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Srikantia N.,M.S. Ramaiah Medical Teaching Hospital | Mukesh S.,M.S. Ramaiah Medical Teaching Hospital | Krishnaswamy M.,M.S. Ramaiah Medical Teaching Hospital
Journal of Cancer Research and Therapeutics

Tamoxifen is a selective estrogen receptor modulator widely used in the treatment of hormone-responsive breast cancer. Tamoxifen-induced ocular complications are very rare. A post-menopausal woman, diagnosed and treated case of carcinoma of left breast, on follow-up presented with history of gradual diminution of vision in both eyes of 3 months duration. Patient was on tamoxifen therapy 20 mg daily for the last 2 years. Fundus examination showed crystalline maculopathy. Fluorescein angiography, ocular coherence tomography confirmed the diagnosis. Tamoxifen therapy was discontinued. Although ocular toxicity is rare, careful evaluation of patients with visual symptoms on tamoxifen therapy is required. Source

Belagavi A.C.,M.S. Ramaiah Medical Teaching Hospital | Rao M.,M.S. Ramaiah Medical Teaching Hospital | Pillai A.Y.,M.S. Ramaiah Medical Teaching Hospital | Srihari U.S.,M.S. Ramaiah Medical Teaching Hospital
Indian Heart Journal

Objective: Shortness of breath is a common complaint for which the elderly seek medical attention in the emergency department (ED). Differentiating cardiac from respiratory causes of dyspnoea in this population is quite a challenge. N Terminal pro brain-natriuretic-peptide (NT proBNP) has been studied extensively as a biomarker of left ventricular (LV) failure. Methods: The NT proBNP was measured in 100 patients above 60 years of age who presented to the ED with shortness of breath. The level was compared with echocardiographic findings to assess correlation with ejection fraction (EF). Results: The NT proBNP values increased significantly as the functional severity of heart failure (HF) increased (P < 0. 001). The mean NT proBNP level was 1503. 33 pg/mL. Patients with respiratory causes of dyspnoea had a mean NT proBNP level of 309. 28 pg/mL with normal LV function. Conclusion: The NT proBNP levels had a good correlation with worsening LVEF. © 2012, Cardiological Society of India. All rights reserved. Source

Janaki M.G.,M.S. Ramaiah Medical Teaching Hospital | Mukesh S.,M.S. Ramaiah Medical Teaching Hospital | Arul Ponni T.R.,M.S. Ramaiah Medical Teaching Hospital | Nirmala S.,M.S. Ramaiah Medical Teaching Hospital
Indian Journal of Palliative Care

Carcinoma of cervix is the most common cancer in developing countries. Majority of them present in locally advanced stages. A 36-year-old lady presented with bleeding and white discharge per vagina since four months, vomiting and reduced urine output since two weeks. Patient had an exophytic cervical growth. Investigation revealed elevated serum creatinine. Patient received single fraction radiation and underwent percutaneous nephrostomy. At one month follow-up, serum creatinine returned to almost normal level. Patient underwent bilateral ante grade stenting and completed concurrent chemoradiotherapy. In selected subsets of patients, aggressive management offered longer palliation and good quality of life. Source

Sudhir U.,M.S. Ramaiah Medical Teaching Hospital | Anil Kumar T.,M.S. Ramaiah Medical Teaching Hospital | Srinivasan G.,M.S. Ramaiah Medical Teaching Hospital | Ravi Kumar V.,M.S. Ramaiah Medical Teaching Hospital | Punith K.,M.S. Ramaiah Medical Teaching Hospital
Journal of the Indian Medical Association

Seizures are frequent in patients over 60 years. Often, there is an underlying causative disorder, which aids in the treatment of these patients. To study the aetiological profile of seizures in patients aged 60 years and above, 100 elderly patients with seizures, attending medicine or neurology OPD or admitted under these departments for seizures were studied. A complete history and detailed examination followed by biochemical, haematological, serological tests and neuro-imaging were obtained. Additional studies including cerebrospinal fluid analysis, and toxicology tests were done as and when indicated. There was no gender difference noted in the type or in the aetiology of the seizures. Stroke (31%) was the most common cause of seizures, followed by metabolic derangements (19%). In 24% of the patients, no cause could be found. Infection caused seizures in a significant number of patients when compared to other studies in the literature. Generalised tonic clonic seizure was the most common type of seizure, again a finding differing from many previous studies. The fact that the population size was smaller and the majority of the patients were in the "younger elderly" ie, age group of <75 years could have contributed to the differing result. The commonest aetiology of seizure in the elderly was found to be cerebrovascular accident and a significant number of patients were found to have an infectious cause for their seizures. Source

Arulponni T.R.,M.S. Ramaiah Medical Teaching Hospital | Janaki M.G.,M.S. Ramaiah Medical Teaching Hospital | Nirmala S.,M.S. Ramaiah Medical Teaching Hospital | Ramesh B.S.,M.S. Ramaiah Medical Teaching Hospital | And 2 more authors.
Journal of Obstetrics and Gynecology of India

Objective: Carcinoma cervix is the commonest cancer seen in our department. The purpose of this study is to discuss the unique problems we have encountered and address our concerns. Materials and methods: A retrospective analysis was done on 257 patients with carcinoma cervix seen between 1998 and 2005. A descriptive analysis was done wherein the proportion of patients coming from rural areas, the results of treatment and complications were brought out. Results: More than 50% (140/257) of the patients were from the rural areas. Sixty (23%) were defaulters and 197 (77%) completed the scheduled treatment. Forty four out of 197 (22%) received palliative RT and 153/197 (78%) who received curative treatment were analyzed. Status of 54 patients were unknown because 24 patients were from the camp and 30 patients were lost to follow-up. Thus, 78/99 (79%) patients were NED. Conclusion: A similar disease pattern and patient characteristics are expected in future. Communication with referring doctors, effective counseling of patients and relatives during treatment will hopefully bring down the default rates and the number of cases lost to follow up. © 2010 Federation of Obstetrics and Gynaecological Societies of India (FOGSI). Source

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