Most of the GPs are not very confident of diagnosing pancreatic diseases. I am sure that after reading this issue they will develop confidence to face patients having pancreatic disorders. The credit for this goes to our guest editors Dr. SK Mathur and Dr. Kishore Adyanthaya who have really worked hard to collect a feast of articles for which they deserve to be congratulated heartily.
Although in private practice, E coli is the commonest cause of urinary tract infection. Liua Deodhar and Priya Miskeen from Bombay Hospital, on pg 124 show that 7.38% patients had Enterococcigrowth in the urine culture, the commonest being Enteroeoecus faecalis. This study is important because urinary tract infection is one of the most common complications seen in the hospital patient.
Everybody knows that hepatitis B can cause chronic hepatitis and cirrhosis but Deepak Amarapurk,ti al from Bombay Hospital on pg 128 have shown that even glomerulonephritis can be caused by this viru~ Since patients who are on dialysis are prone to get infection with this virus, a good workup is essential to establish that HBV infection is the "cause" of the kidney disease. Fortunately the authors had the services of Anjali Amarapurkar, one of the leading histopathologists of Mumbai. The diagnosis t~ importamt because some of these patients can be cured with a course of interferon.
On pg 135, Saluja et al from Mumbadevi Homoeopathic Hospital present their results of sputum cytology done in 40 patients. This sort of research work may not be worth the time and energy when molecular laboratories have been set up in different parts of this city. In fact, it is high time that the pathologists should start accepting sputum in their own laboratories by making the patients inhale lroi» :1 nebulizer with the help of saline. Thus the role of other secretions like saliva etc. will be ~uiititni/ed However, in a poor country like ours such studies do enlighten us.
Although the study of Malay Dave and HS Dhavale, psychiatrists from TN Medical College, oIt p~: 139, will be very useful to practising physicians, who blame coronary heart disease for every chest pain. it will be worth noting that such patients should be cleared by experienced cardiologists. This is because ischaemic heart disease can be due to disease of the small vessels or the spasm of the coronary arteries anti once branded as a psychiatric patient, there are chances that these patients will never go back to a cardiologist.
On pg 148, RB Gurav and S Kartikeyan from Rajiv Gandhi Medical College present their expericncc w levels of blood pressure in an urban community and show that 9.52% of the male popuation, hypertensive while 18.95% of the female population was hypertensive. It is possible th;c , carried out stress treadmill test or ambulatory blood pressure monitoring, the incidence would have been much higher.
Prolapse of uterus is extremely common in Indian women especially in elderly who not only refus any surgery but are often unfit for a major surgical procedure. Anahita Pandole et al from LTMG hospital. pg 159, describe "Introital tightening for huge prolapse in elderly unfit patients, a procedure which will he readily acceptable to our Indian population.
Pradyumna Raiturker and AA Salunkhe from Sassoon General Hospital, Pune, on pg 162, iiiciaitnr thcit experience of `Minimally invasive plate osteosynthesis (MIPO) in the treatment of multitragmentar%° fractures of the tibia' and show that excellent to good outcome was present in 93.75%, patients, a figure which is worth noting.
Pancreatic surgery is one of the most difficult surgeries which a GI surgeon faces. Bapat et al I rom Seth GS Medical College and KEM Hospital, on pg 175 present an excellent review of 'choice of ;urOtcal procedures for chronic pancreatitis'.
JC Patel et at, on pg 185, describe a new physical sign named as `BH Node' in the diagnosis of cervical spondylosis. Since all the GPs can do metaresearch in their private practice, it will not be difficult for an average GP to confirm the presence of this sign. Since cervical spondylosis is present in more or less the whole population above the age of 35-40 years, it will also be worthwhile noting whether the sign is only positive during the period of complaints; if so, then only it will be useful in private practice.
Pradeep Moonot and VG Telang from Bhagwati Hospital present the review of literature of the role of `the Mennen Plate in Periprosthelic hip fracture' on pg 207.
And finally, Apte and Tibrewala from Bombay Hospital on pg 211. Present a very interesting and rare case of biotinidase deficiency.