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  Access statistics : Table of Contents
   2018| July-September  | Volume 6 | Issue 3  
    Online since June 12, 2019

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Obstructive sleep apnoea
BV Murali Mohan, Aneesha Jallepalli
July-September 2018, 6(3):16-22
Identified as a clinical entity only about 50 years ago, OSAS is now recognised as one of the most important clinical conditions with manifestations affecting different organ systems. Studies indicate a prevalence of at least 2-4% of the population aged over 40 years. Worldwide, at least a similar prevalence is reported, though all may be underestimates. OSAS is more often identified in the obese, but it is increasingly being diagnosed in the non-obese. Other identifiers like cranio-facial abnormalities, associations like refractory hypertension and poorly controlled diabetes, cardiac conditions like coronary artery disease, unexplained heart failure and cardiac arrhythmias and neurological conditions like strokes and neurocognitive problems may all give clues to its presence. Patients commonly present with excessive daytime sleepiness and loud snoring, with good quality sleep being interrupted by the recurrent apnoeas and hyponoeas. Poor sleep quality impairs the ability to concentrate, affects social functioning, with consequently poorer academic and work performance and increases the risk of accidents including road traffic accidents. The diagnosis is made by polysomnography, but increasingly home based polygraphy studies are found adequate to confirm the diagnosis and initiate treatment. The treatment of choice is nocturnal continuous positive airway pressure; it is highly effective clinically, but compliance with treatment is often poor. Alternative strategies include surgery, mandibular advancement devices and hypoglossal nerve stimulation devices, the effectiveness and wide-scale applicability of which are still under evaluation.
[ABSTRACT]   Full text not available  [PDF]
  411 60 -
Neurofibromatosis associated lung disease
Vasantha Kamath, R Venkateswara Reddy
July-September 2018, 6(3):25-28
Von Recklinghausen disease or neurofibromatosis type 1 is an autosomal dominant dysplasia of ectoderm and mesoderm with a variable clinical expression characterized by neuro fibromas, café-au-lait spots and hamartomas of iris (Lisch nodules). Neurofibromatosis has a prevalence of 1 in 3000 and in 30-50% of cases there is no family history of the disease1. The involvement of respiratory system in these patients is very rare. We present an interesting case of a patient with Neurofibromatosis induced lung disease in the form of multiple thin walled bullae, fibrosis and bronchiectasis.
[ABSTRACT]   Full text not available  [PDF]
  397 69 -
ZIKA : Global Epidemiology, is it a threat to India?
Shreyashi Ganguly, N Karthik, Vasantha Kamath
July-September 2018, 6(3):44-55
Zika virus is an emerging arthropod borne virus transmitted by the female Aedes aegypti and Aedesalbopictus mosquitoes. The virus belongs to the genus Flavivirus. Zika virus was first isolated from a rhesus monkey in the Zika Forest of Uganda, in 1947. In 2007, the first documented outbreak of Zika virus disease occurred in the Pacific. Since 2013, cases and outbreaks of the disease have been reported, as of now from 70 countries and territories. Between the late 2015 and early 2016, Zika is established as a neurotropic virus. Its neurological sequelae (GBS) and its teratogenic potential (microcephaly) is demonstrated. Since 2016, 11 countries from Asia have reported Zika. A recent study by Musso and Gubler concluded that the co-circulation of ZIKV with DENV and CHIKV might occur in countries where DENV and CHIKV are endemic. As of May 2017, the Health Ministry of India has reported only 4 laboratory-confirmed cases in India so far. WHO now classifies India as a category 2 country for Zika transmission. India's burgeoning population renders it vulnerable to this threat. The lack of access to laboratory services, under-reporting or misdiagnosis can mask this disease especially in areas with endemicity of dengue or chikangunya. This otherwise non-fatal disease can increase India's maternal mortality burden significantly and increased childhood morbidity if it goes unchecked. These findings make it imperative to escalate the measures adopted to spread awareness and prevent the spread of this disease.
[ABSTRACT]   Full text not available  [PDF]
  408 55 -
Emergence and control of multidrug resistant organisms, from urinary tract infections in Shivamogga, a tier 2 city of Karnataka
Pavaman V Bhat, JS Manjula
July-September 2018, 6(3):9-14
Context: Urinary tract infections (UTIs) is one of the most common bacterial infections in general practice. Antimicrobial resistance in urinary pathogens, particularly the most common being Escherichia coli, is directly associated with prescribing in primary care. Diagnosis of UTI requires laboratory examination of urine sample in addition to clinical evaluation, which may lead to higher cost of treatment, but the proper treatment of the case that will lead to complete recovery with no recurrence episodes far outweigh the cost issue of microbiological investigation. Even though UTIs are a very common diagnosis, management of this condition is not consistent in general practice. This study was conducted in an effort to see the extent of presence of multi drug resistant organisms in local set up. Aim: To describe the common urine isolates observed in Shivamogga, Karnataka and also to test for drug resistance among them. Materials and Methods: A retrospective review was conducted of Gram negative bacilli and Gram positive cocci isolated from the clinical urine samples collected from patients of various hospitals and private clinics in Shivamogga City, Karnataka. The study period was between July 2017-December 2017. Result: A total of 803 urine samples were included in the study. Escherichia coli was the most commonly isolated organism with 62.39% of total isolates and Pseudomonas aeruginosa was the least isolated with 0.87%. It was seen that 46.45% of the total isolated organisms were multidrug resistant (MDR). 52.49% of Escherichia coli isolates were MDR. Conclusion: Only with the combined efforts of the local laboratories and clinicians, the looming threat of the pandrug resistant organisms in small cities can be avoided. However, more such studies are required from both clinicians and laboratory health care professionals in order to arrive at a common consensus, and uniformity can be brought about in the community regarding prescription practices.
[ABSTRACT]   Full text not available  [PDF]
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E C G Diagnosis
M Premanath
July-September 2018, 6(3):35-35
Full text not available  [PDF]
  392 43 -
A young man with Hyperhomocysteinemia with low Vitamin B 12 causing Cerebral Venous Thrombosis
Malav Patel, Sangram Biradar, MG Pastapur
July-September 2018, 6(3):36-38
Background: Cerebral venous sinus thrombosis is an uncommon condition and can be precipitated by various conditions. We report a case of cerebral venous sinus thrombosis in a young man in whom the serum homocysteine level was found to be elevated along with low serum Vitamin B12. Case presentation: A 22 years old man was admitted with sudden onset of severe headache in the right side with transient visual obscuration. Investigations revealed complete thrombosis of superior sagittal sinus (SSS), right transverse sinus and right sigmoid sinus. Workup for the etiology revealed elevation of serum homocysteine with low serum vitamin B12 level. Conclusions: Hyperhomocysteinemia is a potential risk factor for arterial and venous thrombosis. Hyperhomocysteinemia is commonly seen in chronic alcoholics secondary to low vitamin B12 level. Unless actively intervened, CVT is devastating due to increased intracranial tension.
[ABSTRACT]   Full text not available  [PDF]
  380 53 -
Stroke in young - A case of vitamin B 12 deficiency with hyperhomocysteinemia and carotid artery thromb
Vijayalakshmi , Sangram Biradar
July-September 2018, 6(3):29-34
Ischaemic stroke in young adults has many causes which are diverse. It is important that a comprehensive search is made since many of the underlying disorders are treatable and cause should not be missed, given the life expectancy of this age group. Vitamin B12 deficiency with hyperhomocystinemia, is a rare and treatable cause of stroke in young, to be diagnosed early especially with risk factors like alcoholics.
[ABSTRACT]   Full text not available  [PDF]
  371 60 -
Posterior reversible encephalopathy syndrome
Sangram Biradar, Muddasir Indikar
July-September 2018, 6(3):39-43
PRES is a reversible syndrome characterized by headache, seizure, altered consciousness and loss of vision PRES can be associated with a number of conditions, all of which result incerebralvasogenic oedema and white matter changes on imaging predominantly in the posterior cerebral hemispheres. The global incidence of PRES is unknown. It has been reported in patients ranging from 4 to 90 years of age, with most cases occurring in young-aged to middle-aged adults. A marked female preponderance is observed which may reflect some of the underlying causes. PRES occurs in association with a number of causes, most commonly hypertension, pre-eclampsia/eclampsia and immunosuppressive agents. This study reports a 31-year-old primigravida who presented with altered consciousness and focal seizure. The MRI of her brain showed E/O discrete area of T2,FLAIRhyperintensity in bilateral parito-occipital cortex and sub-cortical white matter. She was treated successfully with pregnancy termination, anti-hypertensives, anticonvulsants low molecular weight heparin, and supportive care. It is concluded that early diagnosis is important to prevent permanent neurologic damage and mortality.
[ABSTRACT]   Full text not available  [PDF]
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Emergence and control of multidrug resistant organisms in urinary tract infections
Sangram S Biradar
July-September 2018, 6(3):7-8
Full text not available  [PDF]
  332 51 -
Hypertension guidelines - Were they worth the wait?
Nagaraj Desai, Prabhakar Koregol
July-September 2018, 6(3):56-58
Full text not available  [PDF]
  325 52 -
ECHO Diagnosis
Suresh V Sagaard, Sweta A Biradar, B Mahalingappa
July-September 2018, 6(3):23-24
Full text not available  [PDF]
  320 47 -
Radiological Diagnosis
Sangram Biradar
July-September 2018, 6(3):15-15
Full text not available  [PDF]
  283 57 -
“Sir you were probably right”
B Sadananda Naik
July-September 2018, 6(3):61-61
Full text not available  [PDF]
  265 57 -
From your Editor in Chief
M Premanath
July-September 2018, 6(3):6-6
Full text not available  [PDF]
  256 63 -
Dr M Shivakumar Shetty
M Premanath
July-September 2018, 6(3):59-59
Full text not available  [PDF]
  248 71 -
Dr C Bheemaiah
M Premanath
July-September 2018, 6(3):60-60
Full text not available  [PDF]
  246 67 -