S. Alan, N. Karadaǧ, A. Akatlı, F. Tecellioglu, N. Şahin, M. Huz
Annexin A1 (ANXA1) which plays a role in tumor development and metastasis has been reported to be an effective regulator for tumor stroma and interacts with different components in the tumor microenvironment. The role of ANXA1 in tumorigenesis has not been fully understood. One of the main reasons for this is the great variability of ANXA1 expression in malignant tumors across different tumor types. Archived hematoxylin-eosin stained preparations of lung adenocarcinoma, breast invasive ductal carcinoma, colonic adenocarcinoma, and prostatic acinar carcinoma were re-evaluated and tumor regions to be analyzed with the tissue microarray method were determined. The ANXA1 expressions between the tumors and tumor microenvironment were evaluated immunohistochemically. ANXA1 expression was decreased in the lung, breast, colon, and prostate adenocarcinomas. The most prominent staining was seen in lung adenocarcinoma cases. There was no statistically significant difference between the tumors in terms of ANXA1 staining (P > 0.05). ANXA1 was shown to be a more stained tumor microenvironment than in the tumor. Statistically significant staining with ANXA1 between within tumor and tumor microenvironment was observed in breast adenocarcinomas (P < 0.05). Our study showed differences between ANXA1 expression in different cancers, in tumor cells, and tumor microenvironment. Considering the effects of ANXA1 on tumor development and metastasis, a potential use as a biomarker may be suggested. Particularly, in breast adenocarcinomas, the high expression of ANXA1 in the tumor microenvironment supports the notion that it could induce the tumor stroma response.
{"title":"Evaluation of annexin A1 expression in lung, breast, colon, and prostatic adenocarcinomas and in tumor microenvironment","authors":"S. Alan, N. Karadaǧ, A. Akatlı, F. Tecellioglu, N. Şahin, M. Huz","doi":"10.25259/ijms_185_2021","DOIUrl":"https://doi.org/10.25259/ijms_185_2021","url":null,"abstract":"\u0000\u0000Annexin A1 (ANXA1) which plays a role in tumor development and metastasis has been reported to be an effective regulator for tumor stroma and interacts with different components in the tumor microenvironment. The role of ANXA1 in tumorigenesis has not been fully understood. One of the main reasons for this is the great variability of ANXA1 expression in malignant tumors across different tumor types.\u0000\u0000\u0000\u0000Archived hematoxylin-eosin stained preparations of lung adenocarcinoma, breast invasive ductal carcinoma, colonic adenocarcinoma, and prostatic acinar carcinoma were re-evaluated and tumor regions to be analyzed with the tissue microarray method were determined. The ANXA1 expressions between the tumors and tumor microenvironment were evaluated immunohistochemically.\u0000\u0000\u0000\u0000ANXA1 expression was decreased in the lung, breast, colon, and prostate adenocarcinomas. The most prominent staining was seen in lung adenocarcinoma cases. There was no statistically significant difference between the tumors in terms of ANXA1 staining (P > 0.05). ANXA1 was shown to be a more stained tumor microenvironment than in the tumor. Statistically significant staining with ANXA1 between within tumor and tumor microenvironment was observed in breast adenocarcinomas (P < 0.05). Our study showed differences between ANXA1 expression in different cancers, in tumor cells, and tumor microenvironment.\u0000\u0000\u0000\u0000Considering the effects of ANXA1 on tumor development and metastasis, a potential use as a biomarker may be suggested. Particularly, in breast adenocarcinomas, the high expression of ANXA1 in the tumor microenvironment supports the notion that it could induce the tumor stroma response.\u0000","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87808675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Ismail, Saja A. Albanaa, Ali M. Neamah, Noor F. Hassan, Yasir A. Mohialdeen, Awfa Aktham Abdulateef, Samer S. Hoz
Arteriovenous malformations of the corpus callosum (CC-AVMs) are rare and challenging lesions, accounting for 8–9% of all cerebral AVMs. They are associated with a high risk of recurrent hemorrhage and historically were considered inoperable. This case report describes the successful surgical resection of a high-grade CC-AVM following failed stereotactic radiosurgery. A 19-year-old female with an anterior CC-AVM presented with seizures despite being on triple anti-epileptics. The patient had previously undergone conservative management for an intraventricular hemorrhage and stereotactic radiosurgery for the AVM. Pre-operative imaging revealed a 5 cm CC-AVM located at the genu and rostrum of the corpus callosum with intraventricular extension into the third ventricle. The AVM was classified as grade 4 according to the Spetzler-Martin grading system and grade 6 according to the supplementary grading system. The lesion was exposed through the anterior interhemispheric trans-callosal approach, and microsurgical nidal dissection was performed. The large draining vein was identified, coagulated, disconnected, and resected along with the nidus. The total operative time was 12.5 h. Postoperatively, the patient had no neurological deficits and was discharged on day 10. Complete resection was confirmed on postoperative magnetic resonance imaging, and the patient remained seizure-free at the 18-month follow-up visit. This case report demonstrates the feasibility of complete surgical resection for high-grade CC-AVMs that have failed non-surgical therapy. Careful surgical planning and technique can lead to favorable outcomes in these challenging cases.
{"title":"Complex arteriovenous malformation of the corpus callosum: Surgical nuances","authors":"M. Ismail, Saja A. Albanaa, Ali M. Neamah, Noor F. Hassan, Yasir A. Mohialdeen, Awfa Aktham Abdulateef, Samer S. Hoz","doi":"10.25259/ijms_93_2023","DOIUrl":"https://doi.org/10.25259/ijms_93_2023","url":null,"abstract":"\u0000\u0000Arteriovenous malformations of the corpus callosum (CC-AVMs) are rare and challenging lesions, accounting for 8–9% of all cerebral AVMs. They are associated with a high risk of recurrent hemorrhage and historically were considered inoperable. This case report describes the successful surgical resection of a high-grade CC-AVM following failed stereotactic radiosurgery.\u0000\u0000\u0000\u0000A 19-year-old female with an anterior CC-AVM presented with seizures despite being on triple anti-epileptics. The patient had previously undergone conservative management for an intraventricular hemorrhage and stereotactic radiosurgery for the AVM. Pre-operative imaging revealed a 5 cm CC-AVM located at the genu and rostrum of the corpus callosum with intraventricular extension into the third ventricle. The AVM was classified as grade 4 according to the Spetzler-Martin grading system and grade 6 according to the supplementary grading system. The lesion was exposed through the anterior interhemispheric trans-callosal approach, and microsurgical nidal dissection was performed. The large draining vein was identified, coagulated, disconnected, and resected along with the nidus. The total operative time was 12.5 h. Postoperatively, the patient had no neurological deficits and was discharged on day 10. Complete resection was confirmed on postoperative magnetic resonance imaging, and the patient remained seizure-free at the 18-month follow-up visit.\u0000\u0000\u0000\u0000This case report demonstrates the feasibility of complete surgical resection for high-grade CC-AVMs that have failed non-surgical therapy. Careful surgical planning and technique can lead to favorable outcomes in these challenging cases.\u0000","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87923531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Khulud K. Alharbi, A. Alzahrani, Majed Matir J. Aldadi, Aisha Mosa M. Basisi, Aljuhara Mushbab A. Alshareef, Ruba Asabi M. Alghamdi, Noran Talal S. Aldebane, Jumana Mohammed S. Zamzami
Assessing population health needs have been an important factor that enables healthcare systems to attain value-based care and use resources efficiently. This study aims to assess the health needs for two communities residing in Makkah City, Saudi Arabia. A qualitative study design with focus groups were conducted between January 2022 and March 2022 to assess health needs among two communities residing in two different districts in Makkah City (Alzaidy and Al-hajj Street). Recruited participants were divided into five groups according to their age (0-12 (parents represented this group); 13-24; 25-45; 46-65; and over 65 years), and each group had 5 to 9 participants. Participants have identified several needs and concerns within their communities. These needs were classified into five main themes: Access to physical activity; access to healthcare services; healthy lifestyle; environmental instability; and education/promotion programs for community. Although, identified needs varied among age groups and geographic locations of communities, the needs to access healthcare services and physical activities was frequently mentioned among participants. This is the first study to assess community health needs in Makkah. Even though the results were not generalizable, the study has laid the foundation for future projects and research assessing population health needs. A population-level data might help in determining population health needs and inform future policies and decision-making.
{"title":"Assessment of community health needs in Makkah: A qualitative study","authors":"Khulud K. Alharbi, A. Alzahrani, Majed Matir J. Aldadi, Aisha Mosa M. Basisi, Aljuhara Mushbab A. Alshareef, Ruba Asabi M. Alghamdi, Noran Talal S. Aldebane, Jumana Mohammed S. Zamzami","doi":"10.25259/ijms_82_2023","DOIUrl":"https://doi.org/10.25259/ijms_82_2023","url":null,"abstract":"\u0000\u0000Assessing population health needs have been an important factor that enables healthcare systems to attain value-based care and use resources efficiently. This study aims to assess the health needs for two communities residing in Makkah City, Saudi Arabia.\u0000\u0000\u0000\u0000A qualitative study design with focus groups were conducted between January 2022 and March 2022 to assess health needs among two communities residing in two different districts in Makkah City (Alzaidy and Al-hajj Street). Recruited participants were divided into five groups according to their age (0-12 (parents represented this group); 13-24; 25-45; 46-65; and over 65 years), and each group had 5 to 9 participants.\u0000\u0000\u0000\u0000Participants have identified several needs and concerns within their communities. These needs were classified into five main themes: Access to physical activity; access to healthcare services; healthy lifestyle; environmental instability; and education/promotion programs for community. Although, identified needs varied among age groups and geographic locations of communities, the needs to access healthcare services and physical activities was frequently mentioned among participants.\u0000\u0000\u0000\u0000This is the first study to assess community health needs in Makkah. Even though the results were not generalizable, the study has laid the foundation for future projects and research assessing population health needs. A population-level data might help in determining population health needs and inform future policies and decision-making.\u0000","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89392663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In India, more than 43 million people were infected with the novel coronavirus (CoV), and more than 0.5 million deaths occurred in 2020– 2022. This severely affected the surgical services as well as the management of non-CoV disease (COVID) patients, especially in a transformed tertiary COVID care center. This cohort study was conducted at the Department of Surgical Gastroenterology, Medical College Hospital, Kolkata, India, from March 12, 2020, to May 31, 2022. The study included patients hospitalized for gastrointestinal surgeries matched with those having the same pathology and treated before February 29, 2020, (pre-pandemic) in a 1:1 ratio. Patients treated primarily in other departments and those who died undiagnosed were excluded from the study. In total, 344 patients were operated on. A comparison of 30-day mortality did not show any significant difference (P = 0.74, odds ratio [OR]: 0.093, 95% confidence interval [CI]: 0.021–2.458). Time to admission (P = 0.003, OR: 1.512, 95% CI: 0.124–3.587) and time to surgery (P < 0.001, OR: 2.031, 95% CI: 0.023–6.738) were significantly high. Only pulmonary complications (P = 0.002, OR: 1.958, 95% CI: 1.021–3.968) were significantly high in the COVID-19 era. Patients infected with CoV in the perioperative period had a significantly higher morbidity (n = 50, OR: 2.58, 95% CI: 1.74–14.62). When scientifically managed, improved outcomes may be expected in the pandemic, even though many stones of epidemiology remain unturned.
{"title":"COVID-19: From resource restriction to surgical services – How we waived off the waves","authors":"Ravi Shankar Biswas","doi":"10.25259/ijms_91_2023","DOIUrl":"https://doi.org/10.25259/ijms_91_2023","url":null,"abstract":"\u0000\u0000In India, more than 43 million people were infected with the novel coronavirus (CoV), and more than 0.5 million deaths occurred in 2020– 2022. This severely affected the surgical services as well as the management of non-CoV disease (COVID) patients, especially in a transformed tertiary COVID care center.\u0000\u0000\u0000\u0000This cohort study was conducted at the Department of Surgical Gastroenterology, Medical College Hospital, Kolkata, India, from March 12, 2020, to May 31, 2022. The study included patients hospitalized for gastrointestinal surgeries matched with those having the same pathology and treated before February 29, 2020, (pre-pandemic) in a 1:1 ratio. Patients treated primarily in other departments and those who died undiagnosed were excluded from the study.\u0000\u0000\u0000\u0000In total, 344 patients were operated on. A comparison of 30-day mortality did not show any significant difference (P = 0.74, odds ratio [OR]: 0.093, 95% confidence interval [CI]: 0.021–2.458). Time to admission (P = 0.003, OR: 1.512, 95% CI: 0.124–3.587) and time to surgery (P < 0.001, OR: 2.031, 95% CI: 0.023–6.738) were significantly high. Only pulmonary complications (P = 0.002, OR: 1.958, 95% CI: 1.021–3.968) were significantly high in the COVID-19 era. Patients infected with CoV in the perioperative period had a significantly higher morbidity (n = 50, OR: 2.58, 95% CI: 1.74–14.62).\u0000\u0000\u0000\u0000When scientifically managed, improved outcomes may be expected in the pandemic, even though many stones of epidemiology remain unturned.\u0000","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88801686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Verma, B. Kundu, Roopali Dahiya, Rahul Yadav, G. Kumar
Sarcoidosis is a multisystemic inflammatory disorder whose clinical presentation varies from asymptomatic disease to organ failure and death. Isolated cardiac sarcoidosis (CS) often escapes detection in absence of clinically apparent disease in other organs. Our case illustrates the evaluation of a young female presenting with syncopal attack with complete heart block which was later diagnosed being due to sarcoidosis. This is a rare case of sarcoidosis presenting with cardiac symptoms as its initial presentation. Our study emphasizes that the differential diagnosis of sarcoidosis should be kept in an advanced atrioventricular block especially in a young patient with no predisposing factors. Establishing the diagnosis of CS enables benefit from immunosuppressant therapy and prevents morbidity as well as mortality.
{"title":"Cardiac sarcoidosis as initial presentation of multisystemic sarcoidosis","authors":"P. Verma, B. Kundu, Roopali Dahiya, Rahul Yadav, G. Kumar","doi":"10.25259/ijms_221_2022","DOIUrl":"https://doi.org/10.25259/ijms_221_2022","url":null,"abstract":"Sarcoidosis is a multisystemic inflammatory disorder whose clinical presentation varies from asymptomatic disease to organ failure and death. Isolated cardiac sarcoidosis (CS) often escapes detection in absence of clinically apparent disease in other organs. Our case illustrates the evaluation of a young female presenting with syncopal attack with complete heart block which was later diagnosed being due to sarcoidosis. This is a rare case of sarcoidosis presenting with cardiac symptoms as its initial presentation. Our study emphasizes that the differential diagnosis of sarcoidosis should be kept in an advanced atrioventricular block especially in a young patient with no predisposing factors. Establishing the diagnosis of CS enables benefit from immunosuppressant therapy and prevents morbidity as well as mortality.","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80474808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. N. Dahanayake, Farah Yoosoof, Konara Mudiyanselage Nadeeshan Thar Chathuranga, Chathuni Pamodya Jayakody, Wickramage Dona Buddhi Chathurika Janadari, Kencho Pelden, Ishara Udithamali Saranapala, Gayathma Kavindi Ruwanpathirana, Moosa Lebbe Mohamed Shamith
Myocardial infarction (MI) is a leading cause of death worldwide and is associated with a sizeable economic impact in terms of health expenditure and loss of workforce. Current trends depict Central and South Asia to be the epicenter of this public health issue which is only set to worsen with predicted population growth. Added to this, the history of a single MI increases the risk for subsequent episodes. Improved cardiovascular-related health literacy including knowledge of the illness and secondary preventive strategies is a major precautionary strategy in the prevention of subsequent MI in post-MI patients, which can, in turn, lead to major health and economic benefits. An understanding of the nature and level of health literacy can identify roadblocks to secondary preventive programs and help target interventions to suit the needs of the local healthcare setting and individuals. Thus, the objective of this study was to describe the current level of knowledge regarding MI and its secondary preventive strategies as well as the self-reported level of adherence to preventive strategies in a cross-section of post-MI patients in a healthcare center in Sri Lanka. It also explored the association of self-reported adherence with secondary preventive strategies and the level of knowledge. A cross-sectional descriptive study was conducted on consenting attendees to a cardiology clinic with a history of at least one MI in the past. A pre-tested and researcher-administered questionnaire collected sociodemographic data and tested the participant’s knowledge on various aspects of MI and secondary preventive strategies. Knowledge subscores in each category were summed to determine the overall knowledge level. The participants also self-reported their adherence to secondary preventive strategies. The knowledge level and level of adherence to preventive strategies were then categorized as either excellent, good, or poor. Descriptive statistics were calculated as frequencies and percentages. Fishers extract test was used to determine the relationship between overall knowledge level and level of adherence. Among the sample of 120 post-MI clinic patients, the overall knowledge score showed that two-thirds of the sample possessed a good level of overall knowledge (61.7%), while 36.7% of participants had an excellent knowledge level, and only 1.7% had poor knowledge. The self-reported compliance with preventive practices of a majority (68.3%) of the participants was excellent, while just below one-third of the participants (30.0%) had a good level of compliance. Overall knowledge and self-reported compliance with secondary preventive strategies were not influenced by sociodemographic factors in this sample and no significant association could be determined between the level of adherence and knowledge. While local secondary preventive programs for post-MI patients seem to be showing some success, the relative deficiency of knowledge in lifestyle modifica
{"title":"A cross-sectional study of the knowledge of post-myocardial infarction patients in a low-middle-income country regarding myocardial infarction and adherence to secondary preventive strategies practices","authors":"D. N. Dahanayake, Farah Yoosoof, Konara Mudiyanselage Nadeeshan Thar Chathuranga, Chathuni Pamodya Jayakody, Wickramage Dona Buddhi Chathurika Janadari, Kencho Pelden, Ishara Udithamali Saranapala, Gayathma Kavindi Ruwanpathirana, Moosa Lebbe Mohamed Shamith","doi":"10.25259/ijms_289_2022","DOIUrl":"https://doi.org/10.25259/ijms_289_2022","url":null,"abstract":"\u0000\u0000Myocardial infarction (MI) is a leading cause of death worldwide and is associated with a sizeable economic impact in terms of health expenditure and loss of workforce. Current trends depict Central and South Asia to be the epicenter of this public health issue which is only set to worsen with predicted population growth. Added to this, the history of a single MI increases the risk for subsequent episodes. Improved cardiovascular-related health literacy including knowledge of the illness and secondary preventive strategies is a major precautionary strategy in the prevention of subsequent MI in post-MI patients, which can, in turn, lead to major health and economic benefits. An understanding of the nature and level of health literacy can identify roadblocks to secondary preventive programs and help target interventions to suit the needs of the local healthcare setting and individuals. Thus, the objective of this study was to describe the current level of knowledge regarding MI and its secondary preventive strategies as well as the self-reported level of adherence to preventive strategies in a cross-section of post-MI patients in a healthcare center in Sri Lanka. It also explored the association of self-reported adherence with secondary preventive strategies and the level of knowledge.\u0000\u0000\u0000\u0000A cross-sectional descriptive study was conducted on consenting attendees to a cardiology clinic with a history of at least one MI in the past. A pre-tested and researcher-administered questionnaire collected sociodemographic data and tested the participant’s knowledge on various aspects of MI and secondary preventive strategies. Knowledge subscores in each category were summed to determine the overall knowledge level. The participants also self-reported their adherence to secondary preventive strategies. The knowledge level and level of adherence to preventive strategies were then categorized as either excellent, good, or poor. Descriptive statistics were calculated as frequencies and percentages. Fishers extract test was used to determine the relationship between overall knowledge level and level of adherence.\u0000\u0000\u0000\u0000Among the sample of 120 post-MI clinic patients, the overall knowledge score showed that two-thirds of the sample possessed a good level of overall knowledge (61.7%), while 36.7% of participants had an excellent knowledge level, and only 1.7% had poor knowledge. The self-reported compliance with preventive practices of a majority (68.3%) of the participants was excellent, while just below one-third of the participants (30.0%) had a good level of compliance. Overall knowledge and self-reported compliance with secondary preventive strategies were not influenced by sociodemographic factors in this sample and no significant association could be determined between the level of adherence and knowledge.\u0000\u0000\u0000\u0000While local secondary preventive programs for post-MI patients seem to be showing some success, the relative deficiency of knowledge in lifestyle modifica","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86528127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Infections of sterile body fluids are important and significant causes of mortality and morbidity, especially healthcare-associated infections. Species-level identification and antimicrobial resistance profile of bacteria are important determinants while selecting appropriate antimicrobials for empirical and targeted therapy. We conducted this study to observe the distribution of various bacteria and their antimicrobial resistance profile isolated from sterile body fluids. We conducted this study in a tertiary care teaching hospital from western Uttar Pradesh for a period of 2 years. All sterile body fluid samples were processed by conventional aerobic bacterial culture followed by their identification up to species level by conventional biochemicals following standard microbiological procedures. The antimicrobial susceptibility of the bacterial pathogens grown in culture was tested by Kirby–Bauer disk diffusion method and interpretation of susceptibility testing was done according to CLSI guidelines 2020. A total of 1980 sterile body fluid samples were collected during the study period and 192 samples were found positive on culture for bacterial pathogens. Gram-negative bacilli (GNB) were predominantly isolated comprising 83.33% in comparison to 16.67 % of Gram-positive cocci. Among Staphylococcus aureus isolates, 75% were methicillin-resistant S. aureus. All S. aureus isolates were sensitive against vancomycin and linezolid. Among GNB, 25% were extended-spectrum beta-lactamase producers while 62.5% were carbapenemase producers. All GNBs were sensitive to colistin. From this study, we concluded that the pathogenic bacteria implicated in infections of sterile body fluids are predominantly multidrug-resistant. There is a huge variation in data on the distribution of bacterial species isolated from sterile body fluids and their antimicrobial resistance patterns from different geographical locations and healthcare settings. Thus, data from a particular healthcare setting are important for empirical treatment in that healthcare setting.
{"title":"Sterile body fluids infections: Profile of bacteria and their antimicrobial resistance pattern in a tertiary care hospital from Uttar Pradesh","authors":"Peetam Singh, A. Pandey, A. Bisht","doi":"10.25259/ijms_63_2023","DOIUrl":"https://doi.org/10.25259/ijms_63_2023","url":null,"abstract":"\u0000\u0000Infections of sterile body fluids are important and significant causes of mortality and morbidity, especially healthcare-associated infections. Species-level identification and antimicrobial resistance profile of bacteria are important determinants while selecting appropriate antimicrobials for empirical and targeted therapy. We conducted this study to observe the distribution of various bacteria and their antimicrobial resistance profile isolated from sterile body fluids.\u0000\u0000\u0000\u0000We conducted this study in a tertiary care teaching hospital from western Uttar Pradesh for a period of 2 years. All sterile body fluid samples were processed by conventional aerobic bacterial culture followed by their identification up to species level by conventional biochemicals following standard microbiological procedures. The antimicrobial susceptibility of the bacterial pathogens grown in culture was tested by Kirby–Bauer disk diffusion method and interpretation of susceptibility testing was done according to CLSI guidelines 2020.\u0000\u0000\u0000\u0000A total of 1980 sterile body fluid samples were collected during the study period and 192 samples were found positive on culture for bacterial pathogens. Gram-negative bacilli (GNB) were predominantly isolated comprising 83.33% in comparison to 16.67 % of Gram-positive cocci. Among Staphylococcus aureus isolates, 75% were methicillin-resistant S. aureus. All S. aureus isolates were sensitive against vancomycin and linezolid. Among GNB, 25% were extended-spectrum beta-lactamase producers while 62.5% were carbapenemase producers. All GNBs were sensitive to colistin.\u0000\u0000\u0000\u0000From this study, we concluded that the pathogenic bacteria implicated in infections of sterile body fluids are predominantly multidrug-resistant. There is a huge variation in data on the distribution of bacterial species isolated from sterile body fluids and their antimicrobial resistance patterns from different geographical locations and healthcare settings. Thus, data from a particular healthcare setting are important for empirical treatment in that healthcare setting.\u0000","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"259 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79602508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Malaria is a vector-borne tropical disease well known for causing a multitude of complications. One such rare but familiar complication is symmetrical peripheral gangrene (SPG). SPG is a distinct entity resulting from a horde of infectious and non-infectious illnesses. We report the case of a 32-year-old male infected with Plasmodium falciparum malaria and Human Immunodeficiency Virus who presented to us with renal failure and developed SPG of both feet 3 days into admission.
{"title":"Symmetrical peripheral gangrene in an atypical case of Plasmodium falciparum malaria with HIV coinfection","authors":"Bishakha Swain, Saurabh Kumar Singh, U. Singh","doi":"10.25259/ijms_219_2022","DOIUrl":"https://doi.org/10.25259/ijms_219_2022","url":null,"abstract":"Malaria is a vector-borne tropical disease well known for causing a multitude of complications. One such rare but familiar complication is symmetrical peripheral gangrene (SPG). SPG is a distinct entity resulting from a horde of infectious and non-infectious illnesses. We report the case of a 32-year-old male infected with Plasmodium falciparum malaria and Human Immunodeficiency Virus who presented to us with renal failure and developed SPG of both feet 3 days into admission.","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84953414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ananthu Narayan, R. Jadon, P. Garg, U. Arora, Ushasi Saraswati, R. M. Goyal, M. Aggarwal, A. Ray, Arvind Kumar, S. N. Dwiwedi, Aparna Ningombam, A. Biswas, N. Wig
Eosinophilia is a prevalent laboratory abnormality that we encounter in day-to-day practice both in outpatient and inpatient settings. The causes range from primary to secondary spanning from an allergic response to clonal neoplastic proliferations. Identifying an etiology may be challenging in many cases and may sometimes require extensive evaluation. We aimed to find the clinical and etiological profile of patients with eosinophilia and the association of eosinophilia with end-organ involvement and IgE levels. The study was designed as a cross-sectional study over a period of two years (2019 to 2020). The study setting was outpatient and inpatient medical wards of a tertiary care center in north India. A detailed history and clinical examination were done on patients with eosinophilia detected in blood counts. Standard diagnostic protocols guided by positive clinical and diagnostic tests were followed to find etiologies in patients with eosinophilia. In our study, the most common cause overall and in each category of eosinophilia was parasitic infections (35%) followed by allergic disorders (29.3%). The most frequent symptoms were cough (32%), generalized weakness (25.5%), dyspnoea (24%), and a history suggestive of atopy (21%). On clinical examination, the most common finding was rhonchi or wheeze (24.5%). The most commonly affected end-organ was the lungs (13.2%) followed by the skin (4.7%). Parasitic infections are the most common cause of eosinophilia in our population. IgE levels correlate with a diagnosis of atopy or asthma and do not show a correlation with AEC. The lungs were the most frequently involved as end-organ in eosinophilia followed by the skin. We found no significant association between end-organ involvement and the degree of eosinophilia which highlights the importance of working up symptomatic patients for end-organ damage irrespective of the eosinophil count.
{"title":"Eosinophilia: Clinical experience from a tertiary care center in India","authors":"Ananthu Narayan, R. Jadon, P. Garg, U. Arora, Ushasi Saraswati, R. M. Goyal, M. Aggarwal, A. Ray, Arvind Kumar, S. N. Dwiwedi, Aparna Ningombam, A. Biswas, N. Wig","doi":"10.25259/ijms_192_2022","DOIUrl":"https://doi.org/10.25259/ijms_192_2022","url":null,"abstract":"\u0000\u0000Eosinophilia is a prevalent laboratory abnormality that we encounter in day-to-day practice both in outpatient and inpatient settings. The causes range from primary to secondary spanning from an allergic response to clonal neoplastic proliferations. Identifying an etiology may be challenging in many cases and may sometimes require extensive evaluation. We aimed to find the clinical and etiological profile of patients with eosinophilia and the association of eosinophilia with end-organ involvement and IgE levels.\u0000\u0000\u0000\u0000The study was designed as a cross-sectional study over a period of two years (2019 to 2020). The study setting was outpatient and inpatient medical wards of a tertiary care center in north India. A detailed history and clinical examination were done on patients with eosinophilia detected in blood counts. Standard diagnostic protocols guided by positive clinical and diagnostic tests were followed to find etiologies in patients with eosinophilia.\u0000\u0000\u0000\u0000In our study, the most common cause overall and in each category of eosinophilia was parasitic infections (35%) followed by allergic disorders (29.3%). The most frequent symptoms were cough (32%), generalized weakness (25.5%), dyspnoea (24%), and a history suggestive of atopy (21%). On clinical examination, the most common finding was rhonchi or wheeze (24.5%). The most commonly affected end-organ was the lungs (13.2%) followed by the skin (4.7%).\u0000\u0000\u0000\u0000Parasitic infections are the most common cause of eosinophilia in our population. IgE levels correlate with a diagnosis of atopy or asthma and do not show a correlation with AEC. The lungs were the most frequently involved as end-organ in eosinophilia followed by the skin. We found no significant association between end-organ involvement and the degree of eosinophilia which highlights the importance of working up symptomatic patients for end-organ damage irrespective of the eosinophil count.\u0000","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"426 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79561966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To combat the Coronavirus Disease 2019 (COVID-19) pandemic, the World Health Organization announced the emergency license for the usage of COVID-19 vaccinations. Various literature postulated a few cross-talks between autoimmune disease and COVID-19 vaccination. The molecular mimicry between autoimmune diseases as well as autoimmune antibodies and the antibodies against Severe Acute Respiratory Syndrome Coronavirus-2 S proteins triggers the development of a severe form of autoimmune disease. The causal association between autoimmune disease and COVID-19 vaccinations is still under debate. Hence, in this study, we aim to analyze the impact of COVID-19 vaccination on patients with autoimmune diseases. Patients were recruited from a nationwide survey throughout India from October 1, 2021, to December 30, 2021. All patients of autoimmune diseases enrolled in this study had received a diagnosis of COVID-19. A Google form was created in the English language with relevant items, including demographic variables, COVID-19 vaccination-related variables, and its impact on autoimmune disease. Association between the COVID-19 severity, vaccination status, and autoimmune disease status was analyzed. Eight hundred and forty-two patients with autoimmune disease participated in the study with 86% of vaccination rate. We noted comparable infection rates among vaccinated (37.5%, n = 272) and non-vaccinated (33.3%, n = 39) respondents with autoimmune disease (P = 0.38). Although 22.5% (n = 163) of patients with autoimmune disease demonstrated deterioration following vaccination, 75.3% (n = 546) of patients did not show any change in disease profile. We noted a significant increase in the computed tomography (CT) severity score of COVID-19 infection among non-vaccinated individuals (odds ratio = 1.1,95% confidence interval [0.29, 2.29], P < 0.001). Moreover, we also noted a significant increase in the need (P = 0.01) and length of hospitalization (P < 0.001) among COVID-19 non-vaccinated individuals. We also noted vaccination significantly prevented an acute flare-up of auto-immune disease when infected with COVID-19 (P < 0.001). Although vaccination did not affect the incidence of disease among patients with auto-immune disease, it did significantly decrease the CT severity score, hospitalization rate, and length of stay following COVID-19 infection. Moreover, vaccination also prevented acute flare-ups of autoimmune disease following COVID-19 infection.
{"title":"Impact of COVID-19 vaccination in patients with auto-immune diseases – A nationwide survey from 842 autoimmune patients","authors":"S. Muthu, Mithun Manohar, Preethi Selvaraj, Naveen Jeyaraman, Madhan Jeyaraman, Akshay Samagani, Ravikant Bhardwaj","doi":"10.25259/ijms_50_2023","DOIUrl":"https://doi.org/10.25259/ijms_50_2023","url":null,"abstract":"\u0000\u0000To combat the Coronavirus Disease 2019 (COVID-19) pandemic, the World Health Organization announced the emergency license for the usage of COVID-19 vaccinations. Various literature postulated a few cross-talks between autoimmune disease and COVID-19 vaccination. The molecular mimicry between autoimmune diseases as well as autoimmune antibodies and the antibodies against Severe Acute Respiratory Syndrome Coronavirus-2 S proteins triggers the development of a severe form of autoimmune disease. The causal association between autoimmune disease and COVID-19 vaccinations is still under debate. Hence, in this study, we aim to analyze the impact of COVID-19 vaccination on patients with autoimmune diseases.\u0000\u0000\u0000\u0000Patients were recruited from a nationwide survey throughout India from October 1, 2021, to December 30, 2021. All patients of autoimmune diseases enrolled in this study had received a diagnosis of COVID-19. A Google form was created in the English language with relevant items, including demographic variables, COVID-19 vaccination-related variables, and its impact on autoimmune disease. Association between the COVID-19 severity, vaccination status, and autoimmune disease status was analyzed.\u0000\u0000\u0000\u0000Eight hundred and forty-two patients with autoimmune disease participated in the study with 86% of vaccination rate. We noted comparable infection rates among vaccinated (37.5%, n = 272) and non-vaccinated (33.3%, n = 39) respondents with autoimmune disease (P = 0.38). Although 22.5% (n = 163) of patients with autoimmune disease demonstrated deterioration following vaccination, 75.3% (n = 546) of patients did not show any change in disease profile. We noted a significant increase in the computed tomography (CT) severity score of COVID-19 infection among non-vaccinated individuals (odds ratio = 1.1,95% confidence interval [0.29, 2.29], P < 0.001). Moreover, we also noted a significant increase in the need (P = 0.01) and length of hospitalization (P < 0.001) among COVID-19 non-vaccinated individuals. We also noted vaccination significantly prevented an acute flare-up of auto-immune disease when infected with COVID-19 (P < 0.001).\u0000\u0000\u0000\u0000Although vaccination did not affect the incidence of disease among patients with auto-immune disease, it did significantly decrease the CT severity score, hospitalization rate, and length of stay following COVID-19 infection. Moreover, vaccination also prevented acute flare-ups of autoimmune disease following COVID-19 infection.\u0000","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"167 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75768663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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