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Superior Vena Cava Syndrome is the clinical manifestation of the Superior Vena Cava obstruction, with severe reduction in venous return from the head, neck and upper extremities. More than 80% cases of SVCS is nearly attributable to advanced malignancy, most commonly lung cancer. SVC syndrome is characterized by congestion and swelling of the face and upper thorax, with distended superficial chest veins. The most severe complications of SVC syndrome include Glottic edema and venous thrombosis in the central nervous system. We represent a case SVC syndrome due to Small Cell Cancer of the lung.
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Kerala has made significant contribution to Ayurvedic literature. The traditional medical knowledge, gained from years of critical observations and clinical experiences has been documented by the great physicians. The medical literature of Kerala can be classified as, commentaries of the original texts as well as independent works based on these texts, compilation works by details of Oushada yogas and Kriyakramas from the Vaidyas. The text book of regional literature are rich source of information’s like formulations and treatment modalities based on geographical, climatic and cultural situations of various regions, based on their thoughts and lifestyle. The text Arogya chandrika athava kudumba vaidyan written by Sri Swami Sachidananda is an important work both from medical and poetic merits. The book was written in Malayalam language because it is specially meant for the native physicians of Kerala. It is a user– friendly text for the guidance of students and physicians. The uniqueness of the text is that it has mentioned simple and potential treatments for common diseases. The text is enriched with grammatical styles like Vritha. The text addresses the preventive as well as curative concept of Ayurvedic thoughts. Arogya chandrika athava kudumba vaidyan can be considered as an important contribution from Kerala’s regional literature to the Ayurveda community. The present paper is to critically analyze the subject matter of the text Arogya chandrika athava kudumba vaidyan. This will definitely enrich the literary data base of Ayurveda.
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Irido-Corneal Endothelial (ICE) syndrome is an uncommon clinical entity which includes corneal endothelial damage, obstruction of anterior chamber angle, iris atrophy, and polycoria.ICE syndrome is a spectrum of clinical entities namely Progressive Iris Atrophy (PIA), Cogan Reese Syndrome (CRS), and Chandler Syndrome (CS). It is considered to be sporadic, usually unilateral and diagnosed in young adults, females and occasionally in children. Corneal decompensation and glaucoma are the commonest causes of vision loss in patients with ICE syndrome.Medical management of this condition is usually with topical antiglaucoma medication. In most cases medical therapy fails and requires Glaucoma Filtration surgery. Glaucoma drainage devices are the mainstay of treatment and many patients require keratoplasty. We wanted to study the clinical profile of ICE syndrome patients, its association with glaucoma in Indian population and compare the findings with those of previous studies. METHODSIn this retrospective study, data of 50 consecutive patients having ICE syndrome at a tertiary eye care centre was collected. RESULTSOut of 50 patients, 28 (56%) were females, aged 7 to 65 years (median - 40.72 years). 49 patients (98%) had unilateral presentation, and one had bilateral involvement (2%). Progressive Iris Atrophy (PIA) was seen in 20 (40%), Chandlers Syndrome (CS) in 20 (40%) and 10 eyes (20%) had Cogan-Reese Syndrome (CRS). 46 (92%) eyes had glaucoma. Mean Intra-Ocular Pressure (IOP) was 23.70 ± 11.7 mm of Hg. Mean AGM used was 2.44 ± 1.3. 44 (88%) eyes were diagnosed to have glaucoma at presentation, 1 (2%) eye was diagnosed with glaucoma during follow up. 20 (40%) eyes were managed medically for IOP control. 8 (16%) eyes had undergone previous glaucoma surgery. 20 (40%) eyes underwent glaucoma surgery for IOP control. 15 (30%) eyes had Trabeculectomy with Mitomycin C, 5 (10%) had Ahmed glaucoma valve. 4 (8%) eyes underwent diode cyclophotocoagulation. 6 (12%) eyes required more than 1 surgery for IOP control. 6 (12%) eyes underwent penetrating keratoplasty (PK) for corneal oedema. Mean period of follow up was 8.4 ± 6.4 months. There were no cases of sight threatening complications like suprachoroidal haemorrhage, blindness or endophthalmitis. CONCLUSIONSGlaucoma is strongly associated with ICE syndrome. ICE patients may require more than 1 surgery for IOP control. They are commonly associated with corneal complications which may require penetrating keratoplasty.
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Coronary artery disease is an important cause of cardiovascular morbidity and mortality all over the world. Hypertension has been identified as an important risk factor for the development of CAD. Retinal vessel changes can occur in patients with uncontrolled or poorly controlled hypertension and are a predictor of the effect of hypertensive damage in the body. Retina is a place where end artery circulation can be directly visualized and quantifying retinal vessel changes in hypertensive patients presenting with angina can help in determining the risk and identifying those patients who need coronary angiogram especially in a primary care set up as it is an expensive investigation. We wanted to analyse retinal vessel changes in elderly hypertensives presenting with angina and correlate the same with the risk of developing coronary artery disease.METHODS50 elderly hypertensives who presented with acute angina were included in the study and were subjected to a coronary angiogram. They were divided into case and control groups. Those with the disease on angio are taken as cases and those without are considered as controls. The effect of age, sex, BMI, smoking, presence of retinopathy, LVH on ECG, grade of retinopathy were all analysed and correlated with the risk of developing CAD.RESULTSAge, Sex, BMI, smoking, LVH had no relation with development of CAD in our study. Presence of retinopathy had a significant correlation with development of CAD (p = 0.031, p<0.05) with OR of 5.81. Commonest grade of retinopathy in our study was Grade 2 and this also showed a significant correlation with the risk of developing CAD.CONCLUSIONSRetinal vessel changes are a significant predictor of risk of developing CAD in elderly hypertensives presenting with angina. The risk of developing CAD was six fold more in those with retinopathy changes and this can help as a screening tool to determine those who need angiography in a primary setting.
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Background: Antenatal care services including supplementary nutrition services are the essential services for reducing maternal mortality. As per National Family Health Survey (NFHS) 4 data, 62% pregnant mothers received supplementary nutrition in Karnataka state and only 49.4% received health and nutrition education. Study was conducted to assess utilization of antenatal services with special reference to supplementary nutrition and advice on nutrition.Methods: A cross sectional study was conducted among the mothers admitted in obstetrics and gynecology department of Yenepoya Medical College Hospital. All the 140 mothers admitted during August and September 2017 for safe confinement of pregnancy were enrolled in this study and data was collected using semi-structured questionnaire. SPSS software version 22 was used for data analysis. Descriptive statistics was expressed in terms of frequencies and percentages. Chi square test was used to study the factors association with utilization of antenatal services.Results: Of the 140 participants, most of them i.e. 38.6% were in 25-30 years age group. The mean age was 46 years. Only 86 mothers (61.42%) received supplementary nutrition of whom only 53 (37.85%) had consumed it. Utilization of antenatal services was 100% with respect to minimum antenatal visits, routine laboratory investigations and TT immunization. Awareness about Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA) was very poor (5%). Educational status of mother was found to be associated with utilization of supplementary nutrition (p=0.026).Conclusions: Utilization of routine antenatal services was reported to be very good. Efforts should be made to improve utilization about supplementary nutrition and awareness about nutrition education.
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Objective: The objective was to compare the biochemical changes of amikacin by autoinjector delivery and manual injection in rats. Materials and Methods: Amikacin drug cartridge (500 mg/2 mL) for autoinjectors was diluted to 63 mg/mL and rats were administered 1.2 mL, i.p. One group was given 3 and a second group 7 injection on consecutive days. 3 and 7 days manual injection of same dose of amikacin (about 500 mg/kg, i.p.) and a control group (saline) were also included (total 5 groups). On day 4 or 8 biochemical parameters were studied. Results: Significant increase in urea, creatinine and aspartate aminotransferase were observed in 7 days administration in both autoinjector and manual injection groups compared to control group. All other parameters viz., glucose, cholesterol, total triglycerides, bilirubin, uric acid, total protein, albumin, alanine aminotransferase and alkaline phosphatase did not show any significant change. No significant change was observed in 3 days administration groups. Conclusion: High dose of amikacin for longer duration is known for its nephrotoxicity which is evidenced by the increase in urea and creatinine in both autoinjector and manual injection groups. This study shows that autoinjector device for amikacin which is new can be considered for further research work.
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Detection of slime in Pseudomonas aeruginosa can be useful in understanding the virulence of this organism. Here, comparative studies of two phenotypic methods using the tube method and the spectrophotometric method for slime production from 100 clinically and 21 environmentally significant isolates of P. aeruginosa were performed. A total of 68 isolates were positive by either of the tests whereas only 34 were positive by both the tests. The tube method detected slime significantly in more number of isolates than the spectrophotometric method. The tube test was found to be superior to the spectrophotometric method in ease of performance, interpretation and sensitivity. Among the clinical isolates, systemic isolates produce less slime compared to wound, respiratory and urinary isolates. Isolates from the hospital environment produced more slime indicating that this virulence marker helps the organism to survive for longer periods and cause nosocomial infections.
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An attempt to induce resistance to ciprofloxacin in vitro was made against clinical and environmental isolates of Pseudomonas aeruginosa. This in vitro manipulation of strains resulted in the increase of minimum inhibitory concentration from 0.4 microg/ml to 1 microg/ml of the original strains to 9.0 to 12.5 microg/ml indicating development of resistance to ciprofloxacin and a major decrease in the size of zone diameters of norfloxacin and ofloxacin indicating cross resistance to these agents. Results indicate the induced resistance to ciprofloxacin can promote development of cross resistance to other fluoroquinolones. This suggests that caution should be taken while using fluoroquinolones for the treatment of Pseudomonas aeruginosa infections.