Publisher: Medip Academy   (Total: 12 journals)   [Sort by number of followers]

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Intl. J. of Advances in Medicine     Open Access   (Followers: 5)
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Intl. J. of Clinical Trials     Open Access   (Followers: 5)
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International Journal of Advances in Medicine
Number of Followers: 5  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2349-3925 - ISSN (Online) 2349-3933
Published by Medip Academy Homepage  [12 journals]
  • Chest X-ray findings in COVID-19 patients: a descriptive study

    • Authors: Asraf Hussain, Jeetendra Mishra, Achutanand Lal Karn, Alok Kumar Singh, Parwez Ansari, M. Kalim Akhtar, Bikranta Rimal, Dambar Shah, Rajan Mahato, Sagun Bista, Aadarsh Singh, Omprakash Kushwaha, Surendra Yadav, Rupesh Shah, Ramji Ram
      Pages: 617 - 620
      Abstract: Background: Early suspicion and diagnosis remains the cornerstone for the better outcome of patients and to decrease cross infection in cases of COVID-19 pneumonia. In a country like Nepal X-ray facilities are readily available radiological tool in most of the centers and can be important screening tool.  There is a lack of studies detailing the chest XR (C-XR) findings in these patients when compared to that dedicated to the CT features. Study aims to describe the patterns of the lung opacities in CXR in these patients.Methods: This is retrospective descriptive study conducted at NMCTH in COVID-19 patients from 12 September to 17 October 2020. Demographic characteristics, symptoms, co-morbidities and C-XR findings were studied. CXR findings were categorized according to BSTI classification.Results: Among 111 COVID-19 RT-PCR positive cases admitted 102 (91.9%) belonged to age group 18-65 years, 89 (80.2%) were males. Cough and fever were the commonest symptoms present in 109 (98.2%) patients. Ischemic heart disease and hypertension in 32 (28.8%) patients were the commonest co morbidities. According to British society of thoracic imaging (BSTI) COVID-19 CXR classification, six patients (5.4%) had normal chest X-rays. Classic/probable COVID-19 picture was present in 79 (71.17%) patients while (7.2%) had intermediate for COVID-19 X-ray findings. Among 79 patients with classic/probable COVID-19 CXR findings 71 (89.8%) had bilateral consolidation/ground glass haze, 72 (91.1%) had peripheral lung involvement while 66 (83.5%) had middle and lower zone involvement.Conclusions: Ground glass opacities/consolidations with bilateral location, peripheral distribution and middle- lower zone predominance were the commonest X-ray findings in our study.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • Outcomes and experience of telemedicine in the management of diabetes
           mellitus during COVID-19 pandemic

    • Authors: Shahjada Selim, Hafiza Lona
      Pages: 621 - 627
      Abstract: Background: Telemedicine has been promoted as an economical and effective way to enhance patient care, but the experience and its outcome in the diabetes management are not well understood. Thus, this study aims to assess the experiences and outcomes of diabetes management by tele-consultation.Methods: A comparative study included 958 patients with T2DM attending the clinics for diabetes management. Of them 467 (48.75%) patients consulted the endocrinologists through telemedicine and 491 (51.25%) patients attended the clinics physically during the study period.Results: The mean age was 58.5±4.3 years in telemedicine group and 55.8±5.1 years in the physically attending group. Male patients comprised about half [46.03% in telemedicine group; 51.32% in physically attending group)] of the study population and around half [55.46% in telemedicine, 44.54% in physically attending group] of them came from urban areas. The majority of patients were on MNT along with 2 or more OADs [42.18% versus 40.53%; p 0.90]. Among telemedicine users, 59.74% visited the clinic as regular follow up visits and the highest number of patients [49.67% (232)] used video calling, apps, WhatsApp. About 62.21% (291) of the telemedicine users did not face any difficulties in communication. Two-fifths of the participants (40.02%) required assistance for communication; 74.09% of the patients could understand the advices and instructions of the physicians and 76.45% found it cost effective and more than four-fifths of them admitted that telemedicine could save time. The majority of patients with T2DM (91.43%) were satisfied with telemedicine service.Conclusions: For most patients with T2DM, telemedicine can be as good, or even better than, in-person care, especially for those who face geographical and time barriers to access during COVID-19 pandemic and may be afterword. population.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • A descriptive cross-sectional study on the awareness level towards the
           COVID-19 among the internet users of Bangladesh

    • Authors: Fahad Bin Aziz Pavel, Shimul Halder, Md Saeed Siddik, Md Abdul Muhit
      Pages: 628 - 635
      Abstract: Background: Coronavirus disease (COVID-19), a pandemic worldwide is caused by SARS-CoV-2 and represents the causative agent of a potentially contagious disease that is of great global public health concern. The present study aimed to assess the knowledge, attitude and practice towards the COVID-19 pandemic among the internet users of Bangladesh.Methods: A web-based cross-sectional descriptive study was conducted with a structured questionnaire implemented through google form and circulated online over distinctive social media from April 2020 to June 2020. Data were analyzed using SPSS software version 23.0 employing univariate, bivariate and multivariate techniques and also one-way ANOVA where applicable.Results: From the obtained data, 98.8% of the participants were aware of the COVID-19, among them 60.7% obtained the information from social media. The general transmission knowledge level score was found at 3.37±0.71. Overall knowledge level score on signs and symptoms and treatment options were found 2.8±0.05 and 5.17±1.44, respectively. This study demonstrated that a significant portion of the population (80.7%) is dissatisfied with the role of the government in combating COVID-19. One-way ANOVA reveals that women show more adherence with practicing the precautions required to refrain from COVID-19 which was highly significant (p value 0.066). The backward likelihood ratio analysis showed that education and sex have significant p value in case of treatment knowledge score and practice score, respectively.Conclusions: Although the perception towards the COVID-19 is encouraging among the populations who are using the internets, our study findings suggest that updated knowledge, safety guidelines and preventive measures must be provided by the concerned authorities to enhance the awareness and to reduce the spreadability of the COVID-19 outbreak.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • Factors responsible for low serum vitamin-D levels in type-2 diabetes
           mellitus females: a cross-sectional study

    • Authors: E. Dinesh Ragav, Arthi P. S.
      Pages: 636 - 643
      Abstract: Background: Diabetes mellitus are a group of disorders as a result of reduced insulin secretion, insulin resistance, and increased glucose production and many more unknown etiologies. As compared to diabetic non-obese, diabetic obese individuals have an increased chance of 13.5 % in developing diabetic complications. Many diabetic patients are found to be vitamin-D deficient and its role in insulin regulation is being studied in many studies. Thus, diabetic complications and vitamin-D deficiency are likely to be developed in obese diabetic females.Methods: Type-2 diabetic females from 30 years to 60 years, attending in medicine as out-patient and female type-2 diabetes patients admitted in medical ward of RRMCH were assessed clinically. Parameters such as anthropometric measurements, weight, height, waist-hip ratio, tested for serum levels vitamin-D including other relevant investigations related to diabetes were done. Totally, 156 patients were assessed.Results: Assessment of 156 patients are as follows, 48.47±9.56years was the mean age of this study group. SD: 5.10±4.36 years is the mean diabetic duration of this study population. 0.98 was the mean waist-hip ratio. 98.93 cm was the mean waist circumference. 24.97 was the mean BMI. Mean fasting blood sugar (FBS) and post-prandial glucose test (PPBS) were: 202.73 mg/dl, 280.99 mg/dl respectively, 9.33% was the mean HbA1C. Majority of the females with type-2 diabetes (92.5%) had low levels of serum vitamin-D. 16.19 ng/ml was the mean serum vitamin-D levels. lower levels of serum vitamin-D were significantly associated with diabetic duration (p=0.082+), poor glycaemic control (p<0.001**) and increased BMI (p=0.011*).Conclusions: Majority of the females with type-2 diabetes mellitus were with waist-hip ratio more than 0.8 and Waist circumference more than 80 cm. Most of the study population had poor diabetic control. Lower levels of serum vitamin-D were found in almost all females with type-2 diabetes mellitus (92.5 %) and the most likely risk factor being obesity and poor glycaemic control as a conclusion of this study.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • Clinical profile and outcome of snakebite poisoning in sub-district
           hospital Akhnoor

    • Authors: Chandan Sharma, Ashima Badyal, Sanjeev Kumar
      Pages: 644 - 647
      Abstract: Background: In a predominantly agricultural country like India, with rich in flora and fauna, long rainy season and rural background, the encounter between man and snake is a frequent occurrence. Viper-bites are more common than other poisonous snakebites. Only the cases of snakebite with severe envenomation reach the health care centers. This study was planned to analyze the presentation of complaints and symptoms in snake bite patients.Methods: This ‘record based descriptive observational study’ was carried out over a period of 6 months from May 2020 to November 2020 in Sub District hospital Akhnoor. A total of 96 patients with a history of snake bite and signs of envenomation were included in this study. Results: Incidence was higher among people from rural background (86.46%), more among males (67.71%) and highest among farmers (53.13%) and labourers (16.67%). Maximum no of snakebites took place during night and on the lower parts of body, mainly legs (54.17%); while the period of the study contained the peak rainy season of the region. As many as 39.58% of victims didn’t receive any kind of formal first aid at all and as many as 48.96% patients reported after a minimum delay of 6 hours, which could be considered as potentially fatal. Chief complaints among the reported patients of snake bite were found to be: Local edema, bleeding, vomiting, drowsiness, ptosis and Ophthalmoplegia.Conclusions: There is an urgent and dire need for awareness and education among rural population about the hazards involved and treatment of snakebite.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • Practice of insulin injection techniques among persons with diabetes in
           central India: an observational survey

    • Authors: Animesh Choudhary, Jitendra Chouhan, Sanjeev Gulati, Jogesh Kumar Vishandasani
      Pages: 648 - 652
      Abstract: Background:  Correct injection technique used by the patient can determine the outcomes with insulin therapy in type 2 diabetes mellitus, however most patients on insulin remain unaware of the proper insulin injection techniques. The purpose of this study was to assess the current practice of insulin administration among diabetes patients.Methods: This cross-sectional study was conducted in 3 tertiary care centers delivering specialized diabetes care in central India from November 2019 to February 2020. The study included patients (n=150) using insulin for at least three months by either syringe or pen. All of them answered a survey questionnaire which focused on key insulin injection parameters.Results: Abdomen was the most common (53.33%) site of insulin injection. About 95.33% of subjects were following the injection site rotation instructions. The practice of hand washing, and cleaning of the injection site was practiced by 120 (80%) and 112 (74.66%) respondents respectively. Needle reuse was a common practice, and 146 (97.33%) subjects were using the same needle more than once. Around 73.33% were storing insulin at proper temperature, while 54.66 % reported having pain at the injection site and 14.66% had noticed persistent swelling at their injection sites. Conclusions: There is a significant gap between the insulin administration guidelines and current insulin injection practice. Education and counseling about proper insulin injection techniques should be provided to all persons with diabetes to ensure optimal usage of the drug to achieve the desired glycemic control.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • Electrocardiography in post hemodialysed chronic kidney disease patients

    • Authors: Jatin Soren, Chakradhar Majhi, Nayan K. Patel
      Pages: 653 - 656
      Abstract: Background: Chronic kidney disease (CKD) is associated with higher risk of cardiovascular events and Electrocardiographic changes are common in CKD patients. Electrocardiography (ECG) is cheap and easily available investigation that could pick up abnormalities of heart. Our study focuses on electrocardiographic changes seen within 24 hours in post hemodialysis CKD patients.Methods: It is a cross sectional, observational study of 298 CKD patients who underwent hemodialysis at tertiary care facility of VIMSAR, Burla during the period between November 2018 to November 2020. 12 leads ECG of these patients were taken post hemodialysis and abnormalities were interpreted.Results: Total number of patients included in the study were 298 with mean age distribution of 47±8.4 years. Mean Serum urea level was 126 mg/dl. Creatinine levels ranged between 5-10 mg/dl. Left ventricular hypertrophy (LVH) and left atrial enlargement (LAE) were seen in 14.76% and 8.3% of patients respectively. Atrial fibrillation was present in 4.3% of patients. Left axis deviation (LAD 7%), right axis deviation (RAD 6%), atrial ectopics (2.6%) and tall T waves (7.3%) were the other ECG changes observed.Conclusions: ECG changes are common in CKD patients in post hemodialysis state, so it becomes important to monitor these changes in these patients for early detection of any cardiac abnormalities.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • A cross sectional study to estimate the prevalence of vitamin B12
           deficiency among type 2 diabetes cases on metformin therapy: a one year
           study

    • Authors: Veeranarayana Gundu, Venkata Subrahmanyam Chintha
      Pages: 657 - 661
      Abstract: Background: Type 2 diabetes mellitus is associated with long term neurological complications. Metformin usage as first line drug for longer duration is associated with Vitamin B12 deficiency. Metformin on longer usage is associated with B12 deficiency in various studies and prevalence is variable. The study aims to estimate the prevalence of Vitamin B12 deficiency and its associated risk factors among T2DM on metformin therapy.Methods: A cross sectional study for one year was conducted at Narayana Medical college a tertiary care hospital. All T2DM cases attending the department and on Metformin usage were enrolled and data of age, sex, duration of T2DM, dosage of Metformin were noted as variables. Levels of Hb1Ac and complete blood picture were noted. Statistical analysis was conducted by Statistical package for social sciences (SPSS) version 21 v and p<0.05 was considered statistically significant.Results: A total of 258 participants were enrolled of which 68 (26.36%) were B12 deficient, 46 cases (17.83%) moderately deficient and 144 (55.81%) were normal. Prevalence of Vitamin B12 in the study was 26.36%. There was a statistically significant association between Vitamin B12 levels and daily dose of metformin usage. (p>0.005)Conclusions: Our study clearly highlighted the association of Vitamin B12 deficiency among T2DM on metformin therapy. Prevalence of Vitamin B12 deficiency among T2DM patients on metformin is quite considerable and cannot be neglected. Physicians prescribing the drug should plan inclusion Vitamin B12 supplementation as regular drug in T2DM cases.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • Demographic profile, staging and CA-125 levels in a patient with pelvic
           lesions of probable ovarian origin at presentation in a tertiary care
           hospital

    • Authors: Rajeev Gupta, Shveta Mahajan, Sharandeep Kaur, Ankush Bansal, Dinesh Kumar, Jasneet Kaur Sodhi
      Pages: 662 - 666
      Abstract: Background: In Indian women, ovarian cancer is one of the most commonly diagnosed cancer. We wanted to analyze the demographic profile, staging, and sensitivity and specificity of CA-125 levels in a patient with ovarian cancer in an indian scenario.Methods: A retrospective study was performed and information was collected from 250 patients who visited SGRD Hospital, Vallah, Amritsar from 1 April 2016 to 30 April 2020, with pelvic lesions of probable ovarian origin on demographic profile, the staging of the disease and CA-125 levels. Data was collected, analyzed, and presented in frequency tables and figures.Results: The study comprised of 250 patients. CA-125 was mainly used to investigate a wide range of signs and symptoms and few tests were for follow up or screening of ovarian cancer. In female patients having a CA-125 for very high suspicion of malignancy/ovarian cancer, only 90 (36%) of the abnormal results were caused by ovarian cancer. False-positive results were largely caused by other malignancies. The specificity of CA-125 for ovarian cancer increased with concentrations over 1000 kU/litre. Serous adenocarcinoma was found the most common malignant tumor type of the ovary (53%). In the demographic profile, ovarian cancer was found to be highest in the sikh religious group (75%) and prevalent in the middle socioeconomic status 32% (n=80).Conclusions: These results confirm the high false-positive rate and poor sensitivity and specificity associated with CA-125 and the most common tumor type. The substantial inappropriate usage of CA-125 has led to results that are useless to the clinician, have cost implications, and add to patient anxiety and clinical uncertainty.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • Estimation of left ventricular function in chronic alcoholics

    • Authors: K. S. Sindhya, Arthi P. S.
      Pages: 667 - 671
      Abstract: Background: Alcohol abuse is one of the leading causes of millions of deaths, it is also a burden in society. Direct toxicity of ethanol affects cardiac muscle Acute intoxication shows pathological electrocardiogram changes such as sinus tachycardia in alcohol dependence syndrome, sinus arrhythmias, prolongation of QT interval, ventricular polarising complexes, poor progression of R wave, torse de pointes. Changes found in echocardiography are alteration in septal and ventricular wall thickness, left atrial dimensions, left ventricle dimension and mass.Methods: Patients attending outpatient and inpatients section in our tertiary care hospital Shri Balaji Vidhyapeet University were considered in study for a period of two years. Study size was 85 patients, Data were collected regarding proportion of ethanol intake, history of duration, symptoms related to cardiovascular system, blood parameters including thyroid function test, blood sugars are done, body mass index calculated, blood pressure recorded master chart made for statistical verification. The three-dimensional echocardiography in M mode is done by our cardiologist.Results: Echocardiography findings were correlated with duration of intake of alcohol end diastolic volume index (EDVI), End systolic volume index (ESVI), Left ventricle mass index (LVMI) had positive correlation of p-value less than 0.05. when quantity of ethanol intake correlated with echocardiography, Left ventricular inner dimension (LVID), fractional shortening (FS), ejection fraction (EF), posterior wall thickness, E/A ratio has no significance with p value. Abnormality is noted in left ventricle diastolic function and is corresponded to quantity and duration of alcohol. Moderate amount of less than 150grams of ethanol did not showed toxic effects in heart while severe quantity and duration more than ten years of intake showed left ventricle dysfunctionConclusions: Ethanol consumption in massive amount impair cardiac contractile function. Change in left ventricle volume takes place before the defect in the ventricular filling, which would be a marker for effect of ethanol in heart.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • Assessment of serum ferritin and thyroid hormones level in acute ischemic
           stroke and their association with hemorrhagic conversion

    • Authors: Richa Giri, Faim Ahamed, Saurabh Agarwal, Lalit Kumar
      Pages: 672 - 678
      Abstract: Background: Acute ischemic stroke is a significant cause of mortality and the leading cause of long-term disability in the United States. Collective evidence suggests that low T3 levels and serum ferritin levels instantly following acute ischemic stroke are connected with greater stroke sternness, higher death rates, and poor functional outcomes. The aim of the study was to assess the serum ferritin and thyroid hormones level in acute ischemic stroke their association with hemorrhagic conversion.Methods: In this observational study, 60 acute ischemic stroke patients aged ≥ 18 years of both gender who were reported with focal neurological deficit lasting greater than 24 hours were included. Clinical severity of stroke was assessed at admission and on the 7th day using Glasgow coma scale (G.C.S.), serum ferritin level, and thyroid hormones level were measured at admission and on the 7th day in all these subjects.Results: Overall mean age of patients was 56.28±11.45 years with a range of 29-87 years; 61.7% were male patients. Ischemic stroke was found in 55 (91.7%) patients, while 5 (8.3%) patients showed hemorrhagic conversion. Serum Ferritin and T3 level shows a significant association with G.C.S. score (p<0.05). Hemorrhagic Conversion patients were significantly greater in-hospital stay than the acute ischemic stroke group (p<0.05).Conclusions: In our study, it was observed that after acute ischemic stroke high ferritin level and low T3 is associated with worse neurological outcome and linked to the poorer results at hospital discharge.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • A study of serum C peptide levels in newly detected diabetic patients in
           tertiary care hospital

    • Authors: Balakrishna Teli, Prabhu S., Sneha Biradar
      Pages: 679 - 684
      Abstract: Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. The deficiency of C-peptide in type 1 DM or its excess in type 2 DM leads to the development of disorders which includes the cardiovascular, nervous, excretory and other systems. The present study is done to assess the serum C-peptide levels in newly detected diabetic patients and its significance in classification of diabetes and deciding about management.Methods: This cross sectional study was conducted within the hospitals attached to Bangalore medical college and research institute. 65 newly detected diabetes patients who gave consent for study and satisfy the inclusion criteria were included in the study. Data was collected using semi structured questionnaire, clinical examination and relevant investigations. Statistical analysis was performed using SPSS software. A p value of <0.05 was considered significant.Results: C-peptide levels showed that 34 (52.3%) subjects had C-peptide levels >2 followed by 10 (15.4%) subjects having 0.1 to 0.6, 9 (13.8%) subjects having 1 to 2, 6 (9.2%) subjects each having 0.6 to 1 and <0.1.Conclusions: Serum C-peptide levels are useful as an index of endogenous insulin production. Low C-peptide levels need insulin treatment due to poor insulin reserve. Majority of the subjects, who had low serum C-peptide levels also had low BMI suggesting a positive correlation between C-peptide levels and BMI.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • Comparison of prophylactic dexmedetomidine and ketamine for the control of
           shivering under spinal anaesthesia

    • Authors: Rituparna Murmu, Amartya Das, Swarupa Roychoudhury
      Pages: 685 - 690
      Abstract: Background: Shivering is a common problem during neuraxial block. Thermoregulatory control gets compromised by neyraxial block and as a result the incidence of shivering can go up to 56.7%. Aim of the current investigation was to evaluate the effectiveness of prophylactic use of intravenous dexmedetomidine and ketamine for the control of shivering and to note any side-effects of the drugs used during subarachnoid block.Methods: This randomised single blind study was conducted in 151 ASA grade I and II patients. SAB was performed with 3.0mL (15 mg) of 0.5% bupivacaine heavy in all patients. Patients were randomly allocated into two groups of 75 and 76each to receive dexmedetomidine (0.5 µg/kg) in group D and ketamine (0.5 mg/kg) in group K respectively. Temperature and hemodynamic parameters were recorded at every 15mins interval. Shivering was graded from 0 to 4 according to Tsai and Chu and if grade 3 shivering occurred, the study was stopped and pethidine 25 mg was given intravenously as rescue drug.Results: 2.67% of patients in group D had shivering whereas 38.16% patients in group K experienced shivering at the 5th minute after spinal anaesthesia and it was statistically significant. However the difference in the incidence of shivering was not statistically significant between the two groups after the initial 5 minutes till the end of surgery.Conclusions: The prophylactic use of dexmedetomidine reduced incidences of shivering more effectively as compared to prophylactic use of ketamine. None of the drugs caused any untoward side effects.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • The lipid profile as a marker for predicting the severity of dengue fever

    • Authors: Ravi K., Keerthi Kumar N., Aishwarya D. Malagi
      Pages: 691 - 695
      Abstract: Background: Dengue fever is a mosquito-borne viral disease. WHO currently estimates 390 million dengue infections annually worldwide. In India between 2015 to 2020, out of 7,08,783 cases about 1,144 deaths have been reported according to National vector borne disease control programme data. This study aims at evaluating the changes in lipid profile among dengue patients with relation to severity and complications.Methods: It is a cross sectional observational study conducted on 200 patients. The dengue patients were grouped according to WHO classification. The lipid profile was estimated and changes in its parameters were correlated with severity of dengue infection.Results: The age distribution in our study was between 18 to 65 years with mean age of 28.5±9.2 years. As per WHO 2009 criteria out of 200 patients, 120 (60%) were dengue without warning signs, 68 (34%) were dengue with warning signs and 12 (6%) were severe dengue. There was decreased total cholesterol, LDL-C, HDL-C found in all forms of dengue and statistically significant (p<0.05) lowest levels noted in patients with severe disease according to ANOVA test. Correlation analysis showed a significant negative correlation between LDL-C (r=-0.716), HDL-C (r=-0.657) and total cholesterol(r=-0.621) with relation to severity of dengue (p<0.05).Conclusions: Results of this study showed serum cholesterol levels are important correlates of dengue pathophysiology and severity and these may be used as a marker for predicting the severity of dengue fever.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • Clinical profile and bacteriological eitiology in cases of acute
           exacerbation of COPD in a tertiary care: a tertiary care study

    • Authors: K. A. Sahana Neelamma, Dinesh Ragav E.
      Pages: 696 - 700
      Abstract: Background: Acute exacerbation a prominent feature of COPD, is a major entity altering the course of the disease. These exacerbations are by complex interactions between host, bacteria, viruses and environment. Many studies done earlier indicate bacteria being the major cause of these exacerbations. This study is hence done to determine the bacteriological profile, haematological profile severity and grade clinical signs and symptoms based of ‘Gold’ criteria.Methods: A cross sectional descriptive study, done on a total of 80 cases for a period of 18 months on patients admitted to Sathya Sai medical college with acute exacerbations of chronic obstructive pulmonary disease. Cases of acute exacerbation of COPD satisfying the eligibility criteria were included in the study. Clinical and microbiological parameters were noted with special preference to sputum culture and spirometry.Results: Bacteria was not present in 46 (57.5%) of the study population. Klebsiella pneumoniae was present in 12 cases (15.0%), pseudomonas aeruginosa in 6 (7.5%), staphylococcus aureus in 6 (7.5%), streptococcus pneumoniae in 5 (6.2%) and actinobacter in 5 (6.2%). 34 cases were sensitive to antibiotics (52.5%). Majority being sensitive to ceftriaxone, piperacillin and levofloxacillin.  43 cases belonged to ‘Gold’ criteria on spirometry. Hyper inflated lung, tubular heart was present in 39 (48.8%) cases. With normal chest X-ray findings in the rest.Conclusions: Bacteria causing exacerbations is different in India as compared to other studies from different countries. Klebsiella pneumonia being most common organism followed by Pseudomonas aeruginosa, Staphylococcus aureus,Streptococcus pneumoniae and actinobacter. AECOPD patients with bacteria showed sensitivity to ceftriaxone, piperacillin and levofloxacillin. Hence, these etiology with sensitivity pattern should be kept in mind for starting a patient on empirical antibiotic therapy.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • Test dosing as an alternative treatment approach in urinary tract
           infection patient with Cefoperazone allergy

    • Authors: I. Made Adi Narendranatha Komara, Ketut Suryana
      Pages: 701 - 703
      Abstract: Drug hypersensitivity reaction (DHR) is classified as adverse reaction which is based on immunologic mediated reaction. Antibiotics are the most frequently prescribed drugs given to patients to treat bacterial infections, but also cause adverse drug reactions due to hypersensitivity in patients. We present here a case of cefoperazone drug allergy in a 75 years old patient with urinary tract infection requiring the test dosing approach.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • Giant hepatic capillary hemangioma, a diagnostic dilemma: case report

    • Authors: Arkadeep Dhali, Anirban Hazra, B. Rathna Roger, Gopal Krishna Dhali, Avik Sarkar
      Pages: 704 - 707
      Abstract: Hepatic Hemangiomas (HH) are benign tumors of the liver consisting of a blood-filled cavity supplied by the hepatic artery. Most of the HH are asymptomatic and are discovered incidentally during radiological imaging of various unrelated pathology. Typical capillary hemangiomas range from a few millimeters to three centimeters and are unlikely to generate any future symptomatology. However, giant liver hemangiomas (more than 10 cm) are a very rare entity and might become symptomatic, hence requiring prompt intervention. We are reporting this case to make the readers aware of the pitfalls and radiological uncertainties while interpreting vascular lesions of the liver. We reported a case of a 21-year-old female with complaint of awareness of a mass over the right upper abdomen since a period of one year which has been gradually increasing in size. On pre-operative Contrast-Enhanced Computed Tomography, features suggestive of Fibrolamellar variant of Hepatocellular Carcinoma was found which was substantiated by biochemical investigations. However, post-operative histopathological examination revealed a capillary hemangioma.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • Hypertrophic cardiomyopathy mimicking inferior wall myocardial infarction

    • Authors: Prachi Sharma, Akshyaya Pradhan, Pravesh Vishwakarma
      Pages: 708 - 711
      Abstract: Electrocardiogram is most often the first-hand diagnostic tool with a cardiologist. Promptly identifying life threatening arrhythmias and myocardial infarction with ECG saves many lives. Quite often the electrocardiogram may have dubious findings and further testing helps arriving at the right diagnosis. Herein, we present a case of hypertrophic cardiomyopathy where the ECG mimicked inferior wall myocardial infarction along with a raised high sensitive Troponin T (hsTnT). A coronary angiogram failed to reveal any acute or chronic obstructive lesion in the coronary arteries. We discussed the varied ECG patterns in hypertrophic cardiomyopathy and causes of troponin elevation apart from myocardial infarction. We also discussed other causes of ‘pseudo-infarct’ pattern on ECG. This provides insight into a more comprehensive approach in management of each patient.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • Recurrent hepatic encephalopathy precipitated by urinary tract infection
           in patient with liver cirrhosis: a case report

    • Authors: Desak Putu Gayatri Saraswati Seputra, Luh Putu Dea Sasmita Pralambari, Ketut Suryana
      Pages: 712 - 715
      Abstract: Liver cirrhosis is a chronic liver injury marked by necro-inflammation and fibrogenesis. It is associated with several life-threatening complications. Hepatic encephalopathy remains to be one of the most debilitating complication of liver cirrhosis. The occurrence of hepatic encephalopathy may be directly related to endogenous worsening of liver function or occurs in the presence of specific precipitating factor. Infection such as urinary tract infection is a common precipitant of hepatic encephalopathy. We present a case of 66 year old female with recurrent hepatic encephalopathy in hepatitis B-related liver cirrhosis precipitated by urinary tract infection. Rapid and precise recognition of precipitating factor in hepatic encephalopathy is very substantial for implementation of preventive measures and optimal treatment plan in order to achieve better outcomes in liver cirrhosis patient.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • Disseminated hydatid disease, both above and below diaphragm: a rare
           presentation

    • Authors: Neeraj Singla, Suraj Agrawal
      Pages: 716 - 718
      Abstract: Echinococcosis is a common infectious disease in middle east countries. Human being, sheep, swine and goat are in determinate accidental hosts while dog is definitive host. Liver is most common site of involvement but simultaneous affection of another organ may occur in abdominal cavity. We present a case of hydatid disease with liver, spleen and lung involvement simultaneously which is a rare presentation.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • Computed tomography manifestation of novel corona virus pneumonia

    • Authors: Gursimran Singh Nayyar, Ashish Behera, Tejinder Pal Singh Grewal
      Pages: 719 - 720
      Abstract: Since December 2019, the outbreak of the novel corona virus has impacted nearly >60 million peoples in more than 150 countries. In this case report, we aim to define the chest computed tomography findings of 2019-novel corona virus associated with pneumonia. A 47-year-old female patient, who is known case of hypertension and diabetes, presented with chief complaints of fever and shortness of breath since, two days. Chest computed tomography was performed and showed bilateral multifocal ground glass opacities with consolidation which suggested viral pneumonia as a differential diagnosis, and subsequent 2019-novel corona virus pneumonia nucleic acid test was positive.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • Eribulin: clinical review and new perspective in advanced breast cancer

    • Authors: Arvind Gadekar
      Pages: 721 - 727
      Abstract: Eribulin is a unique microtubule inhibitor with mitotic and nonmitotic mechanisms of action. Eribulin has substantial activity in patients with pretreated (anthracycline and a taxane) advanced or metastatic breast cancer was confirmed by large-scale phase III clinical trials. We review recent pharmacological and clinical findings of eribulin use in metastatic breast cancer, particularly highlighting eribulin in difficult-to-treat and aggressive disease and safety data in specific patient populations. Furthermore, recent advancements and potential future directions for its clinical usage in our understanding are discussed. Ongoing studies of eribulin in combination with immunotherapies and established cytotoxic agents may facilitate to shape the future landscape in the treatment of breast cancer.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • Is neutrophil lymphocyte ratio a prognostic marker of acute ST elevation
           myocardial infarction'

    • Authors: Sneha Barkur Sadashiva, Chenthil K. S.
      Pages: 728 - 731
      Abstract: Several inflammatory biomarkers have been implicated in the pathogenesis of acute coronary syndromes. The present study aims to determine the prognostic value of neutrophil lymphocyte ratio (NLR) to predict the immediate outcomes in patients with acute ST elevation myocardial infarction and if any correlation exists between NLR and TIMI risk score. A review of articles published in Pubmed database on the prognostic importance of neutrophil lymphocyte ratio in determining major adverse cardiac events (MACE) such as arrhythmias, cardiogenic shock and in hospital mortality was done. NLR was found to be a reliable prognostic tool to assess the immediate outcome in ST elevation myocardial infarction (STEMI) patients.
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
  • Vagus nerve stimulation in chronic refractory epilepsy: chasing the
           cardiologist

    • Authors: Ansh Chaudhary, Bhupendra Chaudhary
      Pages: 732 - 734
      Abstract: Epilepsy the second most common chronic neurological disorder after stroke affect 0.5-2% population worldwide. Antiepileptic drugs though remain the corner stone in management of epilepsy in majority of patients but still 30% of patients continues to have seizure or experience unacceptable pharmacological side effect. Electrical stimulation of vagus nerve is an effective and promising neurophysiological treatment for patients with refractory epilepsy who are either unsuitable candidate of surgery or falls in category of surgically refractory epilepsy. 
      PubDate: 2021-04-22
      Issue No: Vol. 8, No. 5 (2021)
       
 
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