Lateral rhinotomy - revisited.

The lateral rhinotomy approach is one of the most commonly used techniques for exploration of the difficult sinonasal masses. Though endoscopic advances have progressed rapidly since last few years, but the excellent exposure provided by the lateral rhinotomy approach makes it suitable for resection of sinonasal masses with extensive spread. Our study is an attempt to establish the different spectra of pathologies encountered in the sinonasal region, which were removed by the lateral rhinotomy approach and to establish its importance in the context of modern rhinological surgeries.

Medical abortion in late second trimester--a comparative study with misoprostol through vaginal versus oral followed by vaginal route.

A randomised controlled trial was conducted to compare the relative efficacies of two regimens: Misoprostol given only vaginally or orally followed by vaginal administration of the same drug, for second trimester abortion. Multiparous women with a pregnancy of 16 to 20 weeks with no contra-indications to the drug were selected. They were randomly allocated into two groups.

Olanzapine-induced obesity and diabetes in Indian patients: a prospective trial comparing olanzapine with typical antipsychotics.

The association of hyperglycaemia and weight gain with the use of atypical antipsychotics has been documented. However, there is still not enough data from India. The fact that Indian patients usually have a lower body weight compared to European and American counterparts makes it difficult to extrapolate available data to the Indian context.

Acute myopia induced by topiramate: report of a case and review of the literature.

Topiramate, a new anticonvulsant, is also used for the prophylaxis of migraine and cluster headache. A serious but not often discussed side effect of the drug is the development of acute myopia and acute angle-closure glaucoma in the early stage of therapy that subsides rapidly with prompt discontinuation. One such case is reported here and the relevant literature in this regard is also reviewed.

Wandering ascaris coming out through the T-tube tract--a rare occurrence.

A case of ascariasis of the common bile duct in the postoperative period of cholecystectomy and choledocholithotomy with T-tube drainage is reported. The living adult wandering ascaris came out through the T-tube tract immediately after removal of the T-tube. No such previous report has been found in the available literature.

Becker's variant of myotonia congenita in two siblings--a clinico-genetic study.

We report a family of a brother and sister of myotonia congenita, conforming to autosomal recessive transmission (Becker's variety). To the best of our knowledge, no account of a family of autosomal recessive myotonia (Becker's disease), has earlier been reported from India.

Haemobilia due to a large gall bladder polyp.

A 61-year-old male presented with recurrent bouts of haematemesis and melaena for last 10 days. On examination, he was found anaemic and had jaundice and a mass felt in the right hypochondrium. He required multiple blood transfusions.

Testicular tuberculosis mimicking testicular malignancy.

A 22 years old male presented with right sided scrotal swelling of 5 months duration. On examination it was found to be of orange-sized, firm to hard in consistency with mild tenderness. Ultrasonography of testes failed to arrive at a diagnosis.

Orthostatic tremor: report of a case and review of the literature.

Orthostatic tremor is a rare movement disorder characterized by tremulousness of the lower limbs on standing that disappears on walking, sitting or on lying down and a distinctive electromyographic burst of 14 to 16 Hz. On inspection, fine ripples can sometimes be seen over the quadriceps on standing. The tremor has a tendency to reappear even in the supine posture if the lower limb muscles are put to an isometric contraction state, indicating thereby that in spite of the fact that the tremor occurs on standing, it is essentially 'orthostasis independent' and the central factor is the contraction of the muscles.

Comparison of granisetron and granisetron plus dexamethasone for the prevention of postoperative nausea and vomiting after laparoscopic cholecystectomy.

Background: Laparoscopic cholecystectomies are associated with an appreciably high rate of postoperative nausea and vomiting (PONV). This study was designed to compare the effectiveness of granisetron plus dexamethasone with granisetron alone for the prevention of postoperative nausea and vomiting in patients after laparoscopic cholecystectomy.

Methods: In a randomized, double-blind study, 120 patients of both sexes received granisetron 40 micro g kg-1 alone or granisetron 40 micro g kg-1 plus dexamethasone 8 mg (n=60 of each) intravenously immediately before induction of anesthesia.

Left sided cervical and thoracic malignant extra-adrenal pheochromocytoma.

Extra-adrenal Pheochromocytomas are rare entities. High index of suspicion among diastolic hypertensives followed by screening test for 24-hour urinary catecholamine level helps in diagnosis. 123I MIBG scintigraphy is specific for tumour localisation and surgical debulking of tumour or 131I MIBG therapy are alternative modes of treatment.

Intrathecal midazolam for postoperative pain relief in caesarean section delivery.

Postoperative pain relief is a growing concern to an anaesthesiologist since no single analgesic is free from side-effects. Moreover, it becomes a challenge after caesarean section delivery to provide postoperative pain relief without much sedation, respiratory depression or problems like nausea, vomiting, so that early baby acceptance and care by mother is promoted. Antinociceptive effect of midazolam is well established by now and its safety is documented.

Sporadic paroxysmal exercise induced dystonia: report of a case and review of the literature.

Sporadic paroxysmal exercise induced dystonia (PEID) is a rare condition. So far only fifteen cases have been reported in the world literature. It is characterised by dystonic posture on prolonged exercise, which gets relieved with rest.

A comparative study of the efficacy and safety of synthetic prostaglandin E2 derivative and 15-methyl prostaglandin F2 alpha in the termination of midtrimester pregnancy.

A comparative study of a synthetic prostaglandin E2 (PGE2) derivative and 15-methyl prostaglandin F2 alpha (PGF2 alpha) in the termination of midtrimester pregnancy of 13-20 weeks of gestation by intramuscular route, showed 97.5% success rate in both the groups but in comparison to 15-methyl PGF2 alpha which produced severe side-effects eg. diarrhoea and vomiting, synthetic PGE2 derivative had minimal or no side-effects.

Study of clinical anaesthesia with pedius A anaesthesia system using ketamine or halothane with muscle relaxant.

In pedius anaesthesia system, oxygen enriched air and air are generated through an electrically driven oxygen generator 'Permox', obviating the need of compressed gas cylinder or pipe line. Effect of anaesthesia with pedius A anaesthesia system using ketamine or halothane with muscle relaxant in 2 groups of patients had been studied. Both groups had satisfactory results clinically.

Experiences with fine needle aspiration cytology as a diagnostic procedure for breast lesions in a Calcutta Hospital.

Nine hundred and forty cases of breast lesions were subjected to fine needle aspiration. Nine hundred twenty-four of them were females and sixteen were males. Smears from the 60 female cases were rejected as unsatisfactory.

Inhalation steroids, some aspects and ways in the management of asthma.

Inhalation of steroid is important in the management of asthma and at present various steroids are available for inhalation. Aerosol treatment with steroids is most effective if used in several doses throughout the day. In moderately severe asthma it may be ineffective until airways are cleared by adequate oral doses.