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Background: Ophthalmic dirofilariasis is an uncommon zoonotic parasitic infection caused by species of Dirofilaria, a dog tapeworm that is transmitted to human by mosquitoes. Man is a dead?end host for the parasite. Ophthalmic involvement is rare and includes periorbital, subconjunctival, subtenon, and intra?ocular involvement. We report the removal of a subconjunctival worm and identification by light microscopy (LM) and scanning electron microscopy (SEM). Purpose: A 62?year?old female presented with complaints of redness, discharge, and foreign body sensation with difficulty in opening eyes in the left eye for the last 3 days. The patient is a non?vegetarian. On examination, her best corrected visual acuity in both eyes was 20/20. On slit lamp examination, there was a long, thin, round, coiled white subconjunctival live worm in the left eye superiorly. The rest of anterior segment evaluation, intra?ocular pressure, and fundus was normal in both eyes. The parasite was removed under local anesthesia from subconjunctival space [Video]. External surface morphology under LM revealed fine transverse cuticular striations with tapered cephalic and caudal ends. Uterus was long and coiled with indistinguishable masses inside. The finding was also confirmed by SEM. Synopsis: A subconjuctival parasite was removed and identified as Dirofilaria repens by characteristic LM and SEM findings. Highlight: Dirofilaria species may lodge in many tissues of human bodies including eye and adnexa. Dirofilaria is a natural parasite of carnivorous animals, mostly dogs, cats, and foxes.[1] The most common mode of transmission to human is usually by bite of mosquitoes like Culex and Aedes, which are considered as vectors, and it is often thought that parasitemia is because of accidental conduction.[1] Simple surgical removal of the worm is curative. After removal, the worm should be visualized directly under LM. All the internal structures of the transparent worm could be seen and compared with those under SEM.
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Schwannomas exhibit histopathological variation that leads to diagnostic dilemmas, although less frequent in the oral cavity. We describe a case with unique histopathology and no relevant clinical history that adds to the breadth of literature on the diversity presented by Schwannoma. A 60-year-old female patient presented with a small dome-shaped, asymptomatic swelling on the alveolar ridge 6 years in duration. Histopathologically, it showed rich cellular pathology with a unique arrangement of tumor cells forming irregular rosettes. Each rosette presented with a central core of fibrincollagenous material and the tumor cells were arranged on the periphery, exhibiting epithelioid change with evidence of mild cellular and nuclear pleomorphism. On immunohistochemical evaluation, the cells were strongly and diffusely positive for S-100 and negative for Ki-67. A diagnosis of benign Schwannoma with a rosette-like arrangement with epithelioid change was made. The case report emphasizes the risk of misdiagnosis and the importance of awareness regarding rare histopathological variants of Schwannoma.
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Background: Pulmonary hypertension (PH) is a recently recognized complication of chronic kidney disease (CKD), especially in end-stage renal disease. Cardiovascular disease is the most important cause of morbidity and mortality in CKD. This study was done to assess the prevalence of Pulmonary Hypertension in CKD patients and to assess the severity of Pulmonary Hypertension in different stages of CKD. The study Materials And Methods: was performed on 140 patients. At M. L. N. medical college prayagraj. All patients were evaluated by clinical, laboratory and imaging. All patients were subjected to echocardiography for assessment of Pulmonary arterial Hypertension. A total Results: of 140 patients were included. Mean age of statics was 55.61±11.65 years. Male: Female was 2.33:1. Out of 140 study subjects, PH was found in 45 patients (32.1%.). Amongst which 26 had mild PH, 13 moderate and 6 had severe PH. Prevalence of Severe PH was signi?cantly higher in stage 5 CKD subjects (23.5%) compared to stage 3(1.3%) & 4(2.3%). As CKD progresses Conclusion: the prevalence and severity of PH increases
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Overview: Hemorrhoidal disease (HD) is a common surgical disorder. The treatment modalities can be surgical or nonsurgical. Every surgical option has its own indications and limitations. Postsurgical symptomatic recurrence rates are low and vary between different techniques. The ideal way to deal with recurrent HD is not clear. Material and Methods: The present prospective case series enrolled a total of 87 patients (54male/33 female). Thirteen out of 87 patients (15%) had history of previous intervention for HD. Amodification of the standard technique was adopted for patients with recurrent HD. A mean follow-up of 22 months was achieved. Results: Stapled hemorrhoidectomy (SD)was performedin13patientswho had historyof previous surgical intervention for HD. There were no adverse events related to the technique. Patients with recurrent HD had severe pain scores with SH as compared to patients who underwent SH at the first time. There were no wound related complications. Conclusion: Stapled hemorrhoidectomy can be performed easily and offers good results in patients with recurrent HD. (AU)
Subject(s)
Humans , Male , Female , Recurrence , Surgical Stapling , Hemorrhoidectomy/methods , Hemorrhoids/surgery , Hemorrhoids/therapy , Treatment Outcome , Hemorrhoids/epidemiologyABSTRACT
Abstract Background: Fibromyalgia is a chronic pain disorder characterized by widespread musculoskeletal symptoms, primarily attributed to sensitization of somatosensory system carrying pain. Few reports have investigated the impact of fibromyalgia symptoms on cognition, corticomotor excitability, sleepiness, and the sleep quality — all of which can deteriorate the quality of life in fibromyalgia. However, the existing reports are underpowered and have conflicting directions of findings, limiting their generalizability. Therefore, the present study was designed to compare measures of cognition, corticomotor excitability, sleepiness, and sleep quality using standardized instruments in the recruited patients of fibromyalgia with pain-free controls. Methods: Diagnosed cases of fibromyalgia were recruited from the Rheumatology department for the cross-sectional, case-control study. Cognition (Mini-Mental State Examination, Stroop color-word task), corticomotor excitability (Resting motor threshold, Motor evoked potential amplitude), daytime sleepiness (Epworth sleepiness scale), and sleep quality (Pittsburgh sleep quality index) were studied according to the standard procedure. Results: Thirty-four patients of fibromyalgia and 30 pain-free controls were recruited for the study. Patients of fibromyalgia showed decreased cognitive scores (p = 0.05), lowered accuracy in Stroop color-word task (for color: 0.02, for word: 0.01), and prolonged reaction time (< 0.01, < 0.01). Excessive daytime sleepiness in patients were found (< 0.01) and worsened sleep quality (< 0.01) were found. Parameters of corticomotor excitability were comparable between patients of fibromyalgia and pain-free controls. Conclusions: Patients of fibromyalgia made more errors, had significantly increased reaction time for cognitive tasks, marked daytime sleepiness, and impaired quality of sleep. Future treatment strategies may include cognitive deficits and sleep disturbances as an integral part of fibromyalgia management.(AU)
Subject(s)
Humans , Fibromyalgia/diagnosis , Cognition , Chronic Pain , Sleep Hygiene , Cortical Excitability , Reaction Time , Pain Measurement/instrumentation , Case-Control Studies , Cross-Sectional Studies , Stroop Test , Observational StudyABSTRACT
OBJECTIVE@#Bergenia ciliata (Haw.) Sternb. is used in the Indian traditional system of medicine to treat various ailments including rheumatism and to heal wounds. The objective of the present study was to perform a preclinical characterization of the B. ciliata-based botanical extract IIIM-160.@*METHODS@#IIIM-160 was chemically standardized and analyzed for heavy metal content, aflatoxins, pesticides and microbial load. The in vitro and in vivo efficacies were determined in suitable models of inflammation, arthritis and nociception. An acute oral toxicity study was performed in Swiss albino mice. A suitable oral formulation was developed and characterized.@*RESULTS@#Bergenin was found to be the major component (9.1% w/w) of IIIM-160. The botanical lead displayed inhibition of lipopolysaccharide-induced production of proinflammatory cytokines in THP-1 cells, with selectivity toward interleukin-6 (IL-6) and had an excellent safety-window. It showed anti-inflammatory, anti-arthritic and antinociceptive activity in animal models and was not toxic at oral doses up to 2 g/kg in Swiss-albino mice. The gastroretentive, sustained-release capsule formulation showed sustained-release of the bergenin over the period of 24 h, resulting in improved plasma-exposure of bergenin in Sprague-Dawley rats.@*CONCLUSION@#The dual-activity of IL-6 inhibition and antinociception marks the suitability of IIIM-160 for treating rheumatoid arthritis. This study will serve as the benchmark for further research on this botanical formulation.
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Background: Analysis of TIMI risk score & correlation with ST elevation myocardial infarction (STEMI). Methods: This is a 12 months Observational Cross- sectional study conducted at NIMS Medical College and Hospital- a tertiary hospital in rural areas close to Jaipur. In this study we included 60 patients with acute myocardial infarction who were admitted to the coronary care unit of NIMS HOSPITAL JAIPUR during the year JAN 2015 –DEC 2015. The data obtained were analysed using Excel sheet/SPSS software. Tests of significance were done using the Chi - square test at 95% confidence interval. Results: According to our study myocardial infarction was more common in male compared to female (male:female ratio 4:1) Complications rate is significantly higher in male patients(p=0.0010) compared to female patients(p=0.0114). Mortality is increased with the increase in TIMI risk score. Conclusion: TIMI Risk score for ST segment Elevation Myocardial Infarction (STEMI) may be readily applied at the bedside at the time of hospital presentation and captures the majority of prognostic information offered by a full logistic regression model. The mortality increased proportionally with TIMI score. This risk assessment tool is likely to be clinically useful in the triage and management of patients eligible for fibrinolytic therapy and may also serve as a valuable aid in clinical research. Sufficiently simple to be practical at the bedside and effective for risk assessment across a heterogeneous spectrum of patients, the TIMI risk score may be clinically useful in the triage and treatment of patients with STEMI who undergo acute reperfusion therapy.
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Though modern medicine is well developed in most of the world, large sections of the population in developing countries still rely on heral medicines and other natural products for their primary care. In recent years public interest in Industrialized countries has increased greatly towards the natural therapies with the expanding use of medicinal plants and herbal medicine. Traditional medicinal products have evolved against widely different ethnological, cultural, climatic, geographical and even philosophical backgrounds; nevertheless they face many regulatory challenges in ensuring their safety and efficacy. The efforts of WHO in the development of modern guidelines in this field have been very helpful in recognition of the role of herbal remedies in health care and in supporting their potential use in national health care system in different parts of the world