Amebic Liver Abscess With Intra-Biliary Rupture

The case of a large amebic liver abscess with an atypical presentation is reported. High output bile drainage persisted after ultrasound guided percutaneous catheter drainage because of a preexisting communication of the abscess with the right hepatic ductal system. The abscess was managed successfully by surgical evacuation and internal drainage into a defunctioned jejunal loop

Non-Hodgkin's lymphoma: Is India ready to incorporate recent advances in day to day practice?

Background : Non Hodgkin\u2032s Lymphoma (NHL) cure rates are increasing and morbidities are decreasing, with more active pharmacological agents and technological advancements. In spite of this, India is still battling with the prejudices of an economically and educationally impoverished patient base. Methods and Results : We analyzed NHL cases from 2000 to 2006 using data from case sheets. Of 303 cases, only 100 patients had complete workup and received some form of treatment. For 203 patients, reasons for non-compliance were: financial constraint (119), distance from center (38), inability of physician to provide guarantees of cure (13), poor prognosis/fear of recurrence (28)), preferences for alternate medicine (5). Most common investigations that could not be afforded for staging were whole body CT scans and bone marrow aspiration and biopsy. Thirteen patients were in stage III and 53 in Stage IV. The most common regimen was CHOP (Cyclophosphamide, Adriamycin, Vincristine, Prednisolone). Forty-five patients did not complete six courses of CHOP and 35 patients had significant delay. Reasons for delay were intermittent availability of cash (35), intolerable toxicities (30), absence of supportive care (21), given-up attitudes (17). Eighty-three patients suffered Grade III/IV debilitating toxicities. Overall survival at five years was 50%. Conclusions : NHL in India is no different from the developed world. However, there are disparities in survivorship and outcomes, due to un-affordability and attitudes of the patients. Therefore, we suggest the development of Community Health Insurance Schemes (CHIs), with the hospital as the nodal center to address the above mentioned issues

Haplós: Vibrotactile somaesthetic technology for body awareness

Inspired by somatic methodologies and neurophysiology, Haplós is a low-cost, wearable technology that applies vibrotactile patterns to the skin, can be incorporated in existing clothing and implements, and can be programmed and activated remotely. We review existing vibrotactile technologies and known uses of vibrotactile stimuli; describe the hardware, textile, and software components of Haplós; describe results from a quasi-experimental workshop to evaluate Haplós; and discuss future research and development directions

Prevention of febrile neutropenia: use of prophylactic antibiotics

Febrile neutropenia (FN) causes significant morbidity and mortality in patients receiving cytotoxic chemotherapy and can lead to reduced chemotherapy dose intensity and increased overall treatment costs. Antibiotic prophylaxis reduces the incidence of FN. Recent research and meta-analyses confirm that prophylactic fluoroquinolones decrease FN and infection-related mortality in patients with acute leukaemia and those receiving high-dose chemotherapy. Fluoroquinolone prophylaxis also lowers the incidence of FN and all-cause mortality following the first cycle of myelosuppressive chemotherapy for solid tumours. Levofloxacin has been the agent studied most thoroughly in this context. Although there is no convincing evidence that colonisation of individuals with resistant organisms due to antibiotic prophylaxis increases FN or mortality, such concerns must be taken seriously and the use of prophylaxis should be limited responsibly for patients with the greatest chance of benefit. Fluoroquinolone prophylaxis is well tolerated and cost-effective and should be offered to patients receiving chemotherapy for haematological malignancies and high-dose chemotherapy for solid tumours in which prolonged (>7 days) neutropenia is expected. It should also be considered for those receiving chemotherapy for solid tumours and lymphomas during the first cycle of chemotherapy when grade 4 neutropenia is anticipated

ICAR: endoscopic skull‐base surgery

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Atomic Capture of mumusup−sup - Mesons in Chemical Compounds and The "Fermiteller Z Law"

Experimental studies of the relative atomic mu --meson capture probabilities in the constituents of chemical compounds are described. Fermi and Teller had predicted that the atomic-capture probability is proportional to the nuclear charge of the atomic species weighted by its atomic concentration. This is sometimes referred to as the Fermi-Teller Z law.'' Previous experiments indicated no clear systematics to this capture process, and there are conflicts between the results of several measurements made with the same or similar compounds. In these experiments the capturing atom was identified by detection of either mesic x rays or decay electrons from mu /sup -/ mesons bound in the mesic K shell in the atomic species, In these experiments oxides and sulfides of some medium- and high-Z elements as well as two metallic solutions were used, and a nuclear capture product (neutron) rather than the decay electrons was detected. Results show that among the substances examIned, namely CuO, Sb/sub 2/O/sub 3, PbO, CuS, Sb/sub 2/S/sub 3/, PbS AgLi, and CuAu, the Z law'' behavior is not indicated either in insulators or in metals, although in all cases there is a preference for capturing in the atom of higher Z. If the atomic-capture probability is proportional to Z/sup n/ (n being any positive or negative number), then it is found that the experimental results fall approximately in the range n = 2/3 to n = 1.4, where n = 1 would define the prediction by Fermi and Teller, The measured atomic-capture ratios are: Cu/O = 6.14 plus or minus 0.85; Sb/O = 1.86 plus or minus 0.096; Pb/O = 4.56 plus or minus 0.53; Cu/S = 1.89i 0.18; Sb/S = 1.64 plus or minus 0.10; Pb/S = 2.87 plus or minus 0.35; Ag/Li = 11.66 plus or minus 3.39; Au/Cu = 0.34 plus or minus 0.032. In connection with this experiment it was alao necessary to measure the mu --meson lifetimes in a number of elements (including Au, which was not reported before). The measured lifetimes are (in nsec): S =498 plus or minus 17; Cu = 162.6 plus or minus 1.9; Ag = 84.4 plus or minus 1.0; Sb =91.3 plus or minus 1.4; Au = 68.6 plus or minus 1.3; Pb =74.1 plus or minus 1.0. (auth