Pub Date : 2023-10-25DOI: 10.18203/2349-3933.ijam20233209
Selvi Hokman, Dewi Catur Wulandari
Gestational trophoblastic disease, also referred to as GTD, is an extremely rare form of pregnancy-related complication that can arise. It covers a wide range of conditions, from choriocarcinoma to molar pregnancy. Patients who are diagnosed with gestational trophoblastic disease have an increased likelihood of developing hyperthyroidism. It is speculated that this occurs as a result of molecular mimicry that exists between human chorionic gonadotrophin (hCG) and thyroid-stimulating hormone (TSH), which results in cross-reactivity with the TSH receptor. This would explain why the two molecules would react similarly to each other. The gestational trophoblastic disease-induced thyroid storm is an extremely rare but potentially fatal complication that can arise during pregnancy. It is necessary to detect and treat this complication as soon as possible in order to prevent additional complications from occurring. Once the patient's hemodynamic status has been stabilized, the removal of the mole is the primary component of the definitive treatment that will be administered. In most cases, hyperthyroidism usually resolves once the gestational trophoblastic disease has been successfully treated and the hCG levels have been brought back to normal.
{"title":"The hyperthyroidism in gestational trophoblastic disease: a case report","authors":"Selvi Hokman, Dewi Catur Wulandari","doi":"10.18203/2349-3933.ijam20233209","DOIUrl":"https://doi.org/10.18203/2349-3933.ijam20233209","url":null,"abstract":"Gestational trophoblastic disease, also referred to as GTD, is an extremely rare form of pregnancy-related complication that can arise. It covers a wide range of conditions, from choriocarcinoma to molar pregnancy. Patients who are diagnosed with gestational trophoblastic disease have an increased likelihood of developing hyperthyroidism. It is speculated that this occurs as a result of molecular mimicry that exists between human chorionic gonadotrophin (hCG) and thyroid-stimulating hormone (TSH), which results in cross-reactivity with the TSH receptor. This would explain why the two molecules would react similarly to each other. The gestational trophoblastic disease-induced thyroid storm is an extremely rare but potentially fatal complication that can arise during pregnancy. It is necessary to detect and treat this complication as soon as possible in order to prevent additional complications from occurring. Once the patient's hemodynamic status has been stabilized, the removal of the mole is the primary component of the definitive treatment that will be administered. In most cases, hyperthyroidism usually resolves once the gestational trophoblastic disease has been successfully treated and the hCG levels have been brought back to normal.","PeriodicalId":13827,"journal":{"name":"International Journal of Advances in Medicine","volume":"434 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134973645","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}
Pub Date : 2023-10-20DOI: 10.18203/2349-3933.ijam20233158
R. Venkateshwaran, M. A. Arumugam
Background: Left ventricular ejection fraction serves as a vital gauge of left ventricular overall function and plays a crucial role in assessing the severity and prognosis of ischemic heart disease. Another approach for evaluating left ventricular function is through the assessment of regional function using the wall motion score index. In this study, our objective was to assess and compare the predictive value of both WMSI and LVEF in patients with Acute Myocardial Infarction for their ability to predict all-cause mortality and readmission due to heart failure. Methods: This prospective study was conducted on admitted patients in Government Kilpauk Medical College on 70 patients with Acute myocardial infarction between the first 48 hours of symptoms and before hospital discharge. Follow-up with clinic visits was conducted 3, 6 and 12 months after discharge. The primary endpoint was the composite of all-cause mortality and readmission for heart failure. Results: 63% of patients had LVEF of less than 40%, and 55% had WMSI>1.5. After a follow-up of 1 year, 3.7% mortality and 11% readmission for heart failure were observed. WMSI>1.5 and LVEF<40% were associated with poor survival, while the WMSI proved to be a better predictor for rehospitalisation. 81% of STEMI group patients had EF<40%, but only 18% of the NSTEMI group had EF < 40%, which is statistically significant. There is no superiority between WMSI and LVEF in the STEMI and NSTEMI groups. Killip classification proved to be an independent predictor of mortality, but no statistical significance was observed in readmission. Conclusions: Both LVEF and WMSI were predictors of all-cause mortality, while the WMSI was a predictor for readmission for heart failure.
{"title":"Wall motion score index and left ventricular ejection fraction as predictors of cardiovascular events after acute myocardial infarction","authors":"R. Venkateshwaran, M. A. Arumugam","doi":"10.18203/2349-3933.ijam20233158","DOIUrl":"https://doi.org/10.18203/2349-3933.ijam20233158","url":null,"abstract":"Background: Left ventricular ejection fraction serves as a vital gauge of left ventricular overall function and plays a crucial role in assessing the severity and prognosis of ischemic heart disease. Another approach for evaluating left ventricular function is through the assessment of regional function using the wall motion score index. In this study, our objective was to assess and compare the predictive value of both WMSI and LVEF in patients with Acute Myocardial Infarction for their ability to predict all-cause mortality and readmission due to heart failure. Methods: This prospective study was conducted on admitted patients in Government Kilpauk Medical College on 70 patients with Acute myocardial infarction between the first 48 hours of symptoms and before hospital discharge. Follow-up with clinic visits was conducted 3, 6 and 12 months after discharge. The primary endpoint was the composite of all-cause mortality and readmission for heart failure. Results: 63% of patients had LVEF of less than 40%, and 55% had WMSI>1.5. After a follow-up of 1 year, 3.7% mortality and 11% readmission for heart failure were observed. WMSI>1.5 and LVEF<40% were associated with poor survival, while the WMSI proved to be a better predictor for rehospitalisation. 81% of STEMI group patients had EF<40%, but only 18% of the NSTEMI group had EF < 40%, which is statistically significant. There is no superiority between WMSI and LVEF in the STEMI and NSTEMI groups. Killip classification proved to be an independent predictor of mortality, but no statistical significance was observed in readmission. Conclusions: Both LVEF and WMSI were predictors of all-cause mortality, while the WMSI was a predictor for readmission for heart failure.","PeriodicalId":13827,"journal":{"name":"International Journal of Advances in Medicine","volume":"31 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135567628","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}
Pub Date : 2023-09-27DOI: 10.18203/2349-3933.ijam20232915
Rizwana R. Khan, Thanadar A. Flora, Urmilata Biswas, Jubyda S. Rashid, Shirin G. Zabin
Background: Cervical cancer, ranking as the second most prevalent cancer and a leading cause of female cancer-related deaths in low to middle-income nations, exhibits a notable connection between tumor proliferation (Ki-67) and invasiveness (e-cadherin). Both factors contribute significantly to cervical cancer's aggressiveness. This study aims to establish the clinical-pathological link between e-cadherin and Ki-67 expression in cervical carcinoma, and assess their potential as diagnostic biomarkers. Methods: This cross-sectional study spanned July 2017 to June 2019 at Sir Salimullah Medical College and Mitford Hospital Dhaka. It encompassed 60 adult female patients histopathologically diagnosed with cervical cancer. All patients underwent e-cadherin, Ki-67 expression assessments, and histopathological diagnosis. Ethical clearance was granted by SSMC Institutional Ethics Committee. Results: E-cadherin expression presented as follows: strong intensity in 36.7% cases, weak and homogeneous in 35.0%, weak and heterogeneous in 8.3%, negative staining in 15.1%, and negative expression in 5.0%. Ki-67 mean levels varied significantly among different types of cervical cancer (p<0.05). Squamous cell carcinoma was predominant (80.0%), with heightened e-cadherin expression in well-differentiated cases (14 cases). Notably, cases with no e-cadherin expression exhibited Ki-67 mean of 71.0±7.9, while those with strong E-cadherin expression displayed Ki-67 mean of 56.5±8.2 (p<0.05). A significant negative correlation (r=-0.300; p=0.022) emerged between Ki-67 LI (%) and e-cadherin expression. Conclusions: E-cadherin correlates effectively with clinicopathological features and Ki-67 expression in cervical carcinoma. This underscores its pivotal role in cervical cancer progression.
{"title":"Expression of e-cadherin and Ki-67 in cervical cancer: a study in a tertiary care hospital, Dhaka, Bangladesh","authors":"Rizwana R. Khan, Thanadar A. Flora, Urmilata Biswas, Jubyda S. Rashid, Shirin G. Zabin","doi":"10.18203/2349-3933.ijam20232915","DOIUrl":"https://doi.org/10.18203/2349-3933.ijam20232915","url":null,"abstract":"Background: Cervical cancer, ranking as the second most prevalent cancer and a leading cause of female cancer-related deaths in low to middle-income nations, exhibits a notable connection between tumor proliferation (Ki-67) and invasiveness (e-cadherin). Both factors contribute significantly to cervical cancer's aggressiveness. This study aims to establish the clinical-pathological link between e-cadherin and Ki-67 expression in cervical carcinoma, and assess their potential as diagnostic biomarkers. Methods: This cross-sectional study spanned July 2017 to June 2019 at Sir Salimullah Medical College and Mitford Hospital Dhaka. It encompassed 60 adult female patients histopathologically diagnosed with cervical cancer. All patients underwent e-cadherin, Ki-67 expression assessments, and histopathological diagnosis. Ethical clearance was granted by SSMC Institutional Ethics Committee. Results: E-cadherin expression presented as follows: strong intensity in 36.7% cases, weak and homogeneous in 35.0%, weak and heterogeneous in 8.3%, negative staining in 15.1%, and negative expression in 5.0%. Ki-67 mean levels varied significantly among different types of cervical cancer (p<0.05). Squamous cell carcinoma was predominant (80.0%), with heightened e-cadherin expression in well-differentiated cases (14 cases). Notably, cases with no e-cadherin expression exhibited Ki-67 mean of 71.0±7.9, while those with strong E-cadherin expression displayed Ki-67 mean of 56.5±8.2 (p<0.05). A significant negative correlation (r=-0.300; p=0.022) emerged between Ki-67 LI (%) and e-cadherin expression. Conclusions: E-cadherin correlates effectively with clinicopathological features and Ki-67 expression in cervical carcinoma. This underscores its pivotal role in cervical cancer progression.","PeriodicalId":13827,"journal":{"name":"International Journal of Advances in Medicine","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135580788","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}
Pub Date : 2023-09-27DOI: 10.18203/2349-3933.ijam20232916
Nishtha Pansari, Arundhati Diwan, Ashwin Rajbhoj
Background: Peripheral neuropathies are disorders of peripheral nerve cells and fibres. Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of anticancer treatment, and it can affect the patient's long-term survival. The prevalence of CIPN is around 38%. Peripheral neurotoxicity (PN) is a side effect of paclitaxel that can lead to treatment discontinuation. The intensity and severity of neuropathy is more with patients receiving weekly paclitaxel chemotherapy. Methods: 60 patients of CA breast receiving weekly paclitaxel monotherapy who fulfilled inclusion and exclusion criteria were enrolled in the study. Clinical examination and grading of neuropathy was done according to NCI-CTCAE version 4.0. All patient had undergone nerve-conduction studies at baseline and 3 months after baseline. Results: 50% of patients, developed signs symptoms of peripheral neuropathy, out of which tingling sensation was the most common symptom (40%). The incidence of grade 1 peripheral neuropathy at 3 and 6 months were 35%, and 31.66%, while grade 2 neuropathy was noted in 18.33%, and 14.75% of patients, respectively. There was a significant difference in the SNAP value between baseline and 3 months for right ulnar nerve, right and left sural nerve and CMAP for right median nerve, right ulnar nerve, right and left tibial nerves which suggests development of neuropathy during 3 months of paclitaxel chemotherapy. Conclusions: This study provides information on the incidence and severity of peripheral neuropathy in patients receiving weekly paclitaxel chemotherapy, which can help physician in further management.
{"title":"A prospective observational study to assess peripheral neuropathy in patients receiving weekly paclitaxel chemotherapy","authors":"Nishtha Pansari, Arundhati Diwan, Ashwin Rajbhoj","doi":"10.18203/2349-3933.ijam20232916","DOIUrl":"https://doi.org/10.18203/2349-3933.ijam20232916","url":null,"abstract":"Background: Peripheral neuropathies are disorders of peripheral nerve cells and fibres. Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of anticancer treatment, and it can affect the patient's long-term survival. The prevalence of CIPN is around 38%. Peripheral neurotoxicity (PN) is a side effect of paclitaxel that can lead to treatment discontinuation. The intensity and severity of neuropathy is more with patients receiving weekly paclitaxel chemotherapy. Methods: 60 patients of CA breast receiving weekly paclitaxel monotherapy who fulfilled inclusion and exclusion criteria were enrolled in the study. Clinical examination and grading of neuropathy was done according to NCI-CTCAE version 4.0. All patient had undergone nerve-conduction studies at baseline and 3 months after baseline. Results: 50% of patients, developed signs symptoms of peripheral neuropathy, out of which tingling sensation was the most common symptom (40%). The incidence of grade 1 peripheral neuropathy at 3 and 6 months were 35%, and 31.66%, while grade 2 neuropathy was noted in 18.33%, and 14.75% of patients, respectively. There was a significant difference in the SNAP value between baseline and 3 months for right ulnar nerve, right and left sural nerve and CMAP for right median nerve, right ulnar nerve, right and left tibial nerves which suggests development of neuropathy during 3 months of paclitaxel chemotherapy. Conclusions: This study provides information on the incidence and severity of peripheral neuropathy in patients receiving weekly paclitaxel chemotherapy, which can help physician in further management.","PeriodicalId":13827,"journal":{"name":"International Journal of Advances in Medicine","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135581591","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}
Pub Date : 2023-09-27DOI: 10.18203/2349-3933.ijam20232919
Sreemanta M. Baruah, John K. Das, Imdadul Hossain, Nongmaithem B. Singh
Background: Poisoning with organophosphorus compounds (OP) is a common problem throughout the world particularly in developing countries. Standard treatment involves resuscitation, administration of the anti-muscarinic agent atropine, an acetylcholinesterase reactivator (pralidoxime) and assisted ventilation if necessary. In this study we compared the efficacy of add-on pralidoxime therapy over therapy with atropine alone in OP poisoning. Methods: The study included 103 patients, out of 103 OP poisoning cases, 54 patients received both atropine and PAM (group A) and 49 received only atropine (group B). Main outcome parameters of the study were total hospital stay and mortality. The data was compared using ‘t’ test while mortality was compared using Fisher’s exact test. Data was tabulated, analysed, reviewed and evaluated. Results: There was no difference in duration of hospital stay between the two group. The mean hospital stay in group A was 3.71±1.92 days and in group B was 3.14±2.01 days (p value >0.05). No difference in mortality was seen between the two group. Out of 54 in group A, 8 died and in group B out of 49, 7 died (p value >0.05). Importantly cost burden is very high in the pralidoxime added group. Conclusions: There is no significant difference in use of atropine alone or atropine-pralidoxime combination in terms of morbidity and mortality in OP poisoning rather the later incurs more economic burden which may not be practicable in poor countries like India. However, a larger multicentric prospective study needs to be conducted, to be able to draw a definitive conclusion.
背景:有机磷化合物(OP)中毒是全世界特别是发展中国家普遍存在的问题。标准治疗包括复苏、抗毒蕈碱药物阿托品、乙酰胆碱酯酶再激活剂(哌拉西肟)和必要时辅助通气。在这项研究中，我们比较了加用普拉多肟治疗与单独使用阿托品治疗OP中毒的疗效。方法:103例OP中毒患者中，54例同时使用阿托品和PAM (A组)，49例仅使用阿托品(B组)。研究的主要结局参数为总住院时间和死亡率。数据比较采用t检验，死亡率比较采用Fisher精确检验。数据被制表、分析、审查和评估。结果:两组患者住院时间差异无统计学意义。A组平均住院时间为3.71±1.92 d, B组平均住院时间为3.14±2.01 d (p值>0.05)。两组之间的死亡率没有差异。A组54例患者死亡8例，B组49例患者死亡7例(p值>0.05)。重要的是，加用哌拉西肟组的费用负担非常高。结论:单独使用阿托品与阿托品-普拉多肟联合使用在OP中毒的发病率和死亡率方面没有显著差异，但后者带来的经济负担更大，这在印度等贫困国家可能不可行。然而，需要进行更大的多中心前瞻性研究，才能得出明确的结论。
{"title":"A comparative study of atropine and atropine plus pralidoxime in the management of organo-phosphorous poisoning","authors":"Sreemanta M. Baruah, John K. Das, Imdadul Hossain, Nongmaithem B. Singh","doi":"10.18203/2349-3933.ijam20232919","DOIUrl":"https://doi.org/10.18203/2349-3933.ijam20232919","url":null,"abstract":"Background: Poisoning with organophosphorus compounds (OP) is a common problem throughout the world particularly in developing countries. Standard treatment involves resuscitation, administration of the anti-muscarinic agent atropine, an acetylcholinesterase reactivator (pralidoxime) and assisted ventilation if necessary. In this study we compared the efficacy of add-on pralidoxime therapy over therapy with atropine alone in OP poisoning. Methods: The study included 103 patients, out of 103 OP poisoning cases, 54 patients received both atropine and PAM (group A) and 49 received only atropine (group B). Main outcome parameters of the study were total hospital stay and mortality. The data was compared using ‘t’ test while mortality was compared using Fisher’s exact test. Data was tabulated, analysed, reviewed and evaluated. Results: There was no difference in duration of hospital stay between the two group. The mean hospital stay in group A was 3.71±1.92 days and in group B was 3.14±2.01 days (p value >0.05). No difference in mortality was seen between the two group. Out of 54 in group A, 8 died and in group B out of 49, 7 died (p value >0.05). Importantly cost burden is very high in the pralidoxime added group. Conclusions: There is no significant difference in use of atropine alone or atropine-pralidoxime combination in terms of morbidity and mortality in OP poisoning rather the later incurs more economic burden which may not be practicable in poor countries like India. However, a larger multicentric prospective study needs to be conducted, to be able to draw a definitive conclusion.","PeriodicalId":13827,"journal":{"name":"International Journal of Advances in Medicine","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135582152","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}
Pub Date : 2023-09-27DOI: 10.18203/2349-3933.ijam20232917
T. M. Nithisha, Linto Mathew Thomas, Isha S. Joshi, Tejaswini P.
Background: Studies have linked increased cholesterol esters in meibomian secretions to patients with meibomian gland dysfunction. Dyslipidemia has been linked to the development of MGD. This study of serum lipid profile in established cases of MGD. Methods: A cross sectional study was conducted in department of ophthalmology at Rajarajeswari medical college and hospital Kambipura, Bengaluru from January 2021 to June 2022. 75 study participants with clinical diagnosis of MGD were included. Results: The mean age of the study participants was found to be 55.97±14.019. Mild MGD grade was found in 32% and 26.7% of the study participants in the right eye and left eye respectively. Moderate MGD grade was 38.7% and 42.7% of the study participants in the right and left eye respectively. 4% each of the study participants had very severe MGD grade in the right and left eye respectively. Marx line grading of 1 was found in 40% and 46.7% of the study participants in the right eye and left eye respectively. Marx line grading of 2 was found in 54.7% and 36% of the study participants in the right and left eye respectively. Marx line grading of 3 was 5.3% and 17.3% of the study participants in right left eye respectively. severity of MGD grading of the study participants increases, the Lipid profile values also increases. The association was statistically significant between the MGD grading and lipid profile. Conclusions: MGD patients exhibit a higher degree of total cholesterol, LDL, lower degree of HDL in their serum lipid profiles than normal reference levels and the severity of MGD increases, the values of lipid profile increase. Elevated serum cholesterol was associated with MGD.
{"title":"A cross sectional study to assess the severity of meibomian gland dysfunction and its association with dyslipidemia","authors":"T. M. Nithisha, Linto Mathew Thomas, Isha S. Joshi, Tejaswini P.","doi":"10.18203/2349-3933.ijam20232917","DOIUrl":"https://doi.org/10.18203/2349-3933.ijam20232917","url":null,"abstract":"Background: Studies have linked increased cholesterol esters in meibomian secretions to patients with meibomian gland dysfunction. Dyslipidemia has been linked to the development of MGD. This study of serum lipid profile in established cases of MGD. Methods: A cross sectional study was conducted in department of ophthalmology at Rajarajeswari medical college and hospital Kambipura, Bengaluru from January 2021 to June 2022. 75 study participants with clinical diagnosis of MGD were included. Results: The mean age of the study participants was found to be 55.97±14.019. Mild MGD grade was found in 32% and 26.7% of the study participants in the right eye and left eye respectively. Moderate MGD grade was 38.7% and 42.7% of the study participants in the right and left eye respectively. 4% each of the study participants had very severe MGD grade in the right and left eye respectively. Marx line grading of 1 was found in 40% and 46.7% of the study participants in the right eye and left eye respectively. Marx line grading of 2 was found in 54.7% and 36% of the study participants in the right and left eye respectively. Marx line grading of 3 was 5.3% and 17.3% of the study participants in right left eye respectively. severity of MGD grading of the study participants increases, the Lipid profile values also increases. The association was statistically significant between the MGD grading and lipid profile. Conclusions: MGD patients exhibit a higher degree of total cholesterol, LDL, lower degree of HDL in their serum lipid profiles than normal reference levels and the severity of MGD increases, the values of lipid profile increase. Elevated serum cholesterol was associated with MGD.","PeriodicalId":13827,"journal":{"name":"International Journal of Advances in Medicine","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135581608","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}
Pub Date : 2023-09-27DOI: 10.18203/2349-3933.ijam20232920
Ivan Buntara, Sari Purnama Hidayat, Christina Siuwandy Buulolo, None Hendsun
Lung abscess is a condition that characterized by formation of pus or tissue necrosis in lung parenchyma. The prevalence of lung abscess in Indonesia is still unknown, but the incidence seems to be decreased. Lung abscess could be categorized in many forms based on the duration, etiology and the way of spreading. Early sign and symptoms usually cannot be differentiated from pneumonia. Lung abscess also could be preceded by fever of unknown origin, so it could be challenging to diagnose. This case report presented a-57-years old man that preceded by fever of unknown origin. Chest X-ray show unspecified lung infiltrate, thus treated as a pneumonia. Further X-ray showed the clear image of cavities with abscess. Lung CT-scan was performed and bronchiectasis also lung abscess were found. Comprehensive history taking, physical examinations and diagnostic tests were done in this patient until the diagnosis is established.
{"title":"Lung abscess preceded by fever of unknown origin: a case report","authors":"Ivan Buntara, Sari Purnama Hidayat, Christina Siuwandy Buulolo, None Hendsun","doi":"10.18203/2349-3933.ijam20232920","DOIUrl":"https://doi.org/10.18203/2349-3933.ijam20232920","url":null,"abstract":"Lung abscess is a condition that characterized by formation of pus or tissue necrosis in lung parenchyma. The prevalence of lung abscess in Indonesia is still unknown, but the incidence seems to be decreased. Lung abscess could be categorized in many forms based on the duration, etiology and the way of spreading. Early sign and symptoms usually cannot be differentiated from pneumonia. Lung abscess also could be preceded by fever of unknown origin, so it could be challenging to diagnose. This case report presented a-57-years old man that preceded by fever of unknown origin. Chest X-ray show unspecified lung infiltrate, thus treated as a pneumonia. Further X-ray showed the clear image of cavities with abscess. Lung CT-scan was performed and bronchiectasis also lung abscess were found. Comprehensive history taking, physical examinations and diagnostic tests were done in this patient until the diagnosis is established.","PeriodicalId":13827,"journal":{"name":"International Journal of Advances in Medicine","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135582146","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}
Reactive arthritis (ReA) is an inflammatory arthritis that manifests days to weeks after a gastrointestinal or genitourinary infection. It is also described as a classic triad of arthritis, urethritis, and conjunctivitis. Here we discuss the clinical presentation of ReA in a 20-year-old male who presented with typical triad of symptoms. But there was presence of hematuria which couldn't be explained by this single diagnosis. So further investigations where necessary to find the cause of his haematuria. A 20-year-old male student with history of childhood onset renal stone disease presented with complaints of dysuria for 3 days followed by bilateral conjunctival congestion along with pain around right hip joint, painful swelling around right ankle joint for 2 days. All examination were normal except for bilateral conjunctivitis and features of right ankle joint arthritis. His blood investigations showed neutrophilic leucocytosis with raised CRP levels. Chlamydia IgM Antibody was detected positive, which revealed the causative organism being Chlamydia Trachomatis. Urine routine showed 50-55 RBC’S and 2+ proteinuria. Hematuria was attributed to the CT evidence of renal stone and abnormal retroaortic coarse of his left renal vein described as posterior nutcracker syndrome.
{"title":"A rare case of reactive arthritis with intermittent hematuria in a young male","authors":"Bhargavan Pallivalappil, Anuja Jacob, Sadab Raza Khan, Sherin Khader, Babitha Mekkayil","doi":"10.18203/2349-3933.ijam20232921","DOIUrl":"https://doi.org/10.18203/2349-3933.ijam20232921","url":null,"abstract":"Reactive arthritis (ReA) is an inflammatory arthritis that manifests days to weeks after a gastrointestinal or genitourinary infection. It is also described as a classic triad of arthritis, urethritis, and conjunctivitis. Here we discuss the clinical presentation of ReA in a 20-year-old male who presented with typical triad of symptoms. But there was presence of hematuria which couldn't be explained by this single diagnosis. So further investigations where necessary to find the cause of his haematuria. A 20-year-old male student with history of childhood onset renal stone disease presented with complaints of dysuria for 3 days followed by bilateral conjunctival congestion along with pain around right hip joint, painful swelling around right ankle joint for 2 days. All examination were normal except for bilateral conjunctivitis and features of right ankle joint arthritis. His blood investigations showed neutrophilic leucocytosis with raised CRP levels. Chlamydia IgM Antibody was detected positive, which revealed the causative organism being Chlamydia Trachomatis. Urine routine showed 50-55 RBC’S and 2+ proteinuria. Hematuria was attributed to the CT evidence of renal stone and abnormal retroaortic coarse of his left renal vein described as posterior nutcracker syndrome.","PeriodicalId":13827,"journal":{"name":"International Journal of Advances in Medicine","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135582147","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}
Pub Date : 2023-09-27DOI: 10.18203/2349-3933.ijam20232922
Ajinkya V. Mahorkar, Virag U. Mahorkar, Uday K. Mahorkar, Avanti A. Vidhale, Suresh J. Sarwale
Acute thrombotic closure of more than one coronary artery causing STEMI is an infrequent finding in coronary angiography during primary angioplasty in myocardial infarction (PAMI). We presented a case of 37 years old male with acute inferior wall myocardial infarction (IWMI) with complete heart block (CHB) with left ventricular failure (LVF). Coronary angiography showed thrombotic occlusion in right coronary artery (RCA) and circumflex arteries. Clinical condition improved only after percutaneous transluminal coronary angioplasty (PTCA) of both arteries. Given this unique presentation, the best management is not standardized. Further studies are needed to better predict outcomes and guide future management.
{"title":"A tale of two culprits: a case report","authors":"Ajinkya V. Mahorkar, Virag U. Mahorkar, Uday K. Mahorkar, Avanti A. Vidhale, Suresh J. Sarwale","doi":"10.18203/2349-3933.ijam20232922","DOIUrl":"https://doi.org/10.18203/2349-3933.ijam20232922","url":null,"abstract":"Acute thrombotic closure of more than one coronary artery causing STEMI is an infrequent finding in coronary angiography during primary angioplasty in myocardial infarction (PAMI). We presented a case of 37 years old male with acute inferior wall myocardial infarction (IWMI) with complete heart block (CHB) with left ventricular failure (LVF). Coronary angiography showed thrombotic occlusion in right coronary artery (RCA) and circumflex arteries. Clinical condition improved only after percutaneous transluminal coronary angioplasty (PTCA) of both arteries. Given this unique presentation, the best management is not standardized. Further studies are needed to better predict outcomes and guide future management.","PeriodicalId":13827,"journal":{"name":"International Journal of Advances in Medicine","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135580176","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}
Background: By therapeutic apheresis is to remove a pathologic element from blood or to modulate cellular function. By this study we observed, complications after the therapeutic plasma exchange (TPE) within 24 hours with respect to patient’s demographic profiles and procedural variations. Methods: One-year prospective observational study conducted by the Department of Transfusion Medicine in collaboration with the Medicine Department, King George’s Medical University, Lucknow India. Results: In our study total of 60 cases and total of 150 TPE cycles were performed. Maximum mean age (36±4) was observed for cough and vomiting both and maximum mean BMI was observed followed for Infection at phlebotomy site (36.34±5.09). Maximum mean variation of hemoglobin was observed for vomiting (2.28±0.00), followed by internal bleeding. Maximum mean variation of activated partial thromboplastin time (aPTT) was observed for cough (22.05±0.34), followed by vomiting. Maximum mean variation of prothrombin time (PT) was observed for hypothermia (13.16±10.47), followed by internal bleeding. Maximum mean variation of S. creatinine was observed for abdominal discomfort (0.23±1.54), followed by vomiting. Maximum mean variation of systolic blood pressure (SBP) was observed for cough (7.00±5.20), followed by bipedal edema. Maximum mean variation of SpO2 was observed for death. Conclusions: Complication within 24 hours after the procedure was abdominal discomfort mainly in males with a correlation with body mass index (BMI). We observed significant positive association with complication versus APTT, PT, S. urea, S. creatinine, pulse, SBP, SpO2 and BMI. This emphasizes the decreasing trend of the complications with the increase in number of cycles.
{"title":"Complications after therapeutic plasma exchange within 24 hours","authors":"Jyoti Bharti, Tulika Chandra, Archana Solanki, Ashutosh Singh, D. Himanshu Reedy, Mallika Agarwal","doi":"10.18203/2349-3933.ijam20232918","DOIUrl":"https://doi.org/10.18203/2349-3933.ijam20232918","url":null,"abstract":"Background: By therapeutic apheresis is to remove a pathologic element from blood or to modulate cellular function. By this study we observed, complications after the therapeutic plasma exchange (TPE) within 24 hours with respect to patient’s demographic profiles and procedural variations. Methods: One-year prospective observational study conducted by the Department of Transfusion Medicine in collaboration with the Medicine Department, King George’s Medical University, Lucknow India. Results: In our study total of 60 cases and total of 150 TPE cycles were performed. Maximum mean age (36±4) was observed for cough and vomiting both and maximum mean BMI was observed followed for Infection at phlebotomy site (36.34±5.09). Maximum mean variation of hemoglobin was observed for vomiting (2.28±0.00), followed by internal bleeding. Maximum mean variation of activated partial thromboplastin time (aPTT) was observed for cough (22.05±0.34), followed by vomiting. Maximum mean variation of prothrombin time (PT) was observed for hypothermia (13.16±10.47), followed by internal bleeding. Maximum mean variation of S. creatinine was observed for abdominal discomfort (0.23±1.54), followed by vomiting. Maximum mean variation of systolic blood pressure (SBP) was observed for cough (7.00±5.20), followed by bipedal edema. Maximum mean variation of SpO2 was observed for death. Conclusions: Complication within 24 hours after the procedure was abdominal discomfort mainly in males with a correlation with body mass index (BMI). We observed significant positive association with complication versus APTT, PT, S. urea, S. creatinine, pulse, SBP, SpO2 and BMI. This emphasizes the decreasing trend of the complications with the increase in number of cycles.","PeriodicalId":13827,"journal":{"name":"International Journal of Advances in Medicine","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135581858","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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