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Biomedical subjects

J Philip

Publications and source records attributed to J Philip.

At least 19 recordsLinked to original sources
PubMed2007

Anger in palliative care: a clinical approach.

Anger in patients and families is a common problem in the care of persons with advanced disease. Whereas it is widely accepted that anger may be a justifiable reaction to significant illness and loss, it frequently creates difficulties for the doctors involved in care. In particular, there is often a personal impact on the doctor at whom anger is directed. This paper examines results of qualitative research with palliative care workers in the context of the broader published literature and the authors' clinical experiences. The ability to interact effectively with angry patients is a skill that is often learned with experience and is extremely useful in both transforming the patients' reaction into a more creative emotion and in developing a therapeutic relationship. Despite conscientious efforts, however, a few patients continue to be angry. A practical approach to anger, useful for the clinician directly involved in care, is outlined along with some strategies to adopt in the face of persistent anger.

Adaptation, Psychological↗
PubMed2006

Semiorganic nonlinear optical material for frequency doubling: preparation and properties of sodium p-nitrophenolate dihydrate (SPNP).

Sodium p-nitrophenolate (SPNP), a semiorganic nonlinear optical (NLO) material useful for frequency doubling in the IR region, has been synthesized. The solubility studies have been carried out in the temperature range 30-50 degrees C. Single crystals (size 12 mmx7 mmx4 mm) have been grown by slow evaporation of the saturated aqueous solution (methanol as solvent) at 30 degrees C. The lattice parameters of the grown crystals have been determined by single crystal X-ray diffraction technique. The UV-vis-NIR transmittance spectrum has been recorded in the range 200-1500 nm. The molecular structure was confirmed by FT-IR and FT-NMR. SPNP was thermally stable up to 103 degrees C as determined by TG/DTA curves. By a modified Kurtz and Perry method, the powder SHG efficiency was found to be five times that of KDP and its phase matching property was established. Laser damage threshold of SPNP was determined using a Nd:YAG laser.

Crystallization↗
PubMed2006

Carrier-controlled ferromagnetism in transparent oxide semiconductors.

The search for an ideal magnetic semiconductor with tunable ferromagnetic behaviour over a wide range of doping or by electrical gating is being actively pursued as a major step towards realizing spin electronics. A magnetic semiconductor having a high Curie temperature, capable of independently controlled carrier density and magnetic doping, is crucial for developing spin-based multifunctional devices. Cr-doped In(2)O(3) is such a unique system, where the electrical and magnetic behaviour-from ferromagnetic metal-like to ferromagnetic semiconducting to paramagnetic insulator-can be controllably tuned by the defect concentration. An explicit dependence of magnetic interaction leading to ferromagnetism on the carrier density is shown. A carrier-density-dependent high Curie temperature of 850-930 K has been measured, in addition to the observation of clear magnetic domain structures in these films. Being optically transparent with the above optimal properties, Cr-doped In(2)O(3) emerges as a viable candidate for the development of spin electronics.

Alloys↗
PubMed2006

Patient reporting and doctor recognition of dyspnoea in a comprehensive cancer centre.

The aim of this study was to examine different aspects of dyspnoea in an Australian acute cancer care population, specifically prevalence, recognition, reporting, symptom control methods and prognostic significance. Patients and treating hospital medical officer were concurrently asked to evaluate the experience of dyspnoea. The prevalence of dyspnoea was 33%, with discrepancies observed between patient and doctor reporting of the presence of dyspnoea (P = 0.021), as well as its intensity and distress. Symptomatic methods for the relief of cancer-related dyspnoea are underused, particularly opioids. The medical underestimation of dyspnoea is consistent with previous studies and potentially detracts from effective management of this symptom.

Adult↗
PubMed2005

Amplification of femtosecond laser filaments in Ti:sapphire.

Femtosecond laser filamentation is studied in a broadband amplifying medium, sapphire doped with electronically excited Ti ions. Evidence for fluence amplification of self-guided pulses, increase of filamentation length, as well as a lowering of the input laser power necessary for filamentation is reported.

Journal Article↗
PubMed2005

Relationship between infant birth weight </=2000 g and maternal zinc levels at Muhimbili National Hospital, Dar Es Salaam, Tanzania.

The objective of this study was to determine the relationship between infant birth weight </=2000 g and maternal zinc status. The study was an unmatched case control. The study was conducted at Muhimbili National Hospital (MNH) in labor ward, from July to September 2002. The study population consisted infants with birth weight of or=3000 g and their mothers formed the control group. There were 81 cases and 84 control infant-mother pairs. Maternal and infants venous blood samples were taken after delivery. Plasma zinc was analyzed using Atomic Absorption Spectrophotometer method. Data were analyzed using Epi-info version 6. Logistic regression was used to assess the contribution of other risk factor on infant birth weight. Date was converted to STATA format and logistic regression analysis was done using STATA program version 8. The results showed that there is significant relationship between infant birth weight and maternal zinc levels. Mothers with low zinc levels were two and half time more at risk of having an infant weighing <or=2000 g compared to those with normal zinc levels (OR 2.62, CI 1.36-5.73 p = 0.002). Cord blood zinc concentration was significantly lower in low birth weight compared to control babies. Infants with low zinc levels were almost three times more at risk of being born with birth weight <or=2000 g compared to those with normal zinc levels (OR 2.79, CI 1.36-5.73 p = 0.0016). This study indicated that there is a relationship between low infant birth weight <or=2000 g and maternal zinc deficiency. There is a relationship between infant birth weight and infant zinc levels. Maternal age of <or=19 years is associated with low infant birth weight and low maternal zinc levels. Plasma zinc level in mother correlated with plasma zinc level is their offspring.

Adult↗
PubMed2005

Importance of TURP in diagnosing prostate cancer in men with multiple negative biopsies.

OBJECTIVE: Patients with persistently elevated PSA and multiple negative TRUS guided 12-core biopsies, present a clinical conundrum. We evaluated the efficacy of transurethral biopsy and/or resection in abetting prostate cancer diagnosis. PATIENTS AND METHODS: Eleven patients who had prostate cancer diagnosed only on TURP following TRUS guided (24-48 cores) negative biopsies, including five who underwent radical prostatectomy were assessed. Extent and site of tumour was analysed in relation to the TURP cavity. RESULTS: Mean age was 61.8 years (PSA range: 3.8-20.9 ng/ml.). Patients had TURP for worsening LUTS with chippings diagnosing invasive prostate cancer. Organ confined anterior prostate cancer was diagnosed in five who had radical prostatectomy. CONCLUSION: Anteriorly directed transurethral biopsies and/or TURP help in the diagnosis of prostate cancer in patients with multiple negative biopsies. Patients with anterior prostate cancer tend to have organ-confined disease even with higher PSA.

Aged↗
PubMed2005

Coexistence of ferromagnetism and superconductivity in Ni/Bi bilayers.

In spite of a lack of superconductivity in bulk crystalline Bi, thin film Bi deposited on thin Ni underlayers are strong-coupled superconductors below approximately 4 K. We unambiguously demonstrate that by tuning the Ni thickness the competition between ferromagnetism and superconductivity in the Ni/Bi can be tailored. For a narrow range of Ni thicknesses, the coexistence of both a superconducting energy gap and conduction electron spin polarization are visible within the Ni side of the Ni/Bi bilayers, independent of any particular theoretical model. We believe that this represents one of the clearest observations of superconductivity and ferromagnetism coexisting.

Journal Article↗
PubMed2005

A randomized, controlled trial comparing lidocaine periprostatic nerve block, diclofenac suppository and both for transrectal ultrasound guided biopsy of prostate.

PURPOSE: Lidocaine periprostatic nerve block (PPNB) provides good procedural pain relief for transrectal ultrasound (TRUS) prostatic biopsy. However, post-procedural pain can be significant. The addition of diclofenac suppository (DS) to lidocaine PPNB might provide additional, particularly post-procedural pain relief. We assessed the procedural and post-procedural pain relief for TRUS biopsy provided by DS, and the combination of DS and lidocaine PPNB compared with lidocaine PPNB alone. MATERIALS AND METHODS: A total of 165 patients were randomized into 3 groups, namely group 1-lidocaine PPNB, group 2-DS and group 3-a combination of lidocaine PPNB and DS. In all patients 12 core biopsy was performed. Pain/discomfort at various intervals after the procedure was recorded on a visual analogue scale of 0 to 10 cm. RESULTS: Biopsy pain was significantly lower in patients who received lidocaine alone or in combination compared with DS alone (median 1.95, IQR 1.08 to 3.12, 3, IQR 1.25 to 5.47 and 1.8, IQR 0.85 to 3.0, respectively, p = 0.018), while evening pain scores were significantly lower in patients who received DS alone or in combination compared with that in patients who received lidocaine alone (median 1.25, IQR 0.38 to 3.0, 0.3, IQR 0.03 to 1.08 and 0.4, IQR 0 to 1.0, respectively, p = 0.001). There were no significant differences in pain/discomfort due to the probe (p = 0.107), that 1 hour after biopsy (p = 0.076) and that on the day after the procedure (p = 0.165). There were no significant differences in hemorrhagic or infective complications among the groups. CONCLUSIONS: The combination of lidocaine PPNB with DS provides additional pain relief during and after prostatic TRUS biopsy.

Aged↗
PubMed2004

Spinal anesthesia for cesarean section following inadequate labor epidural analgesia: a retrospective audit.

BACKGROUND: High blocks have been reported when spinal anesthesia is used for cesarean section following inadequate labor epidural analgesia. We have therefore modified the practice at our institution to minimize this risk and conducted a retrospective observational study of outcome following the change of practice. METHOD: The records of 115 women with inadequate epidural labor analgesia who required cesarean section between July 1998 and January 2002 were studied. No epidural boluses were administered in the 30 min preceding spinal anesthesia and a reduced spinal dose, median (range) 9.38 mg (7.5-11.3 mg) of 0.75% hyperbaric bupivacaine and fentanyl 15 microg (10-25 microg) was used. Patients were left sitting for 2 min and then positioned supine with left uterine displacement and were closely monitored for symptoms or signs that would suggest a high block. RESULTS: No parturient developed a high spinal necessitating intubation, and there was no adverse neonatal outcome. CONCLUSION: These findings do not conclusively establish this method as safe, but should spinal anesthesia for cesarean section following suboptimal labor epidural analgesia be considered, avoiding epidural boluses immediately preceding spinal injection, using a lower spinal dose, and delayed supine positioning following spinal injection may be advisable.

Adult↗
PubMed2004

Late first-trimester invasive prenatal diagnosis: results of an international randomized trial.

OBJECTIVE: To assess, in a randomized trial, the safety and accuracy of amniocentesis and transabdominal chorionic villus sampling (CVS) performed at 11-14 weeks of gestation, given that this time frame is increasingly relevant to early trisomy screening. METHODS: We compared amniocentesis with CVS from 77 to 104 days of gestation in a randomized trial in a predominantly advanced maternal age population. Before randomization, the feasibility of both procedures was confirmed by ultrasonography, and experienced operators performed sampling under ultrasound guidance; conventional cytogenetic analysis was employed. The primary outcome measure was a composite of fetal loss plus preterm delivery before 28 weeks of gestation in cytogenetically normal pregnancies. RESULTS: We randomized 3,775 women into 2 groups (1,914 to CVS; 1,861 to amniocentesis), which were comparable at baseline. More than 99.6% had the assigned procedure, and 99.9% were followed through delivery. In contrast to previous thinking, in the cytogenetically normal cohort (n = 3,698), no difference in primary study outcome was observed: 2.1% (95% confidence interval 1.5, 2.8) for CVS and 2.3% (95% confidence interval, 1.7, 3.1) for amniocentesis. However, spontaneous losses before 20 weeks and procedure-related, indicated terminations combined were increased in the amniocentesis group (P =.07, relative risk 1.74). We found a 4-fold increase in the rate of talipes equinovarus after amniocentesis (P =.02) overall and in week 13 (P =.03, relative risk = 4.65), but data were insufficient to determine this risk in week 14. CONCLUSION: Amniocentesis at 13 weeks carries a significantly increased risk of talipes equinovarus compared with CVS and also suggests an increase in early, unintended pregnancy loss. LEVEL OF EVIDENCE: I

Abortion, Induced↗
PubMed2004

Effect of peripheral biopsies in maximising early prostate cancer detection in 8-, 10- or 12-core biopsy regimens.

OBJECTIVE: To assess the cancer detection rate per individual core biopsy in a 12-core protocol and develop an optimal biopsy regimen for detecting early prostate cancer. PATIENTS AND METHODS: The study included 445 new patients who had a 12-core transrectal ultrasonography (TRUS)-guided prostatic biopsy over a 40-month period. The 12- core biopsy protocol included parasagittal sextant and six peripheral biopsies. The cancer detection rate per individual core was evaluated to give an optimal biopsy protocol. RESULTS: Prostate cancer was detected in 142 patients (31.9%). Parasagittal sextant biopsy would have failed to detect 40 (28.2%) of the cancers. Among the various possible biopsy protocols, the optimum 10-core biopsy strategy excluding the parasagittal mid-zone biopsies from the 12-core protocol achieved a cancer detection rate of 98.6%. CONCLUSION: The cancer detection rate increased from 71.8% for parasagittal sextant biopsies to 88.7% by adding peripheral basal biopsies (8-biopsy protocol); 98.6% of cancers in the series would have been detected with a 10-biopsy strategy omitting the parasagittal mid-zone biopsies. Thus we recommend a 10-core protocol incorporating six peripheral biopsies in patients with elevated age- specific prostate-specific antigen levels (2.6-10.0 ng/mL) for maximising cancer detection.

Adult↗