Pub Date : 2021-07-01DOI: 10.4103/amit.amit_145_21
S. Bohara, R. Das, N. Tripathi, Lawanya Verma
Introduction: Tuberculosis (TB) is one of the leading causes of mortality and morbidity in India, and extrapulmonary cases from the lymph nodes account for one-fifth of the overall disease burden. TB is known for its varied clinical presentations as well as different sites (organs) of involvement. Fine-needle aspiration cytology (FNAC) plays an important role in diagnosing a significant number of cases which present as granulomatous lesions. Here, we study the cytomorphological and clinical presentation of swellings showing granulomatous pattern of inflammation and correlate them with acid-fast bacilli (AFB) positivity. Materials and Methods: A retrospective study of 3-years duration was done from January 2018 to December 2020 in a tertiary care hospital. Slides of 356 cases showing epithelioid granulomas on cytology were taken out. The clinical data were collected from patient requisition forms. All the available clinical and cytological findings were recorded. The slides were re-examined and characterized into specific patterns of granulomatous inflammation on the basis of predominant background population of cells, necrosis, and hemorrhage. These were correlated with the presence of positive AFB staining on Ziehl–Neelsen (ZN) stain. Chi-square test was used for comparison between groups and P < 0.05 was taken to be statistically significant. Results: The mean age of presentation was 25 years (ranging from 5 months to 75 years) with a slight female preponderance (male-to-female ratio being 0.9:1). The cervical lymph nodes were the most common site. The sites of presentation were varied. The aspirates were gray–white to blood mixed on gross and cytological examination in 186 cases (52.25%). On microscopy, the suppurative pattern was seen in 202 cases (56.74%) and necrosis was seen in 182 cases (51.12%). The AFB positivity on ZN staining was seen in 96 (26.96%) cases in FNAC smears. There was a significant association of positive AFB staining with younger age group (<25 years), larger sized swellings (>2 cm), fixed and matted swellings, longer duration of symptoms (>2 weeks), and absence of pain and fever. The whitish/purulent aspirates on gross examination as well as suppurative and necrotic patterns on cytomorphology on microscopic examination showed a highly significant positive correlation with AFB staining. Conclusion: The gross and microscopic patterns of suppuration and necrosis on FNAC in combination with clinical signs and symptoms are highly suggestive of TB. ZN staining on cytology smears is a very simple and useful investigation, especially in suppurative and necrotic patterns of cytology, for clinching an early diagnosis, which goes a long way in the management of tuberculosis.
{"title":"Clinical and cytomorphological patterns of granulomatous inflammation and its correlation with Ziehl–Neelsen staining","authors":"S. Bohara, R. Das, N. Tripathi, Lawanya Verma","doi":"10.4103/amit.amit_145_21","DOIUrl":"https://doi.org/10.4103/amit.amit_145_21","url":null,"abstract":"Introduction: Tuberculosis (TB) is one of the leading causes of mortality and morbidity in India, and extrapulmonary cases from the lymph nodes account for one-fifth of the overall disease burden. TB is known for its varied clinical presentations as well as different sites (organs) of involvement. Fine-needle aspiration cytology (FNAC) plays an important role in diagnosing a significant number of cases which present as granulomatous lesions. Here, we study the cytomorphological and clinical presentation of swellings showing granulomatous pattern of inflammation and correlate them with acid-fast bacilli (AFB) positivity. Materials and Methods: A retrospective study of 3-years duration was done from January 2018 to December 2020 in a tertiary care hospital. Slides of 356 cases showing epithelioid granulomas on cytology were taken out. The clinical data were collected from patient requisition forms. All the available clinical and cytological findings were recorded. The slides were re-examined and characterized into specific patterns of granulomatous inflammation on the basis of predominant background population of cells, necrosis, and hemorrhage. These were correlated with the presence of positive AFB staining on Ziehl–Neelsen (ZN) stain. Chi-square test was used for comparison between groups and P < 0.05 was taken to be statistically significant. Results: The mean age of presentation was 25 years (ranging from 5 months to 75 years) with a slight female preponderance (male-to-female ratio being 0.9:1). The cervical lymph nodes were the most common site. The sites of presentation were varied. The aspirates were gray–white to blood mixed on gross and cytological examination in 186 cases (52.25%). On microscopy, the suppurative pattern was seen in 202 cases (56.74%) and necrosis was seen in 182 cases (51.12%). The AFB positivity on ZN staining was seen in 96 (26.96%) cases in FNAC smears. There was a significant association of positive AFB staining with younger age group (<25 years), larger sized swellings (>2 cm), fixed and matted swellings, longer duration of symptoms (>2 weeks), and absence of pain and fever. The whitish/purulent aspirates on gross examination as well as suppurative and necrotic patterns on cytomorphology on microscopic examination showed a highly significant positive correlation with AFB staining. Conclusion: The gross and microscopic patterns of suppuration and necrosis on FNAC in combination with clinical signs and symptoms are highly suggestive of TB. ZN staining on cytology smears is a very simple and useful investigation, especially in suppurative and necrotic patterns of cytology, for clinching an early diagnosis, which goes a long way in the management of tuberculosis.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"86 1","pages":"88 - 93"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83933626","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}
A. Vimalraj, Neethu George, V. Sundaram, M. Anbarasi, R. Manoranjitham, V. Shanmugam
Introduction: The COVID-19 pandemic had enforced several restrictions which were necessary to abate the spread of the virus, however, the blow of these limitations on health behaviors and lifestyles remains vague. Therefore, this study was carried out to assess the behavioral and lifestyle consequences of complete lockdown during the pandemic. Materials and Methods: The Lockdown and its Impact on Food and Exercise study was a pilot study conducted in the form of a questionnaire which was handed out to the public and circulated electronically. The questions regarding exercise were adapted from the International physical activity questionnaire and those regarding food habits were taken from the Public Library of Science and the Self-regulation of Eating Behavior Questionnaire. This survey was conducted from March 28 to April 14, 2020, during which a complete lockdown prevailed. Results: The COVID-19 complete lockdown had a negative impact on all intensity exercise levels, vigorous exercise (64.34% vs. 41.20%, P ≤ 0.00001), moderate exercise (95.67% vs. 84.57%, P ≤ 0.00001), and walking (55.42% vs. 42.89%, P = 0.0003). Food consumption and meal patterns (58.55% vs. 47.95%, P = 0.0022) were also more unhealthy (78.60% vs. 87.94%, P = 0.0096) during complete lockdown with only the consumption of late night snack decreasing significantly. Conclusion: The results of this analysis indicate that physical activity had decreased significantly and eating behaviors were unhealthy. Hence, our survey will help to develop interventions which would potentially alleviate these negative lifestyle and nutrition behaviors.
{"title":"Lockdown and its impact on food and exercise study","authors":"A. Vimalraj, Neethu George, V. Sundaram, M. Anbarasi, R. Manoranjitham, V. Shanmugam","doi":"10.4103/amit.amit_61_21","DOIUrl":"https://doi.org/10.4103/amit.amit_61_21","url":null,"abstract":"Introduction: The COVID-19 pandemic had enforced several restrictions which were necessary to abate the spread of the virus, however, the blow of these limitations on health behaviors and lifestyles remains vague. Therefore, this study was carried out to assess the behavioral and lifestyle consequences of complete lockdown during the pandemic. Materials and Methods: The Lockdown and its Impact on Food and Exercise study was a pilot study conducted in the form of a questionnaire which was handed out to the public and circulated electronically. The questions regarding exercise were adapted from the International physical activity questionnaire and those regarding food habits were taken from the Public Library of Science and the Self-regulation of Eating Behavior Questionnaire. This survey was conducted from March 28 to April 14, 2020, during which a complete lockdown prevailed. Results: The COVID-19 complete lockdown had a negative impact on all intensity exercise levels, vigorous exercise (64.34% vs. 41.20%, P ≤ 0.00001), moderate exercise (95.67% vs. 84.57%, P ≤ 0.00001), and walking (55.42% vs. 42.89%, P = 0.0003). Food consumption and meal patterns (58.55% vs. 47.95%, P = 0.0022) were also more unhealthy (78.60% vs. 87.94%, P = 0.0096) during complete lockdown with only the consumption of late night snack decreasing significantly. Conclusion: The results of this analysis indicate that physical activity had decreased significantly and eating behaviors were unhealthy. Hence, our survey will help to develop interventions which would potentially alleviate these negative lifestyle and nutrition behaviors.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"28 1","pages":"125 - 131"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81029641","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 : 2021-07-01DOI: 10.4103/amit.amit_137_21
S. Puri, P. Singhal, S. Singhal
Introduction: COVID-19 infection has been affecting vast population all over the world since 2019. It is very important to make optimum use of routine laboratory parameters in evaluating severity of COVID-19 disease. This will help the clinicians to improve allocation of technical human resources to patients who require it the most. During the path of the COVID-19 disease, inflammatory indices such as lactate dehydrogenase (LDH), C-reactive protein (CRP), interleukin-6 (IL-6), biomarkers like serum procalcitonin (PCT), and ferritin and indices of coagulation profile like D-Dimer, PT levels, and hematological parameters like total leukocyte count, platelets carry prognostic value. The objective of the study is to estimate the utility of various laboratory Biochemical and Hematological parameters in COVID-19 disease. Materials and Methods: The present study is a retrospective cross-sectional observational study conducted in tertiary care rural teaching hospital. The study was conducted from September 1, 2020, to January 31, 2021. The study was carried out on the patients who were hospitalized in Isolation Ward and COVID ICU in our L3 COVID hospital. All patients with positive SARS-CoV-2 nucleic acid test results were included in the study. A sample size of 310 patients was taken. The basic demographic details were collected from the admission records. The confirmatory test for SARS-CoV-2 was done using the WHO-approved kits based on real-time reverse transcription polymerase chain reaction for which suspected cases underwent nasopharyngeal/oropharyngeal swab testing. The levels of CRP, IL-6, PCT, ferritin LDH, D-dimer, complete blood counts, PT were based on standardized methods obtained using various biochemical and hematological laboratory analyzers. Data of investigation reports were gathered from electronic patient record system. Statistical analysis was performed using the Statistical Package for the Social Sciences for Windows (version 25.0). Results: Our study clearly shows that levels of IL-6, D Dimer, PT, and LDH are quite significantly raised in majority of patients while PCT and ferritin being somewhat nonspecific show an increase but not to that significant numbers. The hematological parameters show levels which indicate mild anemia, leukocytosis, neutrophilia , lymphopenia, and thrombocytopenia in patients infected with COVID-19 disease. Conclusion: COVID-19 is an unexplored, new entity with a sudden worldwide onset. The medical fraternity is yet to conquer and analyse this novel virus.
自2019年以来，COVID-19感染一直影响着全球广大人群。优化使用常规实验室参数对评估COVID-19疾病严重程度非常重要。这将有助于临床医生改善技术人力资源分配给最需要的患者。在COVID-19疾病发展过程中，乳酸脱氢酶(LDH)、c反应蛋白(CRP)、白细胞介素-6 (IL-6)等炎症指标、血清降钙素原(PCT)、铁蛋白等生物标志物、d -二聚体、PT水平等凝血指标、白细胞总数、血小板等血液学参数具有预后价值。本研究的目的是评估各种实验室生化和血液学参数在COVID-19疾病中的效用。材料与方法:本研究是在农村三级医疗教学医院进行的回顾性横断面观察性研究。该研究于2020年9月1日至2021年1月31日进行。本研究以我院L3 COVID医院隔离病房和COVID ICU住院患者为研究对象。所有SARS-CoV-2核酸检测结果阳性的患者均纳入研究。选取了310名患者作为样本。从入院记录中收集了基本的人口统计细节。使用世卫组织批准的基于实时逆转录聚合酶链反应的试剂盒进行了SARS-CoV-2的确认试验，疑似病例进行了鼻咽/口咽拭子检测。CRP、IL-6、PCT、铁蛋白LDH、d -二聚体、全血细胞计数、PT的水平基于使用各种生化和血液学实验室分析仪获得的标准化方法。调查报告数据从电子病历系统中收集。使用Statistical Package for the Social Sciences for Windows (version 25.0)进行统计分析。结果:我们的研究清楚地表明，大多数患者IL-6、D二聚体、PT、LDH水平均有相当明显的升高，而PCT和铁蛋白水平虽有一定的非特异性，但均有升高，但没有明显的升高。血液学参数显示感染COVID-19患者的轻度贫血、白细胞增多、中性粒细胞增多、淋巴细胞减少和血小板减少。结论:COVID-19是一种未被探索的新型实体，具有全球突发性。医学界尚未征服和分析这种新型病毒。
{"title":"Study of laboratory parameters in COVID-19 patients at a tertiary care teaching hospital in Uttar Pradesh","authors":"S. Puri, P. Singhal, S. Singhal","doi":"10.4103/amit.amit_137_21","DOIUrl":"https://doi.org/10.4103/amit.amit_137_21","url":null,"abstract":"Introduction: COVID-19 infection has been affecting vast population all over the world since 2019. It is very important to make optimum use of routine laboratory parameters in evaluating severity of COVID-19 disease. This will help the clinicians to improve allocation of technical human resources to patients who require it the most. During the path of the COVID-19 disease, inflammatory indices such as lactate dehydrogenase (LDH), C-reactive protein (CRP), interleukin-6 (IL-6), biomarkers like serum procalcitonin (PCT), and ferritin and indices of coagulation profile like D-Dimer, PT levels, and hematological parameters like total leukocyte count, platelets carry prognostic value. The objective of the study is to estimate the utility of various laboratory Biochemical and Hematological parameters in COVID-19 disease. Materials and Methods: The present study is a retrospective cross-sectional observational study conducted in tertiary care rural teaching hospital. The study was conducted from September 1, 2020, to January 31, 2021. The study was carried out on the patients who were hospitalized in Isolation Ward and COVID ICU in our L3 COVID hospital. All patients with positive SARS-CoV-2 nucleic acid test results were included in the study. A sample size of 310 patients was taken. The basic demographic details were collected from the admission records. The confirmatory test for SARS-CoV-2 was done using the WHO-approved kits based on real-time reverse transcription polymerase chain reaction for which suspected cases underwent nasopharyngeal/oropharyngeal swab testing. The levels of CRP, IL-6, PCT, ferritin LDH, D-dimer, complete blood counts, PT were based on standardized methods obtained using various biochemical and hematological laboratory analyzers. Data of investigation reports were gathered from electronic patient record system. Statistical analysis was performed using the Statistical Package for the Social Sciences for Windows (version 25.0). Results: Our study clearly shows that levels of IL-6, D Dimer, PT, and LDH are quite significantly raised in majority of patients while PCT and ferritin being somewhat nonspecific show an increase but not to that significant numbers. The hematological parameters show levels which indicate mild anemia, leukocytosis, neutrophilia , lymphopenia, and thrombocytopenia in patients infected with COVID-19 disease. Conclusion: COVID-19 is an unexplored, new entity with a sudden worldwide onset. The medical fraternity is yet to conquer and analyse this novel virus.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"193 1","pages":"100 - 106"},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79719821","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}
R. Bhardwaj, S. Hathila, Himanshu Joshi, V. Vaniya
Introduction: Medical education today is equipped with an armamentarium of newer online-based methods of correspondence courses, computerized virtual patient simulation, many open online courses in medical sciences, and tele-learning. The sudden, unplanned change from conventional teaching to online teaching during COVID-19 poses unique challenges and opportunities for teachers and learners, both. Many themes and principles have emerged for good online teaching learning and assessment practices (GOTLAP). Materials and Methods: The present study, involving 392 MBBS first year students from two universities, was conducted with an aim of comparing students' perception regarding online and offline teaching methodology, and online v/s offline method of assessment and to recommend the principles of GOTLAP. Data collected were analyzed by Strength, Weakness, Opportunity, and Threat (SWOT) analysis to provide a focused measure on how students perceive the program of online teaching and assessment. Results: In the present study, majority of the students (approximately 49.6%) have shown preference for offline teaching methodology, 22.9% has shown similar preference for both methods, while 27.5% has shown preference for the offline teaching method. SWOT analysis applied on qualitative data is a useful tool for assessing our present status in online learning and laying a ground work for formulating GOTLAP and a plan of future strategy. Conclusions: The GOTLAP principles can effectively pave way for the incorporation of blended learning (currently underutilized) in undergraduate medical education.
{"title":"Pre-COVID conventional offline teaching v/s intra-COVID online teaching: A descriptive map of preference patterns among first year M.B.B.S students","authors":"R. Bhardwaj, S. Hathila, Himanshu Joshi, V. Vaniya","doi":"10.4103/amit.amit_34_21","DOIUrl":"https://doi.org/10.4103/amit.amit_34_21","url":null,"abstract":"Introduction: Medical education today is equipped with an armamentarium of newer online-based methods of correspondence courses, computerized virtual patient simulation, many open online courses in medical sciences, and tele-learning. The sudden, unplanned change from conventional teaching to online teaching during COVID-19 poses unique challenges and opportunities for teachers and learners, both. Many themes and principles have emerged for good online teaching learning and assessment practices (GOTLAP). Materials and Methods: The present study, involving 392 MBBS first year students from two universities, was conducted with an aim of comparing students' perception regarding online and offline teaching methodology, and online v/s offline method of assessment and to recommend the principles of GOTLAP. Data collected were analyzed by Strength, Weakness, Opportunity, and Threat (SWOT) analysis to provide a focused measure on how students perceive the program of online teaching and assessment. Results: In the present study, majority of the students (approximately 49.6%) have shown preference for offline teaching methodology, 22.9% has shown similar preference for both methods, while 27.5% has shown preference for the offline teaching method. SWOT analysis applied on qualitative data is a useful tool for assessing our present status in online learning and laying a ground work for formulating GOTLAP and a plan of future strategy. Conclusions: The GOTLAP principles can effectively pave way for the incorporation of blended learning (currently underutilized) in undergraduate medical education.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"105 1","pages":"28 - 31"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85885895","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}
Shilpa Patrick, Preeti Singh, R. Choudhary, P. Matreja
Introduction: Knowledge and acceptance of COVID-19 vaccine among health-care professionals (HCPs) are an important aspect in the success of the vaccination drive in India, as HCPs are the first group to receive the vaccine. Various factors affecting the attitude of getting COVID-19 vaccine and to better address those factors will help in widespread acceptance among the general public. Materials and Methods: This was a cross-sectional study which was conducted among HCPs by circulating Google form. The form was distributed among the medical students and physicians through social networking sites such as E-mail and WhatsApp. The questionnaire consisted of 18 questions focusing on the assessment of knowledge and acceptance about COVID-19 vaccine. It was a self-administered and pilot-validated questionnaire. Results: Out of total participants, 473 (78%) were willing to take vaccination and were in the opinion that getting vaccination is a good idea. Eighty-eight percent of the participants were worried about the effectiveness of the COVID-19 vaccine. Fifty-five percent of the participants were anxious regarding getting vaccine and its efficacy. Conclusion: Knowledge and acceptance were moderate, but overall attitude of getting vaccination was positive. Majority of the HCPs are still anxious about the long-term efficacy; therefore, appropriate steps need to be taken to address the factors contributing to the low acceptance of the COVID-19 vaccine.
{"title":"Acceptance and Knowledge of COVID-19 Vaccine among Health-Care Professionals in Western Uttar Pradesh, India","authors":"Shilpa Patrick, Preeti Singh, R. Choudhary, P. Matreja","doi":"10.4103/amit.amit_45_21","DOIUrl":"https://doi.org/10.4103/amit.amit_45_21","url":null,"abstract":"Introduction: Knowledge and acceptance of COVID-19 vaccine among health-care professionals (HCPs) are an important aspect in the success of the vaccination drive in India, as HCPs are the first group to receive the vaccine. Various factors affecting the attitude of getting COVID-19 vaccine and to better address those factors will help in widespread acceptance among the general public. Materials and Methods: This was a cross-sectional study which was conducted among HCPs by circulating Google form. The form was distributed among the medical students and physicians through social networking sites such as E-mail and WhatsApp. The questionnaire consisted of 18 questions focusing on the assessment of knowledge and acceptance about COVID-19 vaccine. It was a self-administered and pilot-validated questionnaire. Results: Out of total participants, 473 (78%) were willing to take vaccination and were in the opinion that getting vaccination is a good idea. Eighty-eight percent of the participants were worried about the effectiveness of the COVID-19 vaccine. Fifty-five percent of the participants were anxious regarding getting vaccine and its efficacy. Conclusion: Knowledge and acceptance were moderate, but overall attitude of getting vaccination was positive. Majority of the HCPs are still anxious about the long-term efficacy; therefore, appropriate steps need to be taken to address the factors contributing to the low acceptance of the COVID-19 vaccine.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"15 1","pages":"24 - 27"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78839006","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 : 2021-01-01DOI: 10.4103/amit.amit_190_20
Payal Paliwal, C. Kalyani, Maneesh Sharma, Kusum K. Rohilla
Introduction: Preserving independence in tasks and continuing an active life are the most significant features in improving elderly's health care. The aim of the present study was to identify and compare elderly general health status and functional independence among rural and urban areas of the Sub-Himalayas region, India. Materials and Methods: The study was nonexperimental comparative design, in which multistage sampling techniques were used. 200 elderly participants were selected, i.e., 100 elderly from rural and urban areas, respectively. Results: Majority elderly of rural and urban areas belong to 61–70 years, male, Hindu, married, living with their children, receiving government pension, taking three times meals/day and have a previous history of medical illness. The general health status of the rural elderly is good (P = 0.000 [3.45, 5.16]) as compared to the urban elderly. Rural elderly were functional independent (P = 0.009 [0.37, 1.38]) than urban elderly. Conclusions: It is important to monitor the general health status and functional independence of the elderly. The status of daily living activity always has a great impact on the level of happiness, well-being, and quality of life of the elderly.
{"title":"General health status and functional independence of rural and urban elderly population of sub-himalayas region, India: Comparative study","authors":"Payal Paliwal, C. Kalyani, Maneesh Sharma, Kusum K. Rohilla","doi":"10.4103/amit.amit_190_20","DOIUrl":"https://doi.org/10.4103/amit.amit_190_20","url":null,"abstract":"Introduction: Preserving independence in tasks and continuing an active life are the most significant features in improving elderly's health care. The aim of the present study was to identify and compare elderly general health status and functional independence among rural and urban areas of the Sub-Himalayas region, India. Materials and Methods: The study was nonexperimental comparative design, in which multistage sampling techniques were used. 200 elderly participants were selected, i.e., 100 elderly from rural and urban areas, respectively. Results: Majority elderly of rural and urban areas belong to 61–70 years, male, Hindu, married, living with their children, receiving government pension, taking three times meals/day and have a previous history of medical illness. The general health status of the rural elderly is good (P = 0.000 [3.45, 5.16]) as compared to the urban elderly. Rural elderly were functional independent (P = 0.009 [0.37, 1.38]) than urban elderly. Conclusions: It is important to monitor the general health status and functional independence of the elderly. The status of daily living activity always has a great impact on the level of happiness, well-being, and quality of life of the elderly.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"68 1","pages":"71 - 74"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87839575","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}
A. Singh, R. Rastogi, Neha, V. Khare, Vijai Pratap, N. Huda
Introduction: Wrist joint is a commonly used joint in day-to-day activities and hence is not only susceptible to various pathologies but is also the cause of significant morbidity in cases of painful wrist. Although magnetic resonance imaging (MRI) is the usual imaging investigation preferred for the evaluation of painful wrist joint, its inherent limitations in form of high cost, limited availability, higher scan time, and lack of comparison with contralateral side have prompted us to design a study comparing the role of high-resolution ultrasonography (HRUS) with MRI in such cases. Materials and Methods: Forty patients of painful wrist joint were evaluated with HRUS and MRI following approval of IEC and after informed consent. The two imaging modalities were compared not only in the detection of various findings related to painful wrist joint as joint effusion, synovitis, synovial hypertrophy, tenosynovitis, rice bodies, bone erosions, etc., but also in diagnosing the final group of disease. Appropriate statistical tests were then used to analyze the results. Results: Our study revealed that HRUS is similar to MRI in the detection of joint effusion, synovitis, synovial hypertrophy, tenosynovitis, rice bodies, etc., but is very poor in the detection of bony pathologies, especially marrow edema or chronic fractures. In our study, HRUS was equivalent to MRI in the final diagnosis in 67.5% cases, was inferior to MRI in 30% cases and was superior to MRI in 2.5%. Conclusions: Since HRUS has a high accuracy in detecting the pathologies in cases of painful wrist joint, it should be used as the first imaging modality. Patients with equivocal diagnosis or requiring surgical planning may, however, be subjected to MRI.
{"title":"Comparative evaluation of high-resolution ultrasonography and magnetic resonance imaging in painful wrist joint","authors":"A. Singh, R. Rastogi, Neha, V. Khare, Vijai Pratap, N. Huda","doi":"10.4103/amit.amit_14_21","DOIUrl":"https://doi.org/10.4103/amit.amit_14_21","url":null,"abstract":"Introduction: Wrist joint is a commonly used joint in day-to-day activities and hence is not only susceptible to various pathologies but is also the cause of significant morbidity in cases of painful wrist. Although magnetic resonance imaging (MRI) is the usual imaging investigation preferred for the evaluation of painful wrist joint, its inherent limitations in form of high cost, limited availability, higher scan time, and lack of comparison with contralateral side have prompted us to design a study comparing the role of high-resolution ultrasonography (HRUS) with MRI in such cases. Materials and Methods: Forty patients of painful wrist joint were evaluated with HRUS and MRI following approval of IEC and after informed consent. The two imaging modalities were compared not only in the detection of various findings related to painful wrist joint as joint effusion, synovitis, synovial hypertrophy, tenosynovitis, rice bodies, bone erosions, etc., but also in diagnosing the final group of disease. Appropriate statistical tests were then used to analyze the results. Results: Our study revealed that HRUS is similar to MRI in the detection of joint effusion, synovitis, synovial hypertrophy, tenosynovitis, rice bodies, etc., but is very poor in the detection of bony pathologies, especially marrow edema or chronic fractures. In our study, HRUS was equivalent to MRI in the final diagnosis in 67.5% cases, was inferior to MRI in 30% cases and was superior to MRI in 2.5%. Conclusions: Since HRUS has a high accuracy in detecting the pathologies in cases of painful wrist joint, it should be used as the first imaging modality. Patients with equivocal diagnosis or requiring surgical planning may, however, be subjected to MRI.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"25 1","pages":"38 - 43"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86635723","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}
Introduction: Neonatal hyperbilirubinemia is a common neonatal ailment and is mostly benign except in few cases where it might progress to kernicterus. Neonatal jaundice is preventable and treatable if detected in time, and therefore, it is crucial to identify risk factors for developing severe hyperbilirubinemia. Materials and Methods: A prospective observational study was conducted with the aim to examine the risk factors for significant jaundice and also for readmission to the hospital. Results: A total of 1159 neonates were enrolled, of which 11.2% (n = 134) developed significant neonatal jaundice prior to discharge and 2.1% (n = 25) were readmitted with significant jaundice. The maternal risk factors for significant jaundice were primigravida with age range between 23 and 27 years, "O" blood group, conception by in vitro fertilization and embryo transfer (IVF-ET), antenatal oxytocin use, and lower segment cesarean section delivery. The neonatal risk factors for significant jaundice were late preterm male neonates born with birth weight between 2 and 2.5 kg and delayed cord clamping (DCC). The maternal risk factors for readmisssion jaundice were young primigravida with "O" blood group hailing from North India with antenatal use of oxytocin and gestational diabetes mellitus. The neonatal risk factors for readmission jaundice were low birth weight, DCC, twin pregnancies, neonates discharged between 48 and 72 h after birth. Conclusion: The statistically significant factors (P < 0.05) associated with an increased risk of developing significant hyperbilirubinemia requiring readmission included low birth weight, gestational age 35–36 weeks and 6 days, DCC, and IVF-ET conception.
{"title":"Maternal and neonatal risk factors for neonatal jaundice and readmission – An Indian perspective","authors":"N. Kaur, G. Dhillon, S. Sasidharan, H. Dhillon","doi":"10.4103/amit.amit_62_21","DOIUrl":"https://doi.org/10.4103/amit.amit_62_21","url":null,"abstract":"Introduction: Neonatal hyperbilirubinemia is a common neonatal ailment and is mostly benign except in few cases where it might progress to kernicterus. Neonatal jaundice is preventable and treatable if detected in time, and therefore, it is crucial to identify risk factors for developing severe hyperbilirubinemia. Materials and Methods: A prospective observational study was conducted with the aim to examine the risk factors for significant jaundice and also for readmission to the hospital. Results: A total of 1159 neonates were enrolled, of which 11.2% (n = 134) developed significant neonatal jaundice prior to discharge and 2.1% (n = 25) were readmitted with significant jaundice. The maternal risk factors for significant jaundice were primigravida with age range between 23 and 27 years, \"O\" blood group, conception by in vitro fertilization and embryo transfer (IVF-ET), antenatal oxytocin use, and lower segment cesarean section delivery. The neonatal risk factors for significant jaundice were late preterm male neonates born with birth weight between 2 and 2.5 kg and delayed cord clamping (DCC). The maternal risk factors for readmisssion jaundice were young primigravida with \"O\" blood group hailing from North India with antenatal use of oxytocin and gestational diabetes mellitus. The neonatal risk factors for readmission jaundice were low birth weight, DCC, twin pregnancies, neonates discharged between 48 and 72 h after birth. Conclusion: The statistically significant factors (P < 0.05) associated with an increased risk of developing significant hyperbilirubinemia requiring readmission included low birth weight, gestational age 35–36 weeks and 6 days, DCC, and IVF-ET conception.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"49 1","pages":"44 - 49"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90503475","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}
Nidhi Nair, P. Chikkannaiah, S. Venkataramanappa, Ragunatha Shivanna
Introduction: Cutaneous metastasis (CM) is an uncommon clinical presentation and poses trouble in diagnosis. However, it is remarkable and can occur due to a known or an unknown primary tumor. Despite the fact that clinical assessment helps in the diagnosis, Fine-needle aspiration cytology (FNAC) is a modest, basic, and quick principle line of investigation for the finding of CM. Materials and Methods: It was a retrospective study conducted in the department of pathology at a tertiary care teaching hospital. The study was conducted from January 2010 to May 2020. All cases of CM that has been diagnosed by FNAC were included. Results: During the study period, a total of 37 cases of CM were observed, constituting 0.15% of all FNACs. The age of the patients ranged from 35 to 74 years, and the male: female ratio was 1.05:1. Primary tumor was known in all 37 cases. Among males, lung carcinoma was the more common whereas breast was the most common organ of primary among females. The most common lesion was a single nodule (27 cases), with predominant site being chest wall (32.5%), and the most common tumor at microscopy was metastatic adenocarcinoma. Conclusion: FNAC is a fast and safe procedure that can be utilized as a first line of investigation in diagnosing metastatic skin lesions. Basic assessment of cytomorphology alongside significant clinical subtleties could help in recognizing the site of an unknown primary.
{"title":"Utility of fine-needle aspiration cytology in diagnosis of cutaneous and subcutaneous metastasis","authors":"Nidhi Nair, P. Chikkannaiah, S. Venkataramanappa, Ragunatha Shivanna","doi":"10.4103/amit.amit_8_21","DOIUrl":"https://doi.org/10.4103/amit.amit_8_21","url":null,"abstract":"Introduction: Cutaneous metastasis (CM) is an uncommon clinical presentation and poses trouble in diagnosis. However, it is remarkable and can occur due to a known or an unknown primary tumor. Despite the fact that clinical assessment helps in the diagnosis, Fine-needle aspiration cytology (FNAC) is a modest, basic, and quick principle line of investigation for the finding of CM. Materials and Methods: It was a retrospective study conducted in the department of pathology at a tertiary care teaching hospital. The study was conducted from January 2010 to May 2020. All cases of CM that has been diagnosed by FNAC were included. Results: During the study period, a total of 37 cases of CM were observed, constituting 0.15% of all FNACs. The age of the patients ranged from 35 to 74 years, and the male: female ratio was 1.05:1. Primary tumor was known in all 37 cases. Among males, lung carcinoma was the more common whereas breast was the most common organ of primary among females. The most common lesion was a single nodule (27 cases), with predominant site being chest wall (32.5%), and the most common tumor at microscopy was metastatic adenocarcinoma. Conclusion: FNAC is a fast and safe procedure that can be utilized as a first line of investigation in diagnosing metastatic skin lesions. Basic assessment of cytomorphology alongside significant clinical subtleties could help in recognizing the site of an unknown primary.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"123 1","pages":"57 - 61"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83440489","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}
N. Verma, R. Rastogi, Vijai Pratap, Arawat Pushkarna
Introduction: Urinary tract (UT) pathologies are common causes of morbidity presenting mainly as acute flank pain, obstructive uropathy, and hematuria with calculus being the commonest cause. Computed tomography (CT) (noncontrast, contrast enhanced and urography) of the kidney, ureter, and bladder region has been considered as the mainstay in evaluation of patients with UT symptoms. Limitations of radiation exposure and risks of contrast injection in CT have provided space for magnetic resonance urography (MRU) that has recently gain acceptance. However, MRU is limited by its availability and higher cost. Thus, with the aim of evaluating the scope of MRU in various UT pathologies, we planned a comparative study between CT scan and MRU. Materials and Methods: Thirty-five patients with UT symptoms (acute flank pain, obstructive uropathy, and hematuria) were evaluated with CT scan and MRU after obtaining approval from Institutional Ethics Committee and written informed consent from the participants of the study. CT scan was performed on 128-slice CT scanner while MRU was performed on 1.5T magnetic resonance scanner using the standard protocol. The data thus recorded in a single-blinded manner were analyzed using appropriate statistical methods and tools. Results: Compared with CT scan, MRU had a poor accuracy in detecting UT stones especially <6 mm and without secondary signs of obstruction. However, MRU performed very well in patients with obstructive uropathy and hematuria subgroup with no significant difference in accuracy from CT scan. Overall, MRU had a moderate sensitivity of 76.3%, high specificity of 96.9% and moderately high accuracy of 85.7%. Conclusions: Although MRU has lower sensitivity to small sized UT calculus but is very specific to secondary signs of obstruction as well as to causes of obstructive uropathy and hematuria. It can serve as an excellent alternative tool especially in patients with contraindication of contrast injection in CT scan as well as in children, during pregnancy and in conditions requiring repetitive examinations.
{"title":"Comparison of imaging characteristics on computed tomography and magnetic resonance urography in urological conditions","authors":"N. Verma, R. Rastogi, Vijai Pratap, Arawat Pushkarna","doi":"10.4103/amit.amit_12_21","DOIUrl":"https://doi.org/10.4103/amit.amit_12_21","url":null,"abstract":"Introduction: Urinary tract (UT) pathologies are common causes of morbidity presenting mainly as acute flank pain, obstructive uropathy, and hematuria with calculus being the commonest cause. Computed tomography (CT) (noncontrast, contrast enhanced and urography) of the kidney, ureter, and bladder region has been considered as the mainstay in evaluation of patients with UT symptoms. Limitations of radiation exposure and risks of contrast injection in CT have provided space for magnetic resonance urography (MRU) that has recently gain acceptance. However, MRU is limited by its availability and higher cost. Thus, with the aim of evaluating the scope of MRU in various UT pathologies, we planned a comparative study between CT scan and MRU. Materials and Methods: Thirty-five patients with UT symptoms (acute flank pain, obstructive uropathy, and hematuria) were evaluated with CT scan and MRU after obtaining approval from Institutional Ethics Committee and written informed consent from the participants of the study. CT scan was performed on 128-slice CT scanner while MRU was performed on 1.5T magnetic resonance scanner using the standard protocol. The data thus recorded in a single-blinded manner were analyzed using appropriate statistical methods and tools. Results: Compared with CT scan, MRU had a poor accuracy in detecting UT stones especially <6 mm and without secondary signs of obstruction. However, MRU performed very well in patients with obstructive uropathy and hematuria subgroup with no significant difference in accuracy from CT scan. Overall, MRU had a moderate sensitivity of 76.3%, high specificity of 96.9% and moderately high accuracy of 85.7%. Conclusions: Although MRU has lower sensitivity to small sized UT calculus but is very specific to secondary signs of obstruction as well as to causes of obstructive uropathy and hematuria. It can serve as an excellent alternative tool especially in patients with contraindication of contrast injection in CT scan as well as in children, during pregnancy and in conditions requiring repetitive examinations.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"15 1","pages":"50 - 56"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79524186","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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