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International Journal of Advances in Medicine
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ISSN (Print) 2349-3925 - ISSN (Online) 2349-3933
Published by Medip Academy Homepage  [12 journals]
  • Characteristics of probable COVID-19 Omicron symptoms in Sanglah hospital

    • Authors: I Gusti Ayu Putu Putri Ulandari, Gede Oky Aryanthana, Ida Bagus Ngurah Rai, Ni Wayan Candrawati, Ida Ayu Jasminarti Dwi Kusumawardani, Ni Luh Putu Eka Arisanti, I Gede Ketut Sajinadiyasa, Putu Andrika, Pande Made Andikayasa
      Pages: 989 - 994
      Abstract: Background: Omicron (B.1.1.529) is a variant of COVID-19 which is first reported from Gauteng Province, South Africa in November 2021. This variant was considered the fifth variant of concern (VOC) by the world health organization (WHO) due to its much faster transmission but with milder clinical manifestations than other COVID-19 variants.Methods: This retrospective cross-sectional descriptive study was conducted in Sanglah general hospital, Denpasar, Bali in March 2022. Subjects of this study were all patients who were diagnosed with probable COVID-19 Omicron by having a positive S-gene target failure (SGTF) of a reverse transcriptase polymerase chain reaction (RT-PCR) test in Sanglah general hospital from January to February 2022. All subjects must age 18 years old or older. Data on patient characteristics and clinical manifestations were obtained from medical record data and analyzed using statistical package for service solution (SPSS) for windows version 25.Results: A total of 79 probable COVID-19 Omicron patients were analyzed in this study. Most of them were elderly who age more than 65 years old (30.4%), male (50.6%), and work as an entrepreneur (24.1%). The majority of probable COVID-19 Omicron patients were symptomatic (89.9%) with the most common clinical manifestation found was cough (54.9%). Other clinical manifestations found were shortness of breath (50.7%), fever (38.0%), fatigue (21.1%), runny nose (11.3%), sore throat (8.5%), nausea and vomit (2.8%), headache (1.4%), diarrhea (1.4%), and anosmia (1.4%).Conclusions: The clinical manifestations of probable COVID-19 Omicron patients vary but most of them were classified as mild symptoms.
      PubDate: 2022-09-23
      DOI: 10.18203/2349-3933.ijam20222394
      Issue No: Vol. 9, No. 10 (2022)
  • Dysnatremia in patients with chronic liver disease: a cross-sectional
           observational study

    • Authors: Ram Dev Chaudhary, Kirti Kumari Sah, Ram Prabodh Chaudhary
      Pages: 995 - 1000
      Abstract: Background: The clinical significance of serum sodium levels and its association with a higher rate of complications in cirrhosis is debatable. This study was done to study the serum sodium levels in chronic liver disease (CLD) patients and establish its association with the severity of disease in such patients.Methods: In this cross-sectional study, we included adult patients diagnosed with CLD and assessed their serum electrolytes. The severity of liver disease was assessed using Child Pugh score (CPS) and model for end stage liver disease (MELD). Those with serum sodium levels less than 130 mEq/l were classified as group A, 131 to 135 mEq/l as normal group B and greater or equal to 136 mEq/l as Group C.Results: In the present study, hepatic encephalopathy (p<0.01), hepatorenal syndrome (p<0.01) and coagulopathy (p<0.01) were found to occur significantly more common among patients from Group A, as compared to those in patients from group B or C. Mean MELD, CPS score and mortality was significantly higher among group A patients.Conclusions: Patients with lower serum salt levels had a substantially higher MELD score and CPS. Low blood sodium levels were linked to more severe liver disease, greater complications, and increased death. As a result, we urge that serum salt levels be checked on a frequent basis in patients with chronic liver disease. 
      PubDate: 2022-09-23
      DOI: 10.18203/2349-3933.ijam20222395
      Issue No: Vol. 9, No. 10 (2022)
  • Sociodemographic profile of patients with snakebite in Jharkhand

    • Authors: Vikram Thakur
      Pages: 1001 - 1005
      Abstract: Background: Snakebites are a very serious issue that affects people all around the world. The world health organization (WHO) has recently classified snake bites as one of the neglected tropical diseases.Methods: It was an observational, prospective and cross-sectional study conducted at the department of general medicine, (Rajendra institute of medical sciences, Ranchi). A total of 60 patients suffering with first time snakebite were selected for this study by using a purposive sampling technique. Demographic data of the 60 selected cases were recorded in pre-designed standard study forms by means of structured personal interview of patients and attendants after taking informed consent.Results: The mean age ± standard deviation of participants’ age was 37.35±13.123. There were 61.7% tribal people and 38.3% non-tribal people. Out of 60 cases included in this study, 93 % were from rural area and only 7% belonged to urban areas. The sociodemographic analysis showed that 93% patients were belonging to lower socioeconomic status and 7% were belonging to middle socioeconomic statusConclusions: The present study concluded that majority of the snakebite fresh cases in Jharkhand belonged to male gender. Majority of cases fell in the age range of 16-48 years, majority of cases belonged to tribal community and rural areas.
      PubDate: 2022-09-23
      DOI: 10.18203/2349-3933.ijam20222396
      Issue No: Vol. 9, No. 10 (2022)
  • Prevalence and outcome of hyponatremia in patients admitted with COVID-19

    • Authors: Vishranth N. Shetty, Jayaprakash B., Gurukanth Rao
      Pages: 1006 - 1011
      Abstract: Background: Hyponatremia occurs in up to 30% of patients with pneumonia and is associated with increased morbidity and mortality. The prevalence of hyponatremia associated with coronavirus disease 2019 and the impact on outcome is unknown. We aimed to identify the prevalence, and outcome of patients having hyponatremia admitted with COVID-19. Methods: This was a retrospective observational study conducted among admitted adult patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Srinivas institute of medical sciences and research centre, Mukka, Surathkal.Results: This difference in hyponatremia was statistically significant with regard to age (p<0.001), respiratory rate (p=0.002), SpO2 (p=0.029), total counts (p=0.03), CRP (p=0.005), and d-dimer (p=0.015).Conclusions: In patients with COVID-19, age, hypotension, respiratory rate, SpO2, total counts, CRP, and D-Dimer have significant correlation with hyponatremia. Also, patients with COVID-19 and hyponatremia have higher rates of mechanical ventilation and mortality.
      PubDate: 2022-09-23
      DOI: 10.18203/2349-3933.ijam20222397
      Issue No: Vol. 9, No. 10 (2022)
  • A prospective study on the relevance of crush or squash cytology of
           central nervous system lesions, in the present-day surgery

    • Authors: Roma Singh, Nipun Saproo
      Pages: 1012 - 1016
      Abstract: Background: The intra-operative cytology in the evaluation of central nervous system (CNS) lesions is a simple and rapid technique, and a useful tool. There is not much literature available on the value of crush cytology during the operation. The current study was planned to assess the feasibility and efficacy of intra-operative squash cytology as standalone method in the rapid intra-operative diagnosis of intracranial tumor.Methods: A prospective observational study was carried out in the department of neurology in collaboration with department of pathology, Medanta: The Medicity, Gurugram, for a period of six months from January 2019 to June 2019, on randomly selected 60 patients, aged: 18 years and above. Two to three tissue bits, from different sites of the mass, were taken to prepare squash cytology smear.Results: Out of 60 patients operated, 54 had neoplastic and 6 had non-neoplastic lesions. Neoplastic benign lesions were observed in 41 patients and neoplastic malignant lesions were diagnosed in 13 patients. There was 17.67% offering a wrong diagnosis on crush cytology. Out of the 13 cases of meningioma, there was a discrepancy in 3 (three) cases.Conclusions: Crush cytology is a useful adjunct to the diagnosis in neurosurgical practice. This study suggests and confirms the reliability of squash cytology, but further multicentre studies with larger number of patients may help to decide its use in clinical practice.
      PubDate: 2022-09-23
      DOI: 10.18203/2349-3933.ijam20222398
      Issue No: Vol. 9, No. 10 (2022)
  • Clinical and functional outcome of total knee arthroplasty in
           osteoarthritic patients at a tertiary care center in Kerala: a prospective

    • Authors: Navaneeth P. K., Prakash Nayar S., T. M. Jose
      Pages: 1017 - 1022
      Abstract: Background: Osteoarthritis affects the knee joint more frequently than any other joint. Osteoarthritis is a chronic joint disease that affects the older age group, women more frequently, and is associated in 90% of cases with a varus deformity of the knee. The following study was conducted to evaluate the functional outcome of total knee arthroplasty in osteoarthritis using the knee society score.Methods: The study was conducted in patients treated for osteoarthritis of the knee joint at Jubilee Mission Medical College and Research Institute, Thrissur, Kerala during the period from December 2019 to March 2022. Thirty patients diagnosed with osteoarthritis of the knee joint were taken into the study, all were undergone total knee arthroplasty. Patients were followed up at 4 weeks, 12 weeks, and 24 weeks.Results: The sample consisted of thirty osteoarthritic patients with 8 males and 22 were females. The patients' ages ranged from 45-75 years. Among these 30 patients, 14 involved the right side, and 16 involved the left knee joint. The mean pre-operative knee clinical score was 36.93 which was improved to post-operative 84.70 following total knee arthroplasty. The mean pre-operative knee functional score was 16.83 which was improved to post-operative 71.17 following total knee arthroplasty. The outcome was rated as per knee society score. We got excellent results in 25 cases (83%), good in 3 (10%), and fair in 2 patients (7%) according to knee clinical score whereas 8 excellent (27%), 16 good (53%), 5 fair (17%) and 1 poor (3%) results were found according to knee functional score.Conclusions: Total knee arthroplasty shows drastic improvement in the functional ability of the patient and the ability of the patient to get back to a pre-disease state, which is mainly because of pain-free joint movements, reflected by the improvement in the post-operative knee clinical score and knee functional score.
      PubDate: 2022-09-23
      DOI: 10.18203/2349-3933.ijam20222399
      Issue No: Vol. 9, No. 10 (2022)
  • Analysis of the relation between elevated neutrophil lymphocyte ratio, and
           erythrocyte sedimentation rate in Helicobacter pylori positive chronic
           gastritis patients

    • Authors: Priyadharshini V., Sachin K. Dhande, Gowtham Hanumanram, Sanjay Surya G. S., Gowri Shankar A.
      Pages: 1023 - 1026
      Abstract: Background: Aim of the study was to analyse the relation between elevated neutrophil lymphocyte ratio (NLR), and erythrocyte sedimentation rate (ESR) in Helicobacter pylori (H. pylori) positive chronic gastritis patients, as compared to the control group containing H. pylori negative chronic gastritis patients.Methods: Chronic gastritis patients were segregated in equal numbers based on H. pylori status. NLR was calculated, and ESR noted from the observations, comparison was done between the control and the study groups.Results: A total of 100 patients were included in the study. The 50 each from the control and study group. An observation of elevation in NLR and ESR in H. pylori positive chronic gastritis patients, as compared to the control group was seen. With an average NLR of 2.43 and 1.43, in the control and study group, respectively.Conclusions: Raise in NLR in H. pylori positive chronic gastritis patients with an associated raise in ESR suggests, the severity of the infection and the need for eradication and prevent complications. 
      PubDate: 2022-09-23
      DOI: 10.18203/2349-3933.ijam20222400
      Issue No: Vol. 9, No. 10 (2022)
  • Organophosphorus poisoning: study of evaluation of clinically relevant

    • Authors: Prashant H. Bhattad, Sneha P. Bhattad
      Pages: 1027 - 1030
      Abstract: Background: POP scale and serum cholinesterase estimation are purported to be meaningful indicators for mortality prediction in the cases of organophosphorus poisoning. The present study was undertaken to substantiate the correlation of POP scale score and serum cholinesterase levels in acute OP poisoning with mechanical ventilation requirement and mortality in our setting.Methods: Data of 150 eligible participants was collected, with POP scale and serum cholinesterase levels being assessed during initial presentation in each of them. Clinical course of the cases was monitored and documented.Results: The observed case fatality rate was 32.7%. POP scale scoring revealed 30 out of 75 patients to be from moderate group and 19 out of 22 patients to be from severe group. Forty nine out of 75 in moderate group & all patients in severe group required ventilator support. With respect to Serum Cholinesterase level; 20 out of 23 and 29 out of 77 patients died in the severe & moderate poisoning categories respectively. Forty eight out of 77 in moderate poisoning and all patients in severe poisoning required ventilator support.Conclusions: POP scale scoring and serum Cholinesterase level assessments are clinically relevant indicators in acute OP poisoning cases and are of great utility towards assessment of mechanical ventilation requirement and mortality prediction.
      PubDate: 2022-09-23
      DOI: 10.18203/2349-3933.ijam20222401
      Issue No: Vol. 9, No. 10 (2022)
  • A unique formulation of sodium bicarbonate buffered pantoprazole powder
           for oral suspension: perspectives from an active controlled cross-over
           bioequivalence study

    • Authors: Virukalpatti Gopalratnam Mohan Prasad, Anindita Chatterjee, Radhakrishna Vaddem, Akhilesh D. Sharma
      Pages: 1031 - 1038
      Abstract: Background: The aim was determining bioequivalence between pantoprazole buffered powder for oral suspension and pantoprazole enteric coated tablets under fasting conditions in healthy volunteers.Methods: In randomized cross-over study, participants were administered a single oral dose of pantoprazole powder as suspension 40 mg (sodium bicarbonate as buffer) or one enteric coated tablet of pantoprazole 40 mg, with 240±2 ml of water as per the randomization schedule in each study period. Blood samples were collected at pre-dose and at 0.33, 0.67, 1, 1.33, 1.67, 2, 2.33, 2.67, 3, 3.33, 3.67, 4, 4.5, 5, 5.5, 6, 7, 8, 9, 10, 12-, 14-, 16- and 24-hours post-dose. Plasma concentration of pantoprazole was determined with LC-MS and various pharmacokinetic parameters like Cmax, AUC0-t, AUC0-inf were compared between test and reference groups.Results: Amongst 41 samples, Cmax (3752.4±1084.6 vs. 3521.7±1099.5 ng/ml) was achieved higher in less Tmax time (1 (0.28) vs. 2.3 (0.83) hrs) with test drug as compared to reference drug. The ratios of geometric least square mean and its 90% confidence interval on log transformed Cmax, AUC0-t and AUC0-inf for pantoprazole fall within the acceptance criteria of 80% to 125%. No adverse events were observed.Conclusions: Pantoprazole powder for oral suspension 40 mg (sodium bicarbonate as buffer) was well tolerated and bioequivalent with pantoprazole enteric coated tablets IP 40 mg in terms of rate and extent of absorption under fasting conditions. At same time, the shift in AUC to the left with reduction in Tmax with the new formulation is suggestive of faster rate of absorption.
      PubDate: 2022-09-23
      DOI: 10.18203/2349-3933.ijam20222402
      Issue No: Vol. 9, No. 10 (2022)
  • A comparative study of sagittal abdominal diameter and other
           anthropometric indices of obesity in adults with family history of
           cardiovascular risk factors

    • Authors: Nishmita R., Ravi K.
      Pages: 1039 - 1045
      Abstract: Background: Obesity is evolving into a modern day epidemic in India. Visceral Adipose Tissue is the main culprit, being the metabolically active component that is responsible for the cardiovascular risk factors. The day-to-day anthropometric indices fail to take body composition and distribution into account and hence miss a chance at early detection. Family history plays an important role by serving as a genetic link in the transmission of risk factors. There is a need for vigorous screening techniques which are clinically plausible for an early diagnosis of visceral adiposity in individuals predisposed to the numerous risks caused by its accumulation. Sagittal abdominal diameter is a useful tool in measuring the visceral adipose tissue clinically and in the current study; a comparison was done between SAD and already existing anthropometric indices.Methods: The study was done on 223 subjects in Bangalore during the period of November 2015 to May 2017.Among the subjects studied, 54.7% were Male and 45.3% were female. When compared to BMI, WC and WHR, SAD correlated better with total cholesterol, fasting blood sugar, post prandial blood sugar and HbA1c.Results: The mean SAD was more in people with a combined history of DM and HTN than in individuals with history of either DM or HTN alone.Conclusions: We could conclude that Sagittal Abdominal Diameter is comparable to Body Mass Index, but it correlates better with metabolic risk profile of an individual than BMI, WC and WHR. 
      PubDate: 2022-09-23
      DOI: 10.18203/2349-3933.ijam20222403
      Issue No: Vol. 9, No. 10 (2022)
  • Signaling pathway of vitamin D, vitamin D receptor and autophagy in
           infection: a systematic review

    • Authors: Katarina Dewi Sartika, Anak Agung Ayu Yuli Gayatri
      Pages: 1046 - 1052
      Abstract: Vitamin D has an immunomodulatory effect that increases antimicrobial responses in macrophages by inducing antibacterial proteins, stimulating autophagy, and increasing autophagosome activity through various signaling pathway. This review emphasizes the several signalling pathway of vitamin D and vitamin D receptor (VDR) to induce autophagy in infection and its role in infectious disease. This study was performed based on PRISMA guidelines. Literature search conducted from Cochrane, PubMed, Science Direct and ProQuest using the terms "vitamin D" and “VDR” and "autophagy in infection". The inclusion criteria were original article, publication in English, published in 2012-2022, investigating vit D, VDR pathway and autophagy mechanism in infection. Twelves studies met our criteria. Despite numerous autophagy signalling in vitamin D and VDR, there are 2 main mechanisms vit D induces autophagy; increase expression LL-37/cathelicidin, CAMP, DEFB4 and upregulated autophagy genes (LC3B, ATG5, BECN1, MMPI, ATG16L1, PR39). While, vit D induced autophagy via expression CYP27B1 and VDR in co-infection HIV and tuberculosis. In sepsis, artesunate relates with VDR to enhance autophagy via NF-κB. Similarly, vitamin D could enhance cell resistance to Aspergillus fumigatus after modulating NF-κB. Vitamin D3 through PDIA3-STAT3-MCOLN3-Ca2+ axis and CAMP/LL-37 (cathelicidin antimicrobial peptide) are mediator for autophagy induction in H. pylori. Upregulated autophagy gene activity through vit D/VDR appears as new target therapy for infection in future.
      PubDate: 2022-09-23
      DOI: 10.18203/2349-3933.ijam20222352
      Issue No: Vol. 9, No. 10 (2022)
  • A neglected cause of anaemia: hereditary hemorrhagic telangiectasia

    • Authors: Sadhana Rajasekhar, Rameshwar R., Ramkumar M., Jagadeesan M., Magesh Kumar S.
      Pages: 1053 - 1056
      Abstract: Hereditary hemorrhagic telangiectasia (HHT) or Osler-Weber-Rendu syndrome is an inherited disorder characterized by vascular dysplasias leading to hemorrhages. If affects approximately 1 in 10,000 Caucasian people. The most common presentation is chronic and recurrent epistaxis whereas bleeding from other sites can lead to life-threatening complications.
      PubDate: 2022-09-23
      DOI: 10.18203/2349-3933.ijam20222404
      Issue No: Vol. 9, No. 10 (2022)
  • Hepatitis C associated membranoproliferative glomerulonephritis treated
           with directly acting antivirals for hepatitis C

    • Authors: Jasmeen Chahal, Harleen Sood, Aman Bharti
      Pages: 1057 - 1059
      Abstract: Hepatitis C virus (HCV) infection affects kidneys with different histopathological patterns on kidney biopsy, which commonly include membranoproliferative glomerulonephritis (MPGN) pattern with mixed cryoglobulinemia (CG), thrombotic microangiopathy, membranous nephropathy and small to medium vessel vasculitis. Type 1 MPGN associated with type II mixed CG is the most common glomerulopathy associated with hepatitis C infection. Treatment of these glomerulopathies and cryoglobulinemic renal disease associated with HCV infection includes antiviral therapy for HCV, B-cell depletion therapy for prevention of immune complexes and cryoglobulins or nonspecific immunosuppressive therapy. We describe a patient who presented to us with HCV associated MPGN type 1 with cryogloblinemia and detectable HCV RNA, who recovered completely with directly acting antiviral agents (DAA) alone without immunosuppression.
      PubDate: 2022-09-23
      DOI: 10.18203/2349-3933.ijam20222405
      Issue No: Vol. 9, No. 10 (2022)
  • Challenges in diagnosis and management of acquired factor V inhibitors

    • Authors: Ruchi Gupta, Dinesh Chandra, Sanjeevan Sharma, Priyanka Mishra
      Pages: 1060 - 1063
      Abstract: Inhibitors to factor V is a rare phenomenon with varied clinical presentation ranging from asymptomatic states to life-threatening bleeds. They are known to be associated with exposure to bovine thrombin, drugs, autoimmune diseases and malignancies. Establishing the diagnosis of FV inhibitors is challenging and the presence of lupus-like properties of the inhibitor can further complicate the diagnosis. Here we document an unusual case of an asymptomatic elderly female posted for pacemaker implantation and incidentally, the laboratory workup revealed a disproportionately abnormal coagulation screen. The intricacies in the diagnosis and management are discussed along with a brief review of the literature. An awareness of the diverse manifestations of this underrecognized disorder and difficulties in management is essential for medical practitioners, particularly in patients with idiopathic severe bleeding diathesis.
      PubDate: 2022-09-23
      DOI: 10.18203/2349-3933.ijam20222406
      Issue No: Vol. 9, No. 10 (2022)
  • Adult hemophagocytic lymphohistiocytosis triggered by disseminated
           tuberculosis and Klebsiella pneumoniae co-infection in an immunocompetent
           individual-a diagnostic challenge

    • Authors: Alekya Kondam, Mukhyaprana Prabhu, Shreesha N., Madhavan Vidarshan, Sindhura Lakshmi
      Pages: 1064 - 1068
      Abstract: Here in we report a diagnostically challenging case of adult hemophagocytic lymphohistiocytosis (HLH) triggered by disseminated tuberculosis and Klebsiella pneumoniae co-infection in an immunocompetent Individual. She was a young female presented with complaints of fever, abdominal pain and jaundice. Her evaluation showed cytopenias, hyperbilirubinemia, transaminitis, and hepatosplenomegaly. She progressed to have multi-organ involvement in the form of myocarditis, pleural effusion. Provisional diagnosis of fever with unknown origin and sepsis with multiple-organ dysfunction was made and evaluated for the same. Rapid clinical deterioration with evaluation for sepsis being normal prompted for considering HLH in the differential diagnoses, bone marrow and other criteria have been met resulting in confirmation of the same. Without prior past or family history of HLH, secondary HLH was suspected and substantial evaluation for possible triggers was made, and concomitantly immune suppression was started with corticosteroids. Disseminated tuberculosis was diagnosed and concomitantly Klebsiella pneumoniae was isolated from the bronchioalveolar lavage cultures. As there was no significant immune response culmination, intravenous immunoglobulins were added along with the treatment for possible triggers-tuberculosis and Klebsiella simultaneously. Patient showed significant improvement with this approach. In conclusion management of HLH is different from conventional sepsis and the treatment for each cause of HLH also varies. Furthermore, this case report stresses on the importance for initiating treatment rapidly and tailored approach of management therapy for each case.
      PubDate: 2022-09-23
      DOI: 10.18203/2349-3933.ijam20222407
      Issue No: Vol. 9, No. 10 (2022)
  • An atypical presentation of scrub typhus

    • Authors: Vishranth N. Shetty, Gurukanth Rao, Jayaprakash B.
      Pages: 1069 - 1071
      Abstract: Scrub typhus is caused by Orientia tsutsugamushi, characterised by focal or disseminated vasculitis and perivasculitis which may involve the lungs, heart, liver, spleen and central nervous system. The clinical picture and severity of the symptoms varies widely. The neurological manifestations of scrub typhus are diverse. Meningoencephalitis is classical manifestation of scrub typhus but cerebellitis, cranial nerve palsies, plexopathy, transverse myelitis, neuroleptic malignant syndrome and Guillain-Barre syndrome are other manifestations reported in literature. The availability of literature on the neurological manifestations of scrub typhus is limited to case reports mainly. This article shows a case report of neurological manifestations of scrub typhus. 
      PubDate: 2022-09-23
      DOI: 10.18203/2349-3933.ijam20222408
      Issue No: Vol. 9, No. 10 (2022)
  • Congenital cholesteatoma: a review

    • Authors: Santosh Kumar Swain
      Pages: 1072 - 1077
      Abstract: Congenital cholesteatoma (CC) is a whitish mass lesion found in the middle ear cleft behind the intact tympanic membrane in early life. It is a relatively uncommon disease and shows its growth and extension over a period of time. CC is evidenced with no prior history of tympanic membrane perforation, otorrhea, previous otologic procedures, normal pars tensa, and pars flaccida. The etiopathogenesis of CC is still controversial; however, the epithelial cell rest theory is the most commonly accepted one. The most common sites of CC are the anterior-superior and posterior-superior quadrants of the tympanic cavity. The most common clinical presentation of CC is conductive hearing loss. Early detection and intervention are needed to avoid the complications of CC. The treatment of choice in CC is still surgical. The frequency of recurrence seems to be lower in patients with CC than in acquired cholesteatoma. Rapid progression of the CC may occur in older children and the recurrence has been associated with advanced progression of the cholesteatoma. There are very few reports for CC available in the medical literature This objective of this review article is to discuss the prevalence, etiopathology, clinical manifestations, diagnosis, and treatment.
      PubDate: 2022-09-23
      DOI: 10.18203/2349-3933.ijam20222409
      Issue No: Vol. 9, No. 10 (2022)
  • Emergence of monkeypox virus: a public health threat

    • Authors: Alla Sai Santhosha Mrudula, Deekshitha Alla, Seepana Muneesh, Thippana Sireesha, Baddi Durga Bhavani, Kanakam Vandana, Gopu Chaturya
      Pages: 1078 - 1080
      Abstract: The human monkeypox virus is a zoonotic infection that is closely related to smallpox virus. It more commonly exists in forested habitats of western and central Africa. In the recent outbreak of the monkeypox virus, the total number of positive cases escalated to 32,760 and 12 deaths were reported so far. With rodents being primary reservoirs, the virus spreads through animals, fomites, respiratory droplets and, direct contact. It typically presents as a vesiculo-pustular rash along with fever, headache, malaise and chills. Taking this clinical spectrum into consideration, differential diagnosis to rule out smallpox is very much significant. Though there are no licensed therapies for monkeypox, treatment regimens and vaccination for small pox can also be used for monkeypox. Effective prevention relies on avoiding contact and limiting respiratory exposure with the infected patients by following standard precautions. This review article gives an insight into epidemiology, clinical presentation, diagnosis, transmission, vaccination, and prevention of infection.
      PubDate: 2022-09-23
      DOI: 10.18203/2349-3933.ijam20222410
      Issue No: Vol. 9, No. 10 (2022)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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