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Giant Cell Fibroblastoma of Hand in an Adult: An Uncommon Presentation 成人手部巨细胞成纤维细胞瘤:一种不常见的表现
Pub Date : 2023-08-31 DOI: 10.58999/cijmr.v2i02.23
Akshay Surana, S. Nandedkar, Virendra K. Mehta
Giant cell fibroblastoma is a rare intermediate grade fibrohistiocytic tumour of childhood and even rarer in adults. It is seen in first decade of life. It is known for its recurrence, but its metastasis has never been reported. Giant cell fibroblastoma requires attention as it was previously misdiagnosed as sarcoma.  So histology  is mandatory and remains the gold standard for its diagnosis. We present a case of 21 year old female who presented with complains of painless lesion over the dorsal aspect of left hand.
巨细胞成纤维细胞瘤是一种罕见的儿童中级纤维组织细胞瘤,在成人中更为罕见。它多见于出生后的头十年。它以复发著称,但从未有转移的报道。巨细胞成纤维细胞瘤以前曾被误诊为肉瘤,因此需要引起重视。 因此,组织学检查是必须的,也是诊断的金标准。我们报告了一例 21 岁女性的病例,她主诉左手背出现无痛性病变。
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引用次数: 0
Measurement and Clinical Usefulness of Delta Bilirubin in Liver Disease 肝脏疾病中德尔塔胆红素的测量和临床用途
Pub Date : 2023-08-31 DOI: 10.58999/cijmr.v2i02.116
Anurag Kesarwani, Prashant Nichat, Nikhil Rajak, G. G. Potey
Delta bilirubin is albumin bound conjugated bilirubin that can be calculated by formula [Total bilirubin - (conjugated + unconjugated bilirubin)]. Newer technology like dry chemistry provide conjugated and unconjugated bilirubin fraction which is more specific and informative than direct and indirect bilirubin by conventional method in which only approximate values of conjugated bilirubin can be measured. In cholestasis conjugated bilirubin combines with albumin non enzymatically and form delta bilirubin in circulation and remains for long duration. The present review describes the usefulness of delta bilirubin in cholestasis, chronicity of liver diseases, in pediatric jaundice, transplant rejection and other jaundice condition.clinical correlation of delta bilirubin in all conditions have been summarized and their future perspectives are discussed.
德尔塔胆红素是与白蛋白结合的结合胆红素,其计算公式为[总胆红素-(结合胆红素+非结合胆红素)]。干化学等新技术可提供结合胆红素和非结合胆红素的分数,这比传统方法中的直接胆红素和间接胆红素更具特异性和信息量,因为传统方法只能测量出结合胆红素的近似值。胆汁淤积时,结合胆红素与白蛋白非酶结合,在血液循环中形成δ胆红素,并长期存在。本综述介绍了δ胆红素在胆汁淤积症、慢性肝病、小儿黄疸、移植排斥反应和其他黄疸病症中的作用,总结了δ胆红素在所有病症中的临床相关性,并讨论了其未来前景。
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引用次数: 0
What are the Major Research Methodology Steps under a Clinical Study? 临床研究的主要研究方法步骤是什么?
Pub Date : 2023-08-31 DOI: 10.58999/cijmr.v2i02.120
S. N. Dwivedi
Keeping in view of the need of quality evidence for public health care/ clinical practice, along with focus on adopting a culture of strong morality at every level of a research work, it is needed to follow each of the major steps required under research methodology for a clinical study. Accordingly the aim of the present write-up is to briefly list major steps under research methodology so that a reader can easily be aware about them at a glance, and choose and follow all relevant/ applicable steps in their clinical study. If feasible, except two steps (sample size & scales of measurements) which are already published in earlier issues of this journal, each of the remaining major steps may be elaborated separately and published in the ensuing issues of the journal.
鉴于公共医疗保健/临床实践需要高质量的证据,同时注重在研究工作的各个环节采用道德文化,因此临床研究需要遵循研究方法学要求的每个主要步骤。因此,本文旨在简要列出研究方法的主要步骤,以便读者一目了然,并在临床研究中选择和遵循所有相关/适用的步骤。如果可行的话,除了两个步骤(样本量和测量尺度)已在本刊前几期发表外,其余主要步骤可分别阐述,并在本刊随后几期发表。
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引用次数: 0
A Case Report of Mucormycosis in a Diabetic Patient and an Approach to its Management in a Tertiary Care Centre of Central India 印度中部一家三级医疗中心的糖尿病患者粘孢子菌病病例报告及其治疗方法
Pub Date : 2023-08-31 DOI: 10.58999/cijmr.v2i02.80
Manoj Gupta, S. Vaidya
Background: Mucormycosis is one of the most rapidly progressing and fulminant forms of fungal infection which  usually begins in the nose and paranasal sinuses following inhalation of fungal spores. Case details:This is a case report of a 65 year old male ,admitted in our hospital with long history of Type 2 diabetes  with pain and swelling on right side of nose  and signs and symptoms indicating Rhino-Orbital-Cerebral-mucormycosis.  Methodology:The level of involvement like nasal cavity, septum, turbinates, sinuses, palate, orbit involvement was noted and the protocol of medical and surgical management was decided in accordance to that. Post surgery KOH mount and HPE report after every debridement,CT and MRI findings were the mainstay. Conclusion : We here report a case of mucormycosis in diabetic patient shows aggressive and alarming mortality,which can be reduced by rapid diagnosis, surgical debridment and administration of drugs like amphotericin B.
背景:粘孢子菌病是真菌感染中进展最快、最严重的一种,通常在吸入真菌孢子后从鼻腔和副鼻窦开始发病。 病例详情:这是一份病例报告,患者为一名 65 岁男性,长期患有 2 型糖尿病,因右侧鼻部疼痛和肿胀以及鼻-眶-脑-粘液瘤病的症状和体征入住我院。 方法:注意鼻腔、鼻中隔、鼻甲、鼻窦、上颚和眼眶的受累程度,并根据受累程度决定药物和手术治疗方案。每次清创、CT 和核磁共振成像结果都是手术后 KOH 切片和 HPE 报告的主要依据。 结论:我们在此报告了一例糖尿病患者的粘液瘤病,该病具有侵袭性和惊人的死亡率,通过快速诊断、手术清创和使用两性霉素 B 等药物可以降低死亡率。
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引用次数: 0
Mullerian Duct Anomaly: Two Patients in Adolescent Age in C. R. Gardi Hospital 穆勒氏管异常:C. R. Gardi 医院的两名青少年患者
Pub Date : 2023-08-31 DOI: 10.58999/cijmr.v2i02.66
Aditi Vashistha, Suchika Agrawal, Surbhi Patidar, P. K. Roy, Case Reports
Clinical manifestations of Mullerian duct abnormalities vary greatly and can range from isolated abnormalities of a single reproductive organ to multiorgan aplasia. An early and precise diagnosis is essential because untreated symptoms may result in pelvic endometriosis, retrograde tubal reflux, and infertility. MRI and ultrasonography are the imaging modality that accurately helps in the diagnosis of mullerian duct anomalies. Two interesting cases came to C. R. Gardi OPD with Mullerian duct anomalies. The first case came with dysmenorrhea and a lower abdominal palpable mass upto 14 wk size was present, which was diagnosed to be bicornuate uterus, obstructed hemivagina. It is a diagnostic dilemma because menses were regular. Another case came with severe cyclic dysmenorrhea and was found to be a hematometra in the non-communicating rudimentary horn on the left side.
穆勒氏管异常的临床表现差异很大,从单个生殖器官的孤立异常到多器官增生都有可能。由于不及时治疗可能会导致盆腔子宫内膜异位症、输卵管逆行返流和不孕症,因此早期准确诊断至关重要。核磁共振成像和超声波检查是准确帮助诊断穆勒管异常的成像方式。C. R. Gardi 手术室接诊了两个有趣的穆勒氏管异常病例。第一个病例伴有痛经,下腹部可触及14周大小的肿块,被诊断为双角子宫、血道阻塞。由于月经规律,这是一个诊断难题。另一个病例伴有严重的周期性痛经,被发现是左侧不沟通的先天性宫角有血子宫。
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引用次数: 0
Drug – Alcohol (Ethyl Alcohol) Interactions 药物与酒精(乙醇)的相互作用
Pub Date : 2023-08-31 DOI: 10.58999/cijmr.v2i02.115
S. P. Dhaneria
Alcohol is the oldest recreational substance, and its consumption is increasing all over the world as it produces a pleasurable effect and also it allows people to relax and unwind. A large number of over the counter and prescription medicine interacts with Alcohol by Pharmacokinetic and/or Pharmacodynamic mechanisms. Alcohol consumption with drugs having CNS depressant property may lead to marked impairment in psychomotor performance and making the person’s injury prone. Alcohol consumption increases the systemic toxicity and organ dysfunction caused by certain drugs. Alcohol consumption may cause unpleasant manifestations with a few drugs/substances (didisulfiram-likeeaction). Alcohol may reduce the therapeutic effect of a few drugs. Awareness about the various interactions of Alcohol with drugs/medicines/food/herbals/occupational agents will ensure the safety of the people consuming Alcohol and may help the physician in clinical decision-making.
酒精是历史最悠久的娱乐性物质,由于它能产生愉悦的效果,还能让人放松和解压,其消费量在全世界不断增加。大量非处方药和处方药会通过药代动力学和/或药效学机制与酒精发生相互作用。酒精与具有中枢神经系统抑制特性的药物一起服用,可能会导致精神运动能力明显减弱,使人容易受伤。饮酒会增加某些药物的全身毒性和器官功能障碍。饮酒可能会使少数药物/物质产生不良反应(类似地索硫铵的作用)。酒精可能会降低少数药物的治疗效果。了解酒精与药物/药品/食品/草药/职业制剂的各种相互作用,可确保饮酒者的安全,并有助于医生做出临床决策。
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引用次数: 0
Association and Correlation of Laboratory Investigation Values and Disease Outcome among COVID-19 Patients in a Tertiary Care Medical College in India 印度某三级医疗学院COVID-19患者实验室调查值与疾病转归的相关性
Pub Date : 2023-02-09 DOI: 10.58999/cijmr.v1i03.45
A. Tripathi, Ashish Sharma, V. Patidar, Babu Lal Bamboriya, Amit Dubey, Ajay Adhikari, H. Jain, Tejaswini Dwivedi
Background- COVID-19 and post-COVID sequel are a persistent challenge in India. We as tertiary careinstitute, managed much of the COVID-19 cases. We have studied associations between COVID-19disease outcomes and common lab investigation values to ascertain their association by analyzing 467 RTPCR confirmed COVID-19 cases.Methods- Records of 467 RTPCR confirmed COVID-19 admitted in ICU were analyzed. Descriptivedata about routine investigation taking all admitted patients as a single cohort were analyzed. Further, patients were divided into 2 groups, those requiring ventilatory support and those not requiring ventilatory support, independent sample t-test was applied to ascertain differences in mean values of investigation in these groups. Pts were also divided according to the severity in chest X-ray films by using RALES score as criteria. A hierarchical regression analysis study was done and model was developed.Results- The descriptive data of investigation values mean median mode and CI was calculated forall admitted patients as single cohort. Among cohort of patients requiring ventilatory support vs notrequiring ventilatory support, an independent t-sample test indicated significant differences of meanvalues (2-tailed p-value < 0.05) among these groups, differences in pulse, SpO2, total leucocyte count, neutrophil%, lymphocyte%, neutrophil to lymphocyte ratio (NLR), serum sodium (S.Na), serumpotassium (S.K), serum urea, serum creatinine, serum ferritin, serum lactate dehydrogenase (S LDH),d-dimer, C reactive protein (CRP), serum glutamic oxaloacetic transaminase (SGOT), chest X-rayradiographic assessment of lung edema (RALE) score. Among the cohort divided on chest X-ray severity on RALES score, we applied hierarchical regression analysis, further 5 tests values were found to pedict adverse RALES outcome more closely, those were SpO2, CRP, LDH, ferritin, RBS on admission with p-values and beta coefficient significant.Conclusion- There is significant association with specific laboratory investigations and adverse disease outcome on COVID-19 pneumonia.
背景- 2019冠状病毒病及其后的后续事件是印度面临的持续挑战。作为三级医疗机构,我们处理了许多COVID-19病例。我们通过分析467例RTPCR确诊的COVID-19病例,研究了COVID-19疾病结局与常见实验室调查值之间的相关性,以确定两者之间的相关性。方法对ICU收治的467例经RTPCR确诊的COVID-19病例进行分析。将所有住院患者作为单一队列进行常规调查的描述性数据分析。进一步将患者分为需要呼吸支持组和不需要呼吸支持组两组,采用独立样本t检验确定两组调查平均值的差异。以RALES评分为标准,根据胸片的严重程度进行分组。进行了层次回归分析研究,建立了模型。结果-将所有住院患者作为单一队列计算调查值、平均中位数模式和CI的描述性数据。在需要通气支持与不需要通气支持的患者队列中,独立t样本检验显示,两组患者的平均值(2尾p值< 0.05)、脉搏、SpO2、白细胞总数、中性粒细胞%、淋巴细胞%、中性粒细胞/淋巴细胞比值(NLR)、血清钠(S.Na)、血清钾(S.K)、血清尿素、血清肌酐、血清铁蛋白、血清乳酸脱氢酶(S LDH)、d-二聚体、C反应蛋白(CRP)、血清谷草转氨酶(SGOT)、胸片评估肺水肿(RALE)评分。在以胸片严重程度划分RALES评分的队列中,我们应用分层回归分析,发现入院时SpO2、CRP、LDH、铁蛋白、RBS 5个检测值与RALES不良结局更接近,p值和β系数均显著。结论-特定实验室调查与COVID-19肺炎的不良疾病转归之间存在显著关联。
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引用次数: 0
Post COVID-19 Vaccine-associated Complications COVID-19疫苗相关并发症
Pub Date : 2023-02-09 DOI: 10.58999/cijmr.v1i03.35
A. Tripathi, Ashish Sharma, Dr Himanshu Jain, Chandrakant Salve, Dr Aayush Malik, Tejaswini Dwivedi
The COVID-19 pandemic is being fought against worldwide; the major weapon against this pandemichas been the vaccine against it. There are reports of neurological complications and sequelae afterCOVID-19 vaccinations, some cases with ChAdOx1 nCov-19 is adenovirus vector-based vaccines. InIndia vaccination program against covid19 is using this vaccine by this vaccine. Reports of vaccineassociated side effects have emerged, which are rare but serious. This case series presents a few such cases reported in our hospitals:- RD Gardi Medical college (CR Gardi Hospital, Ujjain) and Charitable trust Hospital, Ujjain.
全球正在抗击新冠肺炎大流行;对付这种大流行病的主要武器是疫苗。有报道称,covid -19疫苗接种后出现神经系统并发症和后遗症,部分病例接种的是ChAdOx1 nCov-19腺病毒载体疫苗。在印度,针对covid - 19的疫苗接种计划正在使用这种疫苗。疫苗相关副作用的报道已经出现,虽然罕见但很严重。本病例系列介绍了在我们医院报告的一些此类病例:RD加尔迪医学院(乌贾因CR加尔迪医院)和乌贾因慈善信托医院。
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引用次数: 0
Small Cell Neuroendocrine Carcinoma of Cervix: A Rare Case Report 宫颈小细胞神经内分泌癌1例报告
Pub Date : 2023-02-09 DOI: 10.58999/cijmr.v1i03.73
Kavita Jain, P. K. Roy
Neuroendocrine neoplasms (NEN) are derived from endocrine cells and are very rarely seen in gynecological practice. Here we report a case of small cell neuroendocrine carcinoma (SCNEC) of cervix in a 45 year old married female who presented with history of menorrhagia. On gynecological examination, she had bulky uterus with a palpable non tender, hard nodule on posterior wall of cervix. Ultrasonogram of pelvis was reported as bulky ? adenomyotic uterus with 2.7x2.4x1.0cm well defined collection in fundal region of endometrium. She underwent total abdominal hysterectomy for abnormal uterine bleeding. Histopathology with immunohistochemical markers was reported as small cell neuroendocrine carcinoma (SCNEC) of cervix. This case is reported here for its rarity.
神经内分泌肿瘤(NEN)起源于内分泌细胞,在妇科实践中非常罕见。在这里,我们报告一例宫颈小细胞神经内分泌癌(SCNEC)在一个45岁的已婚女性谁提出了月经过多的历史。妇科检查发现子宫肥大,宫颈后壁有可触及的无痛硬结节。骨盆超声检查报告肥大?子宫腺肌病,子宫内膜底区2.7x2.4x1.0cm轮廓清晰。她因子宫异常出血接受了全腹子宫切除术。经免疫组织化学标记的组织病理学报告为宫颈小细胞神经内分泌癌(SCNEC)。此病例因罕见而在此报道。
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引用次数: 0
How to Deal with Sample Size Exploration and its reporting in Clinical Research? 临床研究中如何处理样本量的探索和报告?
Pub Date : 2023-02-09 DOI: 10.58999/cijmr.v1i03.65
S. Dwivedi
The minimum sample size required to answer a specific research question is unavoidable regardlessof study designs, more pertinent in case of randomized controlled trials. Sample size exploration isnot required in many situations, including a pilot study; it is simply decided as feasible or a rule ofthumb. However, in situations, including a conclusive study like the third and final phase of drugdevelopment, it becomes mandatory to ensure optimal power as well as level of confidence to thestudy. The present write-up aims to address various issues related to sample size considerations forclinical studies in a non-statistical language, focusing on making it easily understandable by medicalresearchers.
无论研究设计如何,回答特定研究问题所需的最小样本量都是不可避免的,在随机对照试验中更为相关。在许多情况下,不需要样本量的探索,包括试点研究;它只是被认为是可行的或经验法则。然而,在某些情况下,包括像药物开发的第三和最后阶段这样的结论性研究,必须确保研究的最佳功效和信心水平。本文旨在用一种非统计语言解决与临床研究的样本量考虑相关的各种问题,重点是使医学研究人员易于理解。
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引用次数: 0
期刊
Central India Journal of Medical Research
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