A rare cause of haematemesis: retrograde jejunogastric intussusception.

Retrograde Jejunogastric intussusception is a well-recognised, rare but potentially fatal, long-term complication of gastro-jejunostomy or Billroth-II reconstruction. Only about 200 cases have been reported in literature to date. Diagnosis of this condition is difficult in most of the cases. To avoid mortality early diagnosis and prompt surgical intervention is mandatory. Since gastrojejunostomies with vagotomy are on a declining trend, it is extremely rare to come across such a complication. We report such a case that presented with haematemesis.

Pneumomediastinum and pneumopericardium--a clinical condition of multispeciality interest.

Pneumomediastinum with its usual associations like pneumopericardium has been described in detail including review of literature, aetiopathogenesis, symptoms and signs, complications, necessary investigations and management protocol by the authors in this article of multispeciality interest.

Perceptual-cognitive rehabilitation in left hemiplegia

Perceptual-cognitive impairments that occur following right hemisphere brain damage and its circuits are common and interfere with recovery. The therapeutic intervention incorporates principles of neuropsychology and guiding techniques for restoration of function and maximal independence within the scope of patient's challenges. Identification of impairments, which are not physically seen in the patient like his hemiplegia are observed by the therapist as he performs various functional activities. These observations assist the therapist to draw her own inferences, to plan appropriate therapeutic strategies and to set short and long term goals. Comprehensive and holistic treatment approach is essential to improve the functional activities and spatial awareness, Patient's active participation, family and social support enhances the rehabilitation programme

A study on relative contributions of the history, physical examination and investigations in making medical diagnosis.

Here we report an attempt to quantitate the relative contributions of the history, physical examination and investigations in making medical diagnosis. In this prospective study of 100 patients, with new or previously undiagnosed conditions, we listed their differential diagnosis with confidence score; after the history, after physical examination and after the investigations. In two patients no definite final diagnoses could be arrived even after extensive investigation--these two cases were excluded from the study. In seventy seven patients (78.58%) patients, the history led to diagnosis. The physical examination led to diagnosis in eight patients (8.17%); and investigations led to diagnosis in 13 patients (13.27%). The confidence in correct diagnosis increased from 6.36 on a scale of one to ten after the history to 7.57 after physical examination and 9.84 after investigations--implying that history, physical examination and investigation have their own limitation at each stage and an integrative approach is needed in making a medical diagnosis with more emphasis on history.

Idiopathic intracranial hypertension [Pseudotumor cerebri] in childhood

Two girls with idiopathic intracranial hypertension [psudotumor cerebri] are reported. The diagnostic criteria and management are discussed