Prescribing Practices of Doctors in Management of Acute Diarrhea.

We conducted this study to determine the prescribing practices of doctors in management of acute diarrhea in children in the age group of 6 month -5 year. Antimotility agents and low/zero lactose formula was prescibed in 9.8% and 24.7% cases, respectively by general practitioners.In about 66.6% and 5.7% cases pre/probiotics were prescribed and oral rehydration salt (ORS) were not prescribed by the pediatricians.

Management of primary and metastatic triple negative breast cancer: Perceptions of oncologists from India.

Background: In order to document the understanding of current evidence for the management of triple negative breast cancer and application of this knowledge in daily practice, we conducted an interactive survey of practicing Indian oncologists. Materials and Methods: A core group of academic oncologists devised two hypothetical triple negative cases (metastatic and early breast cancer, respectively) and multiple choice options under different clinical circumstances. The respondents were practicing oncologists in different Indian cities who participated in either an online survey or a meeting. The participants electronically chose their preferred option based on their everyday practice. Results: A total of 152 oncologists participated. Just over half (53.8%) preferred taxane based chemotherapy as first-line chemotherapy in the metastatic setting. In the adjuvant setting, a taxane regimen was chosen by 61%. Over half of respondents (52.6%) underestimated the baseline survival of a patient with node positive triple-negative tumor and 18.9% overestimated this survival compared to the estimate of the Adjuvant! program. Discussion: This data offers insight into the perceptions and practice of a diverse cross-section of practicing oncologists in India with respect to their therapeutic choices in metastatic and adjuvant settings in triple negative breast cancer.

Transthoracic decompression of emphysematous bulla: A novel experience.

Emphysematous bullae are closed air containing spaces in lung parenchyma that may severely compromise lung function in patients of chronic obstructive pulmonary disease (COPD). We describe a simple and minimally invasive procedure to decompress a large emphysematous bullae in a patient with advanced COPD and high surgical risk. Transthoracic decompression of the bulla was accomplished under short-acting anaesthesia and muscle relaxation resulting in significant symptomatic, radiological and functional improvement.

Optimising management of cancer related anemia.

This review article provides the current recommendations and evidence for the correct management of anemia in cancer patients. The various options available include transfusions, iron and erythropoiesis stimulation. The indications, pros and cons of each option are discussed.

Remediation of attention deficits in head injury.

Head injury is associated with psychological sequelae which impair the patient's psychosocial functioning. Information processing, attention and memory deficits are seen in head injuries of all severity. We attempted to improve deficits of focused, sustained and divided attention. The principle of overlapping sources of attention resource pools was utilised in devising the remediation programme. Tasks used simple inexpensive materials. Four head injured young adult males with post concussion syndrome underwent the retraining program for one month. The patients had deficits of focused, sustained and divided attention parallel processing, serial processing, visual scanning, verbal learning and memory and working memory. After the retraining programme the deficits of attention improved in the four patients. Serial processing improved in two patients. Parallel processing and neuropsychological deficits did not improve in any patient. The symptom intensity reduced markedly and behavioural functioning improved in three of the four patients. The results supported an association between improving attention and reduction of symptom intensity. Attention remediation shows promise as a cost effective, time efficient and simple technique to improve the psychological and psychosocial functioning of the head injured patient.

Brachytherapy for solid tumors in children.

The standard treatment after surgery and chemotherapy in pediatric solid tumors is external beam to the tumor with a generous (5 cm) margin for local control. This treatment is given over a five to six-week period, requires use of repeated deep sedation, and leads to unacceptable morbidity (especially organ and bone-growth retardation) in infants and younger children. Limited volume irradiation by brachytherapy over a few days may be sufficient therapy for children treated with aggressive chemotherapy. Brachytherapy allows high doses of radiation to be limited accurately to the tumor bed, spares the surrounding normal tissues, and thus minimizes late sequelae. Manually afterloaded removable iridium-192, iodine-125, and cesium-137 have been used with good results. The major disadvantages of LDR brachytherapy are: the necessary sedation and immobilization of younger children to prevent accidental removal of the implants during the entire period, radiation exposure to the medical personnel and the parents, and the psychological effect of separating parents from their child. Using a low energy radionuclide such as iodine-125, or remote afterloading technology with LDR and PDR reduces radiation exposure hazards, but prolonged sedation and immobilization are still required. HDR brachytherapy not only eliminates the radiation exposure hazards but, in addition, eliminates the other disadvantages of brachytherapy thereby extending treatment to the infants and younger children. The long term effects of brachytherapy need further study.