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Evaluation of perinatal hypoxic encephalopathy with advanced MR sequences 晚期MR序列对围产期缺氧脑病的评价
Pub Date : 2021-01-01 DOI: 10.5455/jmas.74980
I. Khan, Nadia Khurshid, Irshad Paul, Feroze A. Shaheen, Mushtaq I. Bhat
Perinatal hypoxic ischemic encephalopathy (HIE) among important causes of neurological morbidity and mortality in full-term neonates. Identifying ischemic injury clinically usually is difficult in the immediate postnatal period, nonspecific clinical features are present and consid-erations regarding initiation of active life preserving therapies are needed. MR imaging is the most sensitive and specific imaging tech-nique available for the assessment of perinatal birth asphyxia related brain injury in term-born neonates. This study investigates the utility of MR spectroscopy peak ratios, ADC values along with conventional MRI. To compare the association of encephalopathy following hypoxia in term neonates with proton MRS ratios and ADC values. Conventional MRI (T1 and T2) along with DWI followed by MR Spectroscopy was done in 25 term neonates with clinical and neurological features of en-cephalopathy following perinatal asphyxia. MRS peak ratios, DWI with ADC values and conventional MRI findings were compared with each grade of HIE. Among 25 patients suspected cases of hypoxic enceph-alopathy, 15 patients had early positive conventional MR findings, 16 patients had late positive conventional MR findings, 19 patients had positive DWI, and 22 patients had positive MRS with high lac-tate/choline and lactate/NAA ratio. Higher association was found be-tween spectroscopy findings and hypoxic ischemic injury compared to MR imaging and ADC. The combination of MRS, DWI with ADC values and conventional MRI may assist in localizing and predicting the severi-ty of ischemic injury in HIE patients.
围产期缺氧缺血性脑病(HIE)是足月新生儿神经系统疾病和死亡的重要原因之一。临床上识别缺血性损伤通常是困难的,在出生后的直接时期,非特异性的临床特征存在,需要考虑是否开始积极的生命保存治疗。磁共振成像是最敏感和特异的成像技术,可用于评估围产期分娩窒息相关脑损伤的足月新生儿。本研究探讨了磁共振光谱峰比、ADC值与常规MRI的效用。比较足月新生儿缺氧后脑病与质子MRS比值和ADC值的关系。本文对25例围产儿窒息后有脑病临床和神经学特征的足月新生儿进行了常规MRI (T1和T2)、DWI和MR谱检查。比较HIE各分级的MRS峰比、DWI与ADC值及常规MRI表现。25例疑似缺氧性脑病患者中,MR早期阳性15例,MR晚期阳性16例,DWI阳性19例,MRS阳性22例,乳酸/胆碱、乳酸/NAA比值较高。与磁共振成像和ADC相比,光谱结果与缺氧缺血性损伤的相关性更高。MRS、DWI、ADC值与常规MRI相结合有助于定位和预测HIE患者缺血性损伤的严重程度。
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引用次数: 0
Epidemiological and clinicopathological characteristics of breast cancer in Eastern Indonesia 印度尼西亚东部乳腺癌的流行病学和临床病理特征
Pub Date : 2021-01-01 DOI: 10.5455/JMAS.97327
Elanda Putri Madyaningtias, Daniel Sampepajung, P. Prihantono, M. Faruk
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引用次数: 1
Histomorphological study of premalignant lesions of prostate and their association with adenocarcinoma with utility of immunohistochemistry 应用免疫组织化学研究前列腺癌前病变及其与腺癌的关系
Pub Date : 2021-01-01 DOI: 10.5455/JMAS.126725
V. Sandeep, A. Bansal, Radhika C Sasturkar
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引用次数: 1
A vivid way of differentiating benign and malig-nant cervical lymph node through b-mode ultrasonography and sonoelastography b超和超声弹性超声鉴别颈淋巴结良恶性的一种生动方法
Pub Date : 2021-01-01 DOI: 10.5455/jmas.63227
S. Patil, Sidhesh Murugaiyan, Pravitha Baskar, Divyameenupreetha Ashok, Muhsina Aboobaker, Sindhu Raju
Cervical lymphadenopathy is not a diagnosis but it is a sign or symp-tom. The etiology could be inflammatory or degenerative or neoplastic. Cervical lymph node evaluation plays a vital role in patients with head and neck cancers because the results determine the prognosis and choice of therapy. Ultrasonography can be used to assess the mor-phology, site, number, size and vascularity of cervical lymph node. However, the ultrasound criteria for metastatic lymph nodes are con-troversial. Sonoelastography is a novel imaging modality introduced as a non-invasive technique for evaluating cervical lymph nodes and to map the elastic properties of examined soft tissue. Neck lymph nodes are easily accessible and can be efficiently compressed against under-lying anatomical structures, with use of an ultrasound transducer for elastographic tissue characterization. The detail about the rigidity of a lymph node gives us the direction for percutaneous biopsy and nodal dissection under ultrasound guidance. Use of this information can also improve patient follow-up by enabling detection of cancer recurrence at an early stage. The study aims to differentiate benign and malignant cervical lymph nodes by observing the morphology, vascular Pattern and strain ratio cut-off value. In this trial 40 patients with cervical lym-phadenopathy were studied and the study concluded that Ultrasound elastography is a specific test unlike B-mode ultrasonography in dif-ferentiating benign and malignant cervical lymphadenopathy. The strain ratio cut-off value for benign vs malignant lymphadenopathy is 1.78. Thus Sonoelastography along with B-mode ultrasound increases the rate of detection of malignancy.
宫颈淋巴结病不是一种诊断,但它是一种体征或症状。病因可能是炎症性、退行性或肿瘤性。颈部淋巴结评估在头颈癌患者中起着至关重要的作用,因为其结果决定了预后和治疗的选择。超声检查可对颈淋巴结的形态、部位、数量、大小及血管状况进行评估。然而,转移性淋巴结的超声诊断标准存在争议。超声弹性成像是一种新的成像方式,作为一种非侵入性技术,用于评估颈部淋巴结和绘制被检查软组织的弹性特性。颈部淋巴结很容易接近,可以有效地压缩下层解剖结构,使用超声换能器进行弹性组织表征。淋巴结刚性的细节为超声引导下的经皮活检和淋巴结清扫提供了方向。利用这些信息还可以通过早期发现癌症复发来改善患者的随访。本研究旨在通过观察颈部淋巴结形态、血管形态及应变比截断值来鉴别颈部淋巴结良恶性。本试验对40例宫颈淋巴结病患者进行了研究,研究认为超声弹性成像与b超不同,是鉴别宫颈淋巴结病良恶性的一种特异性检查。良恶性淋巴结病的应变比临界值为1.78。因此超声弹性成像与b超结合可提高恶性肿瘤的检出率。
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引用次数: 0
Trend and determinants of COVID 19 pandemic in a district of Central India: A cross sectional study 印度中部某区COVID - 19大流行的趋势和决定因素:一项横断面研究
Pub Date : 2021-01-01 DOI: 10.5455/jmas.52244
Richa Changulani, Manoj Bansal, D. Shukla
The novel Coronavirus outbreak was originated from Wuhan, China, was first reported in India on 30th January 2020. The impact of an epidemic depends on the number of persons infected, infection transmissibility and the spectrum of clinical severity. To determine the impact of outbreak, analysis of the existing record was done. The objective of this study was to determine the demographic factors, case fatality rate, its association and trend was observed among positive cases reported in Gwalior district. Covid-19 related data collected at the IDSP unit of Gwalior District was analysed. A total of 11281 case reported between 30th March to 11th October was included and their recorded data was analysed using mean, median, chi-square test and logistic regression analysis. The study shows that Mean age of the cases was 39.95±16.75 while their median age was 38.0 (27.0-52.0). Maximum cases were in the age group of 21-30 (25.6%). On assessing the current status, 94.7% patients were discharged from isolation/treatment facility, 4% case were active while 1.3% died. Risk Ratio (Odds Ratio) for death was calculated for different characteristics. It was concluded from the present study that the outcome of disease was found statistically significant in age groups, residence in containment area and isolation status among patients by using logistic regression analysis. Also, no gender predilection of the disease and its mortality.
新型冠状病毒疫情起源于中国武汉,于2020年1月30日在印度首次报告。流行病的影响取决于受感染的人数、感染的传播能力和临床严重程度。为了确定爆发的影响,对现有记录进行了分析。本研究的目的是确定人口因素、病死率及其与瓜廖尔地区报告的阳性病例的关系和趋势。对瓜廖尔地区IDSP单位收集的Covid-19相关数据进行了分析。共纳入3月30日至10月11日报告的11281例病例,并采用均值、中位数、卡方检验和logistic回归分析对其记录资料进行分析。本组病例平均年龄为39.95±16.75岁,中位年龄为38.0(27.0 ~ 52.0)岁。以21 ~ 30岁年龄组最多(25.6%)。在评估现状时,94.7%的患者从隔离/治疗机构出院,4%的病例活跃,1.3%的病例死亡。计算不同特征的死亡风险比(Odds Ratio)。本研究采用logistic回归分析,发现患者的年龄、隔离区居住和隔离状态对疾病结局有统计学意义。此外,没有性别偏好的疾病和它的死亡率。
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引用次数: 0
Epidemiological profile of COVID 19 cases admitted in Dedicated COVID Hospital, Government Medical College, Aurangabad, Maharashtra 马哈拉施特拉邦奥兰加巴德政府医学院专门医院收治的COVID - 19病例流行病学分析
Pub Date : 2021-01-01 DOI: 10.5455/jmas.31834
Rasika Kathar, S. Andurkar, J. Dixit, Shweta N. Salphale, Kailash P. Kagne
Coronavirus disease 2019 (COVID-19) was declared a pandemic by World Health Organization (WHO) three months after the first case of Coronavirus 2 (SARS-CoV2) was reported in Wuhan, China in late December 2019. India recorded its first COVID-19 case on 30th January 2020. As on 30th September 2020, a total of 63,01,156 COVID-19 cases and 98,585 deaths have been reported in the country. An observational study was carried out among all COVID-19 positive cases admitted in Dedicated COVID Hospital Government Medical College Aurangabad, Maharashtra during the period between 1st April to 30th September with the aim to study demographic distribution, clinical manifestation and co morbid status of COVID-19 positive patients. Out of total 6,564 COVID suspect patients admitted in DCH within the study period a total of 2,986 tested positive for COVID-19. Out of these 2,986 patients 1,812 (60.68%) were discharged according to the ICMR guidelines while 724 (24.25%) cases died due to COVID-19. There were still 379 (12.69%) of active cases in the hospital. Among the admitted patients the largest stratum of 1,156 (38.71%) was contributed by patients belonging to the age group of 41-60 years while only 68 (2.28%) patients were in the age group of above 80 years of age. On admission the most frequent clinical profile was characterized by breathlessness (37%) and fever (35%). While 7.82% of the patients were asymptomatic. Among the patients, hypertension (n=679) was the most prevalent co-morbidity followed by diabetes (n=573) and ischemic heart disease (n=166).
2019年12月下旬,在中国武汉报告了首例冠状病毒2型(SARS-CoV2)病例三个月后,世界卫生组织(世卫组织)宣布2019冠状病毒病(COVID-19)为大流行。印度于2020年1月30日记录了首例COVID-19病例。截至2020年9月30日,该国共报告63,01,156例COVID-19病例和98,585例死亡。对4月1日至9月30日在马哈拉施特拉邦奥兰加巴德政府医学院专用COVID-19医院收治的所有COVID-19阳性病例进行观察性研究,目的是研究COVID-19阳性患者的人口分布、临床表现和合并症状况。在研究期间,在DCH收治的6564名COVID疑似患者中,共有2986名COVID-19检测呈阳性。在2986例患者中,1812例(60.68%)根据ICMR指南出院,724例(24.25%)因COVID-19死亡。医院仍有379例(12.69%)活跃病例。入院患者中,41 ~ 60岁患者占1156例(38.71%),80岁以上患者占68例(2.28%)。入院时最常见的临床特征是呼吸困难(37%)和发烧(35%)。7.82%的患者无症状。其中高血压(n=679)是最常见的合并症,其次是糖尿病(n=573)和缺血性心脏病(n=166)。
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引用次数: 0
Neonatal acute kidney injury - how mortality is related to its stage and the common co-morbidity among expired? A hospital based study 新生儿急性肾损伤-死亡率与分期和常见合并症有何关系?一项基于医院的研究
Pub Date : 2021-01-01 DOI: 10.5455/JMAS.135312
S. Laha, K. Karmakar, B. Ghoshal
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引用次数: 0
The effect of banana dose and duration on the decrease of sleep disorders in the elderly 香蕉剂量和持续时间对减少老年人睡眠障碍的影响
Pub Date : 2021-01-01 DOI: 10.5455/JMAS.134020
Emillia Panurywanti, B. Wiboworini, D. Indarto
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引用次数: 0
Current scenario of covid 19 & impact of preventive strategies in curtailing its spread in a district of Gujarat 2019冠状病毒病的现状及预防战略对古吉拉特邦某地区遏制其传播的影响
Pub Date : 2021-01-01 DOI: 10.5455/jmas.38588
Piyushkumar Parmar, Sanjay Kumar, Aniruddha Gohel
COVID-19 outbreak has been declared pandemic by World Health Organization (WHO). This study was planned to know the current COVID-19 situation in district and to know the impact of data driven preventive strategy to curtail the cases (Between 3rd August and 2nd September 2020). This is a cross sectional study done in tribal district of Gujarat. Total registered patients upto 2nd September 2020 were included in the study. Out of total 1189 patients, 34.4% were female. Recovery rate on 3rd August 2020 was 44.8% which is increased to 82.09% on 2nd September 2020. Positivity rate declined from 5.2% to 2.3% despite increase in test per million from 5042 to 51606 between 3rd August and 2nd September 2020. This decrease in test positivity rate attributed to preventive strategy followed by district. Over a period of one month (3rd August to 2nd September) district observed gradual decrease in Compound daily growth rate (CDGR) and increase in doubling time. Over a period of time, downward trend in cases detection and increase in recovery rate observed due to preventive strategies followed by district. To curtail the COVID-19 it is required to keep constant watch on spread, as few cases left undiagnosed can make big spike in district.
新冠肺炎疫情已被世界卫生组织宣布为大流行。本研究计划了解该地区目前的COVID-19情况,并了解数据驱动的预防战略对减少病例的影响(2020年8月3日至9月2日)。这是一项在古吉拉特邦部落地区进行的横断面研究。截至2020年9月2日的注册患者全部纳入研究。1189例患者中,女性占34.4%。2020年8月3日回收率为44.8%,9月2日回收率为82.09%。尽管在2020年8月3日至9月2日期间,每百万检测人数从5042人增加到51606人,但阳性率从5.2%下降到2.3%。检测阳性率的下降归因于各地区采取的预防策略。在一个月的时间里(8月3日至9月2日),该地区的复合日增长率(CDGR)逐渐下降,翻倍时间增加。在一段时间内,由于各区采取了预防战略,病例发现呈下降趋势,治愈率有所提高。为了遏制COVID-19,需要持续关注传播,因为很少有未确诊的病例会在地区造成大的高峰。
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引用次数: 0
Risk factors for ventilator associated pneumonia in patients with trauma and head injury in a tertiary care teaching hospital of rural Gujarat 古吉拉特邦农村三级保健教学医院创伤和头部损伤患者呼吸机相关肺炎的危险因素
Pub Date : 2021-01-01 DOI: 10.5455/jmas.42509
Naimikaben Patel, C. Modi, Suman P. Singh
Ventilator associated pneumonia (VAP) is one of the major complications occurring in patients with mechanical ventilation, particularly in patients with trauma and head injury. The present study was conducted to determine the rate of VAP in patients with trauma and head injury, risk factors associated with them and their microbial profile as well as antimicrobial susceptibility patterns. A prospective observational study was conducted at Surgical Intensive Care Unit at tertiary care teaching hospital between 1st December 2016 and 31st May 2018. All patients with traumatic injury with or without head injury and who have been intubated and put on mechanical ventilation for more than 48 hours, were included in the study. Patients developing VAP were considered as cases whereas those who did not develop VAP served as controls. Out of 174 patients included in the study, 39 patients developed VAP with an incidence rate of 22.4% and incidence density of 21.7 per 1000 ventilator-days. Risk factors such as GCS < 9 on admission, history of vomiting, craniotomy and tracheostomy were found to be statistically significant (p< 0.05) for development of VAP. Duration of ICU stay (30±16 vs 8±4.9 days) and duration of intubation (25.85±16 vs 5.83±4 days) were statistically significant findings. Pseudomonas aeruginosa, Acinetobacter baumannii and Klebsiella pneumoniae were the most common organisms isolated. Most of these organisms were multi drug resistant but were susceptible to colistin. Tracheostomy maintenance and infection control practices for patients undergoing surgical interventions such as craniotomy should be reviewed to bring down VAP rates.
呼吸机相关性肺炎(VAP)是机械通气患者的主要并发症之一,特别是在创伤和头部损伤患者中。本研究旨在确定创伤和头部损伤患者的VAP发生率、与之相关的危险因素、其微生物谱以及抗菌药物敏感性模式。2016年12月1日至2018年5月31日在三级护理教学医院外科重症监护室进行了一项前瞻性观察研究。所有伴有或不伴有颅脑损伤的创伤性损伤患者,气管插管和机械通气超过48小时均纳入研究。发生VAP的患者被视为病例,而未发生VAP的患者被视为对照组。在纳入研究的174例患者中,39例患者发生VAP,发病率为22.4%,发病率密度为21.7 / 1000呼吸机天。入院时GCS < 9、呕吐史、开颅、气管切开术等危险因素对VAP的发生有统计学意义(p< 0.05)。ICU住院时间(30±16天vs 8±4.9天)和插管时间(25.85±16天vs 5.83±4天)差异有统计学意义。铜绿假单胞菌、鲍曼不动杆菌和肺炎克雷伯菌是最常见的分离菌。这些微生物大多具有多重耐药,但对粘菌素敏感。对于接受开颅等手术干预的患者,应审查气管造口术维持和感染控制措施,以降低VAP率。
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引用次数: 0
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Journal of Medical and Allied Sciences
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