Pub Date : 2022-07-01DOI: 10.4103/jcrsm.jcrsm_52_22
B. Antonieo Raja, S. Abirami, P. Jose, Peter Prasanth Kumar Kommu
Hereditary spastic paraplegia (HSP), is a heterogeneous group of corticospinal tract disorders leading to progressive lower limb weakness and spasticity. Recessive mutations in DDHD2 characteristically involve early onset delay in motor and cognitive milestones coupled with spasticity. The complex nature of HSP is always confounding for appropriate management. An 11-year-old boy was brought by his parents for developmental delay noticed from 7 months of age and was diagnosed to have possible spastic cerebral palsy initially. Due to increasing spasticity, he underwent tendon release surgery for achilles and iliopsoas at 4 years of age. Now, he presented to us with increasing stiffness in his lower limbs even after regular physical therapy and myoclonic jerks. He had severe spasticity in the lower limbs with a power of 4/5. His activities of daily living were restricted due to severe spasticity. The lower limb deep tendon reflexes are exaggerated with positive Babinski sign and Scissoring of gait. He also had a mild intellectual disability. He was started on symptomatic management with muscle relaxants. Clinical exome sequencing showed a novel homozygous nonsense variation in exon 6 of DDHD2 gene. Prenatal genetic counseling was given for the next pregnancy and hence chorionic villus sampling for the variant testing of the developing fetus was done. The reports revealed a heterozygous state and asymptomatic carrier, unlikely to be affected by DDHD2-associated phenotype (spastic paraplegia genes 54). HSP should be considered when there is global developmental delay and increasing spasticity in lower limbs despite rehabilitation therapies.
{"title":"A rare case of the complex phenotype of hereditary spastic paraparesis due to a mutation in a novel gene variant","authors":"B. Antonieo Raja, S. Abirami, P. Jose, Peter Prasanth Kumar Kommu","doi":"10.4103/jcrsm.jcrsm_52_22","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_52_22","url":null,"abstract":"Hereditary spastic paraplegia (HSP), is a heterogeneous group of corticospinal tract disorders leading to progressive lower limb weakness and spasticity. Recessive mutations in DDHD2 characteristically involve early onset delay in motor and cognitive milestones coupled with spasticity. The complex nature of HSP is always confounding for appropriate management. An 11-year-old boy was brought by his parents for developmental delay noticed from 7 months of age and was diagnosed to have possible spastic cerebral palsy initially. Due to increasing spasticity, he underwent tendon release surgery for achilles and iliopsoas at 4 years of age. Now, he presented to us with increasing stiffness in his lower limbs even after regular physical therapy and myoclonic jerks. He had severe spasticity in the lower limbs with a power of 4/5. His activities of daily living were restricted due to severe spasticity. The lower limb deep tendon reflexes are exaggerated with positive Babinski sign and Scissoring of gait. He also had a mild intellectual disability. He was started on symptomatic management with muscle relaxants. Clinical exome sequencing showed a novel homozygous nonsense variation in exon 6 of DDHD2 gene. Prenatal genetic counseling was given for the next pregnancy and hence chorionic villus sampling for the variant testing of the developing fetus was done. The reports revealed a heterozygous state and asymptomatic carrier, unlikely to be affected by DDHD2-associated phenotype (spastic paraplegia genes 54). HSP should be considered when there is global developmental delay and increasing spasticity in lower limbs despite rehabilitation therapies.","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":"33 1","pages":"206 - 208"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75220708","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 : 2022-07-01DOI: 10.4103/jcrsm.jcrsm_87_21
Antonieo Raja Balraj, R. Bhowmick, A. Kasinathan, Peter Prasanth Kumar Kommu
The incidence rate of acute flaccid myelitis (AFM) in India was 12/100,000 people, whereas it is 0.71/million in the United States. The incidence of nonpolio AFM has increased over the years.[1] We present a young infant with a 3-day fever followed by irritability and paucity of movements of the left lower limb for 24 hours. The initial laboratory evaluation was negative for bacterial meningitis. However, a polymerase chain reaction was used to detect enterovirus ribonucleic acid in cerebrospinal fluid. The patient's condition improved as a result of supportive care. This case shows a serious nonpolio enteroviral central nerve infection that presents as acute flaccid paralysis.
{"title":"Acute flaccid paralysis in an infant","authors":"Antonieo Raja Balraj, R. Bhowmick, A. Kasinathan, Peter Prasanth Kumar Kommu","doi":"10.4103/jcrsm.jcrsm_87_21","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_87_21","url":null,"abstract":"The incidence rate of acute flaccid myelitis (AFM) in India was 12/100,000 people, whereas it is 0.71/million in the United States. The incidence of nonpolio AFM has increased over the years.[1] We present a young infant with a 3-day fever followed by irritability and paucity of movements of the left lower limb for 24 hours. The initial laboratory evaluation was negative for bacterial meningitis. However, a polymerase chain reaction was used to detect enterovirus ribonucleic acid in cerebrospinal fluid. The patient's condition improved as a result of supportive care. This case shows a serious nonpolio enteroviral central nerve infection that presents as acute flaccid paralysis.","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":"30 1","pages":"190 - 191"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75764416","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 : 2022-07-01DOI: 10.4103/jcrsm.jcrsm_15_22
Tribeni Goswami, Mathew S. Krishnamurthy, S. Varghese
Background: Diabetes mellitus (DM) has become a global disease that is affecting millions of people, and currently, India has about 50 million patients. Urinary tract infections (UTIs) have long been recognized as a significant problem in patients with DM. This study aimed to find out the pathogenic microorganisms and antibiotic sensitivity patterns for UTI in diabetes patients. Methodology: This was a cross-sectional study conducted in the Department of Microbiology at a tertiary care hospital. The duration of the study was for 10 months. Diabetic status was confirmed as per the recommended diagnostic criteria. The identification of the bacterial isolates and antimicrobial sensitivity was carried out by conventional or Vitek-2 compact system. Data were entered in Microsoft Excel and were analyzed using the SPSS version 20. Variables were represented by the frequency and percentage analysis. Results: There were 59 positive urine cultures in diabetes patients from January 2021 to October 2021, and the highest number of patients belong to the >70 years' age group. Escherichia coli was the predominant organism isolated and was most sensitive to carbapenems. Conclusions: In our study, the elderly female population were found to be the most vulnerable group. The highest sensitivity was observed in carbapenem which can be used for empirical treatment in admitted patients.
背景:糖尿病(DM)已成为影响数百万人的全球性疾病，目前印度约有5000万患者。尿路感染(UTI)一直被认为是糖尿病患者的一个重要问题，本研究旨在了解糖尿病患者尿路感染的病原微生物和抗生素敏感性模式。方法:这是一项横断面研究，在三级护理医院微生物科进行。研究时间为10个月。按照推荐的诊断标准确诊为糖尿病。采用常规或Vitek-2紧凑系统进行分离菌鉴定及药敏试验。数据在Microsoft Excel中输入，并使用SPSS version 20进行分析。变量用频率和百分比分析表示。结果:2021年1月至2021年10月，糖尿病患者尿培养阳性59例，其中70岁以上患者最多。大肠杆菌是分离的优势菌，对碳青霉烯类最敏感。结论:在我们的研究中，老年女性人群是最脆弱的群体。碳青霉烯敏感性最高，可用于住院患者的经验性治疗。
{"title":"A study on the pathogenic microbes and antibiotic-sensitivity patterns in urinary tract infection among diabetes patients at a tertiary care hospital in Central Kerala","authors":"Tribeni Goswami, Mathew S. Krishnamurthy, S. Varghese","doi":"10.4103/jcrsm.jcrsm_15_22","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_15_22","url":null,"abstract":"Background: Diabetes mellitus (DM) has become a global disease that is affecting millions of people, and currently, India has about 50 million patients. Urinary tract infections (UTIs) have long been recognized as a significant problem in patients with DM. This study aimed to find out the pathogenic microorganisms and antibiotic sensitivity patterns for UTI in diabetes patients. Methodology: This was a cross-sectional study conducted in the Department of Microbiology at a tertiary care hospital. The duration of the study was for 10 months. Diabetic status was confirmed as per the recommended diagnostic criteria. The identification of the bacterial isolates and antimicrobial sensitivity was carried out by conventional or Vitek-2 compact system. Data were entered in Microsoft Excel and were analyzed using the SPSS version 20. Variables were represented by the frequency and percentage analysis. Results: There were 59 positive urine cultures in diabetes patients from January 2021 to October 2021, and the highest number of patients belong to the >70 years' age group. Escherichia coli was the predominant organism isolated and was most sensitive to carbapenems. Conclusions: In our study, the elderly female population were found to be the most vulnerable group. The highest sensitivity was observed in carbapenem which can be used for empirical treatment in admitted patients.","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":"40 1","pages":"140 - 145"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72729339","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 : 2022-07-01DOI: 10.4103/jcrsm.jcrsm_55_22
A. Velavan, Shashikala, P. Anitha, P. Stalin, R. Kumar, A. Purty
Background: Dengue virus infection is an important global public health issue. India is one of the high-burden countries with the resurgence of dengue in recent years. Surveillance based on hospital data can be misleading. Seroprevalence studies in the community are extremely useful in measuring the extent of transmission. This community-based study was done to identify the breeding sites of the Aedes mosquito and measure the seroprevalence of dengue infection in an urban area of Puducherry. Methodology: A cross-sectional study was done for 6 months in an urban area of Puducherry to assess the breeding sites for dengue and to find the serological prevalence of dengue. House-to-house visits were done in the study area to collect details on sociodemographic data, environmental data, and breeding sites for dengue. Blood samples were obtained from all willing participants aged 9 years and above to detect specific immunoglobulin G antibodies to dengue virus by enzyme-linked immunosorbent assay. Results: The seroprevalence of dengue infection was found to be 8.3%. Flower vase with water 72 (18%), animal water container 32 (8%), roof gutter/sunshades, 25 (6.3%), and open water storage tanks 18 (4.5%) were the most commonly prevalent breeding sites in the study area. The houses with potential breeding sites, such as roof gutters and sunshades, were significantly associated with the prevalence of dengue seropositivity among the study participants. Conclusion: The seroprevalence was found to be relatively low in the study area and the potential breeding sites for dengue were identified.
{"title":"Assessment of breeding sites and seroprevalence of dengue in an urban area of Puducherry – A community-based study","authors":"A. Velavan, Shashikala, P. Anitha, P. Stalin, R. Kumar, A. Purty","doi":"10.4103/jcrsm.jcrsm_55_22","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_55_22","url":null,"abstract":"Background: Dengue virus infection is an important global public health issue. India is one of the high-burden countries with the resurgence of dengue in recent years. Surveillance based on hospital data can be misleading. Seroprevalence studies in the community are extremely useful in measuring the extent of transmission. This community-based study was done to identify the breeding sites of the Aedes mosquito and measure the seroprevalence of dengue infection in an urban area of Puducherry. Methodology: A cross-sectional study was done for 6 months in an urban area of Puducherry to assess the breeding sites for dengue and to find the serological prevalence of dengue. House-to-house visits were done in the study area to collect details on sociodemographic data, environmental data, and breeding sites for dengue. Blood samples were obtained from all willing participants aged 9 years and above to detect specific immunoglobulin G antibodies to dengue virus by enzyme-linked immunosorbent assay. Results: The seroprevalence of dengue infection was found to be 8.3%. Flower vase with water 72 (18%), animal water container 32 (8%), roof gutter/sunshades, 25 (6.3%), and open water storage tanks 18 (4.5%) were the most commonly prevalent breeding sites in the study area. The houses with potential breeding sites, such as roof gutters and sunshades, were significantly associated with the prevalence of dengue seropositivity among the study participants. Conclusion: The seroprevalence was found to be relatively low in the study area and the potential breeding sites for dengue were identified.","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":"2 1","pages":"152 - 155"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88127321","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 : 2022-07-01DOI: 10.4103/jcrsm.jcrsm_67_22
Leander Pradeep, U. Jyothish, R. Fernando, K. Ravichandran, Subhasis Das
Background: Diabetes is primarily a genetic disorder. Whether the forearm muscle fatigue, handgrip strength (HGS), and phase angle difference between young adults with diabetic genes and their counterparts are not known. We designed a cross-sectional study to compare these variables among young healthy adults with diabetic parents in one group and nondiabetic parents in the other. Methodology: Forearm muscle fatigue, HGS, and phase angle were measured in 60 young healthy adults aged 18 to 23 years with body mass index between 18 and 23.4. Among them, 30 had at least one parent who had been a diabetic for more than 3 years and the other thirty had nondiabetic parents (both parents having fasting blood sugar <100 mg/dl). Results: The continuous variables between the groups, which were normally distributed, were analyzed using the independent sample t-test. Data that were nonnormally distributed were analyzed using the Mann–Whitney U test. Forearm muscle fatigue of young adults with diabetic parents increased significantly compared to their counterparts (P = 0.005). HGS was greater among adults with nondiabetic parents compared to adults with diabetic parents, although this was not statistically significant. Phase angle did not show any significant difference between the two groups. Conclusion: A simple noninvasive measurement like forearm muscle fatigue is found to be increased among young healthy adults with diabetogenic genes when compared to their counterparts without diabetogenic genes. Prospective studies need to be performed to show increased muscle fatigue as a predictor of future incidence of diabetes.
{"title":"Comparison of forearm muscle fatigue among apparently healthy young adults with and without diabetogenic genes","authors":"Leander Pradeep, U. Jyothish, R. Fernando, K. Ravichandran, Subhasis Das","doi":"10.4103/jcrsm.jcrsm_67_22","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_67_22","url":null,"abstract":"Background: Diabetes is primarily a genetic disorder. Whether the forearm muscle fatigue, handgrip strength (HGS), and phase angle difference between young adults with diabetic genes and their counterparts are not known. We designed a cross-sectional study to compare these variables among young healthy adults with diabetic parents in one group and nondiabetic parents in the other. Methodology: Forearm muscle fatigue, HGS, and phase angle were measured in 60 young healthy adults aged 18 to 23 years with body mass index between 18 and 23.4. Among them, 30 had at least one parent who had been a diabetic for more than 3 years and the other thirty had nondiabetic parents (both parents having fasting blood sugar <100 mg/dl). Results: The continuous variables between the groups, which were normally distributed, were analyzed using the independent sample t-test. Data that were nonnormally distributed were analyzed using the Mann–Whitney U test. Forearm muscle fatigue of young adults with diabetic parents increased significantly compared to their counterparts (P = 0.005). HGS was greater among adults with nondiabetic parents compared to adults with diabetic parents, although this was not statistically significant. Phase angle did not show any significant difference between the two groups. Conclusion: A simple noninvasive measurement like forearm muscle fatigue is found to be increased among young healthy adults with diabetogenic genes when compared to their counterparts without diabetogenic genes. Prospective studies need to be performed to show increased muscle fatigue as a predictor of future incidence of diabetes.","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":"35 1","pages":"146 - 151"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82631835","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 : 2022-07-01DOI: 10.4103/jcrsm.jcrsm_35_22
J. Gupta, Monica Soni, Harsha Charaya, A. Nayak
Background: Preeclampsia is called the “disease of theories” because its direct cause is still debated. Among all maternal deaths worldwide, 19% of deaths are due to hypertension during pregnancy (World Health Organization 2014). Early diagnosis and management remain the cornerstone in the management of preeclampsia. Estimation of serum lipid profile early in pregnancy could help to identify high-risk cases prone to preeclampsia, thereby reducing morbidity and mortality associated with preeclampsia. The study aimed to determine the role of serum lipid profile in the early prediction of preeclampsia. Methodology: This was a hospital-based prospective study done among pregnant women with a period of gestation of 20 ± 1 week enrolled after screening for inclusion and exclusion criteria and informed consent and institutional ethical committee approval, samples for lipid profile were taken. Patients were divided into two groups (100 each) based on lipid profile – Group A: normal lipid profile and Group B: abnormal lipid profile. Both groups were followed and closely observed for the development of hypertension, albuminuria, and signs and symptoms of preeclampsia. Data were collected and systematically analyzed. Results: In Group A, eight participants developed preeclampsia, whereas in Group B, 27 participants developed preeclampsia during the study period. The difference was found statistically significant (P = 0.003). Conclusion: In our study, it was observed that dyslipidemia in pregnancy is positively associated with an increased risk of preeclampsia.
{"title":"The role of lipid profile as an early indicator of preeclampsia","authors":"J. Gupta, Monica Soni, Harsha Charaya, A. Nayak","doi":"10.4103/jcrsm.jcrsm_35_22","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_35_22","url":null,"abstract":"Background: Preeclampsia is called the “disease of theories” because its direct cause is still debated. Among all maternal deaths worldwide, 19% of deaths are due to hypertension during pregnancy (World Health Organization 2014). Early diagnosis and management remain the cornerstone in the management of preeclampsia. Estimation of serum lipid profile early in pregnancy could help to identify high-risk cases prone to preeclampsia, thereby reducing morbidity and mortality associated with preeclampsia. The study aimed to determine the role of serum lipid profile in the early prediction of preeclampsia. Methodology: This was a hospital-based prospective study done among pregnant women with a period of gestation of 20 ± 1 week enrolled after screening for inclusion and exclusion criteria and informed consent and institutional ethical committee approval, samples for lipid profile were taken. Patients were divided into two groups (100 each) based on lipid profile – Group A: normal lipid profile and Group B: abnormal lipid profile. Both groups were followed and closely observed for the development of hypertension, albuminuria, and signs and symptoms of preeclampsia. Data were collected and systematically analyzed. Results: In Group A, eight participants developed preeclampsia, whereas in Group B, 27 participants developed preeclampsia during the study period. The difference was found statistically significant (P = 0.003). Conclusion: In our study, it was observed that dyslipidemia in pregnancy is positively associated with an increased risk of preeclampsia.","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":"17 1","pages":"162 - 167"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84348616","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}
Background: Approximately 5% of COVID-19 patients suffer from near-fatal disease. Clinical and radiologic features may predict severe disease although with limited specificity and radiation hazard. Laboratory biomarkers are specific, simple, and point-of-care triage tools that can be used to predict the severity of the disease. This research aimed to study the role of inflammatory markers (serum ferritin, lactate dehydrogenase [LDH], D-dimer, and C-reactive protein [CRP]) in prognosticating COVID-19 patients. Methodology: This was a hospital-based retrospective study conducted on COVID-19 adult inpatients classified into three groups: mild disease-recovered (Group I), severe disease-recovered (Group II), and dead (Group III). Categorical outcomes were compared using the Chi-square test. Univariate binary logistic regression analysis was performed to test the association between the outcome and explanatory variables. An unadjusted odds ratio (OR) along with a 95% confidence interval was calculated. The utility of laboratory parameters (ferritin, LDH, neutrophil/lymphocyte ratio, D-dimer, and platelet/lymphocyte ratio) in predicting the severity of COVID-19 was assessed by the receiver operative curve analysis. P < 0.05 was considered statistically significant. Results: A total of 500 case records were analyzed. The mean age was 49.32 ± 17.1 years. About 72.4% were <60 years and 301 male and 199 female patients were included. The comorbidity count included diabetes 168 (33.6%), hypertension 122 (24.4%), coronary artery disease 23 (4.6%), hypothyroidism 3 (6%), and others 33 (6.6%) The median levels of ferritin among the three groups differed significantly bearing higher levels in Group 3 (P < 0.001). Median LDH and D-dimer values of the three groups showed statistical significance (P < 0.001). Qualitative CRP was significantly associated with poor outcomes (P < 0.001). The odds of patients suffering severe COVID-19 rose with rising values of ferritin, LDH, and D-dimer (unadjusted OR: 1.007, 1.004, and 1.020). Conclusion: Onetime measurement of serum ferritin, LDH, D-dimer, and CRP performed between 7th and 10th day of symptoms significantly predicted outcomes for COVID-19 inpatients.
{"title":"The prognostic role of inflammatory markers in COVID-19 patients: A retrospective analysis in a tertiary care hospital of southern India","authors":"Shivkumar Gopalakrishnan, Babu Krishnan, Malini Krishnan, S. Kandasamy, Peer Sahul Hameed, Velmurugan Karunakaran","doi":"10.4103/jcrsm.jcrsm_4_22","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_4_22","url":null,"abstract":"Background: Approximately 5% of COVID-19 patients suffer from near-fatal disease. Clinical and radiologic features may predict severe disease although with limited specificity and radiation hazard. Laboratory biomarkers are specific, simple, and point-of-care triage tools that can be used to predict the severity of the disease. This research aimed to study the role of inflammatory markers (serum ferritin, lactate dehydrogenase [LDH], D-dimer, and C-reactive protein [CRP]) in prognosticating COVID-19 patients. Methodology: This was a hospital-based retrospective study conducted on COVID-19 adult inpatients classified into three groups: mild disease-recovered (Group I), severe disease-recovered (Group II), and dead (Group III). Categorical outcomes were compared using the Chi-square test. Univariate binary logistic regression analysis was performed to test the association between the outcome and explanatory variables. An unadjusted odds ratio (OR) along with a 95% confidence interval was calculated. The utility of laboratory parameters (ferritin, LDH, neutrophil/lymphocyte ratio, D-dimer, and platelet/lymphocyte ratio) in predicting the severity of COVID-19 was assessed by the receiver operative curve analysis. P < 0.05 was considered statistically significant. Results: A total of 500 case records were analyzed. The mean age was 49.32 ± 17.1 years. About 72.4% were <60 years and 301 male and 199 female patients were included. The comorbidity count included diabetes 168 (33.6%), hypertension 122 (24.4%), coronary artery disease 23 (4.6%), hypothyroidism 3 (6%), and others 33 (6.6%) The median levels of ferritin among the three groups differed significantly bearing higher levels in Group 3 (P < 0.001). Median LDH and D-dimer values of the three groups showed statistical significance (P < 0.001). Qualitative CRP was significantly associated with poor outcomes (P < 0.001). The odds of patients suffering severe COVID-19 rose with rising values of ferritin, LDH, and D-dimer (unadjusted OR: 1.007, 1.004, and 1.020). Conclusion: Onetime measurement of serum ferritin, LDH, D-dimer, and CRP performed between 7th and 10th day of symptoms significantly predicted outcomes for COVID-19 inpatients.","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":"1 1","pages":"108 - 115"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77784350","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 : 2022-07-01DOI: 10.4103/jcrsm.jcrsm_5_22
Sanjay Kolte, M. Kolte, V. Bhargava, S. Bhuyar
Patients with ureteral obstruction often present a diagnostic dilemma on imaging techniques. Ureteritis cystica (UC) is one benign condition which can occasionally be a cause of ureteric obstruction and almost always eludes diagnosis unless ureteroscopic examination is performed. Although no definitive operative technique has been defined for its cure in the literature, ureteroscopic laser ablation is an effective minimally invasive option. We hereby present a short case report of thulium laser ablation in an elderly female with UC in the left upper ureter.
{"title":"Thulium laser ablation for ureteritis cystica","authors":"Sanjay Kolte, M. Kolte, V. Bhargava, S. Bhuyar","doi":"10.4103/jcrsm.jcrsm_5_22","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_5_22","url":null,"abstract":"Patients with ureteral obstruction often present a diagnostic dilemma on imaging techniques. Ureteritis cystica (UC) is one benign condition which can occasionally be a cause of ureteric obstruction and almost always eludes diagnosis unless ureteroscopic examination is performed. Although no definitive operative technique has been defined for its cure in the literature, ureteroscopic laser ablation is an effective minimally invasive option. We hereby present a short case report of thulium laser ablation in an elderly female with UC in the left upper ureter.","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":"26 1","pages":"200 - 202"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89752370","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 : 2022-07-01DOI: 10.4103/jcrsm.jcrsm_47_22
R. Rajendran, S. Seralathan
Background: Antibiotics are one of the major medications used in the intensive care unit (ICU). It is a matter of concern as inappropriate usage of antibiotics in the ICU has led to the development of many infections due to multidrug-resistant (MDR) organisms. The aim was to monitor and assess the empirical antibiotic treatment initiated and the changes made in antimicrobial therapy following the culture report. Methodology: The study was conducted from May 2018 to June 2018 after obtaining ethical clearance from the institute ethics committee which was a cross-sectional prospective type of study. One hundred patients who were on antibiotics were included in the study. A total of 249 culture samples were sent which included blood, urine, endotracheal aspirate, sputum, cerebrospinal fluid, wound swab, etc., The patients were started empirically with antibiotics ceftriaxone, imipenem, meropenem, amikacin, azithromycin, etc., The microorganisms grown in the culture were Escherichia coli, Acinetobacter species, Staphylococcus aureus, Pseudomonas aeruginosa, etc. Results: It was observed that for 54 patients, the empirical antibiotic treatment was continued, for 39 patients, there was a change in antibiotics following the culture report, and for Seven patients, the antibiotics were stopped. Among 39 patients, for 23 patients, there was an escalation, and for 16 patients, there was a de-escalation in the usage of antibiotics from the initial empirical treatment given. Conclusion: A proper prescription pattern and a standard antibiotic policy for prescribing antibiotics are needed to prevent the future development of MDR strains.
{"title":"Audit of antibiotics usage in an intensive care unit of a tertiary care hospital in South India","authors":"R. Rajendran, S. Seralathan","doi":"10.4103/jcrsm.jcrsm_47_22","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_47_22","url":null,"abstract":"Background: Antibiotics are one of the major medications used in the intensive care unit (ICU). It is a matter of concern as inappropriate usage of antibiotics in the ICU has led to the development of many infections due to multidrug-resistant (MDR) organisms. The aim was to monitor and assess the empirical antibiotic treatment initiated and the changes made in antimicrobial therapy following the culture report. Methodology: The study was conducted from May 2018 to June 2018 after obtaining ethical clearance from the institute ethics committee which was a cross-sectional prospective type of study. One hundred patients who were on antibiotics were included in the study. A total of 249 culture samples were sent which included blood, urine, endotracheal aspirate, sputum, cerebrospinal fluid, wound swab, etc., The patients were started empirically with antibiotics ceftriaxone, imipenem, meropenem, amikacin, azithromycin, etc., The microorganisms grown in the culture were Escherichia coli, Acinetobacter species, Staphylococcus aureus, Pseudomonas aeruginosa, etc. Results: It was observed that for 54 patients, the empirical antibiotic treatment was continued, for 39 patients, there was a change in antibiotics following the culture report, and for Seven patients, the antibiotics were stopped. Among 39 patients, for 23 patients, there was an escalation, and for 16 patients, there was a de-escalation in the usage of antibiotics from the initial empirical treatment given. Conclusion: A proper prescription pattern and a standard antibiotic policy for prescribing antibiotics are needed to prevent the future development of MDR strains.","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":"46 1","pages":"156 - 161"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81070387","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 : 2022-07-01DOI: 10.4103/jcrsm.jcrsm_68_22
R. Kanungo
{"title":"Monkeypox: Is the current outbreak tip of an iceberg?","authors":"R. Kanungo","doi":"10.4103/jcrsm.jcrsm_68_22","DOIUrl":"https://doi.org/10.4103/jcrsm.jcrsm_68_22","url":null,"abstract":"","PeriodicalId":32638,"journal":{"name":"Journal of Current Research in Scientific Medicine","volume":"101 1","pages":"99 - 100"},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89243216","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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