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Wilson's disease is an inborn error of copper metabolism that is characterized by deficiency of ceruloplasmin, the serum transport protein for copper. Copper is collected in the liver, and after hepatic binding sites are saturated, it is released. Systemic disease then develops and there is abnormal accumulation of copper in the brain, particularly in the putamen and globus pallidus. Presenting this case of a 32-year-old male patient who presented with peculiar features for Wilson抯 disease.
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Dermatomyositis, a connective tissue disorder, is an idiopathic inflammatory myopathy characterised by skin manifestation.The diagnosis of dermatomyositis is based on rashes on the skin, progressive muscle weakness, elevated serum muscle enzymes, abnormal electromyogram, and abnormal findings on muscle biopsy. Hereby presenting this rare case of a 57-year-old female with dermatomyositis with all the typical clinical findings with interstitial lung disease.
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Purpose: Morphological stability and functional integrity of corneal endothelium are necessary to maintain long-term corneal transparency. When the number of endothelial cells drops below 450�0 cells/mm2, corneal edema, irreversible loss of corneal transparency, and decreased vision occur. There is concern regarding manual small-incision cataract surgery (MSICS) being more harmful to the endothelium in comparison to phacoemulsification. Our study aims to determine which technique maintains the corneal parameters closest to the normal physiological state. Methods: A prospective observational study was conducted over a period of 15 months on 100 eyes, out of which 43 patients underwent phacoemulsification surgery and 57 underwent MSICS. TOPCON SP-1P, Version 1.41, 50� Hz frequency, noncontact specular microscope with pachymeter was used to measure endothelial cell count (ECC) and central corneal thickness (CCT) on four occasions: 1 day prior to surgery and on day 1, 3rd week, and 6th week after surgery. Results: In total, 100 eyes of 100 subjects were studied with no dropout during the study period. The age range was 40� years. There was no statistically significant difference between the preoperative mean ECC and mean CCT in phacoemulsification and SICS groups. A statistically significant difference was observed in the postoperative mean ECC (P < 0.01) and mean CCT (P < 0.001) on day 1 and 3rd week between the phacoemulsification and SICS groups, respectively. The mean endothelial cell loss at 6 weeks was less with SICS but comparable with phacoemulsification. Conclusion: SICS is significantly faster, less expensive, less technology dependent, can deal with all types of cataracts, is relatively safe, and is more appropriate for advanced cataracts.
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Introduction: Type 2 diabetes mellitus (T2DM) with chronic kidney disease (CKD) is dreadful combination necessitatingadequate glycemic control to prevent further complications. Teneligliptin is found to be renal friendly antidiabetic agent whichcan provide effective glycemic control.Objective: The objective of this study was to determine the efficacy of teneligliptin as add-on to existing therapy in patients ofT2DM with CKD.Materials and Methods: This was a retrospective study where patients with T2DM and CKD who received teneligliptin wereincluded in the study. Changes in glycemic parameters such as hemoglobin A1c (HbA1c) (%), fasting plasma glucose (FPG),and postprandial plasma glucose (PPG) and change in estimated glomerular filtration rate (eGFR) were analyzed.Results: In total, 66 patients were included in analysis. Mean age was 57.7 ± 14.0 years and 60.6% were males. BaselineHbA1c, FPG, and PPG levels were 7.8 ± 0.7%, 128.0 ± 25.5 mg/dl, and 214.0 ± 55.9 mg/dl, respectively. There was a significantreduction in HbA1c at 3 and 6 months (mean difference from baseline: −0.9 ± 0.5 and −1.2 ± 0.5 respectively, P < 0.001 forboth). Similarly, mean change in FPG (−28.4 ± 20.9 and −29.9 ± 24.3 mg/dl, respectively) and PPG (−70.5 ± 49.2 and −97.0 ±60.7 mg/dl, respectively) was also significant (P < 0.001 for all comparisons). The change in eGFR was significant at 3 months(P = 0.049) and 6 months (P = 0.014).Conclusion: Teneligliptin is effective in reducing glycemic burden in patients with T2DM and CKD and can be considered asbe considered among first choices for glycemic control in patients with renal impairment.
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Background: A fistula in ano is a pathway, lined by granulation tissue that joins deeply in the anal canal or rectum and superficially on the skin around the anus. A fistulectomy involves complete excision of the fistulous tract. Low anal fistulae have been mainly treated by fistulotomy with good results. However, Marsupialization of the fistulotomy wounds can reduce the healing time further. The purpose of this study was a randomized controlled trial that aimed to compare the fistulectomy to the fistulotomy with marsupialization in the management of simple anal fistula. Methods: This was an analytical type of study which was conducted at departments of surgery of TMMC & RC, Moradabad from September 2017 to September 2018. The patients included in the study were randomly divided into two groups. Group I included seventy patients (70) underwent for fistulectomy and group II consisted seventy patients (70) underwent for fistulotomy with marsupialisation. Results: The healing time was longer in group I (37.6 ± 11.9 day) in comparison to group II (29.8 ± 13.6 days) with a statistically significant p value (<0.05). The length hospital stay for both groups was 4.6 ± 1.4 days. Whereas, length hospital stay individually for group I and group II were 4.4 ± 1.1 days and 4.8 ± 1.7 days correspondingly with an insignificant p value (>0.05). There were significantly less postoperative pain as well as blood loss in group II patients of fistulotomy with marsupialisation in comparison of group I patients of fistulectomy. There was an insignificant difference in the extents of adverse effects of surgery on various aspects of group I and group II. Conclusion: Results of the present study suggested that there was a shorter duration of wound healing as well as less blood loss in patients of fistulotomy with marsupialisation in comparison of patients of fistulectomy. Therefore, fistulotomy with marsupialisation is recommended as a standard surgical procedure in the surgical treatment of low fistula-in-ano. However, studies on larger population and longer period of follow-up are warranted to establish fistulotomy with marsupialisation as standard surgical procedure for the treatment of low fistula-in-ano.
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Background: Gastrointestinal tuberculosis is one of the commonest sites of extra pulmonary involvement. Most of the studies in the literature are on abdominal tuberculosis as a whole, which to a certain extent is responsible for confusion. Hence this study aims at a fresh look into Gastro intestinal tuberculosis as a separate entity. Aim and objectives: 1) to analyze the clinical features of Gastro Intestinal Tuberculosis. 2) To study the pathological features.3) to evaluate the role of surgery and to choose procedures in management of this disease. Methods: A total of 32 patients were included into this prospective study and divided into 4 groups based on the type of presentation namely, Obstruction – 18, Mass- 4, Perforation – 4 & Atypical – 6. They were subjected to thorough clinical evaluation and appropriately investigated. Results: Pain abdomen was the commonest symptom, 94% of the patients. 56% of the patients with obstruction. Commonest abdominal sign was abdominal distension, 66% of the patients. Ileocaecal region was the most common site, 50% of the patients. Ulcerative form was the most common gross pathology, 59% of the patients. Patients were subjected to either conservative management – 5 patients, Or Surgery , emergency in 17 patients and elective in 10 patients, depending on the Mode of presentation. Limited Ileocaecal resection was done in 9 patients and Right Hemicolectomy in 4 patients. Stricturoplasty was done in 8 patients. Complications were more common in emergency surgery. Conclusion: Patients commonly present with complications as intestinal obstruction. Ileocaecal region is the commonest site of disease .Conservative mode of management is preferable in patients not presenting with complications. Patients presenting with acute obstruction or perforation need emergency surgery.
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Background: Chromhidrosis means production of coloured sweat. Case characteristics: A toddler who presented with colored sweat was diagnosed to have chromhidrosis based on skin biopsy. No treatment was attempted considering the young age. Outcome: Parents were counselled about the benign nature of this disorder. Message: Identification of causes of colored sweat requires appropriate investigations.
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Niño , Glándulas SudoríparasRESUMEN
Diagnostic Assessment of bone marrow aspirate particle smears, imprints and biopsy sections was done on 10 Non- Haematological disorders. Core needle biopsy of the bone marrow is a safe and useful procedure. It is a valuable diagnostic aid for measurement of marrow cellularity, metastatic tumours and fibrosis . Bilateral trephine biopsy was conducted wherever necessary. Touch imprints were useful for studying cell morphology, where aspiration yielded dry tap.All the three procedures of bone marrow aspiration, trephine biopsy and touch imprints were found to be complementary to each other and superiority of one method over the other depended on the specific disease process.
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Diagnostic Assessment of bone marrow aspirate particle smears, imprints and biopsy sections was done on 40 haematological disorders. Core needle biopsy of the bone marrow is a safe and useful procedure. It is a valuable diagnostic aid for measurement of marrow cellularity and fibrosis.Bilateral trephine biopsy was conducted wherever necessary.Bone marrow aspiration was the most effective method for studying morphological details and was able to diagnose most of the cases except the 2 cases of myelofibrosis which yielded dry tap for which trephine biopsy was diagnostic.Trephine biopsy was also found to be superior for staging of lymphomas and to study the ALIP in MDS.Touch imprints were useful for studying cell morphology, where aspiration yielded dry tap.All the three procedures of bone marrow aspiration, trephine biopsy and touch imprints were found to be complementary to each other and superiority of one method over the other depended on the specific disease process.
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Present study was an attempt to study the prevalence of nonfermenter and its antibiotic susceptibility pattern at CSM Medical University, Lucknow. All the isolates and samples were selected from clinical specimens received in Bacteriology section, P.G. Depart of Microbiology, for culture. The observation were made on the nonfermenter isolates that can be isolated from clinical specimen using simple Laboratory media e.g. Blood Agar & Mac Conkey agar. All relevant history & information were recorded from the subjects. A total of 8340 specimen were screened for a period of one year. The prevalence of nonfermenters came to be 19.09% among all isolates. Most of spp. belongs to oxidase+ve group (77%). P. aeruginosa was found to be most common isolate (53%). Overall sensitivity profile for ciprofloxacin was 60%, P/T 58% & Amikacin 56%. Sensitivity of imepenem was 60% for multi-resistant isolates. The most resistant isolate was Sachrolytic Acinetobacter spp. The knowledge of synergism between drugs in context to different isolates may aid in effective therapy for these isolates.
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Chikungunya fever is a relatively rare from of vector-borne viral fever caused by chikungunya virus and spread by bites of the Aedes aegypti and Aedes albopictus mosquito. Epidemics of chikungunya fever have been reported in the past from different parts of the world. Although the virus had been passive for quite some time, recent reports of outbreaks of chikungunya fever in several parts of Southern India have confirmed the re-emergence of this virus. Symptoms of this infection include abrupt onset of fever, chills, and headache, rash, severe joint pain, conjunctival injection and photophobia. Ocular manifestations have been recently reported with this infection. We report a case of a 48-year-old female patient, who presented with defective vision two weeks after a serology proven chikungunya infection. There was bilateral neuroretinitis with peripapillary cotton wool spots. These findings should be kept in mind as an ocular manifestation of chikungunya virus infection.
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Infecciones por Alphavirus/diagnóstico , Anticuerpos Antivirales/sangre , Virus Chikungunya/genética , Ensayo de Inmunoadsorción Enzimática , Infecciones Virales del Ojo/diagnóstico , Femenino , Angiografía con Fluoresceína , Lateralidad Funcional , Glucocorticoides/uso terapéutico , Humanos , Inmunoglobulina M/análisis , Persona de Mediana Edad , Neuritis Óptica/diagnóstico , Reacción en Cadena de la Polimerasa , Prednisolona/uso terapéutico , ARN Viral/análisis , Retinitis/diagnóstico , Agudeza VisualRESUMEN
This study analyses distribution and abundance patterns of mesozooplankton communities at 13 stations in the coastal waters over a marine outfall area in the northeastern South China Sea. Cruises were conducted in March, June and September 2002, and plankton samples were collected with a 333 microm North Pacific net. The Mesozooplankton was dominated by calanoid Copepods, Cladocera, Chaetognatha and Pteropoda. Stations located near the entrance of the harbor provided a relatively higher abundance of Noctilucales and Radiolarians. In total, 20 zooplankton groups were identified in which, Calanoida, Cladocera, Chaetognatha, Pteropoda, Poecilostomatoida and Appendicularia comprised 92.77% of the total zooplankton abundance. Copepoda dominated in all three cruises, comprising 65.32% of the total mesozooplankton abundance. Samples collected in June recorded higher mesozooplankton abundance than March and September samples. Onshore stations recorded higher BOD values, higher abundance of Noctilucales and Radiolarians and a relativelylower abundance of the overall mesozooplankton. Total mesozooplankton abundance did not correlate significantly with temperature, pH, or dissolved oxygen, but correlated negatively with BOD.
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Animales , China , Biología Marina , Océanos y Mares , Zooplancton/fisiologíaRESUMEN
Eales’ disease is most frequently found linked with tuberculosis. Hence, the present prospective randomized study was conducted to evaluate the role of anti-tuberculosis therapy in Eales’disease, by carrying out physical, neurological, ophthalmological examination and laboratory tests. The results of present study reveals that there is no rationale for prescribing anti-tuberculosis treatment with active Eales’ disease with no systemic tuberculosis
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Anopheles subpictus was reported to be a complex of four sibling species provisionally designated as species A, B, C and D. Present studies in District Sonepat, Haryana have revealed the sympatricity of species A, C and D based on the reported distinct morphotaxanomical identification characters in different life stages of the mosquito. Studies on field collected adult mosquitoes and isofemale progeny did not show variations in the prevalence of sibling species and also showed a possibility of use of a single reported morphological character in a given life stage for the identification of the members of this complex.