Showing papers in "Journal of Postgraduate Medicine in 1977"

Situs inversus totalis with calculus cholecystitis and mucinous cystadenomas of ovaries

Abstract: An uncommon case of cholelithiasis and cholecystitis with mucinous cystadenomas of ovaries in situs inversus totalis is presented along with its clinical implications. Clinical and radio­logical signs in diagnosis of situs inversus totalis are discussed.

Bilateral simultaneous fracture-dislocation of the shoulder due to muscular violence

Abstract: A convulsive seizure may be fraught with hazard. A case of bilateral anterior fracture-dislocation of the shoulder as a result of convulsions is reported. The need of an awareness of such a possibility during fits is emphasized and a conservative thera­peutic approach is recommended.

Bacteriology of urinary tract infection in patients of renal failure undergoing dialysis.

Abstract: In a study of 114 patients who underwent 808 dialyses for renal failure, a high incidence of urinary tract infection (U.T.I.) was observed both in acute renal failure (A.R.F.) group (73.0%) and chronic renal failure (C.R.F.) group (57.5;;) . Although E. coli was the predominating urinary pathogen, the present study reveal­ed that other gram negative micro-organisms besides E. coli were also frequently isolated from the U.T.I. of both A.R.F. and C.R.F. cases. On the whole, both gram negative and gram positive micro­organisms exhibited high degree of resistance to antimicrobial agents. Antibiotics like Gentamycin Sulphate (98%), Polymyxin B (88%) and Colimycin Sulphate (86%) exhibited better range of total activity as compared to others.

Acceptability of thioamides I. ethionamide

Abstract: Eighty four patients of chronic advanced pulmonary tuber­culosis were subjected to determine the acceptability of ethionamide at different dosage schedules and frequencies of intake of the drug over a period of 10 months. Mild to severe side-effects were observed in 56.6 per cent, 70 per cent and 100 per cent patients of groups A, B and C respectively receiving ethionamide in a dose of 500 mg, 750 mg and 1 gm per day. Gastro-intestinal disturbances were most frequently encountered. Toxic symptoms appeared earlier with higher doses of ethionamide. Patients taking the drug in a single dose had had higher incidence of toxicity than those who were prescribed in two divided doses. Pyrazinamide appeared to enhance ethionamide unacceptability. Age, chronicity of illness and extent of disease did not exhibit any influence on ethionamide acceptability.

epsilon-amino-caproic acid in the treatment of menorrhagia.

Abstract: Epsilon-amino-caproic acid was used in 38 cases of menor­rhagia. In each patient details of bleeding were recorded for four consecutive menstrual periods. Drug was given during two alter­nate periods and the remaining two periods were considered as control periods. Number of days of bleeding and severity of bleed­ing were statistically significantly reduced by epsilon-amino-caproic acid. The drug was found to be safe and effective.

Preliminary report of use of Picrorrhiza Kurroa root in bronchial asthma.

Abstract: A preliminary study of Picrorrhiza Kurroa root in Bronchial asthma in 10 patients is reported. There was evidence of short term benefit in some 6 subjects. In 4 there were significant side effects.

Association of tuberculosis with malignancy.

Abstract: A case of bronchogenie carcinoma developing in a patient with pulmonary tuberculosis is described and literature reviewed.

Ocular and orbital tumours and tumour-like lesions - a clinico-pathological study of 64 cases

Abstract: Sixty-four ocular and orbital tumours were encountered during a period of six years, in the department of Pathology and Micro­biology, Seth G.S. Medical College, Bombay, of which nineteen were ocular and forty-five were orbital tumours. Retinoblastoma was the commonest tumour amongst the first series while vascular tumours formed the largest group amongst the orbital tumours. The series also included rare tumours like orbital rhabdomyosar­coma, chloroma and diktyoma. Details about clinical presentation and gross and microscopic findings of these tumours are presented.

Significance of leucocyte count in the diagnosis of acute appendicitis.

Abstract: Leucocyte count was estimated in 220 suspected cases of acute appendicitis. The significance of white cell count in 192 cases of pathologically proved appendicitis is reported. It is suggested that the routine leucocyte count, a simple and non-time consuming in­vestigation, is valuable in the assessment of a possible case of acute appendicitis. It is further stressed that although a white cell count below 10,000/cu.mm, does not exclude the possibility of acute ap­pendicitis as seen in the present study, (false low count 7.9% false high 5.4%,) , such a value should prompt further review and con­sideration of diagnosis and it appears that correlation of physical signs with leucocyte count would carry more meaning than either of them alone.

Clinical trial with intravenous clonidine in treatment of severe hypertension.

Abstract: Thirty six patients with severe hypertension were treated with intravenous clonidine. In 67% of cases maximum response was obtained within 11 hours of administration of the drug. Aver­age reduction in mean arterial pressure was 29%. Paradoxical rise in blood pressure was observed in some patients, immediately after clonidine administration. This could be prevented with prior administration of phentolamine intravenously. Clonidine (I.V.) sup­plied by two drug firms gave identical results.

The illogic of peptic ulcer

Abstract: The unmitigated failure of peptic ulcer therapy has prompted this overview of the epistemologic and logical fallacies of the prin­ciples and practice of ulcerology. The illogic, rooted in the very term peptic ulcer, assumes a crescendo momentum, to the detri­ment of the patient. Like many other fields, ulcerology is causali­stically oriented, culminating in cure-all drives against the assum­ed cause-the acid-pepsin complex. A plea is made, on grounds scientific, to view the situation from a different angle, holding the ulcer as dyspeptic, and as such irrelevant to the pathology, clinical features and treatment.

Subcutaneous facial aspergillosis.

Abstract: Two cases of subcutaneous facial aspergillosis are being re­ported. As the overlying skin was healthy, the mode of localisa­tion of fungus remains unclear; because of peculiarity of clinical presentation the diagnosis was brought out only by histology. This mode of presentation has to be kept in mind in the predominantly agricultural communities in India.

Munchausen's syndrome (a case report with a review of the literature).

Abstract: This is a case of Munchausen's syndrome which presented in an atypical manner, viz. cessation of menstruation. The patient had been to 25 doctors and had been investigated with great zeal. The case is published along with a review of the literature, with a view to make clinicians more aware of this rare entity.

Serial intramuscular injections of 15 methyl P.G.F.2alpha for second trimester abortions.

Abstract: Second trimester abortions were induced in forty-four cases by giving serial int.rwmuscular injections of 15 Methyl PGF 2α in intial dose of 200 micrograms followed by 300 micrograms every 3 hours till the foetus was expelled or till a maximum time limit of 30 hours whichever was earlier. Tablets containing diphenoxylate -atropine combination were given to minimise side effects. Forty­three cases (97.8%.) were successful; 39 (88.6%) aborted within the specified time limit of 30 hours. The mean abortion time was 18.8 hours. The main disadvantages were a high percentage of incom­plete abortions (48.8%) and a high incidence of side effects, viz. vomiting and diarrhoea.

Prostatic calculi- (a case report)

Abstract: An interesting case of unusually large, multiple, faceted prostatic calculi is presented. The probable aetiopathology is discussed.

Clinical experience with metolazone--a new diuretic--in cases of edema and ascites due to hepatic cirrhosis, C.C.F., and malnutrition.

Abstract: Metolazone [2-methyl-3-(0-tolyl)-6-sulpharnyl-7-chloro-1, 2, 3, 4­tetra hydro-4-quinazolinone] is recently introduced as a new orally acting diuretic. It is structurally related to sulfonamides and benzo­thiazidines. 41 male patients suffering from generalised edema due to various causes including 7 cases of congestive cardiac failure, 6 cases of malnutrition and 28 cases of hepatic cirrhosis were treated with metolazone given orally in a dose varying from 5 to 60 mg per day. The optimum effective dose was found to be 5 mg per day. 36 cases responded well with a loss of body weight ranging from 2.5 kg. to 12 kg. There was a significant increase in the urine volume and the urinary sodium, potassium and chloride excretion. Saluretic response was marked. Urinary sodium increased from 8-20 mEq/ day to 100 to 120 mEq in 24 hours. No serious side effects were observed during this study. Hypokalemia and hyponatremia occurred on increase of the dose. Occasionally leg cramps and abdominal distress were observed. Metolazone was found to be an effective orally active diuretic in a dose of 5 to 10 , mg/day.

The place of ethacridine lactate for mid-trimester M.T.P. (Multicentric study).

Abstract: Ethacridine Lactate is a safe abortifacient with about 80% success and hardly any side effects. The incidence of retained pla­centa is 16%. The extra-amniotic injection is a technically simple procedure and can be carried out even between 13-15 weeks of pregnancy when intraamniotic injection is difficult. Its bactericidal properties minimise the danger o f post-abortal infection. It can be used in certain medical conditions like hypertension, bronchial asthma where hypertonic saline and prostaglandin are contraindi­cated.

Study of glycolytic intermediates in hereditary elliptocytosis with thalassemia.

Abstract: Glycolytic intermediates like ATP, DPG and GSH have been studied in a family with. hereditary elliptocytosis and thalassemia. Results indicate a fall in ATP with a concomitant rise in DPG in the Patient. Findings are discussed in relation to other data.