Journal of the Indian Medical Association
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Acinetobacter infections are fast emerging as a major nosocomial threat across the globe. With a predilection for blood stream infections in critically ill, immunocompromised patients, their presence is now being felt in febrile neutropenics with underlying malignancies and marrow failure. We aimed through this study to ascertain the current circulating pathogens and levels of antimicrobial resistance in blood stream infections in febrile neutropenia patients, with specific emphasis on elucidating acinetobacter and pseudomonas infections. ⋯ Multidrug resistant acinetobacter Infections are a fast emerging threat in febrile neutropenia patients and at this centre in general. Similar early trends from some Indian centres and neighbouring developing countries suggest grave concern. These emerging circulating pathogens and drug resistance patterns demand to systematically evaluate antibiotic and hospital infection policies and to sensitise all clinicians to curb this pathogen capable of rapid nosocomial spread.
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The central fracture dislocation of hip involves displacement of medial wall and superior weight bearing dome of acetabulum. The management of this type of fracture is to be planned after meticulous clinical and radiological planning of the personality of fracture along with status of the patient. Ideally displaced fracture should be treated by anatomic reduction, stable internal fixation and early non-weight bearing exercises. ⋯ Central fracture dislocation of hip is an intra-articular fracture of weight bearing joint, so it is supposed to be managed better by open reduction and stable Internal fixation followed by early movement. But with meticulous evaluation and selection of cases, proper conservative management gives comparable results to the open reduction and internal fixation group even in young patients where secondary congruency is achieved. To conclude conservative management is an effective modality of treatment in appropriate cases of central fracture dislocation of hip.
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Gastro-intestinal stromal tumours are rare tumours of the gastro-intestinal tract. Among non-epithelial tumours of gastro-intestinal tract, gastro-intestinal stromal tumours are the commonest but as they are not extensively documented, they are underestimated, poorly understood and inadequately treated for various reasons, particularly at peripheral centres in India. The gravity of the problem increases further as these tumours respond poorly to conventional cytotoxic chemotherapy and radiation therapy. ⋯ The routine histopathological examination revealed a spindle cell tumour suggestive of gastro-intestinal stromal tumour -intermediate risk group. Immunohistochemical study showed strong positivity for c-kit confirming the diagnosis of gastro-intestinal stromal tumour. The patient was then referred to oncology centre for further management.
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Comparative Study
Three years audit of the emergency patients in the department of ENT of a rural medical college.
Surgical audit is a systematic, critical analysis of the quality of surgical care provided, with the aims of improving quality of care, continuing education for surgeons, and guiding appropriate use of health resources. Emergency service is an integral part of any discipline of clinical medicine and it is considered as an indicator of quality of healthcare system. A three years record based, retrospective, cross-sectional study was carried out in the department of ear, nose and throat (ENT) of Midnapore Medical College, Paschim Medinipur,West Bengal to identify the total attendance of various emergency patients, diagnosis made thereafter, the mode of interference and outcome and the potential problems in the quality of care provided to the community. ⋯ The different types of foreign body impaction in the throat and the inflammatory condition of throat or the inspiratory stridor due to upper airway obstruction were the main emergency situation recorded. Some cases were fatal. The overall mortality was 0.44%.
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This article focuses on issues and challenges regarding why tuberculosis (TB) remains as horrible scourge to mankind even today that too in the era of nanotechnology. It tries to evoke a uniform consciousness among treating doctorsboth at government and private levels to follow a uniform diagnostic algorithm and treatment protocols which is very much readily available under Revised National Tuberculosis Control Programme (RNTCP) Directly Observed Treatment Short course (DOTS) throughout our nation. Even today TB is the singlemost major infectious killer disease which claims 2 deaths in every 3 minutes in India which has one-fifth of global TB burden. ⋯ If the guidelines are maintained one hundred per cent with full involvement of Indian Medical Association/Indian Academy of Pediatrics and various other medical organisations then the author can confidently feels that the day is not far to combat and contain the horrible scourge. Time has come that every medical practitioner should take an oath to evolve a uniform consciousness to adhere to the guidelines prescribed under RNTCP DOTS which may prevent the future generation to succumb to the horrible scourge of TB. Shall we?