PACEMAKER INDUCED PLEURAL EFFUSION:
A CASE REPORT:
Pleural effusion after open heart surgery is known but pace maker induced pleural effusion that too bilateral is rare. Here I report a case of diabetes with IHD developing bilateral pleural effusion (repeated) after pace maker was implanted on the left side of the chest wall.
VinitJ.SangnolP.etall in 2007 published a case of pleural effusion and unusual pericarditis after pace maker.
AshrithGuha, SaiMunjampalli in 2006 reported pleural effusion after pace maker implantation.
Our patient had repeated pleural tapping following implantation of pace maker on left side as there was problem of introducing the catheter on right side. Two week after the procedure he developed bilateral effusion.
All tests were negative for malignancy and tuberculosis. As the fluid was exudative he was given a course of anti TB drugs but he continued to accumulate fluids over a period of four months. He never recovered from it and died of LVF. Here I want to high light that one should keep in mind the problem associated with permanent pacing.
29 April 2010
28 April 2010
A TRIBUTE FROM A STUDENT
The person who has written this tribute about his mentor,guide, philosopher and teacher Prof:Basanta Kumar Satpathy is from a very low socioeconomic class family from a tribal area of Mayurbhanj district of Odissa,India.After the death of his teacher he now guards the house and take care of it as Prof's four sons have no time or interest to renovate or stay in that old modelled house.Like a true disciple he is now totally involved in that house called "Arnnapurna".This is what he wrote in Odiya about his "SIR", fondly he calls him"Boodha Sir"(old teacher).
24 April 2010
DEMYELINATION FOLLOWING MALARIA
Neurological sequalae in complicated malaria.
Acute Demyelination of brain and peripheral nerves are seen with viral, bacterial infection or following immunization but uncommon finding following parasitic infection. Some people have reported GBS following malaria.(1)
DKKochar(2) et all have reported some case of Demyelination following severe malaria, Pseudo bulbar paralysis following malaria have been reported by Mohapatra et(3) all as a sequalae of complicated malaria.
Here we report a case of Demyelination in a case of complicated malaria.
Our patient 55 years old man with multiorgan involvement and positive Vivax and Falciparum malaria(parasite index >15%) was referred from a mining area, in a comatose state (GCS#3) and frequent generalized tonic clonic seizures.Neurologiacl examination showed multiple cranial nerve involvement and bilateral up going planter. The CT scan picture showed areas of hypo dense areas involving pons, midbrain and bilateral basal ganglia. This was suggestive of Myelinolysis, cerebral edema with multiple cerebral infarcts.This could be because of malaria or due to artisunate is difficult to opine.More research is required in this line.
The mortality rate in most of the referral hospitals in the capital city of Odissa, Bhubaneswar, is high despite intensive ICU care, early hemodialysis, blood transfusion and ventilator support due to late referral of cases with multiorgan failure. In recent years the mortality rate of complicated malaria continues to be a problem area for physicians. The reason may be due to late diagnosis, improper therapy, poverty, immunological reaction and multiorgan involvement.
Our observation is, patients requiring ventilator have a high mortality rate. In spite of rampant use of artemesinins compounds even by quacks the mortality is on the rise in cases of complicated Falciparum malaria all over Odissa (earlier Orissa).
I do not know if my colleagues will agree with me or not.
Ref:
1. KanjalkarM, KarnadDR, GBS following malaria.J.Infection1999; 38:48-50.
2. ConnerDH, HerberJM, Parasite infection of the peripheral nervous system,DyckPJ,ThomasPK,WBSaunders,1993p,1338-90
3. Pseudobulbar paralysis: MKMohapatra, GSethi, And SCMohanty: Demyelination a pathological sequalae of severe malaria.
4: DKKochar, PSirohi, SKKochar, Bikaner, Rajastan, India
18 April 2010
ASH TEST
KLM should wait for some time before flying through the cloud of valcanic ash.The world will not come to an end if some people donot fly by KLM immediatly.Lets not endanger the life of some living being for the sake of money.
17 April 2010
COMMITMENT
COMMITMENT
Soon after his graduation in the early 70s, Dr, Binoy joined a hospital in an industrial township, set up during the Nehruvian era in Orissa. Liberalization was unheard of in those days, and the loss making industry was sustained through Government support. More recently, however, in the era of liberalization, most of his colleagues started deserting the sinking ship, Dr.Binoy nursed no such thought.
Managing Directors (MDs, in officialese) came and went making little difference to the health of the company.
The new MD—he was now about a year old in the company---was not particularly known for his managerial skills or generosity.
Rather, jokes about him had started making their rounds. For example, if he denied promotion to anyone, it seems, he would console him by saying: “So what? Life goes on! I have remained as MD for last four years!” the humor springing from the fact that he had already reached the highest rung in his career.
It so happened that Binoy’s next promotion became due during the tenure of the above Dictator. Normally indifferent towards his career, Binoy became some what anxious this time round. For, it was at a crucial juncture in his career.
He did his best at the interview, giving evidence of his continued research interest, and impressive track record. So it came as a shock not only to him but also to his friends and relatives when the result was out for the next promotion.
Dr.Binoy became hassled and decided to meet the all powerful MD to find out where in lay the obstacle to his promotion. Getting an appointment with him (MD) was no easy task. He had to take permission from the health director first. Only if he could be convinced then would be given an appointment with the powerful man called MD. Dr.Binoy pleaded with the health director that he expects nothing except some mental satisfaction of meeting the Managing Director.
But that was not enough. He had to approach people close to the MD to secure an appointment. This was to be three weeks later.
By which time had forgotten over the pain and depression which he had over come in the days immediately following his rejection. Even so, he prepared himself well for the fateful day. With copies of his CV neatly typed out, and all his certificates and credentials stowed in a folder he waited for the summons. Dr.Binoy was briefed from the outset by the PA, that he must be brief and to the point, he must not try to hand over any envelope or printed materials, thanks to the tehelka and anthrax scares!
The MD was brief. In no uncertain terms he told Dr.Binoy” No commitment, no promotion”. This was like a bolt from the blue. Was he not given “best doctor’s and long service certificate”, in a glittering function held only the previous year, before this man joined the PSU as its newest MD---the twelfth one during Binoy’s service period.
Next day Dr.Binoy was admitted with an angina to the ICU only to learn that the great man has joined a new job in a profit making multinational company at Dubai, “What a commitment?”
Soon after his graduation in the early 70s, Dr, Binoy joined a hospital in an industrial township, set up during the Nehruvian era in Orissa. Liberalization was unheard of in those days, and the loss making industry was sustained through Government support. More recently, however, in the era of liberalization, most of his colleagues started deserting the sinking ship, Dr.Binoy nursed no such thought.
Managing Directors (MDs, in officialese) came and went making little difference to the health of the company.
The new MD—he was now about a year old in the company---was not particularly known for his managerial skills or generosity.
Rather, jokes about him had started making their rounds. For example, if he denied promotion to anyone, it seems, he would console him by saying: “So what? Life goes on! I have remained as MD for last four years!” the humor springing from the fact that he had already reached the highest rung in his career.
It so happened that Binoy’s next promotion became due during the tenure of the above Dictator. Normally indifferent towards his career, Binoy became some what anxious this time round. For, it was at a crucial juncture in his career.
He did his best at the interview, giving evidence of his continued research interest, and impressive track record. So it came as a shock not only to him but also to his friends and relatives when the result was out for the next promotion.
Dr.Binoy became hassled and decided to meet the all powerful MD to find out where in lay the obstacle to his promotion. Getting an appointment with him (MD) was no easy task. He had to take permission from the health director first. Only if he could be convinced then would be given an appointment with the powerful man called MD. Dr.Binoy pleaded with the health director that he expects nothing except some mental satisfaction of meeting the Managing Director.
But that was not enough. He had to approach people close to the MD to secure an appointment. This was to be three weeks later.
By which time had forgotten over the pain and depression which he had over come in the days immediately following his rejection. Even so, he prepared himself well for the fateful day. With copies of his CV neatly typed out, and all his certificates and credentials stowed in a folder he waited for the summons. Dr.Binoy was briefed from the outset by the PA, that he must be brief and to the point, he must not try to hand over any envelope or printed materials, thanks to the tehelka and anthrax scares!
The MD was brief. In no uncertain terms he told Dr.Binoy” No commitment, no promotion”. This was like a bolt from the blue. Was he not given “best doctor’s and long service certificate”, in a glittering function held only the previous year, before this man joined the PSU as its newest MD---the twelfth one during Binoy’s service period.
Next day Dr.Binoy was admitted with an angina to the ICU only to learn that the great man has joined a new job in a profit making multinational company at Dubai, “What a commitment?”
13 April 2010
IPL CIRCUS
IPL means Indian political life line because the politicians are not asked to answer questions in Parliament nor are they disturbed during their European Tours.
My friend asked me over his mobile as he was away on highway about the IPL score, I told him "I do not watch IPL matches"
He was puzzled."The whole India is watching it but you must be a mad man not to watch it" was the answer.
"But that's my way of life as i do not enjoy things where results are fixed before hand and we are made "JACK ASS"" was my answer.
Some say its decided at Dubai others say by the Congress party of India, some say by film stars , i do not know.
Who ever wins or loses its immaterial, the players are richer by billions for each IPL annual festival, was my answer to my highway friend.
He had already switched off his mobile by then.
My friend asked me over his mobile as he was away on highway about the IPL score, I told him "I do not watch IPL matches"
He was puzzled."The whole India is watching it but you must be a mad man not to watch it" was the answer.
"But that's my way of life as i do not enjoy things where results are fixed before hand and we are made "JACK ASS"" was my answer.
Some say its decided at Dubai others say by the Congress party of India, some say by film stars , i do not know.
Who ever wins or loses its immaterial, the players are richer by billions for each IPL annual festival, was my answer to my highway friend.
He had already switched off his mobile by then.
12 April 2010
HEATHY HEART
SEX & HEALTH
Sex might take a man's breath away, but at least it won't break his heart.
New research shows that men who make love regularly are up to 45 percent less likely to develop fatal heart conditions than those who only have sex once a month or less.
Since 1987, scientists at the New England Research Institute in Massachusetts have studied the sexual activity of over 1,000 men between the ages of 40 and 70.
According to The Telegraph, the results of the study, which were recently published in the American Journal of Cardiology, show that men who did the deed at least twice a week were significantly less likely to suffer from heart disease than those who only get around to having sex once a month.
Researchers, who took into account risk factors like age, weight, cholesterol levels and blood pressure, believe that the health benefits are caused by both the physical and emotional effects of sex on the male body.
The study has yet to examine the benefits of sex for on a woman's heart, but in an earlier study, scientists at Calgary University in Canada concluded that regular sex can boost a woman's sense of smell.
In fact, coitus seems to beneficial to many aspects of human health.
A study by the National Cancer Institute showed that men, who ejaculated at least five times a week, whether by sex or masturbation, were less likely to get prostate cancer.
Researchers at Wilkes University in Pennsylvania even proved that having sex just once or twice a week in the winter can reduce the risk of catching a cold or flu.
Sex might take a man's breath away, but at least it won't break his heart.
New research shows that men who make love regularly are up to 45 percent less likely to develop fatal heart conditions than those who only have sex once a month or less.
Since 1987, scientists at the New England Research Institute in Massachusetts have studied the sexual activity of over 1,000 men between the ages of 40 and 70.
According to The Telegraph, the results of the study, which were recently published in the American Journal of Cardiology, show that men who did the deed at least twice a week were significantly less likely to suffer from heart disease than those who only get around to having sex once a month.
Researchers, who took into account risk factors like age, weight, cholesterol levels and blood pressure, believe that the health benefits are caused by both the physical and emotional effects of sex on the male body.
The study has yet to examine the benefits of sex for on a woman's heart, but in an earlier study, scientists at Calgary University in Canada concluded that regular sex can boost a woman's sense of smell.
In fact, coitus seems to beneficial to many aspects of human health.
A study by the National Cancer Institute showed that men, who ejaculated at least five times a week, whether by sex or masturbation, were less likely to get prostate cancer.
Researchers at Wilkes University in Pennsylvania even proved that having sex just once or twice a week in the winter can reduce the risk of catching a cold or flu.
11 April 2010
HITOPODESH
HITOPODESH
A man never gets satisfied even with best of women, wives, drinks, luxury and property because a man’s desire is insatiable. As he gets older the desire goes on increasing for worldly pleasures. There is a saying a man should not embrace or sit very close to even sisters and daughters as sexual desires are very powerful enemy of a man.
The problem with us is the expectation from others which creates internal conflicts of mind .A happy and contented man is one who thinks of his duties and the God who is with in him. Never think what others think about you provided you are in the right path.
The family attachments bring the greatest miseries and pleasure for a human being.
Birds and less intelligent animals do not expect their children to take care of them in old age; they live all alone as long as they could survive in their society. Ours is a selfish world so do not be puzzled with the change in the society or the family members or the near and dear ones attitude to wards you or your family.
A man never gets satisfied even with best of women, wives, drinks, luxury and property because a man’s desire is insatiable. As he gets older the desire goes on increasing for worldly pleasures. There is a saying a man should not embrace or sit very close to even sisters and daughters as sexual desires are very powerful enemy of a man.
The problem with us is the expectation from others which creates internal conflicts of mind .A happy and contented man is one who thinks of his duties and the God who is with in him. Never think what others think about you provided you are in the right path.
The family attachments bring the greatest miseries and pleasure for a human being.
Birds and less intelligent animals do not expect their children to take care of them in old age; they live all alone as long as they could survive in their society. Ours is a selfish world so do not be puzzled with the change in the society or the family members or the near and dear ones attitude to wards you or your family.
08 April 2010
BLOGSPOT
Some people use their blog (Film stars) for speaking out their grievances but blog is not meant for it, it's a way of life.Blog writers should and must try to spread their knowledge/ observation and experience with their readers. Should avoid writing in blog for the media to scoop it out for prints.Like i have one observation: why this maosit activities are more in non congress states??Any one can send me a feed back soon.
05 April 2010
FUNNY IDEAS
A BIZARRE COUNTRY CALLED INDIA
A country with glares of problems but still it’s surviving only due to its people.
The politicians, bureaucrats, judiciary are only interested in their personal affairs but show off as if there heart bleeds for the country.
A: accidents kill thousands of people but neither the society nor the road safety department tries to find out a solution to it. The road from Bhubaneswar to Purl is a death trap (recently two young photographers from AAJ-TAAK died due to RTA).I think the greatest killer (for young and fit people) in India is Road traffic accidents (RTA).
B: Beer & Bars (driving with beer is a fashion now a days.)
C: Corruptions/Cricket (A norm, others are doing why can’t I?)
D: Democracy (When ministers or Governors go on the road then only you realize you are in a kingdom not in democracy)
E: Electricity (Hook it or temper your meter, choice is yours)
F: Food ( Go to big bazaar)
& Flood (politicians dream but people's night mare)
G: Gundagiri (You have to bear with it or fight at your own risk)
H: Hoarding (Must be hand in glove with the Government)
I: Inflation & IPL (PM says both are good for economy)
J: Judiciary (Must live long to hear the verdict)
K: Kashmir (will remain as a tourist spot)
L: Literacy (Judge it from the sale of news papers)
M: Malaria, Maoists & Mines (Major hurdle for the country)
N: Narcissism (Watch ministers with currency garlands)
O: Oath taking (Watch the live telecast if you are physically handicapped)
P: Parliament (Wastage of money)
Q: Quality ( What is that)
R: Rally (With out rally country comes to a stand still)
S: Sentence :( Enough time for some hijacking)
T: Temple (Find every where,even on the middle of a road.)
U: Utopia (Will remain a dream)
V: Vampires (Do not have to search)
W: Weather (A/C companies are worshiping Sun God)
X: Xanthoma (yellow vision ministers)
Y: Yes (Country of yes sir)
Z: Zigzag (A country of zigzag culture)
A country with glares of problems but still it’s surviving only due to its people.
The politicians, bureaucrats, judiciary are only interested in their personal affairs but show off as if there heart bleeds for the country.
A: accidents kill thousands of people but neither the society nor the road safety department tries to find out a solution to it. The road from Bhubaneswar to Purl is a death trap (recently two young photographers from AAJ-TAAK died due to RTA).I think the greatest killer (for young and fit people) in India is Road traffic accidents (RTA).
B: Beer & Bars (driving with beer is a fashion now a days.)
C: Corruptions/Cricket (A norm, others are doing why can’t I?)
D: Democracy (When ministers or Governors go on the road then only you realize you are in a kingdom not in democracy)
E: Electricity (Hook it or temper your meter, choice is yours)
F: Food ( Go to big bazaar)
& Flood (politicians dream but people's night mare)
G: Gundagiri (You have to bear with it or fight at your own risk)
H: Hoarding (Must be hand in glove with the Government)
I: Inflation & IPL (PM says both are good for economy)
J: Judiciary (Must live long to hear the verdict)
K: Kashmir (will remain as a tourist spot)
L: Literacy (Judge it from the sale of news papers)
M: Malaria, Maoists & Mines (Major hurdle for the country)
N: Narcissism (Watch ministers with currency garlands)
O: Oath taking (Watch the live telecast if you are physically handicapped)
P: Parliament (Wastage of money)
Q: Quality ( What is that)
R: Rally (With out rally country comes to a stand still)
S: Sentence :( Enough time for some hijacking)
T: Temple (Find every where,even on the middle of a road.)
U: Utopia (Will remain a dream)
V: Vampires (Do not have to search)
W: Weather (A/C companies are worshiping Sun God)
X: Xanthoma (yellow vision ministers)
Y: Yes (Country of yes sir)
Z: Zigzag (A country of zigzag culture)
01 April 2010
OLD HABITS DIE HARD
This is a common sight in the morning hours.You see bad (good?) habits die hard.
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