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Biomedical subjects

A Deshpande

Publications and source records attributed to A Deshpande.

80 records · Page 5Linked to original sources

Oral rehydration for diarrhoeal diseases in children.

Electrolyte disturbances and response to oral electrolyte therapy were studied in 88 children with mild to moderate dehydration due to acute gastroenteritis. A solution with a sodium concentration of 50 mmol/litre was tested in a group of 60 children and results obtained with those in a group of 28 children taking a standard oral solution with a concentration of 90 mmol/litre. Adequate hydration was accomplished in both groups and none of them received intravenous fluids. Neither group received additional water or other fluid in the first 24 hours. There was a significant rise in sodium concentration with both solutions and none of the children developed hypernatraemia. A significant rise in potassium is observed in children with clinical kwashiorkor when hydrated with the low sodium solution.

Administration, Oral↗

Use of general-purpose negation detection to augment concept indexing of medical documents: a quantitative study using the UMLS.

OBJECTIVES: To test the hypothesis that most instances of negated concepts in dictated medical documents can be detected by a strategy that relies on tools developed for the parsing of formal (computer) languages-specifically, a lexical scanner ("lexer") that uses regular expressions to generate a finite state machine, and a parser that relies on a restricted subset of context-free grammars, known as LALR(1) grammars. METHODS: A diverse training set of 40 medical documents from a variety of specialties was manually inspected and used to develop a program (Negfinder) that contained rules to recognize a large set of negated patterns occurring in the text. Negfinder's lexer and parser were developed using tools normally used to generate programming language compilers. The input to Negfinder consisted of medical narrative that was preprocessed to recognize UMLS concepts: the text of a recognized concept had been replaced with a coded representation that included its UMLS concept ID. The program generated an index with one entry per instance of a concept in the document, where the presence or absence of negation of that concept was recorded. This information was used to mark up the text of each document by color-coding it to make it easier to inspect. The parser was then evaluated in two ways: 1) a test set of 60 documents (30 discharge summaries, 30 surgical notes) marked-up by Negfinder was inspected visually to quantify false-positive and false-negative results; and 2) a different test set of 10 documents was independently examined for negatives by a human observer and by Negfinder, and the results were compared. RESULTS: In the first evaluation using marked-up documents, 8,358 instances of UMLS concepts were detected in the 60 documents, of which 544 were negations detected by the program and verified by human observation (true-positive results, or TPs). Thirteen instances were wrongly flagged as negated (false-positive results, or FPs), and the program missed 27 instances of negation (false-negative results, or FNs), yielding a sensitivity of 95.3 percent and a specificity of 97.7 percent. In the second evaluation using independent negation detection, 1,869 concepts were detected in 10 documents, with 135 TPs, 12 FPs, and 6 FNs, yielding a sensitivity of 95.7 percent and a specificity of 91.8 percent. One of the words "no," "denies/denied," "not," or "without" was present in 92.5 percent of all negations. CONCLUSIONS: Negation of most concepts in medical narrative can be reliably detected by a simple strategy. The reliability of detection depends on several factors, the most important being the accuracy of concept matching.

Abstracting and Indexing↗

Granular cell ameloblastoma of the jaw. A report of two cases with fine needle aspiration cytology.

BACKGROUND: Fine needle aspiration cytology (FNAC) of jaw tumors has not been studied extensively. Ameloblastomas are jaw tumors that show a wide morphologic spectrum and thus may pose some diagnostic difficulties. Of the many types, granular cell ameloblastoma (GCA) is an uncommon variant that possesses distinctive features. To the best of our knowledge, there have been no previous reports on the cytologic findings of GCA. We present two cases diagnosed by FNAC. CASES: Two cases of GCA were diagnosed on cytology and subsequently confirmed on histology. Both patients presented with a large, lytic jaw tumor. FNAC smears showed characteristic granular cells along with spindle and basaloid cells. CONCLUSION: Although GCAs are rare tumors, they possess distinctive features that permit an accurate diagnosis, provided that this entity is kept in mind. This tumor has to be differentiated from cystic odontogenic lesions, epulis and granular cell myoblastoma. An accurate preoperative diagnosis also helps the surgeon to plan more extensive surgery as these tumors show a great propensity for malignant change and metastases.

Ameloblastoma↗

Shouldice's herniorrhaphy versus Moloney's darn herniorrhaphy in young patients (a prospective randomised study).

AIMS: Shouldice's repair (SR) and Moloney's darn repair (DR) are commonly practised repairs for hernias in the young age group with acceptably low recurrence rates. The SR is considered technically challenging and difficult, while the DR is gaining popularity in recent years. Therefore, there is a need to compare these repairs. MATERIAL AND METHODS: To compare these techniques a total of 50 cases (age group 18-40 years) were randomised to two groups (SR 25, DR 25). These were well matched for age, the side and the type of hernia. Both groups were studied with respect to operative time; postoperative pain at 6,12 and 24 hours (evaluated by pain scale 1-10) need for analgesia, ambulation (evaluated by a four-point scale), complications and return to work. RESULTS: The SR required a longer time (average 81 minutes) compared to DR (average 43 minutes). Patients undergoing SR complained of pain of a higher scale at 6, 12 and 24 hours post surgery and had a significant higher need for analgesia on day 1 and 2 (p < 0.05). Ambulation grades were significantly better in the DR group on the first postoperative day (p < 0.05). There was no significant difference in the two groups with respect to postoperative complications, return to work, and recurrences rate (2-year follow-up). CONCLUSION: The SR and DR are comparable for young patients having a primary hernia. However, DR is superior in terms of the time taken, post-operative pain, need for analgesia and early ambulation.

Adult↗

Isolated breast mucormycosis.

Mucormycosis is unusual in surgical practice. Awareness of the classical findings leads to early detection. Excisional therapy whenever possible along with systemic antifungal treatment is the key to successful outcome. A 70 year old female, a known case of diabetes mellitus and chronic obstructive pulmonary disease, on inhalational steroids and oral hypoglycemic agents, presented to us with complaints of sudden onset pain, redness and swelling of left breast. A diagnosis of severe mastitis was made and a release incision was taken. The entire breast became gangrenous in next 24 hours and simple mastectomy had to be performed as a life saving measure. Histopathology revealed mucormycosis of breast. To the best of our knowledge this is the first reported case of mucormycosis of breast in the English literature.

Aged↗

Pancreatic leiomyosarcoma in a middle-aged lady.

Leiomyosarcoma is an uncommon malignant tumour of the pancreas. Many retroperitoneal leiomyosarcomas grow silently and are extremely large when diagnosed. We report a 45 year old lady who presented with abdominal lump and haemoptysis. Ultrasound guided biopsy of the mass revealed a pancreatic leiomyosarcoma. The patient had lung metastasis and received chemotherapy. She is alive with disease at last followup.

Diagnosis, Differential↗