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Chest CT imaging as an essential tool to detect the severity of COVID-19 infection in patients and its correlation with RT-PCR 胸部CT成像作为检测患者COVID-19感染严重程度的重要工具及其与RT-PCR的相关性
Pub Date : 2022-09-15 DOI: 10.18231/j.ijfcm.2022.022
Anand Sorikunte Huchappa, Vineetha Kolar Venkataravanappa, Kambathanahalli Paramashivaiah Suresh Babu
Since its emergence in 2019, RT-PCR is a standard test for the detection of SARS-CoV-2 viral infection (COVID-19). Chest-CT scans are the preferred most common routine test to determine the spread and severity of the disease. The present study aims to demonstrate a comparative analysis of chest CT and RT-PCR as diagnostic tests for COVID-19 detection.In this prospective single-center study a total of 979 patients (Male= 614, female= 365) from Tumkur, Karnataka (India) who were suspected of novel coronavirus infection underwent both chest CT and RT-PCR assay.Patients with positive RT-PCR and abnormalities in chest CT images were identified. The patients with negative RT-PCR and positive chest-CT images and vice versa were screened for the accuracy of both techniques. Out of 979 patients, 674 (68.85%) patients had positive CT index scores, whereas 613 (62.61%) patients had positive RT-PCR tests. Most of the patients (47%) were from the age group 36-55 years with most of the population having hypertension (8.27%) and diabetes (6.44%). Corad score revealed 88.36% of patients (865) with high infection. In patients with negative RT-PCR reports (31.15%; 305/979), a positive CT index was observed in 7.25% of patients indicating higher sensitivity to this technique. A chest CT scan is superior in sensitivity for the detection of COVID-19 than that of RT-PCR. The CT scan can be used asa confirmatory diagnostic test for COVID-19 suspects whose RT-PCR test results are negative.
自2019年出现以来,RT-PCR是检测SARS-CoV-2病毒感染(COVID-19)的标准检测方法。胸部ct扫描是确定疾病扩散和严重程度的首选常规检查。本研究旨在对胸部CT和RT-PCR作为COVID-19检测诊断方法进行对比分析。在这项前瞻性单中心研究中,来自印度卡纳塔克邦图姆库尔的979例疑似新型冠状病毒感染的患者(男614例,女365例)接受了胸部CT和RT-PCR检测。鉴定出RT-PCR阳性、胸部CT影像异常的患者。筛选RT-PCR阴性和胸部ct阳性的患者,反之亦然,以确定两种技术的准确性。979例患者中,674例(68.85%)患者CT指数评分阳性,613例(62.61%)患者RT-PCR检测阳性。大多数患者(47%)年龄在36-55岁之间,大多数患者患有高血压(8.27%)和糖尿病(6.44%)。Corad评分显示88.36%(865例)患者为高感染。在RT-PCR报告阴性的患者中(31.15%;305/979), 7.25%的患者CT指数呈阳性,表明该技术敏感性较高。胸部CT扫描检测COVID-19的敏感性优于RT-PCR。对于RT-PCR阴性的疑似患者,CT扫描可作为确诊性诊断检查。
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引用次数: 0
Traumatic rupture of heart due to blunt trauma to chest: an autopsy case report with review of literature 胸部钝性创伤致外伤性心脏破裂:一例尸检报告并文献复习
Pub Date : 2022-09-15 DOI: 10.18231/j.ijfcm.2022.028
P. S. Ghormade, Kavyesh Sahu, S. Akhade
Road traffic accidents (RTA) result in the deaths of approximately 1.3 million people around the world each year; among them, more than half of all road traffic deaths and injuries involve vulnerable road users, such as cyclists, motorcyclists, along with pillion riders and pedestrians. Blunt cardiac trauma (BCT) often results from high-impact mechanisms caused by motorcycle crashes, motor vehicle accidents, fall injuries, and crush injuries. Thoracic injuries, causing a significant injury to the myocardium, account for morbidity and mortality (often instantly fatal) among trauma patients. We encountered a case of RTA in which 24 years old male sustained blunt trauma to chest. Autopsy findings revealed traumatic rupture of anterior wall of left ventricle leading to hemopericardium. Cardiac contusions were found over the right ventricle and left atrium. Histopathology of heart ruled out the myocardial infarction. Present case highlights the plausible mechanism involved in traumatic rupture of the heart. Finding out the exact cause of cardiac rupture in such cases have profound medicolegal significance.
道路交通事故每年在全世界造成约130万人死亡;其中,半数以上的道路交通死亡和伤害涉及易受伤害的道路使用者,如骑自行车者、骑摩托车者以及骑靠垫者和行人。钝性心脏创伤(BCT)通常由摩托车碰撞、机动车事故、坠落伤和挤压伤引起的高冲击机制引起。胸外伤对心肌造成严重损伤,是创伤患者发病率和死亡率(通常是立即死亡)的主要原因。我们遇到一个病例的RTA,其中24岁的男性持续钝性创伤的胸部。尸检结果显示外伤性左心室前壁破裂导致心包出血。在右心室和左心房发现心脏挫伤。心脏组织病理学检查排除心肌梗塞。本病例强调了创伤性心脏破裂的可能机制。找出此类病例心脏破裂的确切原因具有深远的医学意义。
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引用次数: 0
Age estimation from sternum of eastern Indian population: Autopsy based study 印度东部人口胸骨年龄估计:基于尸检的研究
Pub Date : 2022-06-15 DOI: 10.18231/j.ijfcm.2022.014
M. Sahu, P. Tripathy, M. Mohanty, K. S. Padhi, A. Naveen
The age determination of an individual is indispensable in various civil and criminal cases. The sternum is one of the key bones for age estimation beyond 25 years. Many studies were done in the past on age determination from the sternum had variable and inconclusive results. Further, the region-specific research on the sternum for age determination is lacking from the eastern Indian population. The present study was done to examine the sternum for its fusion status along each segment, mesosternum-xiphisternal (MXJ) junction, and manubrium-sternal (MSJ) joint by direct inspection. This cross-sectional, observational study was conducted in the mortuary of a tertiary health care center in ABC. 102 sterna were collected from known corpses during autopsy which included 73 males and 29 females aged between 6 years to 85 years. The earliest complete fusion of manubrium with the body was observed to be 17 years in females and 24 years in males. Whereas the maximum number of cases of complete fusion was observed among 51-60 years of age irrespective of the sexes, indicative of a very limited role of the sternum in estimating the age. The fusion of each segment of mesosternum has utility in determining age beyond 20 years and the xiphisternal joint remains reliable corroborative evidence for the age beyond 40 years.
在各种民事和刑事案件中,个人年龄的确定是不可缺少的。胸骨是估计25岁以上年龄的关键骨骼之一。过去许多关于胸骨年龄测定的研究结果都是不确定的。此外,在东印度人口中缺乏针对特定区域的胸骨年龄测定研究。本研究通过直接检查来检查胸骨各节段、胸骨-剑胸骨(MXJ)连接处和胸骨柄-胸骨(MSJ)关节的融合情况。这项横断面观察性研究是在ABC三级卫生保健中心的太平间进行的。在解剖过程中,从已知尸体中收集了102个胸骨,其中男性73个,女性29个,年龄在6 ~ 85岁之间。最早的柄骨与身体完全融合是在女性17岁和男性24岁。然而,在51-60岁年龄组中观察到的完全融合病例最多,与性别无关,这表明胸骨在估计年龄方面的作用非常有限。中胸骨各节段的融合可用于确定20岁以上的年龄,而剑胸骨关节仍然是确定40岁以上年龄的可靠证据。
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引用次数: 1
Cell phone uses among students: Two aspects of coin 学生使用手机:硬币的两个方面
Pub Date : 2022-06-15 DOI: 10.18231/j.ijfcm.2022.020
I. A. Khan
Mobile phones and similar gadgets are increasingly being used owing to the massive growth in internet and advancement in digital device technology. Learning via mobile phones and similar gadgets has become one of the most popular and useful teaching tools used by different class of students across the world. But any new technology has some drawbacks also which should be addressed in timely and efficiently to reduce its ill effects. A multipronged approach may be utilised to curtail the ill effects of mobile phones and similar gadgets.
由于互联网的大规模发展和数字设备技术的进步,手机和类似的小工具越来越多地被使用。通过手机和类似的小工具学习已经成为世界各地不同班级的学生使用的最流行和最有用的教学工具之一。但任何新技术也有一些缺点,应及时有效地加以解决,以减少其不良影响。可以采用多管齐下的方法来减少手机和类似电子产品的不良影响。
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引用次数: 1
A study to compare the disease severity between vaccinated and unvaccinated COVID 19 patients in Tumkur city 图尔库尔市接种疫苗和未接种疫苗的COVID - 19患者疾病严重程度的比较研究
Pub Date : 2022-06-15 DOI: 10.18231/j.ijfcm.2022.013
Sudheer K N, Savitha Rani B B, Greshma C Nair, Vinay K S, Gopinath S
WHO declared coronavirus 2(SARS-CoV-2) as a pandemic on March 11, 2020. COVID-19 vaccines have been rapidly developed and distributed to help fight the pandemic. By January 2021, use of the Covishield vaccine and Covaxin vaccine use was approved. India began its vaccination program on 16 January 2021. The objective of the study is to assess the severity of COVID 19 infection among those vaccinated and unvaccinated as this will help us to assess the efficacy of the vaccines.By Convenient sampling technique the data of all those patients who were admitted in tertiary care centers in Tumkur district during second wave (April-July 2021) of COVID 19 infection were assessed from their medical records. The severity of the COVID 19 infection was assessed by evaluating the CT scores, lymphocyte/ neutrophil ratio, platelet distribution width, medical treatment provided and outcome which was later compared to vaccine status of the patients. Out of 220 patients in the study, 188(85.5%) were not vaccinated, 183(83.2%) had a positive RT PCR report, with most having CT of moderate changes (45.9%). Only 42(19.1%) patients underwent intubation and 28(12.7%) patients died. Using Chi Square test it was seen that those who were not vaccinated had moderate to severe CT scores (P = 0.026).Those who were not vaccinated had a higher chance of developing moderate to severe CT changes, though the death rate was less. Vaccine is found to be efficacious in fighting against COVID-19.
世卫组织于2020年3月11日宣布冠状病毒2(SARS-CoV-2)为大流行。COVID-19疫苗已迅速开发和分发,以帮助抗击大流行。到2021年1月,批准使用Covishield疫苗和Covaxin疫苗。印度于2021年1月16日启动了其疫苗接种规划。这项研究的目的是评估接种疫苗和未接种疫苗的人感染COVID - 19的严重程度,这将有助于我们评估疫苗的有效性。采用便捷抽样技术,对第二波(2021年4月至7月)在图姆库尔地区三级医疗中心收治的所有患者的病历数据进行评估。通过CT评分、淋巴细胞/中性粒细胞比值、血小板分布宽度、所接受的治疗及转诊结果与患者疫苗接种情况进行比较,评估患者感染的严重程度。在该研究的220例患者中,188例(85.5%)未接种疫苗,183例(83.2%)RT - PCR报告阳性,大多数CT显示中度变化(45.9%)。42例(19.1%)患者接受了插管,28例(12.7%)患者死亡。卡方检验显示,未接种疫苗者CT评分为中度至重度(P = 0.026)。未接种疫苗的人发生中度至重度CT改变的几率更高,但死亡率较低。疫苗被发现对抗击COVID-19有效。
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引用次数: 0
A rare case of fatal thalamic hemorrhage with intraventricular extension complicating drowning in an underweight woman 一个罕见的致命的丘脑出血与脑室内延伸合并溺水在一个体重过轻的妇女
Pub Date : 2022-06-15 DOI: 10.18231/j.ijfcm.2022.017
M. Sahu, A. Naveen, M. Mohanty, M. Sable, Baishwanar Banerjee
Death from natural diseases prior to or after entering the water is relatively rare but does occur. These underlying natural diseases lead to the incapacitation of the water victims and culminate in accidental or unintentional drownings. People who are unaware or ignorant of their disease status, living in rural areas with nearby open water sources, and belonging to economically backward communities in developing countries are more vulnerable to these unintentional drownings and pose a substantial challenge in determining the cause of death. Here we present a 45-year-old, underweight woman who brought a history of drowning in a pond near her house where she regularly took a bath. The history from the relatives and crime scene investigation was unremarkable. Thalamic hemorrhage, intraventricular hemorrhage, triple vessel atherosclerosis of the heart, and left ventricular hypertrophy suggestive of undiagnosed hypertension were discerned only after the autopsy, besides profound findings of drowning. This report highlights the significance of a meticulous autopsy to explain the cause of death in unwitnessed open water drownings, thus benefitting the bystanders and investigating team.
在入水之前或之后死于自然疾病的情况相对罕见,但确实发生过。这些潜在的自然疾病导致水受害者丧失行为能力,并最终导致意外或无意溺水。不知道或不知道自己疾病状况的人,生活在附近有开放水源的农村地区的人,以及属于发展中国家经济落后社区的人,更容易受到这些意外溺水的伤害,并在确定死因方面构成重大挑战。这里我们介绍一位45岁,体重过轻的女性,她带来了在她家附近的一个池塘溺水的历史,她经常在那里洗澡。亲属和犯罪现场调查的历史并不引人注目。丘脑出血,脑室内出血,心脏三支血管粥样硬化,左心室肥厚提示未确诊的高血压,只有在尸检后才发现,除了深刻的发现溺水。本报告强调,在无人目击的开阔水域溺水事件中,细致的尸检对于解释死亡原因的重要性,从而有利于旁观者和调查小组。
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引用次数: 0
Cross-country comparison of health policies in eight countries 8个国家卫生政策的跨国比较
Pub Date : 2022-06-15 DOI: 10.18231/j.ijfcm.2022.016
R. Gupta, P. Sodani
The primary objective of this paper is the comparison and describe features of health policies across the selected countries viz, Argentina, Australia, Finland, Kenya, India, South Korea, United Kingdom (U.K), United States (U.S). The second objective of the paper is to understand the political commitment in each country by comparing the allocation of adequate resources toward health. To study health policies, eight countries are selected from each geographical region and to determine political commitment toward health policy, three related variables are analyzed. Databases of the multilateral organization including the World Health Organization (WHO) are searched for the latest data. Out of the eight countries studied, only India and Kenya have a National Health Policy. The rest of the countries have medical care policies or health insurance policies or national law to lay down the vision for the health sector. The data indicate that countries which fall in the higher income bracket spend more on health. However, the spending data or the lack of it indicates that there is perhaps no focus on primary care, nutrition, and sanitation, among the prominent drivers of health outcomes. Many countries continue to struggle, to maintain continuity in the broad direction of the health policy. The realm of health process formulation is a major area which needs further research, evidence, re-orientation, and training for policymakers across countries to ensure structured and evidence-based policy formulation. Once there is a structured health policy process, the health policies may effectively address the ground-level issues and may lead to better health outcomes.
本文的主要目的是比较和描述选定国家的卫生政策特点,即阿根廷、澳大利亚、芬兰、肯尼亚、印度、韩国、英国(uk)、美国(us)。本文的第二个目标是通过比较适当的卫生资源分配情况来了解每个国家的政治承诺。为了研究卫生政策,从每个地理区域选择了八个国家,为了确定对卫生政策的政治承诺,分析了三个相关变量。在包括世界卫生组织(卫生组织)在内的多边组织的数据库中搜索最新数据。在研究的八个国家中,只有印度和肯尼亚制定了国家卫生政策。其他国家有医疗保健政策或健康保险政策或国家法律,以确定卫生部门的远景。数据表明,收入较高的国家在卫生方面的支出更多。然而,支出数据或缺乏支出数据表明,在健康结果的主要驱动因素中,可能没有关注初级保健、营养和卫生设施。许多国家仍在努力保持卫生政策大方向的连续性。卫生进程制定领域是一个需要进一步研究、证据、重新定位和对各国决策者进行培训的主要领域,以确保有组织和以证据为基础的政策制定。一旦有了结构化的卫生政策进程,卫生政策就可以有效地解决基层问题,并可能带来更好的卫生成果。
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引用次数: 0
Death due to kodalikkizhangu poisoning: A case report kodalikkizhangu中毒致死亡1例
Pub Date : 2022-06-15 DOI: 10.18231/j.ijfcm.2022.019
Ramalingam S, Narayanan S, Narendar R
Deaths due to accidental ingestion, suicidal consumption and homicide poisoning with colchicine alkaloid containing extracts have been documented and reported in innumerable literature across the world. The lowest reported lethal dose of oral colchicine are 7-26 mg. Gloriosa superba, regionally known as Kodalikkizhangu is a highly poisonous flowering plant, seen wide spread in south and south East Asia. Colchicine is concentrated in the seeds and tubers of the plant. Colchicine content of Gloriosa tuber is 0.3%. These tubers are often mistaken as yams and accidentally ingested. Ingestion of tubers of Gloriosa results in colchicine poisoning. Toxicity of Gloriosa is due to the anti-mitotic effect of its toxic principle namely colchicine and Gloriosin on the rapidly proliferating cells such as stomach and oesophagus. Cardiac manifestation of Gloriosa poisoning is due to the impaired cardio myocyte conduction and contractility. Deaths in these cases are due to multi-organ failure. No specific antidote is available. A 71-year-old male who was a chronic alcoholic and known hypertensive got admitted in toxicology ward, with symptoms of acute gastroenteritis, 11 hours after alleged consumption of tubers of a wild plant. 24 hours after ingestion the patient succumbed to death and post-mortem was done to establish cause of death.
由于意外摄入,自杀性消费和杀人性中毒,含有秋水仙碱提取物的死亡在世界各地的无数文献中都有记录和报道。据报道,口服秋水仙碱的最低致死剂量为7-26毫克。金凤花,在当地被称为Kodalikkizhangu,是一种剧毒的开花植物,广泛分布在南亚和东南亚。秋水仙碱集中在这种植物的种子和块茎中。秋水仙碱含量为0.3%。这些块茎经常被误认为是山药而误食。食用秋水仙碱会导致秋水仙碱中毒。其毒性是由于其毒性原理秋水仙碱和黄芩苷对胃和食道等快速增殖的细胞具有抗有丝分裂作用。冠脉中毒的心脏表现是心肌细胞传导和收缩能力受损。这些病例中的死亡是由于多器官衰竭。没有特定的解药可用。一名71岁的男性慢性酗酒并患有高血压,在据称食用一种野生植物块茎11小时后,因急性胃肠炎的症状被送入毒理学病房。摄入24小时后,患者死亡,并进行尸检以确定死因。
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引用次数: 0
Epidemiological linkage study of an outbreak of 2019 novel coronavirus diseases (COVID-19) in a small town Badnagar of Madhya Pradesh 中央邦巴德那格尔小镇2019年新型冠状病毒病(COVID-19)暴发的流行病学关联研究
Pub Date : 2022-06-15 DOI: 10.18231/j.ijfcm.2022.015
D. Pandey, L. Kot, S. Dixit
A sudden outbreak of pneumonia of unknown cause occurred worldwide which later confirmed as the corona virus disease 2019 (COVID-19) infection has posed significant threats to international health and the economy. On 30 January, 2020, the World Health Organization (WHO) declared it to be a Public Health Emergency of International Concern. Initially a large number of cases this suspected to this disease reported from a small town near to this center. A team constituted with the administration which later investigated this whole phenomenon and reported to higher authority.
世界范围内突然爆发不明原因肺炎,后被确认为2019冠状病毒病(COVID-19)感染,对国际卫生和经济构成重大威胁。2020年1月30日,世界卫生组织(世卫组织)宣布其为国际关注的突发公共卫生事件。最初,该中心附近的一个小镇报告了大量疑似该病病例。由行政当局组成的一个小组后来调查了整个现象并向上级报告。
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引用次数: 0
COVID-19 pandemic’s biggest lesson: Strengthen primary health care services COVID-19大流行的最大教训:加强初级卫生保健服务
Pub Date : 2022-06-15 DOI: 10.18231/j.ijfcm.2022.011
S. Yadav, A. R. Piyush
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引用次数: 0
期刊
Indian journal of forensic and community medicine
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