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   2012| June  | Volume 4 | Issue 6  
    Online since June 14, 2012

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Foregut duplication cyst: An unusual presentation during childhood
Ahmad Hammoud, Mohammad Hourani, Mouniat Akoum, Mariam Rajab
June 2012, 4(6):287-289
DOI:10.4103/1947-2714.97213  PMID:22754882
Congenital duplications can occur anywhere in the GIT, one third of all duplications are foregut duplications (esophagus, stomach, first and second part of duodenum). Respiratory symptoms are the most common symptoms in foregut duplications, most cases present with respiratory distress which may be present from birth, or symptoms may be insidious with cough, wheeze, or recurrent respiratory infections. We are presenting a 2-year-old boy presenting with cough and fever. Radiological investigation showed left mediastinal mass that was removed by excisional biopsy and revealed an esophageal cyst. Cough with or without fever could be rare presentations for esophageal cyst.
  5,031 329 2
High level of awareness but poor practices regarding dengue fever control: A cross-sectional study from North India
Palanivel Chinnakali, Nishant Gurnani, Ravi Prakash Upadhyay, Komal Parmar, Tejas M Suri, Kapil Yadav
June 2012, 4(6):278-282
DOI:10.4103/1947-2714.97210  PMID:22754880
Background: Delhi, the capital of India, has suffered many outbreaks of dengue in recent past and despite the obvious magnitude of problem, very scarce evidence exists that documents the knowledge, awareness and practices of the people regarding dengue. Aim: To assess the knowledge and practices related to control of dengue fever and to assess the differences in knowledge and practices based on sex and literacy. Materials and Methods: A cross-sectional study was conducted among persons visiting a tertiary care hospital in New Delhi. A systematic sampling procedure was adopted and a pretested questionnaire was used. Results: A total of 215 individuals were interviewed. Majority of the respondents (96.3%) had heard about dengue. The important sources of information were television (54.9%) and newspaper/magazines (51.7%). Around 89% of the study participants considered dengue as "serious problem." Nearly 86% participants were aware of the spread of dengue by mosquitoes while 73% were aware of one of the correct breeding sites of Aedes mosquito. Mosquito mats/liquidators were used by 61% of respondents, coils by 56% and repellant creams by 22%. Conclusion: The awareness regarding dengue and mosquito control measures was satisfactory to an extent. Programs should focus that this knowledge gets translated into practice.
  4,317 794 20
Fetal and maternal outcomes in pregnancies complicated with fetal macrosomia
Mohamed Alkhatim Alsammani, Salah Roshdy Ahmed
June 2012, 4(6):283-286
DOI:10.4103/1947-2714.97212  PMID:22754881
Background: Fetal macrosomia remains a considerable challenge in current obstetrics due to the fetal and maternal complications associated with this condition. Aim: This study was designed to determine the prevalence of fetal macrosomia and associated fetal and maternal morbidity and mortality in the Al Qassim Region of Saudi Arabia. Materials and Methods: This register-based study was conducted from January 1, 2011 through December 30, 2011 at the Maternity and Child Hospital, Qassim, Saudi Arabia. Macrosomia was defined as birth weight of 4 kg or greater. Malformed babies and those born dead were excluded. Results: The total number of babies delivered was 9241; of these, 418 were macrosomic. Thus, the prevalence of fetal macrosomia was 4.5%. The most common maternal complications were postpartum hemorrhage (5 cases, 1.2%), perineal tear (7 cases, 1.7%), cervical lacerations (3 cases, 0.7%), and shoulder dystocia (40 cases, 9.6%) that resulted in 4 cases of Erb's palsy (0.96%), and 6 cases of bone fractures (1.4%). The rate of cesarean section among women delivering macrosomic babies was 47.6% (199), while 52.4% (219) delivered vaginally. Conclusion: Despite extensive efforts to reduce fetal and maternal complications associated with macrosomia, considerable fetal and maternal morbidity remain associated with this condition.
  4,181 803 17
Pregnancy in type 1 diabetes mellitus: How special are special issues?
Navneet Magon, Monica Chauhan
June 2012, 4(6):250-256
DOI:10.4103/1947-2714.97202  PMID:22754875
India leads the world with largest number of diabetics earning the dubious distinction of "the diabetes capital of the world." Diabetes is associated with maternal and perinatal morbidity and mortality. The number of pregnant women with pre-existing diabetes is increasing, mainly from an increase in type 2 diabetes, but also an increase in type 1 diabetes. Overall, type 1 diabetes accounts for approximately 5% to 10% of all diabetes outside of pregnancy, and in pregnancy put together with type 2 account for 10% of diabetic pregnancies. Management of the pregnant diabetic woman is a complex task that ideally begins before conception. Specific attention is required for diabetic pregnancies in different trimesters of pregnancy. Diabetes, especially type 1 diabetes, can be a challenge in pregnancy, but with education, close monitoring, and latest therapeutic modalities, these women can have healthy newborns. Close attention to diet, glycemic control, metabolic stresses, and early diagnosis and monitoring of complications can make pregnancy a successful experience for women with diabetes. A MedLine search was done to review relevant articles in English literature on diabetes and pregnancy, and specific issues related to pregnancy in type 1 diabetes were reviewed.
  3,926 700 13
The autonomic and rate pressure product responses of Tai Chi practitioners
Michael A Figueroa, Ronald E DeMeersman, James Manning
June 2012, 4(6):270-275
DOI:10.4103/1947-2714.97208  PMID:22754878
Background: Spectral analysis of autonomic nervous system activity can provide insight into cardiovascular function. Rate pressure product is the parameter often targeted pharmacologically to decrease the incidence of myocardial events. Aim: The purpose of this study was to investigate whether or not Tai Chi Chuan practitioners would demonstrate autonomic responses that would be more cardioprotective when compared to non-trained controls. Materials and Methods: This was a cross-sectional study that measured the autonomic responses and rate pressure product of 2 groups of subjects; a Tai Chi Chuan trained (n = 13) and non-trained sedentary controls (n = 13) at rest and during 2 stressor phases that simulated functional activities of daily living. Results: The Tai Chi group maintained a greater parasympathetic outflow at rest and during the isometric grip stressor phase (P<0.05). Sympathetic outflow, systolic blood pressure and rate pressure product were significantly lower in the Tai Chi group at rest, during the isometric grip and standing stressor phases (P<0.05). Conclusion: Although a cause-and-effect relationship cannot be concluded in this study, the Tai Chi group was able to demonstrate efficiency of the myocardium with suppressed rate pressure product values and autonomic responses that favored parasympathetic outflow. This type of training may complement non-pharmacological anti-hypertensive therapy.
  3,006 479 7
Immune reactivity in psoriatic Munro-Saboureau microabscesses, stratum corneum and blood vessels
Ana Maria Abreu Velez, Paul B Googe, Michael S Howard
June 2012, 4(6):257-265
DOI:10.4103/1947-2714.97204  PMID:22754876
Background: A characteristic feature of early active psoriatic lesions is the intraepidermal penetration of neutrophils, with attendant formation of Munro-Saboureau microabscesses. Previous immunofluorescence studies have shown reactivity of in vivo binding of stratum corneum antibodies (SCAs) within the Munro-Saboreau microabscesses in cases of psoriasis. Aims: In our study, we aimed to investigate any correlation between the SCAs and the Munro-Saboureau microabscesses. Materials and Methods: We investigated 50 archival biopsies of psoriasis with Munro-Saboureau microabscesses, and attempted to confirm antibody colocalization within these microabcesses via immunohistochemistry staining. As controls, we utilized 50 skin biopsies from healthy patients undergoing esthetic plastic surgery procedures. Results: Within the Munro-Saboureau microabscesses, the following markers were statistically significantly positive relative to controls: CD1a, CD8, CD23, cyclooxygenase-2, myeloid histoid antigen, albumin, fibrinogen, kappa, lambda, von Willebrand factor, IgG, IgM, IgD, complement/C3c, C3d, myeloperoxidase, and carcinoembryonic antigen (P < 0.05). Autoreactivity to blood vessels was also detected, with multiple immunoglobulins and complement factors. Conclusions: We document important correlations between the Munro-Saboureau microabscesses, SCAs, and other immunoreactants.
  2,787 385 1
Stress, workload and physiology demand during extravehicular activity: A pilot study
Balwant Rai, Jasdeep Kaur, Bernard H Foing
June 2012, 4(6):266-269
DOI:10.4103/1947-2714.97205  PMID:22754877
Background: Extravehicular activity (EVA), such as exercise performed under unique environmental conditions, is essential for supporting daily living in weightlessness and for further space exploration like long Mars mission. Aim: The study was planned stress, workload, and physiological demands of simulated Mars exploration. Materials and Methods: In this study, the six-person crew lived (24 hours) for 14 days during a short-term stay at the Mars Desert Research Station. The heart rates, salivary cortisol, workload, peak oxygen uptake or maximal aerobic capacity of the crew are measured before, during and after an EVA. Results: Data for heart rate showed the same trend as peak oxygen uptake or maximal aerobic capacity, with a maximal increase to 85% of peak. The rating of subscale showed a significant increase in EVA as compared to run. Salivary cortisol levels and heart rates were increased in both groups, although significant increased of cortisol levels and heart rates more in EVA as compared to hill running crew members. Conclusion: Further study is required on large scale taken into account of limitations of this study and including other physiological and psychological parameters in Mars analog environment.
  2,673 421 3
Pyogenic brain abscess in Thailand
Somsri Wiwanitkit, Viroj Wiwanitkit
June 2012, 4(6):245-248
DOI:10.4103/1947-2714.97200  PMID:22754873
Pyogenic brain abscess is important in neurology. This infectious disease is fatal and the management is usually complicated. Here, the authors review and discuss the clinical aspects of pyogenic brain abscess found in the earlier reports from a tropical setting in Thailand. The literature review was compiled through standard reference database searching and the derived publications were further extracted to obtain clinical data. The main clinical characteristics of pyogenic brain abscess in this setting were similar to others. However, there are some specific characteristics on the nature of tropical setting.
  2,598 422 7
Peroral extrusion of the peritoneal catheter in an infant
Mahesh Gupta, Naseeb C Digra, Narendra Sharma, Subhash Goyal, Amit Agrawal
June 2012, 4(6):290-291
DOI:10.4103/1947-2714.97214  PMID:22754883
Peroral extrusion of the distal end of a ventriculo-peritoneal shunt tube is the potentially hazardous end result of a bowel perforation with only few case reports in the literature. The distal end of the peritoneal catheter got fractured in a 4-year-old child and it protruded out through the mouth. The cranial incision was opened and the shunt divided below the chamber. The ventricular end and the chamber and distal end were removed through this incision. In the present successfully managed case we review the current strategies in the management of such a rare complication and discuss the possible pathogenesis of this entity.
  2,331 244 4
Tai Chi improves natural harmony in autonomic function
Ching Lan
June 2012, 4(6):276-277
  1,735 306 -
Pyogenic brain abscess
Venkatesh S Madhugiri
June 2012, 4(6):249-249
  1,460 254 1