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
{"title":"Unusual Finding in a Patient of COVID-19 Associated Pulmonary Aspergillosis: A Case Report","authors":"Neha Sharad, Smriti Srivastava, Purva Mathur, Rajesh Malhotra","doi":"10.46347/jmsh.v9i2.23.49","DOIUrl":"https://doi.org/10.46347/jmsh.v9i2.23.49","url":null,"abstract":"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","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":"203 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871142","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 : 2023-10-31DOI: 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
{"title":"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","authors":"Smita Mahapatra, Kaushik Patra, Manu Mangat Marandi","doi":"10.46347/jmsh.v9i2.22.442","DOIUrl":"https://doi.org/10.46347/jmsh.v9i2.22.442","url":null,"abstract":"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","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135870149","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: 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
{"title":"Is There Any Relation Between High-Grade Prostate Cancer and Central Obesity, Hyperinsulinemia and Dyslipidemia?","authors":"Vishal Kirti Jain, Madan Mohan Agrawal, Sher Singh Yadav, Neeraj Agarwal","doi":"10.46347/jmsh.v9i2.22.436","DOIUrl":"https://doi.org/10.46347/jmsh.v9i2.22.436","url":null,"abstract":"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","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871197","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}
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
{"title":"Clinical Profile of Anterior Uveitis in Tertiary Eye Care Center","authors":"B V Vinutha, Rashmi Shetu, . Sundeep, Konduru Rishitha, V Pallavi Naragund, J Babitha","doi":"10.46347/jmsh.v9i2.23.2","DOIUrl":"https://doi.org/10.46347/jmsh.v9i2.23.2","url":null,"abstract":"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","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135869518","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: 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
{"title":"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","authors":"Mythri Sannamadhu, Maithri Chikkabasavanahalli Manjegowda, Raghunath Hanumantharaya","doi":"10.46347/jmsh.v9i2.22.453","DOIUrl":"https://doi.org/10.46347/jmsh.v9i2.22.453","url":null,"abstract":"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","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135872237","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: Postoperative pain prolongs hospital stay after laparoscopic cholecystectomy and remains a major challenge during the postoperative period. Effective pain control encourages early ambulation, which significantly reduces postoperative complications. In recent years, multimodal analgesia has been recommended with fewer adverse effects and more effective analgesia. The primary objective of this study was to compare the efficacy of analgesia between Transversus Abdominis Plane Block (TAP) Block and intraperitoneal instillation of bupivacaine by comparing the meantime of the first dose of rescue analgesia in either group and the total supplementary analgesia required. Methods: This retrospective observational study was conducted on 150 patients who underwent laparoscopic cholecystectomy Group 1 comprised of patients who had received Intraperitoneal Bupivacaine for analgesia and Group 2 received TAP Block for pain relief. Results: Time of the first dose of analgesia after surgery was observed earlier in Group 1 as compared to Group 2 (Time – hours: 9.2 ± 2 vs. 12.3 ± 1.6; p = 0.0001. The Total dose of analgesic was higher in the Intra Peritoneal Bupivacaine Group as compared to the TAP group. Conclusion: AP block provided for a better quality of analgesia as assessed by the reduced requirement of intravenous supplementary analgesia which was less in patients who were given TAP Block as compared to local instillation of Bupivacaine. Keywords: Cholecystectomy, Bupivacaine, Transversus abdominis plane block
{"title":"Ultrasound-Guided Transversus Abdominis Plane Block Versus Intraperitoneal Instillation of Bupivacaine after Laparoscopic Cholecystectomy – A Randomized Control Trial","authors":"Rajesh Matam, Vikas Chawla, Shaleen Trivedi, Ajit Bhardwaj, Shivinder Singh","doi":"10.46347/jmsh.v9i2.22.394","DOIUrl":"https://doi.org/10.46347/jmsh.v9i2.22.394","url":null,"abstract":"Background: Postoperative pain prolongs hospital stay after laparoscopic cholecystectomy and remains a major challenge during the postoperative period. Effective pain control encourages early ambulation, which significantly reduces postoperative complications. In recent years, multimodal analgesia has been recommended with fewer adverse effects and more effective analgesia. The primary objective of this study was to compare the efficacy of analgesia between Transversus Abdominis Plane Block (TAP) Block and intraperitoneal instillation of bupivacaine by comparing the meantime of the first dose of rescue analgesia in either group and the total supplementary analgesia required. Methods: This retrospective observational study was conducted on 150 patients who underwent laparoscopic cholecystectomy Group 1 comprised of patients who had received Intraperitoneal Bupivacaine for analgesia and Group 2 received TAP Block for pain relief. Results: Time of the first dose of analgesia after surgery was observed earlier in Group 1 as compared to Group 2 (Time – hours: 9.2 ± 2 vs. 12.3 ± 1.6; p = 0.0001. The Total dose of analgesic was higher in the Intra Peritoneal Bupivacaine Group as compared to the TAP group. Conclusion: AP block provided for a better quality of analgesia as assessed by the reduced requirement of intravenous supplementary analgesia which was less in patients who were given TAP Block as compared to local instillation of Bupivacaine. Keywords: Cholecystectomy, Bupivacaine, Transversus abdominis plane block","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":"44 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135869641","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 : 2023-10-31DOI: 10.46347/jmsh.v9i2.23.36
Sneha Kakoty, Dhaval Jetly, Paheli Maru, Anurag Saha, Varnika Rai
Foamy gland carcinoma (FGC) is a distinct histological variant of prostatic acinar adenocarcinomas. It was first described by Epstein and Nelson in 1996. It is characterized by abundant xanthomatous cytoplasm, pyknotic nuclei, and intermediate Gleason grade. However, FGC with a high Gleason grade exists. FGC is found admixed with conventional acinar adenocarcinoma in 17 to 22% of needle biopsies and 13 to 22% of radical prostatectomy specimens and only rarely found in pure form. We report six cases of pure foamy gland carcinoma of prostate. The mean age in our study was 62.83 years and 5 out of the 6 cases presented with an elevated serum PSA level. Histopathological examination of our cases showed tumor cells with abundant foamy cytoplasm and low nucleo-cytoplasmic ratio. This deceptively benign-looking morphology can mimic nonneoplastic prostatic glands, Cowper’s gland, mucinous metaplasia, and xanthomatous prostatitis and hence often pose diagnostic challenges, especially in core needle biopsies. PNI was detected in two of our cases. PSA and AMACR staining was positive in all our cases (100%). p63 Staining was negative in all four cases where it was performed. Three, two, and one of our cases had a Gleason score of 7, 8, and 6 respectively. The prognosis depends on the Gleason score and the presence or absence of PNI or extraprostatic extension. Three of the cases presented with bony metastasis. We report this case series in view of the rarity and also to raise awareness of this entity which is often missed on small biopsies. Keywords: Foamy gland carcinoma, Gleason score, Prostate
{"title":"Pure Foamy Gland Carcinoma of Prostate - A Series of Rare Cases","authors":"Sneha Kakoty, Dhaval Jetly, Paheli Maru, Anurag Saha, Varnika Rai","doi":"10.46347/jmsh.v9i2.23.36","DOIUrl":"https://doi.org/10.46347/jmsh.v9i2.23.36","url":null,"abstract":"Foamy gland carcinoma (FGC) is a distinct histological variant of prostatic acinar adenocarcinomas. It was first described by Epstein and Nelson in 1996. It is characterized by abundant xanthomatous cytoplasm, pyknotic nuclei, and intermediate Gleason grade. However, FGC with a high Gleason grade exists. FGC is found admixed with conventional acinar adenocarcinoma in 17 to 22% of needle biopsies and 13 to 22% of radical prostatectomy specimens and only rarely found in pure form. We report six cases of pure foamy gland carcinoma of prostate. The mean age in our study was 62.83 years and 5 out of the 6 cases presented with an elevated serum PSA level. Histopathological examination of our cases showed tumor cells with abundant foamy cytoplasm and low nucleo-cytoplasmic ratio. This deceptively benign-looking morphology can mimic nonneoplastic prostatic glands, Cowper’s gland, mucinous metaplasia, and xanthomatous prostatitis and hence often pose diagnostic challenges, especially in core needle biopsies. PNI was detected in two of our cases. PSA and AMACR staining was positive in all our cases (100%). p63 Staining was negative in all four cases where it was performed. Three, two, and one of our cases had a Gleason score of 7, 8, and 6 respectively. The prognosis depends on the Gleason score and the presence or absence of PNI or extraprostatic extension. Three of the cases presented with bony metastasis. We report this case series in view of the rarity and also to raise awareness of this entity which is often missed on small biopsies. Keywords: Foamy gland carcinoma, Gleason score, Prostate","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135869783","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 : 2023-10-31DOI: 10.46347/jmsh.v9i2.23.403
V Rajasekar, D Thirunaaukarasu, R Surendar
Background: Epidemiology of HIV infection in India is varied and depends on multitude of factors such as socio-demographic profile, geographic location and behavioural pattern. HIV/AIDS is not only a public health issue in India but also one of the most serious socioeconomic and developmental concerns as nearly 86% of reported cases occur in sexually active and economically productive age group (15-49yrs). Thus, for planning targeted interventions, it is essential to know the socio-demographic and clinical profile of the HIV/AIDS patients in a particular area as important for control of HIV replication, disease progression and ultimately containment of the disease. Hence this study was planned to describe the Socio-demographic profile and ART treatment adherence of People Living with HIV/AIDS attending The ART Centre, KKGMCH, Asaripallam, Kanyakumari District, Tamil Nadu. Objectives: To describe the Socio-demographic profile and ART treatment adherence of People Living with HIV/AIDS attending The ART Centre, KKGMCH, Asaripallam, Kanyakumari District, Tamil Nadu. Materials & Methods: This was a Cross- sectional study conducted among adult people living with HIV/AIDS who were on treatment at ART centre. The study was done during January 2014 to July 2014. The data was collected by using a semi structured questionnaire derived from WHO-BREFQOL. Result: The age of the study population varies from minimum 18 to maximum 59 years with the mean ± SD age of 39.5 ± 8.3 years. Around 69 (46.0%) participants are in the 31 – 40 years age group followed by 51 (39.0%) are in the 41 – 50 years age group. Regarding the Family type, 127 (84.7%) are from nuclear family; 19 (12.7%) are from extended family and another 4 (2.7%) are from the Joint family. The prevalence of opportunistic symptoms among the study participants, around 44% of the study participants developed respiratory related symptoms followed by Skin (24%). Among 150 subjects taking ART, 120 (80.0%) are receiving Regimen 1 and 30 others (20%) are receiving Regimen 2. Around 92 (61.3%) have good adherence to ART. 53 (35.3%) have fair and 5 (3.3%) have poor adherence. Conclusion: Non-adherence as a hindering factor for the success of therapy is well-established. Keywords: HIV/AIDS, Socio-demographic profile, Drug Adherence, Targeted intervention
{"title":"Socio-Demographic Profile and Adherence to Anti-Retroviral Treatment among HIV/AIDS Patients Attending the ART Centre in Tamil Nadu","authors":"V Rajasekar, D Thirunaaukarasu, R Surendar","doi":"10.46347/jmsh.v9i2.23.403","DOIUrl":"https://doi.org/10.46347/jmsh.v9i2.23.403","url":null,"abstract":"Background: Epidemiology of HIV infection in India is varied and depends on multitude of factors such as socio-demographic profile, geographic location and behavioural pattern. HIV/AIDS is not only a public health issue in India but also one of the most serious socioeconomic and developmental concerns as nearly 86% of reported cases occur in sexually active and economically productive age group (15-49yrs). Thus, for planning targeted interventions, it is essential to know the socio-demographic and clinical profile of the HIV/AIDS patients in a particular area as important for control of HIV replication, disease progression and ultimately containment of the disease. Hence this study was planned to describe the Socio-demographic profile and ART treatment adherence of People Living with HIV/AIDS attending The ART Centre, KKGMCH, Asaripallam, Kanyakumari District, Tamil Nadu. Objectives: To describe the Socio-demographic profile and ART treatment adherence of People Living with HIV/AIDS attending The ART Centre, KKGMCH, Asaripallam, Kanyakumari District, Tamil Nadu. Materials & Methods: This was a Cross- sectional study conducted among adult people living with HIV/AIDS who were on treatment at ART centre. The study was done during January 2014 to July 2014. The data was collected by using a semi structured questionnaire derived from WHO-BREFQOL. Result: The age of the study population varies from minimum 18 to maximum 59 years with the mean ± SD age of 39.5 ± 8.3 years. Around 69 (46.0%) participants are in the 31 – 40 years age group followed by 51 (39.0%) are in the 41 – 50 years age group. Regarding the Family type, 127 (84.7%) are from nuclear family; 19 (12.7%) are from extended family and another 4 (2.7%) are from the Joint family. The prevalence of opportunistic symptoms among the study participants, around 44% of the study participants developed respiratory related symptoms followed by Skin (24%). Among 150 subjects taking ART, 120 (80.0%) are receiving Regimen 1 and 30 others (20%) are receiving Regimen 2. Around 92 (61.3%) have good adherence to ART. 53 (35.3%) have fair and 5 (3.3%) have poor adherence. Conclusion: Non-adherence as a hindering factor for the success of therapy is well-established. Keywords: HIV/AIDS, Socio-demographic profile, Drug Adherence, Targeted intervention","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":"1 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871599","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: 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
{"title":"Pattern of Thyroid Dysfunction in Type II Diabetes Mellitus Patients in a Tertiary Care Center: A Cross-Sectional Study","authors":"Sangamesh Asuti, Shambhulinga Purad, Prakash Hosamani","doi":"10.46347/jmsh.v9i2.23.125","DOIUrl":"https://doi.org/10.46347/jmsh.v9i2.23.125","url":null,"abstract":"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","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135869462","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: 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
{"title":"Neuromuscular Disorders: A Histomorphological and Clinicopathological Evaluation in a Tertiary Care Centre","authors":"Ashmeet Kaur, Anita Harsh, Kapil Takhar, Kusum Mathur, Rateesh Sareen","doi":"10.46347/jmsh.v9i2.23.78","DOIUrl":"https://doi.org/10.46347/jmsh.v9i2.23.78","url":null,"abstract":"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","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135871830","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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