Insulinoma-a case report

BNM, a 40 years Hindu male presented with history of intermittent fainting attacks and had increase in body weight for last 2 years. He used to take a lot of sweets to recover from the attact. His body wht was 100 kg. His fasting blood sugar was 50 mg/dl and insulin glucose (I/G) ratio was 0.6. CT scan of abdoman showed one solitary tumour in the body of pancreas near its tail. Laparotomy was done. The tumour was found to be a benign insulinoma on microscopic examination. Though the postoperative period was uneventful but he succumbed probably due to pulmonay embolism.     

PATIENT SATISFACTION IN PROSTHETIC REHABILITATION PROGRAMME

Patient satisfaction is an important outcome measure independent of other outcomes. Its measurement is important to assess the effectiveness of a programme and to gain insight into the patients'' perception of the programme. In this study conducted in a large rehabilitation centre it was found that majority of patients express satisfaction with care inspite of perceived discomfort. Various demographic factors, severity or duration of the disability or the level of rehabilitation do not influence patient satisfaction. Patients express more concern with aspects such as delay in issue of the prosthesis, or hotel component of the hospital services. Patients did not appear too concerned about the level of information provided. Patient satisfaction is an individual reaction to the overall care process and is influenced by the initial expectation level of the patient. Emotional response of the patient appears to be more important determinant of patient satisfaction than the cognitive evaluation. Periodical assessment of patient satisfaction should be an important component of any programme evaluation exercise.KEY WORDS: Amputation, Patient satisfaction, Programme evaluation, Prosthesis, Quality of care, Rehabilitation     

Disseminated cutaneous rhinosporidiosis in a HIV sero--positive patient

Rhinosporidiosis is a chronic disease, classically involving the nose and nasopharynx, clinically presenting as polypii. However,disseminated rhinosporidiosis, involving various other sites including lips, conjunctiva, uvula, vagina, larynx. trachea. scalp and skin is also known to occur. A case of rhinosporidiosis, with nasal, oropharyngeal and multiple cutaneous lesions, in a patient who is sero--positive for HIV is reported.     

Diagnosis of superficial mycoses by direct microscopy - A statistical evaluation

A mycological study was undertaken in 250 cases of superficial mycotic infections, which included 210 cases of dermatophytosis, 18 cases of cutaneous candidiasis and 22 cases of tinea versicolor. The scrapings from all the cases were subjected to direct microscopic examination in 10% KOH solution and culture was done in case of candidiasis and dermatophytosis. Out of 250 cases direct microscopy was positive (KOH +ve) in 88 cases of dermatophytosis, 11 cases of candidiasis and all cases of tinea versicolor. Culture for dermatophytes and candida species in SDA medium were positive in 76 and 9 cases respectively. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value and the overall efficiency of the direct microscopy in the diagnosis of superficial mycotic infections were calculated to be 89.41%, 83.90%, 76.76%, 93.02% and 85.96% respectively.     

The burden of behavioral emergencies: need for specialist emergency services

Behavioral emergencies constitute an important component of medical emergencies. Psychiatric emergency services, which handle the bulk of behavioral emergencies, are inadequate to meet the burden. Strategies to deal with them are also hampered by the lack of adequate research and availability of data. Since behavioral emergencies may present differently in different groups, requiring differing management, consensus guidelines need to be arrived at for tackling behavioral emergencies. In addition, training professionals for psychiatric emergency services should form a part and parcel of emergency management services.     

Drill biopsy in the diagnosis of lung lesions.

A high speed pneumatic drill was used to perform 190 percutaneous transthoracic biopsies in 161 patients. The resultant cores of tissue provided a definite diagnosis in 146 patients, giving a success rate of 90.7%. Complications occurred in 58 patients, subcutaneous emphysema being the most common, though only seven patients required active treatment, giving a rate of 3.7% for important complications. One patient died within 24 hours of the biopsy procedure owing to asphyxia resulting from aspiration of the contents of an acutely dilated stomach. Our experience clearly establishes that the drill biopsy as used by us is simple and safe and can be carried out in an outpatient department, yielding better overall results than any other procedure for closed biopsy of the lung currently practised.     

Management of zygomatic complex fracture in armed forces

Introduction: The Armed Forces personnel are exposed to various kinds of injuries due to the nature of their duties. Increase in motorized population without taking protective measures and rise in violence has contributed towards maxillofacial injuries. The aim of this study was to determine the incidence, aetiology and management of injuries resulting in fracture of the Zygomatic complex in Armed Forces personnel and their families.     

钩藤碱对血小板聚集和血栓形成的影响

钩藤碱(Rhy)明显抑制AA,胶原及ADP诱导的大鼠血小板聚集。Rhy不影响血小利用外源性AA合成TXA_2,但抑制胶原诱导的TXA_2生成;在抗血小板聚集有效剂量时,对PGI_2的生成无影响。Rhy有显著降低血栓形成诱导剂ADP及胶原加肾上腺素静脉注射所致小鼠死亡率。