The Journal of the Association of Physicians of India
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J Assoc Physicians India · Sep 2005
Neuromuscular respiratory failure in Guillain-Barre Syndrome: evaluation of clinical and electrodiagnostic predictors.
Guillain-Barre Syndrome (GBS) has an unpredictable clinical course with up to 30% of patients requiring assisted ventilation during the course of their illness. Successful management mandates anticipation, prompt recognition and optimal treatment of neuromuscular respiratory failure in GBS. ⋯ Early progression to peak disability, bulbar dysfunction and autonomic instability predicted the development of neuromuscular respiratory paralysis in GBS. Early electrodiagnostic studies in this series suggest axonopathic GBS as a predictor of respiratory paralysis, a finding that needs to be evaluated with sufficient data to permit statistical analysis.
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J Assoc Physicians India · Sep 2005
Case ReportsCo-occurrence of emphysematous cystitis and emphysematous myositis in type 2 diabetes.
Emphysematous cystitis (EC) and emphysematous myositis (EM) are rare disorders and concurrent occurrence of both in a patient with type 2 diabetes has not been reported previously. We report a patient who presented with pneumaturia and later with pain in thigh and diagnosed of both concurrently.
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J Assoc Physicians India · Aug 2005
Status of inhalation therapy in bronchial asthma in adults above twelve years of age in armed forces.
The aim of this study was to evaluate the status of inhalation therapy in bronchial asthma in terms of frequency of its use, role of general physicians and general practitioners in prescribing inhalation therapy, role of inhaled steroids and B2 agonists, concurrent use of oral drugs, technique of using inhaler devices, use of spacer devices and peak flow monitoring. ⋯ Although inhalation therapy was being prescribed in large number of patients, more so by general physicians, yet the therapy was not being effective considering the fact that the referral to chest clinic in all the cases was for uncontrolled asthma. The main reasons for ineffective inhalation therapy were, underuse of inhaled steroids, overuse of B2 agonists and incorrect use of inhaler devices. There is an urgent need to educate general physicians especially in regards to usefulness of inhaled steroids, as on demand use of B2 agonists, demonstration of correct inhalation technique to patients, use of spaces devices and peak flow monitoring.
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Recombinant activated factor VII (rFVIIa, NovoSeven) enhances haemostasis in individuals, with its predominant action limited to areas of injury, apparently without systemic activation of the coagulation cascade. rFVIIa is currently licensed in most countries worldwide, for its use in the treatment of bleeding episodes in patients with hemophilia and the presence of inhibitors. Recently in the European Union, rFVIIa, has been approved for use in congenital Factor VII deficiency and Glanzmann's thrombasthenia. ⋯ It has been reported to reduce bleeding in patients with liver disease, thrombocytopenia/thrombocytopathia, trauma, spontaneous intracerebral hemorrhage and in the reversal of anticoagulant overdosage or toxicity. A number of trials have been carried out, which have shown that it is a relatively safe and well tolerated drug with a few episodes of unwanted thrombosis.
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J Assoc Physicians India · Jul 2005
Candidemia--an under-recognized nosocomial infection in Indian hospitals.
To study the occurrence of candidemia as a nosocomial infection in a large Indian teaching hospital and to evaluate the predisposing factors for development of such infections. ⋯ Candidemia is an important problem in Indian hospitals. Diagnostic delays could be shortened by more active screening for candidemia especially in the intensive care settings. The rising incidence of non-albicans candidemia in the United States probably is true here as well. There should be a concerted effort to control known risk factors especially in intensive care units.