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Background: Glenohumeral joint is highly susceptible to dislocation due to its wide range of movements. Recurrent anterior shoulder dislocations are common in young adults. The Bristow Latarjet procedure is one of the effective techniques for the treatment of recurrent anterior shoulder dislocation. This study aimed to assess the clinical and functional outcome of the Bristow Latarjet procedure in the management of recurrent anterior shoulder dislocation. Material & Methods: This prospective interventional study was conducted in the Department of Orthopaedic Surgery, BSMMU, from October 2017 to September 2019. Within this period, a total of 40 cases of recurrent anterior shoulder dislocation that meet inclusion criteria were taken as a sample. Patients were evaluated both pre and postoperatively for functional outcomes according to Rowe’s score for instability. A purposive non-randomized sampling technique was used in this study. All the data were compiled and sorted properly and the quantitative data were analyzed statistically by using Statistical Package for Social Science (SPSS-25). The results were expressed as frequency, percentage and mean ± SD. Paired Student’s‘t’ test was performed to compare pre and final postoperative follow-up. The level of significance was calculated at a confidence interval of 95% and p-value <0.05. Results: : In this study age of the patient ranged from 18-40 years and the mean age was 28.2±6.3. 29(72.5). Surgery was done within 4-6 months of the first dislocation in 5 patients, within 6-12 months in 21 patients and after 12 months in 14 patients. The mean (±SD) Rowe score for instability was significantly (p<0.001) higher 6 months after the Bristow Latarjet procedure at 91.87(±9.00) in comparison to preoperative periods 52.62(±18.40). Results were excellent in 32(80%), good in 4(10%), fair in 3(7.5%) and poor in 1(2.5%) patients. 36(90%) patients were in the satisfactory group and only 4(10%) in the unsatisfactory group. Only 1(2.5%) patient developed screw migration, 2(5%) patients developed subluxation, and 1(2.5%) patient developed postoperative arthritis. Conclusion: It can be concluded that the Bristow-Latarjet procedure is a very effective and safe procedure with reduced complications, presenting very satisfactory functional results in the treatment of recurrent anterior shoulder dislocation.
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Background: Ca-125 is a large molecular-weight glycoprotein synthesized by different cells originating from the coelomic epithelium. Although classically it has been used to monitor the course of ovarian epithelial cancer, there are other established circumstances associated with high serum Ca -125 levels and pulmonary tuberculosis is one of them. Diagnosing pulmonary tuberculosis, which is not bacteriologically positive often very challenging. Because many procedures are available for such cases but they are of limited use because some of them are lengthy or expensive or need sophisticated equipment, highly skilled personnel, etc. Serum CA-125 is a rapid, relatively inexpensive investigation. Objective: The present study aimed to assess the role of CA-125 in distinguishing pulmonary TB from bacterial pneumonia. Methods: This analytical cross-sectional study was conducted in the Department of Medicine, Dhaka Medical College Hospital for the period of March 2018 to September 2020.100 pulmonary tuberculosis patients were taken in group I, and 100 bacterial pneumonia patients were taken in group II according to selection criteria. Informed written consent was taken from each of the participants. All were subjected to detail clinical and demographic history along with thorough physical examination. Relevant investigations were done including serum CA-125. All final data were collected in the semi-structured and pretested case record form. After data collection, data were checked for errors, and analysis was done. Results: In this study, the mean CA-125 value was 62.29 (SD±31.51) IU/mL in group I(pulmonary tuberculosis). In group II (bacterial pneumonia) mean value was 22.95(±8.25) IU/mL. The mean value of CA-125 was significantly higher (p-value <0.001) in group I patients compared to group II. About 59.0% of patients in group I had a high level of serum CA-125 which had a significant difference from group II (p<0.001). ROC analysis of CA-125 in the diagnosis of patients with active pulmonary tuberculosis showed a cut-off value of ?31.7 IU/mL had sensitivity, specificity, PPV, NPV, PLR, NLR, and accuracy of 72%, 87%, 84.7%, 75.7%, 5.54%, 0.321%, and 79.5% respectively. Conclusion: This study’s findings stated that serum CA-125 may be a useful marker in distinguishing PTB from bacterial pneumonia. Therefore, further study with a more generalized study population is recommended.
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Background: In chronic kidney disease (CKD), renal regulatory mechanisms may be insufficient to balance intestinal magnesium absorption hence insufficient to maintain homeostasis. But related data are relatively sparse and not readily available, especially in Bangladesh context. Aim of the study: The aim of the study was to assess the pattern of serum magnesium level in different stages of CKD patients. Material & Methods: This descriptive cross-sectional study was conducted in the Department of Medicine and the Department of Nephrology, Dhaka Medical College Hospital (DMCH) for nine months’ period. Approval for the study was taken from the ethical review committee of DMC before the commencement of the study. Diagnosed patients of chronic kidney disease (CKD) were approached for the inclusion of the study. Informed written consent was taken from each patient. All patients were subjected to detailed history taking, physical examination, and relevant investigations. For the study purpose, serum magnesium was done for all patients. Results: After compiling data from all participants, statistical analysis was performed using the statistical package for social science (SPSS) version 22 for windows, and a p < 0.05 was considered statistically significant. Mean age of the patients was 53 years with male predominance (male 64% vs female 36%). Of all, 6.7% of cases had hypomagnesemia and 55.3% had hypermagnesemia. The mean serum magnesium level was 2.68±0.81 mg/dl. Assessment of serum magnesium in a different stages of CKD showed that hypermagnesemia is associated with higher staging (p<0.05), and there is a negative correlation between lower e-GFR with serum magnesium ((r=-0.753, p<0.01). Conclusion: Nearly two-third of CKD patients were found with altered magnesium level in the form of hypomagnesemia or hypermagnesemia in this study. Serum magnesium was found increased in higher stages of CKD. That means serum magnesium level increases along with higher stage of the disease. Urinary magnesium excretion also decreases when eGFR of patient decreased.
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Background: Poisoning is a common medico-social problem in our country causing around 300,000 episodes and around 2000 deaths per year. Attempted suicide among adult females are a major public health problem. The number of self-poisoning in females are increasing in our country day by day. The incidence, nature, etiology, age group affected and the outcome of self-poisoning in females of our country is different from that of the western world. Objective: The objective of the study was to analysis the socio-demographic profile & pattern of deliberate self-poisoning among adult females admitted in the Medicine Department, Dhaka Medical College Hospital. Material and Methods: This was a descriptive cross sectional study conducted in the Department of Medicine, Dhaka Medical College Hospital from January 2016 to June 2016. 100 admitted female participants were enrolled in this study as study population. A purposive sampling method was applied for sampling from study population. Results: The age of the participants were from 18 to 55 years with the mean age of 28.19 (± 9.84) years. Most number of the participants were in 21-29 year’s age group (42%) followed by ?20 year’s (29%). House wife (30%) was the most common occupation followed by student (25%). Most of the participants were from lower economic class (51%), followed by middle class (41%). 48% participants were in primary level, 24% in secondary level and 22% were illiterate. Most of the participants were married (51%), followed by unmarried (35%), divorced (9%) and widow (5%). 62% participants from rural and 38% from urban area. 75% were Muslim and 25% were Hindu. 55% were from the joint family and 45% were from the nuclear family. Most of the self-poisoning occurred between 6 am to 12 pm (42%), followed by 6 pm to 12 am (30%), 12 pm to 6 pm (20%) and 12 am to 6 am (8%). Insecticide was the most common poison materials (43%), followed by drug ingestion (30%), household detergent (13%), rodenticide (6%) and others (8%). Maximum participants reported the reason for self-poisoning was family disharmony (35%) followed by romantic disappointment (27%). 17% participants reported previous suicidal attempt and 11% had previous psychiatric disorder. Nearly half of the participants (43%) sought medical care within 2 hours and one fourth participants (31%) within 4 hours. About two-thirds of the participants (66%) received primary medical care from different govt. hospitals. Most of the female participants with self-poisoning were recovered completely (71%), while 20% participants recovered with complications and 9% participants died. In the study, fatality rate was found 33.3% in rodenticide and 16.3% in insecticide poisoning. Conclusions: As evident from the study, by intervene these problems by various measures might be helpful to prevent many of deliberate self-harm. Early diagnosis and prompt institution of appropriate treatment can make a favorable outcome in deliberate self-poisoning of female participants.
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@#Discordant lymphoma (DL) is the coexistence of two or more distinct subtypes in separate anatomic sites. There are limited reports on DL cases especially involving more than two subtypes in more than two sites. We report a 76-year-old man who presented with constitutional symptoms, flank mass and painless lymphadenopathies for six months. Laboratory tests revealed moderate anaemia, markedly elevated serum IgM (13400 mg/dL), IgM Lambda paraproteinemia and Lambda light chain paraproteinuria with unmeasurable serum lactate dehydrogenase due to hyperviscous sample. CT scan showed multiple subcutaneous masses over chest wall and retroperitoneum, with lytic bone lesions, and hepatosplenomegaly. Further biopsy findings with morphological, immunohistochemical and molecular analysis of the tissue sections revealed diffuse large B-Cell lymphoma in the chest wall mass, follicular lymphoma in the inguinal lymph node and lymphoplasmacytic lymphoma in the bone marrow. This case highlights the rare DL. The importance of histopathological evaluation of lymphoma despite the availability of PET-CT scans for disease staging is undeniable.
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The incidence of chronic kidney disease (CKD) is increasing worldwide and the current prevalence rate is 13.4%. There are > 120 million CKD patients in China and this number is expected to increase. One of the main abnormalities in patients with CKD and kidney impairment is decreased synthesis of erythropoietin (EPO), which causes anemia and affects iron metabolism. The probability of developing is higher in anemia patients with CKD than in the general population, and the incidence increases as kidney function decreases. Deficient EPO production by the kidney is the most important cause of renal anemia. Notably, anemia in patients with CKD has multiple causes, such as bleeding caused by platelet dysfunction, iron deficiency due to digestive and absorption disorders of the gastrointestinal tract, and shorter red blood cell life. Anemia is also a leading cause of hospitalization in patients with CKD. A new oral medication to treat renal anemia, the hypoxia-inducible factor prolyl hydroxylase inhibitor called roxadustat (FG-4592), regulates iron metabolism and promotes erythropoiesis. This drug has a therapeutic effect on patients with CKD. Roxadustat showed advantages over EPO in clinical experiments. This review summarizes the mechanisms of action, clinical applications, effectiveness, and safety of roxadustat.
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The study was undertaken from September 2018 to April 2019 to determine the prevalence of cutaneous leishmaniasis in human beings living in six districts of Karachi. Suspected persons were screened for the disease and positive cases were identified on the basis of skin lesions and blood samples. Samples were observed by mounting their smear. A total of 207 subjects of different ages and sex groups were investigated, however, only 192 (92%) of the suspected cases were found to have the disease 64% of cases were male which were significantly high (p<0.05), than female 36%. The lesion was more frequently detected among the youth ages of 21-30 years (31%) as compared to other groups. In both sexes, legs were found to be more infected (25% male + 20% female) followed by arms (20% male + 0% female) and face (15% male +11% female). The mixed body parts had shown the lowest infections such as (4% in males + 5%) in females. In conclusion, the highest and lowest leishmaniasis infections were observed in District West (23% male + 9% female) followed by District East (15% male + 7% female), District Malir (11% male+ 4% female), District Central (7% male + 5% female), District Korangi (4% male + 7% female) and District South (4% male + 4% female) respectively.
O estudo foi realizado de setembro de 2018 a abril de 2019 para determinar a prevalência de leishmaniose tegumentar em seres humanos que vivem em seis distritos de Karachi. Pessoas suspeitas foram rastreadas para a doença e os casos positivos foram identificados com base em lesões de pele e amostras de sangue. As amostras foram observadas montando seu esfregaço. Um total de 207 indivíduos de diferentes idades e grupos sexuais foi investigado, no entanto apenas 192 (92%) dos casos suspeitos foram encontrados para ter a doença; 64% dos casos eram do sexo masculino, que foram significativamente elevados (p < 0,05), e do sexo feminino 36%. A lesão foi detectada com maior frequência entre os jovens de 21 a 30 anos (31%) em comparação com os outros grupos. Em ambos os sexos, as pernas estavam mais infectadas (25% homens + 20% mulheres), seguidas pelos braços (20% homens + 0% mulheres) e rosto (15% homens + 11% mulheres). As partes mistas do corpo mostraram as infecções mais baixas (4% homens + 5% mulheres). Em conclusão, as infecções de leishmaniose mais altas e mais baixas foram observadas no Distrito Oeste (23% homens + 9% mulheres) seguido pelo Distrito Leste (15% homens + 7% mulheres), Distrito Malir (11% homens + 4% mulheres), Distrito Central (7% homens + 5% mulheres), Distrito Korangi (4% homens + 7% mulheres) e Distrito Sul (4% homens + 4% mulheres), respectivamente.
Subject(s)
Male , Female , Humans , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/parasitology , Leishmaniasis, Cutaneous/blood , PrevalenceABSTRACT
Abstract. The study was undertaken from September 2018 to April 2019 to determine the prevalence of cutaneous leishmaniasis in human beings living in six districts of Karachi. Suspected persons were screened for the disease and positive cases were identified on the basis of skin lesions and blood samples. Samples were observed by mounting their smear. A total of 207 subjects of different ages and sex groups were investigated, however, only 192 (92%) of the suspected cases were found to have the disease 64% of cases were male which were significantly high (p 0.05), than female 36%. The lesion was more frequently detected among the youth ages of 21-30 years (31%) as compared to other groups. In both sexes, legs were found to be more infected (25% male + 20% female) followed by arms (20% male + 0% female) and face (15% male +11% female). The mixed body parts had shown the lowest infections such as (4% in males + 5%) in females. In conclusion, the highest and lowest leishmaniasis infections were observed in District West (23% male + 9% female) followed by District East (15% male + 7% female), District Malir (11% male+ 4% female), District Central (7% male + 5% female), District Korangi (4% male + 7% female) and District South (4% male + 4% female) respectively.
Resumo O estudo foi realizado de setembro de 2018 a abril de 2019 para determinar a prevalência de leishmaniose tegumentar em seres humanos que vivem em seis distritos de Karachi. Pessoas suspeitas foram rastreadas para a doença e os casos positivos foram identificados com base em lesões de pele e amostras de sangue. As amostras foram observadas montando seu esfregaço. Um total de 207 indivíduos de diferentes idades e grupos sexuais foi investigado, no entanto apenas 192 (92%) dos casos suspeitos foram encontrados para ter a doença; 64% dos casos eram do sexo masculino, que foram significativamente elevados (p 0,05), e do sexo feminino 36%. A lesão foi detectada com maior frequência entre os jovens de 21 a 30 anos (31%) em comparação com os outros grupos. Em ambos os sexos, as pernas estavam mais infectadas (25% homens + 20% mulheres), seguidas pelos braços (20% homens + 0% mulheres) e rosto (15% homens + 11% mulheres). As partes mistas do corpo mostraram as infecções mais baixas (4% homens + 5% mulheres). Em conclusão, as infecções de leishmaniose mais altas e mais baixas foram observadas no Distrito Oeste (23% homens + 9% mulheres) seguido pelo Distrito Leste (15% homens + 7% mulheres), Distrito Malir (11% homens + 4% mulheres), Distrito Central (7% homens + 5% mulheres), Distrito Korangi (4% homens + 7% mulheres) e Distrito Sul (4% homens + 4% mulheres), respectivamente.
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Introduction: The Postgraduate medical training is long and emotionally taxing. These occupations are associated with stress and good workload along with night shifts which effects the sleep quality. Studies have documented that high levels of stress among medical residents have been associated with sleep problems. Our study aims to investigate sleep quality among the postgraduate residents of a tertiary care hospital using Pittsburgh Sleep Quality Index. Material and Methods: It was a cross sectional study that was conducted from 1 November 2021 to 31 December 2021. Study participants included Postgraduate medical residents working at a tertiary care hospital in district Srinagar of Kashmir valley. A total of 400 participants took part in the study. Results: The mean age of the participants was 33.4 years (S.D 4.9). Majority of the participants (54%) were females. The mean global Pittsburgh Sleep Quality Index score (±SD) for sleep quality was 8.46 (±4.5) with a median score of 6 and Inter Quartile Range of 6.5. Conclusion: Poor sleep quality was reported in 75% of the residents. This highlights the need for awareness about this problem. There is a need for early interventions in order to introduce flexible working hours for medical residents and to provide shifts of manageable durations.
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Introduction: cancers is associated with a favourable outcome. Stomach cancer is one of the most common cancers of gastrointestinal tract. Majority patients visit physicians in developed stages. To evaluate theObjective: reporting pattern of stomach cancer patients living in Kashmir valley in order to determine the median time of delay from the beginning of symptoms to diagnosis. Total 116 proven stomach cancer patientsMethod: were evaluated for the pattern of presentation at endoscopy laboratory of Super Speciality Hospital, Shireen Bagh Kashmir from April 2019 to September 2020. In this study, the mean age (SD) of participantsResults: was 60.22 ± (11.90) years. Majority of the participants (69.8%) were males. Cases were predominantly from the rural area (58%).Only 15.5 % of the cases were diagnosed within one month of their symptoms while as 3.4% of the cases had a total delay of more than 12 months. The study found a considerable total delay in the diagnosis of stomach cancer. The mean of the patient delay was 45.6 days. The median total delay was 20 weeks. Since stomach cancer has high mortality and morbidity rates associated, creatingConclusion: awareness among the population and training of physicians regarding timely referral of patients seems important
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Background: Neonatal sepsis is a major cause of mortality and morbidity in newborn in developing countries. The spectrum of bacteria which causes neonatal sepsis varies in different parts of the world. Surveillance of causative organisms and their antibiotic sensitivity pattern promotes rational use of antibiotics and antibiotic stewardship. Objective: To assess the clinical and bacteriological profile of neonatal sepsis.Material & Methods:A retrospective study was conducted at Department of Pediatrics, Rajshahi Medical College Hospital, Rajshahi, Bangladesh from January to June 2019. Of the 207 neonates with clinical suspicion of sepsis, 55 neonates included. Culture positive sepsis was defined as isolation of bacterial pathogen from blood in neonates with clinical suspicion of sepsis.Results:Of the 207 neonates with clinical suspicion of sepsis, 55 neonates had blood culture positive sepsis. Sepsis was predominant in males (64.5%). Low birth weight (47.2%) and prematurity (40.9%) were important neonatal risk factors for sepsis. Early onset sepsis occurred in 58.1% of the cases and late onset sepsis in 41.9% of the neonates. Gram-positive cocci constituted 67.52% of all isolates and gram negative 30.76%. The most frequently isolated organism in blood was methicillin resistant coagulase negative staphylococcus (MRCONS) (32.47%). Gram positive organisms included MRCONS, methicillin resistant Staphylococci aureus (MRSA), group B Streptococci (GBS), Staphylococcus aureus and Enterococci. Among Gram-negative organisms, Acinetobacter was most frequently isolated followed by Klebsiella, Escherichia coli, Pseudomonas, Citrobacter and Burkholderia species. The mortality in the study group was 13.5%. Gram negative organisms were most resistant to ampicillin and cephalosporins. Gram positive isolates were least resistant to vancomycin and linezolid.Conclusion:In conclusion, gram positive sepsis was found to be common in present study, although mortality was high in gram negative sepsis. Careful measures have to be taken to overcome the change in trend of organisms causing sepsis, and selection of antibiotics should be prudent.
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Background: Maternal Near-miss (MNM) is one of the related concepts to maternal mortality. MNM is a special category of survivors, whose stories provide unique insights and valuable information on maternal mortality. Characterizing near-miss morbidity is valuable for monitoring the quality of hospital-based obstetric care and should be calculated regularly for planning, monitoring, and evaluating provided maternal healthcare. Objectives: The study aimed to observe the factors like patterns and predictors related to maternal near-miss in our demographic.Material & Methods:This cross-sectional observational study was conducted at the Department of Obstetrics and gynaecology, Sirajgonj Medical College and Hospital, Sirajgonj, Bangladesh. The study duration was 1 year, from June 2019 to May 2020. During the study period, a total of 1277 deliveries were conducted at the study hospital, among which, 69 cases were of MNM. Results:The rate of maternal near-miss in our study was 5.41% of the total admitted maternal pregnancy cases. The maternal near-miss mortality ratio (MNM: 1 MD) was 1:13.8. Out of the 69 near-miss cases, 82.6% of women met the MNM criteria already at admission, and another 17.4% of near-miss cases were distributed: 10.1% developed near-miss after admission within the first 12 hours of the hospital admission, whereas the occurrence of MNM after 12 hours of the hospital admission was observed in 7.3% of cases. Conclusions:MNM cases are alarmingly high. Hypertensive disorders of pregnancy and obstetric hemorrhage were the two main direct obstetric causes of near-misses that require strict and quick management protocols. A proper antenatal check-up to discourage early marriage and pregnancy and timely referral to well-equipped health facilities with logistic support is necessary for saving human life.
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Background: Acute confusional state or delirium is a clinical syndrome characterized by disturbed consciousness, cognitive function, or perception. The delirium usually develops over a short period of time (usually hours to days) and it has a tendency to fluctuate during the course of the day. Materials and methods: This study was undertaken on the patients presenting with acute confusional state to the emergency wing of Acharya Shri Chander College of Medical Sciences and Hospital, Jammu to find out the Outcome, Hospital Stay and Prognosticate of different causes of ACS. Patients of acute confusion state that were admitted in the emergency wing of Postgraduate Department of Medicine Acharya Shri Chander College of medical sciences and hospital were enrolled prospectively in the study. Sixty patients of acute confusional state from November 2015 to October 2016 were enrolled who were selected from various patients admitted in ASCOMS. Results: Most patients were in the age group of 61-70 years i.e. 6th decade. Mean age of males was 63.78 (range, 35 to 92) years and of females was 65.85 (range, 26 to 95) years. Median age of males was 64 years and of females 68 years. Sex wise, patients were equally distributed with 32 (53.33%) males and 28 (46.67%) females with male to female ratio of 1.14:1 Out of 60 patients there were 10 deaths, the mortality being 16.67%, 39 (65%) had good recovery and 11 (16.67%) patients had partial recovery. Overall mortality was 16.67%. The mortality depends on age, etiology of acute confusional state, initial GCS and some lab Parameters (TLC, PH, SO2). Conclusion: The increased hospital stay and the prolonged acute confusional state in patients discharged alive were increased age, etiology of ACS, abnormal CT head, decreased PO2 and SO2, focal neurological deficit.
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Background: The vasculitis are a heterogenous group of conditions characterized by blood vessel inflammation and necrosis. Vasculitis are relatively uncommon conditions whose etiology is still poorly understood. Treating vasculitis is as regarding as establishing diagnosis. In the absence of treatment, most of patients will suffer or die. With treatment most of patients improve, many will achieve remission and a few will be cured. Disease classification is the process of categorizing illnesses in a larger framework of medical conditions. Objectives: To study the pulmonary and neurological profile of vasculitis patients at a tertiary care centre. Materials and methods: The present hospital based observational study was conducted in the Department of Internal Medicine, SKIMS Srinagar. The study had two parts; retrospective and prospective. Retrospective part: All patients of vasculitis who were admitted or evaluated in OPD from March 2012 to Sept. 2018, were enrolled for the analysis. Prospective part: All Patients of vasculitis admitted or evaluated in OPD from Oct. 2018 to May 2020 were enrolled for study. Patients were classified as vasculitis if they fulfil ACR / EULAR / EMA / Chapell Hill consensus classification criteria for vasculitis and biopsy. Results: Our study was an observational study of 77 patients. Majority of patients i.e. 5 (33.33%) each in LVV group belonged to age groups of <30 and 31-40 years. In SVV group, majority of patients i.e. 11 (27.5%) belonged to age group of <30 years followed by 9 (22.5%) patients each who aged between 31-40 years and 41-50 years. In group LVV there were 12 (80%) males compared to 3 (20%) females. In group SVV, there were 8 (20%) males compared to 32 (80%) females while as 13 (59%) males and 9 (41%) females constituted others group. Chest x-ray was normal was normal in majority of patients in all three groups. CT Chest was done in 23 patients in which nodules were seen in 7 (35%) patients, 4 (20%) patients each had consolidation, DAH and 2 (10%) patients had ILD. CT head were suggestive of encephalomalacia in 1, ischemic stroke in 1 and normal findings in 1 (33.3%) patients. CT Chest and Head findings were compared in three study groups with SVV group showing abnormal findings as compared to other two groups. Tuberculosis profile was negative in 26 (96.3%) of 27 patients. TB profile was positive in only 1 (11.1%) patient in others group. On NCV, peripheral neuropathy was observed in 11 (68.8%) of the 16 patients. On NCV, peripheral neuropathy was observed in 9 (75%) patients in SVV group and 2 (50%) patients in others group. Conclusion: Most of abnormalities on CT Chest, Head, and NCV were present in SVV group. They mostly presented with ILD, DAH, encephalomalacia, ischemic stroke, peripheral neuropathy.
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Zygomaticomaxillary fractures are complex fractures that can involve the ?oor of the orbit. These fractures often lead to complications like diplopia, disability in rotation of the eye superiorly due to herniation of muscle and orbital fat into the maxillary sinus. These fractures if left untreated can result in malunion, visual disturbances and are not aesthetically pleasing due to effect on the symmetry of face. Various treatment modalities are available for the treatment of zygomaticomaxillary fracture and reconstruction of the ?oor of the orbit. Complications include retrobulbar hemorrhage, orbital ?ssure syndrome, and reduction in orbital volume, with minor effects like ectropion or entropion. A case report of a 21-year-old male patient with a Orbit zygomaticomaxillary complex fracture is described.
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With 1st case being reported in Wuhan city of China in December 2019, COVID?19 infection cases made their way to every corner of the world. Then, on January 07, 2020, laboratory results led to pneumonia being named as COVID?19. Scant data is available from Northern India, thus to reveal the trend of COVID?19 infection since last year of COVID?19 pandemic onset, this study took shape. The unit of analysis of our study was District Anantnag, Jammu and Kashmir. Till February 05, 2021, a total of 4625 cases of COVID?19 virus were reported in District Anantnag, Jammu and Kashmir. Negative history of close contact with COVID?19 patient (66.1%) constituted the most common exposure, majority (84.4%) were asymptomatic and comorbidities were present in 68 (1.5%). COVID?19 infection was more prevalent among younger age group, with higher male predominance, with comorbid being at higher risk, hence most stringent measures must be adopted.
Subject(s)
Humans , Mycetoma/diagnosis , Mycetoma/epidemiology , Pakistan/epidemiology , Tertiary Care CentersABSTRACT
Previous research has investigated whether hyperuricemia serves as an independent risk factor for cardiovascular and renal diseases. Hyperuricemia is defined as an abnormally high level of uric acid (UA; i.e., serum urate level > 6.8 mg/dL). Hyperuricemia has been considered a complication of chronic kidney disease (CKD). However, it seems to play a pathogenic role in the progression of renal diseases. There has been increasing focus on the link between hyperuricemia and CKD. The results of randomized controlled trials have implied independent associations between hyperuricemia and the progression of cardiovascular and renal morbidities. These associations may be mediated by renin-angiotensin system activation, nitric oxide synthase inhibition, and macrovascular/microvascular disease development. There remains controversy regarding the use of serum UA level as an indirect index of renal vascular disease. This literature review focuses on the role of asymptomatic hyperuricemia in the progression of CKD, as well as the association between hyperuricemia and cardiovascular disease. It also provides a general overview of the physiological metabolism of UA.
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Background: Sepsis is still one of the most leading cause of death in world. 19 million sepsis (formerly severe sepsis) cases and 5 million sepsis-related deaths are estimated to occur annually. Sepsis is also one of the most common cause of patients getting critically ill and getting admission in intensive care unit. The main focus of this study is to identify the culture isolate from the critically ill patients and to check for the antibiotic sensitivity and resistance and identify if the report has changed the course of treatment and outcome of the patients. Critical illness is a life-threatening multisystem process that can result in significant morbidity or mortality. Critically ill patients are those who have dysfunction or failure of one or more organs/system and depend on survival from advanced instruments of monitoring and therapy. The aim of the study was to identify the causative organism causing sepsis in critically ill patients.Methods: It will be multi central retrospective study which included patients of critical illness of Rohilkhand Medical college, Bareilly, Uttar Pradesh and Varun Arjun Medical college, Shahjanpur, A total of 468 patients were taken for the analysis during period of from August 2018 to November 2019 among of which 324 samples came positive. Samples were taken on day one of the patient’s presentation to the hospital and were analysed in BD BACTEC culture medium. Patient’s data were taken from records available at both the hospitals. Sensitivity was performed using disk diffusion method and the results were compared with the records of patients.Results: Among of samples taken that is 324; 194 were male and 130 were female. Maximum patients which were tested positive for Staphylococcus aureus (n=198). Others included Streptococcus pneumococcus (n=25), Escherichia coli (n=50), Klebsiella oxytoca (n=13), Klebsiella pneumoniae (n=15), Pseudomonas aeruginosa (n=20), and Acinetobacter (n=3). In retrospective analysis of the patients of all 324 cases treatment in approximately 148 patients was changed due to change in the sensitivity of antibiotics.Conclusions: Staphylococcus still dominates the sepsis. It is advisable to add an antibiotic with gram negative if patients count does not improve in first 24 hour.
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Abstract Objective: Left ventricular assist device (LVAD) implantation with concomitant Dor plasty is only reported anecdotally. We herein aimed to describe our experience with LVAD and concomitant Dor procedures and describe long-term outcomes of this special subset of heart failure patients. Methods: Between January/2010 and December/2018, 144 patients received LVAD therapy at our institution. Of those, five patients (80% male, 60.4±7.2 years) presented with an apical aneurysm and received concomitant Dor plasty. Apical aneurysms presented diameter between 75 and 98 mm, with one impending rupture. Results: Procedural success was achieved in all patients. No unplanned right ventricular assist device implantation occurred. Furthermore, no acute 30-day mortality was seen. In follow-up, one patient was lost due to intentional disconnection of the driveline. One patient underwent heart transplantation on postoperative day 630. The remaining three patients are still on device with sufficient flow; pump thromboses were successfully managed by lysis therapy in one patient. Conclusion: LVAD implantation with concomitant Dor procedure is feasible, safe, and occasionally performed in patients with ischemic cardiomyopathy. Major advantages are prevention of thromboembolism and facilitation of LVAD placement by improving pump stability and warranting midventricular, coaxial alignment of the inflow cannula. In long-term follow-up, no adverse event associated with Dor plasty was observed.