Pub Date : 2022-09-15DOI: 10.46347/jmsh.v8i2.22.33
Sheela Mathew, Aquil Kalanad, Muhammed Masood Khan, Anees Mullappally Abdul Hameed, Anusha Sathyapal, Paramesh Mohankumar
Following COVID -19 infection people are prone for developing bacterial, viral and fungal infections. The main reasons highlighted for increased susceptibility to infection are severe COVID -19 infection and use of immune suppressants. We had 3 cases of cryptococcal meningitis where two patients had mild COVID -19 and one had asymptomatic COVID -19. Evaluation for immune suppression revealed persisting pan lymphocyte depletion in one patient, isolated CD4 depletion in second patient and underlying HIV infection in the third patient with a very low CD4 count of 11 which was totally asymptomatic till then. Cryptococci is a ubiquitous pathogen and both innate and adaptive immunity is important in eradicating infection. COVID -19 per se as well as the various treatment modalities given in COVID -19 infection disrupts the immune system making people vulnerable for opportunistic infections. Even mild COVID -19 infection can predispose such diseases. A brief description of innate and acquired immune mechanisms preventing cryptococcal infection and how this is altered in COVID -19 infection is highlighted in this article. Post COVID patients when come with infections, unusual pathogens also should be considered. Unusual infection when occur in immune competent people, asymptomatic COVID -19 infection should also be ruled out. Keywords: CD4 cytopenia, Pan lymphocyte depletion, Cryptococcal meningitis, Cryptococcus, Covid 19 infection
{"title":"Cryptococcal Meningoencephalitis in Post COVID Period: Case Series and Review of Literature","authors":"Sheela Mathew, Aquil Kalanad, Muhammed Masood Khan, Anees Mullappally Abdul Hameed, Anusha Sathyapal, Paramesh Mohankumar","doi":"10.46347/jmsh.v8i2.22.33","DOIUrl":"https://doi.org/10.46347/jmsh.v8i2.22.33","url":null,"abstract":"Following COVID -19 infection people are prone for developing bacterial, viral and fungal infections. The main reasons highlighted for increased susceptibility to infection are severe COVID -19 infection and use of immune suppressants. We had 3 cases of cryptococcal meningitis where two patients had mild COVID -19 and one had asymptomatic COVID -19. Evaluation for immune suppression revealed persisting pan lymphocyte depletion in one patient, isolated CD4 depletion in second patient and underlying HIV infection in the third patient with a very low CD4 count of 11 which was totally asymptomatic till then. Cryptococci is a ubiquitous pathogen and both innate and adaptive immunity is important in eradicating infection. COVID -19 per se as well as the various treatment modalities given in COVID -19 infection disrupts the immune system making people vulnerable for opportunistic infections. Even mild COVID -19 infection can predispose such diseases. A brief description of innate and acquired immune mechanisms preventing cryptococcal infection and how this is altered in COVID -19 infection is highlighted in this article. Post COVID patients when come with infections, unusual pathogens also should be considered. Unusual infection when occur in immune competent people, asymptomatic COVID -19 infection should also be ruled out. Keywords: CD4 cytopenia, Pan lymphocyte depletion, Cryptococcal meningitis, Cryptococcus, Covid 19 infection","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45663351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-15DOI: 10.46347/jmsh.v8i2.21.192
A. Naik, S. Naik, S. Shinde, Mugdha C. Vaje
Background: Heart disease(HD) in pregnancy remains an important cause of maternal, fetal morbidity and mortality especially in a developing country like India, where incidence of cardiac disease that complicates pregnancy is between 1% to 4% & Rheumatic heart disease (RHD) still remains the most common type of heart disease complicating pregnancy due to Poor socioeconomic condition. Methods: This is a retrospective observational study carried out in Department of Obstetrics and Gynaecology at S.M.B.T. Institute of medical sciences, Dhamangaon during the period of 24 months to assess the maternal and fetal outcome on patients of heart disease with pregnancy. Result: Among the 3182 patients delivered in the study 35 had cardiac disease with prevalence of 1.1%, all patients were booked and diagnosed with heart disease during ANC checkup. Rheumatic Heart disease (70%) was the commonest form of heart disease with MS with MR predominating (22%). NYHA grade 2 patients (41%) were maximum with Anemia as the associated complicating factor.4 patients with severe MS required balloon mitral valvotomy (BMV) of them 1 patient went into pulmonary edema. There was no maternal mortality. 2 patients underwent medical termination of pregnancy (MTP) for cardiac reason and there was 1 neonatal mortality. Conclusion: RHD is still the commonest heart disease in pregnancy; BMV can be performed in third trimester on patients with severe MS reducing intra and postpartum complications. Giving good and timely antenatal, Intranatal and postnatal care at a tertiary care hospital with good cardiac, obstetric & Neonatal care setup reduces maternal and fetal morbidity in patients of heart disease with pregnancy. Keywords: Rheumatic heart disease in pregnancy, Congenital heart disease in pregnancy, Balloon Mitral Valvotomy in pregnancy
{"title":"A Retrospective Study to Evaluate the Maternal and Fetal Outcome in Patients of Heart Disease in Pregnancy at a Tertiary Rural Hospital","authors":"A. Naik, S. Naik, S. Shinde, Mugdha C. Vaje","doi":"10.46347/jmsh.v8i2.21.192","DOIUrl":"https://doi.org/10.46347/jmsh.v8i2.21.192","url":null,"abstract":"Background: Heart disease(HD) in pregnancy remains an important cause of maternal, fetal morbidity and mortality especially in a developing country like India, where incidence of cardiac disease that complicates pregnancy is between 1% to 4% & Rheumatic heart disease (RHD) still remains the most common type of heart disease complicating pregnancy due to Poor socioeconomic condition. Methods: This is a retrospective observational study carried out in Department of Obstetrics and Gynaecology at S.M.B.T. Institute of medical sciences, Dhamangaon during the period of 24 months to assess the maternal and fetal outcome on patients of heart disease with pregnancy. Result: Among the 3182 patients delivered in the study 35 had cardiac disease with prevalence of 1.1%, all patients were booked and diagnosed with heart disease during ANC checkup. Rheumatic Heart disease (70%) was the commonest form of heart disease with MS with MR predominating (22%). NYHA grade 2 patients (41%) were maximum with Anemia as the associated complicating factor.4 patients with severe MS required balloon mitral valvotomy (BMV) of them 1 patient went into pulmonary edema. There was no maternal mortality. 2 patients underwent medical termination of pregnancy (MTP) for cardiac reason and there was 1 neonatal mortality. Conclusion: RHD is still the commonest heart disease in pregnancy; BMV can be performed in third trimester on patients with severe MS reducing intra and postpartum complications. Giving good and timely antenatal, Intranatal and postnatal care at a tertiary care hospital with good cardiac, obstetric & Neonatal care setup reduces maternal and fetal morbidity in patients of heart disease with pregnancy. Keywords: Rheumatic heart disease in pregnancy, Congenital heart disease in pregnancy, Balloon Mitral Valvotomy in pregnancy","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47753748","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: Anxiety and depression are the common mental disorders, which affect the general population upto 15%, once at their life span and an important reason of disability in world with high impact on social-economic status of affected persons. The Benzodiazepines preferred for the treatment of generalized anxiety as they provide immediate relief, however the high potential for abuse and dependence, limits the utilization of Benzodiazepines. Literature suggests that increased serotonergic neurotransmission in synapse leads to allosteric modulation of serotonergic system by 5-HT1A partial agonists and with the blockade of 5-HT3 receptor by its antagonists develop anti anxiety effect which may serve as alternatives to Benzodiazepines as anxiolytic because of lesser side effects and better tolerability with favourable pharmacological records in patients. Objective: To evaluate anxiolytic activity of ondansetron in mice model. Material and methods: Male Swiss albino mice (20-30 g BW) were divided in five groups. Study was undertaken after approval from IAEC, People’s College of Medical Science and Research Centre, Bhopal. Animals received intraperitoneally either Ondansetron (0.1, 0 .5 and 1mg/kg), diazepam (1mg/kg) in intervention group or vehicle (1ml dw) in control. Elevated plus maze and hole board test were used to compare the effects of ondansetron with diazepam for evaluation of anxiolytic activity. In addition, assessment of drugs on motor activity was done by photo actometer. Result: Ondansetron exhibited significant anxiolytic activity at 0.5, 1.0 mg/kg BW dose. Comparison between groups shows significant variation (p<0.05) in dose dependent manner. Locomotor activity was not significantly changed by ondansetron at these test doses. Conclusion: Ondansetron was found to exhibit significant anxiolytic activity in mice models. Further researches are required for elucidating the mechanism and to explore its role in psychopharmacology and its therapeutic application in various psychiatric disorders including anxiety. Keywords: Ondansetron, Anxiolytic, Benzodiazepines
{"title":"Evaluation of Anxiolytic Activity of Ondansetron in mice models — An Animal Experimental Research","authors":"V. Jain, Kaore Navinchandra Shilpa, Sankadia Rajnish, Jain Megha, Upadhyay Ritesh, Dandotiya Dileep","doi":"10.46347/jmsh.v8i2.22.5","DOIUrl":"https://doi.org/10.46347/jmsh.v8i2.22.5","url":null,"abstract":"Background: Anxiety and depression are the common mental disorders, which affect the general population upto 15%, once at their life span and an important reason of disability in world with high impact on social-economic status of affected persons. The Benzodiazepines preferred for the treatment of generalized anxiety as they provide immediate relief, however the high potential for abuse and dependence, limits the utilization of Benzodiazepines. Literature suggests that increased serotonergic neurotransmission in synapse leads to allosteric modulation of serotonergic system by 5-HT1A partial agonists and with the blockade of 5-HT3 receptor by its antagonists develop anti anxiety effect which may serve as alternatives to Benzodiazepines as anxiolytic because of lesser side effects and better tolerability with favourable pharmacological records in patients. Objective: To evaluate anxiolytic activity of ondansetron in mice model. Material and methods: Male Swiss albino mice (20-30 g BW) were divided in five groups. Study was undertaken after approval from IAEC, People’s College of Medical Science and Research Centre, Bhopal. Animals received intraperitoneally either Ondansetron (0.1, 0 .5 and 1mg/kg), diazepam (1mg/kg) in intervention group or vehicle (1ml dw) in control. Elevated plus maze and hole board test were used to compare the effects of ondansetron with diazepam for evaluation of anxiolytic activity. In addition, assessment of drugs on motor activity was done by photo actometer. Result: Ondansetron exhibited significant anxiolytic activity at 0.5, 1.0 mg/kg BW dose. Comparison between groups shows significant variation (p<0.05) in dose dependent manner. Locomotor activity was not significantly changed by ondansetron at these test doses. Conclusion: Ondansetron was found to exhibit significant anxiolytic activity in mice models. Further researches are required for elucidating the mechanism and to explore its role in psychopharmacology and its therapeutic application in various psychiatric disorders including anxiety. Keywords: Ondansetron, Anxiolytic, Benzodiazepines","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43954267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-15DOI: 10.46347/jmsh.v8i2.21.39
Amitava Dutta, R. Hiremath, Satyasheel Y Hasure
Objectives: To access knowledge, attitude, and practices about dog bites and their management in the rural community of Maharashtra. Methodology: A cross-sectional study was conducted in an identified rural community with a sample size of 279 using systematic random sampling data was collected using personal interview using pretested questionnaire and descriptive and inferential statistics was applied. Results: The mean age of the subjects was 42.8±7.5 years and the majority (68.8%) were male and 31.2% were female. 72.4% didn't have any pet dog and all (100.0%) have experienced a dog bite for themselves or anyone in the family in their lifetime. The majority (93.4%) have described rabies illness and 100% correctly know that the main animal of rabies in India is a dog and the correct mode of disease transmission. However, only 7.9% know the most common age group affected. The majority (59.1%) have heard about the anti-rabies vaccine. Awareness of anti-rabies vaccine varies in different groups based on their educational qualification and Pearson's chi-square value was statistically significant. Vaccination of pet dogs as a periodic activity to prevent rabies has been strongly disagreed by 22.2% of participants. 23.3% strongly agreed that stray dogs are a social nuisance. The majority 24.7% have disagreed with the implementation of the Animal Birth Control program. The relationship between the level of education and attitude towards native/traditional healers in preventing rabies after a dog bite was significant (p<0.05). It was also found that the following dog bite only 28.0% would like to wash the wound with soap and water following a dog bite. Conclusion: There exists a considerable gap in knowledge attitudes and practices about Dog bites and their management. Increasing the awareness, and changing the attitude and beliefs among the study population is the need of the hour, Accordingly Regular IEC activities to be planned at various centers Keywords: Knowledge, attitude, practices, Dog bite, Management
{"title":"A KAP Study on Dog Bite and Its Management in a Rural Community — Need for Increasing the Awareness","authors":"Amitava Dutta, R. Hiremath, Satyasheel Y Hasure","doi":"10.46347/jmsh.v8i2.21.39","DOIUrl":"https://doi.org/10.46347/jmsh.v8i2.21.39","url":null,"abstract":"Objectives: To access knowledge, attitude, and practices about dog bites and their management in the rural community of Maharashtra. Methodology: A cross-sectional study was conducted in an identified rural community with a sample size of 279 using systematic random sampling data was collected using personal interview using pretested questionnaire and descriptive and inferential statistics was applied. Results: The mean age of the subjects was 42.8±7.5 years and the majority (68.8%) were male and 31.2% were female. 72.4% didn't have any pet dog and all (100.0%) have experienced a dog bite for themselves or anyone in the family in their lifetime. The majority (93.4%) have described rabies illness and 100% correctly know that the main animal of rabies in India is a dog and the correct mode of disease transmission. However, only 7.9% know the most common age group affected. The majority (59.1%) have heard about the anti-rabies vaccine. Awareness of anti-rabies vaccine varies in different groups based on their educational qualification and Pearson's chi-square value was statistically significant. Vaccination of pet dogs as a periodic activity to prevent rabies has been strongly disagreed by 22.2% of participants. 23.3% strongly agreed that stray dogs are a social nuisance. The majority 24.7% have disagreed with the implementation of the Animal Birth Control program. The relationship between the level of education and attitude towards native/traditional healers in preventing rabies after a dog bite was significant (p<0.05). It was also found that the following dog bite only 28.0% would like to wash the wound with soap and water following a dog bite. Conclusion: There exists a considerable gap in knowledge attitudes and practices about Dog bites and their management. Increasing the awareness, and changing the attitude and beliefs among the study population is the need of the hour, Accordingly Regular IEC activities to be planned at various centers Keywords: Knowledge, attitude, practices, Dog bite, Management","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45916989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-15DOI: 10.46347/jmsh.v8i2.21.23
M. Borah, Chandana Deka, Parimita Roychoudhury
Background: Health seeking behaviour of mothers plays an important part in the well-being of low birth weight (LBW) babies. Infant mortality is very high in Assam and care seeking behaviours of mothers influence the health outcomes of infants. Objective: This study was attempted with the objective of assessing the prevailing care seeking behaviours among mothers from tribal community for their LBW babies during their first year of life. Materials & Methods: A cross section study was conducted among 112 tribal mothers of LBW babies in a rural block of Kamrup district of Assam. A predesigned pretested questionnaire was used to collect data among mothers of LBW babies after obtaining informed consent, regarding socio-demographic characteristics of mothers, feeding and care practices for LBW babies, knowledge on special care to LBW babies, health seeking behaviours of mothers. Collected data compiled, tabulated and analysed using appropriate software. Results: Our study found that 87.5% of mothers could recognize LBW condition. Most of them (84.8%) understood the need for special care to their LBW babies. Exclusive breastfeeding, good nutrition to mother and baby, Kangaroo Mother Care, delayed bathing were some of the special care practices adopted by our study population. In our study 30% mothers were found to be practising KMC. Conclusion: On analysis of determinants of health seeking behaviours we found that adequate exposure of mothers to mass media was significantly associated with appropriate health seeking behaviours. Keywords: Health seeking behaviours, Low birth weight, Tribal mothers, Breastfeeding, Kangaroo mother care
{"title":"Determinants of Health Seeking Behaviours among Tribal Mothers having LBW Babies in a Rural District of Assam","authors":"M. Borah, Chandana Deka, Parimita Roychoudhury","doi":"10.46347/jmsh.v8i2.21.23","DOIUrl":"https://doi.org/10.46347/jmsh.v8i2.21.23","url":null,"abstract":"Background: Health seeking behaviour of mothers plays an important part in the well-being of low birth weight (LBW) babies. Infant mortality is very high in Assam and care seeking behaviours of mothers influence the health outcomes of infants. Objective: This study was attempted with the objective of assessing the prevailing care seeking behaviours among mothers from tribal community for their LBW babies during their first year of life. Materials & Methods: A cross section study was conducted among 112 tribal mothers of LBW babies in a rural block of Kamrup district of Assam. A predesigned pretested questionnaire was used to collect data among mothers of LBW babies after obtaining informed consent, regarding socio-demographic characteristics of mothers, feeding and care practices for LBW babies, knowledge on special care to LBW babies, health seeking behaviours of mothers. Collected data compiled, tabulated and analysed using appropriate software. Results: Our study found that 87.5% of mothers could recognize LBW condition. Most of them (84.8%) understood the need for special care to their LBW babies. Exclusive breastfeeding, good nutrition to mother and baby, Kangaroo Mother Care, delayed bathing were some of the special care practices adopted by our study population. In our study 30% mothers were found to be practising KMC. Conclusion: On analysis of determinants of health seeking behaviours we found that adequate exposure of mothers to mass media was significantly associated with appropriate health seeking behaviours. Keywords: Health seeking behaviours, Low birth weight, Tribal mothers, Breastfeeding, Kangaroo mother care","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46249580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-15DOI: 10.46347/jmsh.v8i2.21.64
K. Santosh, Manjunath K N, V. Ravikumar, H. Ravikumar
Trichoadenoma is a rare benign tumor with differentiation to hair follicle. There are several reports of a melanocytic naevus seen in association with another benign adnexal tumor with hair follicular differentiation - trichoepithelioma. However, there is, to the best of our knowledge, only one case of a collision tumor of trichoadenoma with a melanocytic naevus - with an admixture of the two components. Trichoadenoma and trichoepithelioma are considered parts of a spectrum, with trichoadenoma being better differentiated than trichoepithelioma. Herein we present an unusual case of dual tumors - trichoadenoma and melanocytic naevi of the face. Unlike the previously reported case, the current case had simultaneous occurrence of trichoadenoma and naevi at different locations. The exact cause for the association of these tumors - trichoadenoma and melanocytic naevi - is uncertain. Key Messages : Benign dermal adnexal tumors like trichoepithelioma and trichoadenoma may be found in association with melanocytic naevi. Keywords: Dermal adnexal tumor, Trichoadenoma, Melanocytic Naevi
{"title":"Dual Tumors — Trichoadenoma of Nikolowski and Melanocytic Naevi","authors":"K. Santosh, Manjunath K N, V. Ravikumar, H. Ravikumar","doi":"10.46347/jmsh.v8i2.21.64","DOIUrl":"https://doi.org/10.46347/jmsh.v8i2.21.64","url":null,"abstract":"Trichoadenoma is a rare benign tumor with differentiation to hair follicle. There are several reports of a melanocytic naevus seen in association with another benign adnexal tumor with hair follicular differentiation - trichoepithelioma. However, there is, to the best of our knowledge, only one case of a collision tumor of trichoadenoma with a melanocytic naevus - with an admixture of the two components. Trichoadenoma and trichoepithelioma are considered parts of a spectrum, with trichoadenoma being better differentiated than trichoepithelioma. Herein we present an unusual case of dual tumors - trichoadenoma and melanocytic naevi of the face. Unlike the previously reported case, the current case had simultaneous occurrence of trichoadenoma and naevi at different locations. The exact cause for the association of these tumors - trichoadenoma and melanocytic naevi - is uncertain. Key Messages : Benign dermal adnexal tumors like trichoepithelioma and trichoadenoma may be found in association with melanocytic naevi. Keywords: Dermal adnexal tumor, Trichoadenoma, Melanocytic Naevi","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47417677","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}
To highlight a very uncommon presentation of intestinal perforation in a child caused due to foreign body. 10-year-old kid presented to the emergency with chief complains of pain abdomen for 2 days. There was no evidence of any peritonitis. X-ray and Contrast enhanced computed tomography scan revealed no pathology other than gas under diaphragm. On exploration there was a concealed perforation caused due to chocolate stick ingested by the kid. There was no free fluid or contamination found in the peritoneal cavity. Foreign body ingestion by kids is very common. 80-90 % these objects pass with stool not causing any injury to the viscera. In 10 to 20 % cases they require endoscopic removal. 1 % of these cases can cause perforation and have to be removed surgically. Majority of the times these foreign bodies are not seen on X-rays or CT scans. There may be cases in which patients may not present with features of perforation peritonitis but still patients must be assessed properly to undertake intervention at appropriate time to reduce complication. In such children presenting to emergency with acute pain abdomen, a high degree of suspicion for foreign body ingestion should be kept in mind and evaluated accordingly. Keywords: Concealed perforation, Pediatric age group, No signs of peritonitis, X-ray, CECT Whole abdomen
{"title":"Chocolate Stick Causing Concealed Intestinal Perforation with no Signs of Peritonitis in a Child: A Case Report","authors":"Manabendra Baidya, Satendra Kumar, Ashutosh Kumar Singh, Sandeep Pandey, S. Giri","doi":"10.46347/jmsh.v8i2.22.49","DOIUrl":"https://doi.org/10.46347/jmsh.v8i2.22.49","url":null,"abstract":"To highlight a very uncommon presentation of intestinal perforation in a child caused due to foreign body. 10-year-old kid presented to the emergency with chief complains of pain abdomen for 2 days. There was no evidence of any peritonitis. X-ray and Contrast enhanced computed tomography scan revealed no pathology other than gas under diaphragm. On exploration there was a concealed perforation caused due to chocolate stick ingested by the kid. There was no free fluid or contamination found in the peritoneal cavity. Foreign body ingestion by kids is very common. 80-90 % these objects pass with stool not causing any injury to the viscera. In 10 to 20 % cases they require endoscopic removal. 1 % of these cases can cause perforation and have to be removed surgically. Majority of the times these foreign bodies are not seen on X-rays or CT scans. There may be cases in which patients may not present with features of perforation peritonitis but still patients must be assessed properly to undertake intervention at appropriate time to reduce complication. In such children presenting to emergency with acute pain abdomen, a high degree of suspicion for foreign body ingestion should be kept in mind and evaluated accordingly. Keywords: Concealed perforation, Pediatric age group, No signs of peritonitis, X-ray, CECT Whole abdomen","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48728122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-15DOI: 10.46347/jmsh.v8i2.21.182
Matuli Das, Saswati Sen, Ridhima Pokharna, P. Sahu
A 28-year-old female, presented with complaints of diminution of vision in left eye and floaters and flashes in right eye. Her visual acuity was 6/9 in right eye and counting fingers- ½ meters in left eye. Patient had high myopia and her posterior segment showed total retinal detachment in left eye. She was advised for surgery and visual prognosis was explained. The patient however was not convinced and was lost to follow up. The patient came back one year later with loss of vision. Her visual acuity in both eyes was then perception of light +ve and projection of rays inaccurate. She gave history of switching to alternative medicine in the intervening period. Had our counselling been proper and treatment initiated at the right time, we could have restored vision in left eye and also retain some useful vision in the right eye. We aim to highlight the importance of counselling through this case report. Keywords: prognosis, compliance, counselling
{"title":"Role of Counselling in Deciding the Fate of a Patient with Retinal Detachment: A Case Report","authors":"Matuli Das, Saswati Sen, Ridhima Pokharna, P. Sahu","doi":"10.46347/jmsh.v8i2.21.182","DOIUrl":"https://doi.org/10.46347/jmsh.v8i2.21.182","url":null,"abstract":"A 28-year-old female, presented with complaints of diminution of vision in left eye and floaters and flashes in right eye. Her visual acuity was 6/9 in right eye and counting fingers- ½ meters in left eye. Patient had high myopia and her posterior segment showed total retinal detachment in left eye. She was advised for surgery and visual prognosis was explained. The patient however was not convinced and was lost to follow up. The patient came back one year later with loss of vision. Her visual acuity in both eyes was then perception of light +ve and projection of rays inaccurate. She gave history of switching to alternative medicine in the intervening period. Had our counselling been proper and treatment initiated at the right time, we could have restored vision in left eye and also retain some useful vision in the right eye. We aim to highlight the importance of counselling through this case report. Keywords: prognosis, compliance, counselling","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48048418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-15DOI: 10.46347/jmsh.v8i2.21.173
Garima Uikey, Hemant Ahirwar, Rajesh K Kori, V. Yogi, Suresh Yadav, O. Singh, Rishika Saxena, Sachet Saxena
Background : Breast cancer molecular subtypes have been established a close relationship with site specific metastasis, disease prognosis, selection of therapy and response to therapy. This study is the evaluation of primary tumor molecular determinants and its clinical outcome in association with metastatic behavior of breast cancer. Material and Methods: This prospective study was included 221 patients of breast cancer registered in the department between January 2016 to December 2018. Based upon hormonal status, patients with breast cancer were categorized into four groups i.e. luminal (ER+, PR+, HER 2neu-), HER 2neu enriched (ER-, PR-, HER 2neu+), triple positive (ER+, PR+, HER 2neu+) and triple negative (ER-, PR-, HER 2neu-). Metastatic sites were divided into skeleton and visceral (lung, liver, and brain). The study data was compiled using Microsoft Excel sheet and Chi-Square test was used to assess the association between categorical variables. P value less than 0.05 was considered as statistically significant. Results : The mean age of the patients was 48.21±11.4 years (ranging from 22 to 80 years). About 36.7% and 24.9% patients were diagnosed as stage III A and stage II B respectively. Majority of patients were categorized as luminal (43%), followed by 24%, 17.2% and 15.8% as triple negative, triple positive and HER 2neu enriched respectively. Metastasis to bone following breast cancer was observed in majority i.e. 11.8% cases. Lung and liver metastasis observed in 6.3% cases each whereas brain metastasis was observed in 0.9% cases only. The higher proportions of TNBC cases metastasized to bone (22.6%), liver (7.5%), lung (7.5%) and brain (1.9%). The association between metastasis and hormonal status was statistically highly significant for bone metastasis (p<0.05). Conclusion : Breast cancer molecular subtypes have been related to considerable distinction in pattern of distant spread. Bone is the most predominant site of metastases followed by liver lung and brain. Luminal and HER 2 neu enriched subtypes having greater propensity for visceral metastasis where as TNBC predominantly show bone metastasis in this study. Keywords: Breast cancer, molecular subtypes, site-specific metastasis
{"title":"Metastatic Trends in Breast Cancer According to Molecular Subtypes, Estrogen Receptor, Progesterone Receptor and Human Epidermal Growth Factor Receptor 2neu Status","authors":"Garima Uikey, Hemant Ahirwar, Rajesh K Kori, V. Yogi, Suresh Yadav, O. Singh, Rishika Saxena, Sachet Saxena","doi":"10.46347/jmsh.v8i2.21.173","DOIUrl":"https://doi.org/10.46347/jmsh.v8i2.21.173","url":null,"abstract":"Background : Breast cancer molecular subtypes have been established a close relationship with site specific metastasis, disease prognosis, selection of therapy and response to therapy. This study is the evaluation of primary tumor molecular determinants and its clinical outcome in association with metastatic behavior of breast cancer. Material and Methods: This prospective study was included 221 patients of breast cancer registered in the department between January 2016 to December 2018. Based upon hormonal status, patients with breast cancer were categorized into four groups i.e. luminal (ER+, PR+, HER 2neu-), HER 2neu enriched (ER-, PR-, HER 2neu+), triple positive (ER+, PR+, HER 2neu+) and triple negative (ER-, PR-, HER 2neu-). Metastatic sites were divided into skeleton and visceral (lung, liver, and brain). The study data was compiled using Microsoft Excel sheet and Chi-Square test was used to assess the association between categorical variables. P value less than 0.05 was considered as statistically significant. Results : The mean age of the patients was 48.21±11.4 years (ranging from 22 to 80 years). About 36.7% and 24.9% patients were diagnosed as stage III A and stage II B respectively. Majority of patients were categorized as luminal (43%), followed by 24%, 17.2% and 15.8% as triple negative, triple positive and HER 2neu enriched respectively. Metastasis to bone following breast cancer was observed in majority i.e. 11.8% cases. Lung and liver metastasis observed in 6.3% cases each whereas brain metastasis was observed in 0.9% cases only. The higher proportions of TNBC cases metastasized to bone (22.6%), liver (7.5%), lung (7.5%) and brain (1.9%). The association between metastasis and hormonal status was statistically highly significant for bone metastasis (p<0.05). Conclusion : Breast cancer molecular subtypes have been related to considerable distinction in pattern of distant spread. Bone is the most predominant site of metastases followed by liver lung and brain. Luminal and HER 2 neu enriched subtypes having greater propensity for visceral metastasis where as TNBC predominantly show bone metastasis in this study. Keywords: Breast cancer, molecular subtypes, site-specific metastasis","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46625839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-15DOI: 10.46347/jmsh.v8i2.21.211
P. Sneka, V. Sangamithra, K. Hamsadwani
Scrub typhus accounts for a considerable number of cases presenting with acute febrile illness with rash. The clinical presentation of the illness varies from non-specific illness to fatal disease. It is very important to have a high index of suspicion and to diagnose the disease at an early stage to prevent morbidity and mortality due to disease complications. KEYWORDS: Scrub, Rickettsia, Doxycycline.
{"title":"Scrub Typhus - A Case Series","authors":"P. Sneka, V. Sangamithra, K. Hamsadwani","doi":"10.46347/jmsh.v8i2.21.211","DOIUrl":"https://doi.org/10.46347/jmsh.v8i2.21.211","url":null,"abstract":"Scrub typhus accounts for a considerable number of cases presenting with acute febrile illness with rash. The clinical presentation of the illness varies from non-specific illness to fatal disease. It is very important to have a high index of suspicion and to diagnose the disease at an early stage to prevent morbidity and mortality due to disease complications. KEYWORDS: Scrub, Rickettsia, Doxycycline.","PeriodicalId":33653,"journal":{"name":"Journal of Medical Sciences and Health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46905121","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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