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Objectives: To describe the clinical presentation, phenotype and outcome of multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19) from a tertiary care center in southern India. Methods: 257 children fulfilling the inclusion criteria of MIS-C were prospectively enrolled from June, 2020 to March, 2022. Results: Median (range) age at presentation was 6 year (35 day to 12 years). Presenting features were fever (98%), vomiting (75.8%), red eyes (63%), rashes (49%), pain abdomen (49%), shock (45.9%), lymphopenia (73%, thrombocytopenia (58.3%) and anemia (45%). 103 (39.7%) children required intensive care admission. Shock phenotype, Kawasaki-like phenotype and no specific phenotype were diagnosed in 45.9%, 44.4%, and 36.6% children, respectively. Left ventricular dysfunction (30.3%), acute kidney injury (13%), acute liver failure (17.4%), and hemophagolymphohistiocytosis (HLH) (13.6%) were the major system involvement in MIS-C. Mitral regurgitation (P=0.029), hyperechogenic coronaries (P=0.006), left ventricular dysfunction (P=0.001) and low ejection fraction (P=0.007) were significantly associated with shock. Overall mortality was 11.7%. Conclusions: Kawasaki-like and shock-like presentation were common in MIS-C. Coronary abnormalities were seen in 118 (45.9%) children. Children with acute kidney injury, HLH, need for mechanical ventilation, and echocardiogram evidence of mitral regurgitation in MIS-C have a poor outcome.
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Background: Semitendinosus and gracilis muscle tendons are among the most frequently used grafts in anterior cruciate ligament reconstructive surgery. Gracilis is also frequently used in breast reconstruction as well as in upper and lower limb reconstruction as a free graft. Materials and Methods: A total of 60 human cadaver lower limbs were studied of 30 adults (12 men and 18 women) who have been embalmed at a tertiary care institution. Those cadavers whose lower limb had undergone surgery in the past and those with concomitant pathology that would have affected the local anatomy were excluded. Gracilis and semitendinosus tendons were taken out of embalmed remains after the cutaneous and subcutaneous tissues had been carefully dissected. Results: It was observed that the maximum load of all the semitendinosus tendons studied had a mean value of 768.2 ± 130.4 N. The semitendinosus tendon’s maximal load in males ranged from 698.4 to 1133.9 N. However in females, the semitendinosus tendon’s maximal load ranged from 589.5 to 780.0 N. Conclusion: The topographical and morphometric data from this study can be utilized as a database of anthropological parameters for the Semitendinosus and Gracilis muscle tendons of a population in a south Indian setting,
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Background: Systemic lupus erythematosus is an autoimmune disease of unknown etiology, characterized by the involvement of multiple organ systems. Organ damage is mediated by tissue binding autoantibodies and immune complexes. High anti-dsDNA titer and low serum complement levels (C3, C4) correlate with disease activity of SLE, especially with lupus nephritis (LN). Aim of the study: To evaluate the correlation between a serological profile (anti-dsDNA, serum C3, and C4) and histopathology of lupus nephritis and to find out the class of LN which has a significant correlation with the serological profile. Materials and methods: This retrospective study was conducted in the Department of Nephrology, Kilpauk Medical College and Hospital, Chennai between 2013-2017 with 50 ANA positive female SLE patients with evidence of lupus nephritis (proteinuria, microscopic hematuria or increased serum creatinine). Serological profile (anti-dsDNA, serum C3, and C4) and renal biopsy were done in all patients. Results: Of 50 patients, 35 (70%) had class IV lupus nephritis, 7 (14%) class II, 4(8%) class V and 4 patients (8%) had class IV and V on renal biopsy. The prevalence of anti dsDNA was 97.1% in LN and 97.4% (38 of 39 pts) in proliferative LN (p<0.001). The C3 level was low in 68% of patients with LN and 84.6% with proliferative LN (p <0.001). C4 level was low in 74% of patients with LN and 87.2% with proliferative LN (p <0.001). In our study, 72% (28 of 39 pts) of the patients with Vasudevan Chelliah, Ramesh Subramanian. A study to evaluate the correlation between serological profile and histopathology of lupus nephritis. IAIM, 2019; 6(4): 36-41. Page 37 proliferative LN (class IV, IV and V) had the combination of anti-dsDNA positivity, low C3,and low C4 levels but none of the patients with class II or class V LN had this combination of serology. Conclusion: In our study, the serological profile of SLE had a significant correlation with histopathology of lupus nephritis. Anti-dsDNA, low C3, and low C4 had a significant independent correlation (p<0.05) with proliferative LN (class IV, IV and V).
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Background: The jugular foramen, the bony opening on the base of skull, is an opening through which pass the ninth, tenth, and eleventh cranial nerves, two dural sinuses, and the meningeal branches of the occipital and ascending pharyngeal arteries. The increasing use of modern diagnostic procedures and new surgical approaches has created a need for much more detailed anatomical studies and explanations. This article reveals some additional features. Material and Methods: 324 jugular foramina of skulls of persons of unknown age and gender were examined. The morphological characteristics of all the investigated jugular foramina were described, measured, and compared, taking into consideration their side. Results: Jugular foramina were studied for a review of its morphology, morphometry and its comparison with previous studies. Different shapes and sizes of jugular foramen were seen. Laterality was also noticed, compartmentation was also observed which was found to be statistically significant. Conclusions: A detailed examination of the jugular foramen anatomy was performed. The main types of jugular foramina and the frequencies of bipartite or tripartite division were established. Several dimensions of the parts of the jugular foramen were measured. Some new data could provide important information about the anatomy of the jugular foramen for reliable surgical interventions in this area.