Australasian Medical Journal
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Right Ventricular Endomyocardial Fibrosis
Get PDFEndomyocardial fibrosis (EMF) is a progressive type of restrictive cardiomyopathy. It affects inflow portion of right and/or left ventricle and apex. It is a neglected tropical disease. Here we report a rare case of right ventricular endomyocardial fibrosis. A 70 year old female presented to us with history suggestive of right-sided heart failure of two months duration. There was no eosinophilia. Chest X-ray showed cardiomegaly. Echocardiogram showed dilated right atrium and obliteration of the apex of the right ventricle. A diagnosis of Right ventricular Endomyocardial fibrosis was made. She was treated with diuretics and anticoagulants and she improved
Triple falx cerebelli associated with two aberrant venous sinuses in the floor of posterior cranial fossa
Get PDFDuring regular dissection classes, authors came across tripled falx cerebelli in a male cadaver. The main (middle) falx cerebelli was large and was attached to the internal occipital crest. It contained the occipital sinus. There were two smaller folds (right and left), one on either side of the falx cerebelli. There were two aberrant venous sinuses; each one connecting the ipsilateral sigmoid and transverse sinuses with each other. The complex dural-venous variation reported here is seldom reported in the literature. Knowledge of such variation is important for neurosurgeons and neuroradiologists as these aberrant folds could cause haemorrhage during suboccipital approaches or may lead to erroneous interpretation during imaging of the posterior cranial fossa
Letter from the European Association of Hospital Pharmacists and European Public Health Alliance on the topic of medicines shortages
No full textLetter to the Editor
No full text[Immune boosting properties of zinc are known, and its role in diarrhea is well established. Studies on role of zinc in pneumonia have shown variable results. However literature is scarce regarding its role in bronchiolitis.]
Aims
[To compare the efficacy of zinc versus placebo for treatment of severe bronchiolitis.]
Method
[Setting: Pediatrics department of a tertiary care teaching hospital.
Study duration: April 2010 to March 2011
Type of study: Double blind, randomized, placebo-controlled trial.
Participants and intervention: 100 children between 3 months to 2 years of age with clinical diagnosis of severe bronchiolitis were randomized to receive oral zinc (10 mg/day for 3-6 mo, and 20 mg/day for > 6 mo) or placebo in once daily dose for 7 days in addition to standard supportive care.
Outcome measures:Time to resolution of severe bronchiolitis; Secondary outcome variables: Resolution of individual signs/symptoms (lower chest indrawing, fast breathing, inability to feed,); duration of hospitalization, duration of intravenous fluid therapy, and duration of oxygen therapy.]
Results
[Children receiving zinc or placebo were found to be comparable for median duration of resolution of severe bronchiolitis (46 hours vs. 40 hours, P =0.37), resolution of lower chest indrawing (46 hours vs. 40 hours, P =0.35), resolution of fast breathing (64 hours vs. 72 hours, P =0. 90) and resolution of inability to feed (16 hours vs. 8 hours, P =0.19). Also, no significant difference was observed in secondary outcomes between the two groups.]
Conclusion
[Short term supplementation with zinc, given during the course of illness does not result in faster resolution of severe bronchiolitis.
Incidence and Risk Factors of Ventilator Associated Pneumonia in a Tertiary Care Hospital
Get PDFBackgroundVentilator associated pneumonia (VAP) is a type of nosocomial pneumonia associated with increased morbidity and mortality. Knowledge about the incidence and risk factors is necessary to implement preventive measures to reduce mortality in these patients.Method A prospective study was conducted at a tertiary care teaching hospital for a period of 20 months from November 2009 to July 2011. Patients who were on mechanical ventilation (MV) for more than 48 hours were monitored at frequent intervals for development of VAP using clinical and microbiological criteria until discharge or death.ResultsOf the 76 patients, 18 (23.7%) developed VAP during their ICU stay. The incidence of VAP was 53.25 per 1,000 ventilator days. About 94% of VAP cases occurred within the first week of MV. Early-onset and late-onset VAP was observed in 72.2% and 27.8%, respectively. Univariate analysis showed chronic lung failure, H2 blockers usage, and supine head position were significant risk factors for VAP. Logistic regression revealed supine head position as an independent risk factor for VAP.ConclusionVAP occurred in a sizeable number of patients on MV. Chronic lung failure, H2 blockers usage, and supine head position were the risk factors associated with VAP. Awareness about these risk factors can be used to inform simple and effective preventive measures
A case report of Melioidosis in a Diabetic patient in a Union Territory
Get PDFMelioidosis is an emerging disease in India. Cases have also been reported from South East Asia, Australia and Japan. Major risk factors for melioidosis are diabetes mellitus, pre-existing renal disease and thalassemia. Exposure to contaminated soil and water are also significant occupational hazards associated with the disease. A patient with diabetes of six years duration on regular medication presented with fever, generalised myalgia and headache for a week. Blood and bone marrow culture yielded Burkholderia pseudomallei. A Computed tomography (CT) study of the thorax also revealed multiple scattered nodules in both lungs. The patient was treated with imipenem and doxycycline. His condition improved gradually and he was advised oral sulfamethoxazole/trimethoprim and doxycycline for a period of three months and has been followed up regularly