ABSTRACT
Histoplasmosis is a systemic fungal infection caused by H. capsulatum usually in immunocompromised individuals such as those with HIV-AIDS. Though oral manifestations are rare, they could be the only and initial manifestation of HIV-AIDS. We report the case of a 23-year-old female who presented with oral ulcer and palatal perforation and detected to be suffering from disseminated histoplasmosis. She also turned out to be HIV positive. Her CD4+ count was undetectable. She responded well to intravenous liposomal Amphotericin B, oral itraconazole and antiretroviral therapy. To the best of our knowledge, histoplasmosis presenting as palatal perforation as the first manifestation of HIV-AIDS has not been reported from South India previously. A high index of suspicion is needed in such cases of exaggerated oral lesions even in states like Kerala to avoid delay in diagnosis and therapy.
ABSTRACT
CONTEXT: Tuberculosis is a major public health problem in India. Tuberculous pleural effusion is a paucibacillary manifestation of the Tuberculosis, so isolation of Mycobacterium tuberculosis is difficult, biomarkers being an alternative for diagnosis. Pleural fluid Adenosine deaminase (ADA) level is being used in diagnosis of Tubercular pleural effusion. The combination of ADA and pleural fluid lymphocyte count is being recognized as a better method for increasing the specificity of ADA test. The present study was conducted to analyze the diagnostic usefulness ofAIM: ADA alone (? 40U/L) compared with the combination of ADA and pleural fluid lymphocyte count ( ? 50% ). SETTINGS AND DESIGN: METHODS AND MATERIAL:Retrospective study. Study was conducted for a period of one year from May 2017 to April 2018. A total of 110 pleural fluid samples data was analysed. SPSS 20STATISTICAL ANALYSIS USED: statistical software. ADA level in Tuberculous pleural effusion ranged from 40U/L to 112U/L with mean value ofRESULTS: 69.4U/L. Sensitivity, Specificity, Positive predictive valve (PPV) and Negative predictive values (NPV) for ADA alone were 93.2%, 76.4%, 82% and 90.6% respectively. For ADA and lymphocyte count the Specificity and PPV increased (98% and 98.1% respectively) with hardly any decrease in sensitivity or NPV (89.8% and 89.5% respectively). CONCLUSION: Combined use of ADA and pleural fluid lymphocyte count increases the specificity and PPV when compared to the specificity of ADA test alone in diagnosing Tubercular pleural effusion
ABSTRACT
The use of electrocautery for making skin incisions remains controversial. Its effect on the rate of Superficial Surgical Site Infection (SSSI) vis-à-vis scalpel use was compared in this study. Atotal of 100 patients undergoing open inguinal hernia repair were divided into two: 50 in Electrocautery group, 50 in Scalpel group. Patients were assessed for up to 30 days post-operatively by an assessor blinded to the method used for making skin incision. CDC/NHSN criterion for SSSI was adopted for wound assessment while grading was done using Southampton Wound Grading System. Both groups had comparable mean age (p-value=0.29) and BMI (p-value=0.39). The difference in the incidence of SSSI (5 in Electrocautery, 7 in Scalpel group) on statistical analysis was found to not be significant (p-value=0.53). We conclude that skin incision made with electrocautery is a safe alternative and a convenient method for performing surgeries.
ABSTRACT
Introduction: Ventricular enlargement is a characteristic physical change that is present frequently in a numberof cerebral disorders encountered in neurologic and psychiatric practice. Quantitative assessment of neuroimagesfor ventricular size is an effective approach to reveal structural changes in conditions such as Alzheimer’sDisease, schizophrenia, Huntington’s disease, hydrocephalus and many other neurological and psychiatricdisorders.Aim: The present study is being done with the aim to establish normal ventricular indices of brain in both sexesand to find the correlation between these indices in different age groups in Indian population.Materials and Methods: The data for the present study are 300 CT scan which are collected from department ofRadiology, Ramaiah hospitals. The following indices such as Evans index, bifrontal index, bicaudate index, cellamedia index, third ventricular index , Huckman’s index and ventricular index were calculated. The parameterswere tabulated and statistically analyzed.Results: The ventricular indices showed statistically significant difference between males and females in all theindices except for cella media index. There was positive correlation coefficient between age and indices whichwas statistically significant.Conclusion: The knowledge of normal anatomy of ventricular system of brain helpful for clinicians, neurosurgeonsand radiologists in day to day clinical practice