lvlAnililHtiLiloAL SOOIETY + MARINEMEDICAL SOCIETY (RegdF-3611) President SUTgVADM JC SHARMA PVSM, VSM' PHS DGMS (NAVY) VicePresidents Surg RADM VK PAHWA Surg RADM HP MUKHERIBE AVSM, VSM CMO WesternNaval Command CommandingOfficer,INHS Asvini Executive Committee Surg Cmde SP MALHOTRA Surg Cmde WP THERGAONKAR DMS (P&M) Naval Headquarters CMO, EasternNaval Command Surg Cmde BPS Rawat, VSM Surg Cmde N{L GUPTA VSM CMO, SouthernNaval Command Dental Adv. (Navy) Surg Cmde AK CHAUDHARI Surg Cmde PS Valdiya DMS (H& S) Naval Headquarters Director,InstituteofNavalMedicine Surg Cmde AK Paharia Surg Capt S NANGPAL ExecutiveOfficer,INHS Asvini Sr.Adv Marine Medicine Surg Cdr D D'Costa Surg LCdr S BHANDARI INS Vajrabahu SHO (Mumbai) Secretary Surg Cdr KBS CHEEMA Treasurer Surg Capt GS GREWAL Address for Correspondence Secretary MARINE MEDICAL SOCIETY Instituteof Naval Medicine. Colaba,Mumbai 400 005.INDIA Fax:022-2150670 E-mail : [email protected]& [email protected] ? JOURNAL OF MARINE MEDICAL SOCIETY JAN-JUN2OOO PublishedBiannually Clief Editor SuTgRADMVKPAHWA Editor Surg Capt S NANGPAL Co Editors SurgCapt GS GREWAL Surg CdTGIRISH GUPTA Sub Editors Naval Headquarters SuTgCdTAAHUJANM Western Naval Command SurgCdr D D'COSTA Eastern Naval Command Surg Cdr VRG PATNAIK Southern Naval Command SurgCapt MJ JOHN EditctrialAclvisory Board SurgCmde (D) MLGUPTA,VSM SurgCmde PSVALDIYA SurgCmde RTAWASTHI CoIHS PRUTHI SurgCapt RAMESH KUMAR Addre s s fo r Co ne spondence Editor JOURNALOF IIIARINEMEDICAL SOCIETY Instituteof NavalMedicine, Colaba,Mumbai400 005. Telefax:022-215 0670 E-rnail: [email protected] & [email protected] Printedand Publishedby SurgCdr KBS CHEEIviAon behalfof DirecrorGeneral of Medical Services(Navy) andprinted at Typo Graphics,Mumbai 400 103and publishedat Instituteof Naval Medicine,Colaba, Mumbai 400 005. Editor : SurgCapt S NANGPAL i JOURNAL OF MARINE MEDICAL SOCIETY sli df CONTENTS OJ In an From The Editor's Desk ttu ca EDITORIAL >( \ Medicineon theintemet : Thenew millennium beckons Surg Lt Cdr IK Indrajil, Surg Capt S Nangpal inj th: ORIGINAL ARTICLES in rie A Studyof InjuriesAmongst Naval Personnel of WestemNaval Comm and (1997 -1999) t2 SurgLt Cdr M llankumaran,Surg Mdm VK Pahwa,Surg Cap KK Dutta Gupta, Jurg Lt Cdr SundeepBhandari rat acl MagneticResonance Imaging (MRI) in Tuberculosisof theSpine l8 m: surg Lt cdr IK Indrajit, surg cdr s Ganesan,surg Cdr p sarin, surgcdr CC verma 8llr Aetiology - of UpperrGastrointestinal Haemorrhage An EndoscopicStudy rer Col HS Pruthi,Lt Col SK Sharma,.Wg Cdr B Singh,Lt ColAC Anand as FieldStudy of InsecticidesAgainst Mosquito Larvae 28 Di surg capt KK Dutta Gupta,surg capt MJ John, surgcapt s Nangpal,surg cdr A chatterjee, SurgCdr GSGrewal wi Resistotypingandzymogram Study of Klebsiellain NosocomiarInfection 3l SurgCdr RN Misra, Maj AD Sen an sai - TranscanalTympanoplasty Surgical Outcome J) SurgLt Cdr D Raghavan tra Importance of PhosphorousSupplementation in Prevention of Osteopeniain Preterms 39 frc surg cdr Girish Gupta,Dr. sushmitaGupta, surg Is Cdr G Khuttar, surgcapt KS Bawa of -Zstimation of MCV in Casesof AlcoholDependence 45 be surg cdr AA Pawar, surg CmdePS valdiya, surg Lt cdr KK Mishra, surg capt MK Gupta inj Prognosticvalue of clinical Varibalesin Patientsof SepsisSyndrome and ler Correlationwith Interleukin6 48 TA SugCdr YD Singh,Surg Cdr RN Misra,Lt Col IsaacMathew, Lt Col AS Kashyap,Col AS Kasthuri Dir MercurySphygmomanometer - Is it Timefor FinalCurtain Call? 55 SurgCdr MSNMurthy, Lt Col ASNarula Da UPDATE ARTICLB HBOTand AIDS 58 M. surg LCdr c Kodange,surg Capts Nangpal,surg cdr B sudarshan,surg CaptMJ John Tu w TI COMMENTARY Fr SubmarineRescue - FutureTrends 6l Sa SurgCdr G Verghese Sr ComparativeStudy of Autoref/KeratometerWith ManualKeratometer and Retinoscope 65 SurgCdr SSPannu Tr I EMERGING TRENDS Monitoring and PatientCare Equipment in Clinical HyperbaricChambers 69 Cdr GeorgePaul, SurgCdr B Sudarshau SurgCapt S Nangpal CASEREPORTS Multiple HydatidCysts Lungs and Liver - A CaseReport 75 Is Col G Ravindranath,VSM, Maj (AMC) SanjaySharna, SurgCapt RanteshKwnar, Is Col (AMC) S Saclnr, SurgIs Cdr Aarti Sorin Naidu PostVaccination Hepatitis-B Antigenemia in a Child with Jaundice SurgLt Cdr ShankarNarayan, SurgLt Cdr NavneetNath SurgIl Cdr VivekHande Aircrew - Aircraft Incompatibilitywith a SeaVariant Personal Sirrvival Pack SurgCdr I(Y Sundar An UnusualForeign Body in the bronchus SurgCdr PS Tampi, SurgCdr S Ganesan,Surg l*dr D Raglnvag Col HS Pntthi, Col BN Borgohain PERSONAL COMMTJMCATION CorrectiveFlying Spectacles: Types and Designs 84 Wg Cdr GKG Prasad VSM ABSTRACTS 86 FROM THE EDITOR'SDESK This millennium'sfirst issueof thejournal is now in yourhands. Thisissue contains several articles, which were presented at the National Conference on Marine and Allied Medicineat Mumbaion 16and 17 Oct 99. Alcoholconsumption is wide spreadin all segmentsof our societyand is graduallyincreasing. This issue is of contemproaryinterest to the healthauthorities. Estimation of MCV is a simpleprocedure which can helpthe clinician in monitoringcases of alcoholdependence. An articleon thesubject by SurgCdr AA Pawar andSurg Cmde PS Valdiyaet al discussesthis issuein detail.Aetiology of upperGI tracthemorrhage has alwaysbeen a dilemmafor.the physician. Data painstakingly compiled over almost a decadeby Col Pruthi is presentedin his articlein the currentissue. The speedwith which internethas premeated our daily life is truly amazing.A majoroffshoot of this IT revolutionhas been the amountof medicalliterature available on line.An articlei'Medicine on the internet : thenew millennium beckons" by SurgCdr IK Inderjitet al compilesa list of themore reliable and important websitesand addresses for themedical fratemity. As Asvinimodernisition advances and we get progressively "online"this informationwill be of greatuse to theclinician. Althoughwe havebeen practicing hyperbaric clinical medicinefor nearlytwo decades,inadequacy of patientmonitoring facilities particularly the critically ill insidethe chamber remains. "Monitoring and patient careequipments in clinical hyperbaricchambers" an articleby Cdr G Paulet al liststhe advancedfacilities availableworld wide. Sphygamomanometeror the mercuryBP apparatushas been the gold standardand work-horsefor the clinicianfor morethan a century.However an obituaryof sortshas now beenwritten by SurgCdr Murthy et al in his article,but the questionis, "is this sturdy,solid and reliable instrument ready to be consignedto thedustbin ofhistory yet"? Any comments. Jour. Marine Medical Society,Jan-Jun 2000, Vol.2, No. I Editorinl MEDICINE ON THE INTERNET : THE NEW MILLENNIUM BECKONS Surg Lt Cdr IK INDRAIIT*, Surg Capt S NANGPAL** INTRODUCTION aspectof human interestincluding medicine,com- he internet is a vast network of computers munications,commerce, science, media, law, art spanningthe entire globe. Created initially to etc. are representedin some form or fashion. suit the requirements of the military in To leam the intemet, there are many basic books United Statesof America, it has now broken all available.However, for those who are desirousto barriersand hasbeen seamlessly integrated into the learn the Net on the Net itself. there are a host of personalcomputer, at home or office. From recrea- sitesthat fulfill the need.These include the under- tion to applied scienceand technology,and from mentioned : Doctors guide to Internet at critical care medicine case scenariosto digitized http://www.pslgroup.com/docguide.htm, Begin- radiology imagesand pathologyspecimens, the in- ners guide to Internet at http://www.silver- temet has become increasinglyuseful for medical link.net/poke/IlP/, Learn the net at practitioners.This anicle describesthe power of http://www.leamthenet.com/english/index.html internet when applied in the context of medicine. andHitchhikers web guide at http://www.hitchhik- Furthermorean attempt has been made to briefly ers.net/guide.phtml. overview the gamut of medical websites on the Relatedto Intemet is a working knowledge of internet,to provide the readera nutshellview ofthe computers.A conciseand informativeonline basic powerful and magicalworld of intemet. primer of computersin medicineis availablefrom WHAT IS INTERNET? the BMJ group of publications: ABC of Medical Computing The intemet was createdin 1969,when the ad- http://www.bmjpg.com/data/abcmc.htm.Another vancedresearch projects agency ofthe UnitedStates websitedealing with basicinformation of computers departmentof defensefunded up an experimentala is What is Computers http://www.whatis.com. long-distancetelecommunication network consist- Onceone becomes familiar with intemetthere many ing of only four computers. In the 1980s, AR- sitesoffering a variety of internetrelated features. PANET was supersededby NSFNET, a seriesof One such popular site is Internet Tools networkscreated by the National ScienceFounda- http://www.december.com/neVindex.html. tion, which establishedthe present-daystructure of the intemet []. Over the last few years there has OVERVIEW OF MEDICINE ON THE NET been an exponential explosion in the number of The intemethas 800 million sitesapproximately computersadded to this network.It is estimatedthlt at the moment,with a remarkabletendency to grow internettraffic doublesevery 100 days with more further. Of these,it hasalso beenestimated that there than 100 million people worldwide now on-line. areclose to 100million sitesdealing primarily with Telecommunicationson the intemet are stand- medicine.Truly, medicalteaching has evolved from ardizedby