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Background: India has experienced an unprecedented heave of mucormycosis (MCR) cases during second wave of COVID-19. Possible mechanisms may involve immune and inflammatory processes. The aim of the study is to estimate the role of inflammatory markers for triaging patients of COVID-19 associated rhino-orbital-cerebral mucormycosis (CAROCM) at tertiary care hospital in north India. Methods: A retrospective observational study was conducted between September 2021 to December 2021, at Government medical college and hospital, Patiala (Pb), 83 CAROCM patients admitted in ENT department were evaluated for serum ferritin, D-dimer and PCT. Results: The median age of the patients was 50 years. The number of male patients were 45 and female patients were 38. Based upon the medical history and associated comorbidities involved, 83 CAROCM patients were divided into three groups. 43 diabetic patients in group I, 33 patients with multiple risk factors in group II and 7 patients with no comorbidity in group III. The mean D-dimer levels were 702 ng/ml in group 1, 831ng/ml in group II and 399 ng/ml in group III, and ferritin levels were 522 ng/ml, 711 ng/ml and 426 ng/ml in group I, II and III respectively. Mean PCT levels in group I were 0.27 ng/ml, 1.32 ng/ml in group II and 0.42 ng/ml in group III. Conclusions: Our study concluded that a significant association was observed between levels of inflammatory markers and susceptibility factors. Serum ferritin, D-dimer and procalcitonin, can be used for assessing the severity of infection and decreases the mortality and morbidity in CAROCM patients.
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A field experiment entitled “Effect of foliar application of borax and zinc sulphate on growth, yield and quality of guava (Psidium guajava L.) cv. Gwalior-27” was carried out at Agrotechnology Park, Krishi Vigyan Kendra, College of Agriculture, Gwalior (M.P.) during 2016-2017. The experiment was consisting of 9 treatments having two levels of each Borax (0.2 per cent and 0.4 per cent) and Zinc sulphate (0.4 and 0.6 per cent). The experiment was laid out in Factorial randomized block design with three replications. Among different doses of foliar spray of nutrients, Zinc sulphate @ 0.6 (T5) were found significantly superior over control with respect physiological loss in weight (g) and shelf life of guava. While the minimum spoilage % was recorded with treatment B2Z2 (Borax@ 0.4% + ZnSo4@ 0.6%) at 5th, 10th and 15th day of storage respectively.
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@#Introduction: Mortality following traumatic femoral neck fractures in the elderly (age >60 years) is influenced by many factors. Addressing some of them may reduce the mortality rate thus improving patient survival and quality of life. Materials and methods: This study was a retrospective research using data collected from Hospital Sultanah Bahiyah, Kedah between the years 2008-2018. We measured outcomes such as age, gender, hospital stay, default rate, ambulation post-surgery, American Society of Anaesthesiologists score (ASA) and surgical timing in correlation with mortality rate and 10-year survival of elderly patients treated with Total Hip Arthroplasty for femoral neck fractures in this centre. Results: A total of 291 traumatic femoral neck fractures aged above 60 years post total hip arthroplasty performed were included. There was higher number of female (n =233) compared to male (n=53) Estimated 10 years survival from Kaplan Meier was 42.88% (95% CI: 33.15, 52.54). One year mortality rate in our study was found to be 18.9%. The average time to event was 7.1 years (95% CI:33.15, 52.24) with a mean age group of 75. Discussion: Total hip arthroplasty patients not ambulating after surgery had a 4.2 times higher hazard ratio compared to ambulators. Those with pre-existing systemic disease (ASA III and IV) were found to have the highest hazard ratio, almost five times that of healthy patients, after adjusting for confounding factors. Delay of more than seven days to surgery was found to be a significant factor in 10-year survival with a hazard ratio of 3.8, compared to surgery performed earlier. Conclusion: Delay of more than 7 days to surgery in 10 years survival was significant with high hazard ratio. It is a predictor factor for survival in 10 years. A larger sample size with a prospective design is required to confirm our findings regarding “unacceptable surgical timing” for femoral neck fractures in patients above 60 years of age.
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@#The Livestock Sector of India plays an important role in livelihood security and socioeconomic development of rural households. Leptospirosis is an important zoonotic disease responsible for septicaemia, interstitial nephritis, jaundice, abortion, reproductive problem in most of the animal species. Reproductive disturbances in bovine population is most often restricted to investigation of brucellosis, however apart from brucellosis, there are many undiagnosed diseases like leptospirosis that takes a toll in the reproductive anomalies of cattle and buffalo. Hence, the present study was elucidated to screen the seroprevalence of Leptospira in cattle and buffalo in various hamlets of North India using a user friendly screening test i.e. LipL32 latex agglutination test. The overall seropositivity was found to be 26.01% (230/884) in case of bovine in this study and the LipL32 LAT showed a profound sensitivity and specificity with level of 94.97% and 99.53% respectively.
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Background: Diabetes Mellitus is a chronic disease and its life-long management causes burden on lifestyle and financial condition of the patients. Drug utilization studies provide useful insights into the current prescribing practices.Methods: To evaluate the drug utilization pattern of anti-diabetic drugs in diabetic patients. A prospective observational study was carried out in adult diabetic patients visiting the Wards and Outpatient Department of General Medicine of a tertiary care hospital. The demographic data and utilization of different classes of anti-diabetic agents as well as individual drugs were analyzed.Results: In 125 patients (Male-65, Female-60), a total of 379 drugs (average 3.032±2.05) were used per day, out of which 76 (20.05%) were rational fixed dose combinations (FDCs) and 261 (68.86%) were prescribed from National List of Essential Medicines (NLEM) 2015. The number of drugs prescribed to be ingested was 326 (86.01%) and 63 (16.62%) were injectables.Conclusions: It was found that the prescription tendencies of the doctors were quite rational. More improvement can be done by sensitizing them to prescribe more drugs from NLEM. The limitations in the affordability of rural population should be taken care of while prescribing drugs for this chronic disease.
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Syphilis affects nearly 1.36 million pregnant women, majority of these cases being concentrated in the developing countries. We aimed at analysing the 11 years’ trends in syphilis seroprevalence in antenatal clinics (ANC) and STD clinic cases. Laboratory data of syphilis cases from 2002-2012 were retrospectively analysed. Out of the total 73642 cases, 393 (0.53%) tested positive for Syphilis. A statistically signifi cant decline in syphilis prevalence was found in both ANC and STD clinic cases. The efforts of various interventional programs should continue to make the screening and treatment facilities readily accessible to continue the decline in syphilis seropositivity.
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Objectives : The main objective of the study was a) to differentiate cellulitis and abscess in buccal space region, b) to study the ultrasonographic anatomy of cheek region and c) to investigate the use of ultrasound in the diagnosis of inflammatory swellings of cheek region. Patients and Methods : The study consisted of 25 patients with unilateral buccal space inflammatory swellings of odontogenic origin. The contra lateral side was used as control. Toshiba ultrasonographic device with a linear array transducer (5-8 MHz) was used. The areas of interest were scanned under both transverse and longitudinal sections and were interpreted by a single observer. The clinical diagnosis of cellulitis or abscess was confirmed by the absence or presence of pus respectively both sonographically and by aspiration. Also various anatomical structures present in buccal space were studied. Results : Clinically 23(92%) were diagnosed as buccal space abscess and 2 (8%) were cellulitis. Ultrasonographically and therapeutically 24 (96%) were buccal space abscess and 1 (4%) was cellulits. The sensitivity of clinical criteria over ultrasonographic diagnosis was 96% with a specificity of 100%. Also the cheek thickness in males and females varied from 8.2 to 17.1mm with a mean of 11.6mm±2.1 (SD) and 8.2 mm to 14.2 mm with a mean of 11±1.8 (SD). The subcutaneous tissue appeared moderately echogenic, buccinator - highly echogenic, deep adipose tissue - less echogenic and parotid duct was appreciated as a thin hyperechogenic band crossing the buccinator muscle. Buccal space, masticator space and parotid space were appreciated. Conclusion : This study supports the ultrasonographic method of imaging of orofacial inflammatory swellings with high sensitivity and specificity. This imaging modality can also help in aspiration of pus in different spaces. We have described the ultrasonographic anatomy of the above mentioned spaces which can help a beginner in this field.
Subject(s)
Abscess/diagnostic imaging , Adipose Tissue/diagnostic imaging , Adolescent , Adult , Biopsy, Needle , Cellulitis/diagnostic imaging , Cheek/diagnostic imaging , Diagnosis, Differential , Facial Muscles/diagnostic imaging , Fascia/diagnostic imaging , Female , Focal Infection, Dental/diagnostic imaging , Humans , Male , Middle Aged , Mouth Diseases/diagnostic imaging , Mouth Mucosa/diagnostic imaging , Parotid Gland/diagnostic imaging , Salivary Ducts/diagnostic imaging , Sensitivity and Specificity , Soft Tissue Infections/diagnostic imaging , Subcutaneous Tissue/diagnostic imaging , Suppuration , Temporal Muscle/diagnostic imaging , Young AdultABSTRACT
Clefts of the lip and palate are a common craniofacial anomaly, The etiology is thought to be multifactorial, with both genetic and environmental factors playing a role. Because of the frequent manifestation of cleft lip and palate in association with some syndromes, it is essential that a detailed examination of these patients be carried out. This facilitates early formulation of preventive and treatment advice and aids in overcoming gross deformities in the early stages of development. In this paper, we review three such patients who presented with cleft lip and palate in association with a syndrome.
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A 2nd gravida presented at 27 weeks with antepartum hemorrhage. Ultrasound showed a single live fetus (parameters approximately 23 weeks) and a huge placenta with multiple cystic areas extending into the lower uterine segment; some of which showed increased vascularity on colored doppler. A diagnosis of low lying placenta with a possibility of chorangioma or a partial mole was made. The next bout of antepartum hemorrhage was severe necessitating an emergency cesarean. Histopathology of the placenta (weighing 2240 grams) revealed a myxoid chorangioma. All features in this woman are uncommonly reported in literature (large size, myxoid degeneration and severe antepartum hemorrhage necessitating a cesarean).
Subject(s)
Adult , Cesarean Section , Emergency Treatment , Female , Hemangioma/complications , Humans , Myxoma/complications , Obstetric Labor Complications , Placenta , Placenta Diseases/diagnosis , Pregnancy , Pregnancy Trimester, Third , Uterine Hemorrhage/diagnosisSubject(s)
Humans , Magnetic Resonance Imaging , Male , Middle Aged , Neural Tube Defects/pathology , Spine/pathology , ThoraxSubject(s)
Aged , Aged, 80 and over , Craniopharyngioma/pathology , Humans , Male , Pituitary Neoplasms/pathology , Tomography, X-Ray ComputedABSTRACT
Aneurysmal bone cyst in temporal region is rare. It is a benign condition and may extend intracranially. Total surgical removal is recommended, whenever possible in one stage or in multiple stages. Prognosis is excellent and total removal will effect a cure. An unusual case of aneurysmal bone cyst of temporal region is reported.
Subject(s)
Adolescent , Bone Cysts, Aneurysmal/pathology , Female , Humans , Temporal Bone/pathologyABSTRACT
We present an interesting case of sacral perineural cyst which caused chronic perineal pain. Perineural cyst is relatively rare, especially the sacral region. Chronic perineural pain is an often encountered problem that is difficult to evaluate and sacral perineural cyst may be the etiology of chronic perineal pain in many instances.
Subject(s)
Bone Cysts/complications , Chronic Disease , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Pain/etiology , Perineum , Sacrum , Spinal Canal/pathology , Spinal Diseases/complicationsABSTRACT
PURPOSE: To report a case series of penetrating injury complicated by occurrence of intraocular cilia. METHODS: Retrospective analysis of charts of 11 eyes of 11 patients with penetrating injury and intraocular cilia, presenting between September 1978 and November 1998. Ten eyes underwent surgery for trauma-related problems such as cataract, vitritis, retinal detachment etc., at which time intraocular cilia were removed. One eye did not have surgery and continues to harbour cilia at the posterior perforation site. RESULTS: Metallic wire was responsible for injury in 6 of 11 eyes with intraocular cilia. Five eyes had significant intraocular inflammation. The cilia were located in the anterior segment in 4 eyes; in the posterior segment in 6 eyes and in both in one eye. At the last follow up, 72.7% had 6/18 or better vision. Poor vision in the rest was due to recurrent retinal detachment (2 eyes) and macular scarring (1 eye). CONCLUSION: Intraocular cilia are more commonly associated with injury by a metallic wire. The presentation and management of an injured eye does not seem to be influenced by the presence of cilia in the eye.