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Dr. D.S. Merchant's Articles in Psychology

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  • Dexamethasone in Adults with Bacterial Meningitis
    Methods:
    • a prospective, randomized, double-blind, multicenter trial of adjuvant treatment with dexamethasone, as compared with placebo, in adults with acute bacterial meningitis.
    • Dexamethasone (10 mg) or placebo was administered 15 to 20 minutes before or with the first dose of antibiotic and was given every 6 hours for four days.
    • The primary outcome measure was the score on the Glasgow Outcome Scale at eight weeks (a score of 5, indicating a favorable outcome, vs. a score of 1 to 4, indicating an unfavorable outcome).
    • The mortality rate among adults with acute bacterial meningitis and the frequency of neurologic sequelae among those who survive are high, especially among patients with pneumococcal meningitis.
  • Common Bleeding Disorders
    Hemophilia in Pakistan:
    • A relatively young country, with an ancient past, Pakistan achieved independence from Britain on August 14, 1947, after its bloody partition from India.
    • Pakistan's health care system has crumbled: public hospitals are in appalling condition, even basic treatment unavailable for many common disorders.
    • Private hospitals-modern and fully equipped-foster the only available research, and provide the most advanced and comprehensive care for people with hemophilia, but are extremely expensive and beyond the reach of most.
    • No infrastructure currently exists to provide public and free care to people with this lifelong bleeding disorder.
    • Of the estimated 12,000 people with hemophilia in Pakistan, only 3,100 have been identified.
    • Until early 1980, hemophilia was not even known to exist within the country, and only a few patients were alive. In 1982 the first blood bank was formed.
    • Currently only five major cities-Karachi, Lahore, Rawalpindi-Islamabad, Peshawar Multan, Faisalabad and Quetta-now have facilities to provide plasma or cryo.
    • And treatment at its best in Pakistan is still primitive by Western standards. Virally inactivated high or intermediate purity factor concentrates are available only to the minority elite, who are wealthy enough to pay out of pocket. But the majority of patients, the poor, receive plasma or cryo. They most often receive inferior plasma, which is not always screened for HBV, HCV and HIV.
  • Chronic Obstructive Pulmonary Disease. COPD
    A disease state characterized by airflow limitation that is not fully reversible. Airflow limitation is usually both progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases. Symptoms, functional abnormalities, and complications of COPD can all be explained on the basis of this underlying inflammation and the resulting pathology.
  • Chronic Gastric Diseases
    Overview:
    Gastric Causes of Chronic Vomiting
    - Chronic gastritis
    – Lymphocytic/plasmacytic
    – Eosinophilic
    – Associated with GHLOs
    – Parasitic
    – Reflux gastritis
    - Gastric foreign body
    - Gastric ulceration
    - Gastric motility disorders
    - Gastric neoplasia
  • COPD - Chronic Obstructive Pulmonary Disease
    History:
    SOB
    Productive cough
    Recurrent acute chest illnesses
    Exerbation – cold air, foggy weather, atmospheric pollution etc

    Smoking:
    Previous episodes
    Details of previous admissions
    Current treatment
  • Chronic Obstructive Pulmonary Disease - COPD
    GOLD Staging Criteria:
    GOLD Staging Criteria
    Stage O: Normal spirometry; chronic sx
    Stage 1 (Mild):
    FEV1> 80%
    Stage 2 (Moderate):
    2A: FEV1 50-80% predicted
    2B: FEV1 30-50% predicted
    Stage 3 (severe):
    FEV1/FVC < 70% AND:
    FEV1 < 30% predicted and clinical evidence of R heart failure
  • Bronchiectasis
    The bronchiectatic cavities may be lined by granulation tissue, squamous epithelium or normal ciliated epithelium. There may also be inflammatory changes in the deeper layers of the bronchial wall and hypertrophy of the bronchial arteries. Chronic inflammatory and fibrotic changes are usually found in the surrounding lung tissue.
  • Sleep Disorder
    Risks and ComplicationsYou have the right to be informed that the surgery may involve risks of unsuccessful results, complications, or injury from both known and unforeseen causes. Because individuals vary in their tissue circulation and healing processes, as well as anesthetic reactions, ultimately there can be no guarantee made as to the results or potential complications. The following complications have been reported in the medical literature.
  • Snoring & Sleep Opnea help?
    The treatments for sleep apnea include weight loss, avoidence of sleep depressants (alcohol, sleeping pills, etc), CPAP ( a mask used at night to keep the airway open), dental repositioning devices, and surgery.
  • Obstructive Sleep Opnea & Tonsils
    As noted above, most cases of obstructive sleep apnea in children is caused by enlarged tonsils and adenoids. Surgical interventions are therefore directed to what is causing the obstruction. In the case of enlarged tonsils and adenoids, tonsillectomy and adenoidectomy is usually successful in relieving the problem. If the problem is not the tonsils and adenoids, the cause of the obstruction must be determined. For example, surgery of the jaw may be required. In some cases, even a tracheostomy is necessary. Non-surgical therapies include oral prostheses (difficult in children), medications (steroids, stimulants), and weight reduction.
  • Acnezine To Cure All Types of Acne Lesions
    Acne lesions range in severity from comedones (blackheads and whiteheads) to nodules and cysts. Here is a brief definition of acne lesions:
  • Thyroid Problems Cause Hair Loss
    For both ‘men and women’ hair is simply your ‘crowning glory’. People all over the world place a huge deal of ‘social and cultural’ importance on ‘hair and hairstyles’. Most of you never miss your hair, until you start loosing it. That is usually when you enter a ‘mad race’ to find solutions and remedies to regain your ‘crowning glory’. Unfortunately, many conditions such as heavy amounts of stress, diseases, improper hair care and hormonal imbalance result in excessive loss of hair.
  • Increase Your Thyroid Function!
    Many individuals have symptoms of slow metabolism, including low body temperature, fatigue, weight gain, trouble losing weight and keeping it off, constipation, poor mood, heavy head, dry skin, and energy problems in the afternoon. Thyromine offers significant nutritional support to help maintain the normal function of thyroid hormone.
  • Hypothyroidism Causes Early Menopause
    Thyroid treatment system i.e. thyromine, works by stimulating the body to produce normal levels of thyroxine, because the supplements are all natural this may be done without side effects such headaches and insomnia. The body is also provided with necessary nutrients that help it to function properly. Thyroid treatment supplements may also help to restore deficient iodine levels, as adequate amounts are vital to a healthy thyroid gland.
  • Heavy Menstrual Periods? Blame It on Your Thyroid
    During heavy menstrual period with severe ache, one more noticeable symptom is the repeated occurrences of ‘hot flashes’, which is sudden feeling of heat in the upper part or all of woman’s body. Face and neck become extremely flushed. Flashes can be as mild as a light instant blush or just very severe enough to wake her from a sound sleep (also called night sweats). Most flashes usually last between 30 seconds and 5 minutes. The most common visible effects are the occurrences of red blotches all over the body.

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