Showing papers in "Medical journal, Armed Forces India in 2007"
TL;DR: Thoroughly revised and updated 8th edition presents coverage of the hottest topics in today's practice, including eosinophilic esophagitis, GERD and Barrett's oesophagus, molecular pathogenesis of a variety of disease including colon neoplasia, Whipple's disease, eating disorders and food allergies, management of obesity, diagnosis and management of sprue and sprue like illnesses and bacterial overgrowth states.
Abstract: A comprehensive book for all of those involved in care of patients with gastrointestinal and liver disease. It is an easy to read text that encompasses all clinical aspects of gastroenterology and hepatology. For more than 30 years, this best selling reference has been the resource to consult for the latest knowledge in gastrointestinal and liver diseases. Featuring the practice proven experience of world-renowned expert, the valuable resource provides evidence-based perspectives on all clinically relevant topics, explaining how to apply the latest advances in practice.
Thoroughly revised and updated 8th edition presents coverage of the hottest topics in today's practice, including eosinophilic esophagitis, GERD and Barrett's oesophagus, molecular pathogenesis of a variety of disease including colon neoplasia, Whipple's disease, eating disorders and food allergies, management of obesity, diagnosis and management of sprue and sprue like illnesses and bacterial overgrowth states.
It features four new chapters covering complimentary and alternating medicine, palliative care and gastrointestinal stromal tumour (GIST). It offers more than 1000 illustrations, photographs and tables thus promoting visual grasp of material.
166 citations
TL;DR: Economic analysis of drug expenditure of priced vocabulary of medical stores (PVMS) section 01 for the year 2003 of a 190 bedded service hospital was under taken and drugs were classified in to Category I (AV+BV+CV+AE+AD) comprising 68 drugs, Category II (BE + CE +BD) 159 and Category III (CD) 98 drugs.
Abstract: Background
The basic principle of inventory control is ABC based on cost criteria and VED on criticality.
65 citations
TL;DR: Caudal regression syndrome and cases of lower spine agenesis with additional anomalies of the axial skeleton and internal organs are now considered as defects of blastogenesis, originating in the primary developmental field and/or the progenitor fields, representing polytopic field defects.
Abstract: Caudal regression syndrome is a rare congenital abnormality in which a segment of the spine and spinal cord fails to develop. The severity of the morphologic derangement inversely correlates with residual spinal cord function [1].
Cases of lower spine agenesis with additional anomalies of the axial skeleton and internal organs are now considered as defects of blastogenesis, originating in the primary developmental field and/or the progenitor fields, representing polytopic field defects. Sacral agenesis or caudal dysplasia is an anomaly found more often in offspring of diabetic women. Severe forms are commonly associated with cardiac, renal and respiratory problems, which are responsible for early neonatal death.
43 citations
TL;DR: Respiratory distress is a common emergency responsible for 30-40% of admissions in the neonatal period and should be made in the first few minutes of seeing the baby and immediate lifesaving measures should be undertaken till further management plans are drawn up.
Abstract: Respiratory distress is a common emergency responsible for 30-40% of admissions in the neonatal period. A working diagnosis should be made in the first few minutes of seeing the baby and immediate lifesaving measures should be undertaken till further management plans are drawn up. Respiratory distress in the neonate is diagnosed when one or more of the following is present; tachypnoea or respiratory rate of more than 60/minute retractions or increased chest in drawings on respirations (subcostal intercostal sternal suprasternal) and noisy respiration in the form of a grunt stridor or wheeze. The distress may or may not be associated with cyanosis and desaturation on pulse oximetry. (excerpt)
41 citations
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TL;DR: This report reports an unusual case where in spite of advanced cystic dilations of biliary tree, the patient did not suffer a single episode of cholangitis.
Abstract: Caroli's disease is a rare congenital disorder of the liver characterized by saccular or fusiform dilatation of the intrahepatic biliary ducts. In majority the transmission is autosomal recessive [1] but autosomal dominant inheritance has also been reported [2]. The main clinical features are intermittent abdominal pain, hepatomegaly and recurrent cholangitis [1, 3]. We report an unusual case where in spite of advanced cystic dilations of biliary tree, the patient did not suffer a single episode of cholangitis.
40 citations
TL;DR: Increased awareness must be created about the dangers of chronic mercury poisoning, its prevention, the importance of regular monitoring of blood mercury levels and the mercury vapour levels in the clinic and the practical steps to prevent them needs to be reinforced.
Abstract: Background
This study was conducted to assess and increase the level of awareness of occupational hazards among the dental surgeons of Indian Navy.
38 citations
TL;DR: Changing pattern of antibiotic resistance in enteric fever with reemergence of chloramphenicol sensitivity in northern India is suggested.
Abstract: Background
Enteric fever is a global health problem and rapidly developing resistance to various drugs makes the situation more alarming. Drug sensitivity in Salmonella enterica serovar typhi and Salmonella enterica serovar paratyphi A isolated from 45 blood culture positive cases of enteric fever was tested to determine in-vitro susceptibility pattern of prevalent strains in northern India.
31 citations
TL;DR: The findings of high occupational stress in junior sailors needs to be investigated further with a larger sample of naval personnel serving afloat and ashore.
Abstract: Introduction
Increased stress levels have been reported and it has been implicated for mental illness amongst service personnel. However no study has been reported among Indian naval sailors.
26 citations
TL;DR: Screening of blood for anti - HBc total is practical in the western world as the incidence of HBsAg and anti-HBc is low in these countries and these positive blood units for anti- HBcAg total can be discarded.
Abstract: Background
Transfusion transmitted hepatitis B has always been a dreaded disease, with incidence of increased transmission through donated blood. The screening test for hepatitis B infection is detection of HBsAg that does not rule out the risk of transmission of hepatitis B as the donor may be in the ‘window period’. During this period, detection of the antibody to the hepatitis B core antigen (anti-HBc) IgM type serves as a useful serological marker. The aim of this study was to screen blood donors for anti-HBc type IgM and anti - HBc Ag total for detection and to find their incidence amongst blood donors.
25 citations
TL;DR: These guidelines seek to translate the advances in the understanding of pathogenesis of asthma and in the development of new agents and strategies into practical application at all levels of healthcare by advocating an assessment of the patients to classify the severity of diseases followed by a step-wise approach to treatment.
Abstract: Asthma is a common disease worldwide with significant ethnic and regional variations. An increasing morbidity and mortality, as well as health care burden from asthma have been recognized lately. Several evidence based guidelines have been developed with an aim to standardize and improve the quality of management. These guidelines seek to translate the advances in the understanding of pathogenesis of asthma and in the development of new agents and strategies into practical application at all levels of healthcare. These advocate an assessment of the patients to classify the severity of diseases followed by a step-wise approach to treatment. With the current management we hope to achieve minimum or nil day time and night time symptoms, prevent acute exacerbations and attain normal or near normal lung function, thus improving the overall quality of life.
23 citations
TL;DR: It is demonstrated that over satisfaction and relaxed attitude may have poor academic outcome and anxiety and depression scores fell within normal limits.
Abstract: Background
Training in medicine is emotionally demanding Psychological well being of medical students is a matter of concern There is lack of Indian studies in this area
TL;DR: A high level of suspicion and routine history about the kind of indoor heating, specially in cold climate areas during winter will help in early diagnosis and decrease the incidence of misdiagnosis of CO poisoning.
Abstract: Carbon monoxide (CO) is a nonirritating colourless, odourless gas produced by incomplete burning of carbon containing fossil fuels. The normal concentration in atmosphere is less than 0.001% and a concentration of 0.1% can be lethal. It causes thousands of uncalled for deaths each year. Patients who survive the initial poisoning can develop delayed neurologic dysfunction, which occurs in 14-40% of serious cases. At present CO is one of the commonly encountered poison in our environment and a leading cause of poisoning world wide [1, 2, 3]. Poisoning can be acute, subacute and chronic [4].
TL;DR: In this paper, the authors performed a retrospective analysis of 213 patients who attended a child guidance clinic in armed forces and found mental retardation in 30.97%, behavioral and emotional disorders in 23.06% and neurotic, stress related and somatoform disorders in 15.98%.
Abstract: Background There is a paucity of Indian studies on psychiatric morbidity in children. Present work was undertaken in a child guidance clinic in armed forces. Methods Retrospective analysis of 213 patients who attended a child guidance clinic was done. Results Majority (n=138) were boys. 55.9% were referred from paediatric outpatient department while medical officers in periphery referred 38.5%. The diagnoses was mental retardation in 30.97%, behavioral and emotional disorders in 23.06% and neurotic, stress related and somatoform disorders in 15.98% cases.
TL;DR: It was observed that the samples of thickness 2mm for all the materials underwent least compression, which implies that minimum thickness of the recording materials should be used for recording maxillomandibular relations without sacrificing the strength of the interocclusal record.
Abstract: Background The fabrication of dental prosthesis requires the transfer of interocclusal records from patient's mouth to semi-adjustable articulators using different kinds of recording media. Any inaccuracy in these interocclusal records leads to occlusal errors in the final prosthesis. This study was conducted to evaluate the dimensional changes occurring in the interocclusal recording material over a given period of time and the material's resistance to compression during the cast mounting on the articulator. Methods In this in vitro study, the linear dimensional change and compressive resistance of four commercially available elastomeric interocclusal recording media was tested. Three were addition silicones and the fourth was a polyether material. Cylindrical samples of 10mm diameter of each material were prepared in three different thicknesses of 2, 4 and 6mm. Ten samples each of thickness of 2, 4 and 6mm for all four materials were prepared (total of 120 samples). The linear dimensional changes of the samples were evaluated after 24 hours of fabrication. The compressive resistance was measured when each of these was subjected to a constant compressive load of 25 Newtons. Results The mean linear dimensional change in a horizontal plane was minimum for Kanibite Hard, an addition silicone. Ramitec showed the maximum linear dimensional change. The mean compression distance was least for Futar D Occlusion (an addition silicone) and maximum for Ramitec (a polyether). It was observed that the samples of thickness 2mm for all the materials underwent least compression. Conclusion The compressive resistance of each elastomer was inversely proportional to the thickness of the sample. This implies that minimum thickness of the recording materials should be used for recording maxillomandibular relations without sacrificing the strength of the interocclusal record.
TL;DR: There was a higher incidence of caries index, missing teeth and less filled teeth among psychiatric patients, indicating extensive dental treatment requirement for this group.
Abstract: Background
This study was conducted to assess the dental treatment requirements of psychiatric patients in comparison with the non psychiatric patients admitted in the hospital.
TL;DR: Renal and perinephric space infection continues to be a serious urological problem with high mortality rate and a high index of suspicion, prompt diagnosis, appropriate antibiotics and surgical intervention may be effective in reducing mortality.
Abstract: Background
This study was carried out to assess the spectrum of renal and perinephric space infection among urology patients admitted in the last three years.
TL;DR: An unusual complication of this procedure is highlighted with two of the authors' cases developing spontaneous extrusion of the lower end of the tube through the anal opening, and the possible predisposing factors for this complication are discussed.
Abstract: The diversion of cerebrospinal fluid (CSF) for hydrocephalus is an established surgical practice, after its feasibility was demonstrated in the early 1900s [1]. Various valve assemblies have been devised and we use valve regulated ventriculoperitoneal shunt with a slit lower end [2]. More than 100 shunts have been placed for congenital/post meningitis hydrocephalus in children, at our centre. Many abdominal complications have been described which include fibrous encasement of the peritoneal tip, blocking or kinking of the distal tube, slipping out through the surgical wound or migration of the shunt or its component parts into the various abdominal cavities [2]. Other complications are infection, CSF fistula, paralytic ileus in the immediate postoperative period, failure of peritoneal absorption of the diverted CSF, perforation of the bowel by the abdominal tube, development of hydrocele, appearance of a peritoneal cyst and spontaneous extrusion of the tube through the umbilicus [3, 4]. We highlight an unusual complication of this procedure with two of our cases developing spontaneous extrusion of the lower end of the tube through the anal opening. The possible predisposing factors for this complication are discussed.
TL;DR: It is mandatory for all health care providers to understand the condition and aim at an early diagnosis of bleeding in early pregnancy, and to keep best of the clinicians perplexed of the ectopic pregnancy.
Abstract: Bleeding in early pregnancy may be life threatening. A small amount of bleeding or spotting per vaginum which may be dismissed as trivial can be catastrophic. Hence it is mandatory for all health care providers to understand the condition and aim at an early diagnosis. There are three important causes of bleeding in early pregnancy namely abortion ectopic pregnancy and hydatidiform mole in the order of frequency of their occurrence. However of the three ectopic pregnancy keeps best of the clinicians perplexed and may prove fatal earlier and more often than abortion and hydatidiform mole. (excerpt)
TL;DR: The experience of graft and patient survival of initial 500 renal transplants performed between May 1991 and July 2006, at Army Hospital (R&R) is presented, with short-term graft survival comparable to the best centres of the world.
Abstract: Background
Renal transplantation is the treatment modality of choice for patients with end stage kidney failure. We present our experience of graft and patient survival of initial 500 renal transplants performed between May 1991 and July 2006, at Army Hospital (R&R).
TL;DR: In India 30,000 people die and 1.25,000 become disabled due to traumatic brain injury (TBI) as discussed by the authors and the psychiatric sequalae of TBI can be acute and chronic.
Abstract: In India 30,000 people die and 1,25,000 become disabled due traumatic brain injury (TBI). The psychiatric sequalae of TBI can be acute and chronic. Chronic sequalae of TBI are usually ignored and may take the form of defects of cognition, memory, perception, language or intelligence. It may also lead to inappropriate aggression, sexual behaviour, personality change, mood changes, neurosis and psychosis. Neuropsychological assessment of TBI can be pharmacological or behavioural. Survivors of TBI are referred to a walking wounded and require to be cared for.
TL;DR: A case of bronchial foreign body with an unusual feature of subcutaneous emphysema is reported and the usual presenting symptoms are choking, gagging followed by wheezing and respiratory distress.
Abstract: Airway foreign bodies continue to pose a diagnostic and therapeutic challenge for otolaryngologists. Most airway foreign body aspirations occur in patients below 15 years of age and 80-90% in children below five years of age. Vegetable matter especially peanuts, are the commonest bronchial foreign bodies. These foreign bodies become lodged in the bronchus because of their size and configuration which allows their passage through the larynx and trachea but not through the bronchi.
The usual presenting symptoms are choking, gagging followed by wheezing and respiratory distress. We report a case of bronchial foreign body with an unusual feature of subcutaneous emphysema.
TL;DR: Follow up with color doppler and CT angiography within a week, 6 and 12 months period showed successful regression of pseudoaneurysms in all cases.
Abstract: Background
The incidence of pseudoaneurysm has increased due to the large number of vascular procedures performed and the widespread use of anticoagulation therapy during procedures. Non-invasive methods for management of pseudoaneurysms comprise of ultrasound guided compression (USGC), thrombin therapy, arterial embolisation and endovascular stent graft insertion. We discuss our experience in the management of fourteen cases of pseudoaneurysms using non surgical techniques.
TL;DR: An understanding of the necessary requirement for successful laser lithotripsy became apparent, including the ability to deliver energy through optical fibres, need to limit distant thermal effects and production of a shock wave of sufficient force to exceed the tensile strength of the stone.
Abstract: Albert Einstein can be considered the ‘father’ of laser (light amplification by the stimulated emission of radiation) technology [1]. It was almost seven decades later in 1968 that Mulvaney and Beck [2] developed a ruby laser capable of calculus fragmentation with considerable expenditure of energy, resulting in excessive heat production. The thermal effects on the surrounding tissues precluded its clinical use. Attempts were subsequently made to use continuous wave carbon dioxide and Neodymium : YAG (Nd: YAG) lasers. The inability to transmit carbon dioxide laser via non-toxic fibres suitable for endoscopic applications and thermal effects to adjacent soft tissues associated with the Nd:YAG devices limited their clinical usefulness [3]. Based on the initial experience with these lasers, an understanding of the necessary requirement for successful laser lithotripsy became apparent, including the ability to deliver energy through optical fibres, need to limit distant thermal effects and production of a shock wave of sufficient force to exceed the tensile strength of the stone [4]. The first commercially successful laser lithotrite was the coumarin pulse dye laser but it could not fragment cystine stones. In clinical use the pulsed dye laser has been safe and effective in Nd: YAG and Alexandrite lasers [5, 6]. The holmium: YAG (Ho: YAG) laser is the newest wavelength device available for urological applications. Investigational work for lithotripsy with the Ho: YAG laser dates back to 1990 and clinical use began in 1993. This multi-purpose laser combines the qualities of carbon dioxide and Nd: YAG laser in providing both tissue cutting and coagulation in single device. Since the holmium wavelength can be transmitted down optical fibres, it is especially suited for intracorpreal/endoscopic lithotripsy.
TL;DR: Analysis of parachuting injuries at the Sultans Oman Parachute Unit (SOPRA) concludes that the data compares favourably with other studies except for higher incidence of severe injuries.
Abstract: Background This paper analyses the rate and patterns of parachuting injuries at the Sultans Oman Parachute Unit (SOPRA) in Oman. Methods Data on 150 patients referred to Rustaq Regional Referral Hospital was collected and analysed. The injuries were defined as severe (fractures, dislocation, head trauma) or minor (contusion, bruises, sprains). Result The rate of severe injuries was 9 % and ankle fractures were the commonest. The minor injury rate was 13.5%. The injury rate increased in relation to age (p Conclusion We conclude that our data compares favourably with other studies except for higher incidence of severe injuries.
TL;DR: The resorbable system is a good system for rigid internal fixation in specific conditions where muscular and stress forces are not a determining factor in fragment displacement.
Abstract: Background
Rigid internal fixation with metals is a reliable method of achieving osteosynthesis while allowing the patient passive or even functional loading of the fracture or osteotomised bone segments. The disadvantages with metals have led to the introduction of resorbable polymers in rigid internal fixation.
TL;DR: A case of spontaneous rupture of bladder after acute alcohol intoxication who presented late and mimicked acute renal failure is presented.
Abstract: While bladder rupture commonly occurs in association with blunt or penetrating lower abdominal injuries, spontaneous rupture of bladder is relatively rare. Spontaneous rupture of bladder has been known to occur in a cancer bearing bladder, neurogenic bladders or in post irradiation bladder. We present a case of spontaneous rupture of bladder after acute alcohol intoxication who presented late and mimicked acute renal failure.
TL;DR: ICT is useful for diagnosis of malaria caused by Plasmodium falciparum in field but microscopy of a well-prepared blood smear must not be omitted in a laboratory setting.
Abstract: Background Malaria remains a major cause of morbidity and mortality in India. This study was carried out to evaluate the use of parasite lactate dehydrogenase (pLDH) test in diagnosis of malaria. Methods Blood slides of 400 patients who presented with fever including 104 patients with clinical features suggestive of malaria were studied. The results were compared with microscopy and another immunochromatography test (ICT) based on detection of histidine rich protein-2 antigen [Pfhrp-2] secreted by Plasmodium falciparum . Result In this study the sensitivity and specificity for detection of Plasmodium vivax was 100% while for Plasmodium falciparum the values were 96% and 100% respectively. Conclusion ICT is useful for diagnosis of malaria caused by Plasmodium falciparum in field but microscopy of a well-prepared blood smear must not be omitted in a laboratory setting.
TL;DR: It is concluded that hypothyroidism is common and often under-diagnosed, therefore routine evaluation of female patients with weight gain, generalized weakness, infertility, depression and mood changes should include thyroid profile.
Abstract: Background
The aim of this study was to assess the clinico biochemical spectrum of hypothyroidism and the relative importance of thyroid function tests, clinical symptoms and signs in thyroid dysfunction.
TL;DR: Mycosis fungoides (MF) is the commonest subtype of CTCL and may develop de novo or may persist in one stage for years or slowly progress from patch to plaque stage and later to a nodule.
Abstract: Cutaneous T cell lymphoma (CTCL) is an uncommon fatal skin condition in which there is an abnormal neoplastic proliferation of T cell lymphocytes [1]. The entity varies considerably in clinical presentation, histological appearance, immunophenotype and prognosis of its variants [2, 3]. Mycosis fungoides (MF) is the commonest subtype of CTCL. It may develop de novo or may persist in one stage for years or slowly progress from patch to plaque stage and later to a nodule. Spread to other organs is most likely in this stage, leading to a rapid, progressive, down hill course [3]. Fatality is usually associated with sepsis. We present two cases of MF.
TL;DR: Endodontic therapy in defence dental setup should be simple, predictable and time saving, and single visit root canal treatment was tried to assess its viability in defence environment.
Abstract: Endodontic therapy in defence dental setup should be simple, predictable and time saving. Root canal treatment (RCT) is the preferred management modality for root canal infections. The execution of RCT is more challenging and demanding in molars for their unique multi canal system. The canals are often ‘c’ or's’ shaped and narrow. Since loss of permanent molars is a threat to the occlusal table, single visit root canal treatment was tried to assess its viability in defence environment.