Natl Med J India
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Oral submucous fibrosis (OSF) is a precancerous condition caused by use of the areca nut. The reported prevalence of OSF in Bhavnagar district during 1967 was 0.16%. We investigated whether the impression of an increase in the incidence of the disease was real. ⋯ An increase in the prevalence of OSF, especially in the lower age groups, directly attributable to the use of areca nut products was observed. This could lead to an increase in the incidence of oral cancer in the future.
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Dengue fever/dengue haemorrhagic fever/dengue shock syndrome is a serious health problem in tropical countries. Intravascular fluid depletion due to capillary leak is presumed to be the cause of hypotension in dengue haemorrhagic fever. The treatment guidelines of the World Health Organization lay stress primarily on monitoring and fluid replacement therapy. During the 1996 epidemic in New Delhi, we observed problems in fluid management of such children and prospectively looked for myocardial dysfunction as an additional factor for hypotension. ⋯ The role of myocardial dysfunction remains to be defined as there was no correlation with clinical severity. Myocardial functions need to be assessed in patients with this disease, especially those who have persistent hypotension in spite of adequate hydration.
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Comparative Study
Predictors of mortality in a medical intensive care unit.
Scoring systems to predict mortality in intensive care units have been developed in western populations. There is a need to identify and validate prognostic variables in the Indian context. We compared two scoring systems to predict the discharge outcome in patients admitted to a medical intensive care unit. ⋯ The modified OSF score was superior to the modified APACHE II score in predicting mortality in patients admitted to the medical intensive care unit.
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Preoperative over-ordering of blood is very common and leads to holding up of the blood bank reserve, ageing of the blood unit and wastage of blood bank resources. We evaluated the preoperative blood-ordering and transfusion practices for common elective general surgical procedures at a major Indian hospital. The principal aim of this study was to identify the surgical procedures where type and screen can be introduced and to formulate a maximum surgical blood-order schedule for those procedures where a complete cross-match appears mandatory. ⋯ This study shows that blood was over-ordered in 10 out of the 21 procedures studied. Implementation of the recommended maximum surgical blood-order schedule and introduction of type and screen for eligible surgical procedures is a safe, effective and economic solution to preoperative over-ordering of blood.