2013-06-20T04:39:50Z http://www.doaj.org/oai.article

oai:doaj-articles:b2b1884c1d9aa211f1a52c42cf11fdd7 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 3 4 Rajgopal L http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=3;epage=4;aulast=Rajgopal Animal Cloning Organism ethics legislation & jurisprudence Embryo Research ethics legislation & jurisprudence Human Public Policy Stem Cells

oai:doaj-articles:b020f979be87fce55c225290e390f7c8 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 5 9 Pradhan V Badakere S Iyer Y Kumar R Almeida A BACKGROUND: Anti-neutrophil cytoplasm antibodies (ANCA) play an important role as specific and sensitive markers for small vessel vasculitis and in some other systemic disorders. Indirect immunofluorescence test, known as the "Gold Standard" for screening of ANCA, can be further substantiated by ELISA for confirmation and for identifying sub-specificities like anti-Myeloperoxidase (anti-MPO), anti-Proteinase 3 (anti-PR3) and anti-Lactoferrin (anti-LF). AIMS: The present study was undertaken to investigate the incidence, specificities and strength of ANCA in suspected vasculitis cases and to correlate their presence with that of these auto-antibodies and with the disease. SUBJECTS AND METHODS: Sera from 130 clinically suspected vasculitis patients were studied. Indirect immunofluorescence microscopy (IIF) was used to identify cytoplasmic (c-ANCA), perinuclear (p-ANCA) and atypical (X-ANCA) patterns using ethanol and formalin fixed polymorphonuclear cells (PMN) and HL-60 cells from a human promyelocytic leukaemic cell line as substrates. ELISA was performed for identifying ANCA sub-specificities to anti-MPO and anti-PR3 and HEp-2 cells were used for detection of anti-nuclear antibodies (ANA). RESULTS: ANCA positivity was noted in 42.3% of these patients, wherein p-ANCA positivity rate was 34.6% and c-ANCA positivity was noted in 5.4% subjects. Three patients showed the unusual X-ANCA positivity. ELISA determined the sub-specificities: Out of 45 p-ANCA positive patients, 38 patients (84.4%) had anti-MPO and out of 7 c-ANCA positive patients, 5 patients (71.4%) had anti-PR3 antibodies. One patient with Class IV Lupus Nephritis, showed both anti-MPO and anti-PR3 antibodies and 17.8% p-ANCA positive patients had anti-Lactoferrin antibodies. CONCLUSIONS: Use of the Immunofluorescence method coupled with identification of ANCA sub-specificities by ELISA, is recommended for detection of ANCA in clinically suspected cases of small vessel and other systemic vasculitis. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=5;epage=9;aulast=Pradhan Antibodies Antineutrophil Cytoplasmic blood Autoantibodies immunology Biological Markers Enzyme-Linked Immunosorbent Assay Human Microscopy Fluorescence Neutrophils immunology Vasculitis immunology

oai:doaj-articles:f9a77370e6c22915c485d76194adf568 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 11 6 Giamarellos-Bourboulis E Skiathitis S Dionyssiou-Asteriou A Hatziantoniou S Demetzos K Dontas I Papaioannou G Karatzas G Helen G BACKGROUND: To study whether Pseudomonas aeruginosa may directly trigger peroxidation of polyunsaturated fatty acids, since lipid peroxidation is a mechanism involved in the pathogenesis of sepsis. METHODS: Gamma-linolenic acid (GLA) was administered intravenously at a dose of 25mg/kg in an infusion time of 10 minutes to seven male rabbits. Blood samples were collected from the hepatic veins and from the carotid artery at regular time intervals. One clinical isolate was ex vivo incubated with the serum derived from the latter samples and concentrations of malondialdehyde (MDA) were determined during incubation in the growth medium by the thiobarbiturate assay. RESULTS: Elevated concentrations of MDA compared to their basal levels were found over the first three hours of incubation in the presence of samples collected 30 to 60 minutes after the end of the infusion of GLA. After infusion of GLA concentrations of arachidonic acid in the serum increased to concentrations comparable to those detected in sepsis. CONCLUSION: Direct triggering of lipid peroxidation by nosocomial isolates might be proposed as a pathogenetic mechanism of sepsis. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=11;epage=6;aulast=Giamarellos-Bourboulis Animal Arachidonic Acid blood Cross Infection blood microbiology Lipid Peroxidation Male Malondialdehyde blood Pseudomonas aeruginosa metabolism pathogenicity Rabbits gamma-Linolenic Acid administration & dosage

oai:doaj-articles:31182315365bdd44b8cb9612dffdf01d 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 17 20 Das K Misra H BACKGROUND: Lidocaine, an antiarrhythmic drug has been shown to be effective against post-ischaemic reperfusion injury in heart. However, its effect on pulmonary reperfusion injury has not been investigated. AIMS: We investigated the effects of lidocaine on a postischaemic reperfused rat lung model. MATERIALS AND METHODS: Lungs were isolated and perfused at constant flow with Krebs-Henseilet buffer containing 4% bovine serum albumin, and ventilated with 95% oxygen mixed with 5% CO2. Lungs were subjected to ischaemia by stopping perfusion for 60 minutes followed by reperfusion for 10 minutes. Ischaemia was induced in normothermic conditions. RESULTS: Postischaemic reperfusion caused significant (p < 0.0001) higher wet-to-dry lung weight ratio, pulmonary arterial pressure and peak airway pressure compared to control lungs. Lidocaine, at a dose of 5mg/Kg b.w. was found to significantly (p < 0.0001) attenuate the increase in the wet-to-dry lung weight ratio, pulmonary arterial pressure and peak airway pressure observed in post-ischaemic lungs. CONCLUSION: Lidocaine is effective in preventing post-ischaemic reperfusion injury in isolated, perfused rat lung. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=17;epage=20;aulast=Das Animal Comparative Study Lidocaine pharmacology Lung drug effects Male Models Animal Oxygen administration & dosage Rats Rats Sprague-Dawley Reperfusion Injury prevention & control Support U.S. Gov′t P.H.S.

oai:doaj-articles:fa33c7f4704170333f84ea073ca52340 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 21 4 Ozgenc F Aksu G Aydogdu S Akman S Genel F Kutukculer N Alkanat M Vural Yagci R BACKGROUND: There is growing evidence to suggest that detection of anti-gliadin antibody (AGA) and anti-endomysial antibody (EmA) can serve as sensitive markers of the degree of histological abnormalities in patients with coeliac disease. AIM: To evaluate the association between the presence of AGA and EmA and villous atrophy in intestinal biopsies of children with suspected coeliac disease. SETTINGS AND DESIGN: Intestinal samples of 46 children with failure to thrive, chronic diarrhoea, malabsorption and short stature with either AGA and/or EmA positivity were evaluated, retrospectively. The diagnosis of coeliac disease was based on ESPGHAN criteria. METHODS AND MATERIAL: Patients with total villous atrophy who fulfilled the ESPGHAN criteria for the diagnosis of coeliac disease were diagnosed to have coeliac disease. Nine patients without villous atrophy were taken as negative controls for this study. AGA-IgA was measured both by immunoflourescence (IF) and ELISA and EmA-IgA by IF while patients were on normal diet. Relationship between autoantibody positivity and intestinal total villous atrophy was evaluated. RESULTS: Overall positivity for AGA IgA was 85% (39/46) by IF+ELISA and EmA positivity was 85% (39/46) by IF within the study group. Histological examination revealed total villous atrophy with lymphocyte infiltration and crypt hyperplasia in 37 (80%) patients. AGA IgA was positive in 14 (38%) and 31 (84%) of these children by ELISA and IF, respectively. EmA positivity was detected in 35/37 (95%) cases with atrophy and 4/9 (44%) without atrophy (p=0.002). Thirty out of 37 (81%) patients with villous atrophy had both AGA IgA (IF) and EmA positivity (p=0.186). All of the sixteen patients that had both positive AGA IgA (ELISA+IF) and EmA had total villous atrophy (p=0.037). CONCLUSION: A significant association between total villous atrophy and EmA positivity has been documented in this study. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=21;epage=4;aulast=Ozgenc Adolescent Atrophy diagnosis Autoantibodies blood Case-Control Studies Celiac Disease diagnosis immunology Child Child Preschool Female Gliadin immunology Human Immunoglobulin A blood Infant Intestine Small pathology Male Myofibrils immunology Retrospective Studies

oai:doaj-articles:9051e09ffb6a7922ce2ea5c349f6604d 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 25 8 Pandey M Thomas S Mathew A Nair M BACKGROUND: Malignant tumours of the minor salivary glands are rare and constitute less than 0.5% of all malignant neoplasms. AIM: This study was carried out to evaluate the clinical presentation, site distribution, treatment, survival and predictors of survival in malignant minor salivary gland tumours. SETTING: A tertiary care, superspeciality referral hospital. DESIGN: Retrospective analysis. PATIENTS AND METHOD: Forty-two cases of minor salivary gland tumours treated over a period of 17 years were reviewed for clinical presentation, histopathology, stage distribution, treatment and treatment outcome. STATISTICAL ANALYSIS: Survival by Kaplan Meier Method and the outcomes were compared using log-rank test. RESULTS: The mean age of the patients was 46.9 years with a male to female ratio of 1.4:1. Majority of the patients presented with a painless progressive swelling, with 13 (31%) of them in T2 stage. About one-third of the patients had palpable lymph nodes at presentation, while none had distant metastasis. Palate was the commonest site and mucoepidermoid carcinoma was the commonest hispathological type. About 1/3 of the patients were treated with primary surgery and were followed up by adjuvant radiotherapy. Seven patients underwent palliative treatment alone. Over a mean follow-up of 30 months, 5 patients failed. The disease free survival was 72% at 5-year, none of the factors studied were found to significantly influence survival. CONCLUSIONS: Results of the present study suggest that minor salivary gland tumours should be treated with primary surgery irrespective of site and histological type to achieve best loco-regional control and survival. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=25;epage=8;aulast=Pandey Adolescent Adult Aged Carcinoma diagnosis pathology therapy Disease-Free Survival Female Human Male Middle Age Neoplasm Staging Palate pathology Retrospective Studies Salivary Gland Neoplasms diagnosis pathology therapy Survival Analysis Treatment Outcome

oai:doaj-articles:9d5ea7e3f491943a16861fa398dff441 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 29 30 Sundar S http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=29;epage=30;aulast=Sundar Antiprotozoal Agents therapeutic use Drug Resistance Human India epidemiology Leishmaniasis Visceral diagnosis drug therapy epidemiology

oai:doaj-articles:65585c7d5fe78e9fb13c68bebbaad2ba 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 31 8 Kafetzis D Leishmaniasis, a parasitic disease transmitted by the bite of some species of sandflies affects various age groups depending on the infecting Leishmania species, geographic location, disease reservoir, and host immunocompetence. Visceral leishmaniasis is the most severe form of the disease affecting children. The extent and presentation of the disease depend on several factors, including the humoral and cell-mediated immune response of the host, the virulence of the infecting species, and the parasite burden. Children are at greater risk than adults in endemic areas. Malnutrition contributes to the development of disease, and incomplete therapy of initial disease is a risk factor for recurrence of leishmaniasis. Children usually present with intermittent fever, paleness, refusal to feed or anorexia, weight loss, and abdominal distension. Splenomegaly, hepatomegaly, lymph node enlargement, thrombocytopaenia, anaemia, leukopaenia and hypergammaglobulinemia are the most common findings in Paediatric leishmaniasis. Molecular methods appear to offer the promise of accurate non-invasive tools for the diagnosis of Leishmaniasis. Till these methods are evaluated, definite diagnosis will rely on the demonstration of the infecting parasite in various tissues. World-wide, with the notable exception of India, pentavalent antimonial compounds remain the most effective and the most affordable therapy for this disease. Lipid formulations of amphotericin B were assessed as short duration treatment and were proved to be effective. However, their cost precludes their wide use in developing countries. Miltefosine, a new oral agent, might prove effective, safe, and affordable. Strategies aimed at control of the micro-population of sandflies, eradication of canine leishmaniasis, and offering personal protection against sandfly bites, together with health education programs in developing countries, can help control the disease. Development of an effective vaccine remains a priority. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=31;epage=8;aulast=Kafetzis Animal Antiprotozoal Agents therapeutic use Child Developing Countries Human Leishmania donovani pathogenicity Leishmaniasis Visceral diagnosis epidemiology therapy Protozoan Vaccines therapeutic use Risk Factors

oai:doaj-articles:5d332b8ecd9842ed15bc2e93cde3a4f1 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 39 49 Paredes R Munoz J Diaz I Domingo P Gurgui M Clotet B Herein we review the particular aspects of leishmaniasis associated with HIV infection. The data in this review are mainly from papers identified from PubMed searches and from papers in reference lists of reviewed articles and from the authors′ personal archives. Epidemiological data of HIV/Leishmania co-infection is discussed, with special focus on the influence of Highly Active Antiretroviral Therapy (HAART) on incidence of leishmaniasis and transmission modalities. Microbiological characteristics, pathogenesis, clinical presentation and specific treatment of the co-infection are also presented. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=39;epage=49;aulast=Paredes AIDS-Related Opportunistic Infections diagnosis drug therapy epidemiology parasitology Animal Antimony therapeutic use Antiprotozoal Agents therapeutic use Antiretroviral Therapy Highly Active HIV pathogenicity HIV Infections complications drug therapy Human Leishmania pathogenicity Leishmaniasis complications diagnosis drug therapy epidemiology Risk Factors

oai:doaj-articles:3a623f8da2667c3d3816f09344e2883a 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 50 4 Hepburn N Leishmaniasis is a major world health problem, which is increasing in incidence. In Northern Europe it is seen in travellers returning from endemic areas. The protozoa is transmitted by sandflies and may produce a variety of clinical syndromes varying from a simple ulcer to fatal systemic disease. This review considers the management of simple cutaneous leishmaniasis. Patients usually have a single ulcer that may heal spontaneously, requiring only topical, or no treatment at all. Lesions caused by Leishmania braziliensis may evolve into the mucocutaneous form, ′espundia′, and should be treated with systemic antimony. Sodium stibogluconate 20mg/kg/day i.v. for 20 days is the appropriate first line treatment in these cases. Although it may cause transient bone marrow suppression, liver damage, a chemical pancreatitis, and disturbances in the electrocardiogram, it appears safe. The success of treatment should be assessed 6 weeks after it has been completed and patients should be followed up for 6 months. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=50;epage=4;aulast=Hepburn Animal Antimony Sodium Gluconate therapeutic use Antiprotozoal Agents therapeutic use Cryotherapy Human Leishmania classification Leishmaniasis Cutaneous diagnosis epidemiology pathology therapy Meglumine therapeutic use Organometallic Compounds therapeutic use

oai:doaj-articles:ddf954db71042a2545e9bc2455fc213b 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 55 60 Singh S Sivakumar R Leishmaniasis is a parasitic disease caused by a haemoflagellate Leishmania. There are more than 21 species causing human infection. The infection is transmitted to humans through the bites of female sandflies belonging to 30 species. The disease manifests mainly in 3 forms: the visceral, the cutaneous and the mucocutaneous leishmaniasis. The diagnosis of visceral form is conventionally made by the demonstration of amastigotes of the parasite in the aspirated fluid from the bone marrow, the spleen, and rarely from the lymph nodes, or the liver. The parasite demonstration and isolation rates are rather poor from cutaneous and mucocutaneous lesions due to low parasite load and high rate of culture contamination. Recently several recombinant proteins have been developed to accomplish accurate diagnosis. Recombinant kinesin protein of 39 kDa called rK 39 is the most promising of these molecules. The antigen used in various test formats has been proved highly sensitive and specific for visceral leishmaniasis. It is useful in the diagnosis of HIV-Leishmania co-infection and as a prognostic marker. Molecular techniques targeting various genes of the parasite have also been reported, the PCR being the most common molecular technique successfully used for diagnosis and for differentiation of species. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=55;epage=60;aulast=Singh AIDS-Related Opportunistic Infections diagnosis parasitology Biological Markers Diagnosis Differential HIV Infections complications Human Leishmaniasis diagnosis

oai:doaj-articles:bd54547b07fd897db1381875d436e7f0 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 61 8 Rosenthal E Marty P Visceral leishmaniasis (VL) is a severe disease associated with infection of the reticuloendothelial system by Leishmania species. The infection is acquired through sandfly bites. Recent large scale epidemics of VL in east Africa and India and the emergence of a HIV epidemic make VL a priority for the World Health Organization. Pentavalent antimonials have been cornerstone of treatment for the last six decades. The appearance of antimonial-resistance and the development of lipid formulations of amphotericin B have changed the pattern of VL treatment. Within the past five years, miltefosine has been demonstrated as the first effective and safe oral treatment against VL. The price of miltefosine is yet to be determined. However, miltefosine will certainly be cheaper than lipid formulations of amphotericin B, which are beyond the financial capacity of the poor countries. Because it can be administered orally, miltefosine is suited for the treatment of large number of patients who get affected during epidemics, particularly in regions where the parasites are resistant to the currently used agents. Here, we recommend different treatment schedules according to the resistance pattern and the region-specific socio-economical and cultural factors. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=61;epage=8;aulast=Rosenthal AIDS-Related Opportunistic Infections complications drug therapy parasitology Animal Antiprotozoal Agents economics therapeutic use Antiviral Agents economics therapeutic use Drug Resistance HIV Infections complications Human Interferon Type II economics therapeutic use Leishmania drug effects Leishmaniasis Visceral complications drug therapy epidemiology

oai:doaj-articles:1007137ddb0c3ebf0923ab798921033d 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 69 71 Cinclair R Rice J Agraharkar M Post-transplant lymphoproliferative disorder is treated with rapid decrement of immunosuppressive therapy. This cannot be achieved with ease in patients on long-term glucocorticoid therapy, as chronically suppressed adrenal glands may not be capable of mounting adequate response to stress. A 52-year-old Caucasian male presented with fever, orthostatic hypotension, lymphadenopathy and hyponatraemia. Serum cortisol levels were within normal levels with a sub optimal response to stimulation by ACTH. Hyponatraemia and orthostasis responded poorly to fluid restriction, saline and salt repletion but corrected after increasing the steroid dose. The normal baseline cortisol levels represented a stimulated adrenal gland, however, the ACTH stimulation had inadequate response. This sub optimal stimulation and a good response to increased steroids suggest the presence of relative or occult adrenal insufficiency. Relative adrenal insufficiency must be considered in patients who have received prolonged glucocorticoid therapy and have symptoms such as hypotension and/or hyponatraemia. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=69;epage=71;aulast=Cinclair Adrenal Gland Hypofunction drug therapy etiology Anti-Inflammatory Agents Steroidal therapeutic use Case Report Corticotropin diagnostic use Glucocorticoids pharmacology Human Hyponatremia etiology Hypotension Orthostatic etiology Immunosuppressive Agents pharmacology Kidney Transplantation adverse effects immunology Lymphoproliferative Disorders complications etiology Male Middle Age Prednisone therapeutic use

oai:doaj-articles:8f8f3728d9ac9f11c99c5ca29e037646 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 72 4 Parmar R Somale A Bavdekar S Muranjan M Kawasaki disease (KD) is an acute systemic vasculitis of unknown aetiology that has largely replaced rheumatic heart disease as a cause of acquired heart disease in children of many developed countries. We report a case of incomplete KD in a five-year-old girl. The diagnosis of incomplete KD was made after exclusion of conditions with similar presentation. She was treated with intravenous immunoglobulin following which she made an uneventful recovery but demonstrated thrombocytosis in the second week of convalescence. During the six-month follow up period, she had two episodes of recurrent skin peeling a phenomenon, which is recently reported with KD but not with atypical or incomplete KD. It is important for the treating physicians to become aware of the incomplete KD as prompt diagnosis and early treatment of these patients with intravenous immunoglobulin is vital for the prevention of lethal coronary complications. Physicians need to have a "high index of suspicion" for KD and even, higher for IKD. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=72;epage=4;aulast=Parmar Aspirin therapeutic use Case Report Child Preschool Female Fibrinolytic Agents therapeutic use Human Immunoglobulins Intravenous therapeutic use Mucocutaneous Lymph Node Syndrome classification diagnosis drug therapy Skin Diseases drug therapy etiology

oai:doaj-articles:c6f8622470d917d8ef2f3c748450083b 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 74 77 Saklani A Satheskumar T Nagabhushan J Delicata R http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=74;epage=77;aulast=Saklani Aged Case Report Female Gangrene diagnosis surgery Human Intestinal Obstruction diagnosis surgery Sigmoid pathology surgery

oai:doaj-articles:62ebf3d2514f44968e7375f232856643 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 75 7 Filippou D Papadopoulos V Kiparidou E Demertzis N Adamantinomas of long bones are rare primary low-grade malignant tumours composed of cells with epithelial and fibrous characteristics. Local recurrence, though scarce, occurs 5-15 years after the onset of diagnosis. We report a case of local recurrence of an adamantinoma localised in tibia, along with the presence of two lung metastases, 24 years after diagnosis and surgical therapy of the primary tumour. The local recurrence and the lung metastases were removed surgically. The patient remains free of the disease for 3 years. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=75;epage=7;aulast=Filippou Adult Ameloblastoma diagnosis pathology surgery Bone Neoplasms pathology surgery Case Report Female Human Lung Neoplasms secondary surgery Neoplasm Recurrence Local pathology surgery Tibia pathology surgery

oai:doaj-articles:37d40403b32216ae84ff12b96c5de40e 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 78 80 Ali Z Ali A Tempest M Wiselka M Immunocompromised individuals are susceptible to pulmonary aspergillus infection, but invasive aspergillus infection is extremely rare in the presence of normal immunity. We report a case of invasive aspergillosis in an immunocompetent 63-year-old male with chronic obstructive pulmonary disease (COPD). Patients with COPD may be at risk for developing pulmonary aspergillus infection, which should be considered as a diagnostic possibility in patients with unresolving pulmonary infection. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=78;epage=80;aulast=Ali Aspergillosis complications diagnosis Case Report Human Immunocompetence Lung Diseases Fungal complications diagnosis Male Middle Age Pulmonary Disease Chronic Obstructive complications

oai:doaj-articles:a9209afb28a39c7d37f4440aa60f51cb 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 81 2 Bianca S Ingegnosi C Bonaffini F http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=81;epage=2;aulast=Bianca Case Report Consanguinity Fatal Outcome Genes Recessive Human Ichthyosis Lamellar genetics pathology Infant Newborn Male

oai:doaj-articles:2e5a54ce53680278732df7c3d4352d8f 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 83 4 Alici S Kosem M Kotan C http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=83;epage=4;aulast=Alici Adenocarcinoma pathology secondary therapy Case Report Female Human Middle Age Splenic Neoplasms pathology secondary therapy

oai:doaj-articles:d0d0fd8983dc410c878c4d09ae09e97e 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 85 7 Kini S Pednekar S Nabar S Varthakavi P http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=85;epage=7;aulast=Kini Adult Calcium blood therapeutic use Cardiomyopathy Congestive etiology Female Human Hypocalcemia complications drug therapy etiology Lactation Vitamin D blood therapeutic use

oai:doaj-articles:eaac79214ea7e006fd6af347d60aba91 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 88 9 Shyam Kishore K http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=88;epage=9;aulast=ShyamKishore Animal Comparative Study Ear anatomy & histology Equilibrium physiology Facial Nerve anatomy & histology physiology Hearing physiology Human Phylogeny Vertebrates Vestibulocochlear Nerve anatomy & histology physiology Vibration

oai:doaj-articles:cb2cd37faef95500fb66f55a2c1ff4db 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 90 5 Kaushik S Pandav S Ram J Currently, glaucoma is recognised as an optic neuropathy. Selective death of retinal ganglion cells (RGC) is the hallmark of glaucoma, which is also associated with structural changes in the optic nerve head. The process of RGC death is thought to be biphasic: a primary injury responsible for initiation of damage that is followed by a slower secondary degeneration related to noxious environment surrounding the degenerating cells. For example, retinal ishaemia may establish a cascade of changes that ultimately result in cell death: hypoxia leads to excitotoxic levels of glutamate, which cause a rise in intra-cellular calcium, which in turn, leads to neuronal death due to apoptosis or necrosis. Neuroprotection is a process that attempts to preserve the cells that were spared during the initial insult, but are still vulnerable to damage. Although not yet available, a neuroprotective agent would be of great use in arresting the progression of glaucoma. There is evidence that neuroprotection can be achieved both pharmacologically and immunologically. Pharmacological intervention aims at neutralising some of the effects of the nerve-derived toxic factors, thereby increasing the ability of the spared neurons to cope with stressful conditions. On the other hand, immunological interventions boost the body′s own repair mechanisms for counteracting the toxic effects of various chemicals generated during the cascade. This review, based on a literature search using MEDLINE, focuses on diverse cellular events associated with glaucomatous neurodegeneration, and discusses some pharmacological agents believed to have a neuroprotective role in glaucoma. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=90;epage=5;aulast=Kaushik Apoptosis Cytoprotection Gene Therapy Glaucoma genetics prevention & control Human Neuroprotective Agents therapeutic use Retinal Ganglion Cells drug effects physiology

oai:doaj-articles:9faf06530f308778e13e17c8ce27c697 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 96 7 Maheshwari G Baboo H Patel M Usha G http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=96;epage=7;aulast=Maheshwari Carcinoma Renal Cell secondary therapy Case Report Ethmoid Sinus pathology Human Kidney Neoplasms pathology therapy Male Middle Age Paranasal Sinus Neoplasms secondary therapy Radiotherapy Adjuvant

oai:doaj-articles:abd2c981ffd245426e22147d241e1617 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 96 96 Robinson R Burk M Raman S http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=96;epage=96;aulast=Robinson Adult Antipsychotic Agents adverse effects Autonomic Nervous System Diseases chemically induced Case Report Delirium chemically induced Fever chemically induced Human Male Monocytes drug effects Pirenzepine adverse effects analogs & derivatives

oai:doaj-articles:37f07a67f5faca17b50512b7b7d03bc2 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 97 8 Bawa A Singh R Bansal V Punia R http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=97;epage=8;aulast=Bawa Adenocarcinoma pathology Aged Aged 80 and over Case Report Genital Neoplasms Male secondary Human Male Prostatic Neoplasms pathology Spermatic Cord pathology

oai:doaj-articles:35c11faa5e6559e097f8683f3a448444 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 98 98 Mehta S Goswami D Tempe A http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=98;epage=98;aulast=Mehta Case Report Female Heart Block etiology therapy Human Pacemaker Artificial Pregnancy Pregnancy Complications Cardiovascular diagnosis therapy Pregnancy Outcome

oai:doaj-articles:f04b9d56075dcd8edf4bf629c968fd3e 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 99 100 Bonshahi A Cowey A Vhadra R http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=99;epage=100;aulast=Bonshahi Bone Nails Equipment Design Fracture Fixation Intramedullary instrumentation methods Human Syringes

oai:doaj-articles:2e8090b2b1a87437eff5f1fc0d6736b9 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 1 101 3 More B Bhatt H Kukreja V Ainapure S http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=1;spage=101;epage=3;aulast=More Antiprotozoal Agents pharmacology therapeutic use Human Leishmaniasis Visceral drug therapy Phosphorylcholine analogs & derivatives pharmacology therapeutic use

oai:doaj-articles:8f12f014256ab9eb43f86730dfccac5d 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 107 8 Bavdekar S http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=107;epage=8;aulast=Bavdekar

oai:doaj-articles:c50c06ce7c86f96f7a0bf1231154105f 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 109 13 Gitanjali B Raveendran R Pandian D Sujindra S CONTEXT: Researchers and investigators have argued that getting fully informed written consent may not be possible in the developing countries where illiteracy is widespread. AIMS: To determine the percentage of patients who agree to participate in a trial after receiving either complete or partial information regarding a trial and to find out whether there were gender or educational status-related differences. To assess reasons for consenting or refusing and their depth of understanding of informed consent. SETTINGS AND DESIGN: A simulated clinical trial in two tertiary health care facilities on in-patients. METHODS AND MATERIAL: An informed consent form for a mock clinical trial of a drug was prepared. The detailed / partial procedure was explained to a purposive sample of selected in-patients and their consent was asked for. Patients were asked to free list the reasons for giving or withholding consent. Their depth of understanding was assessed using a questionnaire. Chi-square test was used for statistical analyses. RESULTS: The percentages of those consenting after full disclosure 29/102 (30%) and after partial disclosure 15/50 (30%) were the same. There was a significant (p=0.043) gender difference with a lesser percentage of females (30%) consenting to participation in a trial. Educational status did not alter this percentage. Most patients withheld consent because they did not want to give blood or take a new drug. Understanding of informed consent was poor in those who consented. CONCLUSIONS: The fact that only one-third of subjects are likely to give consent to participate in a trial needs to be considered while planning clinical trials with a large sample size. Gender but not educational status influences the number of subjects consenting for a study. Poor understanding of the elements of informed consent in patients necessitates evolving better methods of implementing consent procedures in India. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=109;epage=13;aulast=Gitanjali

oai:doaj-articles:1b52b0b988b61bfc0467aa227c921c65 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 114 7 Khasnis A Karnad D BACKGROUND: CD4+ T cells restrict parasitaemia during the first attack of falciparum malaria; humoral immunity, develops weeks later and protects against reinfection. HIV infection may affect severity of falciparum malaria and development of protective immunity. AIMS: To study the prevalence of HIV infection in Indian patients with severe falciparum malaria and its effect on severity of illness and recurrences of and mortality related to malarial infection. PATIENTS: Consecutive patients with severe falciparum malaria and voluntary blood donors. SETTING AND DESIGN: Prospective cohort study in a university hospital in Mumbai. RESULTS: Five (11.6%) of 43 patients and 521 (1.8%) of 28749 blood donors had HIV infection (OR 7.1, 95% CI = 2.8 to 18.2, p=0.001). Clinical features, APACHE II score, number of organs affected, parasite index and mortality in patients with and without HIV infection were comparable. CD4+ counts were < 500 cells/ microl in 2 patients and normal in 3. Opportunistic infections including pulmonary tuberculosis in one patient (CD4+ counts > 500 cells/ microl), and oral candidiasis in two (CD4+ counts 275 and 250 cells/ microl) were noted. One patient developed fatal Pneumocystis carinii pneumonia two weeks after recovering from malaria. P. falciparum infection recurred in 2 of the 4 HIV infected survivors and in none of 31 survivors without HIV infection (RR 38.8, 95% CI 2.2 to 671, p=0.01). CONCLUSIONS: HIV infection is associated with increased risk of severe malaria even with normal CD4+ counts; severity of disease and mortality are not increased. However, prior HIV infection impairs protective immune response to Plasmodium falciparum in residents of hypoendemic areas. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=114;epage=7;aulast=Khasnis

oai:doaj-articles:e8c942f0ff6fe1b0283288b6f0e8bc5e 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 118 22 Giamarellos-Bourboulis E Perdios J Gargalianos P Kosmidis J Giamarellou H BACKGROUND: In vitro results have shown that antimicrobial agents may induce the Gram-negative bacteria to release endotoxins (LPS), which in turn, could trigger the secretion of cytokines from monocytes. AIMS: To compare the effect of cefuroxime, netilmicin or ciprofloxacin on serum levels of LPS and tumour necrosis factor-alpha (TNFalpha). METHODS: Seventy-four patients with acute pyelonephritis caused by Gram-negative bacteria and signs of sepsis were randomly assigned to receive one of three intravenous regimens of cefuroxime, netilmicin or ciprofloxacin. Blood samples were collected before therapy and at specified time intervals for 96 hours after the initiation of treatment for the determination of serum levels of LPS and of TNFalpha. RESULTS: Patients treated with cefuroxime presented an early peak of LPS and of TNFalpha in serum two hours after the initiation of treatment compared to the other study groups. After that time interval, concentrations of LPS and TNFalpha were similar in all the study groups. Fever accompanied by endotoxaemia was still detected for 48 hours after the start of therapy in 36, 37.5 and 36% of patients treated with cefuroxime, netilmicin and ciprofloxacin respectively. The corresponding figures for these agents at 72 hours were 28, 12.5 and 24%, respective and 12, 4.2 and 4% at 96 hours (P value not significant). CONCLUSIONS: With the exception of an early peak in the serum levels of LPS and TNFalpha in patients treated with cefuroxime, no significant difference could be detected amongst the study groups as far as their effect on serum levels of LPS and TNFalpha were concerned. This suggests that these three antimicrobial agents may be administered safely at the early stages of sepsis. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=118;epage=22;aulast=Giamarellos-Bourboulis

oai:doaj-articles:8137ffb652e966252f193893e8b2ebc7 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 123 6 Subramaniam R Ghai B Khetarpal M Subramanyam M AIM: To compare the efficacy of ketoprofen and pethidine for peri-operative analgesia and post-operative nausea and vomiting in children undergoing vitreoretinal surgery and surgery for retinal detachment. MATERIAL AND METHODS: Children aged 7 to 16 years and ASA I status, undergoing vitreo-retinal surgery were randomly allocated to receive either ketoprofen 2mg/kg or pethidine 1mg/kg intravenously for peri-operative analgesia. In all patients, general anaesthesia was induced with thiopentone and intubation was facilitated with vecuronium bromide and maintained with 33% oxygen in nitrous oxide and isoflurane. Intra-operative and post-operative monitoring was done by an observer blinded to the technique. Intra-operative rescue analgesia was used if heart rate and/or blood pressure increased by 25% from pre-incision values. Post-operative pain and episodes of nausea and vomiting were evaluated at recovery (0 hour), 2, 6 and 24 hours intervals. Standard rescue analgesia and anti-emetic agents were administered if required. RESULTS: Eighty-six children were enrolled in the study. Forty-four received ketoprofen while 42 received pethidine. Intra-operative analgesia was comparable in both the groups and no significant difference was found in the requirement of intra-operative rescue analgesia, as well. Postoperatively 6/44 (13.6%) children in ketoprofen group had pain at recovery compared to 17/42 (40.4%) in pethidine group. Pain at 2, 6 and 24 hours, and postoperative analgesic requirement were not significantly different among the two groups. Post-operative nausea, vomiting, and antiemetic requirement were significantly less in the ketoprofen group at all time intervals. CONCLUSION: Ketoprofen is a satisfactory alternative analgesic to pethidine for vitreoretinal surgery and results in a lower incidence of postoperative nausea and vomiting. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=123;epage=6;aulast=Subramaniam

oai:doaj-articles:e6faa4f22a44f398f6f6e6f3d990d7d9 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 127 31 Pérez-Calvo J Giraldo P Pastores G Fernández-Galán M Martín-Nuñez G Pocoví M BACKGROUND: Enzyme replacement therapy (ERT) for Gaucher′s disease with alglucerase or imiglucerase is efficacious, well-tolerated and safe. However, cost considerations, visits to medical facilities, potentially duration of theray for life, are issues of major concern to a proportion of treated patients and has, in some cases, led to the withdrawal of therapy. AIMS: To elucidate whether an extension of the interval between enzyme infusions to once every three weeks is as effective in maintaining the clinical responses achieved with the bi-monthly regimen. MATERIALS AND METHODS: Four patients with an optimal response to ERT (at 30 units/kg every two weeks for an average of 27 months), were subjected to enzyme dose/frequency changes that essentially constituted a reduction in cumulative dose over the treatment period. Patients were assessed every 6 months for alterations in haematological parameters, plasma chitotriosidase levels, liver and spleen size, and bone symptoms. RESULTS: All patients had to resume the previous infusion schedule of once every two weeks; one because of new bone marrow infiltrates, two because of visceral enlargement, and the fourth due to progressive anaemia. CONCLUSIONS: This limited experience suggests that a reduction in enzyme dose associated with an extended interval between infusions may lead to variable disease control, and underscores the need for individualization of enzyme therapy. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=127;epage=31;aulast=Pérez-Calvo

oai:doaj-articles:c4d07c770982bde4bd002ad75b73b565 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 132 3 Menon V Brown T INTRODUCTION: The waiting times for elective surgery of Umbilical hernia (UH) in adults are unacceptably long in some cases. During this period, irreducibility and strangulation are possible. We operate on adult patients under local anaesthesia (LA) as day cases to avoid this delay and describe our experience in this paper. AIMS: The aims of our study were to look at the age and sex distribution, body weight, type and amount of local anaesthetic used, morbidity, admission and readmission rates, and waiting times of adult patients operated on for UH under LA. MATERIALS AND METHODS: It was a retrospective study covering a 4 year period from July 1996 to June 2000 including all adult patients undergoing the above procedure under the care of a single consultant general surgeon. A standard Mayo repair using non absorbable material was used without a mesh or a drain. RESULTS: 32 patients with UH were operated on under LA, 23 males and 9 females with a median age of 51 years (range 20 to 86 years). The body weight ranged from 63 to 120 (median 87) kg. The average duration of the procedure was 30 (range 22-40) minutes. Sedation was needed in 4 patients. Two patients developed wound infections, one superficial and one deep. There was no mortality. The median period of follow-up was 24 (range 4-48) months and there was no recurrence. The median waiting time for the operation was 6 weeks. CONCLUSIONS: Day case local anaesthetic repair of UH in adults seems to be safe and feasible with an acceptable morbidity. Suture repair in the right patient has excellent results and the waiting times are acceptable. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=132;epage=3;aulast=Menon

oai:doaj-articles:c21a14c63f9e2a728b48f32538c3b145 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 134 40 Mustafa Abu S Al-Attiyah R Tuberculosis (TB) is an infectious disease of international importance and ranks among the top 10 causes of death in the World. About one-third of the world′s population is infected with Mycobacterium tuberculosis. Every year, approximately eight million people develop active disease and two million die of TB. The currently used BCG vaccines have shown variable protective efficacies against TB in different parts of the world. Moreover, being a live vaccine, BCG can be pathogenic in immunocompromised recipients. Therefore, there is an urgent need to develop new vaccines against TB. The comparative genome analysis has revealed the existence of several M. tuberculosis-specific regions that are deleted in BCG. The work carried out to determine the immunological reactivity of proteins encoded by genes located in these regions revealed several major antigens of M. tuberculosis, including the 6 kDa early secreted antigen target (ESAT6). Immunization with ESAT6 and its peptide (aa51-70) protects mice challenged with M. tuberculosis. The protective efficacy of immunization further improves when ESAT6 is recombinantly fused with M. tuberculosis antigen 85B. In addition, ESAT6 delivered as a DNA vaccine is also protective in mice. Whether these vaccines would be safe or not cannot be speculated. The answer regarding the safety and efficacy of these vaccines has to await human trials in different parts of the world. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=134;epage=40;aulast=MustafaAbu

oai:doaj-articles:4d8170409485b4d6dc7d4d42c3e21cff 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 141 7 Mahoney M Symons A Kimmel S Smallpox virus has gained considerable attention as a potential bioterrorism agent. Recommendations for smallpox (vaccinia) vaccination presume a low risk for use of smallpox as a terrorist biological agent and vaccination is currently recommended for selected groups of individuals such as health care workers, public health authorities, and emergency/rescue workers, among others. Information about adverse reactions to the smallpox vaccine is based upon studies completed during the 1950s and 1960s. The prevalence of various diseases has changed over the last four decades and new disease entities have been described during this period. The smallpox vaccination may be contra-indicated in many of these conditions. This has made pre-screening of potential vaccines necessary. It is believed that at present, the risks of vaccine-associated complications far outweigh the potential benefits of vaccination in the general population. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=141;epage=7;aulast=Mahoney

oai:doaj-articles:c05aa9606d3cf328006a496407055401 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 148 50 Chen C Huan S Lin J Chiu A A 37-years-old female who was suffering from end-stage renal disease for about 6 years received allograft renal transplantation 4 years ago. She has been receiving 50mg of Cyclosporin A orally daily for immuno-suppression since then. Gross haematuria was noted and computerised tomography showed native left renal pelvic and ureteral multi-focal transitional cell carcinoma with severe hydronephrosis. Laparoscopic bilateral nephroureterectomy and bladder cuff excision were performed. In the past, history of previous operation was considered a relative contraindication for laparoscopic surgery. To our knowledge, we present the first case of laparoscopic treatment for native renal pelvic and ureteral transitional cell carcinoma after renal allograft transplantation without a hand-assisted device. This case shows the feasibility of laparoscopic bilateral nephroureterectomy in patients with transplanted kidneys. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=148;epage=50;aulast=Chen

oai:doaj-articles:017816ba1c6545dbcdb7ce544f712c67 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 151 3 Prabhakaran K Patankar J Mali V The Mitrofanoff procedure is a versatile technique that is successfully used in achieving continent urinary diversion for a wide variety of urological conditions. Appendix and usable segment of ureter are commonly employed for this purpose and provide desirable results. This communication describes a teenage girl with lumbosacral agenesis and neurogenic bladder in whom Meckel′s diverticulum was successfully used for the Mitrofanoff procedure. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=151;epage=3;aulast=Prabhakaran

oai:doaj-articles:3b23ebf727bd40b4b607f37e065a3428 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 154 6 Parmar R Sira P This communication reports prenatal diagnosis of partial trisomy 21 resulting from balanced translocation (21q;22q) in a 36-year-old gravida 7, para 1 woman. The lady had only one living child and there was history of recurrent spontaneous first trimester abortions. Triple test was abnormal in the present conception. In addition, the woman had pericentric inversion of chromosome 9, a finding scarcely reported previously with carrier status in Indian literature. A few cytogeneticists consider this as a normal variant. However, many reports in the recent literature link pericentric inversion of chromosome 9 with infertility, recurrent abortions and a number of other abnormal conditions. A review of the relevant literature pertinent to the case is provided. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=154;epage=6;aulast=Parmar

oai:doaj-articles:fdd42c6395ff14bff8525ddb9325ad36 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 157 8 Wright P Jha M Barrett P Bain I Cutaneous metastasis from colon cancer is an uncommon event that usually occurs after identification of the primary tumour and generally indicates diffuse disease. Incisional metastasis occasionally occurs following laparoscopic or open colon cancer resection. However, to the authors′ knowledge only one previous case of colon cancer presenting as a cutaneous metastasis in an old operative scar has been reported. We describe a case of colon cancer presenting as a cutaneous metastasis in an old cholecystectomy scar and discuss possible pathophysiological mechanisms. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=157;epage=8;aulast=Wright

oai:doaj-articles:6536b084c9fb2a83b81c0c954483bd50 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 159 62 Sethuraman K http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=159;epage=62;aulast=Sethuraman

oai:doaj-articles:49c6f4ea7476618fd7575accdf43fffb 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 163 5 de Lusignan S Lakhani M Chan T http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=163;epage=5;aulast=deLusignan

oai:doaj-articles:283cb7212ac3c6ac8d4df0f607e32d4f 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 166 8 Isaac A Baker N Wood M http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=166;epage=8;aulast=Isaac

oai:doaj-articles:5eda2610651fa745049217eb66f837f0 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 169 72 Khasnis A Gokula R http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=169;epage=72;aulast=Khasnis

oai:doaj-articles:6521a8c6843a08820bece84da9686b1d 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 173 4 Thomas N Cherian A Sridhar S http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=173;epage=4;aulast=Thomas

oai:doaj-articles:63d28fc8290a26c0fed9557bfbbc6d5c 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 175 6 Madiwale C Fernandes G Pandit A Kane S http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=175;epage=6;aulast=Madiwale

oai:doaj-articles:f4033956cfaf3c06b3507312d0048987 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 177 8 Maheshwari P Nagar A Shah J Patkar D http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=177;epage=8;aulast=Maheshwari

oai:doaj-articles:0cca89107ea5e4978e1f5a7f0c8e5e55 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 179 81 Wang L Congenital long QT syndrome (LQTS) is a rare but life-threatening disorder affecting cardiac electrophysiology. It occurs due to mutation in genes encoding for the ion channels in ventricular cell membrane. Syncopal attacks and cardiac arrest are the main symptoms of the disease. Anti-adrenergic therapy with oral beta-blockers has been the mainstay of treatment for LQTS. However, up to 30% of patients fail to respond to medical therapy and remain symptomatic. An alarming 10% of patients still experience cardiac arrest or sudden cardiac death during the course of therapy. Left cardiac sympathetic denervation (LCSD) has been used as an alternative therapy in patients who are resistant to beta-blockers. Although LCSD appears effective in reducing the frequency of syncopal attacks and improving the survival rate in both the short and long-term, its use has not gained popularity. The recent advent of minimally invasive thoracoscopic sympathectomy may improve the acceptance of LCSD by physicians and patients in the future. The primary objective of this article was to review the current evidence of the clinical efficacy and safety of LCSD in the management of LQTS. The review was based on Medline search of articles published between 1966 and 2002. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=179;epage=81;aulast=Wang

oai:doaj-articles:8f128127aa68db508da01e428930bbcc 2004-05-31T00:00:00Z Health_Sciences

Medknow Publications Journal of Postgraduate Medicine 00223859 09722823 2003 49 2 182 5 Bhatia V Nayyar P Dhindsa S Currently we are in the midst of a chronic disease epidemic of congestive heart failure (CHF) worldwide. This epidemic is marked by a rapid rise in prevalent cases over the past decade that is due in part to the aging population and improved survival in patients with other cardiovascular conditions. At present there are 5 million Americans with congestive heart failure, with nearly 500000 new cases every year. To provide cost-effective treatment for patients with congestive heart failure, rapid and accurate differentiation of congestive heart failure from other causes of dyspnea must be accomplished. Although echocardiography is considered the gold standard for the detection of left ventricular dysfunction, it is expensive, is not always easily accessible, and may not always reflect an acute condition. B-type natriuretic peptide (BNP) is a cardiac neurohormone specifically secreted from the cardiac ventricles as a response to ventricular volume expansion, pressure overload, and resultant increased wall tension. BNP can be used in the diagnosis of CHF. However, the present American College of Cardiology/American Heart Association practice guidelines (2001) for the evaluation and management of CHF state that the role of blood BNP in the identification of patients with CHF remains to be fully clarified. We have discussed the role of BNP in the diagnosis and management of CHF. http://www.jpgmonline.com/article.asp?issn=0022-3859;year=2003;volume=49;issue=2;spage=182;epage=5;aulast=Bhatia :::doajArticle:50