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  Most popular articles (Since February 12, 2004)

 
 
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CLINICAL SIGNS
Clinical signs in medicine: pulsus paradoxus.
A Khasnis, Y Lokhandwala
January-March 2002, 48(1):46-9
PMID:12082330
  200,478 1,646 8
REVIEW ARTICLES
Multiple ring-enhancing lesions of the brain
RK Garg, MK Sinha
October-December 2010, 56(4):307-316
DOI:10.4103/0022-3859.70939  PMID:20935408
Multiple ring-enhancing lesions of the brain are one of the most commonly encountered abnormalities on neuroimaging. These can be caused by a variety of infectious, neoplastic, inflammatory or vascular diseases. Distinguishing non-neoplastic causes from neoplastic lesions is extremely important because a misdiagnosis can lead to unwarranted neurosurgery and exposure to toxic chemotherapy or potentially harmful brain irradiation. Diligent clinical evaluation and a battery of tests are required for making a definitive diagnosis. Newer advanced diagnostic techniques, such as diffusion-weighted magnetic resonance imaging (MRI), perfusion-weighted MRI, magnetic resonance spectroscopy, single-photon emission tomography and positron emission tomography may help in establishing the etiology. However, early brain biopsy is often needed because several of these diseases are potentially life-threatening.
  114,198 185 20
E-MEDICINE
The Nine Flavours of Open Access Scholarly Publishing
J Willinsky
July-September 2003, 49(3):263-267
PMID:14597793
  111,158 841 21
INVITED ARTICLE
Microteaching as a vehicle of teacher training--its advantages and disadvantages.
N Ananthakrishnan
July-September 1993, 39(3):142-3
PMID:0008051644
  107,787 533 -
CLINICAL SIGNS
Romberg's test.
A Khasnis, RM Gokula
April-June 2003, 49(2):169-72
PMID:12867698
  95,913 1,327 13
REVIEW ARTICLE
Brain natriuretic peptide in diagnosis and treatment of heart failure.
V Bhatia, P Nayyar, S Dhindsa
April-June 2003, 49(2):182-5
PMID:12867703
Currently we are in the midst of a chronic disease epidemic of congestive heart failure (CHF) worldwide. This epidemic is marked by a rapid rise in prevalent cases over the past decade that is due in part to the aging population and improved survival in patients with other cardiovascular conditions. At present there are 5 million Americans with congestive heart failure, with nearly 500000 new cases every year. To provide cost-effective treatment for patients with congestive heart failure, rapid and accurate differentiation of congestive heart failure from other causes of dyspnea must be accomplished. Although echocardiography is considered the gold standard for the detection of left ventricular dysfunction, it is expensive, is not always easily accessible, and may not always reflect an acute condition. B-type natriuretic peptide (BNP) is a cardiac neurohormone specifically secreted from the cardiac ventricles as a response to ventricular volume expansion, pressure overload, and resultant increased wall tension. BNP can be used in the diagnosis of CHF. However, the present American College of Cardiology/American Heart Association practice guidelines (2001) for the evaluation and management of CHF state that the role of blood BNP in the identification of patients with CHF remains to be fully clarified. We have discussed the role of BNP in the diagnosis and management of CHF.
  94,822 1,290 13
Vegetables, fruits and phytoestrogens in the prevention of diseases
David Heber
June 2004, 50(2):145-149
PMID:15235216
The intake of 400-600 g/d of fruits and vegetables is associated with reduced incidence of many common forms of cancer, and diets rich in plant foods are also associated with a reduced risk of heart disease and many chronic diseases of ageing. These foods contain phytochemicals that have anti-cancer and anti-inflammatory properties which confer many health benefits. Many phytochemicals are colourful, and recommending a wide array of colourful fruits and vegetables is an easy way to communicate increased diversity of intake to the consumer. For example, red foods contain lycopene, the pigment in tomatoes, which is localized in the prostate gland and may be involved in maintaining prostate health, and which has also been linked with a decreased risk of cardiovascular disease. Green foods, including broccoli, Brussels sprouts and kale, contain glucosinolates which have also been associated with a decreased risk of cancer. Garlic and other white-green foods in the onion family contain allyl sulphides which may inhibit cancer cell growth. Other bioactive substances in green tea and soybeans have health benefits as well. Consumers are advised to ingest one serving of each of the seven colour groups daily, putting this recommendation within the United States National Cancer Institute and American Institute for Cancer Research guidelines of five to nine servings per day. Grouping plant foods by colour provides simplification, but it is also important as a method to help consumers make wise food choices and promote health.
  90,487 1,726 103
SYMPOSIUM
Cancer Risk and Diet in India
R Sinha, DE Anderson, SS McDonald, P Greenwald
July-September 2003, 49(3):222-228
PMID:14597785
India is a developing country with one of the most diverse populations and diets in the world. Cancer rates in India are lower than those seen in Western countries, but are rising with increasing migration of rural population to the cities, increase in life expectancy and changes in lifestyles. In India, rates for oral and oesophageal cancers are some of the highest in the world. In contrast, the rates for colorectal, prostate, and lung cancers are one of the lowest. Studies of Indian immigrants in Western societies indicate that rates of cancer and other chronic diseases, such as coronary heart disease and diabetes, increase dramatically after a generation in the adopted country. Change of diet is among the factors that may be responsible for the changing disease rates. Diet in India encompasses diversity unknown to most other countries, with many dietary patterns emanating from cultural and religious teachings that have existed for thousands of years. Very little is known, however, about the role of the Indian diet in causation of cancer or its role, if any, in prevention of cancer, although more attention is being focused on certain aspects of the Indian diet, such as vegetarianism, spices, and food additives. Of particular interest for cancer prevention is the role of turmeric (curcumin), an ingredient in common Indian curry spice. Researchers also have investigated cumin, chilies, kalakhar, Amrita Bindu, and various plant seeds for their apparent cancer preventive properties. Few prospective studies, however, have been conducted to investigate the role of Indian diet and its various components in prevention of cancer. From a public health perspective, there is an increasing need to develop cancer prevention programs responsive to the unique diets and cultural practices of the people of India.
  89,296 1,719 127
BRIEF REPORT
Umbilical hernia in adults: day case local anaesthetic repair.
VS Menon, TH Brown
April-June 2003, 49(2):132-3
PMID:12867688
INTRODUCTION: The waiting times for elective surgery of Umbilical hernia (UH) in adults are unacceptably long in some cases. During this period, irreducibility and strangulation are possible. We operate on adult patients under local anaesthesia (LA) as day cases to avoid this delay and describe our experience in this paper. AIMS: The aims of our study were to look at the age and sex distribution, body weight, type and amount of local anaesthetic used, morbidity, admission and readmission rates, and waiting times of adult patients operated on for UH under LA. MATERIALS AND METHODS: It was a retrospective study covering a 4 year period from July 1996 to June 2000 including all adult patients undergoing the above procedure under the care of a single consultant general surgeon. A standard Mayo repair using non absorbable material was used without a mesh or a drain. RESULTS: 32 patients with UH were operated on under LA, 23 males and 9 females with a median age of 51 years (range 20 to 86 years). The body weight ranged from 63 to 120 (median 87) kg. The average duration of the procedure was 30 (range 22-40) minutes. Sedation was needed in 4 patients. Two patients developed wound infections, one superficial and one deep. There was no mortality. The median period of follow-up was 24 (range 4-48) months and there was no recurrence. The median waiting time for the operation was 6 weeks. CONCLUSIONS: Day case local anaesthetic repair of UH in adults seems to be safe and feasible with an acceptable morbidity. Suture repair in the right patient has excellent results and the waiting times are acceptable.
  85,073 442 9
ORIGINAL ARTICLE
Comparative study of hemoglobin estimated by Drabkin's and Sahli's methods.
P Balasubramaniam, A Malathi
January-March 1992, 38(1):8-9
PMID:0001512732
Hemoglobin was estimated by Sahli's and Drabkin's method in samples collected by finger prick and venepuncture. Statistical analysis revealed a significant difference in the hemoglobin values obtained by the two methods (P less than .01 & P less than .05 respectively). Sahli's method carried out by two different groups of workers in samples of blood collected by venepuncture showed statistically significant difference (P less than .001). This could be due to the inbuilt errors of Sahli's method including a subjective bias due to visual comparison. When same samples were subjected to Drabkin's method by the same group of workers no significant difference in the results were obtained (P less than .05). This is due to reliability of the Drabkins method. The aim of this comparative study of hemoglobin estimation by Sahli's and Drabkin's methods is to emphasize the sensitivity and reliability of Drabkin's over Sahli's and utility of Drabkin's method in undergraduate teaching schedule.
  67,901 560 3
REVIEW ARTICLE
Bone graft substitutes: past, present, future.
SN Parikh
April-June 2002, 48(2):142-8
PMID:12215702
Bone grafts are necessary to provide support, fill voids, and enhance biologic repair of skeletal defects. They are used by orthopaedic surgeons, neurosurgeons, craniofacial surgeons, and periodontists. Bone harvested from donor sites is the gold standard for this procedure. It is well documented that there are limitations and complications from the use of autograft, including the limited quantity and associated chronic donor site pain. Despite the increase in the number of procedures that require bone grafts, there has not been a single ideal bone graft substitute Scientists, surgeons, and medical companies, thus, have a tremendous responsibility to develop biologic alternatives that will enhance the functional capabilities of the bone graft substitute, and potentially reduce or eliminate the need for autograft. This article is an attempt to review the past and existing bone graft substitutes, and future directions of research. The historical data was extracted after thorough review of the literature. The data for the current concepts and future directions was compiled from the Internet, and from direct correspondence with medical companies. Since many products are undergoing clinical trials, and are yet not commercially available, their data cannot be found in literature. The main purpose of this article is to give the reader an idea about the existing market products and products likely to be available in near future.
  65,567 1,999 53
LOOKING BACK
History of plastic surgery in India.
RE Rana, BS Arora
January-March 2002, 48(1):76-8
PMID:12082339
  65,466 499 4
CLINICAL SIGNS
Spider nevus.
A Khasnis, RM Gokula
October-December 2002, 48(4):307-9
PMID:12571391
  63,343 614 3
SYMPOSIUM
Recent advances in the diagnosis of leishmaniasis.
S Singh, R Sivakumar
January-March 2003, 49(1):55-60
DOI:10.4103/0022-3859.927  PMID:12865572
Leishmaniasis is a parasitic disease caused by a haemoflagellate Leishmania. There are more than 21 species causing human infection. The infection is transmitted to humans through the bites of female sandflies belonging to 30 species. The disease manifests mainly in 3 forms: the visceral, the cutaneous and the mucocutaneous leishmaniasis. The diagnosis of visceral form is conventionally made by the demonstration of amastigotes of the parasite in the aspirated fluid from the bone marrow, the spleen, and rarely from the lymph nodes, or the liver. The parasite demonstration and isolation rates are rather poor from cutaneous and mucocutaneous lesions due to low parasite load and high rate of culture contamination. Recently several recombinant proteins have been developed to accomplish accurate diagnosis. Recombinant kinesin protein of 39 kDa called rK 39 is the most promising of these molecules. The antigen used in various test formats has been proved highly sensitive and specific for visceral leishmaniasis. It is useful in the diagnosis of HIV-Leishmania co-infection and as a prognostic marker. Molecular techniques targeting various genes of the parasite have also been reported, the PCR being the most common molecular technique successfully used for diagnosis and for differentiation of species.
  56,727 1,383 96
E-MEDICINE
Open Access to Peer-Reviewed Research through Author/Institution Self-Archiving: Maximizing Research Impact by Maximizing Online Access
S Harnad
October-December 2003, 49(4):337-342
PMID:14699234
  57,002 442 15
LOOKING BACK
History and development of forensic science in India.
RK Tewari, KV Ravikumar
October-December 2000, 46(4):303-8
PMID:11435664
  55,927 340 -
ORIGINAL ARTICLE
A study of stress in medical students at Seth G.S. Medical College.
AN Supe
January-March 1998, 44(1):1-6
PMID:0010703558
BACKGROUND: It is usually observed that medical students undergo tremendous stress during various stages of the MBBS course. There is a high rate of suicide among them. METHODS: To determine incidence of stress and factors controlling stress in medical students at various stages of MBBS course at Seth G S Medical college, 238 students (First year 98, Second 76, Third 64) were asked to complete a questionnaire on personal data (gender, stay at hostel, mode of travel, time spent in travel every day, medium of study in school, place of school education.), Stress inducing factors, Zung's depression scale, ways of coping, stress relievers, perceived social support and personality type. Statistical tests used were ANOVA, critical ratio and Student's 't' test. RESULTS: Majority of medical students (175/238--73%) perceived stress. Stress was found to be significantly more in Second and Third MBBS students rather than First MBBS levels (p < 0.05). Stress was not found to differ significantly on the basis of sex, stay at hostel, model of travel, time spent in travel every day, medium of study in school, place of school education. Stress was found to be significantly more in students having more than 95% of marks at 12th Standard as compared to others. Academic factors were greater perceived cause of stress in medical students. There was no significant difference in the students at different levels of MBBS regarding academic factors and social factors as a stress inducing factors. Physical factors were found to be significantly more in Second and Third MBBS students as compared to First MBBS students. Emotional factors were found to be significantly more in First MBBS students as compared to Second & Third MBBS students. Stress was more common in medical students who have dominant strategy of coping as positive reappraisal, accepting responsibility and planful problem solving. Stress was less common in medical students at Seth G S Medical College who have dominant strategy of coping as escaping and distancing from difficult situation. Family and Friend as perceived social supports were more in Second MBBS than First MBBS medical students. Stress was not found to be significantly more in students having their personality factor contributing to stress (Type A--52/67) as compared to others (Type B--123/171). This indicates that the stress was not trait oriented but was process oriented (p = NS). CONCLUSION: Stress in medical students is common and is process oriented. It is more in second and third year. Academic factors are greater perceived cause of stress in medical students at Seth G S medical college. Emotional factors are found to be significantly more in First MBBS. It is dependent on person's ways of coping and social support.
  53,242 868 13
TECHNOLOGY REVIEW
End-tidal carbon dioxide monitoring in pediatrics: concepts and technology.
MS Bhende
April-June 2001, 47(2):153-6
PMID:11832614
  52,180 656 2
SYMPOSIUM
Can We Prevent Parkinsonís and Alzheimerís Disease?
NP Kedar
July-September 2003, 49(3):236-245
PMID:14597787
Parkinsonís disease (PD) and Alzheimerís (AD) are major progressive neurological disorders, the risk of which increases with advancing age (65 years and over). In familial cases, however, early onset of disease (about 35 years) is observed. In spite of extensive basic and clinical research on PD and AD, no preventive or long-term effective treatment strategies are available. Several studies have indicated that oxidative stress is a major risk factor for the initiation and progression of sporadic PD and AD. Even a-synuclein and b-amyloid fragments that are associated with the PD and AD, respectively, mediate part of their action via oxidative stress. Therefore, reducing oxidative stress appears to be a rational choice for the prevention and reduction in the rate of progression of these neurological disorders. This review provides a brief description of the epidemiology and pathogenesis of PD and AD, and the scientific rationale for the use of multiple antioxidants in the prevention of these neurological diseases.
  47,138 782 23
REVIEW ARTICLE
Topical immunomodulators in dermatology
Sujay Khandpur, VK Sharma, K Sumanth
June 2004, 50(2):131-139
PMID:15235214
Topical immunomodulators are agents that regulate the local immune response of the skin. They are now emerging as the therapy of choice for several immune-mediated dermatoses such as atopic dermatitis, contact allergic dermatitis, alopecia areata, psoriasis, vitiligo, connective tissue disorders such as morphea and lupus erythematosus, disorders of keratinization and several benign and malignant skin tumours, because of their comparable efficacy, ease of application and greater safety than their systemic counterparts. They can be used on a domiciliary basis for longer periods without aggressive monitoring. In this article, we have discussed the mechanism of action, common indications and side-effects of the commonly used topical immunomodulators, excluding topical steroids. Moreover, newer agents, which are still in the experimental stages, have also been described. A MEDLINE search was undertaken using the key words "topical immunomodulators, dermatology" and related articles were also searched. In addition, a manual search for many Indian articles, which are not indexed, was also carried out. Wherever possible, the full article was reviewed. If the full article could not be traced, the abstract was used.
  46,080 935 7
LOOKING BACK
History of psychiatry in India.
SR Parkar, VS Dawani, JS Apte
January-March 2001, 47(1):73-6
PMID:11590303
  44,715 478 -
REVIEW ARTICLE
Insulin resistance, insulin sensitization and inflammation in polycystic ovarian syndrome
G Dhindsa, R Bhatia, M Dhindsa, Vishal Bhatia
June 2004, 50(2):140-144
PMID:15235215
It is estimated that 5-10% of women of reproductive age have polycystic ovarian syndrome (PCOS). While insulin resistance is not part of the diagnostic criteria for PCOS, its importance in the pathogenesis of PCOS cannot be denied. PCOS is associated with insulin resistance independent of total or fat-free body mass. Post-receptor defects in the action of insulin have been described in PCOS which are similar to those found in obesity and type 2 diabetes. Treatment with insulin sensitizers, metformin and thiazolidinediones, improve both metabolic and hormonal patterns and also improve ovulation in PCOS. Recent studies have shown that PCOS women have higher circulating levels of inflammatory mediators like C-reactive protein, tumour necrosis factor- , tissue plasminogen activator and plasminogen activator inhibitor-1 (PAI-1 ). It is possible that the beneficial effect of insulin sensitizers in PCOS may be partly due to a decrease in inflammation.
  43,991 656 18
SYMPOSIUM
Antioxidant Micronutrients in the Prevention of Age-related Diseases
MC Polidori
July-September 2003, 49(3):229-235
PMID:14597786
The role and functions of antioxidant micronutrients such as ascorbate (vitamin C), a-tocopherol (vitamin E) and carotenoids that are provided through the diet in aging and in the prevention of age-related diseases are discussed in the present work. In general, a healthy lifestyle involving regular exercise and avoidance of tobacco or alcohol abuse are the key to the prevention of several age-related diseases including cardiovascular diseases, dementia and cancer. A balanced and regular nutrition with at least five portions of fruit and vegetables per day is a critical constituent of such a healthy lifestyle.
  42,871 953 28
Objective structured clinical/practical examination (OSCE/OSPE).
N Ananthakrishnan
April-June 1993, 39(2):82-4
PMID:0008169870
  41,707 0 -
Medicine in Goa--a former Portuguese territory.
SK Pandya
July-September 1982, 28(3):123-48
PMID:0006757412
  40,231 0 -
Online since 12th February '04
© 2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow