Showing papers in "Journal of Postgraduate Medicine in 1979"

Jejuno-Ileal perforations

Abstract: Thirty-two consecutive cases of small bowel perforations have been analysed. The most common aetiology seems to be nonspecific ulceration of the small bowel. The clinical features are not always obvious. Hence careful watch and suspicion are necessary. Four quadrant tap is the most reliable investigation. Early diagnosis is probably the only way to reduce mortality. Minimal surgery gives almost the same results as major surgi­cal procedures.

Pattern of aerobic sputum bacteriology in respiratory tract infections and pneumonias in adults

Abstract: A 4 year study on 93 pneumonias, 70 respiratory tract infec­tions and 20 normals for sputum bacteriology is reported. In controls, mainly Streptococcus pyogenes Staphylococcus and Branhamella catarrhalis were seen and frequently duplicated. In patients, there was a predominance of gram negative bacteria, mainly Enterobacter, Pseudomonas, Klebsiella species. There was some change in the individual frequency over these years, probably attributed to changes in the patterns of antibiotic usage in the general community.

Solitary malignant schwannoma (a case report).

Abstract: A case of retroperitoneal malignant schwannoma is reported. A brief review of the literature is given.

Male infertility and the present status of its management by drugs.

Abstract: Infertility is a common problem and in about 40% of childless couples the husband may also need treatment, alone or alongwith the wife. ln India, however, not much attention has been paid to problems of male fertility and traditionally it is the wife who is primarily held at faith. A proper evaluation of every individual patient and exclusion of surgical conditions like varicocele or obstruction are necessary before starting any drug treatment. No stereotyped regime can succeed for each and every case. Andro­gens, gonadotropins, vitamins A & E, antibiotics and anti-inflam­matory agents are well established modes of therapy, but the dose­schedule has to be carefully determined. Some newer androgens (mesterolone and fIuoxymesterone) can be given orally and are very effective in directly stimulating spermatogenesis. Indigenous drugs (Speman) can be of considerable help in properly selected cases. The hypothalamic releasing factors (GH-RH), Bromocrip­tine etc. are still on trial but hold-promise for the future. Thyroid, anti-estrogens (Clomiphen), corticosteroids, arginine and vitamin B 12 are of doubtful value only. Excessive smoking and alcohol ought to be discouraged. Since the beneficial effect of treatment could be only short lived, it is essential that the wife's fertility is simultaneously assured.

Congenital mitral stenosis

Abstract: Echocardiographic features of congenital mitral stenosis in a six year old female child is described. A significantly reduced ampli­tude of anterior mitral leaflet (8 mm.) in early diastole suggested a tight mitral stenosis with moderate degree of hypoplasia of the left ventricle. Post-operatively echocardiogram was repeated; it was compared with the pre-operative echocardiogram.

Trichobezoar-clinical diagnosis (A case report)

Abstract: Abdominal crepitus over the gastric trichobezoar in the diag­nosis of the same is elucidated and documented radiologically

Heparin rebound--a cause of bleeding following open heart surgery.

Abstract: Fifty patients undergoing open-heart surgery were studied. Twelve patients showed heparin rebound phenomenon in the post­perfusion period and was one of the important factors responsible for bleeding after open-heart surgery. The clotting time came back to normal in all the cases after administration of extra pro­tamine.

Immunoglobulins in newborns: Differential study of premature and full term infants

Abstract: Present study deals with the immunoglobulin levels of the preterm and normal infants born of normal and infected mothers Mean IgG in the full term infants (born of normal mothers) Was found to be 75% of the adult level However mean IgG level was slightly higher in small for date babies than the preterm, but lower than the full term IgM levels were comparable in all the three categories, whereas detectable IgA was found only in full term infants A variable pattern was observed in the infants of all the three groups, born of infected mothers There appeared to be a correlation of increased IgG with higher birth weight while lower birth weight infants had increased IgM

Apert's syndrome--a type of acrocephalosyndactyly (a case report).

Abstract: A case of acrocephalosyndactyly diagnosed at birth is report­ed for its rarity. The typical features are described and the mode of inheritance discussed.

Transplacental haemorrhage and maternal iso-immunization.

Abstract: Foetomaternal haemorrhage is one of the important factors influencing maternal iso-immunization In the present report at­tempt is made to study various aspects of foetomaternal haemor­rhage While the overall incidence of foetal cell leak was observed in 2143%, the incidence in the complicated deliveries ranged from 2794 to 8572% Incidence was not influenced by parity, however ABO compatible deliveries showed slight increase in the incidence (2256%) as compared to ABO incompatible (1875%) deliveries ABO incompatible foetal cells were eliminated within 24 hours after delivery Incidence of foetal cell leak was 828% in medical termination of pregnancy Anth-Rh was produced in two out of nine women having foetal cell leak

Echocardiographic features of the interventricular sep­tal motion in constrictive pericarditis

Abstract: Echocardiographic features of interventricular septum were studied in four patients with constrictive pericarditis. The systolic motion was normal in one patient and paradoxic in the other three. All four patients had an abrupt anterior motion which was followed by a sudden brisk posterior motion immediately in early diastole, following the diastolic dip of the septum. This motion was coinci­dent with the `y' trough of the jugular venous pulse. The septal thickening values were within normal range.

Laryngeal adenoidcystic carcinoma.

Abstract: A 72 year old male patient was admitted with complaints of dyspnoeaa of two months' duration. On local examination of 'he larynx, a polypoidal growth was seen in the sub glottis. Biopsy report was adenoid cystic carcinoma. Total laryngectomy was carried out. Post-operative course was uneventful. Occurrence of adenoid cystic carcinoma in the region of sub glottis is rare.

Ciguatera (a variety of fresh fish poisoning) (a case report)

Abstract: A case of fresh fish poisoning, most probably ciguatera, is reported. A brief review of the literature is presented.

Ehlers-Danlos syndrome with monostotic fibrous dysplasia.

Abstract: An unusual case of Ehlers-Danlos syndrome with monostotic fibrous dysplasia of the humorus is presented. The other orthopae­dic manifestations, its complications and associated features are re­viewed and summarised.

Herpes generalisata assoicated with diabetes mellitus and pulmonary tuberculosis (a case report).

Abstract: An unusual case of Herpes Generalisata with diabetes mellitus and pulmonary tuberculosis is reported. This condition has beer, regularly reported in various immunologically suppressed states like Hodgkin's disease, other lymphomas and leukaemias, but its occur­rence with diabetes mellitus has been described for the first time in our case.

The augmentary effect of intramuscular prostaglandins on ethacridine lactate.

Abstract: A combination of 100 ml of 0.1% Ethacridine lactate solution and two intra-muscular injections of prostaglandin (300 µg each of I5-Methyl-PGF 2α)was tried for safe termination of pregnancy. It was found that the success rate (88%) with this combination regimen was better than ethacridine lactate alone but a little inferior to prostaglandins alone. Average abortion interval was also less than with ethacridine lactate. However, the combination did not reduce the gastro-intestinal disturbances associated with prostaglandins.

Thrombocyte function in relation to the long term application of medroxyprogesterone acetate as a female contraceptive agent

Abstract: In two hundred and twenty eight parous women between thirty and forty years o f age, Medroxyprogesterone acetate 150 mg depot injection every three months proved to be a one hundred per cent contraceptive agent. Minimal side effects were noted with some spotting and amenorrhoea. No significant increase in blood coagula­tion and tendency to thrombosis was noted as tested by the platelet aggregation test during medication.

Echocardiographic features of right ventricular volume overload

Abstract: Interventricular septal motion is studied in sixty tow cases clas­sified into 3 groups; Gr. 1-right ventricular volume overload (RVVO); Gr. II-combined right ventricular volume overload and left ventricular volume overload (RVVO + LVVO); Gr. III-com­bined right ventricular volume overload and right ventricular pres­sure overload (RVVO + RVPO). A linear relationship was obtained between the right ventricu­lar dimension index (RVDI) obtained echocardiographically and the magnitude of the left to right shunt at the atrial level (Qn/Qs). Two rare instances of false negatives in a hemodynamically in­significant left to right shunt and in a large ASD are reported. Modification of abnormal septal motion in Gr. II and Gr. III is studied. Lesion specific features of certain anomalies i.e. Ebstein's ano­maly, total anomalous pulmonary venous return (TAPVR) and en­docardial cushion defects (ECD) are discussed.

Normal left atrial dimensions in indians by echo­cardiography

Abstract: One hundred normal Indian subjects were studied to establish the normal left atrial dimension (LAD), left atrial dimension cor­rected to body surface area (LA index) and left atrium to aorta ratio (LA/AO) for this population. Normal mean LAD was 21.9 ± 3.6 mm (12 mm to 30 mm). Elderly subjects had higher mean LAD (25.2 ± 3.6 mm). The LA index for adults was 14.1 ± 2.5 mm. LA index for younger subjects was higher because of low body sur­face area. Mean LA/AO was 0.95± 0.22;LA/AO greater than 1.17 is suggested as a criterion for LA enlargement.

A case of hypokalaemia simulating hyperkalaemia

Abstract: A case of chronic renal failure with hypokalaemia presenting electrographically as tall `U' waves simulating tall `T' waves of hyperkalaemia is described. The differentiating points between hypokalaemia and hyperkalaemia on ECG have been highlighted.

Serum lactic dehydrogenase isoenzymes and serum hydroxy butyric dehydrogenase in myocardial infarction.

Abstract: Total serum lactate dehydrogenase activity in cases of myocar­dial infarct is difficult to interpret as abnormal values can occur in diseases of liver, kidney and skeletal muscle. The estimation of its isoenzymes is of better diagnostic help because of its tissue specificity. Serum LDH isoenzymes were studied in patients o f myocardial infarction and results are quantitated by densitometry. As LDH 1 represents serum hydroxybutyric dehydrogenase when 2-oxylbutyrate is used as substrate, serum hydroxybutyric dehydro­genase was also estimated in above patients. Greater specificity in diagnosis is achieved with SHBDH because of its myocardial nature and lower incidence of false positive results.

Infective endocarditis causing acute aortic regurgitation. (A case report).

Abstract: Interesting echocardiographic features in a case o f acute onset aortic regurgitation due to infective endocarditis of bicuspid aortic valve are reported. Early closure of mitral valve (ECMV) recog­nised by echocardiography confirmed the clinical diagnosis of acute inset aortic regurgitation. Aortic root echocardiogram showed ec-centric diastolic closure line of bicuspid aortic leaflets and multiple echoes on aortic leaflets due to bacterial vegetations.

Diagnostic and therapeutic value of early synovectomy of the knee joint -(An analysis of 60 cases)

Abstract: A study of sixty well selected cases of synovitis of the knee joint, treated by timely adequate synovectomy, followed up over a period of four years is presented. We have stressed the importance of therapeutic and diagnostic value of synovectomy. The results are found encouraging and the procedure useful in preventing damage to the articular structures of the knee joint. The best results are obtained in non-specific, traumatic and very early cases of rheuma­toid arthritis while infective arthritis benefits to fair extent.

False negative mitral valve echo in a case of lutembacher's syndrome

Abstract: A case of false negative mitral valve echo gram in a case of Lutembacher's Syndrome is reported. In our understanding this is the first case report in the literature.

Aneurysm of membranous interventricular septum

Abstract: Echocardiographic features of an aneurysm of membranous in­terventricular septum are presented in a case of coarctation of aorta with membranous interventricular septal defect. The diagnosis was made by angiography.

Sleep deprivation in depression

Abstract: Ten patients diagnosed as suffering from depressive illness were treated with 2 consecutive nights of sleep deprivation Sleep deprivation was effective in both types of depression viz endoge­nous and reactive The improvement was greater and seemed to last longer in endogenous depression as compared to reactive depression at the time of evaluation, 7 days after completion of sleep deprivation Depressed mood, suicidal tendencies and retard­ation seemed to show the greatest improvement while insight and gastro-intestinal and somatic symptoms, improved the least