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   2013| April-June  | Volume 6 | Issue 2  
    Online since April 10, 2013

 
 
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CASE REPORTS
Vasculotoxic snake bite presenting with sepsis, acute renal failure, disseminated intravascular coagulation, and acute respiratory distress syndrome
Vikram Bhausaheb Vikhe, Ankur Gupta, Prakash Shende, Jinendra Jain
April-June 2013, 6(2):197-199
DOI:10.4103/0975-2870.110314  
Vasculotoxic snake bites are well known to cause local complications like necrosis and cellulitis and systemic complications such as coagulopathy, acute renal failure (ARF), and hemolysis. We report a case of young female patient who was bitten by a viper. She developed cellulitis, sepsis, ARF, and Disseminated Intravascular Coagulation. She was treated for the above complications and all her renal and hematological parameters returned to normal on seventh day. After this, on the same day, patient developed Acute Respiratory Distress Syndrome probably due to the direct toxic effect of venom on pulmonary vascular endothelium which has been reported as a late complication of snake venom. With close monitoring and proper management of complications, the patient recovered and walked out of the hospital on the twenty first day without any complications.
  25,272 721 -
REVIEW ARTICLES
Cognitive behavior therapy
Labanya Bhattacharya, Bhushan Chaudari, Daniel Saldanha, Preethi Menon
April-June 2013, 6(2):132-138
DOI:10.4103/0975-2870.110294  
Cognitive behavior therapy (CBT) is one of the most extensively researched psychotherapeutic modalities which is being used either in conjunction with psychotropic drugs or alone in various psychiatric disorders. CBT is a short-term psychotherapeutic approach that is designed to influence dysfunctional emotions, behaviors, and cognitions through a goal-oriented, systematic procedure. Recent advances in CBT suggest that there is a fresh look on a "third wave" CBT that has a greater impact and newer application that may mitigate the sufferings of mentally ill patients.
  10,876 1,253 3
ORIGINAL ARTICLES
A study of addition of Inj.Butorphanol to hyperbaric Inj.Bupivacaine given intrathecally to patients undergoing lower segment caesarean section: A randomized, controlled trial
Vangipuram Raghavachari Ranga Chari, Anuja Arvind Goyal, Vikas Singh
April-June 2013, 6(2):156-160
DOI:10.4103/0975-2870.110293  
Background: Intrathecal 0.5% hyperbaric injection bupivacaine has become increasingly popular as it provides good sensory and motor block for longer duration without any significant neurological side effects. Spinal opiates have been of much interest in recent times as they potentiate the effect of local anesthetic agent and provide longer lasting post-operative analgesia. We compared injection butorphanol and normal saline as an adjuvant to local anesthetic agent in subarachnoid block in lateral position with respect to onset, duration of sensory and motor block and duration of analgesia. Aim: To evaluate the effect of addition of 25 mg of injection butorphanol to hyperbaric injection bupivacaine 0.5% on onset, quality, duration of sensory and motor block, hemodynamic changes, side effects, and post-operative analgesic effect when administrated intrathecally in patients undergoing elective lower segment cesarean section (LSCS). Methodology: Sixty ASA (American Society of Anaesthesiologist) grade-I and II patients scheduled for elective LSCS aged 18-40 years were divided into two equal and comparable groups. The control group represented patients receiving injection bupivacaine 0.5% (10 mg, 2 ml) + 0.5 ml normal saline (total volume 2.5 ml) intrathecally. The study group were the patients receiving injection bupivacaine 0.5% (10 mg, 2 ml) + injection butorphanol 25 mg in 0.5 ml of normal saline (1 mg/ml preservative-free injection butorphanol diluted up to 20 ml by normal saline and 0.5 ml of this solution was taken) making total volume 2.5 ml by intrathecal route. The principle outcome measures were systolic and diastolic blood pressure changes and the anesthetic and analgesic effects. These were summarized and compared between the two groups. Parametric statistics were used to test the null hypothesis of no difference in the two groups. Results: In the early phase of surgery there was more decrease in systolic and diastolic blood pressures in the study group. However, these were of no serious consequence and in the later stages of surgery there was no difference between the two groups. Time to rescue analgesia was delayed in the study group with a mean of 227 min, standard deviation (SD) 13.18 min, compared with the control group, which had a mean of 149.07 min and an SD of 8.19 min. This difference was significant (P < 0.005). Conclusion: Addition of injection butorphanol gives longer duration of post-operative analgesia compared with control without serious side effects.
  8,087 606 1
Fetomaternal outcome in obstructed labor in a peripheral tertiary care hospital
Sabyasachi Mondal, Arunima Chaudhuri, Gourisankar Kamilya, Debojyoti Santra
April-June 2013, 6(2):146-150
DOI:10.4103/0975-2870.110301  
Background: Obstructed labor is the leading cause of hospitalization, comprising up to 39% of all obstetric patients in developing countries. It is the single most important cause of maternal death and is one of the three leading causes of perinatal mortality. Objectives: To study the different parameters of obstructed labor cases, like its frequency, etiology, management, and complications. This will help to formulate a positive strategy to prevent obstructed labor and its consequences. Materials and Methods: 313 patients admitted with features of obstructed labor were studied. By clinical examination, diagnosis of cephalopelvic disproportion, malposition, malpresentation, obstruction in birth canal, overdistended bladder, hematuria, rupture of uterus, and supermolding of fetal head was done. Screening for maternal exhaustion, dehydration, genital sepsis, pyrexia, rupture of uterus, postpartum hemorrhage, vesico-vaginal fistula, and shock was carried out. Deaths as a consequence of obstructed labor were noted. Diagnosis of asphyxiated or dead fetus or neonatal death was done. Mode of delivery and time interval between referral, admission, intervention done, and related feto-maternal outcome were noted. Statistical analysis was done using Epi Info software. Results: Majority of the patients (87.86%) were from low socioeconomic group, 88.82% were from rural areas, 16.16% were illiterate, and 27.79% were unbooked. The commonest cause of obstructed labor was cephalopelvic disproportion (55.59%). Other causes were malposition (23%), malpresentation (18.21%), fetal congenital abnormality (1.28%), myoma (0.32%), and non-dilatation of cervix (1.60%). The commonest mode of delivery was cesarean section (85.94%). Instrumental deliveries formed 9.58%. Destructive operation was done in 1.92% cases. Rupture uterus was seen in 8 (2.56%) cases, out of which hysterectomy was done in 5 cases and repair in 3 cases. The common maternal complications were sepsis [pyrexia 49.8%, urinary tract infection (UTI) 10.9%, wound infection 7.7%] and post-partum hemorrhage (PPH; 33.9%). Other complications were rupture uterus (2.56%), subinvolution (9.3%), shock (2.2%), bladder injury (1.9%), hysterectomy (1.6%), broad ligament hematoma (1.28%), maternal death (1.6%), vesico-vaginal fistula (VVF; 0.6%), and rectovaginal fistula (RVF; 0.3%). Perinatal mortality rate was 71/313 (22.68%), still birth rate was 57/313 (18.21%), and live birth rate was 256/313 (81.79%). Perinatal morbidity (in 198 cases) was most commonly due to birth asphyxia (29.68%), jaundice (16.80%), septicemia (14.84%), and meconium aspiration syndrome (9.77%). Incidence of PPH, still birth, perinatal mortality, and cesarean section was significantly higher among multiparous women. Conclusions: Cephalopelvic disproportion is the commonest cause of obstructed labor, and proper antenatal care, early diagnosis, and timely intervention may result in decrease in incidence of morbidity and mortality.
  7,578 899 3
The effectiveness of integrated teaching over traditional teaching among first year MBBS students: A preliminary Study
Ravichandran Doraisamy, Shankar Radhakrishnan
April-June 2013, 6(2):139-141
DOI:10.4103/0975-2870.110296  
Background: Medicine is not grasped as a whole subject by the students. Also, the teaching creates disinterest among the students to learn the subject. Teaching basic sciences in different blocks gives no chance for the student to correlate and integrate the knowledge what they had gained. Aim: To assess the effectiveness of the integrated teaching method over the conventional method of teaching among the first year MBBS students. Materials and Methods: A prospective study was done on 100 first year MBBS students of VMKV Medical College, Salem, during April 2012. The students were divided into two groups on a random basis, with 50 in each group. The first group students underwent the conventional type of teaching and for the other group, integrated teaching was practiced. Finally, an evaluation test was conducted for both the groups and the mean marks obtained by the students were analyzed by using unpaired "t" test. Results: The total marks (out of 30) in conventional teaching method was found to be 15.40 ± 4.62, and in integrated teaching method it was 21.8 ± 4.48. So, the marks obtained by students after integrated method were found to be higher than the marks obtained after conventional teaching and this difference was found to be statistically significant (P < 0.0001). Conclusion: The integrated teaching was found to be an effective method of teaching than the traditional conventional method in terms of students' performance in assessment examinations.
  7,251 774 4
A cross-sectional study of the knowledge, attitude, and practice of general practitioners regarding dog bite management in nothern India
Abhishek Singh, Anu Bhardwaj, Prassana Mithra, Adiba Siddiqui, Surendra K Ahluwalia
April-June 2013, 6(2):142-145
DOI:10.4103/0975-2870.110298  
Context: There are many myths and false beliefs associated with wound management. These include application of oils, herbs, and red chilies on wound inflicted by rabid animals, and not washing the wound properly. General practitioners (GPs) constitute a key source of medical care in study area and are approached for anti-rabies treatment by victims of animal bites. Aim: The aim of the present study is to assess the knowledge and practices among the general practitioners (GPs) regarding dog bite management. Settings and Design : Community-based cross-sectional study. Materials and Methods: The present study was carried out in the private and public clinics of Ambala city from January 2012 to April 2012 using a pre-tested self-administered questionnaire. The study population composed of 100 GPs comprising 45 MBBS or above degree holders (Group 1) and 55 other GPs like BAMS, RMPs, etc (Group 2). Statistical Analysis Used: Interpretation of data was done using percentages and proportions. χ2 -Test was used to test the statistical difference in the knowledge between the two groups. Results: Out of the total, 68% and 29% respondents in Group 1 and Group 2, respectively, correctly told that wound must be washed with soap and water for minimum period of 15 min. A total 71% and 11% respondents in Group 1 and Group 2, respectively, could correctly answer about the target groups for pre-exposure prophylaxis. A total 62% GPs did not know the high-risk groups to whom pre-exposure prophylaxis has to be given. Conclusions: There was an apparent lack of awareness among the GPs regarding appropriate animal wound management and vaccine administration. Reorientation programs and continued medical education for GPs are required to highlight the WHO guidelines regarding treatment of animal bite.
  6,955 795 4
REVIEW ARTICLES
Pharmacovigilance in India
Sarita Mulkalwar, Pratibha S Worlikar, Niranjan Munjal, Lopamudra Behera
April-June 2013, 6(2):126-131
DOI:10.4103/0975-2870.110288  
New drug development is a challenging and costly process as it involves focus on quality, efficacy as well as safety. Some of the adverse drug reactions (ADRs) are predicted based upon the previous experience with the pharmacologically similar drugs and others are detected during clinical trials. For detection of ADRs, clinical trials usually provide limited information as they are conducted under strictly controlled condition and largely focus on efficacy evaluation. Some of the ADRs can be detected only after long-term use in large population and in specific patient groups due to specific concomitant medications or disease. The visual field defect of vigabatrin therapy and valve defect of fenfluramine-phenteramine therapy are few such examples. Therefore early recognition of previously unknown adverse effects of medicines during post-marketing period is the primary objective of pharmacovigilance.
  6,909 588 1
CASE REPORTS
Intermuscular hydatid cyst in the thigh: An unusual presentation
Sushma Yalavarthi, Narayana V Satya, T Ramamurti, M Supriya
April-June 2013, 6(2):191-193
DOI:10.4103/0975-2870.110311  
Hydatid cyst is the larval form of Echinococcus granulosus. Hydatid cyst or echinococcosis can be found in any part of the body, but the most commonly affected organs are liver, lungs, and the rest in other organs. Echinococcosis of the musculoskeletal system is very unusual and has a reported incidence of only 0.5-4% of patients in the literature. Primary musculoskeletal Echinococcus infection is very rarely reported in India without involving the thoracic and abdominal organs. Here, we are reporting an unusual case of primary intermuscular hydatid cyst involving left thigh in a 75-year-old male patient, which was diagnosed by fine needle aspiration cytology (FNAC). In the literature, reports of hydatid cyst diagnosed by FNA are very rare. Here, we are presenting both cytological and histopathologic findings of echinococcosis, which will be helpful in the preoperative diagnosis to avoid anaphylactic shock and local recurrence.
  6,568 294 3
ORIGINAL ARTICLES
Hematological aspects in malaria
Pradhan M Pagaro, Pradeep Jadhav
April-June 2013, 6(2):175-178
DOI:10.4103/0975-2870.110310  
Background: Malaria is a major health problem at the global level. In Indian subcontinent, it is a major cause of mortality in immunosuppressed patients and in extreme ages of life. This study is based on early detection of malaria by hematological parameters to reduce the mortality in such cases. Materials and Methods: All patients with fever of less than 7 days in duration were included in the study. Hematological parameters were determined by using automated cell counter. Peripheral blood smear examination for malaria parasite was taken as gold standard for the diagnosis of malaria. Result: A total of 110 patients were included in the study. Ninety nine patients had a positive peripheral smear for malarial parasite. Thrombocytopenia (52.52%) alone (platelet count less than 1, 50,000/mm 3 ) was a predictor for malaria and in combination with anemia (Hb < 10 gm/dl) it was next best parameter. Leucocyte count was not predictive. Conclusion: The conclusion of this study is that the presence of thrombocytopenia in a patient with acute febrile illness increases the probability of malarial infection.
  6,218 334 2
CASE REPORTS
An adolescent girl with Rapunzel syndrome: Case report with review of literature
Pradnya M Diggikar, Prasanna K Satpathy, Arjun L Kakrani, Mukesh Laddha
April-June 2013, 6(2):200-204
DOI:10.4103/0975-2870.110315  
Trichobezoar is a collection of dense mass of hair in stomach. When this extends into any part of the small intestine it is called Rapunzel Syndrome (RS). We report here, a case of RS in an adolescent girl who had presented with epigastric pain and swelling. Gastroscopy confirmed the presence of trichobezoar. She underwent gastrotomy and a large dense mass of hair extending up to first part of duodenum was removed. Her parents revealed their daughter's impulsive nature of scalp-hair pulling. Following surgery, Psychiatric consultation was sought to prevent recurrence. Trichobezoar is a very rare cause of upper abdominal mass and should be considered if there is a very strong history of impulsive hair pulling. Surgical removal of a large trichobezoar is the only treatment of cure and psychiatric treatment that prevents its recurrence.
  5,951 329 3
ORIGINAL ARTICLES
Evaluation of hypertensive retinopathy in patients of essential hypertension with high serum lipids
Rajendra P Gupta, Sonal Gupta, Abha Gahlot, Dhavat Sukharamwala, Jagruti Vashi
April-June 2013, 6(2):165-169
DOI:10.4103/0975-2870.110307  
Purpose: To evaluate the role of hyperlipidemia on fundus changes in hypertensive patients and to correlate the above findings with components of lipid profile. Materials and Methods: A cross-sectional study was carried out in 100 patients who were diagnosed to have systemic hypertension. Patients suffering from diabetes, high myopia, patients with hazy ocular media, and other retinal vascular disorders were excluded from the study. A detailed evaluation of patients' hypertensive status was carried out by a physician after ruling out secondary causes of hypertension. Their detailed ophthalmological examination was carried out. All the patients were investigated for fasting serum lipid profile. Results: Out of the 100 patients with essential hypertension, 69 (69%) had retinopathy and the remaining 31 (31%) subjects having retinopathy were mainly concentrated in the 6 th decade (69.70%), increasing thereafter up to 83.78% who were over 60 years of age. This shows the increasing prevalence of hypertensive retinopathy with increasing age. No sex preponderance toward developing retinopathy was found in this study (o < 0.29). A positive correlation of hypertensive retinopathy was found with total cholesterol (P < 0.002), low-density lipoprotein (LDL)-cholesterol (P < 0.0001), Serum triglycerides (P < 0.01), and an low-density lipoprotein: high-density lipoprotein (LDL:HDL) ratio (P < 0.002). Conclusion: This study proved a definite association between serum lipid parameters and the prevalence of hypertensive retinopathy.
  5,532 532 6
CASE REPORTS
Silent sinus syndrome
Shwetang M Solanki, Yadav W Munde, Vilas M Kulkarni, Sarabjit Singh Thind
April-June 2013, 6(2):194-196
DOI:10.4103/0975-2870.110312  
Silent sinus syndrome is a rare clinical condition. In this report, we are presenting a 40-year-old male with chief complain of orbital asymmetry. Visual acuity was 6/6 and was normal. In magnetic resonance imaging (MRI) of paranasal sinuses, right maxillary sinus volume was decreased but he had no sinonasal or visual symptoms.
  5,698 276 -
Infantile malignant osteopetrosis: A case report of three siblings
Sahil Jain, Vineeta Pande, Geeta R Karambelkar, Sharad R Agarkhedkar
April-June 2013, 6(2):184-187
DOI:10.4103/0975-2870.110306  
Infantile malignant osteopetrosis, a rare hereditary, generalized disorder of bone characterized by a significant increase in the density of the skeletal tissues is described in three siblings. The incidence, genetic etiology, clinical, laboratory, radiological features, management and prognosis have been discussed.
  5,643 312 -
GUEST EDITORIAL
Snake bite envenomation: A neglected public health problem in India
Tushar B Patil
April-June 2013, 6(2):123-125
DOI:10.4103/0975-2870.110286  
  4,407 496 4
CASE REPORTS
Tubercular breast abscess
Pradeep S Jadhav, Pradhan M Pagaro, Anjali Verma, Anjali Deshpande
April-June 2013, 6(2):206-207
DOI:10.4103/0975-2870.110318  
Tubercular breast abscess is a rare clinical entity and affects women from mainly the Indian subcontinent. It often mimics breast carcinoma and pyogenic breast abscess clinically. Routine laboratory investigations are not helpful in the diagnosis. Fine needle aspiration cytology (FNAC) or biopsy is essential for diagnosis, and tuberculous culture when positive may be very useful to start antitubercular treatment.
  4,491 244 2
LETTERS TO THE EDITOR
Ainhum: Rare disease
Gaurav Sali, Iqbal Ali, Gurjit Singh, Ayush Kumar
April-June 2013, 6(2):217-218
DOI:10.4103/0975-2870.110324  
  4,415 258 -
ORIGINAL ARTICLES
Socio demographic factors associated with tobacco use in rural Maharashtra
Ratna Majumdar, Swati S Raje, Ashlesha Dandekar
April-June 2013, 6(2):161-164
DOI:10.4103/0975-2870.110303  
Background: The epidemic of tobacco use is shifting from developed to developing countries, where increased use is expected to result in a large disease burden in the future. Findings from countries of SEAR reveal that tobacco use is higher among the rural, illiterates, and poor population. Aims: To assess use of tobacco in various groups of people and awareness regarding its ill effects in rural Maharashtra. Setting and Study Design: Urban health center of MIMER Medical college, Cross sectional. Materials and Methods: The survey was conducted in field practice area of urban health centre near Pune, Maharashtra. The estimated sample size was 378 with α = 0.05 and 80% power of test. Alternate families were selected by systematic random sampling. All the family members between the age group 15 and 75 years of the selected family were included in the sample. Data was collected using a pre-tested pre-validated questionnaire. Statistical Analysis Used: Data was analyzed using the chi-square test. Results: The study population comprised of 426 people. Percentage of tobacco users decreased with an increase in level of education and the difference was statistically significant (χ2 = 54.56; P < 0.0001). Type of tobacco use differed with sex and education but not with age. Peer pressure turned out to be the major cause (80.5%) for starting the use of tobacco, followed by influence of family members (11.2%). Percentage of female tobacco users was found to be on higher side in this population as compared to other studies. Conclusion: Thus, effective measures are needed to address the uneducated female population of rural India, in order to decrease the use of tobacco significantly.
  4,066 360 3
EDITORIAL
The British Raj and rise and fall of tropical medicine
Amitav Banerjee
April-June 2013, 6(2):121-122
DOI:10.4103/0975-2870.110284  
  3,495 359 2
CASE REPORTS
Kimura disease
Shruti Vimal, Narayan K Panicker, Pinky Soraisham, Shrish S Chandanwale
April-June 2013, 6(2):208-211
DOI:10.4103/0975-2870.110319  
Kimura disease is a rare inflammatory disorder of unknown cause, primarily seen in young Asian males. The disease is characterized by painless subcutaneous swelling, blood and tissue eosinophilia. We describe a 37year old Asian male with Kimura disease who presented with multiple subcutaneous swelling. The diagnosis was based on the characteristic histopathologic findings after surgical excision in conjunction with peripheral eosinophilia.
  3,414 286 4
LETTERS TO THE EDITOR
Declining child sex ratio-no solutions to improve?
Hanmanta V Wadgave
April-June 2013, 6(2):212-213
DOI:10.4103/0975-2870.110320  
  3,350 252 -
ORIGINAL ARTICLES
Prevention of parent to child transmission of HIV: Urgent need to be addressed
Dhrubajyoti J Debnath, Shubhada S Javadekar
April-June 2013, 6(2):179-183
DOI:10.4103/0975-2870.110313  
Context: An estimated 430,000 children were newly infected with HIV in 2008, over 90% of them through mother-to-child transmission (MTCT). Without intervention, the risk of MTCT ranges from 20% to 45% as per the World Health Organization (WHO). Aim: To find the uptake of Prevention of Parent to Child Transmission of HIV/AIDS (PPTCT) services during pregnancy. Setting and Design: Cross-sectional study. Materials and Methods: Ethical approval and informed consent was taken. Uptake of PPTCT services by the mother was obtained in 222 pregnancies. This was compared with the HIV status of children born to them. Statistical Analysis Used: Percentages. Results: In 25.7% pregnancies, the mothers were tested for HIV. One child was born was to a mother who had tested HIV negative in pregnancy. In 50% of the mother-child pairs, both mother and child received PPTCT. Where both the mother and child received PPTCT, only 13.3% children born were HIV positive as against 40% children who were HIV positive where neither mother nor the child had received PPTCT. Conclusion: Uptake of PPTCT services was low. In countries like India where the chances of parent to child transmission of HIV are likely to be more than in developed countries due to breastfeeding practices, the uptake of PPTCT services should be maximized to decrease the burden of pediatric HIV because even a single pediatric HIV infection counts. All the pregnant women need to be voluntarily tested twice for HIV in pregnancy, in which the second test for HIV may be in late pregnancy.
  2,984 288 -
A study of feeding practices among infants born to HIV-infected mothers and its association with morbidity in infants
Megha S Mamulwar, Rujuta S Hadaye, Daksha D Pandit
April-June 2013, 6(2):170-174
DOI:10.4103/0975-2870.110309  
Context: Globally, 2.3 million children have been victims of Human Immunodeficiency Virus (HIV) as of December 2006. Transmission through breastfeeding (BF) is estimated to account for one third to one half of all these pediatric HIV infections. Aim: To study the feeding practices followed by HIV-infected mothers in Mumbai. Settings and Design: It is a prospective observational type of study conducted in a tertiary care hospital with antiretroviral treatment center for a period of one year. Materials and Methods: The study was reviewed and approved by the ethical committee of the hospital. Babies aged 0 to 9 months and born to HIV-positive mothers who are brought to integrated HIV outpatient department were included in the study. Statistical Analysis Used: The data entry and analysis was done using SPSS 15 package, Microsoft Excel 2003, and Epi Info. Results: As per the findings of this study, proportion of exclusive BF was 34.2%, top feeding was 42.1%, and mix feeding (MF) was 23.7%. Diarrhea occurred more frequently in mix-fed infants (53.6%) as compared to exclusively breast-fed infants (2.5%) and top-fed infants (12.7%). The percentage of infants who were exclusively breast fed and had normal weight for age was 53.8%. Moderately malnourished infants were 30.8% and 15.4% of infants were severely malnourished. The percentage of severe malnutrition was more in top-fed and mix-fed infants (23.4% and 32.1%, respectively). Conclusion: MF was associated with increased risk of diarrhea and acute respiratory infection. Top-fed and mix-fed infants were more likely to suffer from infectious diseases.
  2,665 309 -
CASE REPORTS
Pulmonary embolism due to factor V leiden mutation causing worsening of asthma
Kaushik Saha, Arnab Maji, Debraj Jash, Supriya Sarkar
April-June 2013, 6(2):188-190
DOI:10.4103/0975-2870.110308  
Worsening of asthma is usually caused due to noncompliance to medications. The incidence of pulmonary arterial hypertension (PAH) due to asthma is very rare. There are many case reports where PAH was wrongly diagnosed as asthma. Pulmonary hypertension can be associated with asthma and makes a controlled asthma worsened. In our patient pulmonary embolism diagnosed by transesophageal echocardiography due to factor V leiden mutation was the responsible factor for pulmonary hypertension. After proper treatment of pulmonary embolism his asthma gets controlled again.
  2,684 205 -
ORIGINAL ARTICLES
Laparoscopic sleeve gastrectomy in remission of obesity and associated co-morbidities
Sangram Jadhav, Sanjay Borude
April-June 2013, 6(2):151-154
DOI:10.4103/0975-2870.110304  
Background: There is a lot of discussion on bariatric surgery and its effect on weight loss as well as resolution of associated conditions such as diabetes, sleep apnea, and thyroid imbalance. Recent reports also indicate role of laparoscopic sleeve gastrectomy (LSG) in non-obese diabetics. Aims: This study was undertaken to assess medium-term effects of LSG on body weight and co-morbid factors such as diabetes, hypertension, and thyroid imbalance. Materials and Methods: A total of 42 obese subjects (19 males and 23 females; age: 23-65 years; body mass index [BMI]: 45 ± 5 kg/m¼) underwent evaluation of anthropometric/clinical parameters and blood sugar, hypertension and thyroid function tests before, 3 and 9-15 months after LSG. Results: Mean BMI decreased from 45 to 38 after 3 months and 30 at 9-15 months after surgery. Remission of type 2 diabetes mellitus and hypertension occurred in all patients except one. Sleep apnea and asthma was cured in all five patients. Out of the five patients with thyroid imbalance, all except one were off medication within 5 months. Conclusion: Our study showed that LSG is effective in producing a significant and sustained weight loss and improving diabetes mellitus, hypertension, and other co-morbid factors in obese patients.
  2,543 254 1
LETTERS TO THE EDITOR
Anaplastic large cell lymphoma involving extranodal sites and soft tissue infiltration on fine needle aspiration cytology
Srikanth M Shastry, Krishna R Vamshi, T Mallesh Kumar, Saloni Gupta
April-June 2013, 6(2):215-217
DOI:10.4103/0975-2870.110323  
  2,172 214 -
COMMENTARY
Trichobezoars: One good reason for a better liaison Psychiatry
Tiago Santos
April-June 2013, 6(2):204-205
  2,117 171 1
Laparoscopic sleeve gastrectomy for morbid obesity: Is impact more than weight loss?
Ramkrishna Y Prabhu, Avinash Supe
April-June 2013, 6(2):154-155
  1,984 214 1
LETTERS TO THE EDITOR
A case of congenital epulis
Vineeta Pande, Renuka Jadhav, Sharad Agarkhedkar, Vishal Jain
April-June 2013, 6(2):213-214
DOI:10.4103/0975-2870.110321  
  1,933 202 -
COMMENTARY
Congenital epulis: An oral surgeon's perspective
Yadavalli Guruprasad
April-June 2013, 6(2):214-215
  1,646 187 1