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An Autopsy Case of the Decomposed Body with Kronlein's Shot and the Importance of Skull Reconstruction Kronlein枪弹致腐烂尸体尸检一例及颅骨重建的重要性
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-01-01 DOI: 10.4103/ijabmr.ijabmr_354_21
Mayank Gupta, P. Tiwari
In forensic medicine, firearm-related fatalities are regular. The range and velocity of the bullet, the characteristics of the wounds, and the probability of recovery are vital components of forensic analyses. While examining gunshot wounds to the skull, focus on the critical difference between bullet entry and exit points and the distance between the muzzle and the bullet entrance is vital. Determining bullet injury in cases of extreme decay has been a difficult challenge. The police send a corpse in the later stages of decomposition for re-postmortem examination, with a history of severe blunt force injuries to the head in our case report. Following the reconstruction of the skull, it is determined that some regions are bone deficient. A bullet entry wound is present on the left side's upper border of the defect, formed like an arc (representing the upper 1/3rd of a circle), and a corresponding exit wound was discovered on the right side's lower border of the defect, shaped like an arc (representing the lower 1/3rd of a circle). The bullet passed left to right backward and downward. It is noteworthy that in cases of advanced decomposition, where identifying the characteristics of a bullet wound is nearly impossible, fully skeletonizing the body and reconstructing it will provide critical hints to establishing the cause of death.
在法医领域,与枪支有关的死亡是经常发生的。子弹的射程和速度、伤口的特征以及复原的可能性是法医分析的重要组成部分。在检查头骨枪伤时,要注意子弹进入点和射出点之间的关键区别,以及枪口和子弹进入点之间的距离是至关重要的。在极度腐烂的情况下确定子弹损伤一直是一项艰巨的挑战。警方将一具腐烂后期的尸体送去重新验尸,在我们的案件报告中,他的头部有严重的钝器伤史。颅骨重建后,确定某些区域骨缺乏。子弹射入伤口位于缺陷左侧的上边界,形成一个弧形(代表一个圆的上1/3),在缺陷右侧的下边界发现了一个相应的出口伤口,形成一个弧形(代表一个圆的下1/3)。子弹从左到右向后向下射出。值得注意的是,在严重腐烂的情况下,几乎不可能确定枪伤的特征,完整地勾勒出尸体骨架并加以重建,将为确定死因提供关键线索。
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引用次数: 0
“Principles of Assessment in Medical Education”: A Review of Revised Second Edition 《医学教育评价原则》第二版修订述评
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-01-01 DOI: 10.4103/ijabmr.ijabmr_644_21
N. Rege
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引用次数: 0
Diagnostic Accuracy of Calculated Tumor Volumes and Apparent Diffusion Coefficient Values in Predicting Endometrial Cancer Grade 计算肿瘤体积和表观扩散系数预测子宫内膜癌症分级的诊断准确性
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-01-01 DOI: 10.4103/ijabmr.ijabmr_553_21
C. Kakkar, Kamini Gupta, Kunal Jain, V. Narang, Aminder Singh, K. Saggar, N. Bansal, D. Cioni, E. Neri
Background: Magnetic resonance imaging (MRI) has been shown to be an accurate imaging technique for the preoperative assessment of local staging of endometrial cancer and for evaluating the depth of myometrial invasion. Materials and Methods: This was a single-center retrospective study performed on patients with histopathologically proven endometrial carcinoma who underwent an MRI examination of the pelvis between October 2017 and May 2020. Results: In the present analysis, mean apparent diffusion coefficient (ADC) values for each histologic grade were 0.72 ± 0.13 × 10−3 mm2/s (G1), 0.76 ± 0.17 × 10−3 mm2/s (G2), and 0.74 ± 0.12 × 10−3 mm2/s (G3), respectively, showing no significant correlation between ADC values and tumor grade (P = 0.73). Overall, ADC minimum was significant in differentiating grades of endometrial carcinoma (P = 0.02) with the ability to differentiate Grade I and II lesions (P = 0.01). A mean tumor volume of 25.2 cc could differentiate low-grade tumors (Grade I and Grade II) from high-grade tumors (Grade III) with a sensitivity and specificity of 88% and specificity of 89%. The tumor volume/uterine volume ratio (TV/UV) differentiates high-grade tumors from low-grade tumors (P < 0.001), however, no significant difference in the ratio was observed among Grade I and II lesions (P = 0.48). The area under the curve of tumor volume was 0.875 (95% confidence interval 0.0–1.00) (P = 0.001), indicating that tumor volume was an effective tool for distinguishing high-grade and low-grade endometrioid adenocarcinomas. The corresponding sensitivity and specificity were 88.0% and 89.0%, respectively. Conclusion: Preoperative noninvasive radiological assessment for tumor volume, TV/ UV or tumor volume/uterine volume is important surrogate markers for preoperative prognostication of endometrial carcinoma.
背景:磁共振成像(MRI)已被证明是一种准确的术前评估子宫内膜癌局部分期和评估子宫肌层浸润深度的成像技术。材料和方法:这是一项单中心回顾性研究,对2017年10月至2020年5月期间接受骨盆MRI检查的组织病理学证实的子宫内膜癌患者进行了研究。结果:各组织学分级的平均表观扩散系数(ADC)值分别为0.72±0.13 × 10−3 mm2/s (G1)、0.76±0.17 × 10−3 mm2/s (G2)和0.74±0.12 × 10−3 mm2/s (G3), ADC值与肿瘤分级无显著相关性(P = 0.73)。总体而言,ADC最小值在区分子宫内膜癌分级(P = 0.02)和区分I级和II级病变(P = 0.01)方面具有重要意义。平均肿瘤体积为25.2 cc,可区分低级别肿瘤(I级和II级)和高级别肿瘤(III级),敏感性和特异性分别为88%和89%。肿瘤体积/子宫体积比(TV/UV)可区分高级别肿瘤和低级别肿瘤(P < 0.001),而I级和II级病变的比值无显著差异(P = 0.48)。肿瘤体积曲线下面积为0.875(95%可信区间为0.0 ~ 1.00)(P = 0.001),表明肿瘤体积是区分高级别和低级别子宫内膜样腺癌的有效工具。相应的敏感性和特异性分别为88.0%和89.0%。结论:术前无创影像学评估肿瘤体积、TV/ UV或肿瘤体积/子宫体积是预测子宫内膜癌术前预后的重要替代指标。
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引用次数: 3
Serum Creatinine versus Corrected Cockcroft-Gault Equation According to Poggio Reference Values in Patients with Arterial Hypertension 根据Poggio参考值对高血压患者血清肌酐与校正Cockcroft-Gault方程的比较
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-01-01 DOI: 10.4103/ijabmr.ijabmr_301_21
D. Šečić, A. Turohan, E. Begić, D. Rebić, E. Pepić, Z. Begić, A. Iglica, N. Begić, Azra Metović, J. Mušanović
Introduction: Serum creatinine is not enough sensitive marker for the evaluation of glomerular filtration rate (GFR). Cockcroft-Gault (CG) formula is often used to assess GFR, but it is necessary to correct original one for body surface area (BSA), adipositas, and the creatinine tubular secretion. The values of the estimated creatinine clearance and GFR are considered to Poggio reference ones according to biological parameters (age and gender). The aim of the study was to determine the difference in renal function estimation between serum creatinine and corrected CG equation according to the Poggio reference values in the arterial hypertension patients. Materials and Methods: The research included 124 patients of both gender with arterial hypertension, excluding ones with the already verified chronic kidney disease. We estimated creatinine clearance and GFR by CG method corrected for the BSA, body mass index (BMI), and the creatinine tubular secretion according to Poggio reference values. Results: There was no significant difference in both age and gender groups among patients with physiological and pathological values of the renal function determined by the serum creatinine and estimated creatinine clearance by CG equation corrected for BMI, BSA. In both age and gender groups there was significant difference among subjects with physiological and pathological values of the renal function determined by serum creatinine and estimated GFR by CG method corrected for BMI, BSA, and creatinine tubular secretion. Conclusion: There is the most striking difference in the assessment of renal function between serum creatinine and estimated GFR by CG method with three corrections (BSA, BMI, the creatinine tubular secretion). Estimated GFR by CG method with three corrections can help in the early diagnosis of renal dysfunction and optimal treatment in patients with arterial hypertension.
引言:血清肌酐不是评价肾小球滤过率(GFR)的足够敏感的标志物。Cockcroft-Gault(CG)公式通常用于评估GFR,但有必要校正体表面积(BSA)、脂肪和肌酸酐管分泌的原始公式。根据生物学参数(年龄和性别),估计的肌酸酐清除率和GFR的值被视为Poggio参考值。本研究的目的是根据动脉高血压患者的Poggio参考值,确定血清肌酐和校正CG方程之间肾功能估计的差异。材料和方法:这项研究包括124名患有动脉高压的男女患者,不包括那些已经证实患有慢性肾脏疾病的患者。根据Poggio参考值,我们通过校正BSA、体重指数(BMI)和肌酸酐管分泌的CG方法估计了肌酸酐清除率和GFR。结果:通过血清肌酐确定肾功能的生理和病理值,并通过校正BMI、BSA的CG方程估计肌酐清除率,在年龄组和性别组之间没有显著差异。在年龄组和性别组中,通过血清肌酸酐测定肾功能的生理和病理值,并通过校正BMI、BSA和肌酸酐管分泌的CG法估计GFR的受试者之间存在显著差异。结论:血清肌酐与CG法估算的肾小球滤过率在肾功能评估中存在最显著的差异,并有三种校正(BSA、BMI、肌酐管分泌)。用CG法估算GFR,并进行三次校正,有助于动脉高压患者肾功能障碍的早期诊断和最佳治疗。
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引用次数: 0
Practical Manual of Pharmacology for Medical Students: Book Review 医学生药理学实用手册:书评
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-10-01 DOI: 10.4103/ijabmr.ijabmr_628_21
R. Mahajan
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引用次数: 0
Principles of Medical Education: A Review of Book's Fifth Edition 医学教育的原则:书评书的第五版
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-04-01 DOI: 10.4103/ijabmr.ijabmr_172_21
M. Joshi
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引用次数: 0
Humanities in Medical Education 医学教育中的人文学科
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2020-10-01 DOI: 10.4103/ijabmr.IJABMR_604_20
A. Supe
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引用次数: 1
Erratum 勘误表
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2020-01-14 DOI: 10.1159/000505248
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引用次数: 0
Study of Association of C-Reactive Protein with Maternal Chorioamnionitis and Early-Onset Neonatal Sepsis in Premature Rupture of Membranes Deliveries: A Diagnostic Dilemma C反应蛋白与胎膜早破产妇绒毛膜羊膜炎和早期新生儿败血症的相关性研究:诊断难题
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2019-10-01 DOI: 10.4103/ijabmr.IJABMR_119_19
Aabha Suryavanshi, Ruchi Kalra
Introduction: Term prelabor rupture of membranes and preterm premature rupture of membranes (PROM), both pose significant risk to the mother and the fetus. Early identification of sepsis is essential as the mother has risk of chorioamnionitis and neonate is at the risk of early-onset sepsis. Aim: To evaluate the diagnostic value of positive maternal C-reactive protein (CRP) in association with maternal clinical chorioamnionitis and early-onset neonatal sepsis (EONS) in PROM deliveries after 28 weeks of gestation. Methodology: The study was conducted at People's College of Medical Science and Research Centre, Bhopal, from June 1, 2017, to May 31, 2018. Maternal serum CRP test was correlated to the signs of maternal chorioamnionitis and signs of EONS within 72 h of life. Results: The maternal CRP test was compared to clinical signs of chorioamnionitis. Sensitivity of CRP for diagnosing maternal chorioamnionitis was 48% (95% confidence interval [CI] −35.99–61.12), specificity was 81 (95% CI 71.55%–88.98%), and odds ratio of maternal chorioamnionitis was 4.1176 (95% CI 1.99–8.51) with P < 0.0001. Sensitivity of positive maternal CRP in diagnosing EONS was 56.67% (95% CI 43.24%–69.41%), specificity was 84.78% (95% CI 75.79%–91.42%), and odds ratio of neonatal sepsis in maternal CRP positive was 7.28 (95%CI 3.39–15.64) with P < 0.0001. Conclusion: Our study suggests that in PROM deliveries, if maternal CRP test is positive, then it indicates early delivery and neonate screening for EONS.
引言:足月产前胎膜破裂和早产胎膜早破都对母亲和胎儿构成重大风险。败血症的早期识别至关重要,因为母亲有绒毛膜羊膜炎的风险,新生儿有早发性败血症的风险。目的:评价孕妇C反应蛋白(CRP)阳性与孕妇临床绒毛膜羊膜炎和早发性新生儿败血症(EONS)在孕28周后胎膜早破分娩中的诊断价值。方法:该研究于2017年6月1日至2018年5月31日在博帕尔人民医学院和研究中心进行。母体血清CRP检测与母体绒毛膜羊膜炎的体征和72小时内EONS的体征相关。结果:孕妇CRP检测与绒毛膜羊膜炎的临床症状进行了比较。CRP诊断母亲绒毛膜羊膜炎的敏感性为48%(95%置信区间[CI]-35.99-61.12),特异性为81(95%CI 71.55%-88.98%),母亲绒毛膜羊水炎的比值比为4.1176(95%CI 1.99-8.51),P<0.0001。母亲CRP阳性诊断EONS的敏感性为56.67%(95%CI 43.24%–69.41%),特异性为84.78%(95%CI 75.79%–91.42%),新生儿败血症与母亲CRP阳性的比值比为7.28(95%CI 3.39–15.64),P<0.0001。结论:我们的研究表明,在胎膜早破分娩中,如果母体CRP检测呈阳性,则表明早产和新生儿EONS筛查。
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引用次数: 5
Human Papillomavirus Detection in Oropharyngeal Squamous Cell Carcinoma Using p16 Immunohistochemistry 人乳头瘤病毒在口咽鳞状细胞癌中的p16免疫组化检测
IF 1.1 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2019-10-01 DOI: 10.4103/ijabmr.IJABMR_221_18
D. Uppala, A. Sabu, NV Ratna Mouli, N. Tejaswini, V. Rohit, G. Nishitha
Introduction: Oral cancer ranks third among all cancers in the Indian population with approximately 45% of call cancer cases in India being diagnosed as oral cancer, among which 20%–50% of the cases are observed to be associated with human papillomavirus (HPV) infection. Aim: This study aims to detect and evaluate the presence of p16 in oropharyngeal squamous cell carcinoma (OPSCC) patients using immunohistochemistry (IHC). Materials and Methods: This study was based on samples collected from 21 patients with primary OPSCC who were diagnosed and treated during the period of December 2017–March 2018. Inclusion criteria were complete clinicopathologic data, adequate clinical follow-up, and availability of sufficient paraffin-embedded tumor material. HPV immunoreactivity was further investigated by means of IHC using p16 as a marker. Results: IHC results revealed p16 positivity in six OPSCC cases. There was no statistically significant association of the p16 positivity of HPV with the age, gender, or site. Conclusion: Our results suggest that IHC-based detection of p16 provides a suboptimal prognostic information if not combined with detection of HPV DNA. Although p16 expression and HPV DNA infection are correlated with HPV-associated OPSCCs, neither of the tests alone is the optimal method for HPV status detection.
简介:口腔癌症在印度所有癌症中排名第三,印度约45%的癌症病例被诊断为口腔癌症,其中20%-50%的病例被观察到与人乳头瘤病毒(HPV)感染有关。目的:本研究旨在利用免疫组织化学(IHC)检测和评估p16在口咽鳞状细胞癌(OPSCC)患者中的存在。材料和方法:本研究基于2017年12月至2018年3月期间诊断和治疗的21名原发性口腔鳞状细胞癌患者的样本。纳入标准是完整的临床病理数据、足够的临床随访和足够的石蜡包埋肿瘤材料的可用性。以p16作为标记物,通过IHC进一步研究HPV免疫反应性。结果:6例OPSCC患者的IHC结果显示p16阳性。p16阳性HPV与年龄、性别或部位无统计学意义的相关性。结论:我们的结果表明,如果不结合HPV DNA检测,基于IHC的p16检测提供了次优的预后信息。尽管p16表达和HPV DNA感染与HPV相关的OPSCCs相关,但单独的两种测试都不是检测HPV状态的最佳方法。
{"title":"Human Papillomavirus Detection in Oropharyngeal Squamous Cell Carcinoma Using p16 Immunohistochemistry","authors":"D. Uppala, A. Sabu, NV Ratna Mouli, N. Tejaswini, V. Rohit, G. Nishitha","doi":"10.4103/ijabmr.IJABMR_221_18","DOIUrl":"https://doi.org/10.4103/ijabmr.IJABMR_221_18","url":null,"abstract":"Introduction: Oral cancer ranks third among all cancers in the Indian population with approximately 45% of call cancer cases in India being diagnosed as oral cancer, among which 20%–50% of the cases are observed to be associated with human papillomavirus (HPV) infection. Aim: This study aims to detect and evaluate the presence of p16 in oropharyngeal squamous cell carcinoma (OPSCC) patients using immunohistochemistry (IHC). Materials and Methods: This study was based on samples collected from 21 patients with primary OPSCC who were diagnosed and treated during the period of December 2017–March 2018. Inclusion criteria were complete clinicopathologic data, adequate clinical follow-up, and availability of sufficient paraffin-embedded tumor material. HPV immunoreactivity was further investigated by means of IHC using p16 as a marker. Results: IHC results revealed p16 positivity in six OPSCC cases. There was no statistically significant association of the p16 positivity of HPV with the age, gender, or site. Conclusion: Our results suggest that IHC-based detection of p16 provides a suboptimal prognostic information if not combined with detection of HPV DNA. Although p16 expression and HPV DNA infection are correlated with HPV-associated OPSCCs, neither of the tests alone is the optimal method for HPV status detection.","PeriodicalId":13727,"journal":{"name":"International Journal of Applied and Basic Medical Research","volume":"9 1","pages":"212 - 216"},"PeriodicalIF":1.1,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44488111","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}
引用次数: 6
期刊
International Journal of Applied and Basic Medical Research
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