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General Practitoner's Section
 
Ejection Fraction of Gall Bladder
OP Kapoor
 
 

In cardiology, “ejection fraction” is often used by cardiologists to decide line of treatment — medical or surgical.

I wish to draw attention to the fact that in modern days, the ejection fraction of gall bladder can be measured by doing a HIDA scan with CCK (Cholecystokinin). If the ejection fraction of the gall bladder does not increase with this drug, the diagnosis of biliary dyskinesia is made, which may explain undiagnosed upper abdominal pain in patients.
 
Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008
 
 

TUMOUR NECROSIS FACTOR INHIBITORS FOR RHEUMATOID ARTHRITIS

Rheumatoid arthritis that was resistant to methotrexate and sulphasalazine developed in a 25-year-old woman who was evaluated for possible treatment with a tumour necrosis factor inhibitor. These agents are effective in some patients who have not had a response to other therapies. They increase the risk of infection, and their long-term efficacy and safety are not established.
N Engl J Med 2006; 355 : 704, 749.

HIGH-DOSE ATORVASTATIN AFTER STROKE OR TRANSIENT ISCHAEMIC ATTACK

In this five-year placebo-controlled trial involving patients who had a recent stroke or transient ischaemic attack and baseline low-density lipoprotein cholesterol levels of 100 to 190 mg per deciliter (3 to 5 mmol per liter), atorvastain (80 mg daily) resulted in an absolute reduction in nonfatal or fatal stroke of 2.2 per cent and of major cardiovascular events of 3.5 per cent.
N Engl J Med 2006; 355 : 548.
 
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