Mahatma Gandhi Memorial Medical College

About: Mahatma Gandhi Memorial Medical College is a education organization based out in Indore, Madhya Pradesh, India. It is known for research contribution in the topics: Dyslipidemia & Lipid profile. The organization has 210 authors who have published 123 publications receiving 1085 citations. The organization is also known as: MGM Medical College.

Acute onset clozapine-induced hyperglycaemia: A case report.

Abstract: Clozapine is an atypical antipsychotic which is described to have higher efficacy among all available antipsychotic medications. Clozapine is reserved especially for resistant schizophrenia due to its side effects. Clozapine-induced metabolic syndrome and hyperglycaemia are common long-term side effects and are responsible for increased mortality in patients with schizophrenia. In this case, a patient with resistant schizophrenia was presented with acute-onset hyperglycaemia and delirium with the use of clozapine within a week. Withdrawal of clozapine in the patient led to the improvement in delirium and hyperglycaemia without the use of any hypoglycaemic agent. This case supports the notion that in certain cases clozapine can induce hyperglycemia through possible direct pathophysiological mechanisms within a shorter time frame.

Exercise-induced anaphylaxis and antileukotriene montelukast.

Abstract: We report a rare case of exercise-induced anaphylaxis (EIA), occurring exclusively with exercise, without any other associated trigger, detected in the prodromal phase, and prevented from additional anaphylaxis episodes by treatment with cetirizine and 10 mg daily of antileukotriene montelukast to date. EIA is a syndrome in which patients experience a spectrum of the symptoms of anaphylaxis ranging from mild cutaneous signs to severe systemic manifestations such as hypotension, syncope, and even death after increased physical activity. Many people have triggers, such as, a variety of foods, various medications, alcohol, cold weather, humidity, and seasonal and hormonal changes along with exercise that cause the symptoms. Typically, either exercise or the specific trigger alone will rarely cause symptoms. It is differentiated from cholinergic urticaria by the absence of response to passive body warming and emotional stress.

The role of diagnostic imaging in evaluation of nasal and paranasal sinus pathologies

Abstract: Background: The objective of the study was to evaluate the role of radiological imaging in correlation with clinical finding in assessing the severity of nasal and paranasal diseases and in differentiating benign pathologies from malignant sinonasal masses. Methods: In this study 50 patients with complaints of nasal obstruction , nasal discharge, epistaxis were subjected to detailed clinical examination and evaluated radio logically with X ray PNS, CT and MRI of PNS and biopsy taken from nasal and paranasal masses for histopathological confirmation. Results: The main presenting complaints were nasal obstruction (82%) followed by nasal discharge (66%), headache and allergic symptoms (52%). The most common type of disease involving nose and paranasal sinuses was inflammatory disease (86%), followed by benign disease (10%) and malignant disease were found in (4%) of cases. The most common benign disease involving nose and paranasal sinuses were inverted papilloma (80%), followed by hemangioma of nasal septum (20%). The most common radiological pattern of sinus involvement is osteomeatal type seen in 38% of cases, followed by unclassified pattern in 23.8%.Maxillary sinuses were most commonly involved in the study 82% cases. Conclusions: CT is the modality of choice in imaging the paranasal sinuses for evaluating the chronic diseases and associated complication and provides a reliable pre-operative road map. MR imaging plays a critical role in evaluation of sino nasal tumors.

Cutaneous pili migrans: A creeping eruption like condition easy to diagnose and cure.

Abstract: being examined during survival analysis is the time-to-event. For the purposes of our study, it was not important when HAPE would develop. We were not looking at the time-to-event but at only the number of events. Hence survival analysis would not have been appropriate in our situation. The third issue raised is about the lack of statistical power in the study due to insufficient number of participants. The Table in the letter does suggest that the power in the studywas inadequate. We too would have agreed to this view but are prevented from doing so by the likely fundamental fallacy in a post hoc calculation of power, yet we do realise that had the numbers of participants been larger, the strength of our conclusions would have been greater. Nevertheless, we would like readers to focus attention on a more fundamental aspect. Our study essentially wished to examine, whether re-exposure to high altitude after a shortterm absence is really associated with a greater likelihood of suffering HAPE. This belief is based on a cross-sectional viewpoint that sees, in hospital wards and other collections of HAPE patients, a larger number of those re-exposed to high altitude. But this could also simply be due to the fact that population-at-risk of re-exposed is always greater than the population-at-risk of first exposures to high altitude. Readers, who may want to believe that our epidemiological evidence is flawed or weak may also like to remember that there is no epidemiological evidence in favour of the belief that reexposure carries a higher risk for development of HAPE. Fromall the above it follows thatmore evidence needs to be gathered before this academic point can be settled. A much larger epidemiological study is mandated and only then can one come nearer to the truth.We do hope the challengewill be accepted by those presently involved in this field. We once again wish to thank the author of the letter for its stimulating contents and for adding to the academic debate.

A study on prostate movement and dosimetric variation because of bladder and rectum volumes changes during the course of image-guided radiotherapy in prostate cancer

Abstract: Aim To study the impact of bladder and rectum volume changes on prostate positioning and the dosimetric parameters. Background Prostate is a moving organ, and its position is also affected by bladder and rectum volumes. Image-guided radiotherapy (IGRT) is being practiced widely for the treatment of prostate carcinoma (Ca). So, it is important to accurately study the effect of bladder and rectum volume changes in treatment. Materials and methods Thirty patients with Ca prostate were included in this study, and all were treated with 50 Gray (Gy) in 25 fractions for the first phase of treatment. A total of 750 cone-beam computed tomography (CBCT) sessions were performed. Prostate position w.r.t. its day one position was noted, and the bladder and rectum volumes were compared with their volumes on day one. Also, repeat CT was done for five patients after 10 fractions. The initial plan was imported as it was on the repeat CT images, and a hybrid plan was prepared by putting the plan isocenter at the relative anatomical reference point in repeat CT images as it was in primary CT images. The multileaf collimators (MLC) fluence was put as it is, and the dose was calculated using the monitoring units (MU), which were in the initial plan. Doses to bladder, rectum, and the target were analyzed. Results The mean prostate motion in lateral and anterior-posterior direction was found to be 0.71 (±0.69) centimeter cm) and 0.77 (±0.57) cm, respectively. The mean change in bladder and rectum volumes as compared to that in day one CT images was found to be 110.51 (±84.25) cubic centimeters (cc) and 10.89 (±10.17) cc, respectively. No significant variation was observed in the doses to bladder, rectum, and the target volume in a hybrid plan, as compared to that in actual initial plan. Conclusions Bladder and rectum volume affects the position of prostate, rather the dosimetric parameters, and therefore, it can be concluded that daily CBCT should be done for accurate IGRT delivery to the prostate cancer.