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Celebrate good health at our Women's Health Fair, Saturday and Sunday, October 1819, 11 a.m.4 p.m. Here are a few highlights of the. This case describes the acute onset of OCD in an adolescent boy undergoing treatment for relapse of acute lymphoblastic leukemia. The acute onset of his symptoms following abrupt steroid cessation warrants this as a possible cause of his symptoms. Conversely, steroid induction of symptoms or factors involving the patient's underlying leukemia are also considerations. Clinicians must be alert to the emergence of uncommon psychiatric symptoms in conjunction with corticosteroid use and discontinuation and in the context of significant medical illness. Further study is warranted to better characterize both the diverse psychiatric effects involved with corticosteroid treatment and the psychological sequelae of cancer at different developmental stages. Recognise the fear of those who are suffering, writes Meg Gurry. Following a heart valve operation with many complications, the author wrote the following: I crossed an invisible but nevertheless real boundary to become part of the undifferentiated "sick" of our society. It was not a pleasant place. I did however, learn a few things along the way. The experience gave me an insight into the psychologically transforming nature of illness, and just how emotionally complex the whole process can be. In her book, Tiger's Eye, Melbourne historian Inga Clendinnan discusses her experiences as a liver transplant patient. One of her most interesting revelations, I felt, was her observation that the gap between the sick and the well in our society is as least as great as the other big gaps of race, gender and class. It certainly felt that way for me. Now having crossed back to rejoin the "healthy" side of the divide, I'm left wondering how best we can reduce it to make the experience of illness more manageable. This is not, strictly speaking, a medical problem. Rather it is a question of medical culture and therefore, one in which the medical profession must be centrally implicated. It was during slow recovery time that I began thinking about sickness and health in ways I never had before. What had I learnt? My first epiphany related to the debilitating impact of fear in seriously ill patients. Once ill ; . I became psychologically and emotionally paralysed by fear. This in turn deepened my sense of alienation from "normal" life, further inhibited my digestive system, and reduced my strength even more. It seems to me that the medical process has not yet accommodated and worked out adequate responses to patients' fear.The night before my major surgery, the anaesthetist listed all the disasters that could eventuate in the next few days, including a 1% chance of dying of stroke. 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A part of our business focus is product pruning. During 1998-99, we identified 35 packs that were very minor products that were stagnant and had insignificant market share. These were eliminated and resulted in a one-time decline in other products. NPILs speciality divisions have also performed very well in 1998-99. Biotek sales have increased by 70% compared to 1997-98, and Diagnostics by 31%. In both these high technology-high growth areas, NPIL is now a clear market leader in India. Their growth is expected to further accelerate in 1999-2000. Much of this growth would not have occurred without NPILs focus on three key drivers: i ; decentralisation, ii ; empowerment, and iii ; networking. NPIL is decentralised at two levels the strategic business units SBUs ; and the State Business Managers SBMs ; . SBUs were set up last year. These focus on specific businesses or operational units, with clearly delegated responsibilities for sales, profits and development of human capital. SBUs have to keep a very tight watch on the monthly return on capital employed ROCE ; in the unit, provide enhanced training and development programmes, and need to focus on the logistics of modern supply chain management. SBUs have worked well at NPIL. These have increased the empowerment of managers, created a strong sense of ownership and healthy competition, and have driven growth, profits as well as innovation. In 1998-99 NPIL took another step in managerial decentralisation. Each significantly large state within India was set up as a profit centre under the charge of State Business Managers SBMs ; . Each SBM has sales, costs, profits, receivables, and HRD-related targets, and is expected to interact with the various SBUs at the centre to achieve these goals. In the pharmaceutical industry, state level profit centres like SBMs are probably unique to NPIL. Information networking is critical to managing such a decentralised system. NPIL has a state-of-the-art management information system which is continuously improved upon in terms of hardware, software and throughput. In 1999-2000, we shall be introducing another novel concept called cyber-centres in every state for training, conferencing and analysing medical cases and procedures.
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Six had chronic coronary artery disease two with diabetes mellitus ; , four congestive heart failure secondary to hypertension one with diabetes mellitus ; , and one idiopathic cardiomyopathy. Nine of the 1 patients were in New York Heart Association functional class III or IV before admission. Each patient had a left ventricular ejection fraction of 0.40 or less. The mean, for example, nizoral lotion. B. The Medicines Control Council of South Africa "MCC and nolvadex. 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The purpose of this article is to review the potential role of nuclear medicine scanning, especially with 67Ga, in the presumptive diag nosis and clinical management of patients with renal parenchymal malacoplakia RPMP ; , a rare disease associated with coliform bac terial infection of the kidney and characterized by chronic unresolving inflammatory infiltrates containing von Hansemann macro phages in the renal parenchyma. Methods: Published cases of RPMP were collected from the archival literature by searching the MEDLINE database and by reviewing bibliographic references con tained in articles on malacoplakia. Data on the clinical features and radiographie evaluation of patients with RPMP were extracted from the clinical case reports. Results: Forty-three cases of RPMP published over the past 20 yr were identified. Ten of the 43 patients 23% ; had 67Ga scanning as a component of their diagnostic evaluation. In all 10 patients, renal uptake of 67Ga was classified as intense. Two of those 10 patients had serial 67Ga scanning per formed to assess response to antibiotic treatment; both patients exhibited decreased uptake or complete resolution of abnormal renal uptake over time, a finding also exhibited by our patient. Conclusion: Intense renal uptake of 67Ga, typically in the clinical setting of fever, progressive renal failure and nephromegaly, strongly supports a diagnosis of RPMP. In those patients receiving pro longed antimicrobial therapy for RPMP, resolution of abnormal 67Ga uptake over time may provide an objective endpoint for treatment. |