Publication is both an art and a science. For the beginner, not knowing the intricacies of publication, choice of subject and the appropriate journal to get their work published are major obstacles. In this article, the authors share their experience on how to go about getting an article published and selecting the most suitable journal for publication. They hope this article stimulates medical writing.

Objective:To study the prevalence of psychiatric co-morbidity in patients of chronic daily headache (CDH) and compare the efficacy of treatment between various type of headache associated with psychiatric co-morbidity.Materials and Methods:Prospective case control cohort study, 92 consecutive patients of CDH meeting eligibility criteria. The diagnosis of various subtypes of CDH was made according to the IHS criteria. Age, sex, educational, marital and socioeconomic status, matched controls were also selected. Patients were evaluated with the Mini International Neuropsychiatric Interview (MINI) scale at the time of enrolment and at 3 months.Results:CDH accounted for 28% of all headache patients. The mean age of presentation was 30.2 ± 10.3 years, male: Female ratio of 28:64 and mean duration of 4.56 ± 0.56 years. Chronic migraine (CM) accounted for 59 patients, chronic tension type headache (CTTH) 22 patients, new daily persistent headache (NDPH) 3 patients and miscellaneous 8 patients. Psychiatric co-morbidity was present in 53.3% patients with CDH, and was more common in CM (62.7%) as compared to CTTH (36.4%). Single psychiatric co-morbidity was seen in 26 patients, while 23 patients had multiple co-morbidity. Major depressive episode, anxiety disorder, agoraphobia and dysthymia were significant psychiatric co-morbidities. Patients with CM were treated with topiramate or divalproex sodium ER and CTTH were treated with amitriptyline. 55 patients came for follow up at 3 months, improvement in headache was seen in 29 patients.Conclusion:Psychiatric co-morbidity was present in more than 50% patients with CDH and its presence along with a duration of ≥2 years was associated with a poor response to treatment.

In vivo staining reveals cytological details that might otherwise not be apparent. The aim of the study was to test the utility of toluidine blue test in detecting various types of malignant and premalignant lesions in early stage. Fifty patients with lesion in oral cavity having suspicion of malignancy clinically were selected. After subjecting the patients to clinical examination, the suspicious lesions were stained with 1 % toluidine blue. The biopsy site was selected on the basis of clinical appearance and dye retention and in the sites where no retention of the stain occurred, clinical judgment directed the biopsy site. The sensitivity of toluidine blue in detecting premalignant or malignant lesions was found to be 97.8 % and the over all specificity was found to be 100 %. The positive predictive value, negative predictive value and diagnostic accuracy was reported to be 100, 80 and 90 % respectively. Toluidine Blue staining is highly a reliable source for the detection of insitu and invasive carcinomas. Staining with this stains is an adjunct to clinical judgment, assist in the choice of biopsy site, follow up of premalignant lesions and marginal demarcation of the malignant lesions enabling an intervention method to be adopted earlier for the disease, which carries a high rate of morbidity and mortality.

References form the backbone of any medical literature. Presently, because of high inflation, it is very difficult for any library/organization/college to purchase all journals. The condition is even worse for an individual person, such as private practitioners. The solution lies in the free availability of full-text articles. Here, the authors share their experiences about the accessibility of free full-text articles.

No abstract

A South Indian family with three well documented cases of Alport's syndrome with anterior lenticonus are reported. Clinical features of the syndrome including ocular and laboratory findings have been presented and discussed. Macular pigmentation, 5 cases, subcapsular opacity and nephrotic syndrome, one case each, observed in the present series are of great interest and are quite rare in patients with Alport's syndrome. Critical analysis of the family pedigree revealed autosomal dominance with incomplete penetrance as the possible mode of genetic transmission of the disease.

No abstract

Background: Forgotten double-J (DJ) stents is documented commonly in urological cases with consequences varying from encrustation, UTIs, pyelonephritis, hydronephrosis and non-functioning kidney. This study aimed to present the experience of managing patients with forgotten DJ stents (>3 months) over a period of ten years.Methods: The study conducted a retrospective review of patients with forgotten DJ stents from January 2009 to December 2019. The details reviewed included indications for stent placement, indwelling time, presenting complaints, reason for non removal, radiological investigations, management techniques, and complications.Results: 52 patients with forgotten DJ stents for >3 months were reviewed. Mean age was 32.1 years. The majority were literate (73.1%). Ureteroscopy was the most common primary surgery performed (53.8%). The mean indwelling time was 38.96 months. Presence of the ureteric stone, bladder stone, and renal stone was observed in 45 (86.5%), 42 (80.7%), and 28 (53.8%) patients, respectively. The DJ stent was fragmented in 13.4% of the patients. The commonest complaints were pain (88.4%) and dysuria (63.4%). The stents were managed by combinations of various endourological techniques including cystoscopic stent retrieval (CPE), PCNL, URSL, ESWL with cystoscopic stent retrieval, PCLT (percutaneous cystolithotripsy). Cystolithotomy was used for very large bladder stones. Nephrectomy was needed in 2 cases due to nonfunctional kidneys while one required open ureterolithotomy and stent retrieval after failure of endoscopic approach.Conclusions: Forgotten DJ stents have severe consequences and management approach requires combination of various endourological procedures with ESWL, URSL, PCNL, open ureterolithotomy and cystolithotripsy.