Pub Date : 2023-10-02DOI: 10.17727/jmsr.2023/11-54
Meena Ms, Sangumani J, Brahadeesh M, Natrajan A, John J, Jeyaseelan Djw
Introduction: COVID-19 disease was a global health emergency from March 2020 till May 2023 with no effective drug to date. COVID-19 vaccines with other precautious measures like hand washing, disinfection, social distancing etc. were the only ways to decrease the burden of the disease worldwide. The study aimed to determine the association between COVID-19 vaccination and disease severity among COVID-19 patients admitted to a Government Medical College hospital. Methods: This cross sectional study included 983 COVID-19 patients admitted to a tertiary care hospital from March 2021 to December 2021. Secondary data were collected from the case sheets and vaccination details were collected from the patients over the phone and through COWIN App. Chi-square test and binary logistic regression were done and the p value and odds ratio were estimated. Results: 92.9% of study participants were unvaccinated, 2.7% were fully vaccinated, and 4.3% were partially vaccinated. Among fully vaccinated 11.1% had breathlessness, 0% ICU admission, 3.7% died, 20% had COVID pneumonia findings in CT lung, 9% had low lymphocyte levels which were statistically significantly lower than in partially vaccinated (39.5%, 41.9%, 7%, 18.6%, 59.3%, 65.1%, 76.9% respectively) and unvaccinated (31.1%, 27.7%, 2%, 4.6%, 48.2%, 45.2%, 68.4% respectively). Conclusion: Two doses of vaccines provided significant protection from severe forms of the disease. Partially vaccinated were affected more, which may be due to insufficient immunity gained and their careless attitude post-vaccination with decreased shielding behaviour. The present study shows that partial vaccination is not protective against the progression of COVID-19 disease severity. More focus should be made on full vaccination of the community and educating the public about complete vaccination and emphasis on preventive measures even after vaccination must be made to reduce the burden of COVID-19 in the community. Keywords: COVID-19; COWIN App; vaccination; coronavirus disease
{"title":"COVID-19 vaccination and its influence on the disease severity among the COVID patients in a tertiary care hospital – A cross sectional study","authors":"Meena Ms, Sangumani J, Brahadeesh M, Natrajan A, John J, Jeyaseelan Djw","doi":"10.17727/jmsr.2023/11-54","DOIUrl":"https://doi.org/10.17727/jmsr.2023/11-54","url":null,"abstract":"Introduction: COVID-19 disease was a global health emergency from March 2020 till May 2023 with no effective drug to date. COVID-19 vaccines with other precautious measures like hand washing, disinfection, social distancing etc. were the only ways to decrease the burden of the disease worldwide. The study aimed to determine the association between COVID-19 vaccination and disease severity among COVID-19 patients admitted to a Government Medical College hospital. Methods: This cross sectional study included 983 COVID-19 patients admitted to a tertiary care hospital from March 2021 to December 2021. Secondary data were collected from the case sheets and vaccination details were collected from the patients over the phone and through COWIN App. Chi-square test and binary logistic regression were done and the p value and odds ratio were estimated. Results: 92.9% of study participants were unvaccinated, 2.7% were fully vaccinated, and 4.3% were partially vaccinated. Among fully vaccinated 11.1% had breathlessness, 0% ICU admission, 3.7% died, 20% had COVID pneumonia findings in CT lung, 9% had low lymphocyte levels which were statistically significantly lower than in partially vaccinated (39.5%, 41.9%, 7%, 18.6%, 59.3%, 65.1%, 76.9% respectively) and unvaccinated (31.1%, 27.7%, 2%, 4.6%, 48.2%, 45.2%, 68.4% respectively). Conclusion: Two doses of vaccines provided significant protection from severe forms of the disease. Partially vaccinated were affected more, which may be due to insufficient immunity gained and their careless attitude post-vaccination with decreased shielding behaviour. The present study shows that partial vaccination is not protective against the progression of COVID-19 disease severity. More focus should be made on full vaccination of the community and educating the public about complete vaccination and emphasis on preventive measures even after vaccination must be made to reduce the burden of COVID-19 in the community. Keywords: COVID-19; COWIN App; vaccination; coronavirus disease","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139324848","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 : 2023-10-02DOI: 10.17727/jmsr.2023/11-56
Kadel S, Bilolikar Ak, Eswaran Sp, Krishnaveni M, Fatima R, Sahu S
Background: Carbapenem-resistant Enterobacterales (CRE) are an urgent global public health problem. CRE infections are associated with high mortality and have limited available effective treatment. Carbapenemase enzymes are encoded by genes on mobile genetic elements, such as plasmids, which are highly transmissible between organisms and increase the potential spread of resistance. The study aim was to detect carbapenemase production in Gram negative bacilli by phenotypic (CarbaNP and mCIM only or in conjunction with eCIM) and genotypic (Xpert Carba-R) methods. Material and methods: The various clinical samples were processed as per standard recommended procedures. Identification and antibiotic susceptibility test were done by using GN cards and AST N280 & AST N281 cards of Vitek 2 Compact (bioMérieux) respectively. Phenotypic (CarbaNP and mCIM only or in conjunction with eCIM) and genotypic (Xpert Carba-R) methods were used for detection of carbapenemases. Result: 144 carbapenem-resistant Gram-negative bacilli isolated from various ICUs includes Klebsiella pneumoniae 52.7% (76/144) followed by Escherichia coli 18.05% (26/144) and 15.9% (23/144) Acinetobacter baumannii. Phenotypic test (CarbaNP and mCIM and or in conjunction with eCIM) showed sensitivity of 90%, 100% and 93.75% respectively. Genotypic test of 40 isolates showed predominant expression of NDM in 82.5% (33/40) isolates followed by OXA-48 in 40% (16/40). Conclusion: The study showed mCIM as the most useful diagnostic test with less economic burden to the patients. There is an urgent need for more sensitive, rapid, highly precise and accurate genotypic test which is less expensive and less labor-intensive. Keywords: carbapenem resistant; Enterobacterales; mCIM; eCIM; Xpert Carba-R
{"title":"Detection of carbapenemase production in gram negative bacilli in medical and surgical intensive care unit patients in a tertiary care hospital","authors":"Kadel S, Bilolikar Ak, Eswaran Sp, Krishnaveni M, Fatima R, Sahu S","doi":"10.17727/jmsr.2023/11-56","DOIUrl":"https://doi.org/10.17727/jmsr.2023/11-56","url":null,"abstract":"Background: Carbapenem-resistant Enterobacterales (CRE) are an urgent global public health problem. CRE infections are associated with high mortality and have limited available effective treatment. Carbapenemase enzymes are encoded by genes on mobile genetic elements, such as plasmids, which are highly transmissible between organisms and increase the potential spread of resistance. The study aim was to detect carbapenemase production in Gram negative bacilli by phenotypic (CarbaNP and mCIM only or in conjunction with eCIM) and genotypic (Xpert Carba-R) methods. Material and methods: The various clinical samples were processed as per standard recommended procedures. Identification and antibiotic susceptibility test were done by using GN cards and AST N280 & AST N281 cards of Vitek 2 Compact (bioMérieux) respectively. Phenotypic (CarbaNP and mCIM only or in conjunction with eCIM) and genotypic (Xpert Carba-R) methods were used for detection of carbapenemases. Result: 144 carbapenem-resistant Gram-negative bacilli isolated from various ICUs includes Klebsiella pneumoniae 52.7% (76/144) followed by Escherichia coli 18.05% (26/144) and 15.9% (23/144) Acinetobacter baumannii. Phenotypic test (CarbaNP and mCIM and or in conjunction with eCIM) showed sensitivity of 90%, 100% and 93.75% respectively. Genotypic test of 40 isolates showed predominant expression of NDM in 82.5% (33/40) isolates followed by OXA-48 in 40% (16/40). Conclusion: The study showed mCIM as the most useful diagnostic test with less economic burden to the patients. There is an urgent need for more sensitive, rapid, highly precise and accurate genotypic test which is less expensive and less labor-intensive. Keywords: carbapenem resistant; Enterobacterales; mCIM; eCIM; Xpert Carba-R","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139324858","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 : 2023-10-02DOI: 10.17727/jmsr.2023/11-60
Babu Bs, Varghese Cp, Gilvaz Pc
Long-term therapy with antiseizure medications (ASMs) has been associated with metabolic consequences that lead to an increase in the risk of atherosclerosis in patients with epilepsy. This study was conducted to assess the effects of ASMs on vascular risk factors namely, serum Lipid profile and C-reactive protein (CRP) in epileptic patients and to assess the correlation between the duration of the ASMs, and carotid intima media thickness (IMT). Forty three adult patient participants who were receiving ASM monotherapy for more than 2 years and 43 control patients were enrolled in this study. All participants received measurement of common carotid artery (CCA) and IMT by B-mode ultrasonography to assess the extent of atherosclerosis. Other measurements included body mass index (BMI), serum lipid profile and CRP. The correlation between duration of ASM and average carotid IMT was calculated by using the Pearson's correlation coefficient method. The majority of subjects on phenytoin 8 (66.7%) were positive for CRP. There was an equal proportion of patients on carbamazepine who were equally positive 5(50%) and negative 5(50%) for CRP. There was a statistically significant association between phenytoin consumption and CRP positivity. There was positive correlation between duration of phenytoin consumption and average IMT. There was a strong positive correlation between duration of phenobarbitone consumption and average IMT and was statistically significant. Our results also suggest that long-term use of ASMs with prominent effects on the enzyme system, including Carbamazepine, phenytoin, sodium valproate or phenobarbitone may contribute to the progression of atherosclerosis in patients with epilepsy. Keywords: epilepsy; ASMs; IMT; CRP; phenytoin; carbamazepine; sodium valproate; phenobarbitone
{"title":"Effects of long term antiseizure medications on atherosclerosis","authors":"Babu Bs, Varghese Cp, Gilvaz Pc","doi":"10.17727/jmsr.2023/11-60","DOIUrl":"https://doi.org/10.17727/jmsr.2023/11-60","url":null,"abstract":"Long-term therapy with antiseizure medications (ASMs) has been associated with metabolic consequences that lead to an increase in the risk of atherosclerosis in patients with epilepsy. This study was conducted to assess the effects of ASMs on vascular risk factors namely, serum Lipid profile and C-reactive protein (CRP) in epileptic patients and to assess the correlation between the duration of the ASMs, and carotid intima media thickness (IMT). Forty three adult patient participants who were receiving ASM monotherapy for more than 2 years and 43 control patients were enrolled in this study. All participants received measurement of common carotid artery (CCA) and IMT by B-mode ultrasonography to assess the extent of atherosclerosis. Other measurements included body mass index (BMI), serum lipid profile and CRP. The correlation between duration of ASM and average carotid IMT was calculated by using the Pearson's correlation coefficient method. The majority of subjects on phenytoin 8 (66.7%) were positive for CRP. There was an equal proportion of patients on carbamazepine who were equally positive 5(50%) and negative 5(50%) for CRP. There was a statistically significant association between phenytoin consumption and CRP positivity. There was positive correlation between duration of phenytoin consumption and average IMT. There was a strong positive correlation between duration of phenobarbitone consumption and average IMT and was statistically significant. Our results also suggest that long-term use of ASMs with prominent effects on the enzyme system, including Carbamazepine, phenytoin, sodium valproate or phenobarbitone may contribute to the progression of atherosclerosis in patients with epilepsy. Keywords: epilepsy; ASMs; IMT; CRP; phenytoin; carbamazepine; sodium valproate; phenobarbitone","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139324864","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 : 2023-10-02DOI: 10.17727/jmsr.2023/11-55
Bansal Kl, Bansal Ss, Bansal S, Sahay S
Background: Many patients come with respiratory symptoms of cough, expectoration and shortness of breath. They also exhibit history of risk factors like smoking etc. but on spirometry they do not meet spirometric criteria of chronic obstructive pulmonary disease (COPD). GOLD 2023 updates have considered such patients in the category of pre-COPD and preserved ratio impaired spirometry (PRISm) and advised to treat and follow these patients and try to prevent them from progressing to COPD. With this objective we tried to look for PRISm and its characteristics in our area. Material and methods: We analyzed the spirometric pattern of all the patients who underwent spirometry in our institution (GS Medical College & Hospital, Pilkhuwa) from January 2022 to December 2022. After applying inclusion and exclusion criteria, the patients were divided into three groups: (I) Normal Group: Patients having post bronchodilator FEV1/FVC ratio ≥ 0.7 and normal FEV1 and FVC. (II) PRISm Group: Patients having post bronchodilator FEV1/FVC ratio ≥ 0.7 but decreased FEV1 (< 80 %) and / or FVC (< 80 %). (III) Unrevealed COPD Group: Patients having post bronchodilator FEV1/FVC ratio < 0.7 irrespective of FEV1 and FVC. Data observed was compared among various groups and analyzed for various parameters. Results: A total of 986 patients underwent spirometry between 1st January 2022 and 31st December 2022. Of this, 302 patients were not considered for study because of exclusion criteria. 684 patients were considered for the study, of whom 261 (38.16%) had normal spirometry, 207 (30.26%) were in the PRISm group and 216 (31.58%) were found to have unrevealed COPD. Conclusion: Occurrence of PRISm is quite high (30.26%) in patients undergoing spirometry for various reasons in our area. Higher age and higher BMI may have contributed to the observations. Additionally, a considerable number of patients (31.58%) were found to have unrevealed COPD. Another finding is that smoking history is seen in more than 70% of male subjects in both PRISm and unrevealed COPD groups. However, the results need confirmation in more studies from different geographical areas. Keywords: spirometry; PRISm; COPD; pulmonary disease
{"title":"Prevalence of preserved ratio impaired spirometry (PRISM) in patients undergoing spirometry in a medical college hospital","authors":"Bansal Kl, Bansal Ss, Bansal S, Sahay S","doi":"10.17727/jmsr.2023/11-55","DOIUrl":"https://doi.org/10.17727/jmsr.2023/11-55","url":null,"abstract":"Background: Many patients come with respiratory symptoms of cough, expectoration and shortness of breath. They also exhibit history of risk factors like smoking etc. but on spirometry they do not meet spirometric criteria of chronic obstructive pulmonary disease (COPD). GOLD 2023 updates have considered such patients in the category of pre-COPD and preserved ratio impaired spirometry (PRISm) and advised to treat and follow these patients and try to prevent them from progressing to COPD. With this objective we tried to look for PRISm and its characteristics in our area. Material and methods: We analyzed the spirometric pattern of all the patients who underwent spirometry in our institution (GS Medical College & Hospital, Pilkhuwa) from January 2022 to December 2022. After applying inclusion and exclusion criteria, the patients were divided into three groups: (I) Normal Group: Patients having post bronchodilator FEV1/FVC ratio ≥ 0.7 and normal FEV1 and FVC. (II) PRISm Group: Patients having post bronchodilator FEV1/FVC ratio ≥ 0.7 but decreased FEV1 (< 80 %) and / or FVC (< 80 %). (III) Unrevealed COPD Group: Patients having post bronchodilator FEV1/FVC ratio < 0.7 irrespective of FEV1 and FVC. Data observed was compared among various groups and analyzed for various parameters. Results: A total of 986 patients underwent spirometry between 1st January 2022 and 31st December 2022. Of this, 302 patients were not considered for study because of exclusion criteria. 684 patients were considered for the study, of whom 261 (38.16%) had normal spirometry, 207 (30.26%) were in the PRISm group and 216 (31.58%) were found to have unrevealed COPD. Conclusion: Occurrence of PRISm is quite high (30.26%) in patients undergoing spirometry for various reasons in our area. Higher age and higher BMI may have contributed to the observations. Additionally, a considerable number of patients (31.58%) were found to have unrevealed COPD. Another finding is that smoking history is seen in more than 70% of male subjects in both PRISm and unrevealed COPD groups. However, the results need confirmation in more studies from different geographical areas. Keywords: spirometry; PRISm; COPD; pulmonary disease","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139324439","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 : 2023-10-02DOI: 10.17727/jmsr.2023/11-61
Inbasekaran A, Murugesan Sd, Rajendran K, Gnanasigamani S, Urabinahatti Ka, Hanumantha Rkn, Kanagarathinam Ss, Umesh Rn, Thangasamy S, Satyanesan J
Introduction: Splenectomy is one of the most commonly performed surgical procedures worldwide. The splenic hilum is closely related to adjacent organs like the tail of the pancreas, stomach, splenic flexure of colon, and left kidney. One of the morbid complications of splenectomy is injury to the tail of pancreas. The objective of this study was to assess the anatomical details of the pancreatic tail with respect to the splenic hilum by assessing patient’s abdominal computed tomography (CT) imaging. Methods: A total of 150 patients’ abdominal CT imaging was taken for evaluation in this study. The distance between the pancreatic tail and the splenic hilum was measured. The level of location of the pancreatic tail in relation to the splenic hilum was also noted for each patient. Results: The pancreatic tail was inferior to the level of the splenic hilum in 59.3 percent (n =89) of the patients, superior to the level of the splenic hilum in 2.0 percent (n =3) of the patients, and at the level of the hilum in 38.7 percent (n = 58) of the patients. The mean distance from the pancreatic tail to the splenic hilum was 13.1 ± 5.2 mm. Conclusion: Abdominal CT imaging will provide a road map regarding the location of the pancreatic tail and the distance between the pancreatic tail and the splenic hilum. With the preoperative CT imaging details and efficient surgical dissection as close as possible to the splenic hilum, the potential injury to the pancreatic tail can be prevented. Keywords: splenectomy; pancreatic tail injury; splenic hilum; pancreatic fistula
{"title":"Clinico-radiological study of the pancreatic tail in relation to the splenic hilum","authors":"Inbasekaran A, Murugesan Sd, Rajendran K, Gnanasigamani S, Urabinahatti Ka, Hanumantha Rkn, Kanagarathinam Ss, Umesh Rn, Thangasamy S, Satyanesan J","doi":"10.17727/jmsr.2023/11-61","DOIUrl":"https://doi.org/10.17727/jmsr.2023/11-61","url":null,"abstract":"Introduction: Splenectomy is one of the most commonly performed surgical procedures worldwide. The splenic hilum is closely related to adjacent organs like the tail of the pancreas, stomach, splenic flexure of colon, and left kidney. One of the morbid complications of splenectomy is injury to the tail of pancreas. The objective of this study was to assess the anatomical details of the pancreatic tail with respect to the splenic hilum by assessing patient’s abdominal computed tomography (CT) imaging. Methods: A total of 150 patients’ abdominal CT imaging was taken for evaluation in this study. The distance between the pancreatic tail and the splenic hilum was measured. The level of location of the pancreatic tail in relation to the splenic hilum was also noted for each patient. Results: The pancreatic tail was inferior to the level of the splenic hilum in 59.3 percent (n =89) of the patients, superior to the level of the splenic hilum in 2.0 percent (n =3) of the patients, and at the level of the hilum in 38.7 percent (n = 58) of the patients. The mean distance from the pancreatic tail to the splenic hilum was 13.1 ± 5.2 mm. Conclusion: Abdominal CT imaging will provide a road map regarding the location of the pancreatic tail and the distance between the pancreatic tail and the splenic hilum. With the preoperative CT imaging details and efficient surgical dissection as close as possible to the splenic hilum, the potential injury to the pancreatic tail can be prevented. Keywords: splenectomy; pancreatic tail injury; splenic hilum; pancreatic fistula","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139324522","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 : 2023-10-02DOI: 10.17727/jmsr.2023/11-52
Verma S, Sinha R, Jaiswal Cp
Background: Lymphadenopathy may be an incidental finding and/or primary or secondary manifestation of underlying diseases which may be neoplastic or non-neoplastic. The aim of the current study was to evaluate the spectrum of lymph node lesions according to the Sydney system in our setting and to assess the risk of malignancy in each category. Methods: The present study was carried out in the Department of Pathology, Nalanda Medical College and Hospital, Patna (Bihar) retrospectively during a one-year period from November 2020 to October 2021. 332 FNACs were performed on patients and the ROM (Risk of Malignancy) was assessed for each diagnostic category. Results: In the present study, 11 cases were categorized as L1, inadequate/non-diagnostic; 291 cases as L2,benign; 06 cases as L3, AUS/ALUS; 03 as L4, Suspicious for malignancy, and finally 21 cases were categorized as L5, Malignant. The ROM was 1.28% in L2, 50% in L3, and 100% in L4,L5. ROM for L1 category could not be assessed. Conclusion: The universal implementation of the Sydney system of reporting lymph node cytopathology can improve the diagnostic accuracy which will not only instill confidence in the pathologists but also help the clinicians to adopt better management strategies. Keywords: granulomatous; lymphadenitis; lymphoma; metastases; malignancy
{"title":"Spectrum of lymph node lesions as per recent Sydney system of lymph node classification","authors":"Verma S, Sinha R, Jaiswal Cp","doi":"10.17727/jmsr.2023/11-52","DOIUrl":"https://doi.org/10.17727/jmsr.2023/11-52","url":null,"abstract":"Background: Lymphadenopathy may be an incidental finding and/or primary or secondary manifestation of underlying diseases which may be neoplastic or non-neoplastic. The aim of the current study was to evaluate the spectrum of lymph node lesions according to the Sydney system in our setting and to assess the risk of malignancy in each category. Methods: The present study was carried out in the Department of Pathology, Nalanda Medical College and Hospital, Patna (Bihar) retrospectively during a one-year period from November 2020 to October 2021. 332 FNACs were performed on patients and the ROM (Risk of Malignancy) was assessed for each diagnostic category. Results: In the present study, 11 cases were categorized as L1, inadequate/non-diagnostic; 291 cases as L2,benign; 06 cases as L3, AUS/ALUS; 03 as L4, Suspicious for malignancy, and finally 21 cases were categorized as L5, Malignant. The ROM was 1.28% in L2, 50% in L3, and 100% in L4,L5. ROM for L1 category could not be assessed. Conclusion: The universal implementation of the Sydney system of reporting lymph node cytopathology can improve the diagnostic accuracy which will not only instill confidence in the pathologists but also help the clinicians to adopt better management strategies. Keywords: granulomatous; lymphadenitis; lymphoma; metastases; malignancy","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139324618","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 : 2023-10-02DOI: 10.17727/jmsr.2023/11-62
Nerella S, Basu S, Pati S, Biswas T, Majumdar I, Datta S
Background: Following the coronavirus disease-2019 (COVID-19) pandemic, a new entity emerged termed as multisystem inflammatory syndrome in children and adolescents temporally related to COVID-19 (MISC) by the World Health Organization (WHO). Infection with COVID-19 triggers the formation of antibodies to viral surface epitopes. It is believed that low titer non-neutralizing antibodies may accentuate virus-triggered immune responses. The study aimed to describe the various clinical presenting features, deranged laboratory parameters, echocardiographic findings, and immediate outcome and to categorize into 3 types of MISC and find any difference among the 3 types. Methodology: Children 29-days old to 12-years old who clinically satisfied the published WHO’s case definition for MISC were included in the study. All children were subjected to serological testing for total immunoglobulin to viral spike glycoprotein, relevant blood investigations, and echocardiography. Results: Out of 50 cases, we had 24(48%) cases of MISC without shock, 12(24%) cases of Kawasaki disease-like phenotype, and 14(28%) cases of MISC with shock. Fever (96%) and respiratory complaints (64%) predominate followed by gastrointestinal (45%) and red eye (32%). The inflammatory markers were notably elevated- the median CRP was 39.6mg/L, median ESR was 70mm 1sthr, median procalcitonin was 8.2 ng/ml. There is a significant drop in inflammatory markers post-treatment (p=0.019, p=0.000, p=0.016 respectively for CRP, ESR and procalcitonin). Abnormal echocardiographic findings were seen in 46% of cases in terms of decreased ejection fraction and coronary artery aneurysms (CAA). There were 7 deaths (14%), and 42(84%) patients were successfully discharged. Conclusion: Following the COVID-19 pandemic, MISC has emerged with its characteristic clinical pattern which needs early identification and prompt treatment to prevent mortality and morbidity. Keywords: MISC; non-COVID; Eastern India; Kawasaki disease; PIMS-TS; IVIG; immunity
{"title":"Demystifying the three different types of COVID-19 associated multisystem inflammatory syndrome in children: Experience from a tertiary care hospital","authors":"Nerella S, Basu S, Pati S, Biswas T, Majumdar I, Datta S","doi":"10.17727/jmsr.2023/11-62","DOIUrl":"https://doi.org/10.17727/jmsr.2023/11-62","url":null,"abstract":"Background: Following the coronavirus disease-2019 (COVID-19) pandemic, a new entity emerged termed as multisystem inflammatory syndrome in children and adolescents temporally related to COVID-19 (MISC) by the World Health Organization (WHO). Infection with COVID-19 triggers the formation of antibodies to viral surface epitopes. It is believed that low titer non-neutralizing antibodies may accentuate virus-triggered immune responses. The study aimed to describe the various clinical presenting features, deranged laboratory parameters, echocardiographic findings, and immediate outcome and to categorize into 3 types of MISC and find any difference among the 3 types. Methodology: Children 29-days old to 12-years old who clinically satisfied the published WHO’s case definition for MISC were included in the study. All children were subjected to serological testing for total immunoglobulin to viral spike glycoprotein, relevant blood investigations, and echocardiography. Results: Out of 50 cases, we had 24(48%) cases of MISC without shock, 12(24%) cases of Kawasaki disease-like phenotype, and 14(28%) cases of MISC with shock. Fever (96%) and respiratory complaints (64%) predominate followed by gastrointestinal (45%) and red eye (32%). The inflammatory markers were notably elevated- the median CRP was 39.6mg/L, median ESR was 70mm 1sthr, median procalcitonin was 8.2 ng/ml. There is a significant drop in inflammatory markers post-treatment (p=0.019, p=0.000, p=0.016 respectively for CRP, ESR and procalcitonin). Abnormal echocardiographic findings were seen in 46% of cases in terms of decreased ejection fraction and coronary artery aneurysms (CAA). There were 7 deaths (14%), and 42(84%) patients were successfully discharged. Conclusion: Following the COVID-19 pandemic, MISC has emerged with its characteristic clinical pattern which needs early identification and prompt treatment to prevent mortality and morbidity. Keywords: MISC; non-COVID; Eastern India; Kawasaki disease; PIMS-TS; IVIG; immunity","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139324261","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 : 2023-10-02DOI: 10.17727/jmsr.2023/11-53
C. N, Sundar Rns, Kumar Hks, Nataraju G, Esaivani Kb
Introduction: Colorectal cancer is the third most common cancer worldwide and second most common fatal cancer. Tumor budding is an emerging prognostic indicator in cancers. Though tumor budding can be assessed using Hematoxylin and Eosin stain, sometimes peritumoral inflammation and reactive stromal fibrosis obscures the tumor buds. The present study aimed to assess tumor budding using cytokeratin 20 immunohistochemistry in colorectal cancers. Methods: This is a cross sectional study which included 30 cases of colorectal carcinomas. cytokeratin 20 stained slides of colorectal carcinoma were assesed for tumor budding using International Tumor Budding Consensus Conference (ITBCC) 2016 consensus criteria and compared with AJCC cancer stage. Results: Demographic analysis showed peak incidence of colorectal cancer in the age group of 55-64 years (33.3%) and male: female ratio of 1.14:1. Majority of the tumors with score 1(23.3%) showed stage I. While tumors with score 2 had similar incidence of stage I (16.6%) and II (16.6%) and lesser incidence of stage III (3.33%). Most of the tumors with score 3 tumor budding had stage III tumors (26.67%). The p value is < 0.0001, which is statistically significant. Tumor budding signifies the biological and molecular phenomenon of epithelial-mesenchymal transition in the tumor microenvironment. Loss of E-cadherin, alterations in transcription factors including SNAIL, ZEB, TWIST etc and switching of CMS2 to CMS4 are some of the recorded molecular profiles responsible for tumor budding. Conclusion: This study concludes that the tumor stage increases with tumor budding and thus is a reliable marker in predicting the prognosis. This study also states that immunohistochemical study gives objective scoring of tumor buds in colorectal cancers. Keywords: tumor budding; colorectal cancer; cytokeratin 20; prognostic marker
导言结直肠癌是全球第三大常见癌症，也是第二大致命癌症。肿瘤萌芽是癌症预后的一个新指标。虽然可以用苏木精和伊红染色法评估肿瘤萌芽，但有时瘤周炎症和反应性基质纤维化会掩盖肿瘤萌芽。本研究旨在利用细胞角蛋白20免疫组化技术评估结直肠癌中的肿瘤萌芽。研究方法采用国际肿瘤萌芽共识会议（ITBCC）2016年共识标准对细胞角蛋白20染色的结直肠癌切片进行肿瘤萌芽评估，并与AJCC癌症分期进行比较。结果人口统计学分析显示，结直肠癌的发病高峰在55-64岁年龄组（33.3%），男女比例为1.14:1。大多数得分 1 的肿瘤（23.3%）为 I 期，得分 2 的肿瘤 I 期（16.6%）和 II 期（16.6%）发病率相似，III 期发病率较低（3.33%）。大部分得分 3 的肿瘤萌芽为 III 期肿瘤（26.67%）。P 值小于 0.0001，具有统计学意义。肿瘤出芽标志着肿瘤微环境中上皮-间质转化的生物学和分子现象。E-cadherin的缺失、转录因子（包括SNAIL、ZEB、TWIST等）的改变以及CMS2向CMS4的转换是导致肿瘤出芽的一些记录在案的分子特征。结论本研究得出结论，肿瘤分期随肿瘤出芽而增加，因此是预测预后的可靠标志物。本研究还指出，免疫组化研究可对结直肠癌中的肿瘤萌芽进行客观评分。关键词：肿瘤萌芽；结直肠癌；细胞角蛋白20；预后标志物
{"title":"Tumor budding in colorectal adenocarcinoma using cytokeratin 20 immunostaining","authors":"C. N, Sundar Rns, Kumar Hks, Nataraju G, Esaivani Kb","doi":"10.17727/jmsr.2023/11-53","DOIUrl":"https://doi.org/10.17727/jmsr.2023/11-53","url":null,"abstract":"Introduction: Colorectal cancer is the third most common cancer worldwide and second most common fatal cancer. Tumor budding is an emerging prognostic indicator in cancers. Though tumor budding can be assessed using Hematoxylin and Eosin stain, sometimes peritumoral inflammation and reactive stromal fibrosis obscures the tumor buds. The present study aimed to assess tumor budding using cytokeratin 20 immunohistochemistry in colorectal cancers. Methods: This is a cross sectional study which included 30 cases of colorectal carcinomas. cytokeratin 20 stained slides of colorectal carcinoma were assesed for tumor budding using International Tumor Budding Consensus Conference (ITBCC) 2016 consensus criteria and compared with AJCC cancer stage. Results: Demographic analysis showed peak incidence of colorectal cancer in the age group of 55-64 years (33.3%) and male: female ratio of 1.14:1. Majority of the tumors with score 1(23.3%) showed stage I. While tumors with score 2 had similar incidence of stage I (16.6%) and II (16.6%) and lesser incidence of stage III (3.33%). Most of the tumors with score 3 tumor budding had stage III tumors (26.67%). The p value is < 0.0001, which is statistically significant. Tumor budding signifies the biological and molecular phenomenon of epithelial-mesenchymal transition in the tumor microenvironment. Loss of E-cadherin, alterations in transcription factors including SNAIL, ZEB, TWIST etc and switching of CMS2 to CMS4 are some of the recorded molecular profiles responsible for tumor budding. Conclusion: This study concludes that the tumor stage increases with tumor budding and thus is a reliable marker in predicting the prognosis. This study also states that immunohistochemical study gives objective scoring of tumor buds in colorectal cancers. Keywords: tumor budding; colorectal cancer; cytokeratin 20; prognostic marker","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139324714","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 : 2023-07-01DOI: 10.17727/jmsr.2023/11-37
Shreenivasa A, Chaudhary A, Wagganavar PB, Mahmood T, Shukla AD, Acharya KV
Background: Overweight and obesity is the most common co-morbidity and disease modifier of asthma; it has been associated with increased risk of asthma exacerbations, worse respiratory symptoms and poor asthma control. The objective of study was to determine the relation of body mass index (BMI) with the level of asthma control and to study the clinical presentation and spirometric profile of asthma patients from different BMI groups. Materials and methods: The descriptive prospective study done among confirmed asthmatic patients who were attending the Department of Pulmonary Medicine, outpatient department (OPD) and inpatient department (IPD). The study was demographic, clinical and spirometric parameters in asthmatic patients who were on optimal pharmacotherapy among different BMI categories. Results: Total 144 diagnosed asthma patients were included; the overall mean age of the study group was 34.27 ± 11.7 years and the majority of patients 50 (34.72%) were between 18-27 years of age group. Moderate asthma (FEV1 60-79) was observed to be the most common in all BMI groups. The severe asthma (FEV1 <60) was observed with BMI > 30kg/m2 in asthma patients (p=0.27). Conclusions: The poor control of asthma was significantly frequent in the overweight and obese BMI group, regardless of the findings of no differences in spirometry. Our results suggest that obese individuals with asthma show a higher incidence of one-year follow-up hospitalization due to exacerbation symptoms than non-obese individuals.
{"title":"A comparative study to determine clinical and spirometric profile among patients of asthma in different body mass index groups","authors":"Shreenivasa A, Chaudhary A, Wagganavar PB, Mahmood T, Shukla AD, Acharya KV","doi":"10.17727/jmsr.2023/11-37","DOIUrl":"https://doi.org/10.17727/jmsr.2023/11-37","url":null,"abstract":"Background: Overweight and obesity is the most common co-morbidity and disease modifier of asthma; it has been associated with increased risk of asthma exacerbations, worse respiratory symptoms and poor asthma control. The objective of study was to determine the relation of body mass index (BMI) with the level of asthma control and to study the clinical presentation and spirometric profile of asthma patients from different BMI groups. Materials and methods: The descriptive prospective study done among confirmed asthmatic patients who were attending the Department of Pulmonary Medicine, outpatient department (OPD) and inpatient department (IPD). The study was demographic, clinical and spirometric parameters in asthmatic patients who were on optimal pharmacotherapy among different BMI categories. Results: Total 144 diagnosed asthma patients were included; the overall mean age of the study group was 34.27 ± 11.7 years and the majority of patients 50 (34.72%) were between 18-27 years of age group. Moderate asthma (FEV1 60-79) was observed to be the most common in all BMI groups. The severe asthma (FEV1 <60) was observed with BMI > 30kg/m2 in asthma patients (p=0.27). Conclusions: The poor control of asthma was significantly frequent in the overweight and obese BMI group, regardless of the findings of no differences in spirometry. Our results suggest that obese individuals with asthma show a higher incidence of one-year follow-up hospitalization due to exacerbation symptoms than non-obese individuals.","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135812072","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 : 2023-07-01DOI: 10.17727/jmsr.2023/11-39
Krishnamurthy HA, Bhangari VS, Sandesh L
Introduction: Insulin resistance is the most common abnormality associated with obesity, as a major pathophysiological factor in the development and progression of cardiovascular diseases and diabetes mellitus. This study is undertaken to know the significance of ratio of triglycerides (TG) to high-density lipoprotein (HDL) cholesterol as a serum biomarker in assessing the insulin resistance compared to homeostatic model assessment of insulin resistance (HOMA-IR) in type 2 diabetes mellitus (DM) subjects. Materials and methods: This was a cross sectional comparative study done at Mysore Medical College and Research Institute, Mysuru on 180 subjects of type 2 DM from April 2022 to October 2022. The blood sample was subjected for laboratory tests, such as complete blood count (CBC), fasting blood sugar (FBS), post prandial blood sugar (PPBS), HbA1c, lipid profile, ECG, serum insulin level and HOMA-IR, renal function tests (RFT), liver function tests (LFT). The results were tabulated and compared between the HOMA-IR value and triglycerides/HDL cholesterol ratio of type 2 DM subjects. The cut off value of HOMA-IR to assess insulin resistance was 2.50 and triglycerides to HDL ratio was 3.0. Results: The majority of patients i.e. 112(62.22%) had TG/HDL ratio of >3.0 and 116(64.44%) patients had HOMA-IR of >2.5.The patients with uncontrolled type 2 DM had significantly higher TG/HDL ratio [p value 0.01] and HOMA-IR (p value- 0.01). Conclusion: This study concludes that, the ratio of serum triglycerides /HDL cholesterol is a cost effective blood biomarker and it’s correlating significantly with the HOMA-IR and serum fasting insulin levels, while assessing the insulin resistance in type 2 DM subjects.
{"title":"The significance of ratio between serum triglycerides and HDL cholesterol as a common man’s bio marker of insulin resistance in type 2 diabetes mellitus: A cross sectional comparative study","authors":"Krishnamurthy HA, Bhangari VS, Sandesh L","doi":"10.17727/jmsr.2023/11-39","DOIUrl":"https://doi.org/10.17727/jmsr.2023/11-39","url":null,"abstract":"Introduction: Insulin resistance is the most common abnormality associated with obesity, as a major pathophysiological factor in the development and progression of cardiovascular diseases and diabetes mellitus. This study is undertaken to know the significance of ratio of triglycerides (TG) to high-density lipoprotein (HDL) cholesterol as a serum biomarker in assessing the insulin resistance compared to homeostatic model assessment of insulin resistance (HOMA-IR) in type 2 diabetes mellitus (DM) subjects. Materials and methods: This was a cross sectional comparative study done at Mysore Medical College and Research Institute, Mysuru on 180 subjects of type 2 DM from April 2022 to October 2022. The blood sample was subjected for laboratory tests, such as complete blood count (CBC), fasting blood sugar (FBS), post prandial blood sugar (PPBS), HbA1c, lipid profile, ECG, serum insulin level and HOMA-IR, renal function tests (RFT), liver function tests (LFT). The results were tabulated and compared between the HOMA-IR value and triglycerides/HDL cholesterol ratio of type 2 DM subjects. The cut off value of HOMA-IR to assess insulin resistance was 2.50 and triglycerides to HDL ratio was 3.0. Results: The majority of patients i.e. 112(62.22%) had TG/HDL ratio of >3.0 and 116(64.44%) patients had HOMA-IR of >2.5.The patients with uncontrolled type 2 DM had significantly higher TG/HDL ratio [p value 0.01] and HOMA-IR (p value- 0.01). Conclusion: This study concludes that, the ratio of serum triglycerides /HDL cholesterol is a cost effective blood biomarker and it’s correlating significantly with the HOMA-IR and serum fasting insulin levels, while assessing the insulin resistance in type 2 DM subjects.","PeriodicalId":32890,"journal":{"name":"Journal of Medical and Scientific Research","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135812445","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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