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Introduction: Psittacosis, caused by the bacteria Chlamydia psittaci, is primarily a disease of birds that can be transmitted to humans. The clinical manifestations of the disease are wide, ranging from asymptomatic illness to fulminant psittacosis with multi-organ failure. The organism gets attached to the upper respiratory mucosa after inhalation and the majority remain asymptomatic. However, some people may develop symptoms of atypical pneumonia. Case presentation: Psittacosis usually presents with sudden onset fever with chills and rigor, headache, and myalgia. Here we present a case of a 35 years old female with a history of close contact with parrots who presented to the ER with complaints of high-grade fever and headache for 2 weeks which started 2 days after her parrots died. Discussion: The disease usually manifests as flu-like symptoms or pneumonia and is included in the differential diagnosis of community-acquired pneumonia. Investigations reveal neutrophilia, raised erythrocyte sedimentation rate, C-reactive protein, and elevated liver enzymes which were consistent with the findings of our patient. Chest X-ray showed ill-defined consolidation in the right middle and lower lobes which were inconclusive. Hence, a CT chest was done which revealed patchy ground glass opacities with surrounding consolidation giving a reverse halo sign. Due to her contact with birds and CT findings which were suggestive of psittacosis, she was started on doxycycline and her condition improved thereafter. Conclusion: We highlight the importance of proper history taking and awareness on zoonotic diseases to the general public to prevent, diagnose and treat the disease effectively.
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Introduction: Lipofibromatous hamartoma of the nerve is the fibro-fatty overgrowth within the nerve. Most commonly they occur in the median nerve, ulnar nerves, and a few other nerves but the involvement of the sciatic nerve is very rare. The fibro-fatty infiltration causes palpable neurogenic mass and clinically presents lump, moderate numbness, tingling sensation, and pain in its territory. Magnetic resonance imaging is the gold standard for diagnosis. Case presentation: We present a case of a 65 years old female, who presented to OPD with a tingling sensation which progressed to pain in the gluteal region and was associated with a tender swelling. MRI showed a giant space-occupying lesion in the sciatic nerve course. The mass was excised and then sent to the histopathological examination which designated the mass as lipofibromatous hamartoma. Discussion: Unless debilitating, lipomatosis of the nerve doesn't require any intervention as it is a benign condition. Lipofibromatous hamartoma is attributed to the accumulation of fatty and fibrous tissue in the epineurium. Diffusion-weighted imaging in association with conventional magnetic resonance imaging has increased diagnostic yield. The lesion was iso-intense to the subcutaneous fat and there were fine fibrillar appearances inside of it. Simple mass excision was performed on our patient without complications. Conclusion: Lipofibromatous hamartoma of the nerve are rare soft tissue tumors of nerves and sciatic nerve involvement is even rarer. Correct and careful interpretation of the MRI findings can lead to diagnosis with ease and help prevent unnecessary biopsies.
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Background Ventral hernias are usually repaired by an open or laparoscopic approach. Quality of life after ventral hernia repair is a very important but often underestimated parameter. This prospective observational study was conducted to assess the quality of life and other related parameters after all types of ventral hernia repair, mainly between open and laparoscopic repairs. Objectives This study aimed to determine the quality of life after ventral hernia repairs. We also analysed and compared various parameters such as outcomes and satisfaction, postoperative pain, and complications between laparoscopic and open ventral hernia repair. Methods This was a hospital-based prospective observational study conducted from January 2020 to December 2021, which included a total of 70 patients with ventral hernias. Thirty-nine patients underwent open repair and 31 patients underwent laparoscopic repair. Demographic data and other data such as postoperative hospital stay, return to activity, postoperative pain, complications, and quality of life were collected and analysed. Results The distribution of different types of hernias observed in our study included 34% incisional hernias, 33% umbilical and paraumbilical hernias, and 33% epigastric hernias. The incidence of complications was significantly less in laparoscopic repair compared to open repair. Also, satisfaction at 1 month was significantly more in the laparoscopic group compared to the open group. However, there is no significant difference in the postoperative pain, postoperative hospital stay, return to activity, satisfaction at discharge, and quality of life at 1 month in both the laparoscopic and open repairs. Conclusion Laparoscopic ventral hernia repairs are associated with lesser complications and higher satisfaction. The use of tackers and trans-fascial sutures can significantly increase postoperative pain in laparoscopic repair and is the major factor affecting the short-term quality of life in laparoscopic repairs. As there is no difference in postoperative pain, hospital stay, and return to activity, laparoscopic repairs should be preferred wherever possible in view of fewer complications and higher satisfaction.
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Background and Objectives: The ongoing pandemic of COVID-19 has a severe impact on the health-care system worldwide bringing doctors under immense pressure to work under stressful conditions. The main objective of this study was to assess anxiety among doctors and to understand the perceived causes of anxiety. Methodology: Questionnaires were made available to all willing doctors of SN Medical College, Agra; King George's Medical University, Lucknow, and GSVM Medical College, Kanpur, between May 12, 2020, and June 20, 2020 (during nationwide lockdown). The questionnaire consists of three main sections: details about respondents' working status, questions regarding respondents' reasons for concern, and Becks' Anxiety Inventory (BAI) scale. Results: Two hundred and fifty responses were received from about 599 doctors presented with the questionnaire. About 32% of the respondents have already done duties in COVID facilities and the rest are awaiting deployment at those facilities. Forty-two percent reported concern regarding transmitting the illness to close ones/loved ones/family members to be a cause of anxiety and 40% were worried about the quality of protective gear closely followed by examination-related worries. About 28.8% of the respondents scored >7 on BAI with 62.5% of these (18% of total respondents) reporting "moderate" levels of anxiety. Conclusions: Our findings underline the fact that pandemics such as COVID-19 cause significant levels of anxiety among doctors. The levels of anxiety differed for age, sex, and specialty. The perceived causes were the risk of transmitting to loved ones and concerns regarding protective gear. These outcomes highlight the need for early interventions to address anxiety and to provide support for doctors during such crises.
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IntroductionThere have been 214 million confirmed cases of COVID-19 worldwide with a total death tally of 4.4 million. The current study aims to determine the predictive value of 3 minute and 6-minute walk tests in assessment of progression of mild COVID-19 infection at a tertiary care hospital in North India. MethodsThe study population consisted of adults (age more than 18 years) with a confirmed diagnosis of Covid-19 by RT-PCR on nasopharyngeal specimens. Patients with only mild illness were enrolled. After the patients were admitted to the isolation ward, the presenting history, comorbidity status, vital signs and laboratory parameters were recorded. The 3 and 6 minute walk test was performed daily from admission till discharge or progression of severity of COVID-19 and it was used to calculate BDS and NEWS2 scores. ResultsOur study consisted of 50 patients with 34 (68%) males and the mean (SD) age of the patient population being 28.1 (6.4) years. The most common symptoms were fever, sore throat, and cough. All laboratory parameters were within normal ranges for all the patients. 96% recovered without progression, while only 4% of them progressed to moderate illness. Results of the 3 and 6 minutes walk tests, BDS and NEWS2 scores showed improvement over the course of hospital stay. ConclusionsAlthough the walk tests and the scores improved over time, they failed to predict the disease progression.
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India has experienced an early and harshest lockdown from 25th March 2020 in response to the outbreak. However, an accurate estimation of the progression of the spread of infection and the level of preparedness to combat this disease are urgently needed. Using a data-based mathematical model, our study has made predictions on the number of cases that are expected to rise in India till 14th June 2020. The epidemiological data of daily cases have been utilized from 25th March (i.e., the first day of lockdown) to 23rd April 2020. In the study, we have stimulated two possible scenarios (optimistic and pessimistic) for the prediction. As per the optimistic approach of modelling, COVID-19 may end in the first week of June 2020 with a total of 77,900 infected cases including 2,442 fatalities. However, the results under the pessimistic scenario are a bit scary as it shows that a total of 283,300 infected cases with 10,180 fatalities till 14th June. To win the battle, 10 weeks of complete lockdown is much needed at least in the infected states and the union territories of India. Alternatively, the isolation of clusters (hotspot regions) is required if India wants a resume of some essential activities.
