Neonatal respiratory failure-An overview

Respiratory disordersin the neonates still remainthe reason for postnatalhospitalization.Main rea-sons for respiratory failurein the term neonate includetransient tachypnea(TTN)of the neonate;     

Amyloidosis: a global problem common in Papua New Guinea

The increase in different precursor proteins that have been shown to form amyloid fibrils and the identification of common properties have not yet led to any unifying theory or mechanism for the pathogenesis of amyloidogenesis. Papua New Guinea holds a unique place in the story of amyloidosis and in this article we review the current status of amyloidosis research indicating how this relates to those forms relevant to Papua New Guinea. This review concentrates on secondary reactive amyloid (AA), which is found in the highest frequency in the world in parts of Papua New Guinea, and kuru, in which the amyloid protein itself is infectious. The history, pathogenesis and future prospects for these diseases are discussed in the light of what is known about other forms of amyloidosis.     

Genital herpes and public health: addressing a global problem

Genital herpes can be caused by herpes simplex virus 2 (HSV-2) or, less commonly, by herpes simplex virus 1 (HSV-1). With a seroprevalence of antibodies to HSV-2 of 22% in the general population, genital herpes is 1 of the 3 most prevalent sexually transmitted diseases (STDs) in the United States. A central issue in the public health problem of genital herpes is the high proportion of genital HSV infections that are unrecognized by both patients and clinicians. Persons who are HSV-2 seropositive may be symptomatic but nevertheless fail to recognize genital herpes; they serve as reservoirs for transmission. Physicians and patients must be aware of the subclinical presentation of genital herpes and the potential these patients have for transmitting HSV. Serious consequences of HSV infection include neonatal herpes and increased risk of human immunodeficiency virus transmission. Recommendations to physicians for prevention include using type-specific tests for HSV when screening for other STDs and testing for HSV when evaluating patients with genital ulcers. Researchers must evaluate the performance of type-specific tests and strategies to prevent transmission.     

Neuromodulation: an overview

For over two centuries, electricity has been known to induce modification of neural and nerve fiber activity and has been proposed to be used to treat some neurological dysfunctions. The new era of the use of electrical current in the treatment of neurological symptoms began in 1967 with the use of totally implanted devices that deliver a controlled amount of electricity on a precise structure within the nervous systems and was first used to control pain. Extensive research has been carried out ever since to elucidate the mechanism of action of this treatment and extend its indication for the treatment of the other neurological symptoms. So far, there is evidence that the treatment is safe and efficient for long periods of time, as it does not induce permanent damage to the stimulated structure. Most likely, electrical current at the parameters used for therapeutic purpose induces an inhibition of the structure on which it is applied. However, this may be accompanied by either inhibition or excitation of anatomically related structures. For this reason, it seems more convenient to refer to this type of therapy as neuromodulation.A review of the historical development of this fascinating area is presented, with special attention to the evidence derived from experimental work on the parameters that electrical current must maintain to avoid damage to the underlying tissue.     

Peanut allergy: an overview

PEANUT ALLERGY ACCOUNTS FOR THE MAJORITY of severe food-related allergic reactions. It tends to present early in life, and affected individuals generally do not outgrow it. In highly sensitized people, trace quantities can induce an allergic reaction. In this review, we will discuss the prevalence, clinical characteristics, diagnosis, natural history and management of peanut allergy.     

Tic disorders: an overview

Tics are purposeless and repetitive involuntary movements and vocalizations with variable and complex means of expression. Since up to 24 per cent of children can manifest tics at some point in their lives, growing interest has developed in the genetics, etiology, course, diagnosis, and treatment of the tic disorders. This article is a review of the current knowledge about tics and tic disorders.     

Antiphospholipid syndrome: an overview

ANTIPHOSPHOLIPID ANTIBODIES ARE A HETEROGENEOUS GROUP of autoantibodies that are detected by immunoassays and functional coagulation tests. The antigenic targets are negatively charged phospholipids and serum phospholipid-binding proteins. The latter antibodies are frequently associated with thrombosis, fetal loss and other clinical manifestations of the antiphospholipid syndrome. These antibodies are felt to be etiologically important in the syndrome, although the precise pathogenic mechanisms are still being determined. Proposed mechanisms include antibody-mediated interference with coagulation homeostasis, activation of platelets and endothelial cells and a T-cell immune response to serum phospholipid-binding proteins. The mainstay of therapy is anticoagulation, whereas immunosuppression is ineffective.     

Practical symphysiotomy: an overview

Symphysiotomy is an alternative operative procedure where a deliberate division of symphysis pubis is carried out to facilitate delivery in cases of cephalopelvic disproportion, so as to permit the birth of baby by natural passages. Symphysiotomy results in a permanent increase in pelvic diameter (up to 1 cm) by surgically dividing the ligaments of the symphysis under local or general anaesthesia. Symphysiotomy should only be done in a established case of obstructed labour but not in anticipation of obstructed labour. This operation was reviewed in 21 cases of established obstructed labour in Silchar Medical College with little modifications of original operations. All the cases were done by subcutaneous method which is cosmetic and simple. The operation was carried out by dividing upper ligament completely and anterior arcuate ligament partially under local anaesthesia. The posterior arcuate ligament was not touched at all. None of the cases required forceps or vaccum extraction. It resulted in almost negligible complications in comparison to morbidity and mortality in primary caesarean section. Considering the usefulness of the operation it can even be started in rural hospitals by the gynaecologist if they are properly trained to do it in a justified manner in properly selected cases.     

Pulmonary embolism: an overview

Pulmonary embolism and deep venous thrombosis account for hundreds of thousands of hospitalisation and afflict millions of individuals worldwide. A brief overview on the subject concerned is presented here.     

William Osler at 150: an overview of a life

Sir William Osler is one of the most admired and honored physicians in the history of medicine. He influenced the development of medicine in Canada, the United States, and Great Britain, where he held professorships at McGill University, the University of Pennsylvania, Johns Hopkins University, and Oxford University. Through his textbook, The Principles and Practice of Medicine, and other clinical and philosophical writings, he exercised a truly global influence. In this sesquicentennial of his birth, William Osler continues to serve as a model of excellence for the medical profession. This examination of the reasons for his enduring impact reveals a legacy of clinical, scientific, literary, educational, and intraprofessional accomplishments linked to a remarkable personality, and bound together by an extraordinary humanism.