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Unusual Finding in a Patient of COVID-19 Associated Pulmonary Aspergillosis: A Case Report 1例COVID-19相关肺曲菌病的异常发现
Pub Date : 2023-10-31 DOI: 10.46347/jmsh.v9i2.23.49
Neha Sharad, Smriti Srivastava, Purva Mathur, Rajesh Malhotra
Invasive Fungal Infections have posed a difficult challenge in the recovery of people infected with COVID-19. COVID-19-associated pulmonary aspergillosis (CAPA) has been described and found in about 30 % of ICU patients worldwide. Here we present an unusual microscopic finding in a case of CAPA in an ICU patient which was helpful in initiating early definite therapy. A 56-year-old gentleman presented with complaints of fever and shortness of breath and subsequently tested positive for COVID. Post admission, his respiratory distress worsened and his condition deteriorated. A provisional diagnosis of COVID pneumonia with acute respiratory distress syndrome (ARDS) was established based on chest radiographic finding of left lower lobe consolidation, increased pulmonary infiltrates in bilateral lung fields with evidence of pleural effusion. Pleural Aspirate obtained via ultrasound guided thoracocentesis revealed branched hyaline septate hyphae along with structures which were composed of elongated vesicle with one layer of phialides covering two-thirds of the vesicle and bearing globose conidia on KOH direct mount. Aspergillus flavus grew on culture, which was later confirmed by MALDI TOF VITEK MS. Patient was diagnosed with Proven Invasive Pulmonary Aspergillosis with COVID-19 and voriconazole was started. Patient successfully recovered and was discharged. Identifying the Aspergillus species directly on the basis of KOH Mount, helped in decreasing the turnaround time, in early initiation of definite therapy and possibly contributed to the favorable outcome. CAPA is a potentially life-threatening complication in patients with severe COVID-19, thus a timely diagnosis and treatment becomes crucial in the management. Keywords: CAPA, COVID-19, Aspergillus
侵袭性真菌感染对COVID-19感染者的康复构成了艰巨的挑战。在全球约30%的ICU患者中发现了covid -19相关的肺曲霉病(CAPA)。在这里,我们提出了一个不寻常的显微镜发现,在ICU患者CAPA的情况下,有助于开始早期明确的治疗。一名56岁的男士出现发烧和呼吸短促的症状,随后被检测为COVID阳性。入院后呼吸窘迫加重,病情恶化。基于胸片发现左下肺叶实变,双侧肺野肺浸润增加,胸膜积液证据,初步诊断为COVID -肺炎合并急性呼吸窘迫综合征(ARDS)。超声引导下胸腔穿刺术获得的胸腔吸液显示,在KOH直接mount上,分枝的透明分隔菌丝以及由细长的囊泡组成的结构,其中一层囊泡覆盖了囊泡的三分之二,并带有球形分生孢子。培养物中有黄曲霉生长,经MALDI TOF VITEK ms检测证实。患者确诊为浸润性肺曲霉病伴COVID-19,开始使用伏立康唑。患者顺利康复出院。在KOH Mount的基础上直接鉴定曲霉种类,有助于减少周转时间,在确定治疗的早期开始,并可能有助于良好的结果。CAPA是重症COVID-19患者潜在的危及生命的并发症,因此及时诊断和治疗在管理中至关重要。关键词:CAPA, COVID-19,曲霉
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引用次数: 0
Prevalence of Kell Blood Group Antigens among Blood Donors & Impact of its Alloimmunization in Multi-transfused Thalassemia & Sickle Cell Disease Patients with Recommendation of Transfusion Protocol—Need of the Hour 献血者Kell血型抗原的流行情况其同种异体免疫对多次输血地中海贫血的影响镰状细胞病患者输血方案的推荐-时需
Pub Date : 2023-10-31 DOI: 10.46347/jmsh.v9i2.22.442
Smita Mahapatra, Kaushik Patra, Manu Mangat Marandi
Background: The aim of the study was to analyze the prevalence of Kell antigen and its correlation to major blood groups, ABO & Rh system in Eastern India. There was simultaneous retrospective analysis of Kell alloimmunization to find out the implication and recommendation of transfusion protocols in multi-transfused thalassemia and sickle cell patients. Methods: The study was a prospective observational conducted on 3000 donors for KELL and ABO grouping. Retrospective analysis was made to identify common alloantibodies in multi-transfused patients. Results: The overall prevalence of Kell antigen was 2.6% (80) in 3000 donors. Among male, it was highly prevalent i.e. 2.77% and in females 0.65%. Kell antigen was highly prevalent among AB donors, i.e. 5.1%. It was 2.5% in A, 2.9% in B, 1.9% in Blood Donors. Kell prevalence was high in Rh D positive donors, i.e. 2.72% and was 1.72% among Rh D negative donors. Anti-K was the 3rd most common alloantibody detected in 638 cases of multi-transfused thalassemia and sickle cell (SCD) patients (9.25%). Anti-E (42.6%)was most common entity followed by anti-c (24.0%). Conclusion: The higher incidence of Kell prevalence in AB & Rh D Positive Blood groups and also in male persons indicate that there should be a donor database and knowledge of red cell antigen prevalence in a population. This will help blood centers in providing antigen negative compatible blood units to patients with corresponding alloantibodies. Hemolytic transfusion reactions due to Kell alloimmunization are of a significant severity. Prevalence of Kell alloantibody is high among multi-transfused patients and is next to anti E & anti c. Kell sensitized mothers may also cause serious consequences like hemolytic disease of fetus and newborn. Therefore, it is suggested that extended phenotyping including Kell blood group antigen should be implemented in cases of multi-transfused patients. Keywords: Blood donors, Extended phenotyping, Kell, Multitransfused thalassemia patients, Multitransfused sickle cell disease patients
背景:本研究的目的是分析Kell抗原的患病率及其与主要血型、ABO血型和ABO血型的相关性。印度东部的Rh系统。同时对Kell同种异体免疫进行回顾性分析,以了解在多次输血的地中海贫血和镰状细胞患者中输血方案的意义和建议。方法:采用前瞻性观察方法对3000名供体进行KELL和ABO分型。回顾性分析多次输血患者常见的同种异体抗体。结果:在3000名献血者中,Kell抗原的总检出率为2.6%(80)。男性患病率为2.77%,女性患病率为0.65%。Kell抗原在AB供体中较高,占5.1%。A组为2.5%,B组为2.9%,献血者为1.9%。Rh D阳性供者的Kell患病率较高,为2.72%,Rh D阴性供者为1.72%。638例多次输血地中海贫血和镰状细胞(SCD)患者中,抗- k抗体是第三常见的同种抗体(9.25%)。Anti-E(42.6%)最为常见,其次是anti-c(24.0%)。结论:AB &患者Kell患病率较高;Rh D阳性血型和男性也表明应该有一个献血者数据库和人群中红细胞抗原流行情况的知识。这将有助于血液中心为具有相应同种异体抗体的患者提供抗原阴性相容血液单位。由于凯尔异体免疫引起的溶血性输血反应是非常严重的。在多次输血患者中,Kell同种异体抗体的患病率较高,仅次于抗E抗体;抗c. Kell敏感的母亲也可能引起胎儿和新生儿溶血性疾病等严重后果。因此,建议对多次输血患者进行包括Kell血型抗原在内的扩展表型分析。关键词:献血者,扩展表型,Kell,多次输血地中海贫血患者,多次输血镰状细胞病患者
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引用次数: 0
Is There Any Relation Between High-Grade Prostate Cancer and Central Obesity, Hyperinsulinemia and Dyslipidemia? 高级别前列腺癌与中心性肥胖、高胰岛素血症和血脂异常有关系吗?
Pub Date : 2023-10-31 DOI: 10.46347/jmsh.v9i2.22.436
Vishal Kirti Jain, Madan Mohan Agrawal, Sher Singh Yadav, Neeraj Agarwal
Background: Prostate Cancer (PCa) is the sixth leading cause of cancer death in men, worldwide. Incidence of prostate cancer in India is on the rise. Most studies suggest that obesity has a positive correlation with a higher risk of developing high-grade PCa and dying of PCa. Central obesity and related biochemical alterations in terms of hyperinsulinemia and dyslipidemia are associated with severity of prostate cancer in terms of high Gleason score. Materials & Methods: Central obesity was assessed using anthropometric measurements including waist hip ratio (WHR) and body mass index (BMI). Serum PSA, testosterone, and insulin levels were estimated. Serum levels of triglycerides (TG), cholesterol, low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL), high-density lipoprotein (HDL) were also measured. Standard staging procedures were followed and for histopathological evaluation of PCa, Gleason grading was done on core biopsy tissue. Results: In the present population-based study, persons with high Gleason score had significantly higher WHR supporting that central obesity may predispose to high-grade prostate cancer. Study has shown a significant relationship between high Gleason score and cholesterol, TG, VLDL, and low HDL levels; however no significant relation was found with LDL levels. Testosterone is a key prostate growth factor although PCa presents at an age when testosterone levels are declining. Conclusion: In this study, there was no significant difference in testosterone levels in patients with high and low Gleason scores. Keywords: Prostate, Cancer, High grade, Low grade
背景:前列腺癌(PCa)是全球男性癌症死亡的第六大原因。印度的前列腺癌发病率呈上升趋势。大多数研究表明,肥胖与发生高级别前列腺癌和死于前列腺癌的高风险呈正相关。中枢性肥胖和相关的高胰岛素血症和血脂异常的生化改变与高格里森评分的前列腺癌的严重程度有关。材料,方法:采用腰臀比(WHR)和身体质量指数(BMI)等人体测量方法评估中心性肥胖。测定血清PSA、睾酮和胰岛素水平。同时测定血清甘油三酯(TG)、胆固醇、低密度脂蛋白(LDL)、极低密度脂蛋白(VLDL)、高密度脂蛋白(HDL)水平。遵循标准分期程序,对PCa进行组织病理学评估,对核心活检组织进行Gleason分级。结果:在目前基于人群的研究中,Gleason评分高的人WHR明显更高,支持中心性肥胖可能易患高级别前列腺癌。研究表明,高Gleason评分与胆固醇、TG、VLDL和低HDL水平有显著关系;但与低密度脂蛋白水平无显著相关性。睾酮是一个关键的前列腺生长因子,尽管前列腺癌出现在睾酮水平下降的年龄。结论:在本研究中,高、低Gleason评分患者睾酮水平无显著差异。关键词:前列腺癌高分级低分级
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引用次数: 0
Clinical Profile of Anterior Uveitis in Tertiary Eye Care Center 三级眼科保健中心前葡萄膜炎的临床分析
Pub Date : 2023-10-31 DOI: 10.46347/jmsh.v9i2.23.2
B V Vinutha, Rashmi Shetu, . Sundeep, Konduru Rishitha, V Pallavi Naragund, J Babitha
Purpose: To describe the clinical features, causes and management of patients with acute anterior uveitis. Methods: A prospective study of clinical features, complication and prognosis was done on anterior uveitis patients for a period of 10 months. Detailed history, complete ocular examination, systemic evaluation and relevant investigations were done in 64 patients, appropriate systemic and ocular management was done. Results: Of 64 patients, 65.6% were male and 34.3% female. Mean age of presentation was 42.6 years. 71.8% unilateral and 28.1% bilateral eye involvement was seen. Visual acuity was between 6/18-3/60 at the time of presentation. 21.8% had Tuberculosis, 9.3% had Trauma, 4.6% had UTI, 3.1% had ankylosing spondylitis (HLA B27 associated) and 3.1% had rheumatoid arthritis, 3.1% had sarcoidosis and 1.5% had toxoplasmosis. 53.1% were idiopathic. Complications were noted in 50% of cases, 25% had secondary glaucoma, 21.8% had posterior subcapsular cataract and 3.1% has cystoid macular edema. Appropriate medical management was started in patients. Conclusion: Idiopathic uveitis was higher in our study. Trauma was the most common non-infectious entity, Tuberculosis was most common infectious cause in our study, all patients responded well with medication. Keywords: Anterior uveitis, Etiology, Complications
目的:探讨急性前葡萄膜炎的临床特点、病因及治疗。方法:对10个月前葡萄膜炎患者的临床特点、并发症及预后进行前瞻性研究。64例患者进行了详细的病史、完整的眼部检查、系统评价和相关调查,并进行了适当的系统和眼部管理。结果:64例患者中男性占65.6%,女性占34.3%。平均发病年龄为42.6岁。单侧受累71.8%,双侧受累28.1%。视力在6/18-3/60之间。21.8%患有结核病,9.3%患有创伤,4.6%患有UTI, 3.1%患有强直性脊柱炎(HLA B27相关),3.1%患有类风湿关节炎,3.1%患有结节病,1.5%患有弓形虫病。53.1%为特发性。其中继发性青光眼占25%,后囊膜下白内障占21.8%,黄斑囊样水肿占3.1%。对患者进行了适当的医疗管理。结论:特发性葡萄膜炎发生率较高。创伤是我们研究中最常见的非感染性原因,结核病是最常见的感染性原因,所有患者对药物治疗反应良好。关键词:前葡萄膜炎,病因,并发症
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引用次数: 0
A Cross-sectional Study to Assess Insulin Resistance and Atherogenic Index of Plasma as Predictors of Risk of Cardiometabolic Disease among Undergraduate Medical Students at a Tertiary Care Teaching Hospital, Karnataka 一项评估血浆胰岛素抵抗和动脉粥样硬化指数作为卡纳塔克邦三级护理教学医院医科本科生心血管代谢疾病风险预测因子的横断面研究
Pub Date : 2023-10-31 DOI: 10.46347/jmsh.v9i2.22.453
Mythri Sannamadhu, Maithri Chikkabasavanahalli Manjegowda, Raghunath Hanumantharaya
Background: Medical profession is known for stress and challenges due to hectic academic schedules which makes students, high-risk candidates for diabetes mellitus, hypertension and cardiometabolic disease (CMD). Surrogate markers such as homeostatic model assessment insulin resistance (HOMA-IR) and atherogenic index of plasma (AIP) along with routine parameters enable early prediction of the disease. Hence, this study aimed at determining HOMA-IR and AIP along with assessment of their correlation with anthropometric and biochemical parameters associated with CMD risk among undergraduate medical students. Methodology : 460 medical students consented to participate in the study. The data related to socio-demographic profile, anthropometry, blood pressure and biochemical parameters such as fasting plasma glucose (FPG), fasting plasma insulin (FPI) and lipid profile was collected and analyzed. HOMA-IR and AIP were calculated. The strength of association between study variables was determined by relevant statistics. Results: The study showed the prevalence of overweight (17.8%), obesity (20.4%), pre-hypertension (37.82%) and hypertension (3.47%). 98.5% of the participants had normal FPG and FPI, whereas 1.5% had impaired levels. Lipid profile analysis showed hypercholesterolemia (3.7%), hypertriglyceridemia (8.1%), increased LDL-c (33.7%) and reduced HDL-c (55.2%). High HOMA-IR and AIP were contributed by 28.9% and 73.3% respectively. HOMA-IR and AIP showed statistically significant positive correlation with CMD risk factors. Conclusion: HOMA-IR and AIP considered as the better predictors of CMD risk among apparently healthy medical students. Thus, incorporation of these surrogate markers along with routine parameters for regular screening can help in early prediction of the risk of CMD among undergraduate medical students. Keywords: Homeostatic model assessment insulin resistance, Atherogenic index of plasma, Cardiometabolic disease, Medical students
背景:繁忙的学习日程使学生成为糖尿病、高血压和心血管代谢疾病(CMD)的高危人群,医学行业面临着巨大的压力和挑战。替代标记物,如稳态模型评估胰岛素抵抗(HOMA-IR)和血浆动脉粥样硬化指数(AIP)以及常规参数,可以早期预测疾病。因此,本研究旨在确定HOMA-IR和AIP,并评估其与医学本科生CMD风险相关的人体测量和生化参数的相关性。方法:460名医学生同意参与研究。收集和分析与社会人口统计资料、人体测量、血压和生化参数(如空腹血糖(FPG)、空腹血浆胰岛素(FPI)和血脂)相关的数据。计算HOMA-IR和AIP。研究变量之间的关联强度由相关统计来确定。结果:调查结果显示:体重超重(17.8%)、肥胖(20.4%)、高血压前期(37.82%)、高血压(3.47%)患病率较高。98.5%的参与者FPG和FPI正常,1.5%的参与者FPG和FPI受损。脂质分析显示高胆固醇血症(3.7%)、高甘油三酯血症(8.1%)、LDL-c升高(33.7%)和HDL-c降低(55.2%)。高HOMA-IR和AIP分别占28.9%和73.3%。HOMA-IR、AIP与CMD危险因素呈显著正相关。结论:HOMA-IR和AIP能较好地预测表面健康的医学生患CMD的风险。因此,将这些替代标志物与常规筛查参数相结合,有助于早期预测医学生患CMD的风险。关键词:稳态模型评估胰岛素抵抗;血浆动脉粥样硬化指数;心脏代谢疾病
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引用次数: 0
Pattern of Thyroid Dysfunction in Type II Diabetes Mellitus Patients in a Tertiary Care Center: A Cross-Sectional Study 三级保健中心II型糖尿病患者甲状腺功能障碍的模式:一项横断面研究
Pub Date : 2023-10-31 DOI: 10.46347/jmsh.v9i2.23.125
Sangamesh Asuti, Shambhulinga Purad, Prakash Hosamani
Background: Early identification and intervention of thyroid dysfunction which occurs in association with type-II diabetes mellitus may significantly reduce the risk of adverse cerebrovascular and cardiovascular events in such patients. Hence, this study analyzed the pattern of thyroid dysfunction in T2DM (Type 2 Diabetes mellitus) patients. Methods: The present cross-sectional study was done on 250 T2DM patients, who visited the department of General Medicine in a tertiary care teaching center. Medical history was recorded and venous blood samples were collected for investigations (HbA1C (Hemoglobin A1C), FBS (Fasting blood sugar), PPBS (Postprandial blood sugar), TSH (Thyroid stimulating hormone), T4 (Tetraiodothyronine), anti-TPO (Thyroid peroxidase), and fasting lipid profile). Thyroid dysfunction in patients with T2DM was considered as the primary outcome variable. P value <0.05 was considered statistically significant. Data were analyzed using coGuide software, V.1.03. Results: Females (55.6%) outnumbered males (44.4%) in this study. The prevalence of thyroid dysfunction in our study was 23.6% (95%CI 0.184 to 0.293). Subclinical hypothyroidism was found in 67.79% (95%CI 0.543 to 0.793) participants, overt hypothyroidism in 27.11% (95%CI 0.163 to 0.402), and hyperthyroidism in 5.10% (95%CI 0.010 to 0.141). Females (84.6%) had significantly higher prevalence of anti-TPO positivity compared to males (15.4%)(p=0.013). Conclusions: Findings of this study showed that T2DM patients have higher prevalence of thyroid dysfunction with predominance of subclinical hypothyroidism. Hence, this study emphasizes the importance of annual investigation of TSH levels in all the patients with T2DM. Keywords: Autoimmune Diseases, Hyperthyroidism, Hypothyroidism, Thyroid­Stimulating Hormone, Type II Diabetes Mellitus
背景:早期识别和干预与2型糖尿病相关的甲状腺功能障碍可能会显著降低这类患者发生不良脑血管和心血管事件的风险。因此,本研究分析了T2DM(2型糖尿病)患者甲状腺功能障碍的模式。方法:对某三级保健教学中心普通内科就诊的250例T2DM患者进行横断面研究。记录病史并采集静脉血(HbA1C(血红蛋白A1C)、FBS(空腹血糖)、PPBS(餐后血糖)、TSH(促甲状腺激素)、T4(四碘甲状腺原氨酸)、抗tpo(甲状腺过氧化物酶)和空腹血脂)。T2DM患者的甲状腺功能障碍被认为是主要的结局变量。P值<0.05认为有统计学意义。使用coGuide软件V.1.03进行数据分析。结果:女性(55.6%)多于男性(44.4%)。在我们的研究中,甲状腺功能障碍的患病率为23.6% (95%CI 0.184 ~ 0.293)。67.79% (95%CI 0.543 ~ 0.793)的参与者存在亚临床甲状腺功能减退,27.11% (95%CI 0.163 ~ 0.402)的参与者存在明显甲状腺功能减退,5.10% (95%CI 0.010 ~ 0.141)的参与者存在甲状腺功能亢进。女性(84.6%)的tpo抗体阳性率明显高于男性(15.4%)(p=0.013)。结论:本研究结果显示T2DM患者甲状腺功能障碍发生率较高,以亚临床甲状腺功能减退为主。因此,本研究强调每年检查T2DM患者TSH水平的重要性。关键词:自身免疫性疾病,甲状腺功能亢进,甲状腺功能减退,促甲状腺激素,2型糖尿病
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引用次数: 0
Neuromuscular Disorders: A Histomorphological and Clinicopathological Evaluation in a Tertiary Care Centre 神经肌肉疾病:三级保健中心的组织形态学和临床病理学评估
Pub Date : 2023-10-31 DOI: 10.46347/jmsh.v9i2.23.78
Ashmeet Kaur, Anita Harsh, Kapil Takhar, Kusum Mathur, Rateesh Sareen
Background: Neuromuscular disorders are rare, inherited progressive disorders leading to major disabilities over the years. As a group, there prevalence is not so uncommon and requires attention in view of their rising cases. Muscle biopsy forms an integral part of the diagnostic workup for patients with neuromuscular disorder but is performed in a very few institutes in Asia. In this study, we learn the spectrum of neuromuscular disorders presenting in a tertiary care centre of a developing country, India and evaluate the importance of open muscle biopsy. Material and Methods: 112 Muscle biopsies were reviewed and analysed for investigation of patients with suspected myopathy. Results: Of the 112 cases, 74% of the cases were adults. Mean age of presentation was 25 years and 57% of the cases were males. Pediatric cases constituted 26% of the total cases and 71% of them were male patients. Definitive diagnosis following muscle biopsy was made in 58% (n=65) of cases. Routine histological evaluation revealed the diagnosis of inflammatory myopathy 41% (n=46), muscular dystrophy in 34.8% (n=39),7.1% (n=8) neurogenic, 1.78%(n=2) mitochondrial and 0.8%(n=1) congenital myopathy of the cases. Conclusion: The burden of neuromuscular disorders has increased over the years. Molecular tests are not always helpful in diagnosing LGMD and not accessible to everyone. The role of muscle biopsy is inevitable in detecting false positive cases in mitochondrial myopathy, and for the management of Inflammatory myopathies. Awareness of the utility of muscle biopsy, expertise in diagnosing, and diagnostic challenges need more attention of the clinicians, pathologists and orientation of postgraduates to ease the journey of the patients and their families. Keywords: Muscle biopsy, Enzyme histochemistry, Neuromuscular disorders, Mitochondrial myopathy, Inflammatory myopathy, Morphology
背景:神经肌肉疾病是罕见的遗传性进行性疾病,多年来导致重大残疾。作为一个群体,其患病率并不罕见,鉴于其病例的上升,需要引起注意。肌肉活检是神经肌肉疾病患者诊断检查的一个组成部分,但在亚洲很少有机构进行。在这项研究中,我们了解了发展中国家印度三级保健中心出现的神经肌肉疾病的频谱,并评估了开放式肌肉活检的重要性。材料与方法:对112例疑似肌病患者的肌肉活检进行回顾性分析。结果:112例患者中,成人占74%。平均发病年龄为25岁,57%为男性。儿科病例占总病例的26%,其中男性占71%。58% (n=65)的病例在肌肉活检后得到明确诊断。常规组织学检查显示炎性肌病占41% (n=46),肌营养不良占34.8% (n=39),神经源性肌病占7.1% (n=8),线粒体肌病占1.78%(n=2),先天性肌病占0.8%(n=1)。结论:神经肌肉疾病的负担逐年增加。分子测试并不总是有助于诊断LGMD,也不是每个人都能获得。在检测线粒体肌病假阳性病例和炎性肌病的管理中,肌肉活检的作用是不可避免的。对肌肉活检的实用性、诊断方面的专业知识和诊断挑战的认识需要临床医生、病理学家和研究生的更多关注,以缓解患者及其家属的旅程。关键词:肌肉活检,酶组织化学,神经肌肉疾病,线粒体肌病,炎症性肌病,形态学
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引用次数: 0
Detection of Biofilm Production and Antibiotic Resistance Pattern in Clinical Isolates from Orthopaedic Implants Associated Infections 骨科植入物相关感染临床分离株生物膜生成及抗生素耐药模式的检测
Pub Date : 2023-10-31 DOI: 10.46347/jmsh.v9i2.23.5
R Shakthi, D Venkatesha
Introduction: Orthopaedic Implant associated infection is the major problem which leads to implant failure and economic burden to the patient. Implant-associated infections are due to the formation of biofilm at the implantation site leading to multidrug resistant organism. Aim: This study was done to evaluate the causative organisms, their antibiotic sensitivity pattern and their ability to form biofilm over the Implants used in Orthopaedic surgeries. Material and methods: This study was carried out in the department of Microbiology, Adichunchanagiri institute of Medical sciences from September 2019 to August 2022. Swabs from 100 patients who had undergone orthopaedic implant or prosthetic surgery and presented with signs and symptoms of infection were collected and processed as per standard procedures. All the isolates were subjected to detect biofilm production by Congo red agar method, MRSA detection by Cefoxitin disc diffusion test, vancomycin resistant Enterococcus by using Vancomycin (Minimum inhibitory concentration) MIC strips and Extended spectrum β lactamases (ESBL) production by phenotypic confirmatory combined-disc test. Results: Out of the 100 samples processed, culture positivity was observed in 72 specimens. Among them, Staphylococcus aureus 19(26%) was the predominant isolate and 44 (61%) are biofilm producers. 17 (89%) were MRSA (Methicillin resistance Staphylococcus aureus) strains and 15(37%) were ESBL producing strains. Conclusion: The appropriate pre- and post- operative care should be taken to prevent orthopaedic implant associated infections. Staphylococcus spp was the commonest isolate and its ability to produce biofilm indicates the need for an appropriate antibiotic policy and screening for MRSA carriers to reduce the infection. Keywords: Orthopaedic implant, Infection, Biofilm, MRSA, ESBL
骨科种植体相关感染是导致种植体失败和患者经济负担的主要问题。植入物相关感染是由于在植入部位形成生物膜导致多重耐药生物。目的:本研究旨在评估骨科手术中植入物的病原菌及其对抗生素的敏感性及其在植入物表面形成生物膜的能力。材料与方法:本研究于2019年9月至2022年8月在Adichunchanagiri医学科学研究所微生物学系进行。收集100例接受骨科植入物或假体手术并出现感染体征和症状的患者拭子,按标准程序进行处理。采用金果红琼脂法检测生物膜的产生,头孢西丁圆盘扩散试验检测MRSA,万古霉素(最低抑制浓度)MIC条检测耐万古霉素肠球菌,表型验证联合圆盘试验检测扩展谱β内酰胺酶(ESBL)的产生。结果:100份标本中,72份标本培养阳性。其中,金黄色葡萄球菌19(26%)为优势菌株,44(61%)为生物膜产生菌。耐甲氧西林金黄色葡萄球菌(MRSA) 17株(89%),产ESBL 15株(37%)。结论:应采取适当的术前和术后护理,预防骨科种植体相关感染。葡萄球菌是最常见的分离物,其产生生物膜的能力表明需要适当的抗生素政策和筛选MRSA携带者以减少感染。关键词:骨科植入物,感染,生物膜,MRSA, ESBL
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引用次数: 0
A Cross-sectional Observational Study of the Etio-pathology, Socioeconomic Distribution and Clinical Pictures of Ectopic Pregnancy in a Tertiary Medical College and Hospital in Bankura, West Bengal, India 印度西孟加拉邦班库拉某三级医学院和医院异位妊娠的etio病理、社会经济分布和临床影像的横断面观察研究
Pub Date : 2023-10-31 DOI: 10.46347/jmsh.v9i2.23.136
Anirban Talukder, Sougata Kumar Burman, Gairik Bera, Jayeeta Mukherjee, Mousumi Maji, Debojyoti Santra
Background: Ectopic pregnancy or abnormal implantation of embryo is one of the foremost causes of mortality and morbidity in women of reproductive age worldwide. Its serious consequences can be effectively averted by early diagnosis and timely intervention. This study aimed at determining the incidence, predisposing socio-economic factors and etiolo-pathology, and assessment of various clinical manifestations and treatment modalities of ectopic pregnancy. Methods: This observational cross- sectional survey was conducted in the department of obstetrics and gynaecology BSMCH, Bankura from 1.4.2015 to 31.3.2016. It included 100 patients with admitted with clinically or sonologically confirmed ectopic pregnancy after informed consent, data was collected and analysed thereafter. Results: It was observed that 68% of the cases belonged to 21-30 years of age, 80% with low socio-economic status, 69 % comprised of multigravidas. The typical risk factors detected were history of PID, abortion and previous tubal surgery. The most consistent clinical feature was pain in lower abdomen (98%) followed by amenorrhoea (90%) and vaginal bleeding (82%). 97% of the patients presented with pallor and 23% with shock. In 73% patients cervical motion tenderness could be elicited clinically and adnexal mass in USG was found in 95 %. Urine pregnancy test was positive in all patients and right side was the commonest side of involvement (53%). All the patients underwent surgical intervention. Conclusion: Prompt detection from history, clinical features, USG and appropriate and well-timed management are of utmost importance to enhance better maternal survival and conservation of reproductive capacity. Keywords: Ectopic pregnancy, UPT, PID, Tubal surgery, Adnexal mass, POD fluid, Ampulla
背景:异位妊娠或胚胎异常着床是全世界育龄妇女死亡和发病的主要原因之一。早期诊断和及时干预可有效避免其严重后果。本研究旨在确定异位妊娠的发生率、易感的社会经济因素和病因病理学,并评估异位妊娠的各种临床表现和治疗方式。方法:于2015年4月1日至2016年3月31日在班库拉市BSMCH妇产科进行观察性横断面调查。纳入100例经知情同意后经临床或超声确认的异位妊娠患者,收集数据并进行分析。结果:68%的患者年龄在21 ~ 30岁之间,80%的患者社会经济地位较低,69%为多胎。检测到的典型危险因素有盆腔炎史、流产史和输卵管手术史。最一致的临床特征是下腹部疼痛(98%),其次是闭经(90%)和阴道出血(82%)。97%的患者表现为面色苍白,23%的患者表现为休克。73%的患者临床可引起颈椎运动压痛,95%的患者可在超声心动图中发现附件肿块。所有患者尿妊娠试验阳性,右侧是最常见的受累侧(53%)。所有患者均行手术干预。结论:从病史、临床特征、超声心动图等方面及时发现并及时处理是提高产妇生存率和保存生殖能力的重要手段。关键词:异位妊娠,UPT, PID,输卵管手术,附件肿块,POD液体,壶腹
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引用次数: 0
The Acute Inflammatory Biomarkers - Are They Cost Effective and Real Time Early Predictors of Mortality in Acute Pneumonia? - A Prospective Observational Study 急性炎症生物标志物-它们是否具有成本效益和急性肺炎死亡率的实时早期预测指标?-一项前瞻性观察研究
Pub Date : 2023-10-31 DOI: 10.46347/jmsh.v9i2.23.70
H A Krishnamurthy, G T Roja, S Bharathi
Introduction: The CT chest and investigations like IL6 and TNFɑ are the most accurate blood biomarkers of inflammatory changes and can be used to stage the severity and outcome of acute pneumonia. . Getting all the above mentioned investigations in a financially poor patients is not always possible. There are not much studies to look for the association between early raise in serum acute inflammatory bio markers and the prediction of mortality in acute pneumonia. So this study is under taken to know the association between significant raise in serum acute inflammatory biomarkers like hs CRP, LDH, ferritin, NLR, WBCs count in predicting the mortality of acute pneumonia in comparison with the serum IL6,q-SOFA score and CT chest severity score. Materials & Method: All patients underwent standardized workup, including complete blood count, blood biochemistry, ferritin, hs-CRP, LDH,IL6,CT scan of chest ,q-SOFA score assessment and electrocardiogram. All the biochemical investigations were done on day 1 and day 5 of admission to the hospital. The patients were followed-up for the whole in hospital stay duration. Results: All the measured serum acute inflammatory bio markers, IL6, NLR, WBCs count, q-SOFA score and chest CT severity score were significantly elevated in patients with death due to acute pneumonia than the survived ones. [p value-0.01] Conclusion: This study proves that, the early raise in serum acute inflammatory biomarkers have got real and cost effective predictive value and are non-inferior to total WBCs count, NLR,IL6, q- SOFA score and chest CT severity score in assessing the mortality of acute pneumonia. Keywords: Acute Pneumonia, Acute inflammatory bio markers, CT scan of Chest, IL6, NLR (Neutrophils to Lymphocytes ratio), q-SOFA score, WBCs count
胸部CT及il - 6、TNF -等检查是炎症变化最准确的血液生物标志物,可用于分期急性肺炎的严重程度和预后。在经济状况不佳的病人身上进行上述所有调查并不总是可能的。目前还没有太多的研究寻找血清急性炎症生物标志物的早期升高与急性肺炎死亡率预测之间的关系。因此,本研究旨在了解血清急性炎症生物标志物如hs CRP、LDH、铁蛋白、NLR、白细胞计数的显著升高与血清il - 6、q-SOFA评分和CT胸部严重程度评分在预测急性肺炎死亡率中的相关性。材料,方法:对所有患者进行全血细胞计数、血生化、铁蛋白、hs-CRP、LDH、il - 6、胸部CT、q-SOFA评分、心电图等标准化检查。所有生化检查均于入院第1天和第5天进行。在整个住院期间对患者进行随访。结果:急性肺炎死亡患者血清急性炎症生物标志物、il - 6、NLR、白细胞计数、q-SOFA评分、胸部CT严重程度评分均显著高于存活患者。[p值-0.01]结论:本研究证明,血清急性炎症标志物早期升高在评估急性肺炎死亡率方面具有真实且具有成本效益的预测价值,且不低于白细胞总数、NLR、IL6、q- SOFA评分和胸部CT严重程度评分。关键词:急性肺炎,急性炎症生物标志物,胸部CT扫描,il - 6, NLR(中性粒细胞与淋巴细胞比值),q-SOFA评分,白细胞计数
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引用次数: 0
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Journal of Medical Sciences and Health
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