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Case report:- Anesthesia
Pravin Sonuji Sapkal1*, Sudhir Chavan2, V A Kurhekar3, Sampda Rajurkar4 & Prerna Nandedkar5.
1Assistant Professor, 2Head of Department, Dept of Anesthesia, 4Assistant Professor Department of PSM, 5Assistant Professor Department of Biochemistry, Government medical college Akola, Maharashtra, India. 3Associate Professor, Dept of Anesthesia, Government medical college, Miraj, Maharashtra, India.
Abstract:- To Study the effect of Hemoglobin Levels on the induction dose of thiopentone. Background: Thiopentone is the most commonly used induction agent. Its fate is intimately related linked to magnitude of its binding protein, which is deranged in anemia, hypoprotienaemia and A: G ratio. Aim: To evaluate the effect of hemoglobin level alone on the induction dose of thiopentone with normal level of protein, albumin and globulin. Setting and Design: Clinical trial to evaluate the possible interaction between hemoglobin levels and induction dose of thiopentone with the normal levels of proteins like albumin and globulin. Methods and Materials: It is the clinical trial conducted on patients of both sexes between the age of 15-50yrs of ASA grade I and II who follows the criteria during the period of Jan 2010 to Sept 2011. Total 80 subjects are selected in the study. Statistical Analysis used: Z test is used to find the significance. SPSS 17 is used for analysis. Result and conclusion: Dose of thiopentone (MID) in cases is less than that of control group. And it is statistically highly significant. MID of thiopentone is larger in higher hemoglobin concentration. Present study suggests that normal patients vary enormously in their response to thiobarbiturates. The dose of thiopentone sodium required for induction of anesthesia is less in patients with low hemoglobin levels. This may be due to anaemic hypoxia increasing the sensitivity of cerebral cell to drugs. Keywords:- Hemoglobin, induction dose, thiopentone.
References:-
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3.Dundee JW. Thiopentone narcosis in the presence of hepatic dysfunction. Brit. J. Anaestha 1952;24:81-100.
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Copyright © 2013 Pravin S et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Case report & Literature review:- Radiology
Nagarajan K 1*, Muthu S2 & Sushma Nayar3
Departments of Radiology1, General Surgery2 & Pathology3, Chettinad Hospital & Research Institute, Rajiv Gandhi Salai (IT Highway) Kelambakkam, Kanchipuram Dt Tamil Nadu – 603103 India.
Abstract:- Gastro-intestinal carcinoids are common in the ileo-appendiceal region and produce typical appearance of ‘spiculated’ margins in Computed Tomography (CT). Metastasis to liver leads to systemic carcinoid syndrome. We present a case of ileal mesentric carcinoid which was initially suspected as bowel mass and review the literature to underline the importance of identifying the characteristic CT appearance in view of complications associated with biopsy and surgery of such lesions.
Key Words:- Mesentric carcinoid, Imaging, CT, Liver Metastases, Surgery, Biopsy, Complications.
References:-
1.Kalia V, Saggar K, Sandhu P, Ahluwalia A, Vibhuti. Carcinoid tumor of the Ileum. IJRI Indian J Radiol Imag 2006; 16: 503-4.
2.Woodard PK, Feldman JM, Paine SS, Baker ME. Midgut carcinoid tumors: CT findings and biochemical profiles. J Comput Assist Tomogr. 1995; 19(3): 400-5.
3.Buckley JA, Fishman EK. CT evaluation of small bowel neoplasms: spectrum of disease. Radiographics 1998; 18(2): 379-92. 4.Rioux M, Langis P, Naud F. Sonographic appearance of primary small bowel carcinoid tumor. Abdom Imag 1995; 20(1): 37-43.
5.Pantongrag-Brown L, Buetow PC, Carr NJ, Lichenstein JE, Buck JL. Calcification and fibrosis in mesentric carcinoid tumor: CT findings and pathologic correlation. AJR Am J Roentgenol 1995; 206 (6): 387-91.
6.Nikou GC, Lygidakis NJ, Toubanakis C, et al. Current diagnosis and treatment of gastrointestinal carcinoids in a series of 101 patients: the significance of serum chromogranin-A, somatostatin receptor scintigraphy and somatostatin analogues. Hepatogastroenterology 2005; 52(63): 731-41.
7.Rappeport ED, Hansen C Palnaes, Kjaer A, Knigge U. Multidetector Computed Tomography and Neuroendocrine Pancreaticoduodenal Tumors. Acta Radiol 2006; 47(3): 248-56.
8.Boudreaux JP, Putty B, Frey DJ, et al. Surgical treatment of advanced-stage carcinoid tumors: lessons learned. Ann Surg 2005; 241(6): 839-45;
9.Kvols LK, Martin JK, Marsh HM, Moertel CC. Rapid reversal of carcinoid crisis with a somatostatin analogue. N Engl Med 1985; 313: 1229-30.
10.Ahlman H, Ahlund L, Sahlstrom A, et al. Use of a somatostatin analogue in association with surgery and hepatic arterial embolisation in the treatment of carcinoid syndrome. Br J Cancer 1987; 56:840-2.
11.Bissonnette RT, Gibney RG, Berry BR, Buckley AR. Fatal Carcinoid Crisis after Percutaneous Fine-Needle Biopsy of Hepatic Metastasis: Case Report and Literature Review. Radiology 1990; 174: 751-2.
12. Mason RA, Steane PA. Carcinoid syndrome: its relevance to the anesthetist. Anesthesia 1976; 31: 228-42.
Copyright © 2013 Nagarajan K, Muthu S & Sushma Nayar. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Case report:-Microbiology and pathology
Manisa Sahu1*, Prasanna Ku Satapathy2& Ranjita Panigrahi3
1Ex-Assistant Professor, Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha-25 & Consultant Microbiologist, S L Raheja Hospital, A Fortis Associate, Mahim (W), Mumbai-16.India.
2Professor, 3Associate Professor, Department of Pathology, Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha-25.India.
Abstract:- Cryptosporidiosis is an emerging threat in AIDS and other immune suppressed patients. When seen in histopathology sections of endoscopic biopsy specimen should raise a suspicion of underlying immune suppression, especially when stool examination is negative or not obtained at first. We report two cases of intestinal cryptosporidiosis diagnosed by endoscopic biopsy, one of whom was later found to be seropositive for HIV and the other was an operated case of cervical cancer.
Key Words:- Cryptosporidiosis, AIDS, endoscopic biopsy.
References:-
1.Xiao L, Fayer R, Ryan U and Upton SJ:Cryptosporidium taxonomy:recent advances and implications for public health. Clin Microbiol Rev 2004; 17:72-97.
2.Yezid Gutierrez. Diagnostic Pathology of Parasitic Infections: With Clinical Correlations Oxford University Press, Newyork 2nd edn. 2000:170.
3.S.V. Kulkarni, R. Kairon, S.S. Sane, P.S. Padmawar, V.A. Kale, M.R. Thakar et al. Opportunistic parasitic infections in HIV/AIDS patients presenting with diarrhoea by the level of immunesuppression. Indian J Med Res 2009 July; 130: 63-6.
4.Joshi M, Chowdhary AS, Dalal PJ, Maniar JK. Parasitic diarrhoea in patients with AIDS. Natl Med J India 2002; 15:72-4.
5.Agarwal A, Ningthouja S, Sharma D, Mohen Y, Singh NB.Cryptosporidium and HIV. J Indian Med Assoc 1998; 96: 276-7.
6.Ogata S, Sagunama T, Okada C, Inoue K, Kinoshita A, Sato K. A case of sporadic intestinal cryptosporidiosis diagnosed by endoscopic biopsy. Acta Med Okayama 2009; 63(5): 287-91.
7.Clemente CM, Caramori CA, Padula P, Rodrigues MAM. Gastric cryptosporidiosis as a clue for the diagnosis of the acquired immunodeficiency syndrome Arq Gastroenterol 2001 July-September; 37(3): 180-2.
8.Rossi P, Rivasi F, Codeluppi M, Catania A, Tamburrini A, Righi E, Pozio E. Gastric involvement in AIDS associated cryptosporidiosis. Gut 1998; 43:476-7.
9.Ventura G, Larocca LM, Riccioni ME, Tumbarello M, Lucia MB. Gastric cryptosporidiosis complicating HIV infection: case report and review of the literature. Eur J Gastroenterol Hepatol 1997; 9:307.
10.Greenberg PD, Koch J, Cello JP Diagnosis of Cryptosporidium parvum in patients with severe diarrhea and AIDS. Dig Dis Sci. 1996 Nov; 41(11):2286-90.
11.Sreedharan, A., R. S. Jayshree, and H. Sridhar. 1996. Cryptosporidiosis among cancer patients: an observation. J. Diarrhoeal Dis. Res. 14:211–3.
Copyright © 2013 Manisa Sahu, Prasanna K Satapathy & Ranjita Panigrahi. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Case report:-
Yadava Jeve* , Aisha Janjua & Najum Qureshi
Birmingham Women's NHS Foundation Trust Metchley Park Road, Edgbaston, Birmingham B15 2TG, United Kingdom.
Abstract:- This is case of secondary post-partum hemorrhage due to uterine arterio-venous malformation (AVM) caused after caesarean section. AVM was treated with Rusch Balloon and selective uterine artery embolization.
Keywords:- Arteriovenous malformation; Rusch Balloon; Uterine Artery Embolization.
References:-
1.Diwan RV, Brennan JN, Selim MA, et al. Sonographic diagnosis of arteriovenous malformation of the uterus and pelvis. J Clin Ultrasound. 1983;11:295–8.
2.Forssman L, Lundberg J, Schersten T. Conservative treatment of uterine arteriovenous fistula. Acta Obstet Gynecol Scand 1982;61(1):85–7.
3.Yang JJ, Xiang Y, Wan XR, Yang XY. Diagnosis and management of uterine arteriovenous fistulas with massive vaginal bleeding. Int J Obstet Gynaecol. 2005;89:114–119.
4.Poppe W, Assche FA, Wilms G, Favril A, Baert A. Pregnancy after transcatheter embolization of a uterine arteriovenous malformation. Am J Obstet Gynecol. 1987;156:1179–80.
5.Vaknin Z, Sadeh-Mefpechkin D, Halperin R, Altshuler A, Amir P, Maymon R. Pregnancy-related uterine arteriovenous malformations: experience from a single medical center. Ultraschall Med. 2011 Dec;32 Suppl 2:E92-9. Epub 2011 May 25.
6.Bagga R, Verma P, Aggarwal N, Suri V, Bapuraj JR, Kalra N. Failed Angiographic Embolization in Uterine Arteriovenous Malformation. Medscape J Med 2008;10:12
7.Kelly SM, Belli AM, Campbell S. Arteriovenous malformation of the uterus associated with secondary postpartum Haemorrage. Ultrasound Obstet Gynecol. 2003 Jun; 21(6):602-5.
8.Salazar GM, Petrozza JC, Walker TG Transcatheter endovascular techniques for management of obstetrical and gynecologic emergencies. Tech Vasc Interv Radiol. 2009 Jun; 12(2):139-47.
9.Grivell RM, Reid KM, Mellor A. Uterine arteriovenous malformations: a review of the current literature. Obstet Gynecol Surv. 2005 Nov;60(11):761-7.
10.O'Berien P, Neyastani A, Buckley AR, Chang SD, Legiehn GM. Uterine arteriovenous malformation from diagnosis to treatment. J Ultrasound Med 2006; 25:1387-92.
11.Papadakos N, Wales L, Hayes K, Belli AM, Loftus I, Ray S Post-traumatic pelvic pseudoaneurysm and arterio-venous fistula: combined endovascular and surgical approach Eur J Vasc Endovasc Surg. 2008 Aug;36(2):164-6. Epub 2008 Jun 3.
12.Wang Z, Chen J, Shi H, Zhou K, Sun H, Li X, Pan J, Zhang X, Liu W, Yang N, Jin Z Efficacy and safety of embolization in iatrogenic traumatic uterine vascular malformations. Clin Radiol. 2012 Jun;67(6):541-5. Epub 2012 Jan 18.
Copyright © 2013 Yadava Jeve. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Original article:- Physiotherapy
J.John arockia Vijay1* , Jagatheesan Alagesan2 & Vishnu Bhutia3.
1PhD Scholar, CMJ University, Shillong, India. 2Associate Professor, Saveetha College of Physiotherapy, Saveetha University, Chennai, India. 3Professor & PhD Guide, CMJ University, Shillong, India.
Abstract:- Background and Purpose: Diabetic stroke patients have a higher mortality rate than stroke patients without Diabetes Mellitus. This is not only significantly increases the risk of stroke, but also is a predictor of reduced survival following stroke. Diabetes Mellitus may affect the rate of recovery of neurologic function following a stroke. Treadmill exercise training increases insulin sensitivity in diabetic stroke patients. This study is an attempt to reduce the fasting and post prandial blood glucose level by treadmill exercise training on diabetic stroke patients. Methods: 30 subjects with diabetic hemi paresis in the age of 45-60 years are included in the study. All subjects underwent 6 weeks of treadmill walking for 60 minutes twice daily. Quality of life index questionnaire score, fasting and post prandial blood glucose levels measured by glucometer on first day before treatment and at the end of 6 weeks of treatment are analyzed. Results: The data are analyzed by paired t test with level of significance at 0.05. The Mean ± SD for Fasting blood glucose is 180.83 ± 38.01 and 133.16 ± 23.83 for before and after intervention with p value less than 0.001. The Mean ± SD for Post prandial blood glucose level is 357.80 ± 53.02 and 226.50 ± 37.16 for before and after intervention with p value less than 0.001. The Mean ± SD for Diabetic quality of life score is 247.73 ± 54.83 and 379.16 ± 47.58 before and after intervention with p value equal to 0.001. Conclusion: This study finding suggests that treadmill training is effective for reducing the high blood glucose level and improving the quality of life in diabetic stroke individuals.
Key Words:- Diabetic stroke, Treadmill training, Insulin resistance, Quality of life.
References:-
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Copyright © 2013 J.John arockia Vijay, Jagatheesan Alagesan & Vishnu Bhutia. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.