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Methods@#We retrospectively studied 61 patients with C2 (+) OPLL who had posterior instrumented laminectomy and fusion at Ganga Hospital, Coimbatore between July 2011 and January 2021, with a minimum follow-up of 2 years. Data on demographics, clinical outcomes, radiology, and post-surgical outcomes were gathered. @*Results@#Among 61 patients, 56 were males and five were females. The OPLL pattern was mixed in 32 cases (52.5%), continuous in 26 cases (42.6%), segmental in two cases (3.3%), and circumscribed in one patient (1.6%). All of our patients showed signs of neurological improvement after a 24-month follow-up. The mean preoperative modified Japanese Orthopaedic Association (mJOA) score was 10.6 (range, 5–11) and the postoperative mJOA score was 15.8 (range, 12–18). The recovery rate was >75% in 27 patients (44.6%), >50% in 32 patients (52.5%), and >25% in two patients (3.3%). The average recovery rate was 71% (range, 33%–100%). The independent risk factor for predicting recovery rate is the preoperative mJOA score. @*Conclusions@#In C2 (+) OPLL, posterior instrumented decompression and fusion provide a relatively safe approach and satisfactory results.
ABSTRACT
Systemic corticosteroids and immunocompromised state following SARS?CoV?2 infection can predispose individuals to endogenous endophthalmitis. A 66?year?old gentleman presented with complaints of diminution of vision and redness one week post discharge after hospitalization for COVID?19 infection. Clinical examination suggested fulminant endogenous endophthalmitis which responded poorly even after aggressive treatment requiring evisceration. Culture and gene sequenced analysis confirmed Aspergillus fumigatus to be the causative organism. A high degree of suspicion is warranted in the presence of recent onset of floaters in COVID?19?infected individuals to facilitate early diagnosis and outcomes.
ABSTRACT
Background: The gastrointestinal tract of the HIV/AIDS patient (s) is harboured by a number of luminal extracellular and intracellular parasites. These parasites are responsible for deteriorating and worsening the general health condition(s) of these immunocompromised groups of patients. Moreover, these parasitic infections are often correlated with the CD4 counts of the individuals. Therefore, with a view to assess the relationship between the presence of parasitic infection and that of the CD4 count, the present work is being undertaken.Methods: The study was conducted in the Parasitology section of the department of Life Sciences, Manipur University and CD4 count unit of Microbiology Department, RIMS hospital Imphal from 34 HIV positive Antiretroviral treatment (ART) naive patients, aged between 19 to 50 years. The samples were taken from the patients only after obtaining a signed consent form . Techniques like normal saline method, iodine wet preparation method, formol ethyl acetate concentration technique, Baermann modified funnel technique, modified Ziehl Neelsen staining technique and adhesive cellophane tape method were employed for the present investigation.Results: The present study reveals that patients with CD4 count <200 cells/μl were harbouring only two parasites (Cryptosporidium sp and G. lamblia) whereas individuals with CD4 count within the range of 200-500 cells/μl were observed to have harboured G. lamblia, Cryptosporidium sp, E.histolytica, hookworm, S. stercoralis and A. lumbricoides. On the other hand, enteric parasites associated with CD4 count >500 cells/μl included G. lamblia, hookworm, E. vermicularis and S. stercoralis.Conclusions: The present study shows that occurrence of intestinal parasitism is independent of CD4 count in HIV infected patients. Therefore, based on the present findings, it may be suggested that irrespective of CD4 count(s) and whether the patient experiences diarrhoea or not, regular monitoring of the HIV patient(s) for the presence of enteric parasitosis by adopting standard laboratory protocols should be encouraged for maintaining a healthy life of the people living with HIV/AIDS.
ABSTRACT
BACKGROUND: Continuous positive airway pressure (CPAP) therapy is the gold standard treatment for obstructive sleep apnea (OSA), although, associated with poor patient compliance. Conversely, high flow, humidified, temperature-regulated nasal insufflation of oxygen or air is well tolerated.CASE: We describe our experience of three patients with known or suspected moderate to severe OSA who were poorly compliant to CPAP therapy and received high flow nasal insufflation (HFNI) postoperatively. None had significant episodes of desaturation (SpO₂ < 95%) and all patients uniformly reported superior comfort levels than with the CPAP therapy. HFNI generates small amounts of positive end-expiratory pharyngeal pressure, increases inspiratory airflow and decreases dead space ventilation. Due to the open system, less difficulty with the patient-mask interface and improved patient comfort is experienced. These factors help prevent hypopnea and lead to enhanced sleep continuity.CONCLUSIONS: HFNI may be a promising alternative to CPAP therapy in the perioperative setting.
Subject(s)
Humans , Continuous Positive Airway Pressure , Insufflation , Oxygen , Patient Compliance , Sleep Apnea, Obstructive , VentilationABSTRACT
BACKGROUND@#Continuous positive airway pressure (CPAP) therapy is the gold standard treatment for obstructive sleep apnea (OSA), although, associated with poor patient compliance. Conversely, high flow, humidified, temperature-regulated nasal insufflation of oxygen or air is well tolerated.CASE: We describe our experience of three patients with known or suspected moderate to severe OSA who were poorly compliant to CPAP therapy and received high flow nasal insufflation (HFNI) postoperatively. None had significant episodes of desaturation (SpOâ‚‚< 95%) and all patients uniformly reported superior comfort levels than with the CPAP therapy. HFNI generates small amounts of positive end-expiratory pharyngeal pressure, increases inspiratory airflow and decreases dead space ventilation. Due to the open system, less difficulty with the patient-mask interface and improved patient comfort is experienced. These factors help prevent hypopnea and lead to enhanced sleep continuity.@*CONCLUSIONS@#HFNI may be a promising alternative to CPAP therapy in the perioperative setting.
ABSTRACT
BACKGROUND: Rapeseed-mustard is the second most important source of edible oil in India. Several species of Brassica are grown in different parts of country for its oilseeds. OBJECTIVE: The objective was to investigate allergenicity to antigenic extracts of pollen of 4 species of Brassica. METHODS: Brassica campestris, Brassica juncea, Brassica nigra, and Brassica napus were selected for the detailed investigation. Pollen samples from each of the four species were collected from the polliniferous materials. The antigenic and allergenic profiles of these extracts were evaluated by means of sodium dodecyl sulfate-polyacrylamide gel electrophoresis, Skin prick test, enzyme linked immuno sorbent assay and Western blot on atopic individuals. RESULTS: Out of the 159 atopic subjects tested, 21.38% were positive to at least one or other species of Brassica pollen, with highest skin positivity (13.20%) to B. campestris extract. Raised IgE with significant linear correlation with intensity of skin reactions was obtained. Protein fractions of 20, 25, 32, 37, 56, and 90 kDa were recognized by B. campestris and B. juncea whereas 56, 76, 87, and 90 kDa were recognized by B. nigra and B. napus as major IgE binding protein fractions. The patients also showed positivity to other inhalant pollen allergens tested. CONCLUSION: IgE mediated hypersensitivity varied from 4.40% to 13.20% in Indian atopic subjects to pollen of one or the other species of Brassica. Protein fractions of 47, 56, 76, 87, and 90 kDa were identified as IgE binding by all the four species, however individual heterogeneity exists. Thus a local species may be more pertinent for immunotherapy. The major allergen needs to be further characterized.