Health-related quality of life among people living with HIV/AIDS on highly active antiretroviral treatment: A questionnaire-based study

Introduction: The knowledge of the effect of sociodemographic and disease-related factors on health-related quality of life (HRQoL) among people living with HIV/AIDS (PLWHA) is important for planning comprehensive health-care services for them. Material and Methods: Two hundred PLWHA on antiretroviral therapy (ART) volunteered to complete a self-reported World Health Organization’s Quality of Life?HIV brief questionnaire (WHOQoL-HIV-BREF) that examines six domains each with four items (physical, psychological, level of independence, social, environmental, and spiritual) with 25 facets and additional 5 facets specific to PLWHA (symptoms of HIV, social inclusion, forgiveness, worries about the future, and death and dying). Results: Only 135 questionnaires from 73 (53.3%) men and 63 (46.7%) women (male: female – 1.14:1) aged 20–82 years(mean ± standard deviation: 42.9 ± 10.5 years) were found complete. Eighty-five (63%) individuals were aged 41–60 years, 78 (57.8%) individuals were matriculates, graduates, or postgraduates, 76 (56.3%) respondents were married, and 38 (28.1%) were widows/widowers. Staying-alone workers comprised 43 (31.8%) individuals. Overall health and HRQoL were rated satisfactory (n = 85.2%) and good/very good (n = 74.8%) by a significantly greater number of individuals (P = 0.001). Pearson’s Chi-squared test showed no statistically significant (P > ?) associations between good HRQoL and variables such as age >40 years, gender, education, marital status, duration of disease, disclosure of serostatus to family, ART for >3 years, and CD4 >200 cells/mL. Conclusion: Regular ART can result in adequate control of immunosuppression and no comorbidities in a majority of PLWHA, family and social acceptance, and financial security can result in overall good HRQoL in all six domains within the WHOQoL-HIV-BREF. The study is limited by its cross-sectional study design and small sample size.

OHVIRA (OBSTRUCTED HEMIVAGINA WITH IPSILATERAL RENAL AGENESIS) WITH VERTEBRAL FUSION ANOMALY, SCOLIOSIS AND ABSENCE OF COCCYX: AN UNCOMMON MEDLEY

OHVIRA(Obstructed hemi-vagina with ipsilateral renal agenesis),also known as Herlyn-Werner- Wunderlich syndrome(HWW) is a rare case of a complex uterine anomaly.Associationwith congenital vertebral fusion anomalies, curvature abnormality of spine and congenital absence of coccyx together in a single patient has been sparsely documented in literature. We present a case of 15 year old female with varied spectrum of radiographic, ultrasonographic and MRI ?ndings. MRI remains the gold standard investigation for diagnosing this rare congenital uro-genital anomaly.

A Clinical Study to Evaluate the Combined Effect of Karpasasthyadi Taila Nasya and Greevabasti in the Management of Greevastambha w.s.r. to Cervical Spondylosis

In the present era of modernization and fast life, everybody is over busy and living a very stressful life. Faulty dietetic habits and sedentary life style is responsible for early degenerative changes in bodily tissue. As per Ayurveda, Greevastambha has been described under Vataj Nanatmaja Vikaras. Few Lakshanas of Kupitoanilah such as Pani-Prishta-Shirograha, Gatrasuptata, Greevaya-Hundanama, Bhedastoda-arti are the well-known features of Greevastambha. Greevastambha can be correlated with Cervical Spondylosis of modern medical sciences. Cervical Spondylosis is a degenerative condition of cervical spine that affects the vertebral bodies and intervertebral disc of the neck as well as contents of the spinal canal. It leads to pain and stiffness in neck, radiating pain into arm, headache, vertigo, dizziness, paraesthesia, numbness etc. Material and Methods- Patients fulfilling the diagnostic and inclusion criteria were selected for the present study from the OPD/IPD of our institute. The present study was carried out in a single group of 10 patients. In the present study, Snehana Nasya along with Greevabasti with Karpasasthyadi Taila was taken to evaluate the combined effect in the management of Greevastambha w.s.r. to Cervical Spondylosis. Result- Statistically significant results were observed in the present study.

A STUDY OF PARENTAL ENCOURAGEMENT OF UNDERGRADUATE DISTANCE EDUCATION STUDENTS OF PUNJABI UNIVERSITY PATIALA

This paper seeks to find out the parental encouragement of undergraduate distance education students of Punjabi university Patiala. The appropriate data was gathered from total 100 students selected by random sampling technique which of them 50 from arts stream (25 male 25 female) 50 from commerce stream (25 male 25 female) using the parental encouragement scale by Dr. R.R.Sharma (2012). For the analysis of data statically techniques mean, standard deviation, t-test ware used. The study revealed there was insignificant difference in parental encouragement of arts and commerce distance education undergraduate students. The t-value of parental encouragement of arts and commerce distance education undergraduate students comes out to be 1.67 which is significant at 0.05 level significance. Further no significance difference observed in parental encouragement of distance education undergraduate students on the basis of gender. The t-value of parental encouragement of male and female students examined 0.076 which is not significant at 0.05 level.

Assessment and comparison of distal radial artery diameter in anatomical snuff box with conventional radial artery before coronary catheterization

Background: The distal radial artery (dRA) approach at anatomical snuff box has gained attention of the interventional cardiologist in last few years. The procedural success rate by this novel approach depends on size of the radial artery and therefore the study was planned to study the size of distal radial artery. Methods: Total of 1004 patients of >18 years of age undergoing coronary catheterization were included in the study. The vessel diameter was measured from media to media in the anatomical snuff box a day prior to coronary catheterization. Results: The mean diameter of right radial artery at conventional access site was 2.56 ± 0.35 mm and at distal access site 2.23 ± 0.39 mm (p < 0.001). Females had significantly smaller radial artery diameter as compared to males at right conventional access site (2.42 ± 0.36 mm vs 2.60 ± 0.34 mm; p < 0.001) and distal access site (2.09 ± 0.38 mm vs 2.27 ± 0.39 mm; p < 0.001). The diameter of the right dRA was not significantly correlated with age (r2 linear ¼ 0.002, p ¼ 0.0475) but was positively correlated with height and weight (r2 linear ¼ 0.076, p ¼ <0.001 and r2 linear ¼ 0.005, p ¼ <0.001) and negatively correlated with BMI (r2 linear ¼ 0.076, p ¼ 0.519). Conclusions: This study has shown the size of right dRA 2.27 þ 0.39 mm in males and 2.09 þ 0.38 mm in females. Diabetes, hypertension, height and weight are important predictors of dRA diameter

Patch testing with expired Indian patch test kits: Results of a pilot study

Background: The reliability of patch testing with expired Indian standard patch test kits has been not evaluated before. Methods: Thirty adults (men:women 25:5) with allergic contact dermatitis were divided into three groups of ten patients each for patch testing by Finn chamber® method using Indian standard patch test kits having expiry in 2016, 2015 and 2014. The results were compared with those from a new kit with 2018 expiry. Results: Ten patients in group-1, eight patients in group-2 and seven patients in group-3 developed positive reactions of identical intensities and mostly from identical allergens from all four kits. The major contact allergens eliciting positive reactions of identical intensities were parthenium in nine, five and three patients, colophony in four, one and zero patients, fragrance mix in three, three and one patients, thiuram mix in three, one and one patients, and paraphenylene diamine in two, one and three patients from group-1,-2, and -3, respectively. Limitations: Small number of patients in each group remains the major limitation of the study. Whether or not these results can be extrapolated with patch test results from other similar patch test kits available across countries also needs confirmation. Conclusion: The patch test allergens can be used beyond labeled expiry dates but needs confirmation by a few large studies and using other available patch test kits. This is important as the relevance of patch test results for individual allergen in this scenario may remain debatable requiring careful interpretation

Cascade of Complications Following Carotid Body Tumor Excision / 신경중재치료의학

Carotid body tumor excision can lead to various complications including vascular injury and pseudoaneurysm formation. Here we describe a case of carotid body tumor excision followed by series of complications including pseudoaneurysm formation, failure of primary surgical repair, carotid stump syndrome following parent artery occlusion, and persistent hypotension.

Osseous Metaplasia in Leiomyoma: Case Report with Literature Review

Introduction: Leiomyoma is being one of the commonesttumors of the female genital tract during the reproductiveyears. It is a benign neoplasm of smooth muscle.Case report: We present one such case in a 60 year oldpostmenopausal female patient presented with uterovaginalprolapse.Conclusion: The leiomyoma demonstrate a wide spectrum ofhistological variation, but osseous metaplasia is a rare clinicalentity

Delayed Spontaneous Thrombosis of Neglected Direct Carotid-Cavernous Fistula: A Case Report / 신경중재치료의학

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.

Association of new-born birth weight with maternal parameters

Background: Birth weight is the single largest determinant of the neonatal survival and wellbeing. Maternal anaemia is the commonest medical disorder in pregnancy and is associated with significant maternal morbidity and mortality. The effect of haemoglobin levels of the mother on the foetus however remains unclear. This study aims at evaluating the effect of maternal anaemia on neonatal birth weight. It also evaluates the effect of parity, gestational age and maternal age on the new-born birth weight.Methods: A retrospective study was carried out on patients who had delivered in Al Falah hospital, a newly setup medical college in rural Haryana. The population was studied for maternal age, gestational period, and parity and haemoglobin levels. These parameters were correlated with neonatal birth weight. The study was carried out on deliveries which occurred over a period of six months from November 2018 to April 2019.Results: The low birth weight new-borns were 10.5%. Maternal anaemia was present in 79.74 % of women in the study group. Amongst all parameters studied, only higher parity and greater period of gestation had a positive correlation with neonatal birth weight. Haemoglobin levels or maternal age didn’t show a significant impact on the neonatal birth weight. Anaemic mothers didn’t have a higher incidence of low birth weight babies.Conclusion: The most significant contributor to improved neonatal weight is the gestational age of the foetus. All efforts to ensure better neonatal outcome must primarily concentrate on prevention of preterm births. Maternal haemoglobin levels do not directly impact the neonatal birth weight. However, as anaemia is a risk factor for preterm delivery, anaemia indirectly impacts on the neonatal birth weight and outcome.

Sebaceous Cell Carcinoma- Two Rare Case Reports

Bonafide sebaceous carcinoma is extremely rare neoplasm. It may be seen as a component of Muir-Torre syndrome. It should be distinguished from basal cell carcinoma with sebaceous differentiation.

Evaluation of efficacy and safety of intralesional bleomycin in the treatment of common warts: Results of a pilot study

Background: This study evaluated the efficacy and safety of intralesional bleomycin in the treatment of common warts in 50 (32 men, 18 women) patients aged between 14 and 80 (mean ± SD, 28.5 ± 13.27) years. Methods: The warts were present over dorsal hands, feet, palms, soles and periungual skin for 1 month to 10 years. They were infiltrated with bleomycin (1 mg/ml) till blanching. The total cumulative dose did not exceed 2 mg in one session. The treatment was repeated after paring of eschar at 2 weeks in case there was no or partial response. The patients were reviewed at 4, 12 and 24 weeks for cure, adverse effects or recurrences and outcome satisfaction levels. Results: Complete cure without recurrence occurred in 40 (80%) patients and partial response occurred in 7 (14%) patients at the end of the 24-week study period. Three patients did not complete follow-up. No major systemic or local adverse effects other than injection site pain for 2–3 days were noted. All cured patients were very satisfied (Likert scale 5). Conclusion: Intralesional bleomycin appears to be an effective and safe treatment for common warts including palmoplantar and periungual warts. It carries the advantage of low dose, no significant adverse effects and high patient satisfaction. Small number of patients, lack of a control group, comparing different bleomycin concentrations and a short follow-up are a few limitations of this study. Better designed studies are warranted for this useful treatment modality.

Inguinal abscess after gallstone spillage during lap cholecystectomy: An unusual presentation

62 year old lady was presented with small painful swelling in inguinal regional. On examination, there was 2x2 cm swelling in the right inguinal region with overlying skin red in color. Swelling was tender to touch with raised local temperature, firm in consistency, non-reducible and non-compressible with no transmitted pulsations. FNAC report was showing only inflammatory cells. Ultrasound was normal for abdomen but it showed presence of foreign body deep inside the sinus tract. Sinus tract was excised along with foreign body. Gallstone abscess are although rare to develop but they are seen occasionally. As are seen in our case lap cholecystectomy was performed 9 months ago and a single 7 mm stone was extracted from abscess in inguinal region.

CT quadrate lobe hot spot sign

A 14-year-old girl visited our hospital with pyrexia of unknown origin. In view of suspicion of tuberculosis, various haematological and radiological investigations were done. Further examinations revealed titres positive for lupus anticoagulant syndrome. Contrast-enhanced computed tomography [CT] of the chest and abdomen was also advised for further evaluation, which revealed type II superior vena cava obstruction. Contrast-enhanced CT of the abdomen revealed an interesting observation in the left lobe of the liver, which is known as the hot spot sign. CT quadrate lobe hot spot sign' was first described by Ishikawa in 1983. It manifests as an area of intense focal wedge-shaped enhancement of the quadrate lobe [functionally a part of the left lobe of the liver and designated segment IVb in the Bismuth-Couinaud classification system] of the liver in the arterial and venous phase [figure 1].1 This hot spot sign was initially observed on 99mTc sulphur colloid scan of the liver as a focal area of increased radiopharmaceutical uptake and was diagnostic of superior vena cava syndrome.2 Hot spot sign is caused by portosystemic venous shunting between the superior vena cava and the left portal vein via the internal mammary and paraumbilical veins along the ligamentum teres, secondary to superior vena cava obstruction