay yielded a high number of Gram negative rods (62%), indicating their overgrowth. Thus bedside inoculation of sputum after dilution coupled with direct Gram staining serves as a simple and yet valuable laboratory aid in the diagnosis of uncomplicated 'community' acquired bacterial pneumonias.
  17,602 196 1
REVIEW ARTICLE
Statistics in medical research--I.
SK Bowalekar
April-June 1993, 39(2):105-10
PMID:0008169859
  14,315 357 -
ORIGINAL ARTICLE
A multiple dose comparison of ketorolac tromethamine with ibuprofen for analgesic activity.
SM Anaokar, SV Parulekar, UM Thatte, SA Dahanukar
April-June 1993, 39(2):74-6
PMID:0008169867
This study was done to compare a new analgesic ketorolac with ibuprofen in post-operative and post-laparoscopy pain. A total of 40 patients were recruited for the study of which 20 were post-operative and 20 were post-laparoscopy cases. Medication was given over a period of 48 hours after surgery and a pain score based on subjective symptoms was monitored at fixed intervals after each dose. The analgesic efficacy of ketorolac was found to be comparable to that of ibuprofen and the drug was well tolerated in the doses used without any extra medication being required.
  12,479 248 3
Effect of venous hypercarbia and hyperventilation on myocardial contractility in canine haemorrhagic shock.
DR Karnad, SJ Apte, AN Supe
April-June 1993, 39(2):68-71
PMID:0008169865
To study the effect of venous hypercarbia on myocardial contractility, haemorrhagic shock was produced in six healthy mongrel dogs by ex-sanguination of 15 ml of blood/kg body weight every 20 minutes till a loss of 45 ml/kg was achieved. After recording haemodynamic and respiratory parameters, the dogs were hyperventilated by positive pressure ventilation for 30 minutes and haemodynamic and blood gas parameters reassessed. During haemorrhagic shock, mean cardiac output decreased from 4.23 l min to 0.98 l min (p < 0.01), stroke index from 2.25 to 0.35 ml/kg (p < 0.05) and left ventricular stroke work index from 3.72 to 0.19 g. m/kg. The mean mixed venous pCO2 increased from 35 mmHg to 56.7 mmHg (p < 0.05). During hypoventilation, mixed venous pCO2 decreased to 40 mmHg (p < 0.05) and without any volume replacement, mean cardiac output increased 2.5 l min (P < 0.05), stroke index to 1.13 ml/kg (p < 0.05) and left ventricular stroke work index, and index of myocardial contractility, increased to 0.78 g.m/kg (p < 0.05). Thus, although hypovolaemia is the major cause of low cardiac output in haemorrhagic shock, this study shows that venous hypercarbia (which probably indicates tissue respiratory acidosis) further worsens circulatory failure by decreasing myocardial contractility. Hyperventilation improves cardiac functions and increases output by relieving tissue hypercarbia in spite of persistent hypovolaemia.
  12,307 133 -
CASE REPORT
Post-partum pancreatitis.
PR Pai, HK Shah, AB Samsi
April-June 1993, 39(2):93-4
PMID:0008169873
Acute pancreatitis in pregnancy and post-partum period, rarely encountered in surgical practice, can have a lethal effect on the mother and the foetus. We report here a case of a 35 year old tertigravida who presented with high grade fever, abdominal pain with distension, tachycardia and tachypnoea. Chest examination and X-rays were suggestive of pneumonia. The abdomen was tense and tender. Peristalsis was absent. Ultrasound revealed presence of fluid in the abdominal cavity which on paracentesis was found to contain Gram positive cocci. Fluid amylase levels were high. On exploratory laparotomy, haemorrhagic oedematous pancreatitis was noticed. The patient expired on the 2nd post operative day.
  11,392 157 3
Idiopathic retroperitoneal fibrosis: a report of 3 cases.
P Vaideeswar, AS Shenoy, A Sivaraman, JR Deshpande, AA Pandit
April-June 1993, 39(2):95-8
PMID:0008169874
Case histories of three male patients diagnosed as idiopathic retroperitoneal fibrosis either on autopsy or following intra-operative biopsy are reported. Two of them were in the 5th decade and one aged 22 yrs. All of them presented with features of urinary tract obstruction and renal failure. The obstruction was detected either by ultrasonography or following ascending pyelogram. One of them underwent peritoneal dialysis but later on died of sudden cardiac arrest. The remaining two underwent surgery, during which a biopsy was taken. Histological examination in all the three patients revealed fibroblastic proliferation and mononuclear cell infiltration. Features of chronic periaortitis were also found in the autopsy specimen of descending aorta of the first patient. Both the elderly patients had aortic atherosclerosis which is suspected to be the etiological factor for fibrosis. However in the young male patient intense eosinophilic infiltrate was observed in biopsy material pointing towards 'hypersensitivity' reaction as a cause for fibrosis.
  11,276 143 2
ORIGINAL ARTICLE
Diagnosis and prevalence of bacterial vaginosis.
SP Saharan, C Surve, V Raut, M Bhattacharya
April-June 1993, 39(2):72-3
PMID:0008169866
A prospective study of 80 women was undertaken to estimate the prevalence of bacterial vaginosis, and to compare two methods of diagnosing the condition. Bacterial Vaginosis was detected by both Gram stain and compound criteria in 30 women. The prevalence was 37.5%. Gram stain provides a simple and inexpensive method for laboratory confirmation of bacterial vaginosis where facilities for using the compound criteria are not available.
  10,931 188 2
CASE REPORT
Thyrotoxicosis with osteomalacia and proximal myopathy.
R Goswami, P Shah, AC Ammini
April-June 1993, 39(2):89-90
PMID:0008169871
A 36 year old lady, presented with symptoms of proximal myopathy was found to have a history of thyrotoxicosis for which she had taken carbimazole irregularly for 1-1/2 years. On admission, clinical signs of thyrotoxicosis were detected and confirmed by estimating serum T3 and T4. Neurological examination revealed generalised wasting, loss of power in the proximal muscles with a myopathy confirmed on EMG. Serum calcium, phosphorous levels, and a 24 hour urine calcium excretion were low. Alkaline phosphatase levels were high. A diagnosis of thyrotoxicosis with osteomalacia was made. The patient improved within 3 weeks of starting carbimazole and vitamin D.
  9,431 138 2
ORIGINAL ARTICLE
Cardiovascular responses to abdominal exercises in females between 35 and 45 years of age.
S Rao, B Bellare
April-June 1993, 39(2):79-81
PMID:0008169869
Cardiovascular responses viz. systolic and diastolic blood pressure and pulse rate were evaluated in 21 females following muscular exercises for abdominal wall strengthening. Trunk curl exercise and leg raising exercise were selected for this purpose. A significant increase in systolic and diastolic blood pressure and pulse rate was observed following these exercises. These raised values returned to pretreatment value 6 min later after supine lying. These changes indicate that the need for strict supervision during sessions, especially for the hypertensive patients.
  9,207 149 1
CASE REPORT
Pseudoachondroplastic dysplasia.
A Khungar, P Mahajan, G Gupte, M Vasundhara, A Kher, BA Bharucha
April-June 1993, 39(2):91-3
PMID:0008169872
Pseudoachondroplasia is a heterogeneous inherited skeletal dysplasia in which dwarfism is a major feature. We report here a case of a 7 year old girl misdiagnosed as rickets, who presented with short stature, lordosis, genu varum and flexion deformities at both the elbows. Skeletal survey revealed epiphyseal and metaphyseal irregularities. A review of literature is also presented.
  8,477 189 -
REVIEW ARTICLE
Newer concepts in drug therapy of hypertension.
B Dalvi, A Vora
April-June 1993, 39(2):85-8
PMID:0007909564
  7,774 194 -
CASE REPORT
Hemihaematometra with persistent undeveloped Wolffian duct.
SP Saharan, SV Parulekar
April-June 1993, 39(2):98-9
PMID:0008169875
A case of hemihaematometra in a non-communicating rudimentary horn of the uterus in a 14 year old girl is presented. Exploratory laparotomy revealed a persistent undeveloped Wolffian duct. This is the second case in world literature where a persistent mesonephric duct without any development is reported.
  7,180 103 2
REVIEW ARTICLE
The mythology of modern medicine--II. Cocoon of causalism.
MV Kothari, LA Mehta
April-June 1993, 39(2):102-4
PMID:0008169858
  7,032 111 -
Medical education: an epistemiological enquiry.
ML Kothari, LA Mehta
April-June 1993, 39(2):114-7
PMID:0008169861
  6,953 146 -
ORIGINAL ARTICLE
An evaluation of serum and tissue bound immunoglobulins in prostatic diseases.
DR Gahankari, KB Golhar
April-June 1993, 39(2):63-7
PMID:0007513363
In forty-four patients with different prostatic lesions serum immunoglobulins and tissue deposited immunoglobulins were studied by single radial immunodiffusion technique, and direct immunofluorescence and immunoperoxidase (PAP) methods respectively. Serum IgM levels were found reduced only in patients with prostatic carcinomas (80% of cases) as compared to controls. Serum IgA levels showed stage dependence in prostatic carcinoma being more raised in advanced malignancy (stage C and D) than in localized ones (stage B). Localization of immunoglobulins particularly IgM, was characteristically found in stroma and lumen along with intracellular localization in prostatic carcinoma; while normal and benign lesions of prostate only showed characteristic 'necklace' pattern. Also the intensity of deposits of immunoglobulins in poorly differentiated prostatic carcinomas was markedly low as compared to well differentiated carcinomas indicating lowered local immunological response in former. In prostatitis, IgA was also found localized in lumen indicating the immunological defence against infection by secretory antibody (IgA).
  5,528 135 5
CASE REPORT
Xipho-omphalopagous twins--separation in the newborn.
B Birmole, B Kulkarni, R Shah, S Karapurkar, A Vaidya, M Vaidya, S Borwankar
April-June 1993, 39(2):99-101
PMID:0008169876
Male conjoined twins (thoraco-omphalopagous) were delivered by emergency Caesarean section performed in a full term, 3rd gravida who had presented in labour. On examination one of the twins had gross monstrosity and was threatening the survival of the better twin (twin A). The cannulation and dye studies through single umbilical vein demonstrated significant cross circulation across the connecting bridge. The vein was connected to liver of twin A. An emergency separation was performed to salvage the better twin.
  5,549 102 4
Acute severe gastric intolerance to rifampicin.
G Gaude
April-June 1993, 39(2):113-113
PMID:0008169860
  3,611 0 -
Sputum culture--a sacred cow?
AA Mahashur
April-June 1993, 39(2):55-6
PMID:0008169862
  3,300 0 -
Online since 12th February '04
2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow