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Rhino-orbital mucormycosis has seen a huge resurgence in patients post COVID-19 infection. In patients with minimal orbital disease and especially with preserved vision, retrobulbar injections of amphotericin B can be of great help in controlling the disease. Instead of giving daily injections of amphotericin B using needles every time, we used an 18-gauge intravenous (IV) cannula with injection port and suture holes to deliver the amphotericin into the orbital space for a period of 5 days. Patients were more compliant and less distressed with this method compared with being given an injection with a needle daily. We got a good response in terms of orbital disease regression with this method. In our review of the literature, we did not come across any such case of amphotericin B injection using an IV cannula. Injection of amphotericin B into the orbit using an IV cannula is a viable and easy treatment option for cases of rhino-orbital mucormycosis
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Background: There has been an alarming rise in the incidence of various diseases including that of cancer in the world with increase in the incidence of cutaneous malignancies owing to various changes that have taken place in the society over the past few years with respect to the culture, the lifestyle and also a contributory role has been played by the changes in the atmosphere as a result of increase in the air pollutants in the environment. Based on the scenario, we decided to conduct a study to evaluate the presentation and the management cutaneous malignancies in a teaching hospital set up in central india.Methods: A retrospective study was conducted between the time period of 1 year on the records of patients who were diagnosed with cutaneous and related malignancies who were treated at our Institute on a predesigned semi structured performa. SPSS version 23.0 was used for the analysis of the data collected.Results: We evaluated a total of 29 cases, Squamous cell carcinoma (SCC) was the most common histological type (51.72%) followed by melanoma (27.59%) and basal cell carcinoma (BCC, 20.69%). 75.86% of patients with cutaneous malignancies were males and 24.14% were females. Mortality rate observed was 13.7%.Conclusions: The most common cutaneous malignancy seen in this study was squamous cell carcinoma having increased propensity towards males than females. Rate of loco-regional disease and median disease-free survival is directly dependent on the adequacy of disease-free surgical margin and to the limited extent on the adjuvant therapy.
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Head trauma can have immediate transient symptoms, or lead to chronic signs and symptoms. The apparent seriousness of head injury can be misleading. Minor trauma can result in serious problems. In treating traumatic brain injury, viewing images of the brain, particularly injured areas, is crucial for planning treatment. Images of the brain may be obtained through computed tomography (CT) or MRI. These techniques permit imaging of the brain for both diagnosis of injury and choosing therapeutic interventions. Method Fifty patients presented with head injury referred for CT scan and MRI of all the age group were included in the study. Nonenhanced CT scan of brain was performed on a dual slice (multislice) high speed GE machine. A slice thickness of 5 mm was used in all studies. MRI scan of brain was performed on a general electrical permanent 0.2 TESLA Signa Profile-i SR42 machine. Results Most of the patients (52%) were between the age group of 19 and 49 years. Subarachnoid haemorrhage, cranial fractures, cerebral contusion, and diffuse axonal injury were common head injuries. Subdural hematoma was seeen in all cases in FLAIR sequences. Sensitivity of T2WI was less as compared to T1WI and FLAIR sequences. FLAIR is more sensitive than CT in detecting subdural hematoma. FLAIR sequence picked up all subarachnoid haemorrhage cases followed by GRE and T1WI. T2 is not a routine sequence in detecting subarachnoid haemorrhage. MR (FLAIR) is more useful than CT in detecting subarachnoid haemorrhage. Temporal lobe was common site for contusions followed by frontal, parietal, and occipital lobe. Grey-white matter junction was the most common site followed by corpus callosum. MRI is more sensitive than CT in detecting nonhaemorrhagic contusions. FLAIR, T2WI are more sensitive than T1WI and CT in detecting nonhaemorrhagic contusions. Posterior cerebral artery territory infarcts were common. Encephalomalacia and gliosis are more common in frontal lobe followed by temporal lobe. Conclusion FLAIR sequence picked up subarachnoid haemorrhage in all cases followed by GRE and T1WI. MRI was more sensitive in detecting contusions than CT. Grey-white matter junction was the most common site of diffuse axonal injury followed by corpus callosum. Nonhaemorrhagic DAI were common. MRI is more sensitive than CT in detecting haemorrhagic and nonhaemorrhagic DAI. FLAIR, T2WI are more sensitive than T1WI and CT in detecting nonhaemorrhagic contusions. GRE and FLAIR are more sensitive than T1WI and CT in detecting brainstem injuries.
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Background: Non-alcoholic fatty liver disease (NAFLD) has become over the last decade the most common form of chronic liver disease in children and adults. It is tightly associated with obesity and threatens to become a serious public health problem. Non-alcoholic steatohepatitis (NASH) is also commonly associated with type 2 diabetes mellitus (DM). Therefore, this study was carried out to know the Prevalence of NAFLD and NASH in type 2 DM: To study the clinical manifestations, trend and outcome of all confirmed dengue cases admitted in a tertiary care hospital. Methods: This prospective study was designed to enroll known T2DM patients (duration ≥3 years), in age group of 25-65 years, attending an outpatient Medicine department of Dr. D. Y. Patil Medical College, Kolhapur, a tertiary care Centre. NAFLD and NASH will be suspected in a patient who is found to have elevations in liver tests such as alanine aminotransferase (ALT) or aspartate aminotransferase (AST). The only means of proving a confirmatory diagnosis of NASH will be done by liver biopsy. Results: A total of 325 patients, with more number of female patients 180 (55.38%) than male patients 145 (44.61%) were recruited with the suspicion of Nonalcoholic Fatty Liver Disease (NAFLD) and Non-alcoholic steatohepatitis in patients of Type 2 Diabetes Mellitus, Out of 325 patients enrolled in the study, n=178 (54.76%) T2DM patients (n=103 female and n=75 male), was identified as having NAFLD, and n=15 as NASH. Conclusion: We conclude that the prevalence of NAFLD and NASH is high in type 2 DM patients and liver biopsy is the only investigation to differentiate between non-alcoholic fatty liver and steatohepatitis.
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Background: Dengue fever is one of the most common Arbo virus mediated epidemics, causing major concerns in India since the last two decades. Many parts of India, including the Maharashtra region, are now endemic for the Dengue infection. Dengue fever (DF), Dengue haemorrhagic fever (DHF) and Dengue shock syndrome (DSS) are different modes of presentation of the disease. Our study has a objective to study the clinical manifestations, trend and outcome of all confirmed dengue cases admitted in a tertiary care hospital. Methods: This prospective study done on patients diagnosed with dengue fever with one or more warning signs attending the outpatient department and indoor of Dr. D. Y. Patil Medical College, Kolhapur, a tertiary care centre in the state were included in the study. 125 patients were included on the basis of inclusion and exclusion criteria in the study period from March 2014 to December 2014. Results: Out of 125 patients diagnosed Dengue cases, 83 (66.4%) were males and 42 (33.6%) were females and Maximum number of cases were in the age group of 31–45 years, 53 (42.4%) and the least cases were reported above 60 years age group, 4%. The most common presentation was fever 125 (99.1%) followed by myalgia 88 (70.4%), vomiting 54 (43.2%), headache 58 (46.4%), abdominal pain 42 (33.6%), skin rash 32 (25.6%). Bleeding from different sites of the body was evident in 18 patients (14.4%). In bleeding manifestations, petechiae 24 (19.2%) was the most common presentation. Conclusion: The study highlighted the high prevalence of Dengue cases in Kolhapur region. Therefore, clinicians are required to suspect Dengue in all cases of fever presenting at the hospital. Prompt diagnosis and early treatment can decrease the mortality associated with Dengue.
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Neuro-cysticercosis (NCC) and Japanese encephalitis (JE) are common in tropical countries. Two cases of NCC with coexistent JE are presented, which share same socio-demographic and ecologic factors and have the same intermediate host (pig). Patients were on treatment for NCC and presented in comatose state. Sudden clinical deterioration of a patient with NCC should warrant a search for coexistent JE. We report findings of magnetic resonance spectroscopy and diffusion-weighted imaging of the JE.