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Clinical Presentations of Melioidosis and Antibiogram of Burkholderia pseudomallei: An 8-year Study in a Tertiary Care Center, South India Melioidosis 的临床表现与假马勒伯克霍尔德氏菌的抗生素图谱:印度南部一家三级医疗中心的一项为期 8 年的研究
Pub Date : 2024-03-14 DOI: 10.4103/ijamr.ijamr_123_23
Kundoly Velayudhan Suseela, A. Alex, Subi Das
Melioidosis, an infectious disease caused by Burkholderia pseudomallei, is endemic in tropical countries. In nonendemic areas, the disease is rarely suspected because of varying clinical presentations and only a few attempts are made to isolate the pathogen. Many cases are left underdiagnosed or underreported in geographical areas where the disease is not endemic. This study aimed to analyze the clinical presentations, comorbidities, and antibiotic susceptibility patterns in patients with melioidosis in a tertiary care center. A retrospective study was done on culture-confirmed melioidosis patients admitted to a tertiary care center, from January 2015 to December 2022. Relevant information on clinical presentations, mortality rate, comorbidities, and antibiogram was collected from hospital medical records. A total of 73 culture-confirmed cases of melioidosis were included in the study. Common clinical presentations were pneumonia (n = 35, 47.9%), septicemia (n = 13, 17.8%), and deep abscesses (n = 9, 12.3%). The mortality rate from melioidosis was 15.1% (n = 11). No significant difference was found in the mortality rate between pneumonia and septicemia groups (P = 0.716). Diabetes mellitus (DM) was the major comorbidity detected (n = 56, 76.7%). Isolates were susceptible to ceftazidime (n = 71, 97.3%), meropenem (n = 71, 97.3%), and co-trimoxazole (n = 60, 82.2%). Common clinical presentations of melioidosis in our setting were pneumonia and septicemia. DM was the major comorbidity. Nearly one in six patients died. Ceftazidime and meropenem were the effective antibiotics. These findings may help physicians to make an early microbiological diagnosis which is essential to reduce mortality.
Melioidosis 是由假马来伯克霍尔德氏菌(Burkholderia pseudomallei)引起的一种传染病,在热带国家流行。在非流行地区,由于临床表现各异,很少有人怀疑这种疾病,也只有少数人试图分离病原体。在该疾病未流行的地区,许多病例被漏诊或少报。本研究旨在分析一家三级医疗中心中类鼻疽患者的临床表现、合并症和抗生素敏感性模式。 该研究对2015年1月至2022年12月在一家三级医疗中心收治的经培养确诊的类鼻疽患者进行了回顾性研究。研究人员从医院病历中收集了临床表现、病死率、合并症和抗生素图谱等相关信息。 研究共纳入73例经培养确诊的类鼻疽病例。常见的临床表现为肺炎(35例,占47.9%)、脓毒血症(13例,占17.8%)和深部脓肿(9例,占12.3%)。类鼻疽的死亡率为 15.1%(11 人)。肺炎组和败血症组的死亡率无明显差异(P = 0.716)。糖尿病(DM)是发现的主要合并症(n = 56,76.7%)。分离菌株对头孢他啶(n = 71,97.3%)、美罗培南(n = 71,97.3%)和联合新诺明(n = 60,82.2%)敏感。 在我们的病例中,常见的类鼻疽临床表现为肺炎和脓毒血症。糖尿病是主要合并症。近六分之一的患者死亡。头孢他啶和美罗培南是有效的抗生素。这些发现可帮助医生及早做出微生物学诊断,这对降低死亡率至关重要。
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引用次数: 0
Telemedicine is here to Stay: Success and Utility of Video Consultations in Neonatology 远程医疗将继续存在:新生儿科视频会诊的成功与实用性
Pub Date : 2024-02-16 DOI: 10.4103/ijamr.ijamr_190_23
Z. A. Bhat, Nithya Babu Gracy, Femitha Pournami, Jyothi Prabhakar, A. Prithvi, A. Kolisambeevi, Naveen Jain
“Synchronous videoconference telemedicine in neonatal office-practice” (SyNTOP) has been a routine practice in our center since the start of the COVID-19-related lockdown. We recently reported our experience with the “success” of this practice in terms of removing the need to visit the hospital over the next 48 h after the teleconsult. Secondary results of this retrospective descriptive study which analyzed 829 consults are presented in this manuscript. Data from electronic medical records of those who availed teleconsultation facility between March 2020 and April 2021 were retrieved. Relevant information about clinical presentation, findings from the video call, demographic information, decisions made by the clinician, and outcomes were collected. Best efforts were made to obtain follow-up information by the clinical team or guest–patient relations officers. Fever (n = 118) and acute diarrheal disease (n = 58) were the common presenting complaints; most (80.5% and 95.5%, respectively) were resolved without physical examination; 265 developmental assessments were completed by video-facilitated checks. Fast-track vaccination visits where queries were resolved and bills paid online, were an innovation where well babies could avoid queues and possible exposure to crowds. One-fourths of SyNTOP were from outside the district, and 1.4% were from foreign countries. Teleconsults were successfully conducted in neonatal office practice for different health-care enquiries. Strategies such as fast-track vaccinations and online developmental follow-up assessments were performed by leveraging technology. We highlight the benefits of these innovations in our center with a view to enhance their uptake elsewhere. Such approaches have the potential to increase health equity and access to specialty health care.
自 COVID-19 相关封锁开始以来,"新生儿诊室同步视频会议远程医疗"(Synchronous videoconference telemedicine in neonatal office-practice,简称 SyNTOP)一直是我们中心的常规做法。我们最近报告了这一做法的 "成功 "经验,即在远程会诊后的 48 小时内无需到医院就诊。 本手稿介绍了这项回顾性描述研究的次要结果,该研究分析了 829 次会诊。研究人员从 2020 年 3 月至 2021 年 4 月期间使用远程会诊设施的患者的电子病历中检索了数据。研究收集了临床表现、视频通话结果、人口统计学信息、临床医生做出的决定和结果等相关信息。临床团队或客座患者关系官员已尽最大努力获取后续信息。 发热(118 例)和急性腹泻(58 例)是常见的主诉病症;大多数病症(分别为 80.5% 和 95.5%)无需体检即可解决;通过视频协助检查完成了 265 项发育评估。快速通道疫苗接种服务是一项创新,在这里,婴儿可以避免排队和可能的拥挤。四分之一的 SyNTOP 来自区外,1.4% 来自国外。 在新生儿诊室实践中,针对不同的医疗保健咨询成功开展了远程会诊。通过利用技术,实施了快速接种疫苗和在线发育跟踪评估等策略。我们强调了这些创新在我们中心的益处,以期在其他地方推广。这些方法有可能提高健康公平性,增加获得专业医疗保健的机会。
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引用次数: 0
Lamina Cribrosa Thickness in Patients with Branch Retinal Vein Occlusion: A Cross Sectional Comparative Evaluation Using Enhanced Depth Imaging Optical Coherence Tomography 视网膜静脉分支闭塞患者的脉络膜厚度:使用增强深度成像光学相干断层扫描进行横截面比较评估
Pub Date : 2024-02-15 DOI: 10.4103/ijamr.ijamr_158_23
Rahul Bhardwaj, Aeshvarya Dhawan, V. Vats, Priyanka Gupta, Anupam Singh, Nidhi Tomar
Retinal vein occlusion (RVO) is one of the most common causes of retinal vascular disease, second to diabetic retinopathy. We aimed to compare the lamina cribrosa thickness (LCT) of patients with unilateral branch RVO (BRVO) versus healthy individuals. This was a hospital-based, prospective, cross-sectional, and comparative study. Participants were newly diagnosed RVO cases (n = 25) and apparently normal age-matched healthy controls (n = 25). All the participants underwent systemic and comprehensive ophthalmic examination, including refraction and enhanced depth imaging optical coherence tomography. Relevant parameters were compared between the groups using the independent t-test. Statistical significance thresholds were set at a P < 0.05. The mean age of cases (66.7% female) and controls (52% female) was 55.9 ± 7.4 and 59.4 ± 7.0 years, respectively, (P = 0.089). The mean LCT of the affected eyes in cases (176.6 ± 28.3 μm) was significantly lower compared to the unaffected eyes of cases (200.6 ± 33.1 μm, P = 0.008) and control eye (230.9 ± 36.9 μm, P = 0.001). A thinner lamina cribrosa (LC) was observed in both eyes of unilateral RVO patients compared with healthy, nonglaucomatous subjects’ eyes. The role of LCT as a local mechanical factor in the pathogenesis of BRVO and their relationship to systemic factors merits further investigation.
视网膜静脉阻塞(RVO)是导致视网膜血管疾病的最常见原因之一,仅次于糖尿病视网膜病变。我们的目的是比较单侧分支视网膜静脉阻塞(BRVO)患者与健康人的脉络膜厚度(LCT)。 这是一项基于医院的前瞻性横断面比较研究。研究对象为新确诊的 RVO 病例(25 人)和明显正常的年龄匹配健康对照组(25 人)。所有参与者都接受了系统和全面的眼科检查,包括屈光和增强深度成像光学相干断层扫描。组间相关参数的比较采用独立 t 检验。统计显著性阈值设定为 P <0.05。 病例(66.7% 为女性)和对照组(52% 为女性)的平均年龄分别为 55.9 ± 7.4 岁和 59.4 ± 7.0 岁(P = 0.089)。与未受影响的病例眼(200.6 ± 33.1 μm,P = 0.008)和对照眼(230.9 ± 36.9 μm,P = 0.001)相比,病例眼的平均 LCT(176.6 ± 28.3 μm)明显较低。 与健康的非白内障受试者的眼睛相比,单侧 RVO 患者的双眼中均观察到较薄的颅底薄层(LC)。LCT作为局部机械因素在BRVO发病机制中的作用及其与全身因素的关系值得进一步研究。
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引用次数: 0
Lamina Cribrosa Thickness in Patients with Branch Retinal Vein Occlusion: A Cross Sectional Comparative Evaluation Using Enhanced Depth Imaging Optical Coherence Tomography 视网膜静脉分支闭塞患者的脉络膜厚度:使用增强深度成像光学相干断层扫描进行横截面比较评估
Pub Date : 2024-02-15 DOI: 10.4103/ijamr.ijamr_158_23
Rahul Bhardwaj, Aeshvarya Dhawan, V. Vats, Priyanka Gupta, Anupam Singh, Nidhi Tomar
Retinal vein occlusion (RVO) is one of the most common causes of retinal vascular disease, second to diabetic retinopathy. We aimed to compare the lamina cribrosa thickness (LCT) of patients with unilateral branch RVO (BRVO) versus healthy individuals. This was a hospital-based, prospective, cross-sectional, and comparative study. Participants were newly diagnosed RVO cases (n = 25) and apparently normal age-matched healthy controls (n = 25). All the participants underwent systemic and comprehensive ophthalmic examination, including refraction and enhanced depth imaging optical coherence tomography. Relevant parameters were compared between the groups using the independent t-test. Statistical significance thresholds were set at a P < 0.05. The mean age of cases (66.7% female) and controls (52% female) was 55.9 ± 7.4 and 59.4 ± 7.0 years, respectively, (P = 0.089). The mean LCT of the affected eyes in cases (176.6 ± 28.3 μm) was significantly lower compared to the unaffected eyes of cases (200.6 ± 33.1 μm, P = 0.008) and control eye (230.9 ± 36.9 μm, P = 0.001). A thinner lamina cribrosa (LC) was observed in both eyes of unilateral RVO patients compared with healthy, nonglaucomatous subjects’ eyes. The role of LCT as a local mechanical factor in the pathogenesis of BRVO and their relationship to systemic factors merits further investigation.
视网膜静脉阻塞(RVO)是导致视网膜血管疾病的最常见原因之一,仅次于糖尿病视网膜病变。我们的目的是比较单侧分支视网膜静脉阻塞(BRVO)患者与健康人的脉络膜厚度(LCT)。 这是一项基于医院的前瞻性横断面比较研究。研究对象为新确诊的 RVO 病例(25 人)和明显正常的年龄匹配健康对照组(25 人)。所有参与者都接受了系统和全面的眼科检查,包括屈光和增强深度成像光学相干断层扫描。组间相关参数的比较采用独立 t 检验。统计显著性阈值设定为 P <0.05。 病例(66.7% 为女性)和对照组(52% 为女性)的平均年龄分别为 55.9 ± 7.4 岁和 59.4 ± 7.0 岁(P = 0.089)。与未受影响的病例眼(200.6 ± 33.1 μm,P = 0.008)和对照眼(230.9 ± 36.9 μm,P = 0.001)相比,病例眼的平均 LCT(176.6 ± 28.3 μm)明显较低。 与健康的非白内障受试者的眼睛相比,单侧 RVO 患者的双眼中均观察到较薄的颅底薄层(LC)。LCT作为局部机械因素在BRVO发病机制中的作用及其与全身因素的关系值得进一步研究。
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引用次数: 0
Drug Induced Liver Injury: A Descriptive Analyses of Histopathological Patterns and Clinical Outcomes 药物性肝损伤:组织病理学模式和临床结果的描述性分析
Pub Date : 2024-01-31 DOI: 10.4103/ijamr.ijamr_181_23
C. Venkataswamy, Eliz Thomas, R. K. Kartikayan
Given the increased use of complementary and alternative medicine along with over-the-counter drugs, drug-induced liver injury (DILI) has become relatively common and a differential diagnosis for every other patient who presents with a deranged liver function test. As no specific markers or diagnostic tests exist to confirm DILI, it is a diagnosis of exclusion. Liver biopsy is a valuable tool for evaluating patients with clinical suspicion of DILI. However, there are limited published data describing histopathological diagnoses in DILI and their clinical outcomes in the Asian subcontinent. In this 2-year retrospective study conducted between January 2020 and December 2022, records of 34 DILI patients were evaluated. The histological patterns of injury and liver functions (total bilirubin and liver enzymes) were described and the corresponding clinical outcomes were assessed. All the included cases had elevated liver enzymes. The most common histopathological pattern in DILI was cholestatic hepatitis (n = 14, 41.0%). Eosinophilic prominence and inflammation around the portal tract were seen in majority of the cases (n = 25, 73.5%). A few cases had fibrosis as well (n = 12, 35.0%). The most common drug associated with liver injury was herbal/traditional medicines (n = 17, 50.0%). Certain histopathological “clues” can help the pathologist suspect a DILI diagnosis. The main findings associated with DILI are cholestatic hepatitis, lobular disarray, inflammation, and necrosis. Correlation with clinical history and biochemical parameters will help in clinching the diagnosis.
由于补充和替代医学以及非处方药的使用越来越多,药物性肝损伤(DILI)已变得相对常见,也是其他所有肝功能检测异常患者的鉴别诊断之一。由于没有特异性标志物或诊断测试来确诊 DILI,因此这是一种排除性诊断。肝活检是评估临床怀疑 DILI 患者的重要工具。然而,在亚洲次大陆,描述 DILI 组织病理学诊断及其临床结果的公开数据非常有限。 在这项于2020年1月至2022年12月进行的为期两年的回顾性研究中,对34例DILI患者的病历进行了评估。研究描述了损伤的组织学模式和肝功能(总胆红素和肝酶),并评估了相应的临床结果。 所有纳入病例的肝酶均升高。DILI 最常见的组织病理学模式是胆汁淤积性肝炎(14 例,41.0%)。大多数病例的门静脉周围可见嗜酸性粒细胞突出和炎症(25 例,占 73.5%)。少数病例还伴有肝纤维化(12 例,35.0%)。与肝损伤相关的最常见药物是草药/传统药物(17 例,50.0%)。 某些组织病理学 "线索 "可以帮助病理学家怀疑 DILI 的诊断。与 DILI 相关的主要发现是胆汁淤积性肝炎、肝小叶紊乱、炎症和坏死。与临床病史和生化指标的相关性有助于明确诊断。
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引用次数: 0
Primary pancreatic lymphoma - A rare entity 原发性胰腺淋巴瘤-一种罕见的实体
Pub Date : 2023-01-01 DOI: 10.4103/ijamr.ijamr_212_22
L. Prakash, O. Shaikh, U. Kumbhar, Sagar Prakash, G. Balasubramanian
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引用次数: 0
Compulsion beyond hairpulling 除了拔头发以外的强迫行为
Pub Date : 2023-01-01 DOI: 10.4103/ijamr.ijamr_22_23
Dimple Gupta, Avisha Mahla, A. Bhardwaj, Nimmi A. Jose
A mass of hair found trapped in the gastrointestinal system is termed a trichobezoar. Complications such as gastric ulceration, bleeding, perforation, and intestinal obstruction may occur. There is a relative paucity of reports on trichobezoars in psychiatry compared to the surgical literature. Here, we present a case of trichotillomania and pica leading to intestinal obstruction. Our aim was to emphasize the importance of considering trichobezoars as one of the differentials in cases of patients presenting with unexplained abdominal pain, even if clear signs of trichotillomania are not present.
在胃肠系统中发现的大量毛发被称为毛牛黄。可能会出现胃溃疡、出血、穿孔和肠梗阻等并发症。与外科文献相比,精神病学中关于毛霉菌的报道相对较少。在这里,我们介绍一个拔毛癖和异食癖导致肠梗阻的病例。我们的目的是强调在出现不明原因腹痛的患者中,即使没有明显的拔毛癖迹象,也要将拔毛症视为一种差异的重要性。
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引用次数: 0
How to revise and resubmit the manuscript after a favorable peer review? 如何在同行评议后修改并重新提交稿件?
Pub Date : 2023-01-01 DOI: 10.4103/ijamr.ijamr_121_23
Anup Mohta
Authors look forward to acceptance of their manuscripts submitted to any journal. It is important that the authors respond to the observations and suggestions made by the reviewers of the manuscript and the editors of the journal. Corresponding author should submit considered point-wise response to each of the queries raised in a polite manner after discussion with all authors within the time-frame provided. Additional literature, analysis and material may be required to respond to the reviewers' comments. A well crafted complete response is likely to increase the possibilities of acceptance of the manuscript.
作者们期待着他们提交给任何期刊的手稿被接受。重要的是,作者应回应稿件审稿人和期刊编辑提出的意见和建议。通讯作者应在规定的时间内与所有作者讨论后,以礼貌的方式对提出的每一个问题做出深思熟虑的点式回应。可能需要额外的文献、分析和材料来回应评审员的意见。精心制作的完整回复可能会增加手稿被接受的可能性。
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引用次数: 0
How to write a scoping review? 如何撰写范围界定审查?
Pub Date : 2023-01-01 DOI: 10.4103/ijamr.ijamr_91_23
Pooja Sharma, N. Goyal
Scoping reviews have become a common form of evidence synthesis in the past few years. They can collect information from any research methodology as well as from research sources. Thus, they provide a comprehensive overview to address broader research questions as compared to systematic reviews. The original framework for conducting scoping reviews was proposed by Arksey and O'Malley in 2005 and further extended by Joanna Briggs Institute Collaboration in 2017. Preferred Reporting Items for Systematic Reviews Statement extended to Scoping Reviews are the reporting guidelines for a scoping review. The current paper aims to describe various methodological steps for conducting a scoping review.
在过去几年中,范围审查已成为证据综合的一种常见形式。他们可以从任何研究方法以及研究来源收集信息。因此,与系统综述相比,它们提供了一个全面的概述,以解决更广泛的研究问题。Arksey和O'Malley于2005年提出了进行范围审查的原始框架,Joanna Briggs Institute Collaboration于2017年进一步扩展了该框架。系统审查的首选报告项目扩展到范围审查的声明是范围审查的报告指南。本文件旨在描述进行范围界定审查的各种方法步骤。
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引用次数: 0
Critical incident stress debriefing experience, training, and anticipated barriers in emergency medicine providers: A targeted needs assessment 紧急事件压力汇报经验、培训和急救医学提供者的预期障碍:目标需求评估
Pub Date : 2023-01-01 DOI: 10.4103/ijamr.ijamr_186_22
Dana E. Loke, JehannazD Dastoor, A. Fant
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引用次数: 0
期刊
International Journal of Advanced Medical and Health Research
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