On page 366, Prerana Shroff et al from Seth GS Medical
College have described a ‘Comparative Study of epidural
Tramadol v/s Bupivacaine for postoperative analgesics
using disposable non-mechanical elastomeric balloon pump’.
They found that local anaesthetic infusion via an elastomeric
balloon pump can provide good analgesia without significant
respiratory depression or haemodynamic alteration and
nausea/vomiting. If some more studies like this can be
done, it may be very helpful in private practice.
HIV infection can affect any system, but the most interesting
lesions occur in the CNS. On page 370, Sachin Thorat et
al from Bombay Hospital Institute of Medical Sciences
have described ‘Neurological Manifestations in 102
patients admitted with Immunosuppression due to HIV infection’.
If in future, some more studies can confirm the impression
of Rangnekar et al, from Gandhi Medical College, Bhopal,
on the subject of ‘Recurrent abortions’ associated
with cancer history in the same or preceding generations,
on page 381, it might have to be taught to medical students
to help history taking.
Invasive rheumatology must be encouraged and should be
used more often in private practice for diagnostic purposes.
Sangeeta Kulkarni (Bhide) et al from Terna Medical College,
Navi Mumbai, on page 386, show the ‘Role of synovial
fluid analysis and synovial biopsy in joint diseases’.
There is a lot of difference of opinion amongst the physiotherapists
regarding good ‘Quadriceps Exercises’. On
page 420, Sushil Sabnis et al from HBMG Hospital, Mumbai
discuss the subject of ‘Quadriceps Exercises’.
Prem Sheth et al from Bombay Hospital Institute of Medical
Sciences and Medical Research Centre, on page 427, report
a rare case of intracranial tumour, which was ‘Choroid
Ali Reza Shojai et al from MGM Medical College, Navi Mumbai,
on page 434, report a very interesting case of ‘Obstructed
hernia in male intersex’.
Devang Desai et al from Bombay Hospital, on page 443,
present a report on ‘CT findings in a case of Tracheobronchopathia
Osteochondroplastica’, which is very interesting
Finally, total hip replacement is becoming extremely common.
In this context, it will be interesting to read the article
‘Femoral artery injury secondary to total hip arthroplasty’
by Pawan Kumar et al from LTMG Hospital, on page 450.
Are atypical neuroleptics better than the
Newer “atypical” neuroleptic drugs may
not be better than typical neuroleptics in the management
of the behavioural and psychological symptoms of
dementia. Lee and colleagues reviewed five trials
including 1570 patients, evaluating the four oral
atypical antipsychotic therapies in patients with
the disorder. They found that atypical antipsychotic
drugs were superior to placebo, but not to typical
antipsychotic drugs. Adverse events were common
even with the new drugs and included extrapyramidal
symptoms, somnolence, and abnormal gait.
BMJ, 2004; 329 : 75.