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Introduction : Glaucoma is the leading cause of irreversible visual loss in world and also in India. Because of the relatively asymptomatic initial phase of the disease, it is often detected by chance and is frequently associated with extensive and irreversible damage at the time of diagnosis. Objectives: To screen for Glaucoma among patients eligible as per inclusion criteria, to classify the glaucoma cases according to clinical presentation and to correlate the occurrence of glaucoma with different variables. Method: The present study was conducted at one of the tertiary care hospitals of Ahmedabad city during celebration of “World Glaucoma Week - 2021”. Total 1421 patients were offered opportunistic screening after oral informed consent during 6-12 March 2021, who attended the institute. After applying exclusion criteria, 945 were found eligible who underwent a comprehensive ophthalmic examination like visual acuity, intra- ocular pressure measurement, gonioscopy, optical disc and visual filed examinations were carried out as per standard protocols. Sociodemographic details, any relevant ophthalmic history pertaining to glaucoma and systemic illnesses were also assessed. The data were entered and analyzed in MS excel. Results: The incidence of newly diagnosed cases of glaucoma among opportunistic screened cohort was 36.71% (n=347). Of total newly diagnosed, the presentation as per clinical classification was as follows: Primary open angle glaucoma (POAG) - 202 (58.21%), Primary angle closure glaucoma (PACG) - 77 (22.19%), Primary angle closure suspect (PACS) – 41 (11.82%), Ocular hypertension (OHT) – 6 (1.73%), Normal tension glaucoma (NTG) – 10 (2.88%), Secondary glaucoma – 9 (7.09%) and Congenital glaucoma – 2 (0.58%). In yield, 25 (19.68%) were ?40 years and 36 (28.35%) had positive family history of glaucoma. Conclusion: Presence of stand-alone Diabetes and Hypertension or presence of both accompanying – all three conditions were found to be statistically significant determinant for occurrence of particular variety of Glaucoma. There was highly significant statistical association between cup-disc ratio level at the time of presentation and clinical variety of glaucoma
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Diagnosis of pulmonary tuberculosis is challenging till today. Smear microscopy is the easiest, commonest and widely employed tool for confirmatory diagnosis of pulmonary tuberculosis, but it has low sensitivity and specificity. Sputum culture can increase the diagnostic yield by 20-40%, but it takes long duration of 2-8 weeks to give result. The role of newly introduced cartridge based nucleic acid amplification test (CBNAAT) in the revised national TB control program (RNTCP) is highly promising with a higher yield of bacteriological diagnosis in sputum negative pulmonary tuberculosis patients with detection of rifampicin resistance rapidly. However, it also has some limitations which may result in false negative results. Case of a 50- year-old-male was reported who was initially managed for community-acquired pneumonia in view of negative sputum and CBNAAT but was later confirmed to have TB but by then he had developed cavities in lung and had transmitted the infection to his son.
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Background: Enterococcus species are well known for its intrinsic resistance pattern to several antibiotics. Hence, appropriate management and prevention is essential in any healthcare facility. Present study was conducted to establish an accessible biochemical tests to differentiate Enterococcus species at resource limited settings.Methods: Enterococci isolated from various clinical specimens were speciated using an array of biochemical reactions and antimicrobial susceptibility testing was performed by Kirby-Bauer disc diffusion method. Results were interpreted as per Clinical and Laboratory Standards Institute (CLSI) guidelines.Results: Out of 107 enterococcal isolates, 63(59%) were E. faecium, 40(37%) were E. fecalis, 2(2%) were E. hirae, 1(0.9%) was E. raffinosus and 1(0.9%) was E. gallinarum. E. faecium and E. fecalis showed 23% and 7% vancomycin resistance respectively, while E. gallinarum showed low level vancomycin resistance.Conclusions: Enterococcus speciation can be done using simple biochemical reactions and its susceptibility pattern enables to distinguish Van phenotypes too. Hence, it is helpful for management of infections in resource limited settings to a greater extent.
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Background: Asterion Introduction: Enteric fever is a major concern in developing country. It is predominantly caused by serovars typhi and paratyphi of Salmonella enterica. Recently, an upsurge in antimicrobial resistant strains has worsened the management of enteric fever. So, aim of present study is to evaluate the clinical profile, antibiotic sensitivity and prescription pattern in blood culture proven cases of enteric fever in pediatric and adult patients.Methods: Single centre, prospective study was conducted at a tertiary care hospital. Demographic and clinical details of blood culture proven enteric fever admitted in hospital were collected over the period from August 2016 to November 2018.Results: Total 58 blood cultures grew Salmonella spp. , amongst them 84.48 % had growth of Salmonella typhi. Blood culture was sent after a mean period of 9 days and 10 days of fever in pediatric and adult patients respectively. All isolates of S. paratyphi A were pansusceptible, whereas 36.73 % isolates of S. typhi were multidrug resistant and nalidixic acid resistant. 68.97% patients received antibiotics before admission. The difference between mean time to defervescence in patients who received ceftriaxone and those who received more than one antibiotic was not statistically significant. (P value 0.87)Conclusion: Blood cultures are the important diagnostic tool to identify multidrug resistant Salmonellae. Study showed that combination therapy was not statistically superior and awareness of local antimicrobial susceptibility pattern significantly helps for better management of the patients.
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A breast abscess is a rare complication of Salmonella bacteremia; especially, in immunocompetent patients. In the era of antimicrobial resistance, untreated or resistant Salmonella can lead to abscess formation in various organs of the body. The authors report a case of unilateral breast abscess due to Nalidixic Acid Resistant Salmonella enterica serovar Typhi (NARST) in a 30-year-old immunocompetent female. This case report highlights the importance of culture & sensitivity of breast abscesses especially in patients residing in endemic areas or those with a recent history of typhoid fever
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Introduction:The FMS-like tyrosine kinase-3 (FLT3), a member of the Platelet-derived growth factor (PDGF-R) subfamily of receptor tyrosine kinases, expressed on early hematopoietic progenitor cells play an essential role in survival and differentiation of stem cell. Majority of acute myeloid leukemia (AML) patients have mutation in this gene. Two types of frequent mutations are present in this gene. Both the types FLT3-ITD and D835 mutations play an important role in prognosis of AML patients. Methods:Total 33 patients were enrolled in the study. Blood samples were collected from the subjects, from which the DNA isolation was carried out.For FLT3-ITD mutation, PCR was performed and for D835 mutation PCR-RFLP was performed. DNA segments were amplified using Polymerase Chain Reaction (PCR). Results: FLT-3 ITD mutation was detected in 12% of patients and D835 mutation was detected in 3% of patients. The study revealed significant correlation between ITD and Tdt, while D835 negatively correlated with CD33, HLADR and Tdt. However, there was no substantial correlation of D835 with LDH value. also revealed that FLT-3 ITD significantly correlated with LDH values in AML patients. The mean value of LDH was 753.45 IU/L in ITD positive patients as compared to ITD negative patients with 338 IU/L mean LDH value, suggesting higher LDH values in ITD positive. Conclusion:These Genotypic analysis of FLT-3 mutation results from West Indian population provide important tools for understanding of AML pathogenesis and determination of appropriate therapeutic intervention. Further large number of patient data can also corroborate these significant results.
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Background:The double strand break repair pathway, comprising XRCC2 and XRCC3 has crucial role in maintenance of genomic stability and prevention of tumor initiation and progression. Therefore, sequence variants of such DNA repair genes may compromise individual's DNA repair capacity and can influence risk of developing breast cancer. Method and Results:To estimate the impending effect of XRCC2 (Arg188His) and XRCC3 (Thr241Met) polymorphisms on breast cancer, 133 breast cancer patients and 154 healthy controls were evaluated by PCR-RFLP method. In the present study, it was noted that there was no significant correlation between these polymorphisms and breast cancer risk. However, within patient group, significant association of XRCC2 variants with PR negative breast cancer was detected. Further, patients with XRCC2 variant genotypes were also at high risk of developing TNBC and Her2 enriched subtypes as compared to luminal A subtype. Significant relation was also obtained between XRCC3 variants and large sized and infiltrative breast tumors. Conclusion: These noteworthy observations demonstrate potential involvement of XRCC2 and XRCC3 polymorphisms in pathophysiology of breast cancer.
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Background: Malocclusion in the vertical and sagittal planes is easy to observe whereas it is difficult to diagnose malocclusion in the transverse plane. There are yet no criteria defining a normal transverse occlusion. Aim: The aim of this study was to identify a ratio that defines a normal transverse occlusion. Study Design: This was a retrospective study. Materials and Methods: A total sample of 151 maxillary dental models (M = 55, F = 96) in the age range of 12-16 years were randomly selected, with 73 models in control group and 78 in the study group. All the models were mixed up and given to an operator for the measurement of intercanine width (ICW) and inter-palatal molar width (IPMW). Statistical Analysis Used : The data were statistically analyzed using SPSS software version 16.0. Chi-square test was performed to test the statistical significance difference between the groups at p ≤ 0.05. Results: Nearly 98.60% of normal arches were found to have an IPMW to ICW ratio of 1:1 ± 0.05. On further analysis, it was found that when IPMW ≥37.45 mm, then the case may be considered to have normal arches, and if the ratio between IPMW to ICW is 1.15:1 ± 0.05 or more and IPMW is <34.92 mm, then the case may be identified as deficient arch. Conclusion : The IPMW-to-ICW ratio can be used to differentiate deficient and normal arches. This hypothesis (Banker's hypothesis) is an easy and noninvasive method, using only two parameters, developed to help clinicians in identifying normal transverse dimension.
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Dermatofibrosarcoma protuberans (DFSP) is a relatively uncommon soft tissue neoplasm of cutaneous fibrous tissue with low to intermediate grade malignancy. Most of this tumour is focal origin; however the sequential occurrence of the two masses over breast and inguinal region in our case probably represents multifocal origin rather than metastases. To the best of our knowledge case of DFSP having multifocal origin as was our case, have rarely been documented in the literature.