Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
  Citation statistics : Table of Contents
   2016| January-February  | Volume 9 | Issue 1  
    Online since December 22, 2015

 
 
  Archives   Previous Issue   Next Issue   Most popular articles   Most cited articles
 
Hide all abstracts  Show selected abstracts  Export selected to
  Cited Viewed PDF
REVIEW ARTICLE
Substance use disorder and the family: An Indian perspective
Siddharth Sarkar, Bichitra Nanda Patra, Shivanand Kattimani
January-February 2016, 9(1):7-14
DOI:10.4103/0975-2870.172413  
The substance use disorder not only impacts the patient himself/herself, but also affects family members. This is more relevant in a country like India where the familial ties are stronger with family members playing a significant role in the treatment process. This narrative review takes an overview of the inter-relationship between substance use disorder and the family. The domestic violence and adverse familial circumstances, both often arise as a consequence of substance use. Although the spouses of substance users experience greater rates of psychopathology and distress, children of patients with substance user disorders demonstrate higher levels of behavioral disturbances. Codependence often develops in the familial relationship, which perpetuates the substance use disorder. Substance use places quite a burden on the family, both psychologically as well as in terms of resources. Nonetheless, family members provide motivation, emotional support, and practical help during the treatment of substance use disorders and hence need to be engaged in the therapeutic process. Finally, the changing family structure and family dynamics in India might influence the in the future both the effect of substance use disorder on the family, and the familial resource available for treatment.
  21 17,222 1,446
ORIGINAL ARTICLES
Cytomorphological study of lymph node lesions: A study of 187 cases
Shruti Vimal, Arpana Dharwadkar, Shrish S Chandanwale, Vidya Vishwanathan, Harsh Kumar
January-February 2016, 9(1):43-50
DOI:10.4103/0975-2870.172428  
Introduction: As components of peripheral or secondary lymphoid organs, lymph nodes are an important part of immune system. Their enlargement is noted in a wide spectrum of diseases, including infections and malignancy, they are a common finding in clinical practice. Therefore, peripheral lymphadenopathy is common in all age groups and management of cases depends on lymph node pathology, which can be studied by collecting material through fine-needle aspiration or excision biopsy. Objectives: The study was undertaken to assess the cytomorphological features and incidence of various lymph node diseases on fine-needle aspiration cytology (FNAC) and to analyze the utility and diagnostic importance of FNAC in lymph node diseases. Materials and Methods: In the study total of 187 patients were selected who had presented with lymph node enlargement at Department of Pathology in our Tertiary Care Centre. Results: Reactive lymphoid lesions comprised the majority (33.69%) followed by tubercular lymphadenitis, metastatic malignancies, acute suppurative lymphadenitis, and lymphomas, respectively. Conclusion: Reactive lymphoid and tubercular lesions were the most common among the lymph node swellings presentations. FNAC is a simple, safe, reliable, and inexpensive method in early detection of lymph node lesions, which has been proven once again in this study.
  7 42,340 1,006
Impact evaluation of two methods of dental health education among children of a primary school in rural India
Neha Singh, Taramangalam S Ramakrishnan, Anurag Khera, Gagandeep Singh
January-February 2016, 9(1):66-71
DOI:10.4103/0975-2870.167988  
Background: Impact of two methods of dental health education (DHE) on knowledge and practices of primary school children in a rural area regarding oral care was planned to be studied. Materials and Methods: Study population comprised of 199 primary school children aged 10-13 years in rural field practice area of a medical college. After collecting baseline data, students were allocated into two groups by block randomization using variable blocks. DHE with educational pamphlets and demonstrations was given to both groups. In addition, the intervention group was also shown videos showing correct oral health practices. Data were proposed to be collected at 3 and 6 months from baseline for impact evaluation. The results at 3 months postintervention are being presented. Results: The results after 3 months of intervention found significant difference in the impact on: (a) Practices regarding method of cleaning teeth (P < 0.001), (b) knowledge on best method of cleaning teeth (P < 0.001), (c) reason for regular brushing of teeth (P < 0.001), and (d) requirement to clean teeth after eating something sweet (P < 0.001) in favor of group receiving additional intervention. Conclusion: There is a significant difference in the impact of health education using integrated modes of pamphlets distribution, demonstrations, and A-V aids (group A) as compared to demonstrations and pamphlets distribution only (group B).
  5 6,959 687
GUEST EDITORIAL
Family medicine in Thailand: System, training, and obstacles
Viroj Wiwanitkit
January-February 2016, 9(1):4-6
DOI:10.4103/0975-2870.172412  
  4 5,495 453
ORIGINAL ARTICLES
Comparative study to analyze the incidence of sore throat, cough, and hoarseness of voice after general anesthesia with the use of topical benzydamine hydrochloride and 2% lignocaine gel with placebo
Vangipuram Raghava Chari, Arnab Paul
January-February 2016, 9(1):61-65
DOI:10.4103/0975-2870.167972  
Background: Postoperative sore throat (POST) is the most common airway-related complaint of patients after endotracheal intubation. Postextubation coughing during emergence from general anesthesia (GA) is an important problem. Objectives: To compare the effects of topical benzydamine hydrochloride and 2% lignocaine on reducing the incidence and severity of POST, hoarseness, and coughing after general endotracheal anesthesia. Materials and Methods: Patients were randomly allocated into three groups of 30 patients each. In Group B (topical benzydamine hydrochloride), Group L (2% lignocaine gel), Group N (normal saline) was applied to the cuffed endotracheal tube (ETT) before intubation. Results: The trend of the severity of sore throat, hoarseness of voice, and cough during the first 24 h after the GA in benzydamine recipients was significantly lower than the other two groups (P < 0.05). Conclusions: It was observed that the incidence of POST, hoarseness of voice, and cough was significantly less when cuff of ETT was lubricated with topical benzydamine hydrochloride as compared with 2% lignocaine gel.
  4 6,317 483
CASE REPORTS
Unusual infectious mononucleosis complicated by vasculitis
Srimanta Kumar Sahu, Subhash Giri, Sarthak Malik, Nikhil Gupta
January-February 2016, 9(1):104-106
DOI:10.4103/0975-2870.167969  
Infectious mononucleosis (IM) is a clinical syndrome caused by Epstein-Barr virus (EBV). It manifests as fever, pharyngitis, malaise, adenopathy, and atypical lymphocytosis. Cardiovascular complications are thought to be rare in IM. There are very few case reports of EBV-associated vasculitides, like Kawasaki disease and systemic polyarteritis nodosa, however, involvement of the large caliber arteries like the aorta and its branches have been reported only scarcely. Myocarditis also is rare as an early manifestation of EBV infection. We present here a rare case of IM, presented initially with acute myocarditis and later with large-vessels arteritis.
  3 4,872 237
ORIGINAL ARTICLES
The impact of parental alcohol dependence on the development and behavior outcome of children in a tertiary care hospital
Jasmeet Sidhu, Era Dutta, Nilesh M Naphade, Jyoti V Shetty
January-February 2016, 9(1):17-22
DOI:10.4103/0975-2870.172418  
Parents play a pivotal role in upbringing a child and shaping their future. However, children of alcoholics (COAs) suffer due to their parent's dependence pattern. The various domains affected encompass cognitive, behavioural, psychological, emotional and social spheres. This study was designed to assess the impact of alcohol dependence in the parent on the development and behavior of their children, so that further steps could be taken to minimize the negative influences. Aims: To study the impact of parental alcohol dependence on the development and behaviour outcome of children in various domains, alongwith the effect of the family environment. Materials and Methods: The study was a cross-sectional observational study conducted at a tertiary care teaching hospital on 25 children between 6 and 18 years of age, whose atleast one parent was diagnosed as alcohol dependant. The other parent was assessed using a general health questionnaire-28. Child behaviour checklist and family evaluation scale (FES) were then applied. Statistical Analysis Used: The analysis was done according the manuals provided with the respective scales to calculate the score. Results: Both male and female COAs had high externalizing and internalizing scores. The girls have higher internalizing scores while the boys of such parents have higher externalizing scores. The FES showed dysfunction in all the three dimensions, namely the relationship, personal growth and the system maintenance. Conclusions: Our study corroborates the findings of the studies done in the past on COAs. The COAs face various affective, anxiety, somatic, attention deficit/hyperactivity, oppositional defiant conduct problems.
  3 8,726 521
CASE REPORTS
Atorvastatin induced thrombocytopenia: A case report and review of literature
Saibal Moitra, Sukanta Sen, Prasanta Das, Indranil Banerjee
January-February 2016, 9(1):117-120
DOI:10.4103/0975-2870.167984  
A 65-year-old hypertensive male, with co-existing benign prostatic hyperplasia for last 5 years was on tab telmisartan 40 mg and tab tamsulosin 0.4 mg, both once daily. He was found dyslipidemic on a routine investigation and was put on tab atorvastatin 10 mg once daily. The patient developed a petechial rash and bleeding from gums within a week of starting atorvastatin, and his platelet count dropped to 15,000/cmm. Atorvastatin was suspected to be the offender as no other causes of thrombocytopenia could be implicated. Atorvastatin was discontinued and intravenous steroid and platelet transfusion given. Platelet count improved gradually and became normal after 10 days. Causality assessment as per the Naranjo algorithm revealed a "probable association" with atorvastatin therapy.
  2 22,738 543
Sudden onset of atrial fibrillation during neck dissection: Vagal atrial fibrillation
Anjana Sahu, Indrani H Kumar, Priyesh K Rahulgade, Ramkishan G Awarde
January-February 2016, 9(1):121-123
DOI:10.4103/0975-2870.167985  
Intraoperative vagal stimulation can lead to onset of atrial fibrillation (AF). The role of vagus mediated AF is not very much acknowledged. We report a case of AF during handling of great vessels in the neck region. After ruling out other causes of AF, we concluded that this sudden occurrence of AF could be a case of vagus nerve stimulation. In our case report, we also discuss the role of cholinergic activity in the development of AF and its treatment.
  2 4,582 223
Point of care in nursery to diagnose pneumothorax in neonates by new use of LED torch
Deepak Sharma, Srinivas Murki, Tejo Pratap
January-February 2016, 9(1):124-126
DOI:10.4103/0975-2870.167973  
Baby, A preterm female infant, was born to a primi mother at 33 weeks of gestation with a birth weight of 1.5 kg. Tracheo-esophageal fistula was diagnosed on antenatal scan and was confirmed after birth. The infant underwent primary end-to-end anastomosis on day 2 of life and was sustained by mechanical ventilation postoperatively. On day 5 of life, when the baby was on setting of peak inspiratory pressure of 15 mm Hg/peak, end-expiratory pressure of 4 mm Hg, and FiO 2 of 30%, there was a progressive increase in pressure and oxygen requirement. Suspecting air leak transillumination test was executed with a new LED device (Vein Finder @MIHIR NICS, Hyderabad, India). Transillumination tests confirmed the pneumothorax. Chest tube was inserted and baby improved dramatically.
  2 5,520 242
Endobronchial pulmonary mucormycosis diagnosed by fiberoptic bronchoscope: A rare case report
Vinay Mahishale, Bhagyashri Patil, Arati Mahishale, Prakash R Malur, Sindhuri Avuthu, Ajith Eti, Mithchelle Lolly
January-February 2016, 9(1):132-135
DOI:10.4103/0975-2870.167991  
Pulmonary mucormycosis is relatively uncommon, but a life-threatening infection affecting mostly individuals with diabetes mellitus, hematological malignancies, chronic renal failure, posttransplantation and other immunocompromised states. Mucormycosis of the lung has a wide range of clinical and radiological manifestations. Very few cases of pulmonary mucormycosis presenting as a fungal ball, cavity resembling tuberculosis, nonresolving, and recurrent pneumonia in patients with diabetes mellitus or other immunosuppressive conditions, were reported from India. We report a case of pulmonary mucormycosis in an adult male patient with uncontrolled diabetes.
  2 4,830 258
Human immunodeficiency virus-associated deep vein thrombosis
Akhilesh Kumar Singh, Duraikannan Premnath, Keshri Singh Yadav
January-February 2016, 9(1):98-100
DOI:10.4103/0975-2870.167967  
Deep vein thrombosis (DVT) has been reported to occur 2-10 times more common in human immunodeficiency virus-infected individuals than in the general population. We are reporting a case of DVT of right lower limb who was on highly active antiretroviral therapy. The patient did not have any acquired risk factors of DVT. The patient responded well to anticoagulation therapy.
  2 5,278 272
ORIGINAL ARTICLES
Association of smoking with blood lipids in coronary heart disease patients admitted in Taiping Hospital, Perak, Malaysia
A.T.M. Emdadul Haque, Shah Reza Bin Kamaruzzaman, Mainul Haque
January-February 2016, 9(1):36-42
DOI:10.4103/0975-2870.172426  
Introduction: Cigarette smoking is one of the predisposing factors for cardiovascular diseases as it may increase low-density lipoproteins (LDLs) levels and decrease high-density lipoproteins (HDLs). Objective: To measure the blood level of LDL and HDL and compare the result between smokers and nonsmokers who suffered from coronary heart diseases (CHDs). Materials and Methods: This is a cross-sectional study. The information was collected by using a checklist from the records of CHD patients, admitted to Taiping General Hospital, Perak, Malaysia. Data collected were interpreted to find any significant association between smoking, level of total cholesterol, triglycerides, HDL, and LDL. Results: Among the 196 patients included in this study, 85 were active smokers (43.4%), 54 ex-smokers (27.6%), and 57 nonsmokers (29%). Out of 171 patients with decreased level of HDL, 90.6% were smokers, 88.9% ex-smokers, and 80.7% of nonsmokers. It was found that significant changes occurred among the groups with decreased level of HDL (P < 0.05). Conclusion: HDL level is more reduced among the smokers compared to the ex-smokers and nonsmokers especially in the female.
  2 4,067 336
Role of scoring systems in acute pancreatitis
Somnath Gooptu, Gurjit Singh, Abhilash Kumar Pithwa, Iqbal Ali, Mackson Nongmaithem, Samaresh Gooptu
January-February 2016, 9(1):72-78
DOI:10.4103/0975-2870.167994  
Background: Identification of patients at risk for severe disease early in the course of acute pancreatitis is an important step to formulating the management strategies for improving outcomes. Scoring systems designed for such assessment need critical evaluation regarding which and when to apply. Aims: To assess the efficacy of specific scoring systems like Ranson's score, Bedside Index for Severity in Acute Pancreatitis (BISAP) scoring, Acute Physiology Score and the Chronic Health Evaluation II (APACHE II), and Modified Computed Tomography Severity Index (MCTSI) to predict severity, organ failure, and complications leading to mortality in acute pancreatitis. Materials and Methods: Ranson's, APACHE II and BISAP scores were calculated within 24 h of admission. Ranson's score was evaluated also after 48 h of admission. CT scan was performed after a period of 48 h only if the clinical course was unpredictable, morphological changes were detected on ultrasound abdomen or on clinical suspicion. MCTSI was evaluated in such cases. Results: There were 48 patients with acute pancreatitis (89.6% male) of which 11 patients underwent contrast-enhanced CT scan. Six patients developed organ failure and were classified as severe acute pancreatitis. Three patients had died. Six patients had a BISAP score >3, 5 patients with Ranson's score >3, 3 patients with APACHE II >8 and MCTSI >2 was seen in 9 patients. Area under curve for BISAP, Ranson's, APACHE II, and MCTSI in predicting severity are 0.79 (confidence interval [CI]: 0.605-0.967), 0.79 (CI: 0.524-1), 0.94 (CI: 0-1), and 0.61 (CI: 0.286-0.936), respectively. Conclusion: We recommend that although APACHE II score is a better predictor of organ failure, BISAPS should be used for the identification of high-risk patients because of its simplicity. Ranson's score still holds its place in identifying patients at risk of developing severe acute pancreatitis and organ failure. MCTSI though did not perform well, but still helps to identify local and systemic complications without pancreatic necrosis. It also defines scope and extent of the surgical intervention.
  2 11,054 470
CASE REPORT
Anesthesia management in a patient with systemic lupus erythematosus and left ventricular thrombus
Leena Harshad Parate, Balakrishna Shenoy, Saurabh Vig, Chikunda Nagaraja Dinesh
January-February 2016, 9(1):89-91
DOI:10.4103/0975-2870.167959  
Systemic lupus erythematosus (SLE) is a complex autoimmune disorder with heterogeneous presentation. We discuss the perioperative management of a female having SLE with left ventricular thrombus who was scheduled for bilateral femoral head core decompression. Warfarin was stopped preoperatively in order to bring down international normalized ratio <1.5 and restarted postoperatively on next day.
  1 6,685 281
CASE REPORTS
Carbimazole induced agranulocytosis with life-threatening complications, tremendous response with granulocyte-colony stimulating factor
Seema Mahant, Upasana Shobhane, PD Mahant
January-February 2016, 9(1):79-81
DOI:10.4103/0975-2870.172437  
Agranulocytosis is a rare complication of drug carbimazole (0.23%). We are accounting to present a very interesting and rare case of agranulocytosis and neutropenic sepsis secondary to carbimazole that have tremendous response with recombinant human granulocyte colony-stimulating factor (G-CSF). A 35-year-old woman with hyperthyroidism since 1-month, who developed delayed carbimazole induced agranulocytosis. She presented with a fever, cough, sore throat and painful mouth ulcer since 7 day. Investigations revealed hyperthyroidism with neutropenia, white blood cell of 0.3 × 10 9 (neutrophils of 0.0 × 10 9 /L). Bone marrow aspiration revealed a hypocellular marrow with reduced myelopoiesis with minimal maturation, consistent with drug-induced neutropenia. G-CSF was used as an adjunctive therapy with discontinuation of carbimazole, barrier nursing and a broad-spectrum antibiotic (Third-generation cephalosporins) regimen to treat her neutropenic sepsis. Total white cell count and neutrophil count returned to normal on 5 days treatment and she made an uneventful recovery. She was subsequently rendered euthyroid with radioiodine treatment.
  1 15,608 349
Fourth ventricle epidermoid tumor: Radiologic findings
Abhijit Patil, Vilas Kulkarni, Guneet Singh, Preeti Sehrawat
January-February 2016, 9(1):136-139
DOI:10.4103/0975-2870.168001  
Fourth ventricle epidermoid cysts or pearly tumors are uncommon lesions which arise from epithelial remnants at the time of neural tube closure. They are benign extracerebral intra-dural lesions accounting for <2% of intracranial tumors out of which only 5-18% may occur in the fourth ventricle. Epidermoid cysts of the fourth ventricle occur very rarely, with few cases reported in the literature. We present a case of a pathological proven less common fourth ventricle epidermoid cyst.
  1 7,479 308
Sternal foramen
Aseem Tandon, Rama Devi Gara
January-February 2016, 9(1):127-128
DOI:10.4103/0975-2870.167974  
The sternal foramen is a well-known variant of the sternum that carries the risk of life-threatening complications like pneumothorax, injury to vital structures like pericardial and cardiac puncture during acupuncture. A foramen was found in one sternum during the routine bone study of bones of the bank which were secured in Department of Anatomy. It was oval shaped measuring 8.75 mm × 7.35 mm, present in lower one-third of the body of the sternum. Distance from a sternal angle was 68.06 mm and 25.26 mm from the lower end of the sternum. The sternal foramen is usually asymptomatic found incidentally on chest X-ray. Hence this variation should keep in mind while performing invasive procedures like sternal puncture for bone marrow aspiration to prevent life-threatening complications.
  1 6,667 285
ORIGINAL ARTICLES
Spectrum of electroencephalographic abnormalities in a cohort of patients from a teaching tertiary care hospital in Western India
Piyush Ostwal, Varsha S Dabadghao
January-February 2016, 9(1):51-54
DOI:10.4103/0975-2870.172429  
Context: Electroencephalogram (EEG) is a very important tool for investigation of the central nervous system as it provides information about the function of neurons at the time of recording. The major utility of EEG is in the detection of abnormal, excessive electrical activity seen in patients with seizures. Aims: To determine the prevalence of abnormality on EEG in our patient population and to assess the contribution of EEG as a diagnostic modality in a multispecialty hospital. Materials and Methods: EEG findings of 107 patients (age 187 ± 80 months) who underwent EEG for various indications was analyzed. Results: It was found that 20 (18.69%) patients had abnormal EEG. The abnormalities included spikes (50%), sharp waves (50%), spike and wave discharges (20%) and the background abnormalities. Conclusions: The yield of EEG was lower in our study as compared to some other studies. The possible reason may be a higher proportion of patients with febrile seizures and unselected patient population.
  1 2,391 205
Yoga and its impact on counterproductive work behavior
Umesh Dwivedi, Sony Kumari, HR Nagendra
January-February 2016, 9(1):55-60
DOI:10.4103/0975-2870.172430  
Background: Counterproductive work behavior (CWB) is a matter of concern for many organizations because it represents a potential for an extensive range of negative performance and psycho-social outcomes for organization and its members and it results in enormous losses to organizations. Objectives: To assess the effect of yoga on working professionals and its role in the reduction of CWB by overcoming issues of stress, anxiety, aggression, and negative emotions. Materials and Methods: A randomized controlled pre- and post-test study conducted. Study sample included yoga group (n = 80) and control group (n = 80). Yoga module that included asanas, pranayama, meditation, and yogic theory lectures were taught to the yoga group. Mild to moderate physical exercises and management lectures were taught to the control group. Both groups received intervention for ten weeks, covering 1 hour daily, 5 days a week. Measurements of self-reported CWBs were taken as baseline and post intervention for assessment. Within group, comparison was performed in paired t-test and between group comparisons was performed in the analysis of covariance with baseline score as a covariate. Gender difference for CWB scores was measured in an independent t-test. The relationship between variables was investigated using Pearson correlation. Results: Yoga group reported statistically significant reduction in CWB in comparison to the control group. The gender difference was observed in the case of CWB scores. Conclusion: This study provides evidence of yoga practices as viable and costs effective solution in reducing CWB at the workplace and its predictors such as stress, negative affectivity, and aggression. There seems to be a great deal of assurance in the yoga session if conducted at workplace toward getting numerous benefits on the mental and physical health of employees and substantial savings for employers from losses.
  1 4,547 430
Health status of school children in rural area of coastal Karnataka
Muralidhar M Kulkarni, N Varun, Priya Rathi, K Eshwari, K Ashok, Veena G Kamath
January-February 2016, 9(1):31-35
DOI:10.4103/0975-2870.172424  
Introduction: Children are the foundation of a strong and healthy nation. Morbidity among school-going children adversely affects their normal growth and development and hence is a major public health concern. School health program was started as an important component of total health care delivery system in the country with a purpose of addressing the health needs of children. Aim: To assess the morbidity pattern and nutritional status among school children. Materials and Methods: Study design: A cross-sectional study. Study period: 1-year from 1 st July 2012 to 30 th June 2013. Study setting: 14 schools with a total strength of 909 children in a rural area of coastal Karnataka. Data collection: Health examination of the school children was carried out by a trained team. Data regarding anthropometric measurements, refractory error, medical problems and minor ailments were collected using a predesigned proforma. Results: A total of 797 children were examined. Dental caries was the most common ailment observed in 31.86% of children 43.32% of the children were underweight, 53.03% were normal, and 3.65% were overweight for age. Conclusion: The school health program provides a good opportunity to screen, identify and impart education regarding health related issues. The common morbidities found were dental caries, pallor, upper respiratory tract infection and refractory error. Overweight was also observed in the school children and needs to be addressed. There is a scope of providing comprehensive school health services by incorporating dental care.
  1 6,429 587
CASE REPORTS
Maxillo-orbital granulocytic sarcoma in acute myeloid leukemia
Chandana Chakraborti, Krittika Pal Choudhury
January-February 2016, 9(1):82-84
DOI:10.4103/0975-2870.172440  
Granulocytic sarcoma or chloroma, a manifestation of acute myeloid leukemia (AML) is a rare cause of childhood proptosis. A 14-year-old boy presented with progressively increasing unilateral proptosis and swelling of lower eyelid and face on the right side. Contrast enhanced computed tomographic images revealed enhancing infiltrates occupying the right orbit, maxillary antrum, and infratemporal fossa. Incisional biopsy from the orbital swelling and the bone marrow aspirate showing leukemic blast cells confirmed the diagnosis of AML. The peripheral smear was normal initially, but high total leukocytic count with immature blast cells was evident after 1-month of presentation. Chemotherapy brought about the remission of the disease. However, the delay in diagnosis because of negative peripheral blood smear examination and inconclusive fine-needle aspiration biopsy led to the loss of vision in right eye. Diagnosis of such case can be made by a combination of good clinical examination and relevant investigations. This case of maxillo-orbital granulocytic sarcoma is reported because of its rarity and to emphasize the clinical and cyto-histological features and problems concerning differential diagnosis.
  - 2,539 197
Blocked mesocaval shunt with protein C deficiency in a child with extrahepatic portal hypertension
Nikhil Rao, Ira Shah, Sushmita Bhatnagar
January-February 2016, 9(1):85-87
DOI:10.4103/0975-2870.167960  
Portal vein thrombosis (PVT) is an important cause of extrahepatic portal hypertension in children. A majority of children with PVT of unknown etiology have functional protein C deficiency or abnormally elevated levels of anti-cardiolipin antibodies. We present an 8-year-old boy with portal hypertension with protein C deficiency, who underwent mesocaval shunt surgery due to recurrent episodes of bleeding esophageal varices and subsequently developed a block in the mesocaval shunt due to a thrombotic tendency.
  - 3,224 172
Hypoplastic acute myeloid leukemia-M4: A rare case report
Harsh Kumar, Archana Buch, Banyameen Iqbal, Arjun Lal Kakrani
January-February 2016, 9(1):129-131
DOI:10.4103/0975-2870.167987  
Hypocellular acute myeloid leukemia (AML) is defined as AML with bone marrow cellularity <20%. Hypocellular AML is an infrequent entity. Its frequency ranges between 5% and 12% of all cases of AML. Hypocellular variants of acute leukemia almost always have a myeloid phenotype and usually develop secondary to radiation or chemotherapy. We report a rare case of Hypocellular AML-M4 occurring in a 60-year-old woman who was incidentally found to be positive for HIV.
  - 5,432 241
Pyle type spondylometaphyseal dysplasia in a neonate: An interesting case
Srinivas Murki, Sai Kiran Deshbhatla, Deepak Sharma, Jaya Nethagani
January-February 2016, 9(1):107-109
DOI:10.4103/0975-2870.167963  
Spondylo-metaphyseal dysplasia (SMD) is a bone dysplasia with characteristic vertebral and metaphyseal changes and has different grades of severity depending on the subtype. The exact diagnosis of this infrequently seen skeletal disorder is difficult because of spectrum of severity of bone involvement seen at different ages of life. The most common reported SMD in literature is Kozlowski type (OMIM 184252) and the second most common is SMD corner fracture type (OMIM 184255). We report a case of neonatal SMD on the basis of radiological characteristics.
  - 4,565 185
Unilateral pulmonary hypoplasia in an adult
Akshay Ajit Shah, Anjali R Singh, Amit T Kharat
January-February 2016, 9(1):110-113
DOI:10.4103/0975-2870.167971  
Pulmonary hypoplasia is a bronchopulmonary foregut anomaly characterized by a decrease in the number or size of airways, vessels, and alveoli. Unilateral pulmonary hypoplasia is a rare congenital anomaly, which is frequently associated with other congenital anomalies. Clinical symptoms vary depending on the other system anomalies and severity of pulmonary hypoplasia. Although it is usually diagnosed in infancy and childhood, some cases do not show any symptoms until the adolescent ages. A case of the right-sided pulmonary hypoplasia is described. A 20-year-old male was referred to our department with complaints of cough, breathlessness and right sided chest pain. Chest roentgenogram showed a homogeneous opacity, shifting of the mediastinum, and narrowing of intercostal spaces on the right and an overinflated left lung. Computed tomography scan of the thorax confirmed the diagnosis of right-sided pulmonary hypoplasia. It was not associated with any other developmental anomaly.
  - 6,708 245
Cruveilhier - Baumgarten syndrome with multiple splenic artery aneurysms: A case report
Deepti Madhu Cecil, Arti Chaturvedi, Dinesh Kapoor, Abhishek Shekhar
January-February 2016, 9(1):114-116
DOI:10.4103/0975-2870.167983  
Cruveilhier - Baumgarten (CB) syndrome is a rare medical condition in which liver cirrhosis is associated with portal hypertension causing dilatation of the umbilical and the paraumbilical veins (giant paraumbilical vein). It is important to know about the dilatation of the portosystemic circulation to prevent inadvertent bleeding during any surgical procedure. There are only a few reported cases of CB syndrome and only one with associated multiple splenic artery aneurysms.
  - 7,278 208
Leukemoid reaction in a patient with severe alcoholic hepatitis: A case report and review of literature
Puneet Chabbra, Nikhil Gupta, Sarthak Malik, Paritosh Garg
January-February 2016, 9(1):101-103
DOI:10.4103/0975-2870.167968  
Alcoholic hepatitis is a clinicopathologic syndrome that results from active alcohol consumption in a patient with or without underlying alcoholic liver disease. Leukemoid reaction has been described as an adverse prognostic factor in severe alcoholic hepatitis. We describe a case of 40-year-old male who had severe alcoholic hepatitis and on investigations was found to have leukemoid reaction. The patient improved with steroids, and hence we report this case to create awareness among physicians dealing with such cases.
  - 5,677 294
Pseudomyxoma peritonei in a young male
Pavani Marapaka, Jayashankar Erukkambattu, Satyanarayana Gorthi, Ramamurti Tanikella
January-February 2016, 9(1):140-142
DOI:10.4103/0975-2870.168002  
Pseudomyxoma peritonei (PMP) is an uncommon surgical entity, characterized by diffuse deposition of mucin within the peritoneal cavity secondary to mucinous tumors of the ovary or appendix. This gelatinous ascites or "jelly-belly" may result in death from loss of intestinal function and intestinal obstruction. Preoperative diagnosis on cytology is rare. Herein, we report a case of PMP in a young male who presented with intestinal obstruction, diagnosed preoperatively on cytological examination, and confirmed later by histopathological examination.
  - 4,970 197
Giant plexiform neurofibroma of digital nerves: A case report and review of the literature
Bharat B Dogra, Ashwani Kandari, Shamshad Ahmed, Rohit Virmani
January-February 2016, 9(1):143-146
DOI:10.4103/0975-2870.168004  
Neurofibroma is a benign tumor arising from nerve sheath of peripheral nerves, and may present as an isolated lesion or may present as part of von Recklinghausen's disease. Although plexiform neurofibromas usually affect the face, neck, back, and inguinal region, however other areas may rarely be affected. Plexiform neurofibroma of the palm is a very rare entity, which may affect the fine motor functions of the hand. Surgery is the only treatment option available, but due to diffuse involvement of the nerves and infiltrating nature of the lesions, complete resection may be impossible in many of the cases. We are reporting a case of giant neurofibroma of the palm affecting digital nerves in a 37-year-old patient presenting with features of Von Recklinghausen's disease. He presented with pain and swelling over left palm of 8 years duration. We carried out the surgical excision of the mass, and the individual has been followed-up on out-patient basis for about 3 months without showing any evidence of local recurrence.
  - 6,239 327
Utility of reticulin stain in the diagnosis of a completely infarcted chorangioma
Kausalya Kumari Sahu, Aarathi Rau, Pooja K Suresh
January-February 2016, 9(1):95-97
DOI:10.4103/0975-2870.167965  
This report highlights the utility of the reticulin stain in a completely infarcted chorangioma that facilitated the diagnosis. The patient had normal spontaneous delivery with good neonatal outcome in spite of the large size of the chorangioma and the presence of hydramnios in the antenatal period which may perhaps be due to the complete infarction of the tumor.
  - 3,938 220
COMMENTARIES
Role of family in substance uses disorders
Naresh Nebhinani
January-February 2016, 9(1):14-14
  - 1,679 181
Role of family in substance use disorders: Can they contribute constructively?
Abhishek Ghosh
January-February 2016, 9(1):15-16
  - 3,186 274
COMMENTARY
Ebola virus: What is the future challenge?
Viroj Wiwanitkit
January-February 2016, 9(1):151-152
DOI:10.4103/0975-2870.167995  
  - 3,011 125
Short duration fever: Challenge of antibiotic use
Viroj Wiwanitkit
January-February 2016, 9(1):30-30
  - 1,920 161
Thrombophilic states and anticoagulants in portal vein thrombosis
Madhumita Nandi
January-February 2016, 9(1):87-88
DOI:10.4103/0975-2870.167990  
  - 3,421 160
The cause and effects of neonatal/infantile thymectomy
Hasan Ekim, Meral Ekim
January-February 2016, 9(1):148-149
DOI:10.4103/0975-2870.167996  
  - 4,124 138
EDITORIAL
Family medicine in India: Losing the way in spite of the map
Amitav Banerjee
January-February 2016, 9(1):1-3
DOI:10.4103/0975-2870.172411  
  - 3,832 366
INVITED COMMENTARY
Deciphering the dengue liver disease (This invited commentary is in response to the case report, "Alam S, Singh AK, Singh B, Agarwal A.Dengue: A rare differential of acute hepatic failure. Med J DY Patil Univ 2015;8:830-2." published in the previous issue of this journal.)
Vishal Sharma
January-February 2016, 9(1):152-153
DOI:10.4103/0975-2870.167979  
  - 3,080 159
Perioperative considerations of systemic lupus erythematosus and antiphospholipid syndrome
Jyotsna Satish Paranjpe, Ravikiran Jangonda Thote
January-February 2016, 9(1):91-94
  - 24,274 908
LETTER TO THE EDITOR
The immune system in infants thymectomized during surgical correction of congenital heart defects
Dhaval Kanu Thakkar, VM Kulkarni, Tanmayi Vilas Kulkarni, Amarjit Singh, Mansi Jantre
January-February 2016, 9(1):147-147
DOI:10.4103/0975-2870.172457  
  - 1,444 257
LETTERS TO THE EDITOR
Anesthetic management of a case of congenital diaphragmatic hernia; delayed diagnosis
Dhaval K Thakkar, Amit Kharat, Amarjit Singh, VM Kulkarni
January-February 2016, 9(1):149-150
DOI:10.4103/0975-2870.150499  
  - 3,982 179
The newest information about challenge of Ebola in current world
Seyed Hossein Shahcheraghi, Jamshid Ayatollahi, Ali Fattahi Bafghi
January-February 2016, 9(1):150-151
DOI:10.4103/0975-2870.167989  
  - 3,109 151
ORIGINAL ARTICLES
Clinical, serological, microbiological, and outcome study of 200 cases of short duration fever without prior exposure to antibiotic
Prasanna K Satpathy, Mukund Sudhakar Wasekar, Pradnya M Diggikar, RN Misra, Amar Patil, Priyanka Zagde
January-February 2016, 9(1):23-29
DOI:10.4103/0975-2870.172421  
Background : Short duration fever is a very common presenting symptom of infections which are mostly self-limiting and do not require any antibiotics. Most of these patients presenting to primary care centers are exhibited antibiotics irrationally without any investigation results. Antibiotics are not a panacea for all fevers. This title was chosen to discourage the usual practice of indiscriminate use of antibiotics in short duration self-limiting fevers, increasing emergence of antibiotic resistance bacteria. This study was conceived and designed after The Lancet in 2010 reported the emergence of resistant New Delhi strain of metallo-beta-lactamase 1 Gram-negative Enterobacteriaceae from India, Pakistan, and the UK due to irrational use of antibiotics. Moreover, there are very scanty literature reports on "Short duration Fevers." This study is likely to advocate rational scientific approach to the management of short duration fever. Objectives: This study was conducted to (a) arrive at a definite diagnosis and formulate various etiologies of short duration fever in this tertiary care hospital, (b) rational use of specific antibodies when indicated, and (c) study the outcome of therapy. Materials and Methods: This was an observational cross-sectional study comprising 200 fresh consecutive inpatients of fever of <2 weeks duration who has not been exposed to any antibiotic prior to hospitalization between July 2012 and September 2014. They were subjected to clinical, microbiological, and serological studies and other specific studies when indicated. Results: Common etiology for fever was found to be nonspecific viral fever (45%), which did not need antibiotics, then dengue fever (26.5%), enteric fever (7%), and malaria with Plasmodium vivax (4%) predominance. Conclusion: Clinicians needs to restrict to indiscriminate use of antibiotics in any febrile patients to prevent the emergence of antibiotic resistance. More number of similar studies need to be carried out globally to create awareness among clinician regarding the cautious and rational use of antibiotic therapy in short febrile patients.
  - 4,669 220