Anurag Shetty

“Atypical Suicidal” cut throat injury – A case report

Suicide is one of the leading causes of death in the world. The incidence and pattern of suicide vary from country to country. Cultural, religious and social value plays a vital role. Hanging, poisoning, drowning are the common methods of committing suicide. Suicide by incising ones own throat without hesitation marks remains a rare, and only few cases have been reported in the forensic literature. We present here an unusual and rare case of self-inflicted cut throat injury of a 45-year old ex-military man without tentative cuts over the neck, which has resulted from a curved sharp weapon.

Hereditary hemorrhagic telangiectasia

Background: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant disorder, which affects various internal organs and has a tendency for bleeding. It has a classic triad of mucocutaneous telangiectasias, recurrent hemorrhages and positive familial history of first-degree relative. Epistaxis or gastrointestinal telangiectasia can be fatal in a small number of cases. Case Report: A 44-year-old woman came with complaints of recurrent episodes of hematemesis and epistaxis. Patient had a family history of similar complaints. Patient underwent esophagogastroduodenoscopy (EGD), which revealed telangiectasia in the stomach. Imaging of the abdomen showed features suggestive of arteriovenous shunting. Conclusion: HHT can remain undiagnosed for a long time, and is rarely being reported in the literature with management needing a multidisciplinary approach with early inputs from a gastroenterologist.

Is indulging in sexual activity a potential mode of treatment for hypogalactia

Breast-feeding is the global gold standard for infant feeding. Successful breast-feeding is considered very important for healthy development of infants. In doing so, one of the problems encountered by many mothers is hypogalactia. In this context, since prolactin plays a fundamental role in lactogenesis, medical treatment intended to improve mammary function in cases of deficient lactation is the administration of galactogogues like domperidone, metoclopramide and sulpiride that are capable of increasing endogenous prolactin production. However, adverse effects of these pharmacologic medications limit their use [1]. Herein, we would like to propose a new treatment strategy for the treatment of hypogalactia. As already mentioned, it is well known that prolactin plays a significant role in inducing lactogenesis and maintaining an adequate milk production. Recent evidence suggests that significant elevated plasma prolactin concentrations are associated with coitus and other sexual activities. Sexual arousal and orgasm induce a significant long-lasting elevation in plasma prolactin levels in women [2,3]. Considering resumption of coitus after delivery, although there is no definite time after delivery, it is suggested that coitus may be resumed after two weeks [4]. Therefore, sexual activity in the form of masturbation by self or spouse in the early puerperium and coitus in addition to masturbation in the late puerperium may be considered as a potential treatment option because sexual activity leads to significant increased endogenous prolactin levels that aid subsequent lactation. This mode of treatment, a physiologic one, would be devoid of the adverse effects of the pharmaceutical therapeutic agents, and can be considered to aid in initiating and maintaining adequate lactation. According to the aforementioned concept, sexual activity is proposed in cases of reduced or

Quality of life in dyspepsia and its subgroups using EQ-5D (EuroQol) questionnaire

Background/Aim: Dyspepsia has a significant impact on the quality of life. Health-related quality of life (HRQoL) can be assessed by disease-specific and generic HRQoL instruments. The present study evaluated HRQoL and compared it among dyspepsia subgroups by using EQ (Euro QoL)-5D questionnaire. Patients and Methods: Patients with abnormal findings on upper gastrointestinal endoscopy were classified to have organic dyspepsia, whereas those with normal endoscopy were classified as functional dyspepsia if they met the ROME III criteria or as endoscopy negative recent dyspepsia if symptom duration was <6 months. HRQoL was assessed using the EQ-5D questionnaire, and the overall health status on a visual analogue scale (VAS); and the frequency of impairment in each dimension were compared between the dyspepsia subgroups. Results: The overall health status was affected equally in all three dyspepsia subgroups. Impairment in HRQoL was commonly seen in the dimensions of pain (98.4%), usual activities (66.20%), and anxiety/depression (70.60%), however, much less so in mobility (22.70%) and self-care (10.9%). Any impairment in HRQoL was not significantly different between the three subgroups in the dimensions of mobility and usual activities. Self-care was more commonly affected in organic dyspepsia, anxiety/depression was more common with functional dyspepsia, while pain, though significantly different among various subgroups, was very common in all three subgroups. Conclusion: HRQoL was equally affected in all three subgroups of dyspepsia but variably so in the different domains of EQ-5D. These differences need to be studied further to improve the management of different etiological subgroups of dyspepsia.

Comments on “Pelvic floor muscle exercise may improve female sexual function”

[4] Fakhree MAA. Ejaculation as a treatment for nasal decongestion in men is inconvenient, unreliable and potentially hazardous. Med Hypotheses 2008;71:809. [5] Brody S, Kruger THC. Penile–vaginal intercourse decreases weight gain. Med Hypotheses 2008;71:812–3. [6] Ma Y, Qin H. Pelvic floor muscle exercise may improve female sexual function. Med Hypotheses 2009;72:223. [7] Snell RS. Clinical anatomy. 7th ed. Philadelphia: Lippincott Williams and Wilkins; 2004. p. 439.