Showing papers in "Journal of Postgraduate Medicine in 1990"

Effect of Asparagus racemosus (Shatavari) on gastric emptying time in normal healthy volunteers.

Abstract: Asparagus racemosus (Shatavari) is used in Ayurveda for dyspepsia (amlapitta) and as a galactogogue. It was hence compared with a modern drug, metoclopramide, which is used in dyspepsia to reduce gastric emptying time. Gastric emptying half- time (GE t1/2) was studied in 8 healthy male volunteers using a cross-over design. The basal GE t1/2 in volunteers was 159.9 +/- 45.9 min (mean +/- SD) which was reduced to 101 +/- 40.8 min by Shatavari (p less than 0.001) and to 85.3 +/- 21.9 by metoclopramide (p less than 0.001). Metoclopramide and Shatavari did not differ significantly in their effects.

Comparative evaluation of bone marrow aspirate particle smears, imprints and biopsy sections.

Abstract: Comparative evaluation of bone marrow aspirate particle smears, imprints and biopsy sections was done on 30 haematological problems. Core needle biopsy of the bone marrow is a safe and useful procedure. It is a valuable diagnostic aid for measurement of marrow cellularity, metastatic tumours and fibrosis. It should not be taken as a substitute for examination of the marrow by aspiration smear but is a complementary procedure which affords several advantages. Bone marrow biopsy was of maximum utility in myelofibrosis which was diagnosed on biopsy alone. There were three additional cases with normal bone marrow aspiration in which specific diagnosis could only be made from bone marrow biopsy sections. New methodologies i.e. plastic embedding and semi thin sections of undecalcified bone marrow, can be expected to improve the cytological details of tissue obtained by biopsy. Imprint preparations obtained from biopsy can be useful in patients of malignancy but we have found them to be of limited value except in cases of dry tap.

Serum sialic acid levels in healthy individuals.

Abstract: Serum sialic acid values, estimated by thiobarbituric acid method of Warren as modified by Saifer and Gerstenfeld in 50 normal healthy persons of both sexes are reported The average values were 6847 +/- 485 mg% and 6777 +/- 787 mg% for males and females respectively and for both sexes the value was 6812 +/- 670 mg% Age and sex have no influence on sialic acid levels in serum

Outcome of teenage pregnancy.

Abstract: Two hundred consecutive cases up to 19 years of age admitted for confinement at The Nowrosjee Wadia Maternity Hospital, Bombay, were studied. Out of these 200 girls, 6 were unmarried, 51 were anaemic, 20 had toxaemia of pregnancy. Six girls (43%) in the age group 15-17 years delivered prematurely as compared to only 26 girls (14%) in the age group of 17-19 years. This difference is statistically significant. Also, only, 4 girls (29%) in the age group of 15-17 years had full term normal delivery as compared to 113 girls (61%) in the age group of 17-19 years signifying that the outcome of pregnancy becomes worst in girls below the age of 17 years. Ten babies (71%) of mothers in the age group of 15-17 years were LBW as compared to 75 babies (44%) of mothers in the age group of 17-19 years signifying that the incidence of LBW babies is inversely proportional to maternal age. Teenage pregnant girls needed more attention for prevention and treatment of preeclampsia eclampsia, anaemia, prematurity and LBW.

Boari flap calycovesicostomy: a salvage procedure for giant hydronephrosis due to ureteropelvic junction obstruction.

Abstract: The surgical management of two patients with giant hydronephrosis in a solitary kidney treated by Boari flap calycovesicostomy is presented. In one patient, this operation was done following unsuccessful previous pyeloplasty, while in the other this was done as the primary operation. Though free reflux was observed in both the cases, the refluxed contrast emptied satisfactorily after double voiding. No deterioration of renal function was noted during the follow-up period of 12 months.

Pediatric ocular trauma--a clinical presentation.

Abstract: A year long study of ocular injuries in children below the age of 15 years was conducted in the Ophthalmology Department of a general hospital. Fortyfour cases were studied. Of these 45.45% were in the age group of 6-10 years. The male to female ratio was 5.28 : 1. Pointed objects viz. sticks, wires etc. were found to be the common causative agents; the recent trend being of bow and arrow injuries. Ocular perforation was observed in 28 cases. On follow up of all the cases with ocular trauma, only 12 patients were found to have a visual acuity better than 6/18; perception of light was absent in 7 patients. A need for increased parental awareness and supervision of children is stressed upon.

Diagnosis of peripheral arterial occlusive diseases using impedance plethysmography.

Abstract: Impedance plethysmographic observations have been compared with arteriographic findings in 216 patients with peripheral arterial occlusive diseases Impedance plethysmographic diagnosis in these patients was obtained by Parulkar's method without apriori knowledge of arteriographic diagnosis But for minor discrepancy in the anatomical location of the block in few patients, impedance plethysmographic observations correlated very well with arteriographic findings Impedance plethysmographic diagnosis was found to be correct in 312, wrong in 53, false negative in 8 limbs respectively, yielding a sensitivity of 975% and specificity of 981% of this technique

Choledochoduodenal fistula complicating duodenal ulcer disease (a report of 3 cases).

Abstract: Choledochoduodenal fistula complicating duodenal ulcer disease is a rare occurrence. The present paper describes 3 such cases which were incidentally picked up on upper gastro-intestinal (GI) radiographic study and endoscopy done for ulcer like symptoms. The relevant literature is reviewed.

Plasma fibrinogen levels in stroke.

Abstract: Plasma fibrinogen levels were estimated in 56 patients of stroke, admitted in the hospital within 24 hours of symptoms. The levels were found to be raised significantly (531.73 +/- 74 mg%) compared to those of the age and sex matched control group (445.78 +/- 92.28 mg%). When the levels in stroke group with one risk factor were compared to those of individuals with comparable control group with same risk factor, a significant difference was observed in hypertensive, smokers, alcoholics and atherosclerotic stroke groups, which indicates that the observed rise is related to phenomenon of stroke rather than the associated risk factors. However, the rise observed in hypertensive stroke group (554.26 +/- 47.08 mg%) is significantly more (p. less than 0.01) than that occurring for nonhypertensive stroke group (497.82 +/- 93.12 mg%) indicating that the presence of hypertension does contribute to the rise.

Impedance plethysmography of thoracic region: impedance cardiography

Abstract: Impedance plethysmograms were recorded from thoracic region in 254 normal subjects, 183 patients with coronary artery disease, 391 patients with valvular heart disease and 107 patients with congenital septal disorder. The data in 18 normal subjects and 55 patients showed that basal impedance decreases markedly during exercise in patients with ischaemic heart disease. Estimation of cardiac index by this technique in a group of 99 normal subjects has been observed to be more consistent than that of the stroke volume. Estimation of systolic time index from impedance plethysmograms in 34 normal subjects has been shown to be as reliable as that from electrocardiogram, phonocardiogram and carotid pulse tracing. Changes in the shape of plethysmographic waveform produced by valvular and congenital heart diseases are briefly described and the role of this technique in screening cardiac patients has been highlighted.

Impedance plethysmography: basic principles.

Abstract: Impedance Plethysmography technique has been discussed with explanation of two compartment model and parallel conductor theory for the estimation of peripheral blood flow and stroke volume Various methods for signal enhancement to facilitate computation of blood flow are briefly described Source of error in the estimation of peripheral blood flow is identified and the correction has been suggested

Pneumoperitoneum and pneumomediastinum: unusual complications of laparoscopy.

Abstract: Pneumoretroperitoneum and pneumomediastinum are rare complications of laparoscopy. We report one such case. The mechanism of development of these complications is explained. No specific treatment needs to be instituted in most of these patients.

Poisoning in children--analysis of 250 cases.

Abstract: This study is an analysis of 250 cases over a period of 2 years, admitted to our hospital for various poisonings. The total incidence of poisoning was 11.9%, much higher as compared to the other series. Of these, 58.4% were seen in the age group of 1-4 years. Male to female ratio was 1.7:1. Incidence of food poisoning was 48.8% followed by that of kerosene (24%), pesticides (9.6%), chemicals and medicaments (8.4%), plant (3.6%) and animal bites (3.2%). Overall mortality was 0.8%.

Psychiatric referral pattern in general hospital.

Abstract: Here we have tried to analyse the psychiatric referral pattern in general hospital setting In one year period, 2020% of the total new cases in psychiatry OPD were referred cases Majority of the patients were referred at OPD level Males were more than females Physicians referred maximum cases than surgeons and gynaecologist Neurosis was the common diagnosis amongst the referred cases As one of the senior psychiatrists has mentioned 'lack of referral's by the non-psychiatrists has been an unfortunate negative factor for the growth of psychiatry

Technical aspects of impedance plethysmography.

Abstract: This paper describes the basic methods for measurement of body impedance, electrodes and their configuration, and the measuring instrument with its limitations. A microcomputer assisted impedance plethysmograph system, developed at BARC and different lead configurations for impedance plethysmographic investigation are also described. Typical impedance plethysmographic waveforms recorded from a normal subject and measurement of their amplitude and various time intervals are illustrated.

Cystic degeneration in an adenomyoma (a case report).

Abstract: Cystic degeneration though often seen in a leiomyoma, has not been reported so far in an adenomyoma. Hence, a unique case of cystic degeneration in an adenomyoma of the uterus is presented.

Neuralgic amyotrophy: a long term follow-up of four cases.

Abstract: Neuralgic amyotrophy or brachial plexus neuralgia is a condition of uncertain etiology. It needs to be differentiated from the usual brachial plexus injuries. Nerves outside the plexus especially the spinal accessory nerve are involved. Neuralgia is also a feature. Four cases were followed-up in detail over a period of two years. The condition usually resolves almost completely on its own.

Correlation of serum vitamin A and its transport protein (RBP) in malnourished and vitamin A deficient children.

Abstract: Eighty nine children were studied for retinol (vitamin A) estimation and its transport protein--retinol-Binding Protein (RBP) Serum levels of retinol, RBP and serum protein and albumin were found to be low in children with signs of vit A deficiency irrespective of their nutritional status Serum levels of retinol and RBP were risen significantly almost double, after the oral and parenteral administration of vitamin A PEM interferes with hepatic synthesis of RBP and the release of RBP from the liver depends on vitamin A Vitamin A is a limiting factor, the presence of which is required for the release of apo-RBP from the liver

Hashimoto's thyroiditis--a clinical review.

Abstract: Hashimoto's thyroiditis constituted 5.15% of total thyroid disorders examined from January 1983 to July 1987. Females were predominant sufferers. Average age of patients was 41.14 years. Functionally 10 patients were euthyroid, while hyperthyroidism was present in 4 cases. Its preoperative diagnosis was not possible in any of the case. All patients were subjected to surgery and postoperative thyroxine supplement.

Clinical and mycological spectrum of cutaneous candidiasis in Bombay.

Abstract: A total of 150 patients with cutaneous candidiasis were studied. A detailed clinical history was taken. Scrapings were examined in 10% KOH, and the material cultured on Sabouraud's agar. Species were identified by the serum germ tube test, sugar fermentation and sugar assimilation tests. Of 150 patients 79 were females. The commonest presentation was intertrigo (75), vulvovaginitis (19) and paronychia (17). A history of chronic exposure to water was obtained in 94 cases, all had erosio interdigitalis blastomycetica and/or paronychia. Diabetes melltius as a predisposing factor was observed in 22 patients. The 10 cases of balanoposthitis had associated diabetes mellitus. Smear and culture were positive in all the patients. C. albicans was isolated in 136 cases, C. tropicalis in 12, and C. guillermondi in 2. The cultures of C. albicans had positive serum germ tube test. The 6 patients in the paediatric age group having perianal/genital involvement had a stools culture positive for C. albicans.

Congenital lipodystrophy with defective leucocyte function (a case report).

Abstract: A 6 1/2 year old female child with congenital lipodystrophy is being presented. The noteworthy feature in this case was the defective leucocyte function and its association with tuberculous pericardial effusion.

Paroxysmal nocturnal hemoglobinuria: a study of 17 cases.

Abstract: Retrospective analysis of 17 cases of paroxysmal nocturnal hemoglobinuria (PNH) was carried out. The presenting feature of anaemia and hemoglobin of less than 9 gm% were observed in all cases. Fever, jaundice and bleeding tendency were observed in 8, 8 and 7 cases respectively. Bone marrow examination revealed megaloblastic features, erythroid hyperplasia and hypocellularity in 8, 7 and 2 cases respectively. Fourteen cases were refractory to the treatment, while only 3 showed response.

Opponensplasty--an experience of twenty-three cases using three techniques

Abstract: Twenty-three opponensplasties were performed in 21 subjects. Flexor sublimis transfer was carried out in 15 hands, brachioradialis transfer in 4 hands, Makin's translocation of flexor pollicis longus in 2 hands and our modification of Makin's procedure in 2. The results were graded as excellent in 13 hands, good in 6 hands, fair in 3 hands and poor in 1 hand. Further, the power of pinch was graded as good in 14 hands, fair in 7 hands and poor in 2 hands. We suggest that it is almost always possible to devise an appropriate procedure to restore the opposition of the thumb.

Diagnosis of venous disorders using impedance plethysmography.

Abstract: Impedance plethysmography (IPG) was carried out in one hundred and forty-one patients suspected of venous disorders using Parulkar's method. In these patients occlusive impedance phlebography (OIP) and venography were also carried out using standard procedures. Comparison of IPG and OIP observations with venographic findings revealed sensitivity of these methods to be 65% and 77.7% in the diagnosis of primary varicosity of veins and chronic deep vein thrombosis respectively with a specificity of 85%. Occlusive impedance phlebograms showing unilateral decrease in OIP parameters were observed to be sufficiently diagnostic. IPG observations in 5 patients with arterio-venous malformation were observed to be different from those in patients with deep vein thrombosis.

Liver trauma (management in 105 consecutive cases).

Abstract: One hundred and five consecutive patients who sustained liver trauma during the period from Jan 1986 to Dec 1988 are reviewed. Of these, 82 cases suffered from blunt abdominal injury while the rest had penetrating trauma. Simple hepatorrhaphy and use of topical hemostatic agents were the only modes of treatment for 76 cases, hepato-omentorrhaphy was used in 12 cases and hepatotomy with selective vascular ligation and resectional debridement were carried out in remaining 17 cases. Mortality was 36.2% (38/105), 30 patients died of shock in the perioperative period. Uncomplicated recovery occurred in 50 cases.

Evaluation of penfluridol in hospitalised chronic schizophrenic.

Abstract: Thirty chronic schizophrenic patients completed 12 week treatment with a single weekly dose of 20 mg penfluridol, a new long acting oral neuroleptic. The patients were evaluated by using modified rating scale. Significant reduction in scores was demonstrated in 15 out of 26 symptom variables. Few side effects were reported which were easily controlled by conventional antiparkinson agents. Laboratory investigations remained within normal limits.