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VOLUME 3 : Number
2: (May – August 2001)
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Abstracts |
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>>>>Editorial Review |
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Cost-Effective
Management of Drug Resistance in Pulmonary Medicine
Sudheendra
Ghosh.C, Professor and Head, Dept.of Respiratory Medicine,
Medical College, Trivandrum
The changing spectrum of the host and the emergence of new and drug
resistant organisms complicate management of pulmonary infections.
Drug resistance to microorganism has become a world wide problem. Drug
resistance is defined as the temporary or permanent capacity of the
organisms or their progeny to remain viable or multiply in the
presence of the concentration of the drug that would normally destroy
or inhibit the growth of their cells. Resistance among respiratory
pathogens has increased since 1970s. Ampicillin resistant H.influenzae
have increased and now are common many parts of the world. After World
War II, penicillin resistant among gonococci and staphylo coccal
strains was first noted. Methicillin resistant Staphylococcus aureus (MRSA)
emerged in the 1970s. Aminoglycoside resistant pseudomonas aeroginosa
was first noted after the widespread use of gentamicin. Ceftazidime
resistant and ciprofloxacin resistant P.aeroginosa remain a concern
today. Resistance to anti-tuberculosis drugs was noticed immediately
after the introduction of streptomycin. Reported drug resistance in
India shows initial drug resistance 18.5% for INH, 0.6% for RMP and
acquired resistance 50.7% for INH and 33.3% for RMP.
There is no resistance among atypical pulmonary pathogens (e.g.,
Legionella, Mycoplasma pneumoniae, Chlamydia pneumoniae, Q fever,
tularemia, or psittacosis)> Bacteroids fragilis and anaerobic
organisms, in general have not shown any clinically significant
resistance. Acinetobacter is reported in the literature as highly
resistant or multi resistant to several antibiotics.
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>>>>Review
Article |
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Radiological
Imaging in Bronchiectasis
Gupta KB, Sanjeev Tandon,
Monika Tandon, Department of
Tuberculosis and Chest Diseases,
Pt.B.D.Sharma Post Graduate Institute of Medical Sciences,
Rohtak, Haryana.
Bronchiectasis
remains an important and relatively common cause of pulmonary
disability. HRCT is the imaging method of choice after standard chest
radiography and bronchography for examining patients with suspected
bronchiectasis and is an accurate procedure in the recognition of
bronchiectasis especially in patients with clinical symptoms but a
normal chest radiograph.
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>>> Leading
Article |
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Allergen
Immunotherapy : When to Start and When to Stop[No
abstract available]
Balakrishnan
Menon, MPS Menon, VP Chest
Institute, University of Delhi, Dehi
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>>>>Original
Paper |
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Pneumothorax
– An Analysis of 110 Cases
Remshchandra Babu KM, Jovin John Mathew, Santhosh Kumar P.V, James P.T. Institute of
Chest Diseases, Medical College, Calicut.
Abstract:
Objective:
To study the cases of pneumothorax managed in a respiratory
medicine department of a tertiary care centre.
Design:
A retrospective study
Setting:
Institute of Chest Diseases, Calicut Medical College, Kozhikode.
Period
of study: January 1999 to December 2000
Patients
and methods: Records of 110 patients with pneumothorax were
reviewed and analysed.
Results:
Males constituted 86% of the 110 cases studied. Primary
spontaneous pneumothorax occurred in 16% of the patients, secondary
spontaneous pneumothorax in 75% and traumatic pneumothorax consistuted
9% of the cases of which 90% were iatrogenic. Primary spontaneous
pneumothorax was found on the right side twice that on the left and
mostly afflicted patients in their twenties. Intercostal drainage was
done in 55% of the 18 cases with primary spontaneous pneumothorax.
Among those with secondary spontaneous pneumothorax, tuberculosis
constituted the majority, followed by Chronic Obstructive Pulmonary
Disease (COPD). Intercostal drainage had to be done in 52% of the 82
patients with secondary spontaneous pneumothorax. Traumatic
pneumothorax was managed conservatively in all cases. Persistent
pneumothorax constituted 28% of the patients.
Conclusion:
Males are afflicted more than female sin all categories of
pneumothorax. Right-sided lesion outnumber left-sided ones.
Conservative management was done in as many patients as in those in
whom intervention in the form of intercostals drainage was done.
Needle aspiration or drainage of the pleural space may be safely done
in patients with significant pneumothorax, provided all parameters are
stable.
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>>>>Special
Articles |
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Blood
Transfusion in the Critically Ill Patients[No
abstract available]
Jain P.K., Director, Dept.of Critical Care
Medicine, Malabar Institute of Medical Sciences, Calicut,
Kerala
Asthma
Guideline – Simplified [No
abstract available]
Ravindran C, Professor & Head, Dept.of TB & Chest
Diseases, T.D.Medical College, Alappuzha
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>>>> Case
Reports |
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Leiomyoma
of Trachea Presenting as Bronchial Asthma
Ramachandran
PV, Rauf CP*, Della Harigovind,
Neelakandhan KS** KHRWS
Imageology Centre & Chest
Hospital*, Calicut SCTIMST**,
Thiruvananthapuram
Abstract:
Tracheal tumors are often overlooked as a cause of pulmonary symptoms
until they reach an advanced state. They often present with cough and
wheeze, mimicking bronchial asthma. Most tracheal tumors in adults are
cancerous (80% to 90%). Benign tracheal tumors are rare in adult
patients. A case history of a 52 year old lady is presented with a
rare tracheal leiomyoma. She was treated as having bronchial asthma
initially. The possibility of the presence of an upper airway
obstruction was not raised until the stridor was noted and the
flow-volume loop testing suggested the former. A simple investigation
like a plain lateral view X-ray of soft tissues of neck revealed an
intratracheal mass. Bronchoscopy and helical computed tomography with
multiplanar reconstructions and virtual endoscopy confirmed the
diagnosis of upper airway obstruction caused by a tracheal tumor.
Surgical resection and end-to-end anastomosis was performed.
An
Unusual Cause of Dysphagia and Stridor
Ravindran C,Professor & Head, Dept.of TB & Chest
Diseases,T.D.Medical College, Alappuzha
Bronchogenic
carcinoma by itself or through metastatic mediastal lymphadenopathy
may involved esophagus. Oesophageal displacement is rather common that
is functional compromise. Here a case being reported of a 91 year old
female patient who initially presented with dysphagia for which an
oesophageal stent was applied. Subsequently, patient developed stridor,
the cause of which is partly attributed to compression of posterior
wall of trachea by stent.
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>>>> From
the Book of Medical practice |
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Doctor-Patient
Rapport / Relationship
Sarma
O.A.
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