CURRENT MEDICAL JOURNAL
Current Medical Journal        Current Medical Journal
 
     
 
 
 
   Home
   Introduction
   Brief Information
   Subscription
   Contributors
   MCQs
   Instruction to Authors
   Summeries
   Calender
  (from 1800-2399)
   Other Publications
   Other Activities
   Contact Us
 
 
 
 
 

BEE STING AND ITS MANAGEMENT
Prof. B.K. Barik,
Deptt. of Medicine, Institute of MedicalSciences & SUMHospital, Bhubaneswar.


Bee sting is very common to human beings. The females sting, leaving the barbed stinger on the body of the victims and the bee dies.
Venom contains various toxic compounds that produce immediate or delayed reactions and complications. Melittin and Apamin are important toxins. Children, aged and intoxicated people are more vulnerable victims.
 Local reaction usually causes pain, edema, errythema, itching etc. Systemic reactions are urticaria, confluent rash, nausea, vomiting, airway edema, hypotension, chest pain and shock. Delayed reaction may produce serum sickness like symptoms.
 Ocular and renal complications, rebound anaphylaxis, MI and DIC are common. Cerebral edema and  peripheral neuritis are rare.
Quick removal of sting with local treatment prevents further reaction. Adrenaline, antihistamines, steroids and  bronchodilators relieve local as well as systemic reactions.                                   
If a swarm bee approaches, run for shelter, as bees are slow flier. Regarding the preventive measures, avoid  bright colours,  perfumes, fruits juices, hair tonics, suntan lotions and creams, as these draw bees.

Specific Immuno-therapy (SIT) is useful in allergic people for hyposensitisation.Various preventive measures to avoid bee sting decreases morbidity.

*********


DIABETES AND LUNG
Prof. K. B. Gupta,
Head, Deptt. of TB & Pulmonary Medicine, Post Graduate Institute of Medical Sciences, Rohtak.


Prevalence of DM is increasing in several parts of the world. In India, it has been estimated that 2.4% of the rural population and 8.4% of the urban population is affected by diabetes.
Lack of physical activity, changes in dietary patterns and stressful lifestyles have direct and confounding impact on glucose metabolism and hence could accelerate the development of diabetes. There is histopathological involvement of the lung in diabetes mellitus, both in animals and humans. Microangiopathy as well as the non-enzymatic glycosylation of tissue proteins are considered to be involved in pathogenesis of major long-term complications of diabetes mellitus.
Pulmonary dysfunction and complications in diabetes mellitus includes physiological changes, disordered breathing, infections etc.
The diabetics are more prone to bacterial, viral, fungal and tubercular infections. Apart from other factors, it is because of poor host defenses and resistance. Sleep apnea, pulmonary edema, pneumothorax, aspiration pneumonia, pleural effusion etc. are also more common amongst the diabetics.

There is an urgent need of some concrete strategies for screening and identification of  risk abnormalities at early stage  to save the community from the burden of diabetes and its costlier complications.

*********


Physiology of Yogic Healing
Dr. Rajeev Nanda,  
Asso. Prof., Deptt.of Physiology,VSSMedicalCollege & Hosp., Burla-Sambalpur.


Yoga is a science and a lifestyle modification programme which can help  relieve  many of the chronic disorders. The knowledge of yoga helps an individual to know oneself and use one's energy efficiently. Now it has been established that the response of yoga includes beneficial effects on CVS, respiratory system, metabolic system, nervous system, endocrine system, musculoskeletal system etc.
It has effect on immunological processes, higher functions of brain, neuro-hormonal balance etc. Yoga also has benefcial effects on infertility.
There are various aspects of yoga which have fascinated scientists. The claims regarding the wide range of therapeutic benefits of yoga have prompted scientists to examine whether there is any physiological basis for such claims.
Galvanic skin response (GSR) is a measure of sympathetic activity following an alerting stimulus i.e. a sudden loud sound leading to palmar sweating. As sweat is a good conductor, it decreases the electrical resistance of skin. Response is seen within seconds and is over within half a minute.
Magnitude of the response is considered as the indicator of sympathetic reactivity. Recitation of Om and practice of meditation decreases GSR.
 Yoga's primary emphasis is upon general well-being. It is anti-stress, anti-fatigue and anti-ageing.

*********


Benign Breast Lumps
– A Current perspective
 Prof. Navneet Kaur,  
Deptt. of  Surgery, UCMS & GTB Hosp.,Delhi.


Benign breast lumps are  common clinical conditions. About 40% of all patients attending a breast clinic have a benign breast lumps. When a patient presents with a lump in the breast, the physician has to decide whether the lump is truly an abnormality or a normal physiological change. And if the lump is a true abnormality, whether it is a benign or a malignant lump.
ANDI (aberration of normal development and involution) classification has helped to clarify the pathophysiology of benign breast lumps. This classification is based on the knowledge that most benign disorders are relatively minor aberrations of the normal  processes of development, cyclical hormonal response as well as involution and only a few of these conditions will progress to a state with sufficient morbidity to justify being called a disease. 

The common causes of benign breast lumps are cyclical nodularity (focal or diffuse), fibroadenoms, phyllodes tumors, breast cysts, galactocele, traumatic fat necrosis, sclerosing adenosis, chronic abscess etc.
A breast lumps requires to be evaluated by triple assessment i.e. detailed history and physical examination, imaging investigations (USG or mammography) and FNAC. Most of the benign breast lumps can be managed conservatively.
Only few lumps such as giant fibroadenomas, phyllodes tumors etc. require surgical excision.

*********

 

Antenatal Care (ANC)

-When, Where & How?
Prof. Poonam Varma Shivkumar,
Deptt. of  Obs. & Gynae, MGIMS, Sevagram, Wardha.


Antenatal care or prenatal care is beyond doubt a very important tool in having the best fetomaternal outcome of any pregnant woman. 
From cost-benefit point of view also, this care has been proved to be effective  especially in reducing maternal morbidity as well as mortality and improving perinatal outcome.
Thorough examination of a woman, right from the time she conceives and the necessary investigations help in anticipating the problems and complications. Once  an obstetrician detects any complication, the patient should also be prepared for treatment, so that major hazards can be prevented. Fetal problems too can be detected to a great extent through this examination.
This is the period when an  obstetrician can catch most of the dreadful complications of pregnancy and tackle these by early treatment.
How many times during pregnancy, a woman must come for antenatal check-up, still remains controversial. Although, WHO recommends four visits at different periods  to cover up all required examinations and investigations, yet more visits are definitely helpful in the proper guidance and management.
Recommendations about diet, clothings, coitus, travel, exercises etc. should be explained. A good prenatal care alleviates most of the risk factors of fetal morbidity and mortality. 

*********

 

H1N1 Influenza (SWINE FLU) 
 - An Update
DR. Ratnakar Sahoo,  
Asso. Prof., Deptt. of Medicine, PGIMER & Dr RML Hosp., New Delhi.


H1N1 influenza or swine flu has been declared as pandemic across the world. Till now, it has claimed at least 144 lives in 76 countries and more cases are being reported, at the time of going to press.
The new mutant H1N1 influenza virus is highly infectious with secondary attack rate ranging from 22 to 33%. After an incubation period of 18-72 hours, systemic symptoms ensue. Common clinical features are fever, cough, sore throat, rhinitis, headache and myalgia.
People with underlying chronic conditions, such as cardiovascular disease, hypertension, asthma, diabetes, rheumatoid arthritis and several others, are more likely to experience severe or lethal infections.
Oseltamivir and zanamivir are effective agents, both for treatment and prophylaxis. Government of India has started screening all the international passengers on arrival at the airports and set up laboratories to diagnose the infection.
Usually, adult patients should be discharged 7 days after symptoms have subsided.
Containment of the viral spread is the topmost priority of all medical as well as all of non-medical men. The effective vaccine is expected  to reach the market in a period of 6 months.

*********

ANAPHYLACTIC REACTION (AR)

Dr. N.Venkateshwarlu Sharma,  
Asso. Prof., Deptt.of  Medicine, SVSMedicalCollege & Hosp., Mehbubnagar (AP).


Allergy is a commonly encountered problem in day-to-day clinical practice by all medical men, be one a physician, surgeon, gynaecologist, anesthetist, dermatologist or others.
The anaphylactic reaction (AR) can be due to food, drugs, insect stings or idiopathic. Presentation is varied. No definite laboratory tests are available to confirm the allergy, many a times.
There are four types of allergic reactions, of which Type I is anaphylactic reaction. Anaphylaxis and drug allergies account for 230,000 hospital admissions in US to cost more than 600 million US dollars, annually.
Adverse drug reactions can be classified as predictable (or Type A) i.e. dose dependent side- effects, drug pharmacology, interactions etc. and unpredictable (or Type B) i.e. intolerance, idiosyncrasy, immunological reaction etc.
Betalactum antibiotics are the most common cause of anaphylaxis. Development of anaphylaxis and other allergic reactions is influenced by many risk factors such as age, atopy, history of exposure, route of administration, prolonged or repeated courses of therapy, concomitant disease or previous drug allergies.
In high risk patients, discontinue betablockers and possibly ACE-Inhibitors. Use preventive techniques like gradual dosage escalation and desensitization when the patients encounter food or drug allergy.

*********


 
 
 
 
 
Copyright currentmedicaljournal.com © 2009