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Spontaneous cerebellar hemorrhages are rare when compared to cerebral hemorrhages. They are characterized by occipital headache, repeated vomiting, and ataxia of gait. In mild cases there may be only gait ataxia. There may be Dizziness or vertigo, paresis of conjugate lateral gaze towards the side of the lesion, forced deviation of the eyes to the opposite side, or an ipsilateral sixth nerve palsy, blepharospasm, and skew deviation. Dysarthria and dysphagia may occur. The patient often becomes stuporous and then comatose from brainstem compression or obstructive hydrocephalus; immediate surgical evacuation before brainstem compression occurs, may be lifesaving. The introduction of computed tomography (CT) scan, had brought about a sea change in diagnosis and management. The most significant prognostic factors determining the outcome at one month were the grade of quadrigeminal cistern obliteration on the initial CT scan and the Glasgow Coma Scale on admission. The introduction of drugs like nimodepine made all the difference in the outcomes. We hereby share our experience in managing 12 cases of spontaneous cerebellar hemorrhage.
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Background : Health Care Workers are among the frontline COVID warriors who have been fighting all odds in serving their patients at the cost of their lives. Bangalore has been one among the hot cities in news during this pandemic and our centre, being one of the busiest working hospitals right in the middle of the city, we hereby throw limelight to the Health Care Workers of our centre who have been fighting over COVID-19 with all might and courage. This study was done to know the prevalence of COVID-19 and its ENT manifestations among Health Care Workers in our centre. Materials and Methods : A cross sectional study was done in KIMS Hospital, Bangalore, targetting all Health Care Workers of our centre, divided into 3 groups. Prevalence of ENT manifestations was studied. Results : In our study, majority who tested positive for COVID-19 were Doctors (67.6%) followed by staff nurse (27.9%) and auxiliary HCW (4.5%). One fourth of the study subjects had anosmia as the most common ENT manifestation followed by nasal obstruction (24.3%), cough and loss of taste (19.8% each). Conclusion : With inadequate precautions being taken with the mutating virus in air, causing a surge in cases, the health care workers are the most vulnerable group to acquire the deadly infection, during both the waves of the pandemic. We hereby, stress on this, with the help of our study, done during the first wave, targeting our Health Care Workers.
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Purpose: To evaluate the efficacy and safety of hybrid 26?gauge needle drainage in scleral buckling for rhegmatogenous retinal detachment (RRD). Methods: In this retrospective study, we included patients who underwent scleral buckling surgery along with subretinal fluid (SRF) drainage using the ‘Hybrid 26G needle drainage technique’. Pre?operative assessment included the best corrected visual acuity (BCVA), lens status, and extent of retinal detachment. Intra?operative surgical details such as the height of retinal detachment, number of attempts required to drain the fluid, amount of fluid drained, adequacy of break buckle relationship, and any intra?operative or post?operative complications were noted. Post?operatively, the final visual outcome and retina status were assessed at 3 months of follow?up. Results: A total of 10 eyes with primary RRD and proliferative vitreoretinopathy C1 or less were included. Pre?operatively, the mean BCVA was 2.43 ± 1.01 logMAR units, which improved significantly to 0.679 ± 0.45 logMAR units (p value < 0.05) at 3 months of follow?up. Regarding the extent of RRD, five eyes (50%) had a total detachment, two eyes (20%) had a sub?total detachment, and three eyes (30%) had an inferior detachment. Four eyes had shallow detachment, four had a moderate detachment, and two eyes had bullous detachment. Complete drainage of SRF (>75%) was achieved in five patients, and a partial but adequate drainage (50–75%) was achieved in the rest of the five patients. In none of the patients, inadequate or dry tap was encountered. No intra?operative complications were encountered. The retina was attached in eight out of ten eyes at 1 week and at a 1?month follow?up period. Two patients required pars plana vitrectomy for persistent SRF. The retina was attached in all the patients at 3 months of follow?up. Conclusion: The ‘Hybrid needle drainage’ technique is a safe and effective technique for SRF drainage in scleral buckling surgery
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Purpose: To study the retinal and choroidal thickness variations on enhanced depth imaging optical coherence tomography scans in ocular albinism (OA) and compare with age?matched healthy subjects. Methods: This retrospective observational study had 48 eyes of 24 patients diagnosed clinically as OA and age, sex, and axial length?matched control healthy subjects. All patients underwent detailed ophthalmic examination and a single?line horizontal?raster enhanced depth imaging – optical coherence tomography scan (Spectralis, Heidelberg Engineering). Retinal and choroidal thickness was measured, compared, and analyzed between the two groups. Mann–Whitney U test was used for analysis between the two groups. P < 0.05 was considered significant. Results: The mean age was 28.3 ± 11.6 and 29.9 ± 10.6 years in the OA group and control group, respectively. Spherical equivalents ranged from ?8.5D to +10.5D in the OA group and from ?8.0D to +10.0D in the control group. The mean axial length between the two groups (P = 0.652) were comparable. The average retinal thickness (272 ± 34.3 vs. 213 ± 13.8 ?m; P < 0.001) was greater in the OA group as compared to controls. The mean choroidal thickness (184 ± 78.4 vs. 287 ± 46.4 ?m; P < 0.001) was significantly thinner in the OA group. Conclusion: Acquisition of OCT scans in OA can be challenging. This study showed that the subfoveal retinal thickness and choroidal thickness measured across the scans were significantly different in the OA group compared to controls. In the future, more studies are required to evaluate the role of the choroid and its relationship to emmetropization in albinism.
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Visceral Leishmaniasis (VL) or Kala Azar is a chronic protozoal infectious disease caused by the Leishmania donovani complex which causes a variety of hematologic manifestations. It is manifested by fever, hepatosplenomegaly, weight loss, pancytopenia and hypergammaglobinemia. In India it is mainly seen in the states of Bihar and West Bengal. Patients with VL can present to the hematologist for variety of hematological presentation even before the diagnosis of VL is made. Anemia is the most common hematological manifestation of VL. VL may also be associated with leucopenia, thrombocytopenia, pancytopenia, hemophagocytosis and disseminated intravascular coagulation. Hematological improvement is noted with the treatment for VL. Relapses are rare. In this case report, we present a rare case of leishmaniasis with pancytopenia, which is rare in Hyderabad, Telangana, India
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Cerebral arteriovenous malformation (AVM) is a complex network of vascular channels consisting of arterial feeders, a nidus and enlarged venous drainage. AVMs usually increase in size with time, but may rarely obliterate; spontaneous angiographic regression occurs in less than 1.5% of cerebral AVMs. Several causes of spontaneous regression have been postulated such us hemodynamic alterations due to hemorrhage, hypercoagulability, atherosclerosis, and thromboembolism from associated aneurysms. In this report we describe a case of cerebral hemorrhage due to left fronto- parietal AVM with predominant middle cerebral artery and anterior cerebral artery feeders, minor left external carotid artery feeders, mixed pial-dural AVM – Spleitzer Martin Grade 5
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Liver abscess is a suppurative lesion in the liver formed as a result of invasion and multiplication of microorganisms which gain access by entering directly from an injury through the blood vessels or by the biliary ductal system/ septicemia, direct infection latrogenic & cryptogenic. It can be diagnosed by comparing the lab values with the diseased condition such as hemoglobin (10.9g/dl), neutrophils (83), ESR (120mm), Serum albumin (3.4g/dl), ALP (245U/L), Gamma GT (347U/L), prothrombin time (25.2 seconds), APTT (37.9 seconds). By performing the above tests, we have confirmed that the patient was suffering from liver abscess.
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Purpose: To compare multicolor imaging (MCI) with Optos color fundus photography (OCFP) for the evaluation of morphology and extent of preretinal membranes in diabetic tractional retinal detachments (TRD). Methods: In this retrospective study, 30 eyes with diabetic TRDs were imaged using the MCI feature of the Heidelberg Spectralis Spectral?domain optical coherence tomography (SD?OCT) and color photo using the Optos Daytona ultra?widefield fundus camera. Two investigators independently graded and determined the agreeability between the two modalities with respect to the extent of the TRD and preretinal membranes on the SD?OCT B?scan images. Results: The MCI provided better visualization of the attachments and traction points of the posterior hyaloid face and preretinal membranes and is comparable to the SD?OCT B?scan images. The inter?rater agreeability rates for OCFP had a Kappa (?) value of 0.37, while the MCI had a ? value of 0.46. When comparing between images of different wavelengths, grading using infrared reflectance (IR) had a poor agreement (?0.04 ± 0.04) while green reflectance (GR) (0.46 ± 0.32) and blue reflectance (BR) (0.53 ± 0.19) had a moderate agreement. The composite MCI and GR images also had comparatively higher intraclass coefficient when compared to the OCFP (0.25 [?0.09–0.55]) and IR (?0.03 [?0.39–0.34]) images. Conclusion: MCI is more sensitive for determining the extent of TRDs and for the detection of secondary membranes when compared to OCFP, thus, aiding in better surgical planning.
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Context: The ongoing pandemic has affected all the spheres of life and one of the severely affected avenues is the education of a child. The online education has seen an upward curve since the start of COVID-19 pandemic. Schools globally have adopted online class tutorials as the main method to impart education and directly increasing the screen time for a child. Aim: The aim of the present study was to evaluate the cytological effects of prolonged mobile phone usage on the buccal mucosa of children. Settings and Design: Stratified sampling was used for the selection of subjects for the study. After a questionnaire regarding the usage of a mobile phone was distributed among the parents of children. Among them, 90 children were selected on the basis of pattern and frequency of mobile phone usage in the child. Materials and Methodology: The children were divided into three groups based on the per day hours of viewing of mobile phone, i.e., Group 1: Usage of 1–2 h a day, Group 2: Usage of 3–6 h a day, and Group 3: Usage of >6 h a day. The time frame taken into consideration was 1 year after the pandemic started. This was specifically to understand the impact of the online education. Swab was obtained by using the conventional ice-cream stick method from the buccal mucosa. Statistical Analysis: The samples were subjected to histological and microscopical analysis to observe for cytological changes. One-way ANOVA was used to determine the statistical significance if any. Results: The results obtained clearly showed that Group 3 (>6 h usage per day) showed the highest number of cellular and chromosomal aberrations which was significant. Conclusion: The results indicated that impact due to the prolonged screen time on the buccal mucosa is significant. A direct proportionality was seen between the apoptotic changes and chromosomal aberrations and the number of daily hour usage.
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Purpose@#Neonatal near miss (NNM) allows for the detection of risk factors associated with serious newborn complications and death, the prevention of which could reduce neonatal mortality. This study was conducted with the objective of identifying predictors for NNM in a tertiary hospital in Bangalore city. @*Methods@#This was an unmatched case-control study involving 120 NNM cases and 120 controls. NNM was determined using Pileggi-Castro’s pragmatic and management criteria. Data was collected from in-patient hospital records and interviews of postpartum mothers. Multiple logistic regression of exposure variables was performed to calculate adjusted odds ratio (AOR) with 95% confidence interval (CI). @*Results@#Significant predictors were maternal age ≥30 years (AOR, 5.32; 95% CI, 1.12 to 9.29; P=0.041), inadequate antenatal care (ANC) (AOR, 8.35; 95% CI, 1.98 to 51.12; P=0.032), <3 ultrasound scans during pregnancy (AOR, 12.5; 95% CI, 1.60 to 97.27; P=0.016), maternal anaemia (AOR, 18.96; 95% CI, 3.10 to 116.02; P=0.001), and any one obstetric complication (hypertensive disorder in pregnancy, diabetes in pregnancy, preterm premature rupture of membranes, prolonged labour, obstructed labour, malpresentation) (AOR, 4.34; 95% CI, 1.26 to 14.95; P=0.02). @*Conclusion@#The predictors of NNM identified has important implications for public health policy and practice whose modifications can improve NNM. These include expanding essential ANC package to include ultrasound scans, ensuring World Health Organization recommendations of eight ANC visits, capacity building at all levels of health care to strengthen routine ANC and obstetric care for effective screening, referral and management of obstetric complications.
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Purpose@#Neonatal near miss (NNM) allows for the detection of risk factors associated with serious newborn complications and death, the prevention of which could reduce neonatal mortality. This study was conducted with the objective of identifying predictors for NNM in a tertiary hospital in Bangalore city. @*Methods@#This was an unmatched case-control study involving 120 NNM cases and 120 controls. NNM was determined using Pileggi-Castro’s pragmatic and management criteria. Data was collected from in-patient hospital records and interviews of postpartum mothers. Multiple logistic regression of exposure variables was performed to calculate adjusted odds ratio (AOR) with 95% confidence interval (CI). @*Results@#Significant predictors were maternal age ≥30 years (AOR, 5.32; 95% CI, 1.12 to 9.29; P=0.041), inadequate antenatal care (ANC) (AOR, 8.35; 95% CI, 1.98 to 51.12; P=0.032), <3 ultrasound scans during pregnancy (AOR, 12.5; 95% CI, 1.60 to 97.27; P=0.016), maternal anaemia (AOR, 18.96; 95% CI, 3.10 to 116.02; P=0.001), and any one obstetric complication (hypertensive disorder in pregnancy, diabetes in pregnancy, preterm premature rupture of membranes, prolonged labour, obstructed labour, malpresentation) (AOR, 4.34; 95% CI, 1.26 to 14.95; P=0.02). @*Conclusion@#The predictors of NNM identified has important implications for public health policy and practice whose modifications can improve NNM. These include expanding essential ANC package to include ultrasound scans, ensuring World Health Organization recommendations of eight ANC visits, capacity building at all levels of health care to strengthen routine ANC and obstetric care for effective screening, referral and management of obstetric complications.
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Dental pain is most commonly associated with the carious destruction leading to inflammation of the pulp or can also be pain present post operatively; however, much of the dental pain can be attributed to dentinal hypersensitivity (DH). The prevalence of DH is high enough (72.5 % to 98 %) to warrant the development of effective treatment. Surveys among dental professionals worldwide suggest that many lack adequate knowledge about this condition and its management. This study aims to assess the knowledge and awareness of postgraduates and faculty regarding dentinal hypersensitivity in a tertiary dental care hospital in Bangalore. METHODSA descriptive cross-sectional survey was carried out among the staff and post graduate students at Rajarajeswari Dental College & Hospital, Bangalore during October 2019. Ethical clearance was obtained from the Institutional Ethical committee. All the staff and post graduate students who were present on the day of study were included in the study. Informed consent was obtained from all the study participants before the study and participation was entirely voluntary. RESULTSMajority of the participants routinely checked for the signs of DH (F - 77.2 % PG - 77 %) and considered DH as a serious problem (F - 87.5 % PG - 87 %). Participants also thought that DH has to be treated with an interdisciplinary approach (F - 75 % PG - 67.7 %). CONCLUSIONSThe study concludes that even though the knowledge and awareness of Dentinal Hypersensitivity was good, there existed uncertainty concerning diagnosis and management of the same.
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Purpose: The major cause of chronic hepatitis is infections with hepatitis B virus and hepatitis C virus (HCV) globally. However, there exists sparse epidemiological data regarding the prevalence of HCV infection from India. Methodology: We carried out a cross-sectional study to estimate the prevalence of anti-HCV antibody among acute febrile illness cases aged between 1 and 65 years in Idar Taluk, Sabarkantha district, Gujarat state located in West India. A total of 702 serum samples collected from the study area during the year 2017, were screened for anti-hepatitis C IgG by enzyme-linked immunosorbent assay. The serum samples screened positive were then subjected to molecular testing for confirmation. Results: Among the 702 study participants screened, 16 cases were reported to be anti-HCV IgG positive with an estimated seroprevalence rate of 2.3% (95% confidence interval: 1.4%–3.7%). Out of the 16 cases, two samples were confirmed positive by molecular testing indicating active infection. When analysed phylogenetically, one strain was genotyped as HCV1b genotype, and the other one was clustered along with HCV3a genotype. Both the patients with hepatitis C infection were observed to be having a probable 1-year survival rate of 100% and a 2-year survival rate of 85% when the Child-Turcotte-Pugh classification was applied. Conclusion: The estimated seroprevalence of hepatitis C in Idar Taluk, Sabarkantha district, west India was 2.3%. HCV genotypes 1b and 3a were observed to be circulating in the study area.
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Introduction: CT guided lung FNAC/Biopsy is beingincreasingly used for the tissue diagnosis of lung lesions. CTis the safest and most accurate method of biopsying centrallesions and lesions adjacent to or involving the hila andmediastinal structures. This study was aimed at evaluatingthe frequency of complications following CT – guided lungBiopsy/FNACMaterial and methods: This was a retrospective study. 53CT guided procedures performed during the year 2016 wereincluded in the study. All the patients had a CT examination ofthe chest (plain and contrast) done before the guided procedurewhich was used as a road map. CT examination was doneon a Siemens somatom 148 slice scanner. In some patientstable dose oral contrast was also given done to delineate theoesophagus.Results: The incidence of pneumothorax was 1.06% i.e. only1 patient out of 53 had minimal pneumothorax which wastreated conservatively.Conclusion: CT guided lung FNAC/Biopsy is a safeprocedure if done in expert hands with a multi-disciplinaryteam approach. Complications can be minimised by carefulselection of the patient... considering the site and size oflesion; associated lung conditions etc
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Aim: To evaluate the effectiveness and retention of knowledge of two educational methods such as Mind Mapping and conventional teaching method amongdentalundergraduates. Materials and Methods: This cross sectional comparative interventional study was carried out among nal year dental undergraduates (n=80) at RajarajeshwariDentalCollege&Hospital,Bangalore.Studentsweredividedintotwogroups,GroupA:MindMappingGroup/testgroup(40)andGroupB: control group (40). A pretested questionnaire of 10 questions was used to asesess the knowledge at baseline, immediately after and a week after the intervention.Knowledgegainwastheprimaryoutcomevariableandretentionoftheknowledgeafteraweekisthesecondaryoutcome. Results:At the baseline the mean knowledge score was equal in both the group. Immediately after intervention, the mean knowledge score in the control group increased to 8.8, whereasin the mind map group, it increased to 9.4 and the difference wasfound to be statistically signicant(p = 0.003). One week afterintervention,themeanscoreinthemindmapgroupwassignicantlymorethanthetextgroup(9.3Vs8.6;p=0.003). Conclusion:Theresultsofthestudyshowedthatmindmappingmethodwasmoreeffectiveasateachingandlearningmethodthanthelecturebasedmethod
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Background: Dengue viral infection is a major and important public health problem in many South East Asian (SEA) countries and also in more than 100 countries of tropical and subtropical region. The aim of study was to assess the frequency and degree of hepatobiliary dysfunction in adults with dengue infection presenting to our tertiary hospital, Karimnagar.Methods: The study was a prospective observational study conducted on 120 adult patients of serological proven dengue infection with hepatic and biliary manifestations, admitted during the period of from June 2016 to June 2017. Investigations included complete blood count, liver function test, viral serology, sepsis screen, ultrasound abdomen.Results: Majority of cases in age group of 20-56 years with male: female ration of 1.7:1. Of all the cases, 53% patients were categorized into dengue fever group, 25% into dengue hemorrhagic fever group, and 27.7% into dengue shock syndrome group in accordance to WHO guidelines.Conclusions: This study was showed that a significant hepatobiliary derangement is seen in severe cases of dengue. Early recognition of such perturbations helps guide further management to prevent mortality.
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Background: The aim of the present study was to evaluate the potentiation of general anaesthetic activity of ketamine by NMDA receptor antagonist ‘amantadine’ in wistar albino rats.Methods: The wistar albino rats of either sex were divided into three groups of five animals in each group. Group I received ketamine 80mg/kg, group II received ketamine 40mg/kg along with amantadine 40mg/kg and group III received ketamine 80mg/kg along with amantadine 40mg/kg to evaluate the potentiation of general anaesthetic effect of ketamine. The sleep latency time and the total sleeping time were measured in all the three groups.Results: The sleep latency time of group III is significantly decreased (p <0.035) and as equal to that of group II when compared to group I. The sleeping time of group III is significantly increased (p <0.001) when compared to group I.Conclusions: Amantadine - the NMDA receptor antagonist potentiates the general anaesthetic activity of ketamine.
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<p><b>OBJECTIVE</b>To investigate the effect of different processing methods on antioxidant properties of acetone extract of aerial parts from Boerhaavia diffusa and Portulaca oleracea.</p><p><b>METHODS</b>The total phenolic and flavonoid contents were determined by Folin-Ciocalteau and aluminum chloride method, respectively. FRAP, metal chelating activity, DPPH, ABTS, nitric oxide, hydroxyl and superoxide radical scavenging activities, carotene/linoleic acid bleaching activity were used for the determination of antioxidant capacity.</p><p><b>RESULTS</b>The total phenolics in Boerhaavia diffusa (82.79-162.80 mg GAE/g extract) were found to be higher when compared to that of Portulaca oleracea (22.94-10.02 mg GAE/g extract). Hydrothermal processing enhanced the level of inhibition on synthetic radicals such as DPPH (3 439-309 549 mmol TE/g extract) and ABTS (17 808-53 818 mmol TE/g extract) as well as biologically relevant radicals such as superoxide anion (70%-90%) and nitric oxide (49%-57%). In addition, boiling of the vegetables were found to be maximum capacity of FRAP (6 404.95 mmol Fe (II)/g extract) and metal chelating activity (1.53 mg EDTA/g extract) than the respective raw samples.</p><p><b>CONCLUSIONS</b>The present investigation suggests that the processing enhance the functionality and improves the availability of bioactive substances of these vegetables. In addition, they also exhibited more potent antioxidant activity. Therefore these natural weeds from the crop land ecosystem could be suggested as cost effective indigenous green vegetables for human diet and potential feed resources for animals. Further extensive studies on role and importance of those weeds in sustaining the agro biodiversity are also needed.</p>
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Objective: To investigate the effect of different processing methods on antioxidant properties of acetone extract of aerial parts from Boerhaavia diffusa and Portulaca oleracea.Methods:The total phenolic and flavonoid contents were determined by Folin-Ciocalteau and aluminum chloride method, respectively. FRAP, metal chelating activity, DPPH, ABTS, nitric oxide, hydroxyl and superoxide radical scavenging activities, carotene/linoleic acid bleaching activity were used for the determination of antioxidant capacity.Results:The total phenolics in Boerhaavia diffusa (82.79-162.80 mg GAE/g extract) were found to be higher when compared to that of Portulaca oleracea (22.94-10.02 mg GAE/g extract). Hydrothermal processing enhanced the level of inhibition on synthetic radicals such as DPPH (3439-309549 mmol TE/g extract) and ABTS (17808-53818 mmol TE/g extract) as well as biologically relevant radicals such as superoxide anion (70%-90%) and nitric oxide (49%-57%). In addition, boiling of the vegetables were found to be maximum capacity of FRAP (6 404.95 mmol Fe (II)/g extract) and metal chelating activity (1.53 mg EDTA/g extract) than the respective raw samples. Conclusions: The present investigation suggests that the processing enhance the functionality and improves the availability of bioactive substances of these vegetables. In addition, they also exhibited more potent antioxidant activity. Therefore these natural weeds from the crop land ecosystem could be suggested as cost effective indigenous green vegetables for human diet and potential feed resources for animals. Further extensive studies on role and importance of those weeds in sustaining the agro biodiversity are also needed.