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Acute cortical necrosis accounts for <2% of all acute kidney injuries. Pregnancy complications, viperine snake bites, haemolytic uremic syndrome, shock, and severe pancreatitis are all linked to it. There are relatively few case reports of acute cortical necrosis secondary to tranexamic acid, which is utilised in the treatment of acute bleeding because of its antifibrinolytic actions. Acute cortical necrosis is very infrequently brought on by medicines. Here, we present a group of three instances, each of which experienced the onset of oligo-anuria soon after receiving tranexamic acid. Cortical necrosis was demonstrated by contrast computed tomography (CT) and renal biopsy. While the third patient had patchy cortical necrosis and had partially recovered renal functions, the other two patients both had total acute cortical necrosis and are still reliant on dialysis. This case series demonstrates the need for clinicians to be cautious while using tranexamic acid and to be aware of the possibility of abrupt renal cortical necrosis following its administration.
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Background: Blood transfusion is a life-saving intervention. Blood should be accepted from non-remunerated and healthy donors. Proper donor screening procedure minimizes the risk of transfusion transmitted Infections and also wastage of blood and blood products and thus screening of donors is a prerequisite for blood donation. Methods: This is a retrospective study conducted in blood bank center in the Department of Pathology in a Government teaching hospital, Shivamogga from January 2022 to June 2022. All the voluntary and replacement donors were evaluated by the standard questionnaire and medical examination including demographic profile, anthropometry, blood group, vital signs and hemoglobin estimated by cyanmethemoglobin method were collected from the donation requisition forms and online deferred list. The data were represented in the form of percentage, descriptive statistics and analysed. Results: Out of 3,449 blood donors, 252 were deferred. The deferral rate was 7.31%. Among the ineligible donors, males 245 (97.22%) outnumbered females 7 (2.8%). 242 donors (96.03%) were temporarily rejected among which high blood pressure constituted to 23.02% followed by alcohol consumption (11.11%) whereas 10 donors (3.96%) were deferred permanently. 9 donors (3.57%) had low haemoglobin level. Conclusions: Temporary deferrals are more than permanent deferrals thus temporarily deferred donors should be instructed to return for blood donation after their period of deferral days to retain the pool of blood donors.
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The aim of this study was to investigate the effect of biostimulants on quality of cut flower of Chrysanthemum (Dendranthema grandiflora) cv. Denjigar White”. It was carried out at naturally ventilated polyhouse at Ammapuram, village of Thorrur mandal, Mahabubabad district near JVR Horticulture Research Station, Malyal, Mahabubabad district during 2020- 2021. The treatments used were Ascophyllum nodosum (2.5, 5ml L-1), Rhodophyte extract (0.2, 0.4g L-1), Potassium humate (1.5, 3g L-1), Fulvic acid 10% + Seaweed 8% + Spirulina 6 % (2, 4 g L-1) and control (Water spray) in Randomized Block Design (RBD) with nine treatments and each treatment was replicated thrice. Among the treatments, the treatment T2 (Ascophyllum nodosum @ 5 ml L-1) recorded maximum flower diameter (7.48 cm), individual flower weight (6.55 g), stem length (72.10 cm), vase life (21.60 days) and shelf life (5.84 days), gross returns (? 76,93,200), net returns (? 59,82,204) and best benefit cost ratio (3.50). However, control recorded minimum in all the parameters.
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Agriculture production is significantly influenced by the weather. From seeding to crop harvest, it has a significant impact on all aspects of farming. Crop germination, establishment, growth, development and yield are all affected. Extreme weather conditions including drought, floods, heavy rains, heat waves, frost, hailstorms, cyclones, etc. may cause the farming community to suffer significant crop yield losses. Since the farming community will be aware of the upcoming weather conditions in advance, required adjustments may be made to farm level agricultural operations and decisions to lessen the consequences of unfavorable weather conditions. Therefore, Integrated Agro met Advisory Services will make it possible for the farmer to be informed of current and expected weather as well as advice to the farmer the best course of action to reduce losses caused by unfavorable weather conditions and increase the output of agricultural systems. A study was conducted in Telangana state to ascertain the degree of farmer’s awareness on weather-based agro advisory services. Random sampling technique employed to collect data from 120 farmers. Ex-post facto research design was used for the investigation. The data with regards to level of awareness possessed by farmers about weather based agro advisory services, it is revealed that 38.33 % of them had the medium level of awareness followed by low level 35.01 % and high level 26.66% of awareness, respectively. All profile characteristics of respondents showed a significant correlation with the degree to which farmers were aware of weather-based agro advisory services, with the exception of education, annual income, farming experience, mass media exposure, and cropping pattern. Multiple linear regression value 77.61 per cent contributed to the extent of variation towards independent variables.
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Background: Several studies have suggested that online hemodiafiltration (OL-HDF) may reduce the risk of mortality and improve quality of life of these patients compared with standard hemodialysis. Methods: Forty stable out patients on dialysis (20 patients on hemodialysis and 20 patients on online hemodiafiltration) above age of 18 years and dialysis vintage of more than 3 months were followed up for 18 months. Clinical, biochemical parameters of these patients along with the SF-36 score at baseline and after 18 months of follow up were assessed. Results: At 18 months, statistically significant difference was found between hemodialysis (HD) and OL- HDF groups in erythropoietin dose (p=0.047), urea reduction ratio (p=0.016), Kt/V (p=0.005), hemoglobin (p=0.043), serum albumin (p=0.002), phosphorus (p=0.024), parathyroid hormone (p=0.007), potassium (p=0.007), ?2 microglobulin (p=0.002), high sensitive c-reactive protein (p=0.037), and serum bicarbonate levels (p=0.022). We found statistically significant difference in intradialytic complications namely intradialytic hypotension, muscle cramps, simultaneous hypotension and muscle cramps and stoppage of dialysis. In terms of mortality, the difference was not statistically significant (p=0.052). Conclusions: Patients on OL- HDF were having better quality of life than patients on HD. Better solute clearance, anemia control, improved nutritional and Mineral bone disorder parameters were seen in OL-HDF. Less complications during dialysis were seen with OL-HDF. The difference in mortality rate between the HD group and OL- HDF group was not statistically significant.
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Financial inclusion is an important factor for a country's development. Government is continuously taking some measures for financial inclusion, one among such measure is introduction of Pradhan Mandri Jan Dhan Yojan with so many useful features. Even though the Government is taking initiatives, the awareness of public on this scheme questionable. This study is an attempt to study the awareness of PMJDY in Erode District. The researcher has collected 110 samples using convenient sampling technique. The findings stated that, all the socio-economic variables are associated with awareness. Further certain segments are more aware of PMJDY than of others.When it comes to source of awareness, visual media is found to be more influential than others.
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Background: In 2015, there will be an estimated 155,000 new cases of breast cancer and about 76,000 women in India are expected to die of the disease. By the time a breast lump becomes palpable for clinical detection, it is usually advanced. We conducted a study to compare the status of axillary lymph node between the radiologicaland histopathological finding with the clinically negative lymph mode in carcinoma breast in order to limit the axillary lymph node dissection.Methods:This prospective study 50 female patients of carcinoma breast freshly detected and those with non-palpable axillary lymph admitted in S.C.B M.C.H, Cuttack, were included in the study.Results:The mean age of the patients was 51.26 years with standard deviation of 12.26 years with a range of 20 to 80 years. All 50 cases included in the study was done mammography of both breast and among them BIRADS IV 18 cases, BIRADS V 19 cases, BIRADS VI 5 cases and 08 cases were benign. 44 (88%) patients had Karnofsky performance score of 90-100 and 6 (12%) patients had score of 80-90. None (0.00%) of the patients had <80 performance score. Out of the 50 cases enrolled in the study, 04 were underwent wide local excision, 09 were breast conservation surgery and 37 were modified radical mastectomy along with axillary clearance.Conclusions: Higher sensitivity due to axillary ultrasound helps to reduce surgery time as patients with positive axillary lymph nodes directly get an Axillary Lymph Node Dissection (ALND) without preceding Sentinel lymph node biopsy (SLNB).
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Background: The application of controlled levels of negative pressure has been shown to accelerate debridement and promote healing in many different types of wounds. Vacuum assisted closure (VAC) has proved its efficacy for wound dressing leading to faster wound healing and shorter hospital stay. The aim of the study was to determinethe advantage of vacuum assisted closure over conventional dressing in SCBMCH hospital.Methods:The study was conducted at general surgery wards of SCB Medical College hospital. After debridement of the wound vacuum assisted dressing was applied. Control group was given conventional dressing.Results:In the study sample 10% patients were less than 40 years,76% belonged to 41-60 age group and 7% were more than 61 years of age, 60% male and 40% female. Wounds were located in the foot 27 (54%), leg 19 (38%), sole 2 (4%) and forearm 2 (4%). Patients with sterile pre (VAC), culture and sensitivity was not turning non sterile after VAC, but 90% non-sterile turns sterile after vacuum assisted dressing. In 5 days 25% of granulation tissue formed in VAC dressing whereas only 10% in case control. Similarly, in 10 days it was 40% for VAC and 25% in case of control. Finally, in 15 days it was 70% in case of VAC and 40% in case of control.Conclusions:VAC results in better healing, with few serious complications, and a promising alternative for the management of various wounds.
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Phenolics are the largest group of phytochemicals ubiquitous in plant species with considerable interest economically. Recently, search of novel polyphenols increasingly becomes an area of intensive pharmacological research due to their multiple bioactive features such as antioxidant, antimicrobial, anti-carcinogenic, anti-viral and anti-inflammatory potentialities. Anthocyanins are flavonoid group of polyphenols, a group predominant in flowers, fruits and vegetables. The flavonoids, perhaps the unique single group of phenolics in foods, comprise a group of over 4200 C15 aromatic molecules with multiple structural patterns. The functions of anthocyanins as medicinal have been well-accepted in folk medicine throughout the world. In fact, these molecules are connected to an amazingly broad-based range of health benefits. In this juncture, the aim of this work was to evaluate the antioxidant activities of purified anthocyanin from wild balsam species. Initially, anthocyanin was extracted from floral leaves of wild balsam species and purified by chromatographic techniques. Subsequently, it was subjected to NMR and LC MS analysis. The major fractions identified were hesperidin, dimethoxy antirrhinin and trimethoxy antirrhinin. Further, the anthocyanin extracts were subjected to in vitro protocols like 2,2’-azino-bis-3-ethylbenzothiazoline-6-sulphonic acid (ABTS) radical cation, DPPH scavenging assay, ferric reducing antioxidant power (FRAP), beta carotene bleaching assay, metal chelating and H2O2 scavenging power. Interestingly, ABTS, FRAP analyzes yielded significant results as compared to others. The data were comparable with that of synthetic antioxidants like ascorbate and catechin. Meanwhile, beta carotene and H2O2 scavenging assay showed moderate results. DPPH and metal chelating protocols displayed the values 71% and 64% respectively at 25 µg/ml concentration. This study provides model systems for the evaluation of natural antioxidants like anthocyanin. Future in vivo clinical studies are warranted to confirm the obtained data.
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Background: Pneumonia is a lower respiratory tract infection characterized by inflammation of lung tissue accompanied by infiltration of alveoli and bronchioles. Most common type is community acquired pneumonia (CAP). Initial therapy is usually empirical that is designed to treat various pathogens. In CAP cases, antibiotic therapy should begin at the earliest. The objectives of the study include to identify most common causative micro-organisms, to assess risk of developing CAP in patients having co-morbidities, to identify most commonly prescribed antibiotic regimen.Methods: A prospective observational study was conducted for period of 6 months at RIMS, Kadapa. 120 patients were recruited based on inclusion criteria. Treatment was given according to Infectious Diseases Society of America and American Thoracic Society guidelines.Results: In a total of 120 patients, 77 were males and 43 were females. 69 patients belong to 46-55 & above age groups. 84 patients had social habits and 36 patients are without social habits. Patients with single lobe infiltrations are 105 and patients with multiple lobe infiltrations are 15. In our study, streptococcus pneumoniae and pseudomonas aeruginosa were the most common isolated organisms. Monotherapy was given for 7 patients, dual therapy for 97 patients and triple therapy for 16 patients. 33 patients received ceftriaxone (CEF) and augmentin (AUG), 29 patients received CEF and azithromycin (AZI), 7 patients received levofloxacin (LEV), 25 patients received CEF and LEV, 10 patients received CEF and ciprofloxacin (CIP) and 16 patients received CEF, AUG and AZI. 100 patients had less than 8 days of hospital stay.Conclusions: Research study concluded that ? lactum antibiotics were the most commonly prescribed class. CEF and AUG was highly recommended drug regimen.
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A 43-year-old immunocompetent male presented with focal macular retinitis with overlying vitritis in the right eye. His BCVA was counting fingers close to face. OCT showed increased intraretinal thickness at the area of retinitis with adjacent hypo reflectivity of the choroid. Serology was positive for IgM and IgG antibodies for toxoplasma. He received oral clindamycin 300 mg 4 times/day for 8 weeks. At 6 weeks, his BCVA was CF 2 metres. Fundus showed complete resolution of retinitis with formation of near, full thickness macular hole with intact overlying ILM. A small hyper reflective scar was seen at the base of the macular hole.
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Purpose: The aim of this study was to determine the seroprevalence of Lymes disease in a population at risk in south India. Methods: Prospective ongoing study and included screening of forest workers and staff of Nagarahole and Bandipur forest ranges in South India for Lymes disease. Screening included a detailed questionnaire for Lymes disease, complete ocular and systemic examination by an ophthalmologist and infectious disease specialist and blood collection. ELISA for IgM and IgG antibodies for Borrelia burgdorferi were performed on the collected sera samples. Western blot confirmation was done on the seropositive samples. Ticks were also collected from these forest areas for future studies to detect if they harbor B. burgdorferi. Results: Seroprevalence of 19.9% was noted by ELISA. Western blot confirmation was seen in 15.6% of the seropositive samples. There was significant correlation between seropositivity and exposure to tick bites (P = 0.023). Conclusion: There is a high seroprevalence of infection with B. burgdorferi in the forest areas of Nagarahole and Bandipur ranges in south India.
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Direct carotid-cavernous fistula (CCF) refers to direct communication between the cavernous portion of the internal carotid artery (ICA) and the cavernous sinus due to rent in the ICA, most commonly secondary to trauma. These are generally high-flow fistula and rarely resolve spontaneously. We report a case of a young male who developed features of direct CCF after trauma, was denied any treatment for 4 years, and then presented with spontaneous thrombosis of the fistula and a residual large pseudoaneurysm of the cavernous segment of the right ICA, which was subsequently managed with parent vessel occlusion.
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A 10-year-old boy admitted for high-grade fever and pneumonia developed left preseptal and early orbital cellulitis, unresponsive to higher intravenous antibiotics. He received oseltamivir, on testing positive for H1N1 virus on the nasopharyngeal and throat swabs. There was dramatic improvement with resolution of orbital cellulitis within 24 h of starting oseltamivir. We report a very rare presentation of pediatric orbital cellulitis secondary to systemic H1N1 infection. Prompt investigations and timely treatment with oseltamivir aided in complete resolution, avoiding vision and life-threatening complications.
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A 13-year-old boy with a 4-year history of idiopathic pediatric uveitis and recurrent uveitic macular edema had failed conventional immunomodulatory therapy and presented to us with a vision of 6/24 [right eye (OD)] and 6/9 [left eye (OS)]. Fluorescein angiography showed diffuse vascular leakage along with cystoid macular edema (CME). Intravenous tocilizumab (10 mg/kg body) was given as 14 injections over 12 months. Repeat fluorescein angiography every 3 months showed a dramatic improvement in the vascular leakage and resolution of CME. At 13 months OF follow-up, vision had improved to 6/9p (OD) and 6/6(OS) with no recurrence of inflammation or CME.
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Although cancers of rectum and kidney are common malignancies, the occurrence of primary synchronous neoplasms of these organs has been reported rarely. Very few case reports are available in literature till date. The relationship between these two events remains unclear, probably because of the rarity of the association. In this report, we describe incidentally detected renal cell carcinoma in an elderly man, during staging workup of rectal adenocarcinoma and both malignancies were surgically managed simultaneously with curative intent.
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Introduction: To establish the early definite diagnosis in the cases of breast diseases, it is evaluated the relationship between clinical diagnosis, cytological, and histopathological findings. A definite diagnosis of breast disease at the proper time will lead to the correct and successful management. Breasts are the characteristic features of the mammalian family of the animal kingdom. Breasts are present in pairs in all animals. In human beings, mammary glands are present one on each right and the left side of the chest cage in both females and males. The diseases of the breast are more common in females. The common diseases are benign and malignant neoplasm’s, infections such as mastitis and breast abscess. The usual clinical presentation is with a breast lump, breast pain, and breast enlargement. Benign breast diseases are not life-threatening, but malignancyis dangerous for life. The most common cause of death in females, all over the world is breast cancer. Therefore, early detection of the malignant condition is essential for successful treatment and better results which increases survival rate. Materials and Methods: A total of 110 female and seven male patients who attended General Surgery Outpatient Department (OPD) of Maheshwara Medical College and Hospital, Chitkul of Telangana State with various types of clinical breast complaints are included in the present study. The data were collected from the outpatient register, operation theater, cytology, and histopathology register. All the patients who received treatment at this hospital from January 2016 to December 2018 are included in this study, after obtaining the Institutional Ethical Committee Clearance. The clinical provisional diagnosis was confirmed by investigations such as local ultrasound and fine-needle aspiration cytology before the definite line of management was planned. The patients who require surgical intervention were treated accordingly, and surgery under the necessary anesthesia was done. The excised specimen was sent for histopathological examination. The correlation between clinical diagnosis and histopathological findings was compared to evaluate accuracy. Results and Discussion: A total of 110 female patients and seven male patients were studied. The age range was from 13 years to 80 years. The youngest girl of 13 years of age was presented with a lump in the left breast and oldest patient was of 80 years female presented with a mass in the right breast. The maximum number of patients presented clinically with a lump in the breast and the second symptom was a pain in the breast. The common breast diseases were benign and malignant neoplasms. In the benign conditions, most common was fibroadenoma (69 patients 62.72%) in young females. In older age >40 years, the breast cancer is common. All the seven male patients with breast enlargement clinically, diagnosed as gynecomastia and histopathologically confirmed. Conclusion: In this series about 110 female and seven male patients who attended general surgery OPD in 3 years were studied. The provisional clinical diagnosis was compared with cytological and histopathological findings, which was found to be accurate in 86.3% of cases. The common clinical presentation with breast lump was histopathologically found to be fibroadenoma. The older females after menopause or above 50 years of age usually presented with a mass in the breast clinically diagnosed as cancer breast histopathologically proved in all cases 100%
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We report a rare finding of progressive subretinal fibrosis mimicking retinal necrosis in 2 cases of sympathetic ophthalmia. Histopathology of the inciting eye and vitreous biopsy of the sympathizing eye ruled out infections and masquerades. Progression of inflammation and rapid deterioration of vision inspite of maximum immunosuppression are key findings in this variant of sympathetic ophthalmia.