A Cross Sectional Study of Prevalence of COVID-19 and ENT Manifestations among Health Care Workers in Our Centre

Background : Health Care Workers are among the frontline COVID warriors who have been fighting all odds in serving their patients at the cost of their lives. Bangalore has been one among the hot cities in news during this pandemic and our centre, being one of the busiest working hospitals right in the middle of the city, we hereby throw limelight to the Health Care Workers of our centre who have been fighting over COVID-19 with all might and courage. This study was done to know the prevalence of COVID-19 and its ENT manifestations among Health Care Workers in our centre. Materials and Methods : A cross sectional study was done in KIMS Hospital, Bangalore, targetting all Health Care Workers of our centre, divided into 3 groups. Prevalence of ENT manifestations was studied. Results : In our study, majority who tested positive for COVID-19 were Doctors (67.6%) followed by staff nurse (27.9%) and auxiliary HCW (4.5%). One fourth of the study subjects had anosmia as the most common ENT manifestation followed by nasal obstruction (24.3%), cough and loss of taste (19.8% each). Conclusion : With inadequate precautions being taken with the mutating virus in air, causing a surge in cases, the health care workers are the most vulnerable group to acquire the deadly infection, during both the waves of the pandemic. We hereby, stress on this, with the help of our study, done during the first wave, targeting our Health Care Workers.

A STUDY ON CLINICAL PRESENTATIONS AND LABORATORY PROFILE OF ACUTE GLOMERULONEPHRITIS IN CHILDREN ADMITTED IN A TERTIARY CARE HOSPITAL

Introduction: Acute glomerulonephritis is the most common reversible cause of kidney disease in children. Although most common presentations are oedema, hypertension, haematuria and oliguria, glomerulonephritis may manifest with atypical features. The aim of the study was to evaluate the Aims and objectives: frequency of various clinical manifestations of glomerulonephritis and to identify various abnormalities in laboratory pro?le in children with glomerulonephritis. 30 children admitted in paediatric department, King George Materials and methods: Hospital, Visakhapatnam with clinical features of glomerulonephritis were enrolled into the study . Data on clinical features, laboratory parameters and outcome was recorded. Males were more commonly affected. Majority were in the age Results: group of 9-12 years. Most common presentation was facial puf?ness. Atypical presentations were observed in 40% cases. Anaemia was observed in 50% cases. Hypertension was seen in 56% of cases. PSGN was commonest cause of AGN. Hypocomplementemia was seen in 80% cases. Even though most children with acute glomerulonephritis present Conclusion: with common clinical features, early identi?cation of atypical presentations of acute glomerulonephritis should be emphasised as their prompt recognition can lead to reduction in mortality

Study of clinical presentations of lung cancer in tertiary level hospital

Background: Lung cancer is the most common cancer diagnosed worldwide. It is also the leading contributor to cancer-related mortality, resulting in around 1.38 million cancer deaths per year worldwide. The aim and objective of the study was to study the clinical presentations including paraneoplastic manifestations and metastatic effects of lung cancer and to identify reasons for delay in diagnosis of lung cancer. Methods:Hospital based observational study was conducted on 100 consecutive cases. Results: Mean age ofthe cases with lung cancer was 56.36 years and 30% of the cases. Male predominance was seen with 63% males to 37% females. Tobacco smoking was present in 59% cases while exposure to second hand smoke and biomass fuel was seen in 11% and 9% patients. Most common presenting symptoms were cough (22.21%), chest pain (16.13%), fever (14.37%), dyspnea (11%) and hemoptysis (5.22%). Most common type of lung tumor was Adenocarcinoma (53%) followed by Small cell carcinoma (22%) and Squamous cell carcinoma (19%). Mutation analysis by molecular testing where possible in 76.66% NSCLC cases and showed with RAS (26.19%), EGFR (23.8%), ALK1 (11.9%) and ROS (4.7%) mutation. Stage I and II of lung cancer was seen in 17% cases while stage III and IV was seen in 39% and 44% cases respectively. Conclusions:Present study shown tobacco smoking as the most common risk factor in the causation of lung cancer (59%) followed by passive smoking (11%) and biomass fuel exposure (9%). Mortality in the present study was 72% in 2 years of follow up and Median survival in the study was 11 months. We recommend high index of suspicion in the high-riskgroups as smokers and those with chronic respiratory diseases to avoid delay in diagnosis.

Tuberculosis musculoesquelética que imita neoplasia de tejidos blandos: A propósito de dos casos / Musculoskeletal Tuberculosis mimicking soft tissue neoplasms: report of two cases

Resumen La tuberculosis (TB) es una de las enfermedades infecciosas con mayor carga de morbimortalidad a nivel mundial,la presentación pulmonar es la forma más común, sin embargo, las manifestaciones extrapulmonares, especialmente las osteoarticulares, pueden ser difíciles de diagnosticar debido a sus síntomas inespecíficos sugestivos de otras entidades como neoplasias o enfermedades infiltrativas, lo que hace de su diagnóstico un reto clínico. Está enfermedad esta asociada a múltiples factores de riesgo como inmunosupresión, contacto cercano con pacientes con tuberculosis, hacinamiento, residir en zona endémica, entre otros. A continuación, se presentan dos casos de pacientes pediátricos sin compromiso inmune que cursaron con cuadros sugestivos de neoplasias musculoesqueleticas, con hallazgos imagenológicos congruentes, pero con estudios microbiológicos positivos para TB.

Abstract Tuberculosis (TB) is one of the infectious diseases with the highest burden of morbidity and mortality worldwide. Pulmonary presentation is the most common, however, extrapulmonary manifestations, especially osteoarticular, can be difficult to diagnose due to their nonspecific symptoms suggestive of other entities such as neoplasms or infiltrative diseases. Tuberculosis is also associated with multiple risk factors, especially immunosuppression, and among others, household contact with patients with tuberculosis or residing in an endemic area. We present two pediatric patients without immunecompromise, with clinical history suggestive of musculoskeletal neoplasms, with congruent imaging findings, but with positive microbiological studies for TB.

Practice of Oral Case Presentations (OCPs) Teaching Method Utilizing a Playful Learning Approach / 医学教育

Many papers on medical education emphasize the idea that obtaining structure through the practice of Oral Case Presentations (OCPs) is essential and efficient to brush up presentation skills. However, psychological resistance to giving a public presentation is an obstacle in learning OCPs. The aim of this survey is to evaluate the educational effect of our teaching method using a playful learning approach for presentation. This study was conducted by using an anonymous self-administered questionnaire for medical students during their clinical clerkship. One hundred twenty eight students participated in this survey.　Didactics and small group discussions took place during the first week of clerkship, and participants were asked to give presentations about their original theme during the second week. Questionnaires were distributed before and after the end of each session. The results showed that psychological resistance to presentations decreased, positive feelings increased, and students became more aware of the purpose, place, and subject of their presentations. Each parameter statistically improved at each phase. A playful learning approach is effective in teaching presentations, including OCPs.

Uncontrolled per rectal bleeding in chronic myeloid leukaemia: a mere coincidence or a dangerous sign report of an unusual case

Bleeding haemorrhoids present commonly to surgical outpatient departments (OPDs) and sometimes in emergency. Most often conservative management suffices but infrequently the patients can land up in emergency operation theatre for uncontrolled bleeding. Some haematological disorders can also present with rectal bleeding and amongst them Chronic myeloid leukaemia (CML), a haematological malignancy, presenting as bleeding per rectum has been not been reported so far, though instances of CML with gingival bleed, epistaxis have been reported. CML per se is known to be asymptomatic (40% cases) and bleeding is rarely seen. Here we present an interesting case of an emergency hemorrhoidal bleed that was subsequently diagnosed as CML. The patient after failed conservative management for bleeding haemorrhoids was taken up for emergency haemorrhoidectomy and again a relook under general anaesthesia in the post-operative period as he continued to ooze. The total leucocyte counts which were initially high continued to rise further and the bone marrow examination was reported as chronic myeloproliferative neoplasm and the excised mass was consistent with haemorrhoids. Rectal bleeding associated with CML is so far unreported even though bleeding is seen due to platelet dysfunction from gums and nose in chronic phases of the disease. A high index of suspicion is needed particularly with deranged haematological parameters for considering a diagnosis of these rare presentations. and anaesthesia.

Clinical profile and excellent short-term treatment outcome of acute glomerulonephritis: a report from paediatric nephrology unit of university teaching hospital, Uyo, Nigeria

Background: Acute glomerulonephritis (AGN), the commonest of which is acute post streptococcal glomerulonephritis, is common in school aged children and typically presents with haematuria, oedema, oliguria and varying degrees of renal insufficiency. This study evaluated epidemiologic factors, presentations and treatment outcome of AGN patients at University of Uyo Teaching Hospital, (UUTH), Uyo, Nigeria.Methods: This cross-sectional study was conducted among children with AGN at the paediatric nephrology unit of UUTH from January 2015 to December 2019. Data were analysed with statistical package for social sciences version 25 and p values <0.05 were considered statistical significant.Results: Fifteen out of 12,403 paediatric admissions had AGN, giving an average yearly hospital incidence of 3/year and 0.12% of total admission. Age range was three to 15 years. Mean age was 8.07±3.94 years and median was 7.00 years. Males were nine with a male/female ratio of 1.5:1. Eight (53.3%) belonged to the lowest socioeconomic class. Haematuria and peripheral oedema were universal presentations and 4 (26.7%) had antecedent pharyngeal infection. Other clinical presentations were: Oliguria 11(73.3%), Grade II hypertension 10 (66.7%), and pulmonary oedema 5 (33.3%). Four (26.7%) each had acute kidney injury, hyperkalaemia and dipstick massive proteinuria. Other complications were congestive cardiac failure 2 (13.3%), and seizures with encephalopathy in 1 (6.7%). Proteinuria was significantly associated with age at p=0.034 (Fisher Exact test). Major treatment modalities were: fluid management, loop diuretics and antibiotics as indicated.Conclusions: Short-term outcome was excellent with 100% discharge within 28 days of hospitalisation and the majority being discharged within two weeks.

Profile of chest injuries in a tertiary care centre

Background: Trauma is a major cause of mortality worldwide. This study is aimed at the patterns of chest trauma, their presentation and the outcome of management.Methods: A prospective study of trauma patients admitted to a tertiary care centre was carried out the clinical history, physical examination and outcome of management recorded in a predesigned proforma were analysed with SPSS 15 and the patients were followed up in the surgical department.Results: A total of 638 patients were admitted. 57 patents were identified with chest trauma, 43 (75%) were males and 14 (24.56%) were females. The age range was from 3-78 years and the most affected age was in the range of 20 to 39 years. Blunt injury constituted 82.4% while road traffic accident was responsible for 70.1%. The average time taken between accident and admission was 11 hours 12 minutes while the average duration of hospital stay was 11 days. The injury pattern mainly included rib fracture and hemopneumothorax. The mortality rate was 1.75%.Conclusions: Most patients arriving at the hospital survived, requiring general resuscitation or simple tube thoracostomy with few complications. Mortalities from trauma and cause of death at the site of accident are often not accounted for due to non-presentation to the hospital and lack of autopsy for those who present.

Rare presentations of acute appendicitis

Acute appendicitis is the one of the most common emergency conditions that the rural surgeon must deal with. Though the majority of patients present with the typical symptoms of right iliac fossa pain, nausea and anorexia, many patients do present with atypical symptoms and signs. These patients present a challenge to rural surgeons. Acute appendicitis is a great mimic and can present with a variety of symptoms. The eyes don’t see what the mind doesn’t know and it is important to know the various ways in which appendicitis can present and to always keep it as a differential diagnosis while managing a patient with acute abdomen. In this paper we have looked at 4 different presentations of appendicitis. Appendicitis is a great mimic and should always be kept as a differential for acute abdomen.

Clinical and epidemiological characteristics of patients with suspected primary immunodeficiency disorders attending Alexandria University Children's Hospital

Background: Current study was conducted to determine the clinical and epidemiological characteristics of patients with suspected primary immunodeficiencies (PID) seen at Alexandria University Children's Hospital.Methods: Eighty one patients with suspected PID were seen at Alexandria University Children's Hospital in one year in the period from September 2016 to October 2017. Demographic data of the patients as well as data related to their disease status were taken and evaluation sheet was developed for all patients.Results: About 61.7% of patients satisfied the criteria of PID based on WHO Scientific Committee. According to modified IUIS classification predominant antibody deficiency was the commonest (34%) followed by other well defined immunodeficiency syndromes (30%), combined immunodeficiencies (16%), phagocytic defects (14%), diseases of immune dysregulation 4% and complement deficiencies (2%). The most frequent disorder was X-linked agammagloulinemia (XLA) (22%). The mean age at diagnosis was 27.4 months. The consanguinity rate was 55.5%. A positive Family history was a strong pointer to diagnosis for PID (46.9%). The commonest clinical presentation was pneumonia (82.7%). 28.4% of patients died from infections. As observed in other patient registries, diagnostic delay remains the major cause of morbidity and mortality.Conclusions: Primary immunodeficiency disorders are not rare in Egyptian children. Creating awareness of PID should be targeted at hospital pediatricians and families with history of PID and this may reveal more cases within the community. The observed high frequency of combined T- and B-cell immunodeficiencies in this cohort made it a health issue in Egypt as in other developing countries.

Progress in the study for immune escape-related mutation in the S region of hepatitis B virus / 解放军医学杂志

Hepatitis B virus (HBV) infection could lead to different clinical presentations and disease progresses, including acute and chronic hepatitis B, liver cirrhosis, hepatocellular carcinoma, and occult HBV infection, in which the interaction between virus and host plays an important role. Because HBV reverse transcriptase is lack of correction function, HBV is prone to generate mutations under the pressure of host immune response and antiviral drug treatment. Some mutations in the HBV S gene-encoding region can significantly attenuate antibody immune response against HBV and therefore affect clinical presentations and disease progression. Such mutations are termed immune escape-related mutations. In this paper, we mainly review the structure and functional characteristics of HBV S gene, the causes and forms of the immune escape-related mutation, its influence on clinical presentations and antiviral treatment response, as well as clinical detection methods.

Etiological Factors, Clinical Presentations And Treatment Outcome Of Cervical Lymphadenopathy: An Observational Descriptive Study

Aim: To study various etiological factors, clinical presentations of cervical lymphadenopathy. To study the manage-ment and outcome of cervical lymphadenopathy Method:Proper clinical history was first noted, local and systemic examination was performed and a clinical diagnosis was made. Gender wise distribution, presenting symptoms, site distribution, and treatment outcome were noted. Result:Gender wise distribution of male and female was 52%, and 48%, commonest site of primary in cases of metastatic Secondaries was tongue followed by oesophagus and thyroid. After proper diagnosis confirmed by Histopathology (biopsy), treatment constituted properly-Cases of Tubercular Lymphadenitis (49 cases) were Started on Anti-tubercular treatment, all were showed improvement in symptoms. Cases of Reactive lymphadenitis (26 cases) started on antibiotics, all recovered well. Among 14 Cases of Metastatic secondaries, 5 cases were given Chemotherapy/Radiotherapy after expert oncologist opinion out of which 3 showed improved symptoms and 2 were expired, 6 cases were operated out of which 5 showed improved symptoms and 1 expired post operatively, 3 cases were referred to specialized oncological and oncosurgical center for further man-agement. All 6 Lymphoma cases were started on chemotherapy after expert oncologist opinion showed improve-ment in symptoms. Conclusion:Commonest site of primary in cases of metastatic Secondaries was tongue followed by oesophagus and thyroid. Anti-tubercular treatment for tubercular lymphadenitis was highly satisfactory with im-provement in almost all patients. Surgery was restricted as an adjuvant to chemotherapy, as diagnostic biopsy, for treatment of abscess/sinuses and for a lymph nodes that do not resolve with chemotherapy. Non-tuberculous non-neoplastic lesions can be best managed by conservatively.

Tongue image classification method based on transfer learning and fully connected neural network / 第二军医大学学报

Objective To propose a classification method for small sample tongue images based on transfer learning and fully connected neural network, so as to solve the problems of large amount of data, high requirement of training equipment and long training time of deep learning in the classification of tongue images. Methods Effective features such as tongue points and lines of tongue images were extracted by the convolution Inception_v3 network after training on the massive data set of ImageNet. The above features were classified by the fully connected neural network, and the image knowledge acquired by the deep learning network was transferred to the tongue image recognition task, and then the tongue data set were used to train and test the efficiency of the network. Results Compared with the typical tongue image classification method such as K-nearest neighbor (KNN) algorithm, support vector machine (SVM) algorithm and convolutional neural network (CNN) deep learning method, the two methods (Inception_v3＋2NN and Inception_v3＋3NN) in our experiment had higher classification rates for tongue images, with the accuracy rates being 90.30% and 93.98%, respectively, and had shorter training time for the sample. Conclusion Compared with KNN algorithm, SVM algorithm and CNN deep learning method, the tongue image classification method based on transfer learning and fully connected neural network can effectively improve the accuracy rate of tongue image classification and shorten the training time.

Survey on Medical Residents' Attitudes Toward Conference Presentations / 医学教育

Introduction: Conference presentations are a very instructive experience for doctors.Aim: The aim of this study was to evaluate residents' attitude toward conference presentations.Methods: A questionnaire-based survey was conducted on 22 residents at our hospital, regarding their experience with giving a conference presentation.Results: Of the 22 residents, 15 (68%) completed the questionnaires. 13 (87%) of them had experienced giving a presentation for the first time. Overall, 14 (93%) of the 15 residents thought the experience of giving a conference presentation was very instructive. 12 residents (80%) wanted to experience it again. On the other hand, a few residents requested that giving a presentation be made voluntary and not mandatory.Conclusion: The results of our study demonstrates that giving conference presentations would be a very valuable experience for young doctors. The experience of giving a presentation coupled with prior explanations about its instructive value could positively impact intrinsic motivation.

"Saber hacer con" Efectos de un goce de época / "Know how to do with" Effects of a vintage enjoyment

Este artículo se organiza en torno a dos ejes principales: la época actual desde una mirada psicoanalítica y los efectos que ésta conlleva en la clínica contemporánea. No se puede aislar al sujeto y sus síntomas/ fenómenos del devenir de nuestras sociedades. A nivel general, el mundo actual ha puesto de relieve un amplio campo de patologías y presentaciones clínicas: cortes en el cuerpo, fanatismos, comunidades que se congregan en las redes sociales incitando a manifestaciones de violencia y autocastigo (la ballena azul), el aumento creciente de la obesidad en la población mundial, la multiplicación de conductas compulsivas en el marco del empuje al goce sin medidas, el recrudecimiento de los fenómenos de discriminación y segregación (bullying, restricciones inmigratorias, racismo). Incluso, se constata que la clínica de la psicosis también se ha visto modificada desde su presentación sintomática hasta los posibles modos de estabilización. A nivel particular, en lo que respecta a la población que es asistida en hospitales públicos, advertimos también que el contexto cultural, social y económico condicionan las presentaciones clínicas y la orientación del tratamiento, o mejor llamado desde el discurso psicoanalítico, la dirección de la cura. Asimismo, resulta fundamental mencionar que la experiencia analítica, más allá de tener presente el contexto del paciente, trabaja siempre desde la singularidad de cada caso y las soluciones que cada sujeto arma para hacer frente a su malestar. Es nuestra intención abordar dichas problemáticas a la luz de una mirada clínica.

This article is organized around two main axis: the present time from a psychoanalytic point of view and the effects that this entails in the contemporary clinic. We cannot isolate the subject and its symptoms / phenomena from our societies. Today's world has highlighted a wide range of pathologies and clinical presentations: cuts in the body, fanaticism, communities that congregate in social networks inciting violence and self-punishment (the blue whale), the increasing number of obesity in the world population, the multiplication of compulsive behaviors within the framework of the enjoyment without measures, the intensification of the phenomena of discrimination and segregation (bullying, immigration restrictions, racism) are some of the many manifestations which are currently observed. In addition, we observe that clinical psychosis has also been modified in present time from its symptomatic presentation to possible modes of stabilization. In particular, regarding population assisted in public hospitals, we also notice that the cultural, social and economic context conditions clinical presentations and orientation of treatments and the direction of the cure. It is also important to mention that analytical experience, beyond having in mind the context of the patient, always works from the singularity of each case and the solutions that each one builds to deal with their discomfort. It is our intention to face these issues in light of a clinical view.

Este artigo está organizado em dois eixos principais: a época atual desde um olhar psicanalítico e os efeitos deste na clínica contemporânea. O sujeito e seus sintomas / fenômenos/ não se pode isolar do decorrer de nossas sociedades. Em termos gerais, pode-se dizer que o mundo atual salientou um amplo campo de patologias e apresentações clínicas: cortes no corpo, fanatismos, comunidades que se juntam nas redes sociais incitando a manifestações de violência e auto punição (a baleia azul), o acréscimo da obesidade na população mundial e de condutas compulsivas no entorno que impulsiona o gozo sem medida, bem como o reaparecimento dos fenômenos de discriminação e segregação (bullying, restrições imigratórias, racismo). Verifica-se, até, que a clínica da psicose também tem sido alterada em sua apresentação o sintomática e nos possíveis modos de estabilização. No particular, relativo à população que é assistida nos hospitais públicos, revela-se também que o contexto cultural, social e econômico condicionam as apresentações clínicas e a orientação do tratamento, ou de acordo com o discurso psicanalítico, a direção da cura. De igual maneira, é fundamental mencionar q a experiência psicanalítica além de considerar o contexto do paciente, trabalha sempre desde a singularidade de cada caso e das soluções que cada sujeito cria para enfrentarse com seu mal-estar. Nosso intuito é abordar tal problemática à luz de um olhar clínico.

Exantema periflexural asimétrico de la infancia, dos formas de presentación / Asymmetric periflexural exanthem of childhood, two forms of presentation

El exantema periflexural asimétrico de la infancia es una entidad benigna, autolimitada, subdiagnosticada, de etiología desconocida, que compromete mayormente niñas de edad preescolar. Tiene predominancia estacional (invierno y primavera). Su diagnóstico es clínico, y se presenta como un exantema escarlatiniforme, morbiliforme o eccematoso, que generalmente comienza en la axila y se extiende centrífugamente hacia el tronco y el miembro superior homolateral. Puede acompañarse de adenopatías regionales y fiebre. No requiere tratamiento específico, salvo el uso de cremas humectantes y antihistamínicos, en caso de presentar prurito. Se describen 2 pacientes con diferentes formas de presentación de esta entidad, una típica y otra infrecuente.

Asymmetric periflexural exanthema of childhood is a benign, self-limited, underdiagnosed disease of unknown etiology that mainly affects girls at preschool age. It has seasonal predominance (winter and spring). The diagnosis is clinical and is presented as scarlatinform, morbiliform or eczematous exanthem that generally begins in the axilla and centrifugally extends to the trunk and the homolateral upper limb. It may be accompanied with regional adenopathies and fever. It does not require specific treatment except for the use of moisturizing and antihistaminic creams in case of pruritus. Two patients with different forms of presentation, one typical and another unfrequent, were described.

Clinical characteristics of renal cell carcinoma: Five years review from a tertiary hospital in Eastern India.

BACKGROUND: Renal cell carcinoma (RCC) is the one of the dreadful urological carcinoma. In comparison to the West, it is very rarely seen in Asia as well in India. Very small number of studies is available in this geographical area. AIMS: We studied the demographic pattern, presentation, risk factors and survival of RCC in an Eastern Indian institution. We characterized and compared these data with available literature SETTINGS AND DESIGN: Retrospective study. MATERIALS AND METHODS: A total of 81 patients of RCC from January 2008 to December 2012 were enrolled. Their pre‑operative data were reviewed. They were followed as per institutional follow‑up protocol. STATISTICAL ANALYSIS USED: Kaplan‑Meier plot was constructed for survival analysis. Comparison of survival curves was performed by Logrank test. P < 0.05 was considered to be significant. RESULTS: A total of 75 patients were analyzed with a mean follow‑up of 26.3 ± 17.7 months. The mean age of presentation in our study was 52.79 years with a peak at 5th decade. Nearly 73.33% patients having one or more risk factors. 9 out of 10 had presented with some symptoms. The survival for localized RCC was 100% and significantly greater than advanced RCC ( P < 0.0001). Similarly in the stage III, significant greater survival ( P < 0.0001) was noted compare to stage IV. CONCLUSIONS: The age of presentation of RCC in India has been found in 5th decade, which is a decade earlier than the western countries. Symptomatic RCC is still majority in India. Organ confined tumors have good prognosis. When it metastasizes to lymph node or distant organ, the outcome is poor. Our results may form the basis for further studies and it may be used as future reference.

The radiological presentations of invasive pulmonary fungal infections and its clinical value in children / 中国小儿急救医学

With wide applications of invasive diagnostic and therapeutic techniques,as well as immu-nosuppressors clinically,the morbidity of invasive pulmonary fungal infections( IPFIs)in children were in-creasing considerably and becoming one of the important diseases threat to life. The mortality of IPFIs in chil-dren would be reduced and the prognosis would be improved significantly with early diagnosis and treatment in-time. Radiological examinations were the basal component of the clinical evidences for diagnosing IPFIs. The main presentations include pulmonary nodules,some with“halo sign”in invasive pulmonary aspergillo-sis and pulmonary candidiasis,lobular consolidations and a little pleural effusion. Although there was no spe-cific findings radiologically,they would provide the proofs and clues for diagnosis of IPFIs combining with the data of clinics and laboratory.

A correlation study between body mass index and features of tongue manifestation / 国际中医中药杂志

Objective To investigate the correlation between body mass index (BMI) and features of tongue manifestation.Methods A total of 1 655 physical examination individuals were selected,and height and body weight were measured to calculate BMI.Traditional Chinese Medicine tongue inspection was performed,and map of tongue manifestation was photographed by a digital camera.Results Among the 1 655 physical examination individuals,prevalences of normal weight,overweight/obesity and low weight were 50.94％,43.74％ and 5.32％,respectively.The prevalences of individuals had dark red tongue (37.98％ vs.24.56％;x2=40.883,P＜0.001),purplish tongue (5.94％ vs.3.44％;x2=8.133,P=0.017),dark purplish tongue (2.35％ vs.0.59％;x2=10.398,P=0.006),yellow fur (63.95％ vs.58.84％;x2=9.570,P=0.008),thick greasy fur (24.86％ vs.17.20％;x2=18.698,P＜0.001) in the overweight/obesity group were significantly higher than those in the normal weight group,and the prevalence of individuals had exfoliative fur/little fur/less fur in the overweight/obesity group was significantly higher than that in the normal weight group (1.93％ vs.3.91％;x2=6.454,P=0.040).The prevalences of individuals had red or deep red tongue (48.86％ vs.24.72％;x2=24.608,P＜0.001),red dot tongue (7.95％ vs.1.93％;x2=12.254,P=0.002),thin whitish fur (22.73％ vs.9.53％;x2=14.030,P=0.001) in the low weight group were significantly higher than those in the normal weight group.Binary logistic regression analysis showed positive correlation between dark red tongue (OR 1.830,95％ CI 1.515-2.211;P＜0.001),purplish tongue (OR 1.874,95％ CI 1.211-2.901;P=0.005),dark purplish tongue (OR 4.259,95％ CI 1.610-11.266;P=0.003),yellow fur (OR 1.294,95％ CI 1.093-1.531;P=0.003),gray-black fur (OR 6.147,95％ CI 1.816-20.811;P=0.004),thick greasy fur (OR 1.597,95％ CI 1.289-1.978;P＜0.001) and BMI,and negative correlation between pink tongue (OR 0.766,95％ CI 0.637-0.920;P=0.004),red or deep red tongue (OR 0.659,95％ CI 0.549-0.789;P＜0.001),red dot tongue (OR 0.548,95％ CI 0.326-0.921;P=0.023),thin whitish fur (OR 0.695,95％ CI 0.536-0.900;P=0.006),whitish fur (OR 0.821,95％ CI 0.683-0.986;P=0.035) and BMI.Conclusions There is some correlation between BMI and features of tongue manifestation.Abnormal tongue color is mainly dark red tongue in the overweight/obesity individuals,and red or deep red tongue in low weight individuals.Abnormal tongue fur is mainly thick yellow fur.The tongue shape is normal in different body weight groups.