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We report a case of a 56-year-old Caucasian man who presented with acute onset of substernal chest pain at rest with electrocardiogram showing diffuse ST segment depression. He had coronary artery bypass graft surgery 16 years ago with a left internal mammary artery graft to the left anterior descending artery and saphenous vein grafts to the right coronary artery [RCA] and left circumflex artery. He underwent coronary angiography, which showed two large aneurysms in the saphenous venous graft [SVG] to the RCA and a venous leak from the aneurysm. The venous leak was later confirmed with computer tomographic scan to be a fistulous communication between the SVG and the right atrium. We discuss in detail about the treatment options of SVG aneurysm
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We report a case of a 38-year-old-man who presented with altered mental status. The patient was diagnosed with infective endocarditis [IE] originating from the GORE HELEX septal occluder device, which was placed 15 months earlier for symptomatic atrial septal defect. Brain imaging revealed shower emboli phenomena from the known IE. The patient developed hydrocephalus for which external ventriculostomy was performed. Improved neurological status warranted open heart surgery. The patient was later confirmed to be an intravenous drugs abuser, prejudicing IE. This case highlights the importance of meticulously monitoring patients with suspected high-risk behavior with an implanted intracardiac prosthetic device
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Background: Self-medication is use of medicines by individuals to treat selfrecognized symptoms and illness. Self-medication is a common type of self-care behavior in the general public, but medical students differ in such practice, as they have knowledge about drugs and diseases. Methods: The present study involved 100 2nd year final term medical students in “Shivamogga Institute of Medical Sciences,” Shivamogga, Karnataka. Study was questionnaire based, and the results were analyzed by descriptive statistical methods. Results: In our study, 57% were female, and 43% were male. About 60% had knowledge about over the counter (OTC) drugs and considered Ayurveda drugs also OTC drugs. 25% considered self-medication entirely safe, whereas 61% considered self-medication have advantages. Self-medication was preferred by 72% as they felt that there is no need to consult health care professionals for a simple ailment. Selfmedication was practiced by 62% students, among which 86% were appropriate, and 48% among them utilized knowledge from previous consultation. In 28% fever was the most common condition and paracetamol was the most commonly used drug. Conclusions: Self-medication was widely practiced among the students. They had good knowledge of OTC drugs. The practice of self-medication was almost appropriate. In general self-medication must be accompanied by appropriate information. Educating benefits and risks of self-medication is very much needed for medical students and the public now a day.
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Toxic epidermal necrolysis (TEN) is a rare but serious is a rare but potentially lifethreatening condition. It is primarily a cutaneous reaction to various precipitating agents, characterized by wide spread erythema and detachment of the epidermis from the dermis. Among the various cutaneous adverse drug reactions, TEN occupy a primary place in terms of mortality. In TEN large sheets of skin are lost from the body surface, thereby decreasing the protecting function of the skin, which results in complications. Usually, TEN is self-limited in absence of complications. If complicated by sepsis, there will be increased chances of mortality. The main treatment would be cessation of the causative drug and early admission of the patient for supportive care and minimizing the occurrence of complications. The present articles reviews the etiology, pathophysiology, differential diagnosis and treatment protocol, with a case of TEN occurrence in a child of 4 years age after consuming phenytoin syrup for febrile convulsions.
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Background: Heart failure in patients with human immunodeficiency virus (HIV) is often from dilated cardiomyopathy as a result of HIV itself, drug myotoxicity, secondary infections, or druginduced atherosclerosis. Left ventricular noncompaction (LVNC) is a rare cardiac congenital abnormality which occurs due to early arrest of endomyocardial morphogenesis. Case: A 47- year-old female patient with HIV presented with sudden onset shortness of breath and symptoms of congestive heart failure. Echocardiography showed noncompacted endocardium with reduced left ventricular function. She was subsequently diagnosed with LVNC. Discussion: Multiple etiologies have been implicated in cardiomyopathy among HIV patients. LVNC is a rare cause of left ventricular failure, particularly in this population. Echocardiography plays a pivotal role in the diagnosis. Conclusion: It is often challenging to identify the underlying cause of cardiomyopathy in a patient with HIV. While LVNC is a rare cause of left ventricular failure, typical findings on echocardiography can obviate the need for a more complex evaluative strategy.
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Left atrial space occupying lesions pose diagnostic challenge on echocardiography. We report a 79-year-old man with history of pheochromocytoma with left adrenal mass presented with heart failure symptoms after adrenalectomy. Echocardiogram revealed a large echo lucent structure (6.9 x5.9cm) compressing the posterior wall of the left atrium. Further investigation with computer tomography and barium swallow confirmed the diagnosis of hiatal hernia. In this report we explain the differential diagnosis and simple steps to assist the diagnosis of left atrial space occupying lesions noninvasively.
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Background: Wound healing is an important process in regeneration of the lost tissue, it involves various steps. Varieties of substances are known to interact in the healing process, some of the plant products are found to be beneficial. Jasmine leaves are mentioned to have healing effect in ancient literature. Hence the study was carried out to evaluate the wound healing effect by assessing the histopathological parameters. Methods: The study was done in the albino rats which were divided into various groups. The histopathological parameters were studied at regular intervals. Results: It was found that jasmine paste improved the wound healing process at all the stages. Conclusion: Jasminum grandiflorum has wound healing effect in albino rats.
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Background: Thought is a mental process which occurs in the Neo-cortex of the Brain [Cerebral cortices] based on the background knowledge, perception of the event or the action and understanding influenced by the individual traits or personality. Individual thoughts differ from person to person, time to time, and the events in life. Mainly thought is interpreted or understood based on the behaviour or when the person explains about it. Thought process in the brain can be acknowledged by an individual to have acceptable behavioural norms in the society, but cannot be explained by patients with disorder of thought processes. The behaviour of these individuals is acknowledged as the thought of the individual. Abnormal thought process occurs in psychiatric conditions like Psychosis, Anxiety disorder, Post traumatic disorder, mood disorders in varied manners. It also has implications or influences of the hormonal status and age of the person. In this study we are evaluating the thought control in the teenagers. Methods: the study was carried out in the medical students of SIMS-Shimoga. It is a questionnaire based study using a thought control questionnaire (TCQ). Results: The results were studied in five domains namely Distraction, Social, Worrying, Punishment and Re-appraisal, were found to vary within the acceptable limits and comparable with earlier studies. Conclusion: The findings in this study reflect the positive approach, handling of the unwanted and distracting thoughts in the teenagers.
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Background: Wound is a common process leading to inflammation and healing process. Jasminum grandiflorum is a plant widely grown in Karnataka and is mention in ancient medical systems to promote healing. So the study was taken up to confirm the anti-inflammatory effect of the plant. Methods: Excision and incision wound models in albino rats were used to study the wound healing effect. It was mainly studied by the degree of epithelisation at various intervals and compared with control group. The strength of the wound was assessed by its wound breaking strength at the end. Results: It was found that jasmine extract increased the degree of epithelisation and thus promoting wound healing. It was also found that the wound breaking strength was more in the drug treated group compared to normal. Conclusions: Jasminum grandiflorum leaf extract is known to have wound healing property.
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To determine the incidence and density of Demodex species on the eyelashes of subjects with normal eyelids, anterior blepharitis [AB], meibomian-gland dysfunction [MGD], and mixed blepharitis [MB]. One hundred and fifty consecutive patients diagnosed with AB, MGD, and MB were recruited. An additional 50 individuals were recruited who were free of lid and margin disease to serve as a control group. All patients underwent a standard eye examination. Data on ocular symptomatology were gathered. Digital photography was performed of the lid margins. Lash sampling was performed by epilating the lashes and the lashes were checked for Demodex based on morphology using light microscopy. The total number of mites were tabulated for each eye. Comparison between the affected eyes and the control eyes was performed. Data were analyzed using the Chisquare test. A total of 200 patients were included. Twenty percenth had AB, 40% had MGD, and 40% had MB. The incidence of Demodex infestation was 90% in cases of AB, 60% in MGD cases, and 90% in MB cases. The incidence of Demodex in control subjects was 18%. The incidence and density of Demodex infestation was highest in patients with AB and MB. Lid irritation and presence of cylindrical dandruff were indicative of a high-density infestation. These signs should alert the clinician to treat concomitant Demodex infestation