Introduction: Granulomatous dermatitis has a varied differential diagnosis ranging from infectious etiology to immune mediated diseases. In tropical countries like India, infectious etiology forms an important cause of granulomatous dermatitis with tuberculosis (TB) and leprosy being the major contributing factors. The present study was carried out with the aim to determine the frequency of various etiological agents causing infectious granulomatous dermatitis in our hospital setup and to see clinicohistopathological correlation in these cases. Materials and Methods: This is a hospital based retrospective study conducted in the department of pathology over a period of 1 year. All the skin biopsy cases diagnosed as infectious granulomatous dermatitis were retrieved from the histopathology record section for analysis and were categorized based on the causative etiological agents. Special stains were applied wherever necessary in addition to routine hematoxylin and eosin stain. Results: A total of 40 cases of infectious granulomatous dermatitis were included in the present study. Most common diagnosis was leprosy (57.5%), followed by TB (30.0%), actinomycosis (5.0%), dermatophytosis (2.5%), histoplasmosis (2.5%), and cysticercosis (2.5%). Gender wise distribution showed male predominance with 57.5% of cases and age wise distribution showed a peak in the age group of 41–60 years (32.5%). Clinicohistopathological correlation was found in 87.50% of the cases. The unusual clinical presentations were seen in cases of cysticercosis, actinomycosis, and histoplasmosis. Conclusion: Histopathological examination of the skin biopsies is an important diagnostic tool providing definitive diagnosis as well as clinicohistopathological correlation in cases of infectious granulomatous dermatitis.
{"title":"Infectious granulomatous dermatitis: Clinicohistopathological study with some unusual clinical presentation","authors":"P. Singh, Ambrish Kumar","doi":"10.4103/ami.ami_130_20","DOIUrl":"https://doi.org/10.4103/ami.ami_130_20","url":null,"abstract":"Introduction: Granulomatous dermatitis has a varied differential diagnosis ranging from infectious etiology to immune mediated diseases. In tropical countries like India, infectious etiology forms an important cause of granulomatous dermatitis with tuberculosis (TB) and leprosy being the major contributing factors. The present study was carried out with the aim to determine the frequency of various etiological agents causing infectious granulomatous dermatitis in our hospital setup and to see clinicohistopathological correlation in these cases. Materials and Methods: This is a hospital based retrospective study conducted in the department of pathology over a period of 1 year. All the skin biopsy cases diagnosed as infectious granulomatous dermatitis were retrieved from the histopathology record section for analysis and were categorized based on the causative etiological agents. Special stains were applied wherever necessary in addition to routine hematoxylin and eosin stain. Results: A total of 40 cases of infectious granulomatous dermatitis were included in the present study. Most common diagnosis was leprosy (57.5%), followed by TB (30.0%), actinomycosis (5.0%), dermatophytosis (2.5%), histoplasmosis (2.5%), and cysticercosis (2.5%). Gender wise distribution showed male predominance with 57.5% of cases and age wise distribution showed a peak in the age group of 41–60 years (32.5%). Clinicohistopathological correlation was found in 87.50% of the cases. The unusual clinical presentations were seen in cases of cysticercosis, actinomycosis, and histoplasmosis. Conclusion: Histopathological examination of the skin biopsies is an important diagnostic tool providing definitive diagnosis as well as clinicohistopathological correlation in cases of infectious granulomatous dermatitis.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"41 1","pages":"102 - 107"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88522939","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: This was a cross sectional study to understand the prevalence of modifiable risk factors of diabetes among adolescents and young adults in India. Materials and Methods: The pilot study was carried out using a questionnaire based survey. A literature review was performed to explore the common risk factors associated with type 2 diabetes mellitus and a self administered questionnaire was developed and validated. The snowball sampling method was applied and the questionnaire was sent through E mails, social networking sites, and applications. Results: A total of 317 young adults and adolescents, aged between 16 and 25 years, across eight different states of India completed the survey. Among the various risk factors, 64.04% had normal healthy sleeping hours of 6–8 h, and 71.61% happy with the sleep quality. Only 23.08% skipped breakfast more than three times a week and 40.69% reported to consume whole grains every day. About 68.46% had little or no stress. The major concern was the low of physical activity (>150 min/week) and inadequate fruit intake (>1 serving a day) among 75.1% and 81.07% of respondents, respectively. Conclusion: Low physical activity and inadequate fruit intake are the important risk factors prevalent in the given age group.
{"title":"Prevalence of modifiable risk factors associated with diabetes in indian adolescents and young adults: A pilot study","authors":"V. Venugopal, Judu V. Ilavarasu, A. Mooventhan","doi":"10.4103/ami.ami_124_20","DOIUrl":"https://doi.org/10.4103/ami.ami_124_20","url":null,"abstract":"Introduction: This was a cross sectional study to understand the prevalence of modifiable risk factors of diabetes among adolescents and young adults in India. Materials and Methods: The pilot study was carried out using a questionnaire based survey. A literature review was performed to explore the common risk factors associated with type 2 diabetes mellitus and a self administered questionnaire was developed and validated. The snowball sampling method was applied and the questionnaire was sent through E mails, social networking sites, and applications. Results: A total of 317 young adults and adolescents, aged between 16 and 25 years, across eight different states of India completed the survey. Among the various risk factors, 64.04% had normal healthy sleeping hours of 6–8 h, and 71.61% happy with the sleep quality. Only 23.08% skipped breakfast more than three times a week and 40.69% reported to consume whole grains every day. About 68.46% had little or no stress. The major concern was the low of physical activity (>150 min/week) and inadequate fruit intake (>1 serving a day) among 75.1% and 81.07% of respondents, respectively. Conclusion: Low physical activity and inadequate fruit intake are the important risk factors prevalent in the given age group.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"114 1","pages":"108 - 112"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78979208","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}
Asbah Shams, Madhu Sinha, Abhijit Das, N. Gulati, R. Sahu, M. Mehndiratta, Chandra Shekhar
The novel coronavirus-19 (severe acute respiratory syndrome coronavirus-2) pandemic has crossed more than 4,006,257 cases with 278,892 deaths worldwide and 67,152 cases and 2206 deaths in India. The disease has a variable clinical course ranging from mild to severe disease. Although most of the patients are asymptomatic, some patients with comorbidities have a high propensity of clinical worsening and mortality and it is this chunk of patients that we need to recuperate. Studies have shown that a number of laboratory parameters, which are easily available and inexpensive, can adequately predict the disease severity at an early stage. In a resource-limited country like India, where costly investigations cannot be routinely carried out in the magnitude as big as that of this pandemic, it is imperative that patients be monitored with these simple and inexpensive parameters that are elucidated in this review. We carried out an electronic search on PubMed and Google Scholar with keywords “laboratory abnormalities in COVID-19,” “coagulopathy in COVID-19,” “sepsis in COVID-19,” “hematologic abnormalities in COVID-19,” “kidney injury in COVID-19,” “acute respiratory distress syndrome in COVID-19,” “cardiac injury in COVID-19,” “liver injury in COVID-19,” and “severity indicators in COVID-19” till present date (May 11, 2020). All studies that appeared in our search results were scrutinized and 40 studies were selected for the study.
{"title":"Laboratory findings in COVID-19 patients and biomarkers for early assessment of severity and mortality","authors":"Asbah Shams, Madhu Sinha, Abhijit Das, N. Gulati, R. Sahu, M. Mehndiratta, Chandra Shekhar","doi":"10.4103/ami.ami_69_20","DOIUrl":"https://doi.org/10.4103/ami.ami_69_20","url":null,"abstract":"The novel coronavirus-19 (severe acute respiratory syndrome coronavirus-2) pandemic has crossed more than 4,006,257 cases with 278,892 deaths worldwide and 67,152 cases and 2206 deaths in India. The disease has a variable clinical course ranging from mild to severe disease. Although most of the patients are asymptomatic, some patients with comorbidities have a high propensity of clinical worsening and mortality and it is this chunk of patients that we need to recuperate. Studies have shown that a number of laboratory parameters, which are easily available and inexpensive, can adequately predict the disease severity at an early stage. In a resource-limited country like India, where costly investigations cannot be routinely carried out in the magnitude as big as that of this pandemic, it is imperative that patients be monitored with these simple and inexpensive parameters that are elucidated in this review. We carried out an electronic search on PubMed and Google Scholar with keywords “laboratory abnormalities in COVID-19,” “coagulopathy in COVID-19,” “sepsis in COVID-19,” “hematologic abnormalities in COVID-19,” “kidney injury in COVID-19,” “acute respiratory distress syndrome in COVID-19,” “cardiac injury in COVID-19,” “liver injury in COVID-19,” and “severity indicators in COVID-19” till present date (May 11, 2020). All studies that appeared in our search results were scrutinized and 40 studies were selected for the study.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"87 1","pages":"63 - 68"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73621591","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: This study was conducted to find if cord blood lactate correlates well with Apgar score and umbilical cord blood pH and subsequent development of hypoxic ischemic encephalopathy (HIE). Materials and Methods: It was a cross sectional, observational study which was conducted at a tertiary care referral center of North India from June 2018 to June 2019. Monitoring of cord blood lactate levels along with Apgar and cord blood pH was done for correlation of cord blood lactate with Apgar, cord blood pH, and subsequently development of HIE. Results: During the study period, 115 term neonates got enrolled based on inclusion criteria. Out of these, 83 babies had some degree of HIE based on Sarnat staging. Among these 83 neonates with encephalopathy, 36 had Stage III HIE while, 28 and 19 babies had Stage II and Stage I encephalopathy, respectively. Lactate levels correlated negatively with Apgar score and umbilical cord blood pH and higher levels of lactate correlated well with lower Apgar and cord blood pH. The mean lactate level was significantly higher in cases with HIE (5.18 mmol/L) as compared to cases without HIE (2.91 mmol/L). Conclusion: Our study shows that cord blood lactate can be used as a predictor for perinatal hypoxia. With the availability of cheaper handheld lactate monitors, lactate monitoring may become more practical option and need to be explored.
{"title":"Cord blood lactate levels as marker for perinatal hypoxia and predictor for hypoxic ischemic encephalopathy","authors":"A. Simalti, V. Negi, Anil Kumar, S. Pramanik","doi":"10.4103/ami.ami_144_20","DOIUrl":"https://doi.org/10.4103/ami.ami_144_20","url":null,"abstract":"Introduction: This study was conducted to find if cord blood lactate correlates well with Apgar score and umbilical cord blood pH and subsequent development of hypoxic ischemic encephalopathy (HIE). Materials and Methods: It was a cross sectional, observational study which was conducted at a tertiary care referral center of North India from June 2018 to June 2019. Monitoring of cord blood lactate levels along with Apgar and cord blood pH was done for correlation of cord blood lactate with Apgar, cord blood pH, and subsequently development of HIE. Results: During the study period, 115 term neonates got enrolled based on inclusion criteria. Out of these, 83 babies had some degree of HIE based on Sarnat staging. Among these 83 neonates with encephalopathy, 36 had Stage III HIE while, 28 and 19 babies had Stage II and Stage I encephalopathy, respectively. Lactate levels correlated negatively with Apgar score and umbilical cord blood pH and higher levels of lactate correlated well with lower Apgar and cord blood pH. The mean lactate level was significantly higher in cases with HIE (5.18 mmol/L) as compared to cases without HIE (2.91 mmol/L). Conclusion: Our study shows that cord blood lactate can be used as a predictor for perinatal hypoxia. With the availability of cheaper handheld lactate monitors, lactate monitoring may become more practical option and need to be explored.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"90 1","pages":"93 - 96"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83542320","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}
Euclides Nenga Manuel Sacomboio, J. Bande, Santo Doqui Zua
Introduction: Malaria is the leading cause of death in Angola, followed by road accidents, and represents about 20% of hospitalizations in health facilities and about 35% of the demand for curative care. The objective of this study was to assess the effect of social and clinical conditions on the variation of blood pressure in hospitalized Angolans with malaria. Materials and Methods: The study was conducted as a cross sectional and quantitative approach. Results: Of the 333 patients followed, 28% of the patients were normotensive, 50% with moderate hypertension (HTN.1) and 20% with severe hypertension, in the first 48 hours of hospitalization. These data changed after 4 days, where in the last 48 hours before the end of the study, 33% of patients were normotensive, 56% were moderate hypertensive (HTN.2) and 11% were severe hypertensive and the average age of the patients was 27 years old (standard deviation = 9) and the female/male ratio was 153/180, mostly from urban areas in Luanda (76%) and moderate and severe hypertension was more frequent in students, unemployed and business people (72% ). In the first 48 hours, the number of patients with low parasitemia was 42%, with moderate and high parasitemia was 58%. In the last 48 hours before the end of the study, patients with moderate and high parasitemia accounted for only 11% and patients with low parasitemia accounted for 89%, where patients treated with artemether were 90% of the study population and showed significant changes in pressure levels when compared with patients treated with artesunate (10%), the mortality rate was 6%, a large group of them remained hospitalized (63%) and 31% were discharged. Conclusion: In general, many patients with malaria had high blood pressure during hospital admission, and throughout the hospitalization period, in some cases, there was a significant reduction depending on social conditions, parasitemics, and medical and medication treatment.
{"title":"Effect of social and clinical conditions on blood pressure variation in angolans hospitalized with malaria","authors":"Euclides Nenga Manuel Sacomboio, J. Bande, Santo Doqui Zua","doi":"10.4103/ami.ami_84_20","DOIUrl":"https://doi.org/10.4103/ami.ami_84_20","url":null,"abstract":"Introduction: Malaria is the leading cause of death in Angola, followed by road accidents, and represents about 20% of hospitalizations in health facilities and about 35% of the demand for curative care. The objective of this study was to assess the effect of social and clinical conditions on the variation of blood pressure in hospitalized Angolans with malaria. Materials and Methods: The study was conducted as a cross sectional and quantitative approach. Results: Of the 333 patients followed, 28% of the patients were normotensive, 50% with moderate hypertension (HTN.1) and 20% with severe hypertension, in the first 48 hours of hospitalization. These data changed after 4 days, where in the last 48 hours before the end of the study, 33% of patients were normotensive, 56% were moderate hypertensive (HTN.2) and 11% were severe hypertensive and the average age of the patients was 27 years old (standard deviation = 9) and the female/male ratio was 153/180, mostly from urban areas in Luanda (76%) and moderate and severe hypertension was more frequent in students, unemployed and business people (72% ). In the first 48 hours, the number of patients with low parasitemia was 42%, with moderate and high parasitemia was 58%. In the last 48 hours before the end of the study, patients with moderate and high parasitemia accounted for only 11% and patients with low parasitemia accounted for 89%, where patients treated with artemether were 90% of the study population and showed significant changes in pressure levels when compared with patients treated with artesunate (10%), the mortality rate was 6%, a large group of them remained hospitalized (63%) and 31% were discharged. Conclusion: In general, many patients with malaria had high blood pressure during hospital admission, and throughout the hospitalization period, in some cases, there was a significant reduction depending on social conditions, parasitemics, and medical and medication treatment.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"31 1","pages":"121 - 129"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74666480","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}
S. Sharma, Hemlata Sadhanu, Manisha Naithani, Anshuman Darbari, J. Bharadwaj, Maneesh Sharma
Introduction: Heart transplantation is the currently available and established lifesaving therapy for the end stage heart failure. Considering the paucity of data about nurses' awareness and attitude about heart transplantation, this survey was undertaken. The aim of this study was to assess the awareness and attitude regarding heart transplantation among undergraduate nursing students. A questionnaire based cross sectional survey was conducted among undergraduate nursing students studying in an institute of national importance in India. Materials and Methods: A prevalidated questionnaire was administered among 147 randomly selected participants who were willing to participate in the study. Results: All the students (100%) were aware about organ donation, but majority (77.5%) informed that their source of information on this topic is by Internet/media. Around 18.4% of participants had already pledged permission for organ donation after death and 70.8% were willing to donate the organ after death. Conclusion: Results showed the gap existence and need of addressing this among undergraduate nursing students regarding organ donation and heart transplantation.
{"title":"Awareness and attitude about heart transplantation among undergraduate nursing students: An institution-based survey in India","authors":"S. Sharma, Hemlata Sadhanu, Manisha Naithani, Anshuman Darbari, J. Bharadwaj, Maneesh Sharma","doi":"10.4103/ami.ami_152_20","DOIUrl":"https://doi.org/10.4103/ami.ami_152_20","url":null,"abstract":"Introduction: Heart transplantation is the currently available and established lifesaving therapy for the end stage heart failure. Considering the paucity of data about nurses' awareness and attitude about heart transplantation, this survey was undertaken. The aim of this study was to assess the awareness and attitude regarding heart transplantation among undergraduate nursing students. A questionnaire based cross sectional survey was conducted among undergraduate nursing students studying in an institute of national importance in India. Materials and Methods: A prevalidated questionnaire was administered among 147 randomly selected participants who were willing to participate in the study. Results: All the students (100%) were aware about organ donation, but majority (77.5%) informed that their source of information on this topic is by Internet/media. Around 18.4% of participants had already pledged permission for organ donation after death and 70.8% were willing to donate the organ after death. Conclusion: Results showed the gap existence and need of addressing this among undergraduate nursing students regarding organ donation and heart transplantation.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"109 4 1","pages":"76 - 80"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79651125","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: The purpose of the study was to assess the operative characteristics and treatment outcome of percutaneous nephrolithotomy (PCNL) for the treatment of renal calculi at our hospital. Materials and Methods: Patients with significant size symptomatic renal calculi not manageable by conservative management and those with calculi resistant to extracorporeal shock wave lithotripsy (ESWL) were included in the study. Patients excluded from the study were those with significant coagulopathy, active upper urinary tract infection, and renal calculi in ectopic kidneys. Results: Our study group had a mean age of 42.46 ± 11.29 years. Nearly 60% of stones in our study were of size 21–30 mm in the longest diameter with mean stone diameter of 24.56 ± 7.809 mm. Mean hemoglobin drop following the procedure was 1.35 ± 0.843 g/dl. Mean operative time was 93.56 ± 9.90 min. We had an overall success rate of 83.5% in our study. Fourteen failure cases were managed by ESWL (ten cases), second look PCNL (three cases), and by open surgery (one case). Conclusion: Although we find a higher frequency of minor complications such as transient mild hematuria (37.6%), mild puncture site pain (55.3%), or low-grade fever (24.7%), no major or long-term side effects were observed in our series.
{"title":"Treatment outcome of percutaneous nephrolithotomy: The initial experience from a tertiary care Center","authors":"I. Ahmad, I. Ahmad, A. Hamid, E. Khateeb","doi":"10.4103/ami.ami_134_20","DOIUrl":"https://doi.org/10.4103/ami.ami_134_20","url":null,"abstract":"Introduction: The purpose of the study was to assess the operative characteristics and treatment outcome of percutaneous nephrolithotomy (PCNL) for the treatment of renal calculi at our hospital. Materials and Methods: Patients with significant size symptomatic renal calculi not manageable by conservative management and those with calculi resistant to extracorporeal shock wave lithotripsy (ESWL) were included in the study. Patients excluded from the study were those with significant coagulopathy, active upper urinary tract infection, and renal calculi in ectopic kidneys. Results: Our study group had a mean age of 42.46 ± 11.29 years. Nearly 60% of stones in our study were of size 21–30 mm in the longest diameter with mean stone diameter of 24.56 ± 7.809 mm. Mean hemoglobin drop following the procedure was 1.35 ± 0.843 g/dl. Mean operative time was 93.56 ± 9.90 min. We had an overall success rate of 83.5% in our study. Fourteen failure cases were managed by ESWL (ten cases), second look PCNL (three cases), and by open surgery (one case). Conclusion: Although we find a higher frequency of minor complications such as transient mild hematuria (37.6%), mild puncture site pain (55.3%), or low-grade fever (24.7%), no major or long-term side effects were observed in our series.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"29 1","pages":"97 - 101"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88039763","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: The objective was to understand the marital dissatisfaction/satisfaction and problems in different areas of marital life in spouses of patients with bipolar disorder (BD). Materials and Methods: In this cross sectional descriptive study on BD patients and their spouses, a semi structured questionnaire was used to collect sociodemographic details. Couple satisfaction index (CSI) was used to identify marital satisfaction or dissatisfaction, whereas problem areas questionnaire (PAQ) was used to identify areas in which spouses of BD patients were often dissatisfied or have disagreements about their partner's behavior. Results: A total of 170 BD patients, along with their spouses, were included in our study. Marital dissatisfaction was present in 104 (61.2%) and there was no significant relation with sociodemographic variables except for the number of children (P = 0.002). Mean scores on CSI and PAQ were 42.75 ± 17.32 and 28.91 ± 11.28, respectively, with a significant negative correlation between these (r =-0.712; P = 0.0001). Handling family finances; rearing children or parenting, career/job related decisions, demonstrations of affection, handling household tasks, spending recreation leisure time together, moodiness/temper/emotionality, and problems in sex relations were important areas in which partners of BD patients were facing a significant problem. Conclusions: Marital dissatisfaction was very common in spouses of BD patients and they faced a lot of problems in various areas of their lives. As clinicians, we need to evaluate and understand the issues related to the marital life of normal spouses of BD patients to provide emotional and practical support to them, individually as well as couples.
{"title":"Dissatisfaction and problems in marital life of spouses of patients with bipolar disorder: A cross-sectional study from a tertiary care hospital","authors":"B. Bhat, R. Mir, A. Hussain, I. Shah","doi":"10.4103/ami.ami_153_20","DOIUrl":"https://doi.org/10.4103/ami.ami_153_20","url":null,"abstract":"Introduction: The objective was to understand the marital dissatisfaction/satisfaction and problems in different areas of marital life in spouses of patients with bipolar disorder (BD). Materials and Methods: In this cross sectional descriptive study on BD patients and their spouses, a semi structured questionnaire was used to collect sociodemographic details. Couple satisfaction index (CSI) was used to identify marital satisfaction or dissatisfaction, whereas problem areas questionnaire (PAQ) was used to identify areas in which spouses of BD patients were often dissatisfied or have disagreements about their partner's behavior. Results: A total of 170 BD patients, along with their spouses, were included in our study. Marital dissatisfaction was present in 104 (61.2%) and there was no significant relation with sociodemographic variables except for the number of children (P = 0.002). Mean scores on CSI and PAQ were 42.75 ± 17.32 and 28.91 ± 11.28, respectively, with a significant negative correlation between these (r =-0.712; P = 0.0001). Handling family finances; rearing children or parenting, career/job related decisions, demonstrations of affection, handling household tasks, spending recreation leisure time together, moodiness/temper/emotionality, and problems in sex relations were important areas in which partners of BD patients were facing a significant problem. Conclusions: Marital dissatisfaction was very common in spouses of BD patients and they faced a lot of problems in various areas of their lives. As clinicians, we need to evaluate and understand the issues related to the marital life of normal spouses of BD patients to provide emotional and practical support to them, individually as well as couples.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"144 1","pages":"69 - 75"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73630329","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}
Poonam Makhija, Rupinderjeet Kaur, S. Kaur, Paramdeep Singh
Introduction: The diagnosis of coronary artery disease or acute coronary syndrome (ACS) is difficult in patients of chronic kidney disease (CKD). This study was planned to evaluate the role of cardiac biomarkers in diagnosis of ACS in such patients. To evaluate the role of biochemical cardiac markers in the diagnosis of ACS in patients with CKD and to study the relation of stage of kidney disease and biochemical cardiac biomarkers. Materials and Methods: Atotal of 350 patients in different stages of CKD were enrolled and subjected to measurement of blood levels of creatine kinase (CK) MB and Troponin I (Trop I). The data were analyzed by dividing subjects into groups based on positivity of biomarkers, presence of electrocardiogram (ECG) changes, and stage of CKD. Results: Sensitivity of CK MB and Trop I was 60.81% and 56.76% and specificity was 72.1% and 83.33%, respectively. Although both showed low positive predictive values, the negative predictive value of both CK MB and Trop I was good. Stage of CKD did not significantly affect the level or positivity of the biomarker in patients with ECG changes. Conclusions: CK MB and Trop I potentially rule out the probability of ACS in patients showing negative test results, which should always be interpreted in light of ECG changes in CKD patients.
{"title":"Diagnostic accuracy of cardiac biomarkers in chronic kidney disease patients for detecting occurrence of acute coronary syndrome: A comparative study","authors":"Poonam Makhija, Rupinderjeet Kaur, S. Kaur, Paramdeep Singh","doi":"10.4103/ami.ami_81_20","DOIUrl":"https://doi.org/10.4103/ami.ami_81_20","url":null,"abstract":"Introduction: The diagnosis of coronary artery disease or acute coronary syndrome (ACS) is difficult in patients of chronic kidney disease (CKD). This study was planned to evaluate the role of cardiac biomarkers in diagnosis of ACS in such patients. To evaluate the role of biochemical cardiac markers in the diagnosis of ACS in patients with CKD and to study the relation of stage of kidney disease and biochemical cardiac biomarkers. Materials and Methods: Atotal of 350 patients in different stages of CKD were enrolled and subjected to measurement of blood levels of creatine kinase (CK) MB and Troponin I (Trop I). The data were analyzed by dividing subjects into groups based on positivity of biomarkers, presence of electrocardiogram (ECG) changes, and stage of CKD. Results: Sensitivity of CK MB and Trop I was 60.81% and 56.76% and specificity was 72.1% and 83.33%, respectively. Although both showed low positive predictive values, the negative predictive value of both CK MB and Trop I was good. Stage of CKD did not significantly affect the level or positivity of the biomarker in patients with ECG changes. Conclusions: CK MB and Trop I potentially rule out the probability of ACS in patients showing negative test results, which should always be interpreted in light of ECG changes in CKD patients.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"13 1","pages":"130 - 136"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74984325","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}
The multifactorial disease of the elderly, characterized by accelerated bone loss and a high risk of fracture (even with trivial trauma), osteoporosis, is known to primarily affect postmenopausal women. Moreover, the precipitating factors for the same mainly are the hormonal and nutritional deficiency. Clinically, the most common fracture to be encountered is the vertebral compression fracture. Apart from exogenously supplementing calcium and Vitamin D, a diverse group of drugs (bisphosphonates, denosumab, teriparatide, strontium ranelate, raloxifene, and calcitonin) are available to manage the case of osteoporosis. The latest drug to be approved and included in this quiver is a sclerostin-targeting monoclonal antibody, romosozumab. This new drug appears to be promising in managing the postmenopausal patients of osteoporosis. Although the array of adverse effects is not well recognized, a black box warning has been issued for this drug in reference to contraindicated use in patients with comorbid myocardial infarction. The intent of the authors for this review is to discuss the pharmacological profile of romosozumab, with particular emphasis on supportive clinical trials as well as the adverse drug reactions associated with its use.
{"title":"Romosozumab: A new anabolic arrow in quiver for management of osteoporosis","authors":"Ashutosh Kumar Singh, Dhyuti Gupta","doi":"10.4103/ami.ami_68_20","DOIUrl":"https://doi.org/10.4103/ami.ami_68_20","url":null,"abstract":"The multifactorial disease of the elderly, characterized by accelerated bone loss and a high risk of fracture (even with trivial trauma), osteoporosis, is known to primarily affect postmenopausal women. Moreover, the precipitating factors for the same mainly are the hormonal and nutritional deficiency. Clinically, the most common fracture to be encountered is the vertebral compression fracture. Apart from exogenously supplementing calcium and Vitamin D, a diverse group of drugs (bisphosphonates, denosumab, teriparatide, strontium ranelate, raloxifene, and calcitonin) are available to manage the case of osteoporosis. The latest drug to be approved and included in this quiver is a sclerostin-targeting monoclonal antibody, romosozumab. This new drug appears to be promising in managing the postmenopausal patients of osteoporosis. Although the array of adverse effects is not well recognized, a black box warning has been issued for this drug in reference to contraindicated use in patients with comorbid myocardial infarction. The intent of the authors for this review is to discuss the pharmacological profile of romosozumab, with particular emphasis on supportive clinical trials as well as the adverse drug reactions associated with its use.","PeriodicalId":32506,"journal":{"name":"Acta Medica International","volume":"35 1","pages":"57 - 62"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78512418","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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