RESUMO
Complex craniovertebral junction (CVJ) defects account for a considerable proportion of CVJ diseases. Given the heavily assimilated C1, an unfavorable C1–C2 joint orientation, an overriding C2 superior facet, a low-hanging occiput, and an abnormal vertebral artery course with a high-riding vertebral artery, placement of C1 lateral mass screws might be difficult. To address this, a novel technique for placing C1 lateral mass screws that avoid vertebral artery injury, low-hanging occiput, and overriding C2 superior facet was developed in this study. This approach enables firm fixation of C1–C2 even in difficult situations where the placement of the C1 lateral mass is challenging.
RESUMO
Herein, an instrument free facile acid-base titrimetric methodology is reported for lysophosphatidic acid (LPA) measurement in serum and plasma samples for ovarian cancer detection. The concept is based on the titrimetric method in which alkaline solution was titrated with free fatty acid. Free fatty acid is generated due to action of the lysophospholipase to LPA. A phospholipid derivative known as LPA can function as a signaling molecule. A glycerol backbone serves as the foundation for phosphatidic acid, which also has bonds to an unsaturated fatty acid at carbon-1, a hydroxyl group at carbon-2, and a phosphate molecule at carbon-3. Free fatty acid and glycerol-3-phosphate are formed when LPA reacts with lysophospholipase. The formation of free fatty acid depends on the concentration of LPA. The standard graph of known concentrations of LPA, LPA spiked serum and LPA spiked plasma was plotted. The concentration of LPA in unknown serum and plasma were calculated from the standard graph. The limit of detection of LPA in spiked serum and plasma samples via titrimetric assay was calculated as 0.156 μmol/L. A patient's chance of survival may be outweighed by an early diagnosis of ovarian cancer.
RESUMO
Bilateral distal anterior cerebral artery (DACA) aneurysms also called “kissing aneurysms” or “mirror aneurysm” are extremely rare, accounting for only 0.2% of all intracranial aneurysms. There have only been a few examples of mirror DACA aneurysms reported in the literature. Here, we report a rare case of mirror DACA aneurysm in a middle aged female with its successful clipping. Patient was admitted with severe headache and altered sensorium. Computed tomography (CT) head was suggestive of anterior inter-hemispheric hematoma. Digital subtraction angiography (DSA) was done which was suggestive of two distal anterior cerebral artery aneurysms located at same anatomical position. It was treated through microsurgical clipping. Mirror image DACA aneurysms are rare occurrence. All patients with ruptured DACA aneurysms should have angiography with 3D reconstruction studies. This aids in determining the aneurysm’s morphology and planning treatment accordingly.
RESUMO
Background: Single women face many problems in the patriarchal society but receive support from the community. In general, studies on community support showed that belonging to a community and actively participating in communal activities enhanced the quality of life and wellbeing of the individual involved. The present study examines whether the dimensions of community support predict psychological distress, happiness, life satisfaction, and psychological resilience among single women. Method: A sample of 300 single women (divorced, widows, and separated women) in the age group of 25 to 60 years (M = 39.82 years, SD = 7.83) were administered self-report measures of perceived community support, psychological distress, subjective happiness, life satisfaction, and psychological resilience. The dimensions of community support included in the study are community integration, community participation and community organization. Results: Multiple regressions were carried out to analyze the data. Community integration negatively predicted psychological resilience. Community participation positively predicted life satisfaction. Conclusion: These findings highlight the role of community support as resources that promote the positive adaptation of single women to the challenges of everyday life. The implications of the findings for policy, practice, and research are also discussed
RESUMO
Atypical hemolytic uremia syndrome (aHUS) is a rare and life-threatening disease, characterized by the same triad of hemolytic anemia, thrombocytopenia, and renal failure as seen in HUS. It differs in its etiology, being caused by a dysregulation of the complement pathway rather than Shiga-like toxin-producing Escherichia coli. Prognosis is poor, with 50% of cases progressing to end-stage renal disease (ESRD) and 25% succumbing in the acute phase. The treatment of choice is therapeutic plasma exchange which can lower mortality. Monoclonal antibody drugs such as eculizumab, which suppress the dysregulated complement pathway, help to prevent complement-mediated kidney injury. We report the case of a young adult male who presented with thrombocytopenia and worsening acute kidney injury and was diagnosed with aHUS based on high lactic dehydrogenase, low complement C3, and haptoglobin, as well as renal biopsy showing thrombotic microangiopathy
RESUMO
Lumpy skin disease (LSD) is one of the most economically valuable transboundary and OIE-listed diseases caused by Capripoxvirus in the family Poxviridae. LSD should always be included in the differential diagnosis when cattle exhibit tiny nodules development in the head, neck, udder, rump, perineum, and leg area and elevated body temperature, respiration, and salivation. The economic potential of these diseases is of significant concern, provided that they threaten international trade and could be used as economic bioterrorism agents. Because of the scarcity of reliable vaccinations and the widespread poverty in rural areas, capripoxviruses appear to be spreading more widely. The best treatment for reducing the risk factors for the disease could be strict quarantine, vector control, and prophylactic vaccination. The goal of the current study is to give the information that is currently available on the disease’s various aspects, including its clinicopathology, method of transmission, possible treatments, and diagnostic procedures
RESUMO
Background:An unknown pneumonia broke out in Wuhan City in December 2019 and it was confirmed as an acute respiratory infectious disease caused by Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2, formerly known as 2019-nCoV). Consumption coagulopathy, which should be obviated in order to decrease mortality, arises in disseminated intravascular coagulation with a decrease in fibrinogen and an increase in D-dimer levels. However, studies on the predictive and prognostic values of coagulation parameters in the setting of patients with COVID-19 are still limited. The objectiveof this retrospective study was to investigate the correlation of D-dimer and computed tomography severity score in patients with COVID-19 pneumonia.Methods:The present retrospective study was conducted among 108 subjects reported COVID RT-PCR positive admitted during the study period i.e.;January-August 2021 in the department of medicine of Rural Medical College, Loni. Pneumonia was confirmed by Computed tomography (CT) examination and coagulation test completed within 12 hr after admission were enrolled. Coagulation tests, which Fibrinogen (Fib) and D-dimer were performed. CTscore was categorized into mild (0-7), moderate (8-16) and advanced grade (17-25 points).Results:The mean age of male and female was 38.52�34 and 35.67�22 years respectively, with an overall age of 37.79�58 years. Mean D-dimer level was 0.54�09, 0.91�22 and 1.96�47 mcg/ml among subjects having mild, moderate and severe CT score respectively. According to multivariate analysis, higher D-dimer (OR:3.61, p<0.01) was significantly associated with CTseverity score.Conclusions:Study concluded that the D-dimer level's time point was matched to the time of CTscan, we have reasons to correlate that the D-dimer level may predict the severity of inflammation prior to coagulopathy/thrombosis
RESUMO
Mucoepidermoid carcinoma (MEC) is most common malignancy of minor salivary glands in adults. Pulmonary MEC is extremely uncommon comprising of only 0.1%–0.2% of the primary lung malignancies and <1% of primary bronchial tumors. It is even rarer in children and literature limited to few case reports only. Here we present a case report of a 9-year-old boy diagnosed with primary MEC of trachea along with review of the literature. A 9-year-old male child presented with complaint of dry cough for two years which was later associated with shortness of breath after one year. Bronchoscopic examination revealed a growth arising from right lateral wall of carina occluding 50% of the lumen and detailed histopathological examination revealed it to be a MEC of the trachea. Patient underwent local excision of the tumor with primary anastomosis. In view of positive margins adjuvant radiotherapy of 60 Gy in 30 fractions were given to the tumor bed. Patient tolerated the treatment well and is disease free at 6 months follow-up. Experience with MEC of the trachea in children is limited and optimal treatment protocols have not been defined, with current treatment mainly extrapolated from MEC of the salivary glands.
RESUMO
Adrenal myelolipoma is a very rare benign neoplasm usually unilateral, and nonsecreting, occurring in the adrenal gland which consist of fatty tissues and hematopoietic elements. Some cases of this type may cause symptoms like chronic abdominal pain however usually these tumors are small and asymptomatic. Surgery is the modality of treatment where there are severe symptoms with life threatening progression with size of tumor reaching more than 6 cm. Here we report an unusual case of a 59-year-old male with history of chronic abdominal pain from a growing right-sided large adrenal mass. With all possible hematological, histo-pathological as well as imaging investigations warranted a high suspicion for tumor mass, hence decided for surgically excision, which was both diagnostic as well as curative. The histopathological study of the excised mass confirmed the initial diagnosis of adrenal myelolipoma. Surgery is the diagnostic and curative modality of treatment for adrenal myelolipoma after all possible investigations to reach for a clinical diagnosis as well for proper planning for surgery. By this we can prevent complications like spontaneous rupture and hemorrhage of the mass, and subsequent cardiovascular shock. Management varies from individual to individual. Open radical adrenalectomy is the standard treatment for giant myelolipomas (size >10 cm), while the minimally invasive approach has been used in only few cases of small sized tumors. Although it is a benign tumor, surgery plays main role for symptomatic cases and high suspicion of malignancy.
RESUMO
Spontaneous iliopsoas hematoma is a rare complication in patients suffering from bleeding disorders like hemophilia, Von Willebrand’s disease or those taking blood thinners like aspirin and clopidogrel or anticoagulant medications like warfarin for atrial fibrillation or post-thrombotic status. It can present as severe pain, muscle dysfunction, difficult walking or neurological dysfunction due to compression on femoral nerve or lumbar plexus. A high index of suspicion with early blood and radiological investigations like contrast enhanced computed tomography (CECT) or magnetic resonance imaging (MRI) of the part is immensely helpful in diagnosis and prompt management of such patients. A low hemoglobin or hematocrit level and a high INR is supportive while CECT or MRI of the abdomen and pelvis is confirmatory. Management in a hemodynamically and neurologically stable patient include immediate withdrawl of the anticoagulant, bed rest, infusion of I.V. fluids, vitamin K, fresh frozen plasma and packed red cell transfusion, which ensures complete recovery in most of the cases. However angio-embolization to control ongoing arterial bleeding is lifesaving when feasible or emergent open decompression and bleeding control surgery can save the life or prevent permanent neurological damage to the limb. Decompression of the hematoma by ultrasound or computed tomography guided catheter drainage is helpful alternative in few selected cases. We report an elderly patient on warfarin, who suddenly developed difficulty in walking within hours of a strained defecation, diagnosed to suffer from left iliopsoas hematoma and responded to conservative management with complete resolution of symptoms by 3 weeks.
RESUMO
INTRODUCTION:- the present study was planned and the aim of the present study was to compare the clinical, radiological and laboratory manifestations of PTB among geriatric patients. The biological changes associated with aging, associated malnutrition and acute or chronic diseases have been reported to disrupt protective barriers, contribute to the expected age-related diminution in cellular immune responses and impair microbial clearance mechanisms against Mycobacterium TB. METHODOLOGY:- This study analyzed the 100 elderly pulmonary tuberculosis cases. This study was conducted in the Department of TB & Respiratory Diseases, Shri Dev Suman Subharti Medical College, Dehradun. The duration of study was over a period of two year. RESULTS:- In the present study, 85% people had cough, 92% fever, 42%anorexia, 30% chest pain, 21% hemoptysis, 52% weakness. In the sputum microscopy, 23% negative, 11% scanty, 22% 1+, 25% 2+,19% 3+ we were found according to grading of RNTCP. CONCLUSION:- Elderly patients of PTB presented with recognized clinical and radiological features of disease, but a fair number had to be prescribed nonstandard regimens.
RESUMO
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) patients are prone to exacerbation that account for significant morbidity and mortality. According to physio-pathologic and clinical-functional viewpoints, bronchiectasis and COPD have some common characteristics, it has been observed that bronchiectasis was present in up to 50% of patients with moderate to severe COPD . This observation suggests that COPD is a risk factor for bronchiectasis. METHODOLOGY: This study was included 120 totals who were attending the OPD in the department of TB Chest. This study was conducted in the Department of TB & Respiratory Diseases, Shri Dev Suman Subharti Medical College, Dehradun. RESULT: In our study we were included 120 total number of cases, out of all cases 35.5% cases were found from eosinophilic COPD group & 62.5% were found non-eosinophilic COPD group. In eosinophilic COPD group,42 male and 3 females were found. While in non-eosinophilic COPD group ,60 male and 15 females were found. CONCLUSION: This study suggested that flow reversibility associated with this volume reversibility was more in eosinophilic COPD.
RESUMO
Background: The RNTCP (Revised National Tuberculosis Control Programmed) in India provide a strong framework for the outpatient management of tuberculosis yet very less literature is available on tuberculosis in hospitalized patients. Several factors including the clinical and socio- economic status contribute to the burden of hospitalization in tuberculosis. Methods: 150 total numbers of cases were included who had infection of tuberculosis. This study was conducted in the Department of TB & Respiratory Diseases, Shri Dev Suman Subharti Medical College, Dehradun. Results: ‘Among the all cases we found that, 40% having extra pulmonary, 37.3% pulmonary, disseminated 22.7% tuberculosis infection. Conclusion: This study concludes that extra pulmonary TB was most common followed by pulmonary TB.
RESUMO
STUDY DESIGN: Retrospective radiological study. PURPOSE: We aimed to determine the prevalence of ponticulus posticus (PP) and high-riding vertebral artery (HRVA) occurring simultaneously on the same side (PP+HRVA) and in cases of PP+HRVA, to assess C2 radio-anatomical measurements for C2 pars length, pedicle width, and laminar thickness. OVERVIEW OF LITERATURE: PP and HRVA predispose individuals to vertebral artery injuries during atlantoaxial fixation. In cases of PP+HRVA, the construct options thus become limited. METHODS: Consecutive computed tomography scans (n=210) were reviewed for PP and HRVA (defined as an internal height of <2 mm and an isthmus height of <5 mm). In scans with PP+HRVA, we measured the ipsilateral pedicle width, pars length, and laminar thickness and compared them with controls (those without PP or HRVA). RESULTS: PP was present in 14.76% and HRVA in 20% of scans. Of the 420 sides in 210 scans, PP+HRVA was present on 13 sides (seven right and six left). In scans with PP+HRVA, the C2 pars length was shorter compared with controls (13.69 mm in PP+HRVA vs. 20.65 mm in controls, p<0.001). The mean C2 pedicle width was 2.53 mm in scans with PP+HRVA vs. 5.83 mm in controls (p<0.001). The mean laminar thickness was 4.92 and 5.48 mm in scans with PP+HRVA and controls, respectively (p=0.209). CONCLUSIONS: The prevalence of PP+HRVA was approximately 3% in the present study. Our data suggest that, in such situations, C2 pedicle width and pars length create important safety limitations for a proposed screw, whereas the translaminar thickness appears safe for a proposed screw.
Assuntos
Vértebra Cervical Áxis , Atlas Cervical , Prevalência , Estudos Retrospectivos , Artéria VertebralRESUMO
The present market for herbal drugs is estimated about ₹40 billion, which is expected to increase by 16% in next 3-4 years. The current production of many Ayurvedic herbs is less than their market demand, which incentivizes adulteration in the Ayurvedic drug supply chain. The present work aims to highlight the most used Ayurvedic plants that have been listed in the International Union for Conservation of Nature's "red list" of endangered or vulnerable plants. The future of Ayurvedic medicines from these listed plants is uncertain, as the collection of herbs from their natural habitat is prohibited and their cultivation does not meet market demands. Many of these plants, such as Taxus baccata and T. wallichiana, are endangered and are only grown in their natural habitats; their cultivation in other areas is impractical. This is the present state, and will worsen as demand continues to grow, with increasing populations and increasing adoption of this system of medicine. It is possible that in coming years most of the Ayurvedic drugs will be adulterated, and will cause only side effects rather than the therapeutic effects. The Ayurvedic fundamentals are under-explored areas where the Ayurvedic practitioners and research scientists can work together. The scientific work on the basic principles will unravel many unknown or little-known facts of this ancient science. Hence, the present review emphasizes the conservation of Ayurvedic herbs, minimization of the use of medicinal plants and the promotion of the research based on Ayurvedic fundamentals.
RESUMO
Purpose:@#Distal femoral fracture is one of the most common lower limb injuries and accounts for less than 1% of all fractures. Open fracture takes 5%-10% of the all distal femoral fractures, which is at an increased risk of complications. There were limited studies which documented the outcomes of such cases. The present study aims to evaluate the outcome and complications in these fractures using primary definitive fixation with condylar locking plate and antibiotic impregnated collagen sheet secondary to aggressive debridement.@*Methods:@#This is a prospective study conducted in a tertiary care orthopaedic hospital in northern India. Thirty patients of open distal femoral fractures were managed by primary definitive fixation with condylar locking plate and antibiotic impregnated collagen sheet secondary to aggressive debridement. They were followed for minimum of six months. Patients were followed up monthly for first four months, at six months and one year after surgery. Clinical and radiological signs of healing, any complications, time to union, and functional outcome were assessed.@*Results:@#The mean age of patients was 44.33 years (range 20-82 years) with male predominance of 66.7%. According to Gustilo-Anderson classification, there were 5, 15 and 10 patients with open grade I, II and IIIA distal femoral fractures respectively. According to orthopaedic trauma association (OTA) classification, majority of patients in our study were of C3 type. The mean time to bony union was 5.6 months (range 4-9 months). Average postoperative knee range of motion (ROM) at the latest follow-up was 98° (range 70°-120°). Lysholm knee scoring scale showed excellent score in 11 patients, good in 9 patients, fair and poor in 5 patients each; however, there was no significant correlation with fracture pattern types (p < 0.05). Knee stiffness was the major complications encountered in the study. The knee ROM was <90° in 5 patients and 90°-120° in rest of the patients, while 1 patient had extensor lag of 10°. One patient had implant failure and lost to follow-up; 3 patients had deep infection.@*Conclusion:@#An approach of primary definitive fixation with condylar locking plate and antibiotic impregnated collagen sheet secondary to early aggressive debridement in open distal femur fractures shows significant results in terms of functional and radiological outcomes with minimal complications.
RESUMO
Background:Thrombocytopenia refers to abnormal decrease in platelet count in an individual. The condition may rise at different grades of severity in cancer patients under chemotherapy. In most of the cases, thrombocytopenic condition of cancer patient becomes a major therapy limiting factor. Generally, the treatment of thrombocytopenia lies in dose reduction and/or dose delay but this may adversely affect the treatment plan of cancer. Therefore, managing chemotherapy induced thrombocytopenia is still a challenge. This study was conducted to examine the platelet count improving effect of marketed product UPLAT® (Carica papayaleaf extract + Tinospora cordifoliaextract) in cancer patients with chemotherapy induced thrombocytopenia (CIT).Methods:Fourty (40) subjects were recruited as „case? and twenty (20) as „control?. „Cases? were cancer patients with chemotherapy induced thrombocytopenia. UPLAT® containing following active ingredients;Carica papayaleaf extract: 350mg (standardized to 2% flavonoids)and Tinospora cardifoliaextract: 150mg (standardized to 3% bitters) was given twice daily (2units each) for 10 consecutive days. Platelet count was observed at baseline and day 15 (end of the study). Then pre and post-treatment platelet counts were compared individually in both arms by statistical tests. Response was evaluated in fourty (40) „cases? and twenty „control?y.Results:Mean change for platelet count in case group (93990.00±63896.73) was much higher than control group(27600.00±29758.42).No adverse events with the treatment were observed. Conclusions: This study proves the effectiveness of platelet booster UPLAT® (combination of Carica papayaleaf extract and Tinospora cordifolia) as it significantly increased thrombocytes/platelet count in post-chemotherapy cancer patients.
RESUMO
Background: The goal of this study was to evaluate the correlation between body mass index (BMI) and severity of knee pain. Methods: Total 105 OA patients with knee pain selected on the basis of radiological diagnosis of OA knee were included. Evaluation of OA was done by using Kallgren and Lawrence grading along with numerical pain rating scale (NPRS). Results: Findings of the present study showed that number of OA patients 12 (11.4%), 40(38.09%), 30 (28.57%) and 33 (31.4%) were suffering with grade1 to 4 OA severities respectively. Further, Pearson correlation coefficient showed a positive correlation between BMI and NPRS (r=0.237, p>0.001). Conclusion: Findings of the current study show that BMI is significantly correlated with severity of pain of knee in OA patients as higher the BMI greater the pain of knee. Therefore, pain in knee patients with higher BMI should be advised to decrease weight via suitable exercise program.
RESUMO
AIM:To study the clinical profile of H1N1 positive patients admitted in Swine flu ward in NSCB Medical College, Jabalpur in outbreak of 2015. MATERIALS & METHODS: All H1N1 positive patients admitted in NSCB MCH, Jabalpur were analysed retrospectively with respect to morbidity and mortality and possible clinical conclusions were derived. RESULTS: Of 64 H1N1 positive patients, 23 died. Cough, fever & dyspnoea were main symptoms in all patients including those under mortality group. Those with a duration of stay in hospital >10 days had least mortality. Highest mortality seen in patients with duration of stay between 1-10 days. 40 (62.5%) of 64 patients had some co-existing illness of which Anemia & DM were most common. 16 (69.5%) out of 23 patients who died had some co-existing illness of which DM was associated with 9 patients, Anaemia with 8 & Hypertension with 7 patients. 25 (39%) of 64 patients developed some complications of which ARDS & encephalopathy had higher mortality as compared to Renal failure & MODS. Of 23 patients who died, 18 (78%) developed some complication. CONCLUSION: Knowing the potential of Influenza virus for genetic mutations, it is difficult to find a stereotype pattern of illness as also documented by studies done in past. Good clinical skills always carry high value in suspecting & defining H1N1 infection & its complications. Co-existing illness must be taken special care of during an outbreak of Swine flu. Community education, timely immunization of those at high risk & early referral can save many lives
RESUMO
ABSTRACT Pregnancy is a transient physiological state which brings about different hormonal changes in a woman's body. These effects are generalized and there are various oral changes as well. There are a number of especially important alterations in the periodontal conditions within the oral cavity. These changes have important implications as they have been known to cause adverse pregnancy outcomes. Better knowledge about these scenarios among health care professionals and women would go a long way toward avoiding or minimizing these adverse outcomes. Health education is an important tool in creating awareness among pregnant women regarding improvement of their oral health. Awareness among the health professionals and good inter-departmental collaboration would help toward a more efficient treatment of these pregnancy related conditions.
RESUMO A gravidez é um estado fisiológico transitório que produz uma série de alterações hormonais no corpo da mulher. Esses efeitos são generalizados e incluem várias alterações orais. Uma destas afeta condições periodontais. Essas mudanças têm implicações importantes, pois sabe-se que causam resultados adversos na gravidez. Um melhor conhecimento sobre esses cenários entre os profissionais de saúde e entre as mulheres seria um passo importante para evitar ou minimizar tais resultados adversos. A educação para a saúde é uma ferramenta importante na conscientização das mulheres grávidas em relação à melhoria da saúde bucal. A consciência entre os profissionais de saúde e a boa colaboração interdisciplinar ajudaria a efetivar tratamento mais eficiente dessas condições relacionadas à gravidez.