Pub Date : 2024-01-01DOI: 10.4103/jpgm.jpgm_410_23
G A Marraro, C Yunfeng
{"title":"An inappropriate therapeutic intervention can delay completion of treatment: Caution required!","authors":"G A Marraro, C Yunfeng","doi":"10.4103/jpgm.jpgm_410_23","DOIUrl":"10.4103/jpgm.jpgm_410_23","url":null,"abstract":"","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10947730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.4103/jpgm.jpgm_617_23
P Vaideeswar, P A Sathe
{"title":"Placental pathology: Cracks in the feto-maternal bridge.","authors":"P Vaideeswar, P A Sathe","doi":"10.4103/jpgm.jpgm_617_23","DOIUrl":"10.4103/jpgm.jpgm_617_23","url":null,"abstract":"","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10947736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138465259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.4103/jpgm.jpgm_454_23
S Gulati, S Tripathy, T Gupta, S Gaba
Neural connections of the seventh cranial nerve with its neighboring nerves are common and well documented; however, communication with ansa cervicalis is as yet unknown. We present a case with such a connection found during cadaveric dissection, with hitherto unknown consequences. In this specimen, after giving the marginal mandibular and cervical branches, the cervicofacial division continued distally to communicate with the distal loop of ansa cervicalis. Presence of such connection may result in facial muscle paralysis on injury to the ansa or strap muscle paralysis on injury to the facial nerve, depending on the direction of nerve fibers. Such unusual connections bring to light the need for extreme care during surgeries in the neck to safeguard any such connections and when using the ansa as donor.
{"title":"Facial nerve communication with ansa cervicalis - An unusual anatomical variation.","authors":"S Gulati, S Tripathy, T Gupta, S Gaba","doi":"10.4103/jpgm.jpgm_454_23","DOIUrl":"10.4103/jpgm.jpgm_454_23","url":null,"abstract":"<p><p>Neural connections of the seventh cranial nerve with its neighboring nerves are common and well documented; however, communication with ansa cervicalis is as yet unknown. We present a case with such a connection found during cadaveric dissection, with hitherto unknown consequences. In this specimen, after giving the marginal mandibular and cervical branches, the cervicofacial division continued distally to communicate with the distal loop of ansa cervicalis. Presence of such connection may result in facial muscle paralysis on injury to the ansa or strap muscle paralysis on injury to the facial nerve, depending on the direction of nerve fibers. Such unusual connections bring to light the need for extreme care during surgeries in the neck to safeguard any such connections and when using the ansa as donor.</p>","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10947731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138465258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.4103/jpgm.jpgm_969_22
S Karmakar, P C Kala, A Humnekar
Raw area on the breast, especially when it is lactating, can lead to complications, including hyperprolactinemia and development of milk fistulae. A 25-year-old female presented with raw area over the left breast after 2 months of childbirth. She had history suggestive of necrotizing disease, which had primarily been managed elsewhere with debridement and dressings. We excised the raw area and applied split thickness skin grafts with minimal meshing. Bulky dressing prevented breastfeeding. On postoperative day 3, there were blebs containing milk underneath the graft. The blebs were drained and oral cabergoline was administered for 3 months. The skin graft healed well. If expression of breast milk is not possible then suppression of lactation should be considered before definitive cover of the raw area of breast.
{"title":"The curious case of milk collection under skin graft over the breast: Lessons learned!","authors":"S Karmakar, P C Kala, A Humnekar","doi":"10.4103/jpgm.jpgm_969_22","DOIUrl":"10.4103/jpgm.jpgm_969_22","url":null,"abstract":"<p><p>Raw area on the breast, especially when it is lactating, can lead to complications, including hyperprolactinemia and development of milk fistulae. A 25-year-old female presented with raw area over the left breast after 2 months of childbirth. She had history suggestive of necrotizing disease, which had primarily been managed elsewhere with debridement and dressings. We excised the raw area and applied split thickness skin grafts with minimal meshing. Bulky dressing prevented breastfeeding. On postoperative day 3, there were blebs containing milk underneath the graft. The blebs were drained and oral cabergoline was administered for 3 months. The skin graft healed well. If expression of breast milk is not possible then suppression of lactation should be considered before definitive cover of the raw area of breast.</p>","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10947732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-15DOI: 10.1097/00000637-199807000-00020
D. Franey, Z. Frenzel, D. Manchester
Foreign-body aspiration in adults is considerably less common than in children. The clinical course can be life-threatening but often presents in a more indolent manner, leading to difficulties with diagnosis. We report the retrieval of a buprenorphine-naloxone wrapper by flexible bronchoscopy in a 44-year-old male patient with COVID-19 who was on mechanical ventilation. Following removal, the patient completed treatment for COVID-19, his respiratory status improved, and he was discharged from the hospital. Flexible bronchoscopy is an effective means of diagnosis and retrieval of foreign bodies in the distal airway.
{"title":"Waiting to exhale","authors":"D. Franey, Z. Frenzel, D. Manchester","doi":"10.1097/00000637-199807000-00020","DOIUrl":"https://doi.org/10.1097/00000637-199807000-00020","url":null,"abstract":"\u0000 \u0000 Foreign-body aspiration in adults is considerably less common than in children. The clinical course can be life-threatening but often presents in a more indolent manner, leading to difficulties with diagnosis. We report the retrieval of a buprenorphine-naloxone wrapper by flexible bronchoscopy in a 44-year-old male patient with COVID-19 who was on mechanical ventilation. Following removal, the patient completed treatment for COVID-19, his respiratory status improved, and he was discharged from the hospital. Flexible bronchoscopy is an effective means of diagnosis and retrieval of foreign bodies in the distal airway.\u0000","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139000263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.4103/jpgm.jpgm_568_23
D Ghosh, M Thomas
{"title":"Surgical care delivery in India during the COVID pandemic.","authors":"D Ghosh, M Thomas","doi":"10.4103/jpgm.jpgm_568_23","DOIUrl":"10.4103/jpgm.jpgm_568_23","url":null,"abstract":"","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10846803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41158974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.4103/jpgm.jpgm_707_23
V Taskar
{"title":"Chronic thromboembolic pulmonary hypertension - Time is of the essence.","authors":"V Taskar","doi":"10.4103/jpgm.jpgm_707_23","DOIUrl":"10.4103/jpgm.jpgm_707_23","url":null,"abstract":"","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10846817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41242701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-01DOI: 10.4103/jpgm.jpgm_608_23
S Karande, P Vaideeswar, T More
This retrospective study analyzed the concordance level between clinical and autopsy diagnosis of heart diseases over six years. Utilizing the Goldmann classification, the concordance rate was found to be 38.1%. Major discrepancies (Class I and II) were found in 39% cases and minor (Class III and IV) in 22.9% cases.
{"title":"How often are heart diseases correctly diagnosed antemortem in children with fatal illnesses? A retrospective review of medical and autopsy records.","authors":"S Karande, P Vaideeswar, T More","doi":"10.4103/jpgm.jpgm_608_23","DOIUrl":"10.4103/jpgm.jpgm_608_23","url":null,"abstract":"<p><p>This retrospective study analyzed the concordance level between clinical and autopsy diagnosis of heart diseases over six years. Utilizing the Goldmann classification, the concordance rate was found to be 38.1%. Major discrepancies (Class I and II) were found in 39% cases and minor (Class III and IV) in 22.9% cases.</p>","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10846810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41175714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-01DOI: 10.4103/jpgm.JPGM_109_19
B Oza, S Radhakrishna, P Pipalava, V Jose
Biosimilars are being marketed in India since 2000. Like biologics, biosimilars have a large size, complex structure, and complicated manufacturing process, and they are produced in a living organism. It requires specialized delivery devices for administration and needs tighter temperature control to prevent degradation. As biosimilar development follows abbreviated pathway, adverse events (AEs) previously unknown during a clinical trial may be detected postmarketing. In India, the awareness on pharmacovigilance has increased significantly after implementation of the pharmacovigilance guidance in January 2018. However, biologics require tighter monitoring to ensure their safety and efficacy. This review article discusses the importance of pharmacovigilance for biosimilars, how it is different from generics, and provides recommendations to sensitize clinicians and researchers about the requirement of a different approach to improve pharmacovigilance for biosimilars. Pharmacovigilance for biosimilars is as important as it is for innovator biologics and more important than that for generics.
{"title":"Pharmacovigilance of biosimilars - Why is it different from generics and innovator biologics?","authors":"B Oza, S Radhakrishna, P Pipalava, V Jose","doi":"10.4103/jpgm.JPGM_109_19","DOIUrl":"https://doi.org/10.4103/jpgm.JPGM_109_19","url":null,"abstract":"<p><p>Biosimilars are being marketed in India since 2000. Like biologics, biosimilars have a large size, complex structure, and complicated manufacturing process, and they are produced in a living organism. It requires specialized delivery devices for administration and needs tighter temperature control to prevent degradation. As biosimilar development follows abbreviated pathway, adverse events (AEs) previously unknown during a clinical trial may be detected postmarketing. In India, the awareness on pharmacovigilance has increased significantly after implementation of the pharmacovigilance guidance in January 2018. However, biologics require tighter monitoring to ensure their safety and efficacy. This review article discusses the importance of pharmacovigilance for biosimilars, how it is different from generics, and provides recommendations to sensitize clinicians and researchers about the requirement of a different approach to improve pharmacovigilance for biosimilars. Pharmacovigilance for biosimilars is as important as it is for innovator biologics and more important than that for generics.</p>","PeriodicalId":94105,"journal":{"name":"Journal of postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6813686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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