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Renal Biopsy Registry from a Single Center in India: 20-year Experience. 印度单个中心的肾活检登记:20 年的经验。
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.59556/japi.72.0731
Chetan Veeramaneni, Manisha Sahay, Anuradha Kavadi, Kiranmai Ismal, Swarnalata Gowrishankar

Background: There is a geographical variation in pattern of kidney diseases due to multiple factors. Renal biopsy is being performed to establish diagnosis of renal diseases. There are only a few biopsy registries which leads to paucity of information. This study was done to evaluate the spectrum of biopsy-proven renal diseases in a tertiary care hospital in southern India. Materials and methods: Renal biopsy records over 2 decades (2000-2020) performed in the Department of Nephrology in a tertiary care hospital in India were analyzed, and clinicopathological correlation was made. Results: Total of 4,532 renal biopsies were evaluated in our study after excluding inadequate biopsy samples. Of which males were 58 and 48% were females. Mean age in our study was 38.6 ± 31.4 years. The most common clinical presentation in our study was nephrotic syndrome (37.2%). On histology, the most common diagnosis was primary glomerulonephritis (49.9%), followed by secondary glomerular diseases (22%), tubulointerstitial (20.8%), and vascular diseases (3.3%). Minimal change disease (12.8%), diabetic nephropathy (11.3%), and acute tubulointerstitial diseases (11.2%) were the three most common histological diagnoses in our study. Conclusion: Nephrotic syndrome was the most common clinical presentation in our study. Minimal change disease was the most common histological diagnosis in our study. There is a need for a uniform nationwide renal biopsy registry in India and even regional renal biopsy registries to analyze the changing trends of renal diseases over time frame and to analyze regional differences in trends of renal diseases.

背景:受多种因素影响,肾脏疾病的发病模式存在地域差异。进行肾活检可确诊肾脏疾病。目前只有少数几个活检登记处,导致信息匮乏。本研究旨在评估印度南部一家三级医院中经活检证实的肾脏疾病谱。材料和方法:分析了印度一家三级医院肾内科 20 年来(2000-2020 年)的肾活检记录,并进行了临床病理学相关分析。结果:在剔除不完整的活检样本后,我们的研究共对 4532 例肾脏活检样本进行了评估。其中男性占 58%,女性占 48%。平均年龄为 38.6 ± 31.4 岁。在我们的研究中,最常见的临床表现是肾病综合征(37.2%)。组织学诊断中,最常见的是原发性肾小球肾炎(49.9%),其次是继发性肾小球疾病(22%)、肾小管间质疾病(20.8%)和血管疾病(3.3%)。微小病变(12.8%)、糖尿病肾病(11.3%)和急性肾小管间质疾病(11.2%)是本研究中最常见的三种组织学诊断。结论在我们的研究中,肾病综合征是最常见的临床表现。在我们的研究中,微小病变是最常见的组织学诊断。有必要在印度建立全国统一的肾活检登记处,甚至是地区性肾活检登记处,以分析肾脏疾病随时间推移而变化的趋势,并分析肾脏疾病趋势的地区差异。
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引用次数: 0
Stable Angina Pectoris: A Review of Pathophysiology, Diagnosis, and Its Management. 稳定型心绞痛:病理生理学、诊断及其治疗综述》(Stable Angina Pectoris: A Review of Pathophysiology, Diagnosis, and Its Management)。
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.59556/japi.72.0704
Anurag Sharma, Tushor Roy, Paramartha Bhattacharya, Dinesh Agarwal, Rohit Kumar, Syed Mujtaba Hussain Naqvi, Rajan Mittal

India is at the cusp of an impending epidemic of cardiovascular diseases (CVD). It has been triggered by rapid urbanization, industrialization, and globalization. Coronary artery disease (CAD) and ischemic heart disease (IHD) clinically present as angina pectoris (chest pain and discomfort). Despite advances in treatment options for CAD, a lack of awareness of risk factors and disease, access to healthcare, and affordability are the primary concerns in low- and middle-income countries. In India, CAD results in >7 million deaths annually. There is a need for active collaboration between patients, physicians, and healthcare providers to identify the early and adequate use of lifestyle, pharmacological, and primary and secondary preventive measures. Antianginal treatment options are categorized as first line (calcium channel blockers (CCBs), β-blockers, and short-acting nitrates) and second line (ivabradine, nicorandil, ranolazine, and trimetazidine) drugs. This review discusses different CCBs (dihydropyridines (DHPs) or nondihydropyridines) for the management of angina pectoris.

印度正处于心血管疾病(CVD)即将流行的风口浪尖。快速的城市化、工业化和全球化引发了这一流行病。冠状动脉疾病(CAD)和缺血性心脏病(IHD)在临床上表现为心绞痛(胸痛和不适)。尽管冠状动脉疾病的治疗方法在不断进步,但在中低收入国家,人们对风险因素和疾病缺乏认识、医疗服务的可及性和可负担性仍是主要问题。在印度,每年因心血管疾病死亡的人数超过 700 万。患者、医生和医疗保健提供者之间需要积极合作,以确定早期和充分使用生活方式、药物、一级和二级预防措施。抗心绞痛治疗方案分为一线药物(钙通道阻滞剂(CCB)、β-受体阻滞剂和短效硝酸盐)和二线药物(伊伐布雷定、尼可地尔、雷诺拉嗪和曲美他嗪)。本综述讨论了治疗心绞痛的不同 CCBs(二氢吡啶类(DHPs)或非二氢吡啶类)。
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引用次数: 0
Prevalence of Celiac Disease in Patients with Nutritional Anemia in Western Part of India. 印度西部地区营养性贫血患者中乳糜泻的患病率。
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.59556/japi.72.0744
Archita Makharia, Kishan Gopal, Vineet Tiwari, Brateen Roy, Sunil Dadhich, Manoj Lakhotia

Background: Around 1.6 billion people worldwide are affected by nutritional anemia. A small percentage of nutritional anemia cases are attributed to celiac disease (CeD). However, data on the prevalence of CeD among individuals with nutritional anemia in the Western part of India is scarce. Patients and methods: Individuals with nutritional anemia were prospectively investigated for the presence of CeD through the detection of immunoglobulin A (IgA) antitissue transglutaminase antibodies (anti-tTG Ab). Those who had a positive antibody result proceeded to have an upper gastrointestinal endoscopy, accompanied by a duodenal biopsy. The diagnosis of CeD was confirmed following Indian guidelines. Results: A total of 116 patients, including 96 females, were screened, with a mean age of 37 ± 17.8 years. Among them, 19 patients (16.3%) were positive for IgA anti-tTG antibodies. Fifteen of these antibody-positive patients agreed to undergo a duodenal biopsy, which showed villous abnormalities of modified Marsh grade 2 or higher in 11 cases. The overall seroprevalence of CeD was 16.3%, while the biopsy-confirmed prevalence stood at 9.3%. Moreover, an additional four patients (3.4%) were identified as having potential CeD. Chronic diarrhea and short stature emerged as significant predictors of CeD among patients with nutritional anemia. Conclusion: Even in the Western part of India, approximately one in 10 patients with nutritional anemia have CeD, reflecting similar findings across the country. Consequently, we should screen all patients with nutritional anemia for CeD through antitissue transglutaminase antibody testing. This is especially crucial for those with unexplained, persistent nutritional anemia that does not respond to oral iron therapy.

背景:全球约有 16 亿人受到营养性贫血的影响:全世界约有 16 亿人受到营养性贫血的影响。一小部分营养性贫血病例归因于乳糜泻(CeD)。然而,有关印度西部地区营养性贫血患者中乳糜泻患病率的数据却很少。患者和方法:通过检测免疫球蛋白 A (IgA) 抗组织转谷氨酰胺酶抗体(抗-tTG Ab),对营养性贫血患者是否患有乳糜泻进行前瞻性调查。抗体检测结果呈阳性的患者接受了上消化道内窥镜检查和十二指肠活检。根据印度指南确诊为 CeD。结果共有 116 名患者接受了筛查,其中包括 96 名女性,平均年龄为 37 ± 17.8 岁。其中,19 名患者(16.3%)的 IgA 抗-tTG 抗体呈阳性。其中 15 例抗体阳性患者同意接受十二指肠活检,结果显示 11 例患者的绒毛异常为改良 Marsh 2 级或以上。CeD的总血清阳性率为16.3%,而活检证实的阳性率为9.3%。此外,另有四名患者(3.4%)被确定为潜在的 CeD 患者。在营养性贫血患者中,慢性腹泻和身材矮小是预测 CeD 的重要因素。结论即使在印度西部地区,大约每 10 名营养性贫血患者中就有 1 人患有 CeD,这反映了全国各地类似的调查结果。因此,我们应该通过抗组织转谷氨酰胺酶抗体检测来筛查所有营养性贫血患者是否患有 CeD。这对于那些原因不明、口服铁剂治疗无效的持续性营养性贫血患者尤为重要。
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引用次数: 0
Effect of a Structured Tele Based Post COVID-19 Rehabilitation Program in the Indian Population. 基于远程的结构化 COVID-19 后康复计划在印度人群中的效果。
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.59556/japi.72.0739
Poorvi Devani, Nicole Maria Pinto, Shravani Kale, Neha Maru, Priyanka Jain, Amrita Desai, Vaishali Prabhudesai, Pralhad Prabhudesai

Introduction: The emergence of coronavirus disease of 2019 (COVID-19) and the imperative for social distancing have propelled telehealth to the forefront. Even after discharge, patients may experience lingering symptoms, termed post-COVID-19 syndrome, which impairs functioning. This syndrome persists beyond recovery from COVID-19. Hence, timely implementation and sustained access to pulmonary rehabilitation services are crucial for COVID-19 patients. This study aims to assess the impact of a structured telerehabilitation program on post-COVID-19 recovery in the Indian population. Methodology: A total of 53 patients, with their informed consent, were included in the study, comprising 71.7% males and 24.3% females, with a mean age of 57.15 years (SD = 11.74, range: 30-81 years). Upon enrollment, comprehensive assessments were conducted, incorporating the visual analog scale (VAS) score for fatigue, 1-minute sit-to-stand test, post-COVID-19 functional status scale, and Depression, Anxiety, and Stress Scale-21 (DASS-21). Treatment interventions were administered remotely via WhatsApp video or Zoom calls, consisting of pulmonary rehabilitation protocols encompassing warm-up exercises, breathing exercises, aerobic and strength training, yoga, cooldown exercises, and regular educational sessions tailored to individual patient needs. Results: There was a significant improvement in outcome measures: VAS score for fatigue (t = 8.6, S, p < 0.001), 1-minute sit-to-stand (steps: t = 5.9, S, p < 0.001), and health-related quality of life (Z = 5.9, S, p < 0.001). Conclusion: The study shows that a structured tele-based program is not only effective in patients but also an approach that is feasible and should be considered for the delivery of rehabilitation to patients who are unable to participate in center-based rehabilitation.

导言:2019 年冠状病毒病(COVID-19)的出现和拉近社会距离的必要性将远程保健推向了前沿。即使在出院后,患者也可能会出现挥之不去的症状,即 "COVID-19 后综合征",从而影响其功能。这种综合征在 COVID-19 康复后依然存在。因此,对于 COVID-19 患者来说,及时实施和持续获得肺康复服务至关重要。本研究旨在评估结构化远程康复计划对印度人群 COVID-19 后康复的影响。研究方法:研究共纳入 53 名获得知情同意的患者,其中男性占 71.7%,女性占 24.3%,平均年龄为 57.15 岁(SD = 11.74,年龄范围:30-81 岁)。研究人员在注册时进行了综合评估,包括疲劳视觉模拟量表(VAS)评分、1 分钟坐立测试、COVID-19 后功能状态量表以及抑郁、焦虑和压力量表-21(DASS-21)。治疗干预通过 WhatsApp 视频或 Zoom 通话进行远程管理,包括肺康复方案,其中包括热身运动、呼吸运动、有氧运动和力量训练、瑜伽、冷却运动,以及根据患者个人需求量身定制的定期教育课程。结果疗效显著:疲劳 VAS 评分(t = 8.6,S,P < 0.001)、1 分钟坐立(步数:t = 5.9,S,P < 0.001)和健康相关生活质量(Z = 5.9,S,P < 0.001)均有显著改善。结论研究表明,结构化远程计划不仅对患者有效,而且是一种可行的方法,应考虑用于为无法参加中心康复的患者提供康复服务。
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引用次数: 0
Research Methodology and Biostatistics in the Postgraduate Curriculum: The AIIMS-Bhubaneswar Experience. 研究生课程中的研究方法学和生物统计学:AIIMS-Bhubaneswar 的经验。
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.59556/japi.72.0714
Gitanjali Batmanabane, Rituparna Maiti, Mullezhath Babu Nimesh Krishna

Inclusion of research methodology and biostatistics in the postgraduate curriculum by the National Medical Commission is a welcome step to improve the research milieu in medical colleges in India. This step will have a long-term impact on research outcomes and scientific publications. In 2019, AIIMS-Bhubaneswar implemented the revised postgraduate curriculum, which introduced a faculty-facilitated program on research methodology and biostatistics for all postgraduate students. The institute also made the examination in research methodology mandatory, which can be viewed as a complementary mechanism. As the revised curriculum has been in practice for the last 4 years and six sessions of examinations have been completed, the authors tried to look back to check whether the program is having the expected results and share the experience they gained.

国家医学委员会将研究方法学和生物统计学纳入研究生课程,是改善印度医学院研究环境的可喜举措。这一举措将对研究成果和科学出版物产生长期影响。2019 年,AIIMS-Bhubaneswar 实施了修订后的研究生课程,为所有研究生引入了由教师主持的研究方法学和生物统计学课程。该学院还将研究方法论考试作为必修课,这可以被视为一种补充机制。由于修订后的课程已经实施了四年,考试也已进行了六届,作者试图回顾一下该课程是否达到了预期效果,并分享他们获得的经验。
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引用次数: 0
Prevalence of Depression in Patients with Epilepsy: A Single Center Cross-sectional Study at a Tertiary Care Hospital. 癫痫患者的抑郁症患病率:一家三级医院的单中心横断面研究。
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.59556/japi.72.0745
Sriramakrishnan Vayanakkan, Anto Ignat Stany, Vignesh Karunaharan

Background: Depression in persons with epilepsy (PWE) negatively impacts the quality of life (QOL), increasing suicidal risk and increasing healthcare costs. Aim: To assess the prevalence of depression in recently diagnosed PWE and the impact of seizure variables on depression. Study design: A prospective study of recently diagnosed epilepsy patients attending a tertiary hospital in government Tirunelveli Medical College Hospital. Materials and methods: Recently diagnosed epilepsy patients (n = 100) were administered the Beck Depression Inventory (BDI) translated into local vernacular language for quantitative assessment of depression. Statistical analysis: Chi-squared test and logistic regression analysis were used to assess the impact of seizure-related variables on BDI scores (p < 0.05 was considered significant). Results: Using the BDI, the prevalence of depressive symptoms in PWE was 48%. A strong correlation coefficient of 0.8 was obtained on the PWE scores on both scales, demonstrating their effectiveness in detecting depressive symptoms. Conclusion: Depression was more common in PWE than in the general population. Depression may be seen even before the onset of epilepsy in some patients, thereby hinting at a probable similar mechanism. Patients with temporal lobe epilepsy and major depressive disorder show changes in serotonergic 5-hydroxytryptophan (5HT) 1A receptor density in their brains, as observed using positron emission tomography. It is crucial to promptly identify and manage depression in newly diagnosed epilepsy patients, along with administering appropriate antiepileptic drugs.

背景:癫痫患者(PWE)的抑郁症会对生活质量(QOL)产生负面影响,增加自杀风险并增加医疗成本。目的:评估近期确诊的癫痫患者中抑郁症的患病率以及癫痫发作变量对抑郁症的影响。研究设计:一项前瞻性研究,研究对象为在政府提伦韦利医学院附属医院的一家三级医院就诊的近期确诊的癫痫患者。材料和方法:对新近确诊的癫痫患者(n = 100)进行贝克抑郁量表(BDI)测试,该量表已翻译成当地方言,用于抑郁的定量评估。统计分析:采用卡方检验和逻辑回归分析评估癫痫发作相关变量对 BDI 评分的影响(P < 0.05 为显著)。结果使用 BDI,PWE 的抑郁症状发生率为 48%。PWE 在这两个量表上的得分存在 0.8 的强相关系数,这表明它们在检测抑郁症状方面非常有效。结论与普通人群相比,抑郁症在残疾人中更为常见。有些患者甚至在癫痫发作前就可能出现抑郁症状,这说明可能存在类似的机制。根据正电子发射断层扫描的观察,颞叶癫痫和重度抑郁症患者大脑中的血清素能5-羟色氨酸(5HT)1A受体密度会发生变化。对于新确诊的癫痫患者,及时发现和治疗抑郁症并给予适当的抗癫痫药物至关重要。
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引用次数: 0
Hypersensitivity Pneumonitis: The Diagnosis Lies in History. 超敏性肺炎:诊断在于病史
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.59556/japi.72.0723
Jyoti Chauhan, Tanvi Batra, Atul Kakar, Rahul Kumar, Naveen Goud Bollapally, Anjana Jangid

Hypersensitivity pneumonitis (HP)/extrinsic allergic alveolitis (EAA) is defined as a response of lungs to inhaled organic and inorganic substances. This disease is relatively rare, comprising 2% of cases in the category of interstitial lung diseases. Here, we discuss a case of 61-year-old female, who presented with sudden onset breathlessness, with bilateral coarse crackles on physical examination, initially thought to be due to heart failure or atypical pneumonia, but later diagnosed as HP. She was managed initially with antibiotics but due to poor response, steroids were introduced which led to significant improvement. This report emphasizes the importance of exposure history of substances that are toxic, lack of specificity of clinical manifestations, importance of invasive methods for diagnosis, and poor response to therapy in case of delayed diagnosis.

超敏性肺炎(HP)/外源性过敏性肺泡炎(EAA)被定义为肺部对吸入的有机和无机物质的反应。这种疾病相对罕见,只占间质性肺病病例的 2%。在此,我们讨论一例 61 岁的女性患者,她突然出现呼吸困难,体格检查时出现双侧粗大的噼啪声,起初以为是心力衰竭或非典型肺炎所致,但后来被诊断为 HP。起初她接受了抗生素治疗,但由于反应不佳,医生开始使用类固醇,结果病情明显好转。本报告强调了接触有毒物质史的重要性、临床表现缺乏特异性、侵入性诊断方法的重要性以及延误诊断时治疗反应差等问题。
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引用次数: 0
Sporadic Creutzfeldt-Jakob Disease: A Rare Case of Rapid Progressive Cognitive Decline with Special Reference to Magnetic Resonance Spectroscopy. 散发性克雅氏病:一个认知能力快速衰退的罕见病例,特别参考磁共振波谱。
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.59556/japi.72.0632
Karan Jaykrushna Pandya, Bansari Krupal Parmar, Jaya M Pathak

Creutzfeldt-Jakob disease (CJD) is a rare degenerative disorder seen in the 6-8th decade of life. It manifests as a rapidly progressing cognitive deterioration, the etiopathogenesis of which is neuronal accumulation of aberrant prion protein [scrapie-associated prion protein (PrPSC)], resulting in mortality within 1 year of diagnosis. Clinical features such as dementia, myoclonus, cerebellar, and extrapyramidal symptoms are observed in CJD, which may be confused with other degenerative conditions and many infectious diseases like human immunodeficiency virus (HIV), creating a diagnostic challenge. Consequently, a multimodal approach with clinical, electrophysiological, radiological, and biochemical analyses is needed to validate the diagnosis of CJD. There is no effective treatment available for CJD. Early identification of the disease can lead to palliative care. Mortality of the patient occurs due to infection and comorbidities. In this article, we report a case of a 60-year-old male with probable sporadic CJD who presented with dementia, akinetic mutism, and rigidity, along with typical magnetic resonance imaging (MRI) findings of the brain. The magnetic resonance spectroscopy (MRS) study showed lower N-acetylaspartate/creatine (NAA: Cr) and Cho: Cr ratios correlated with progressive neurodegeneration and, hence, poor prognosis.

克雅氏病(CJD)是一种罕见的变性疾病,多见于 6-8 十岁的儿童。其发病机制是神经元内异常朊病毒蛋白(scrapie-associated prion protein,PrPSC)的积累,导致患者在确诊后 1 年内死亡。CJD可出现痴呆、肌阵挛、小脑和锥体外系症状等临床特征,并可能与其他变性疾病和人类免疫缺陷病毒(HIV)等多种传染病混淆,给诊断带来挑战。因此,需要通过临床、电生理学、放射学和生化分析等多模式方法来验证 CJD 的诊断。目前还没有治疗 CJD 的有效方法。及早发现该病可以采取姑息治疗。感染和合并症会导致患者死亡。在本文中,我们报告了一例可能患有散发性 CJD 的 60 岁男性患者,他表现为痴呆、运动性缄默症和僵直,并伴有典型的脑部磁共振成像(MRI)结果。磁共振波谱(MRS)研究显示,N-乙酰天冬氨酸/肌酸(NAA:Cr)和Cho:Cr比率与进行性神经变性相关,因此预后较差。
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引用次数: 0
Segmental Absence of Intestinal Musculature: An Enticing Predicament. 节段性肠肌缺失:诱人的困境
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.59556/japi.72.0734
Nitya Kaul, Rupinder Kaur, Vishesh Dhawan, Ayushi Kediya

Segmental absence of intestinal musculature (SAIM) was first identified as a cause of intestinal perforation and remains difficult to diagnose clinically. Diagnosing SAIM preoperatively can be difficult; however, detection during the surgical procedure may be feasible if gross observations reveal bowel alterations such as a thinned-out wall, signs of gangrenous changes, or adjacent bowel dilatation. A final diagnosis can be made with the help of histopathology, making it a gold standard. Even though this condition is more prevalent among newborns, only a handful of cases have been published in the literature, mentioning involvement of the older patients. Maintaining a high index of suspicion for this disease when dealing with cases of intestinal obstruction or perforation in children and adults is instrumental in facilitating swift diagnosis and prompt treatment, thus improving the patient's outcome. We, hereby, would like to add one more case report of a 4-year-old girl child presenting with this rare entity to the literature.

节段性肠肌缺失(SAIM)最早被认为是肠穿孔的原因之一,但在临床上仍然难以诊断。术前诊断 SAIM 可能比较困难;但是,如果大体观察发现肠壁变薄、坏疽病变迹象或邻近肠管扩张等肠道改变,在手术过程中就有可能发现 SAIM。组织病理学是最终诊断的金标准。尽管这种疾病在新生儿中较为常见,但文献中仅有少数病例提到年长患者也会受累。在处理儿童和成人肠梗阻或穿孔病例时,保持对这种疾病的高度怀疑有助于快速诊断和及时治疗,从而改善患者的预后。在此,我们希望在文献中再增加一例 4 岁女童患这种罕见疾病的病例报告。
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引用次数: 0
Association of Gait Impairment with Executive Dysfunction and Magnetic Resonance Imaging Brain Findings in Elderly Population. 老年人步态障碍与执行功能障碍和脑磁共振成像结果的关系
Q3 Medicine Pub Date : 2024-11-01 DOI: 10.59556/japi.72.0510
Bhawna Sharma, Mitul Kasundra

Objectives: The primary objective was to understand the association between gait impairment and executive dysfunction and magnetic resonance imaging (MRI) brain findings in the elderly Indian population. Also, we aimed to assess the association between executive dysfunction (ED) and MRI brain findings in the elderly Indian population. Materials and methods: This was a prospective observational study conducted in the Department of Neurology at a tertiary care facility in Northwest India for a duration of 1 year between October 2021 and September 2022. Results: Patients with hypertension [odds ratio (OR) 2.85, 95% confidence of interval (CI) 1.59-5.10], raised and/or deranged lipid profile (OR 2.19, 95% CI 1.12-4.30), serum creatinine (Sr. creatinine) (OR 2.16, 95% CI 1.85-2.53) and blood urea (OR 2.27, 95% CI 1.92-2.67) were at increased risk of ED. Smoking tobacco was associated with four times increased risk of ED (OR 3.98, 95% CI 2.18-7.26). Of the tests of frontal assessment battery (FAB), the strength of association was highest for motor Luria (OR 34.81, 95% CI 15.84-76.52), followed by the backward digit span test. Patients with ED had decreased step length, abnormal stride width, abnormal cadence, and decreased velocity. Regarding MRI brain findings, atrophy of the occipital lobe was associated with decreased step length; atrophy of the midbrain and cerebellar atrophy were associated with decreased stride width; and midbrain atrophy was associated with cadence. It was found that the basal ganglia and periventricular hyperintensity were associated with step length. Conclusion: The findings contribute to our understanding of the relationship between ED, brain structural changes, and gait abnormalities, highlighting the potential role of smoking, glycemic control (and related risk factors) and brain regions involved in gait control.

研究目的主要目的是了解印度老年人群中步态障碍和执行功能障碍与磁共振成像(MRI)脑部检查结果之间的关联。此外,我们还旨在评估印度老年人群中执行功能障碍(ED)与磁共振成像(MRI)脑部检查结果之间的关联。材料和方法:这是一项前瞻性观察研究,于 2021 年 10 月至 2022 年 9 月在印度西北部一家三级医疗机构的神经内科进行,为期一年。研究结果高血压[几率比(OR)2.85,95% 置信区间(CI)1.59-5.10]、血脂升高和/或异常(OR 2.19,95% CI 1.12-4.30)、血清肌酐(Sr. creatinine)(OR 2.16,95% CI 1.85-2.53)和血尿素(OR 2.27,95% CI 1.92-2.67)患者发生 ED 的风险增加。吸烟导致罹患 ED 的风险增加四倍(OR 3.98,95% CI 2.18-7.26)。在额叶评估电池(FAB)测试中,运动鲁里亚测试的相关性最高(OR 34.81,95% CI 15.84-76.52),其次是后向数字跨度测试。ED患者的步长减少、步幅异常、步调异常和速度降低。磁共振成像脑部发现,枕叶萎缩与步长减少有关;中脑和小脑萎缩与步幅减少有关;中脑萎缩与步幅有关。研究发现,基底节和脑室周围高密度与步长有关。结论研究结果有助于我们理解 ED、脑结构变化和步态异常之间的关系,突出了吸烟、血糖控制(及相关风险因素)和参与步态控制的脑区的潜在作用。
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The Journal of the Association of Physicians of India
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