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CASE REPORTS |
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| A case of swine flu with ARDS : Our experience M Matta, NK Mahesh January-June 2012, 14(1):81-84 DOI:10.4103/0975-3605.203243
After the first outbreak identified in Mexico in March 2009, influenza A sustained by a modified H1N1 virus (“swine flu”) rapidly spread to all continents. Swine-origin influenza (H1N1) virus is considered a worldwide pandemic and is associated with a large number of patients admitted to intensive care. In a proportion of these patients, acute respiratory distress syndrome (ARDS) can develop. This paper describes a case of life-threatening ARDS associated with H1N1 virus confirmed by a throat swab tested with real-time reverse transcription-polymerase chain reaction. The clinical course was extremely eventful in spite of aggressive management with mechanical ventilation and parental antibiotics. In spite of marked clinical and functional recovery on 30th day admission in ICU, radiological findings suggestive of ARDS persisted.
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FRONTIERS IN MEDICINE |
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| Human embryonic stem cells - role in regenerative medicine Pankaj Talwar January-June 2012, 14(1):36-39 DOI:10.4103/0975-3605.203228
The evolving role of regenerative medicine in functional restoration mandates that all clinicians be aware of its potential and limitation. In this article we attempt an overview of the available knowledge with a look at the technical aspects of cryopreservation techniques.
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MARINE MEDICINE |
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| An overview of habitability onboard naval platforms N Anand, Sundeep Bhandari, B Fanthome January-June 2012, 14(1):20-23 DOI:10.4103/0975-3605.203223
As Indian Navy is sentient of its responsibilities as the primary guarantor of security of Indian National interests wherever they may lie and as such has progressively advanced its blue water capability and also enhanced brown water operations to ensure coastal security. In this evolution habitability has emerged as an important gearwheel in operational readiness of naval platforms. Policy makers have progressively fine-tuned operational needs with habitability needs as each new class of ship is inducted and old ones refitted. The need of the hour is to sustain the bench marks set by successive standardizing agencies in Navy Orders and Books of Reference covering these issues. Given the long service life of Naval Platforms and the unique man-machine interface issues likely to manifest on them, focus is on real-time evaluation and a persistent, pro-active approach to Habitability. This article is an effort towards sensitization of personnel on various aspects and issues concerning habitability.
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| Psychological screening of submariners - is there a need? Kaushik Chatterjee, Chaitanya Kodange January-June 2012, 14(1):24-27 DOI:10.4103/0975-3605.203224
The nature of the profession makes heavy psychological demands on submariners, who operate for prolonged durations in an environment which is cognitivcly demanding, socially isolated, potentially hazardous, with habitability constraints and cireadian rhythm challenges. Various navies around the world have adopted different approaches towards psychological screening of submariners. This article reviews available literature, assesses the need for psychological screening of Indian submariners and discusses the way forward.
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CASE REPORTS |
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| A case of hepatic tuberculosis Vivek Hande, Swapnil Kankare, PC Hande, Naveen Chawla January-June 2012, 14(1):79-80 DOI:10.4103/0975-3605.203242
Tuberculosis (TB) is associated with myriad clinical presentations posing diagnostic challenges to the treating physician. We report a case of Hepatic Tuberculosis presenting as a space occupying lesion (SOL) in the Liver, presenting consequent to successful completion of treatment for tubercular pleural effusion.
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FRONTIERS IN MEDICINE |
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| Cord Blood Banking GD Maiti January-June 2012, 14(1):40-42 DOI:10.4103/0975-3605.203229
The Role and Realistic utility of cord blood banking is an issue of contemporary debate. Abrief overview is presented.
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CLINICAL MEDICINE |
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| Approach to upper GI bleed Atit A Dharia, V Hande January-June 2012, 14(1):58-61 DOI:10.4103/0975-3605.203235
Upper Gastrointestinal hemorrhage can result on devastating outcomes. A review of current trends in the management of UGI bleed is presented.
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MARINE MEDICINE |
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| Hyperbaric medicine: A perspective B Fanthome, H BS Chaudhry, N Anand January-June 2012, 14(1):5-8 DOI:10.4103/0975-3605.203233
Hyperbaric medicine, also known as Hyperbaric Oxygen Therapy (HBOT), is the medical use of oxygen at a level higher than atmospheric pressure. The equipment required consists of a pressure chamber and a means of delivering 100% oxygen. Several therapeutic principles are made use of in HBOT, the main one being the increased overall pressure when used in the treatment of decompression sickness and air embolism, as it provides a physical means of reducing the volume of inert gas bubbles within the body. There are various approved and under-trial indications for HBOT. The main facility required for hyperbaric medicine is the Hyperbaric chamber, which is essentially designed to withstand pressurization so as to enable oxygen delivery at pressures greater than atmospheric pressure. The complications associated with HBOT are related to pressure changes causing barotrauma and those related to oxygen toxicity. The only absolute contraindication to hyperbaric oxygen therapy is untreated tension pneumothorax.
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CASE REPORTS |
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| An interesting case of decompression sickness (DCS) C Kodange, DK Ghosh, H BS Chaudhry January-June 2012, 14(1):73-75 DOI:10.4103/0975-3605.203240
A case of decompression sickness manifesting as shoulder pain, with good response to recompression therapy is presented herewith.
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MARINE MEDICINE |
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| Aeromedicai overview of naval air operations at sea SS Mohapatra, P Patro, RJ Singh, N Anand January-June 2012, 14(1):9-13 DOI:10.4103/0975-3605.203244
Flying in a Maritime Environment offers special challenges. A brief overview of Aeromedicai aspect of Marine Aviation is presented.
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MARINE MEDICINE |
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| Psychological management of claustrophobia Sunitha Shanker, Karan Sud, Austin Fernandes, Sunil Goyal January-June 2012, 14(1):28-29 DOI:10.4103/0975-3605.203225
Here we present a case report of a young sailor with moderate level of claustrophobia, where his symptoms caused him severe distress and interfered with his work and daily functioning onboard a ship.
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| Casualty evacuation using scoop stretcher Anil Pillai January-June 2012, 14(1):30-31 DOI:10.4103/0975-3605.203226
A scoop stretcher is used to evacuate trauma cases, where minimum movement of a patient is advisable. There stretcher are available onboard ships and established of the Indian Navy. The correct use of this stretcher with photographic representation is depicted in the article.
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CLINICAL MEDICINE |
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| Spinal cord injury - Current concepts KS Lakshmi, P Banic, Swati , G Vishwanath January-June 2012, 14(1):65-67 DOI:10.4103/0975-3605.203237
The management of spinal cord injuries involves multiple specialities, dose monitoring and supervised rehabilitation. An overview of spinal cord injury management based on experience of the INHS Asvini spinal care unit is presented.
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FRONTIERS IN MEDICINE |
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| Pre implantation genetic diagnosis : A review Pankaj Talwar January-June 2012, 14(1):49-53 DOI:10.4103/0975-3605.203232
Preventing genetic transmission of disease is of paramount importance. A brief overview of Pre implantation genetic diagnosis is presented.
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CASE REPORTS |
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| A case of colloid cyst of III ventricle presenting with hydrocephalic crisis onboard a warship at sea KI Mathai, R Pant, R Yadav, S Tandon, S Taneja, YP Monga January-June 2012, 14(1):71-72 DOI:10.4103/0975-3605.203239
Colloid cysts of 3rd Ventricle have the potential risk of precipitating Hydrocephalic crises. We present a case of a young German sailor who collapsed onboard his warship while in international waters. Abrief glimpse offered of the paradigm of onboard resuscitation, a staged helicopter evacuation to our centre for emergency life saving surgery followed by evacuation to Germany where further elective surgery was undertaken.
This is the first reported case of a Hydrocephalic crisis at sea with a good out come.
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FRONTIERS IN MEDICINE |
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| What is new in oncology : A review B Fanthome January-June 2012, 14(1):32-35 DOI:10.4103/0975-3605.203227
New knowledge related to Oncology continues to emerge at a rapid pace. The need to cull evidence based information from the enormous mass of data circulating through print and electronic media is crucial for clinicians who are hard pressed for time, attending to patients and committed to providing state of the art treatment from resources at their command. This review is not exhaustive but is an attempt to collate data for the busy clinician based on felt needs over three decades of experience as a surgeon with an abiding interest in Oncology.
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CLINICAL MEDICINE |
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| Radiation - basic concepts, biological effects and protection MJ Jacob, Dibya Prakash January-June 2012, 14(1):62-64 DOI:10.4103/0975-3605.203236
With the increasing use of ionising radiation in diagnostics and therapeutics it is imperative that all clinicians have an understanding of the effects of radiation on tissue.
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FRONTIERS IN MEDICINE |
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| Gene therapy - a review Sheila S Mathai January-June 2012, 14(1):43-45 DOI:10.4103/0975-3605.203230
With increasing capability of genomic manipulation new therapeutic paradigms are evolving. A quick glimpse into the prospect and promise of gene therapy is desirable.
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| Neural stem cells and post traumatic epilepsy: The importance of seizure control KI Mathai, S Ranjan, S Das, A Chagla January-June 2012, 14(1):46-48 DOI:10.4103/0975-3605.203231
Post traumatic seizures induce structural and neurochemical changes in the Neural Stem cell (NSC) niches. The NSC niche shows a classic biphasic response to seizures. In the early weeks after a post traumatic seizure, there is an increase in neurogenesis. However, the integration of these new neurons into existing circuitry is defective leading on to epileptogenic circuits. As seizures continue, there is a decrease in neural proliferation, with consequences on cognition and mood. In this article, we explore the aetiopathogenesis of hippocampal epileptic circuitry and discuss conceptual and evolving therapeutic options.
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CLINICAL MEDICINE |
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| A study of multidrug resistant gram negative organisms at INHS Asvini Ruby Chattopadhyay, Naveen Chawla, Ramesh Rao, Surendra Kumar, Jyothi Gangu, Vivek D Kharolkar January-June 2012, 14(1):54-57 DOI:10.4103/0975-3605.203234
Emerging antibiotic resistance has created a major public health dilemma, compounded by a dearth of new antibiotic options. The development of antimicrobial resistance especially among gram-negative pathogens has been progressive and relentless. Pathogens of particular concern include extended-spectrum β-lactamase- producing Enterobacteriaceae, Carbapenem-resistant Enterobacteriaceae, multidrug-resistant Pseudomonas aeruginosa and multidrug-resistant Acinetobacter spp. which are emerging as significant pathogens in various parts of the world. In some cases, these pathogens have expressed resistance to all clinically available compounds. Of the few new drugs available, many have already become targets for bacterial mechanisms of resistance. Furthermore, the Carbapenems, currently the most successful class of antibiotics are showing signs of vulnerability. While the search for new antibiotic options continues, there is urgent need to employ strategies that will slow the development of resistance to the current available armamentarium.
A one year retrospective study from Jan 2011 to Dec 2011 was carried out at INHS Asvini to recognise the burden of multidrug-resistant gram-negative organisms in causing health care-associated infections. Antimicrobial susceptibility patterns for all available antibiotics classes were studied. Overall, 14.3% of all gram negative isolates were multidrug-resistant gram negative bacilli (MDR-GNB). Of all the antimicrobial agents, the least effective was Ampicillin (88% resistance), while the most effective antibiotic against MDR-GNB were Imipenem (6% resistance), Meropenem (14% resistance) & Piperacillin-Tazobactam (20% resistance). However, a high degree of resistance among isolates was found against Cephalosporins (35% - 40%).
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CASE REPORTS |
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| Knocking on many doors!: Somatisation disorder Kaushik Chatterjee, Prakash Ambekar, Sunil Goyal, K Seby January-June 2012, 14(1):76-78 DOI:10.4103/0975-3605.203241
Somatisation Disorder presents as myriad bodily symptoms, for which repeated clinical examination and detailed investigation reveals no organic basis. Patients seek various doctors and are unconvinced by explanations of lack of major physical illness. It can be conceptualised as a condition where psychological distress is communicated through physical symptoms. Loss of trained manpower can be averted through greater awareness among doctors about this condition.
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CHIEF EDITORS NOTE |
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| Chief Editors Note Nirmala Kannan January-June 2012, 14(1):4-4 DOI:10.4103/0975-3605.203246 Full text not available [PDF] |
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FROM THE PRESIDENTS DESK |
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| From the President's Desk AC Anand January-June 2012, 14(1):3-3 DOI:10.4103/0975-3605.203245 Full text not available [PDF] |
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CLINICAL MEDICINE |
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| Vitamin D in the perinatal period - future trends Sheila Samanta Mathai January-June 2012, 14(1):68-70 DOI:10.4103/0975-3605.203238
The importance of the role of Vitamin D in bone metabolism is well known but its effect on other systems is emerging with greater understanding of this vitamin-cum hormone. The growing evidence of widespread deficiency particularly in high-risk population is alarming. The high prevalence of deficiency in pregnant and lactating mothers and their newborn babies is disturbing. The levels of Vitamin D considered adequate as well as the recommended doses for the pregnant and lactating mother and infant are still areas of controversy. The long-term harmful effects of Vitamin D deficiency on the fetus and newborn need to be addressed urgently. The article highlights these issues and discusses remedial measures.
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MARINE MEDICINE |
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| Indian navy hospital ship - concepts and issues (brown water to blue water navy evolution) Sundeep Bhandari, G Bhanot, Tarun Choudhary January-June 2012, 14(1):14-19 DOI:10.4103/0975-3605.203254
The concept of casualty care supporting naval operations is of “Life & limb saving” care on the ship, with rapid tactical helo aero-medical evacuation to progressively more specialised medical/surgical levels of care. A hospital ship is a desirable support platform for a ‘Blue Wate’ Navy.
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