Epidemic hysteria masquerading as food poisoning.
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Biomedical subjects
Publications and source records attributed to M Mehta.
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Deficits in self help skills are an inevitable problem with the mentally handicapped. The acquisition of self-help skills, learned effortlessly by more intelligent children, is a crucial aspect of the overall development of the mentally handicapped child. In the present study, thirty seven mothers of mentally handicapped children aged between 3 1/2 and 8 years, with an IQ of less than 70, were trained in behavioral techniques such as shaping, task analysis, prompting, and modelling, to develop independent self-help functioning in their children. The self-help areas were toileting, feeding, bathing, washing, and dressing. Thirty two per cent of mothers reported complete skill learning. The problems encountered in the course of training and the subsequent evaluation of its efficacy are discussed.
The effects of the sizes of the stimulus field and of an artificially created central scotoma on simultaneously recorded pattern-reversal electroretinogram (P-ERG) and pattern-reversal visual-evoked response (P-VER) were investigated. With an increase in the stimulus field from 4 degrees X 4 degrees to 12 degrees X 12 degrees, the amplitude of the P-ERG increased steadily. The amplitude of the P-VER also showed an increase up to a stimulus field of 6 degrees X 6 degrees or 8 degrees X 8 degrees, but showed no increase with further expansion of the stimulus field. A central scotoma, created by placing a square of black paper at the center of the 12 degrees X 12 degrees stimulus field, was increased from 4 degrees X 4 degrees to 10 degrees X 10 degrees by 2-degree increments. Amplitudes of both the P-ERG and the P-VER decreased with increasing central scotoma size. The P-VER decreased significantly with a 4 degrees X 4 degrees central scotoma. Although both the P-ERG and the P-VER were influenced by the overall stimulus field and the central scotoma, there was a distinct difference in their behavior. The P-VER showed saturation above a certain stimulus field size and, with a central scotoma of 4 degrees X 4 degrees, much more reduction than the P-ERG, suggesting that the P-VER depends more on the macular area than does the P-ERG. The P-ERG also exhibited a substantial macular dependency, which, however, was not as great as that of the P-VER. The greater macular dependency of the P-VER compared to the P-ERG, as observed in our study, reflects the larger anatomic representation of the macula at the higher visual level.
A prospective study was conducted to determine the usefulness of clinical findings and 25-degree pronation and supination radiologic views to diagnose carpal navicular fractures. All patients presenting to the emergency department during a two-year period who fell on their outstretched hand and had pain and/or swelling in the anatomic snuffbox were evaluated initially and at two weeks. All patients received at least the standard four-view wrist radiography. If a fracture was not detected, two additional views were obtained. Ninety patients were enrolled; 54 fractures of the navicular were evident on initial four-view radiography. Thirty-six patients with a negative initial four-view radiograph had two additional views; 11 of the 36 were found to have a fracture. The other 25 patients failed to show fracture. In this series; no fractures were missed when six-view radiography was used. Anatomic snuffbox tenderness was 100% sensitive and 76% specific and had a 92% positive predictive value for carpal navicular fracture. We conclude that patients clinically suspected of carpal navicular fracture should undergo additional radiologic views if the standard four views of the wrist are negative.
An infant with intussusception who developed an unusual complication of transanal and intraperitoneal prolapse is reported. Complete venous occlusion of the intussusceptum for a prolonged period in a patient with congenital anomalous vascular supply of the colon is suggested as a mechanism responsible for rupture of the intussuscepiens.
The effects of optical defocusing with convex lenses on the amplitudes of pattern reversal visual-evoked response (PVER) were investigated. With the large check size and high-contrast pattern, PVER amplitudes showed a linear decrease in response to initial defocusing up to +5 to +6 dptr. As the degree of defocus increased, the PVER amplitude, though irregular, continued to show reliable, definite responses up to +25 dptr. With the intermediate check size and pattern contrast, PVER amplitudes displayed a linear decrease, but unlike the large-check/high-contrast condition, diminished to noise level after a defocus of greater than +4 to +5 dptr. From these results, we speculate that two phases in this function curve derive from the large-check/high-contrast condition: first, the contrast- or contour-dependent phase, and, second, the luminosity/movement-dependent phase.
Thirty obsessive-compulsive patients were randomly allocated to two treatment conditions. In group A a significant family member was trained to act as cotherapist at home, whereas in group B, only the patient was seen and given home assignments. All 30 patients received a similar treatment regime of systematic desensitisation, exposure, and response prevention. The family-based approach resulted in greater improvement in anxiety, depression, obsessive symptoms, and in social adjustment in occupational and household responsibilities. The personality pattern of the family members also appeared to influence outcome.
We evaluated the effect of endobronchial radiation therapy in 52 patients with malignant airway occlusion. Fifty-five endobronchial applications of the radioisotope iridium 192 were carried out. Response was assessed by change in performance status, symptom resolution, duration of symptom relief, roentgenographic reaeration, pulmonary function tests, and postimplant bronchoscopy. Thirty-three patients showed at least a one-level improvement in performance status. Of a total of 166 symptoms present prior to therapy, 131 resolved or improved. Approximately 70 percent of a patient's lifetime was rendered symptom improved or symptom free. A roentgenographic reaeration response of 30/41 (73 percent) was achieved. The average FEV1 and FVC improved from 1.5 to 2.1 L and from 2.3 to 2.9 L, respectively. Posttherapy bronchoscopy was performed between one and two months following the implant in 15 patients who agreed to undergo the procedure. Eleven (73 percent) of 15 had complete tumor regression. Major long-term complications were noted in seven patients. Endobronchial radiation, therefore, appears to be a safe and effective technique to palliate malignant airway occlusion.
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A total of 1330 children who attended a hospital-based child guidance clinic in last three years were studied retrospectively. 7.37% of these were found to have no psychiatric disorder. Epilepsy and scholastic backwardness without any psychiatric disorder, together constituted 70.41% of this group. Children referred to a child guidance clinic require proper assessment to detect psychiatrically normal children who would otherwise receive unnecessary label of psychiatric disorder and treatment.
A retrospective study of children presenting with pain to the Child Guidance Clinic, during 1984-85 revealed 101 cases of hysteria and 22 of psychalgia. Children in these two groups did not differ significantly with respect to sex, age, education or occupation of parent. Children with psychalgia presented significantly later, and more frequently complained of headaches and abdominal pain. Children with hysteria presented with seizures, abdominal pain and anxiety symptoms. Pain can be of psychological origin also. Early diagnosis is essential to avoid unnecessary investigations and reinforcement of the "sick role".
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The long-term effect of lithium treatment on the digestive and absorptive function has been investigated in male albino rats. The uptake of D-glucose, amino acids and activities of cellular and brush border enzymes were evaluated after every 3 months. Significantly increased uptake was observed in 6-month lithium-treated rats. The absorptive capacity (Vmax) for D-glucose increased significantly without alteration in the Michaelis constant. Activities of cellular, brush border membrane disaccharidase, leucine aminopeptidase and Na+,K+-ATPase enzymes were significantly augmented in 6-month lithium-treated animals. The elevation in sucrase activity may be due to induction of enzyme since only Vmax was increased in lithium-treated animals. The present biochemical alterations suggest that long-term lithium ingestion stimulates the small bowel digestive and absorptive functions.
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Tornwaldt's bursae or nasopharyngeal bursae originate at the interface between the embryonic tissue from which the vertebrae develop (the notochord), and the developing foregut. If the opening through which the bursa drains into the nasopharynx becomes obstructed, a Tornwaldt's cyst will develop. The history, clinical and radiological findings and the operative management of a patient with an infected Tornwaldt's cyst are presented.
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