Salivary duct carcinomas (SDCs) are aggressive rare neoplasms. Whose diagnosis and treatment are a clinical challenge to both the treating doctor as well as the pathologist. Primary surgery with or without neck dissection followed by adjuvant radiation treatment is preferred for those with localized SDCs. Even with localized disease, the 5-year survival is <30%. For metastatic disease, the treatment options are limited. Two important biomarkers identified in SDCs are androgen receptors (ARs) and human epidermal growth factor receptor 2 receptors. Androgen deprivation therapy has evolved from the treatment of prostatic malignancies and various androgen-targeted agents are already in use for prostatic cancers. This case study represents the successful treatment of a metastatic SDC of the submandibular gland with AR-targeted agents. This patient has undergone treatment with multiple lines of Androgen targeted agents which is still ongoing. The main Androgen targeted agents used in this particular patient are Abiraterone and Enzalutamde. The patient has already achieved a disease-free survival of 30 months. Further studies have to be conducted to target ARs and more agents need to be tried.
{"title":"Androgen deprivation therapy in metastatic salivary duct carcinoma of submandibular gland – A case report","authors":"P. George, S. Abraham, A. Sivaram","doi":"10.25259/ijms_343_2021","DOIUrl":"https://doi.org/10.25259/ijms_343_2021","url":null,"abstract":"Salivary duct carcinomas (SDCs) are aggressive rare neoplasms. Whose diagnosis and treatment are a clinical challenge to both the treating doctor as well as the pathologist. Primary surgery with or without neck dissection followed by adjuvant radiation treatment is preferred for those with localized SDCs. Even with localized disease, the 5-year survival is <30%. For metastatic disease, the treatment options are limited. Two important biomarkers identified in SDCs are androgen receptors (ARs) and human epidermal growth factor receptor 2 receptors. Androgen deprivation therapy has evolved from the treatment of prostatic malignancies and various androgen-targeted agents are already in use for prostatic cancers. This case study represents the successful treatment of a metastatic SDC of the submandibular gland with AR-targeted agents. This patient has undergone treatment with multiple lines of Androgen targeted agents which is still ongoing. The main Androgen targeted agents used in this particular patient are Abiraterone and Enzalutamde. The patient has already achieved a disease-free survival of 30 months. Further studies have to be conducted to target ARs and more agents need to be tried.","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"115 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77906885","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}
Antigen retrieval (AR) is an important step in Immunohistochemistry (IHC) which is used to unmask the antigenic sites and facilitate antigen-antibody binding. Adequate fixation of tissue is necessary to achieve consistent demonstration of tissue antigens that can be masked by the chemical process involved in formalin fixation and tissue processing. Out of the various methods of AR, heat-induced epitope retrieval (HIER) methods have greatly improved the quality and reproducibility of IHC. In this study, a comparison of the two most commonly used HIER methods-pressure cooker and microwave oven was done on thirty cases of breast carcinoma. Appropriate tumor sections were taken and subjected to manual IHC testing for estrogen receptor (ER) and progesterone receptor (PR) receptors in each case. The results were divided into technique and microscopy-based. The parameters assessed on microscopy were uniformity of nuclear staining, quality of nuclear staining, internal control staining, presence of background staining, and Allred score. The sensitivity and specificity and positive and negative predictive values for each method were calculated. The parameters assessed on microscopy were comparable for both methods. Using a microwave oven, the sensitivity and specificity for ER and PR were 94% and 100%, respectively. Using a pressure cooker, the sensitivity, and specificity for ER were 94% and 100%, respectively, and for PR were 88% and 100%, respectively. On technical aspects, the pressure cooker method offers the advantage of being more convenient due to the possibility of simultaneous handling of more slides and being more time efficient. Both the AR methods had comparable results on microscopy. However, the pressure cooker has the benefit of being both time and money efficient from a technical standpoint.
{"title":"A comparative analysis of two antigen retrieval techniques: Microwave oven and pressure cooker for immunoexpression of estrogen and progesterone receptors in breast cancer tissue","authors":"Ramandeep Kaur, P. Somal, S. Sancheti","doi":"10.25259/ijms_300_2022","DOIUrl":"https://doi.org/10.25259/ijms_300_2022","url":null,"abstract":"\u0000\u0000Antigen retrieval (AR) is an important step in Immunohistochemistry (IHC) which is used to unmask the antigenic sites and facilitate antigen-antibody binding. Adequate fixation of tissue is necessary to achieve consistent demonstration of tissue antigens that can be masked by the chemical process involved in formalin fixation and tissue processing. Out of the various methods of AR, heat-induced epitope retrieval (HIER) methods have greatly improved the quality and reproducibility of IHC. In this study, a comparison of the two most commonly used HIER methods-pressure cooker and microwave oven was done on thirty cases of breast carcinoma.\u0000\u0000\u0000\u0000Appropriate tumor sections were taken and subjected to manual IHC testing for estrogen receptor (ER) and progesterone receptor (PR) receptors in each case. The results were divided into technique and microscopy-based. The parameters assessed on microscopy were uniformity of nuclear staining, quality of nuclear staining, internal control staining, presence of background staining, and Allred score. The sensitivity and specificity and positive and negative predictive values for each method were calculated.\u0000\u0000\u0000\u0000The parameters assessed on microscopy were comparable for both methods. Using a microwave oven, the sensitivity and specificity for ER and PR were 94% and 100%, respectively. Using a pressure cooker, the sensitivity, and specificity for ER were 94% and 100%, respectively, and for PR were 88% and 100%, respectively. On technical aspects, the pressure cooker method offers the advantage of being more convenient due to the possibility of simultaneous handling of more slides and being more time efficient.\u0000\u0000\u0000\u0000Both the AR methods had comparable results on microscopy. However, the pressure cooker has the benefit of being both time and money efficient from a technical standpoint.\u0000","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"93 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74028650","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}
G. Balasubramaniam, Rajshree H. Gaidhani, Mitali Anand Sapkal, S. Saoba, R. Dikshit, P. Chaturvedi
The main objective of this study is to report on the survival rates of head-and-neck cancer cases seen in Tata memorial hospital (TMH). In the present study comprises of a large number of head-and-neck cancer cases seen in TMH, Mumbai, during the years 2012– 14. The study included 4351 oral cancer, 766 oropharyngeal cancer, 612 hypopharyngeal cancer, 544 laryngeal cancers, and 244 nasopharyngeal cancer. TNM group staging was used to determine the clinical extent of disease.[2] In the study, a major proportion of patients were diagnosed in Stage III and stage IV, except in vocal cord and to a lesser extent in lower lip and anterior tongue. Thus, the treatment offered is either only surgery or in combination with radiotherapy or chemotherapy. The overall 3-year survival rates for oral cancer were 26–43%, 23–33% for oropharyngeal cancer, 22–28% for hypoharyngeal cancer, 28–53% for laryngeal cancers, and 44% for nasopharyngeal cancer. Prognosis differed by site of disease and subsites in this study. The differences in outcome are an indicator of the scope of prevention activities that could be reiterated for better prognosis of head-and-neck cancer.
{"title":"Head-and-neck cancer: Survival analysis of patients treated in a tertiary cancer hospital in Mumbai","authors":"G. Balasubramaniam, Rajshree H. Gaidhani, Mitali Anand Sapkal, S. Saoba, R. Dikshit, P. Chaturvedi","doi":"10.25259/ijms_235_2022","DOIUrl":"https://doi.org/10.25259/ijms_235_2022","url":null,"abstract":"\u0000\u0000The main objective of this study is to report on the survival rates of head-and-neck cancer cases seen in Tata memorial hospital (TMH).\u0000\u0000\u0000\u0000In the present study comprises of a large number of head-and-neck cancer cases seen in TMH, Mumbai, during the years 2012– 14. The study included 4351 oral cancer, 766 oropharyngeal cancer, 612 hypopharyngeal cancer, 544 laryngeal cancers, and 244 nasopharyngeal cancer. TNM group staging was used to determine the clinical extent of disease.[2]\u0000\u0000\u0000\u0000In the study, a major proportion of patients were diagnosed in Stage III and stage IV, except in vocal cord and to a lesser extent in lower lip and anterior tongue. Thus, the treatment offered is either only surgery or in combination with radiotherapy or chemotherapy. The overall 3-year survival rates for oral cancer were 26–43%, 23–33% for oropharyngeal cancer, 22–28% for hypoharyngeal cancer, 28–53% for laryngeal cancers, and 44% for nasopharyngeal cancer.\u0000\u0000\u0000\u0000Prognosis differed by site of disease and subsites in this study. The differences in outcome are an indicator of the scope of prevention activities that could be reiterated for better prognosis of head-and-neck cancer.\u0000","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"356 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75501184","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}
Simi Salim, Ganesh Kumar Saya, Shivanand Kattimani, Sitanshu Sekhar Kar
Objectives: To determine the proportion of depression and anxiety disorders; their association with sociodemographic, NCD-related factors and Quality of Life among persons with type II Diabetes Mellitus or Hypertension at a rural health center in Puducherry. Materials and Methods: This facility-based cross-sectional analytical study recruited 692 participants from May 2020 to September 2021. A structured questionnaire collected sociodemographic and NCD-related history; The Hospital Anxiety and Depression Scale (HADS) and The World Health Organization quality of life (WHOQOL) - BREF questionnaires for depression, anxiety and QOL assessment, respectively. Independent variables were assessed for relationship with depression and anxiety using univariate analysis. Multivariable logistic regression analysis was done to determine the predictors of depression and anxiety. Results: Nearly 17.8% (95% confidence interval [CI] - 13.8%–22.4%) had depression and 12.7% (95% CI - 9.5–16.7%) had anxiety. Age (adjusted odds ratio [aOR] - 0.97; 95% CI - 0.95–0.99), depression/anxiety disorders family history (aOR - 2.58; 95% CI - 1.26–5.26), overall QOL score reduction (aOR - 0.76; 95% CI - 0.60–0.97), and social domain score reduction (aOR - 0.98; 95% CI - 0.97–0.99) were the significant predictors of depression. No formal education (aOR - 10.84; 95% CI - 4.54–25.86), being homemaker (aOR - 3.49; 95% CI - 1.29–9.42), no DM/HTN family history (aOR - 1.51; 95% CI - 0.66–1.54), psychological domain score reduction (aOR - 0.97; 95% CI - 0.95–0.99) and environmental domain score reduction (aOR - 0.96; 95% CI - 0.94–0.98) were significant predictors of anxiety. Conclusion: Nearly one-fifth had depression and more than one-tenth had anxiety among the participants. A fair number of persons with HTN/DM have higher anxiety and depressive scores and most domains had a poor QOL score with depression alone having associated with a depression/anxiety family history.
目的:确定抑郁症和焦虑症的比例;在普杜切里的一个农村保健中心，他们与2型糖尿病或高血压患者的社会人口统计学、非传染性疾病相关因素和生活质量的关系。材料和方法:这项基于设施的横断面分析研究从2020年5月到2021年9月招募了692名参与者。收集社会人口统计和非传染性疾病相关历史的结构化问卷;分别采用医院焦虑抑郁量表(HADS)和世界卫生组织生活质量(WHOQOL) - BREF问卷进行抑郁、焦虑和生活质量评估。使用单变量分析评估独立变量与抑郁和焦虑的关系。采用多变量logistic回归分析确定抑郁和焦虑的预测因素。结果:近17.8%(95%可信区间[CI] - 13.8%-22.4%)患有抑郁症，12.7%(95%可信区间[CI] - 9.5-16.7%)患有焦虑症。年龄(校正优势比[aOR] - 0.97;95% CI - 0.95-0.99)，抑郁/焦虑障碍家族史(aOR - 2.58;95% CI - 1.26-5.26)，总体生活质量评分降低(aOR - 0.76;95% CI - 0.60-0.97)，社会领域分数降低(aOR - 0.98;95% CI - 0.97-0.99)为抑郁症的显著预测因子。没有受过正规教育(aOR - 10.84;95% CI - 4.54-25.86)，家庭主妇(aOR - 3.49;95% CI - 1.29-9.42)，无DM/HTN家族史(aOR - 1.51;95% CI - 0.66-1.54)，心理领域评分降低(aOR - 0.97;95% CI - 0.95-0.99)和环境领域评分降低(aOR - 0.96;95% CI - 0.94-0.98)是焦虑的显著预测因子。结论:近五分之一的参与者患有抑郁症，超过十分之一的参与者患有焦虑症。相当数量的HTN/DM患者有较高的焦虑和抑郁评分，大多数患者的生活质量评分较差，仅抑郁与抑郁/焦虑家族史有关。
{"title":"Depression and anxiety among persons with type II diabetes mellitus and hypertension; A cross-sectional analytical study in the rural field practice area of a tertiary care center in Puducherry","authors":"Simi Salim, Ganesh Kumar Saya, Shivanand Kattimani, Sitanshu Sekhar Kar","doi":"10.25259/ijms_45_2023","DOIUrl":"https://doi.org/10.25259/ijms_45_2023","url":null,"abstract":"Objectives: To determine the proportion of depression and anxiety disorders; their association with sociodemographic, NCD-related factors and Quality of Life among persons with type II Diabetes Mellitus or Hypertension at a rural health center in Puducherry. Materials and Methods: This facility-based cross-sectional analytical study recruited 692 participants from May 2020 to September 2021. A structured questionnaire collected sociodemographic and NCD-related history; The Hospital Anxiety and Depression Scale (HADS) and The World Health Organization quality of life (WHOQOL) - BREF questionnaires for depression, anxiety and QOL assessment, respectively. Independent variables were assessed for relationship with depression and anxiety using univariate analysis. Multivariable logistic regression analysis was done to determine the predictors of depression and anxiety. Results: Nearly 17.8% (95% confidence interval [CI] - 13.8%–22.4%) had depression and 12.7% (95% CI - 9.5–16.7%) had anxiety. Age (adjusted odds ratio [aOR] - 0.97; 95% CI - 0.95–0.99), depression/anxiety disorders family history (aOR - 2.58; 95% CI - 1.26–5.26), overall QOL score reduction (aOR - 0.76; 95% CI - 0.60–0.97), and social domain score reduction (aOR - 0.98; 95% CI - 0.97–0.99) were the significant predictors of depression. No formal education (aOR - 10.84; 95% CI - 4.54–25.86), being homemaker (aOR - 3.49; 95% CI - 1.29–9.42), no DM/HTN family history (aOR - 1.51; 95% CI - 0.66–1.54), psychological domain score reduction (aOR - 0.97; 95% CI - 0.95–0.99) and environmental domain score reduction (aOR - 0.96; 95% CI - 0.94–0.98) were significant predictors of anxiety. Conclusion: Nearly one-fifth had depression and more than one-tenth had anxiety among the participants. A fair number of persons with HTN/DM have higher anxiety and depressive scores and most domains had a poor QOL score with depression alone having associated with a depression/anxiety family history.","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135454351","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}
Patient satisfaction is of paramount importance in breast augmentation surgery. One of the most important determinants of the post-operative outcome is the implant volume. Conventionally, patients are fitted with different-sized implants under their bra to give them an idea of the post-operative result. However, it is cumbersome, and the patient is not able to visualize the final appearance of her breast. With the advent of three-dimensional (3D) simulations, this technique is increasingly being employed in pre-operative counseling sessions to aid the patient in choosing the right implant size for herself. We wished to study the usefulness of 3D simulation as a clinical aid in pre-operative counseling of breast augmentation patients. In this study, we asked a set of three questions to the patients who chose their breast implant size based on 3D simulation to understand their views on the utility of this technique. The majority (85–90%) of the respondents found 3D simulation to be very helpful in choosing the implant and would strongly recommend it to their peers. They also found the post-operative results to be very concordant with the pre-operative simulated image. 3D simulation is a useful aid in choosing the implants for breast augmentation and helps in involving the patient in the decision-making process, resulting in higher satisfaction.
{"title":"Role of 3D Simulation in breast augmentation","authors":"Rajat Gupta, Deepti Gupta","doi":"10.25259/ijms_271_2022","DOIUrl":"https://doi.org/10.25259/ijms_271_2022","url":null,"abstract":"\u0000\u0000Patient satisfaction is of paramount importance in breast augmentation surgery. One of the most important determinants of the post-operative outcome is the implant volume. Conventionally, patients are fitted with different-sized implants under their bra to give them an idea of the post-operative result. However, it is cumbersome, and the patient is not able to visualize the final appearance of her breast. With the advent of three-dimensional (3D) simulations, this technique is increasingly being employed in pre-operative counseling sessions to aid the patient in choosing the right implant size for herself. We wished to study the usefulness of 3D simulation as a clinical aid in pre-operative counseling of breast augmentation patients.\u0000\u0000\u0000\u0000In this study, we asked a set of three questions to the patients who chose their breast implant size based on 3D simulation to understand their views on the utility of this technique.\u0000\u0000\u0000\u0000The majority (85–90%) of the respondents found 3D simulation to be very helpful in choosing the implant and would strongly recommend it to their peers. They also found the post-operative results to be very concordant with the pre-operative simulated image.\u0000\u0000\u0000\u00003D simulation is a useful aid in choosing the implants for breast augmentation and helps in involving the patient in the decision-making process, resulting in higher satisfaction.\u0000","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91090309","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 the midst of extraordinary challenges, uncertainty, and the rapidly changing scenario of the prevailing COVID-19 pandemic, existing tuberculosis (TB) laboratories worldwide had to gear up on very short notice to face the dual challenge of fulfilling the increasing demands of laboratory testing for COVID-19 while simultaneously continuing the TB services. The brunt of the same fell on routine TB laboratory services, which include diagnostics (microscopy, rapid molecular testing, culture, and drug-susceptibility testing), and activities of training, quality assurance, and research pertaining to TB worldwide. With the sudden eruption and rapid spread of the global pandemic of COVID-19, TB diagnostic services were affected or disrupted especially where laboratories lacked adequate infrastructure and adequate resources for safe handling of specimens. The human resource challenges such as panic and apprehensions among laboratory workers to deal with newer pathogens, particularly those performing direct smear microscopy, along with staff shortage due to deployment in COVID-19 management duties and the pressure of continuing TB services with enhanced biosafety practices were difficult to handle. We also experienced decline in specimen workload at our national reference laboratory for TB diagnosis by 31% in 2020 as compared to pre-COVID period (2019). This is worrisome as undiagnosed TB as well as improper follow-up of those on TB treatment during the peak of COVID-19 pandemic could be associated with enhanced community transmission of TB and poorer patient outcomes. As the COVID-19 pandemic stretched out untiringly in the country and world over, we rapidly need to adapt and find ways to effectively sustain TB diagnostic services, training and research activities. In this perspective, we document current challenges of TB laboratories and suggest robust ways to address them including biosafety concerns. The safe integration of diagnostic services for TB and where required newer airborne pathogens, to ensure uninterrupted TB services, must be the utmost priority in the face of ongoing and any future unprecedented pandemics.
{"title":"Resilience strengthening of tuberculosis diagnostic services under national tuberculosis program to withstand pandemic situations","authors":"Sarika Jain, M. Singhai, V. Chadha, N. Somashekar","doi":"10.25259/ijms_275_2022","DOIUrl":"https://doi.org/10.25259/ijms_275_2022","url":null,"abstract":"In the midst of extraordinary challenges, uncertainty, and the rapidly changing scenario of the prevailing COVID-19 pandemic, existing tuberculosis (TB) laboratories worldwide had to gear up on very short notice to face the dual challenge of fulfilling the increasing demands of laboratory testing for COVID-19 while simultaneously continuing the TB services. The brunt of the same fell on routine TB laboratory services, which include diagnostics (microscopy, rapid molecular testing, culture, and drug-susceptibility testing), and activities of training, quality assurance, and research pertaining to TB worldwide. With the sudden eruption and rapid spread of the global pandemic of COVID-19, TB diagnostic services were affected or disrupted especially where laboratories lacked adequate infrastructure and adequate resources for safe handling of specimens. The human resource challenges such as panic and apprehensions among laboratory workers to deal with newer pathogens, particularly those performing direct smear microscopy, along with staff shortage due to deployment in COVID-19 management duties and the pressure of continuing TB services with enhanced biosafety practices were difficult to handle. We also experienced decline in specimen workload at our national reference laboratory for TB diagnosis by 31% in 2020 as compared to pre-COVID period (2019). This is worrisome as undiagnosed TB as well as improper follow-up of those on TB treatment during the peak of COVID-19 pandemic could be associated with enhanced community transmission of TB and poorer patient outcomes. As the COVID-19 pandemic stretched out untiringly in the country and world over, we rapidly need to adapt and find ways to effectively sustain TB diagnostic services, training and research activities. In this perspective, we document current challenges of TB laboratories and suggest robust ways to address them including biosafety concerns. The safe integration of diagnostic services for TB and where required newer airborne pathogens, to ensure uninterrupted TB services, must be the utmost priority in the face of ongoing and any future unprecedented pandemics.","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90614686","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}
V. Gautam, M. Verma, Abhishek Singh, A. Agarwal, Anupama Verma
This study aims to determine whether platelet indices (PI) (platelet count, mean platelet volume [MPV], and platelet distribution width [PDW]) are an additional diagnostic tool for neonatal sepsis (NS). This observational and cross-sectional study was done between April 2020 and April 2021 at the neonatal intensive care unit (NICU) of Lala Lajpat Rai Memorial Medical College Meerut, Uttar Pradesh, India. Neonates with sepsis-like apnea, abdominal distension, refusal of feed, increased pre-feed aspirates, tachycardia, hypothermia, chest retractions, lethargy, and grunting; neonates with sepsis screen positive and/or culture positive; and neonates born to mothers with sepsis risk factors were included in the study. After proper aseptic condition, the venous blood sample was collected in ethylenediaminetetraacetic acid (EDTA) vial and sent to the pathology laboratory for further analysis of complete blood count (CBC) absolute neutrophil count (ANC), total leukocyte count (TLC), C-reactive protein, platelet frequency, MPV, and PDW. The data were analyzed using SPSS v26.0. A total of 60 babies were enrolled, of which 30 neonates with sepsis were categorized as group “cases” (n = 30), and those (n = 30) neonates without sepsis were classified as group “controls.” Platelet count (low), MPV, and PDW (high) were found to be significant predictors of NS (P < 0.05). This study reports that the frequently employed PI (MPV, platelet count, and PDW) are significant predictors of the incidence of NS in NICU settings. There was no significant change in PI in prematurity and low birth weight neonates. These platelet indicators may be used as markers to detect the incidence of NS in low-resource settings.
{"title":"The interpretation of platelet indices (platelet count, mean platelet volume, and platelet distribution width) as additional diagnostic tool for neonatal sepsis","authors":"V. Gautam, M. Verma, Abhishek Singh, A. Agarwal, Anupama Verma","doi":"10.25259/ijms_8_2023","DOIUrl":"https://doi.org/10.25259/ijms_8_2023","url":null,"abstract":"\u0000\u0000This study aims to determine whether platelet indices (PI) (platelet count, mean platelet volume [MPV], and platelet distribution width [PDW]) are an additional diagnostic tool for neonatal sepsis (NS).\u0000\u0000\u0000\u0000This observational and cross-sectional study was done between April 2020 and April 2021 at the neonatal intensive care unit (NICU) of Lala Lajpat Rai Memorial Medical College Meerut, Uttar Pradesh, India. Neonates with sepsis-like apnea, abdominal distension, refusal of feed, increased pre-feed aspirates, tachycardia, hypothermia, chest retractions, lethargy, and grunting; neonates with sepsis screen positive and/or culture positive; and neonates born to mothers with sepsis risk factors were included in the study. After proper aseptic condition, the venous blood sample was collected in ethylenediaminetetraacetic acid (EDTA) vial and sent to the pathology laboratory for further analysis of complete blood count (CBC) absolute neutrophil count (ANC), total leukocyte count (TLC), C-reactive protein, platelet frequency, MPV, and PDW. The data were analyzed using SPSS v26.0.\u0000\u0000\u0000\u0000A total of 60 babies were enrolled, of which 30 neonates with sepsis were categorized as group “cases” (n = 30), and those (n = 30) neonates without sepsis were classified as group “controls.” Platelet count (low), MPV, and PDW (high) were found to be significant predictors of NS (P < 0.05).\u0000\u0000\u0000\u0000This study reports that the frequently employed PI (MPV, platelet count, and PDW) are significant predictors of the incidence of NS in NICU settings. There was no significant change in PI in prematurity and low birth weight neonates. These platelet indicators may be used as markers to detect the incidence of NS in low-resource settings.\u0000","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84393747","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}
E. Leung, Isobel Toy, J. King, Z. Ghani, Adarsh P. Shah
Small bowel obstruction is associated with significant morbidity and mortality. This study aimed to map outcomes of patients admitted with adhesional small bowel obstruction (ASBO ) with a view evaluating the effectiveness of water-soluble contrast agents (WSCA). A retrospective review of all emergency admissions coded for operative and non-operative treatment of small bowel obstruction between January 2018 and June 2020. Electronic patient records were utilized to confirm cases of ASBO. Patient demographics, hospital administrative data, treatment and surgery-related data are collected. A total of 110 patients were admitted with ASBO initiated with conservative management. Median time to computed tomography (CT) scan was 12 h (Range: 3–115 h). Oral contrast was administered in only 11%; of these, 58% (7/12) resolved spontaneously compared to 52% (51/98) in those without contrast. About 43% (47/110) of all patients necessitated surgical intervention. Median time from admission to surgery was 43.5 h (Range: 10– 288 h). There were one 30-day re-admissions in patients surgically managed compared to two in those conservatively managed. Early CT scan facilitates initiation of non-operative management in stable patients with ASBO. In this series, the scant use of WSCA despite international guidelines did not compromise patient outcomes or length of stay.
{"title":"Compliance on the use of water-soluble contrast agent in adhesional small bowel obstruction","authors":"E. Leung, Isobel Toy, J. King, Z. Ghani, Adarsh P. Shah","doi":"10.25259/ijms_210_2022","DOIUrl":"https://doi.org/10.25259/ijms_210_2022","url":null,"abstract":"\u0000\u0000Small bowel obstruction is associated with significant morbidity and mortality. This study aimed to map outcomes of patients admitted with adhesional small bowel obstruction (ASBO ) with a view evaluating the effectiveness of water-soluble contrast agents (WSCA).\u0000\u0000\u0000\u0000A retrospective review of all emergency admissions coded for operative and non-operative treatment of small bowel obstruction between January 2018 and June 2020. Electronic patient records were utilized to confirm cases of ASBO. Patient demographics, hospital administrative data, treatment and surgery-related data are collected.\u0000\u0000\u0000\u0000A total of 110 patients were admitted with ASBO initiated with conservative management. Median time to computed tomography (CT) scan was 12 h (Range: 3–115 h). Oral contrast was administered in only 11%; of these, 58% (7/12) resolved spontaneously compared to 52% (51/98) in those without contrast. About 43% (47/110) of all patients necessitated surgical intervention. Median time from admission to surgery was 43.5 h (Range: 10– 288 h). There were one 30-day re-admissions in patients surgically managed compared to two in those conservatively managed.\u0000\u0000\u0000\u0000Early CT scan facilitates initiation of non-operative management in stable patients with ASBO. In this series, the scant use of WSCA despite international guidelines did not compromise patient outcomes or length of stay.\u0000","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82941933","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}
Empty sella is often an incidental magnetic resonance imaging (MRI) finding. It may be partial or complete and can be primary or secondary due to intracranial hypertension, radiation exposure or pituitary apoplexy. Most of the patients are asymptomatic but features of panhypopituitarism can develop in some. This is a case report of a 70-year-old female who presented with complaints of vomiting, altered sensorium with irritability, generalized weakness, difficulty in speaking, and one episode of seizure. Blood investigations revealed hyponatremia that was euvolemic. On further evaluation, she was found to have decreased cortisol, decreased follicle stimulating hormone, decreased thyroxine, normal prolactin, and thyroid-stimulating hormone values suggestive of panhypopituitarism. MRI brain showed an empty sella. Her serum sodium levels improved after starting glucocoticoids and thyroxine tablets, thereby confirming the diagnosis of panhypopituitarism. In the absence of any history of irradiation, hemorrhage, and surgery, a diagnosis of primary empty sella syndrome was made.
{"title":"Primary empty sella syndrome presenting as hyponatremia","authors":"Nidhesh Khemchandani","doi":"10.25259/ijms_288_2022","DOIUrl":"https://doi.org/10.25259/ijms_288_2022","url":null,"abstract":"Empty sella is often an incidental magnetic resonance imaging (MRI) finding. It may be partial or complete and can be primary or secondary due to intracranial hypertension, radiation exposure or pituitary apoplexy. Most of the patients are asymptomatic but features of panhypopituitarism can develop in some. This is a case report of a 70-year-old female who presented with complaints of vomiting, altered sensorium with irritability, generalized weakness, difficulty in speaking, and one episode of seizure. Blood investigations revealed hyponatremia that was euvolemic. On further evaluation, she was found to have decreased cortisol, decreased follicle stimulating hormone, decreased thyroxine, normal prolactin, and thyroid-stimulating hormone values suggestive of panhypopituitarism. MRI brain showed an empty sella. Her serum sodium levels improved after starting glucocoticoids and thyroxine tablets, thereby confirming the diagnosis of panhypopituitarism. In the absence of any history of irradiation, hemorrhage, and surgery, a diagnosis of primary empty sella syndrome was made.","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82244614","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}
Narayan Sharma, Vanshika Sharma, S. Sharma, S. Thakur, Sompal Singh
Antinuclear antibodies (ANAs) are antibodies directed against one or more molecules within the nucleus. Although, ANA is present in patients suffering from connective tissue diseases, few reports reveal the presence of ANA in a healthy population. The present study aimed to identify the prevalence of ANA in healthy blood donors. Blood samples from 370 healthy blood donors were included in the present study. To detect serum ANA, an indirect immunofluorescence technique was used using HEp-2000 slides. A titer of 1:80 was used and the type of pattern (if positive) cases were also noticed. Out of 370 healthy donors, there were 187 males and 183 females (M: F = 1.02:1). ANA was detected in four out of 370 samples (1.081%). All the positive donors were female (100%). Among all the positive cases, three cases showed a speckled pattern and one showed a homogenous pattern at 1:80 dilution. In conclusion, there is a low prevalence of ANA positivity among healthy individuals. Although, along with clinical signs and symptoms, ANA is diagnostic of autoimmune disease, the mere presence of ANA is not synonymous with the presence of clinically significant autoimmune disease.
{"title":"Prevalence of antinuclear antibodies among healthy blood donors: An experience of a regional blood transfusion center","authors":"Narayan Sharma, Vanshika Sharma, S. Sharma, S. Thakur, Sompal Singh","doi":"10.25259/ijms_10_2023","DOIUrl":"https://doi.org/10.25259/ijms_10_2023","url":null,"abstract":"\u0000\u0000Antinuclear antibodies (ANAs) are antibodies directed against one or more molecules within the nucleus. Although, ANA is present in patients suffering from connective tissue diseases, few reports reveal the presence of ANA in a healthy population. The present study aimed to identify the prevalence of ANA in healthy blood donors.\u0000\u0000\u0000\u0000Blood samples from 370 healthy blood donors were included in the present study. To detect serum ANA, an indirect immunofluorescence technique was used using HEp-2000 slides. A titer of 1:80 was used and the type of pattern (if positive) cases were also noticed.\u0000\u0000\u0000\u0000Out of 370 healthy donors, there were 187 males and 183 females (M: F = 1.02:1). ANA was detected in four out of 370 samples (1.081%). All the positive donors were female (100%). Among all the positive cases, three cases showed a speckled pattern and one showed a homogenous pattern at 1:80 dilution.\u0000\u0000\u0000\u0000In conclusion, there is a low prevalence of ANA positivity among healthy individuals. Although, along with clinical signs and symptoms, ANA is diagnostic of autoimmune disease, the mere presence of ANA is not synonymous with the presence of clinically significant autoimmune disease.\u0000","PeriodicalId":13277,"journal":{"name":"Indian journal of medical sciences","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75809826","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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