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Lésion d'Antopol-Goldman (Antopol-Goldman lesion) is a rare condition characterized by renal pelvic subepithelial hematoma simulating a neoplastic process. A 71-year-old lady presented with macroscopic hematuria and hypoenhancing mass lesion at the upper pole of left kidney. The patient underwent a radical nephrectomy for suspected renal cell carcinoma. Macroscopically a 3.5cm circumscribed hemorrhagic mass lesion was noted flush with the upper pole pelvicalyceal system. Microscopic examination revealed a pelvic subepithelial (suburothelial) organizing hematoma. Extensive sampling did not reveal any neoplastic etiology. The adjacent renal parenchyma and renal vessels were unremarkable. Antopol-Goldman lesion is a diagnostic quagmire, often culminating in unnecessary nephrectomy. This is a rare entity, and clinical awareness as a differential of renal filling defect can preclude a nephrectomy, we hereby discuss its clinico-pathological and treatment implications.
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Background: India contributes to one fifth of global live births and more than a quarter of neonatal deaths. A systematic analysis of global, regional and national causes of child mortality in 2013 identified preterm birth complications and infections to be the two major causes of neonatal deaths in India. So, there is need of a simple, easy to use and reliable screening tool for assessment of gestational age at peripheral level for early referral of a neonate to a tertiary care hospital, thereby reducing neonatal mortality.Methods: A hospital based observational cross-sectional study included 350 live new-borns within 48 hours of birth, from September 2018 to February 2019. Gestational age assessed by new ballard score, birth weight, foot length and right nipple to umbilicus distance were noted. Babies categorised as per the gestational age profile as small, appropriate and large for gestational age using fenton charts. Data analysis done, correlation coefficient, and p value calculated to obtain results.Results: Out of 350 babies, males (185) outnumbered females (165); 154 were LBW, 89 VLBW and 76 were ELBW. AGA neonates were 193, and 157 belonged to SGA. There were no post-term and large for gestational age newborns. Both foot length and right nipple to umbilicus distance correlated well with gestational age in all age groups (p<0.001).Conclusions: Foot length as well as right nipple to umbilicus distance can be used as a reliable tool for assessment of gestational age and birth weight of newborns by any health care professional to identify and refer high risk neonate.
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Background: The doctor-patient relationship is the core foundation for healing, care, establishment of trust and an essential part of modern-day medical ethics. The last few decades have seen an exponential growth in the scientific component of the medical field which has led to a strain on doctor-patient relationship. With the growing trend of patients wanting more information from their doctor in order to have a more active role in their health-care, active communication from the physician’s end is needed. Present study aims to find out what doctors over various fields expect out of this relationship.Methods: A cross sectional prospective study was conducted among a total of 49 urban and rural doctors of various specialities in an urban area of Maharashtra using a pre-structured questionnaire. The statistical tools used to analyse the data was by using Microsoft excel software.Results: It was also noted that time spent with patients was less by the specialists as compared with other doctors for all aspects of consultation. On evaluating experience with the duration of consultation, we noted that doctors having more than 30 years of experience gave lesser time for all aspects of consultation as compared to those with lesser experience. A close range, between 45%-57% of all physicians, admitted to answering phone calls during consultations.Conclusions:It is imperative to study doctor-patient interactions since a better relationship results in a more satisfied patient with better treatment outcome.
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Background: Domestic solid waste collectors play important role in maintain hygiene of a community, especially in developing countries. Yet not many efforts are done to identify their health needs. The main objective of this study is to identify the morbidity pattern and social problems of solid waste collectors in urban Maharashtra.Methods: It was a cross sectional study. Study population consisted of domestic solid waste collectors who are registered under municipal corporation. Sampling was purposive. All the domestic solid waste collectors who came for specially arranged health check-up were included in the sample. Social and demographic information along with clinical history was collected using a structured questionnaire. General physical exam, eye checkup, skin examination and lab investigations were done in a specially organized camp, after obtaining prior consent of the participants. Data was analyzed using SPSS 19 software.Results: More than 90% of 98 solid waste collectors, who participated in the study had frequent cough, fever and diarrhea. Over 85% had back or/and leg pain. More than half of the study population had dryness of skin and 47% of them complained of itching. 15 solid waste collectors were discriminated in marriages.Conclusions: High prevalence of common frequent symptoms such as fever, cough and diarrhea can be controlled by conducting regular health checkups for this community. The need is to reach them rather than waiting for them to come to health facility. Sensitization of community towards importance of work done by the solid waste collectors is also required.
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Background: Pesticides are extensively used in floriculture where workers are mostly unskilled and may not have appropriate knowledge about safety. Acute accidents during spraying are reported, chronic exposure goes unnoticed. There are not many Indian studies regarding health risks and safety practices among floriculture workers in India. Hence this study to assess pesticide exposure, to find their determinants and suggest appropriate preventive measures.Methods: Study was cross sectional in Floriculture Park, Talegaon (D), Pune, Maharashtra, India using cluster sampling from February 2018 to July 2019. Prevalence of morbidities being 63% sample size was calculated as 111 (allowable error 15%). Socio-demographic, work and health related variables were recorded using a pretested structured questionnaire. Clinical examination and laboratory investigations were done by medical experts.Results: A total of 118 workers participated. Only half (51.2%) were using personal protective devices. None were following reentry guidelines. 13.3% males and 4.1% females had low serum cholinesterase level which is a biomarker of pesticide exposure. Sprayers had significantly high risk of low serum cholinesterase levels (OR=3.31) as compared to others. With exposed subjects which included both sprayers as well as polyhouse workers the association increased with OR=4.27. However association was not significant when working in polyhouse alone was considered as a risk factor (OR=1.256).Conclusions: Presence of exposure was the only factor that had a statistically significant association with low Serum Cholinesterase levels. Safe occupational practices like use of personal protective devices, rotation of exposed workers, monitoring of serum cholinesterase levels and health education of workers should be undertaken.
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Background: Staphylococcus aureus has emerged over the past several decades as a leading cause of hospital-associated and community acquired infections. Methicillin resistant S. aureus (MRSA), which are often resistant to several classes of antibiotics, is the most common cause of nosocomial infections and pose a great threat to the world. Vancomycin is regarded as the first-line drug for treatment of MRSA but resistance to this drug is being reported now a day.Methods: It was carried out for a period between January 2014 to June 2017 in the microbiology diagnostic laboratory. MRSA detection was performed by cefoxitin disk diffusion method. Screening for the vancomycin intermediate and the vancomycin resistant S. aureus (VISA and VRSA respectively) was carried out by using vancomycin screen. MIC (minimum inhibitory concentration) of vancomycin was tested by agar dilution method and E strip on all MRSA isolates.Results: A total of 287 S. aureus clinical isolates were included in the study. All MRSA were inoculated on vancomycin screen agar. Visible growth was present in 8 isolates. Five (3.73%) MRSA isolates with MIC of 4 were termed VISA (vancomycin intermediate S. aureus) by agar dilution method. Six isolates had the MIC of 4 and were termed as VISA.Conclusions: As disc diffusion method is not recommended by CLSI for S. aureus, vancomycin screen agar and MIC determination by either of the methods viz. agar dilution or E test can be used.
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Computer Vision Syndrome (CVS) is one among major lifestyle hazard of superfast and advanced 21st century. According to contemporary science, only palliative measures in the form of Tear supplements are available which has to be used lifelong by the patients. So considering the grave nature of the disease, higher incidence and lack of effective measure it has been selected for the present study. As CVS is a technological occupational hazard there are no direct references available in our classics. Though few features mentioned in Netra rogas provide indirect references through which one can understand doctrines behind its treatment. Symptoms of CVS mainly indicate vitiation of Vata and Pitta dosha. So there is a need of finding effective measures which can fulfil the criteria such as Vatapittahara, Snehana, Chakshusya and Rasayana.Considering above facts Aschyotana with Shatavari ghrita is expected to yield better results. In the present study, 10 patients were randomly selected and treated with Shatavari Ghrita Aschyotana, 10 drops i.e., Snehana type, twice daily for a period of 30 days. Follow up study was undertaken for every 15 days upto 3 months. There is significant improvement in condition especially related to subjective symptoms like eye strain, dryness, diplopia and redness. The collected data was statistically analysed and at the end of present study overall response was moderate i.e., 65.96%. Hence we can infer that Ayurvedic siddhantas are eternal and can be applied in understanding any disease. Shatavari Ghrita Aschyotana proved effective in management of Computer Vision Syndrome. So this simple, cost effective formulation can be used in treating CVS.
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Myxofi brosarcoma is one of the rare soft tissue sarcomas. We present a case of a 65-year-old male having large soft tissue mass over right upper arm associated with surface ulceration. On histopathological study tumor was diagnosed as myxofi brosarcoma – high grade according to modifi ed FNCLCC grading system. Like many other tumors of connective tissue, soft tissue sarcoma exhibits high recurrence. In our case, tumor showed features of high grade with local recurrence, large size; however, no evidence of metastasis was noted. For this unpredictable clinical behavior, we are presenting this case.
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In order to examine the relationship between maternal education and maternal and child mortality a survey was carried out in urban slum area of Surat city. The sample for this survey was designed to provide estimates on a large number of indicators on the situation of children and women living in the area where RCH services are provided by the Health Department of Surat Municipal Corporation. We included the mothers who had delivered in the past 1 year and their babies.Various variables with respect to maternal care and child care were investigated. A logistic regression was applied for variables found significantly associated with maternal education. This study showed that maternal education was independently associated with various aspects of maternal health care and child health care services. It is recommended that the local authorities should make effort to increase the maternal education for the betterment of the society.
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The present article reports the case of a calcifying odontogenic cyst Type I variant in the maxilla of a 65-year-old woman. The lesion is unusual in that it has features of a cyst but also has many characteristics of solid neoplasm. It is classified into 2 types Type I-cystic variant and Type II-solid tumor variant. The calcifying odontogenic cyst may present some problems of differential diagnosis, both clinically and histopathologically. The histopathologic examination showed that structures characteristic of calcifying odontogenic cyst. The lesion was benign. After surgical removal of the cyst, the wound healed uneventfully, and the region was free of symptoms.
Sujets)
Sujet âgé , Femelle , Humains , Maxillaire , Maladies du maxillaire supérieur/anatomopathologie , Kyste odontogène calcifiant/diagnostic , Kyste odontogène calcifiant/anatomopathologie , Kyste odontogène calcifiant/chirurgieRésumé
BACKGROUND & OBJECTIVE: As partial D variants are of clinical importance in transfusion medicine, the present study aims to determine the efficiency of commercial anti-D reagents to identify partial D variants. METHODS: Forty two samples of known partial D identified in the Indian population were tested with seven commercial monoclonal anti-D reagents. RESULTS: Most of the monoclonal anti-D reagents gave strong positive reactions (24 to 59%) to weak positive (28 to 47%) with partial D cells. Polyclonal anti-D detected all partial D variants as RhD positive, though reacting weakly with the majority (83%) of them. All the seven commercial monoclonal anti-D reagents detected some variants as D negative. Analysis of pairs of these reagents showed that the combinations of reagents 1 & 2 and 1 & 6 could detect all partial D variants as RhD positive and hence can be used for donor testing. INTERPRETATION & CONCLUSION: Findings of our study showed that none of the monoclonal reagents when used individually could detect all partial D variants. A combination of two suitable anti-D reagents are necessary to detect maximum number of partial D variants.