Substance use and misuse among college students: Results of an online survey from three neighboring cities of North India.

We estimated prevalence and severity of substance use in college students from three cities in North India and explored demographic correlates of substance use. This was a cross-sectional online survey. We used Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST). We contacted respondents through social groups. We performed analyses from the original sample, bootstrapped samples, and random subsamples. A total of 229 (58.3%) respondents reported any lifetime substance use. A third of substance-using respondents were female. Alcohol (54.7%), tobacco (40.2%), and cannabis (15%) use were most commonly reported. Prevalence estimates did not differ between original and subsample analyses. A significant proportion of respondents (alcohol 29.7% and amphetamines 66.7%) were at moderate risk level. Male gender, family history of substance use, and commerce stream correlated with substance use. There were positive correlations between tobacco and alcohol and licit and illicit substance use. The study highlights the need for a comprehensive college substance misuse prevention policy.

Non-shunt Management of Communicating Hydrocephalus in an Immunocompetent Host With Disseminated Central Nervous System Coccidioidomycosis.

Disseminated coccidioidomycosis is associated with significant morbidity and mortality. Involvement of the meninges is often fatal if untreated, typically requiring lifelong antifungal therapy and neurosurgical intervention. We present the case of a young male without any known immunocompromising conditions who opted exclusively for medical management of newly diagnosed coccidioidomycosis meningitis with communicating hydrocephalus and discuss the controversy associated with this approach. This case highlights the importance of shared decision-making between patient and clinician, even if the plan diverges from available guidelines. Furthermore, we discuss clinical considerations in approaching the close outpatient monitoring of patients with central nervous system coccidioidomycosis with hydrocephalus.

Amoxicillin-clavulanate-induced Granulomatous Hepatitis: Case Report and Review of the Literature.

Amoxicillin-clavulanate (AC) is a common cause of drug-induced liver injury, either cholestatic or mixed with hepatitis pattern. Rarely, AC causes granulomatous hepatitis. We report a new case of AC-induced granulomatous hepatitis documented by liver biopsy, with complete resolution of any histological sequelae on a follow-up liver biopsy after AC was withdrawn.

Surface Topography Classification Trees for Assessing Severity and Monitoring Progression in Adolescent Idiopathic Scoliosis.

STUDY DESIGN: A validation study. OBJECTIVE: The aim of this study was to independently validate the diagnostic accuracy of surface topography (ST) classification trees to identify curve severity and progression using a new sample of data in participants with adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: Radiographs for diagnosing and monitoring AIS involve harmful radiation exposure repeated at successive clinical visits. Classification trees using a novel ST technique have been proposed to determine curve severity and progression noninvasively that could be used to monitor scoliosis. METHODS: Forty-five adolescents with AIS treated nonoperatively, with ST scans and radiographs at baseline and follow-up (1 year later), were recruited from a scoliosis clinic. The Cobb angle (CA) from radiographs determined curve severity as mild (10° < CA < 25°) or moderate/severe (CA ≥ 25°) and progression as an increase >5°.ST scans were analyzed to calculate the best plane of symmetry and associated deviation color map. Root mean squares and maximum deviation were calculated for each area of asymmetry. ST measurements were analyzed using two published decision trees developed to maximize sensitivity and negative predictive value. Curves were classified as mild or moderate/severe and curve progression was predicted. Accuracy statistics were calculated to evaluate performance. RESULTS: For curve severity, sensitivity and specificity were 95% and 35%, respectively. Negative and positive predictive values were 90% and 53%, respectively, with an accuracy of 61%. For curve progression, sensitivity and specificity were 73% and 44%, respectively. Negative and positive predictive values were 83% and 30%, respectively, with an accuracy of 51%. Assuming that mild and nonprogressive curves would not require an x-ray, the use of ST decision trees could eliminate 31% of x-rays. CONCLUSION: Decision trees showed strong negative predictive values and sensitivity suggesting it may be possible to safely use ST asymmetry analysis with validated decision trees to reduce x-rays in patients with mild and nonprogressive curves. LEVEL OF EVIDENCE: 2.