Pub Date : 2021-06-01DOI: 10.1177/26339447221098465
Jaideep Dey, Nadeem Akhtar, V. Shama, Arif Mustaqueem, S. Shrivastava
Discrete subaortic stenosis is an uncommon condition in the elderly population. Echocardiographic examination can be useful for diagnosis with high accuracy. We present a case report of an elderly female patient who presented with accelerated hypertension and was subsequently diagnosed with discrete subaortic stenosis on transthoracic echocardiography. A significant, non-dynamic, left ventricular outflow tract pressure gradient in the presence of aortic regurgitation should raise the possibility of this condition in patients of geriatric age group.
{"title":"Discrete Subaortic Stenosis in an Elderly Patient","authors":"Jaideep Dey, Nadeem Akhtar, V. Shama, Arif Mustaqueem, S. Shrivastava","doi":"10.1177/26339447221098465","DOIUrl":"https://doi.org/10.1177/26339447221098465","url":null,"abstract":"Discrete subaortic stenosis is an uncommon condition in the elderly population. Echocardiographic examination can be useful for diagnosis with high accuracy. We present a case report of an elderly female patient who presented with accelerated hypertension and was subsequently diagnosed with discrete subaortic stenosis on transthoracic echocardiography. A significant, non-dynamic, left ventricular outflow tract pressure gradient in the presence of aortic regurgitation should raise the possibility of this condition in patients of geriatric age group.","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"32 1","pages":"47 - 50"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72951172","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 : 2021-06-01DOI: 10.1177/26339447221096200
K. Parvathy, A. Reghukumar, Athul Gurudas, K. Sasidharan, Lakshmi J. Nair
Herpes simplex hepatitis can progress to fulminant hepatic failure in immunocompromised patients as well as in pregnancy due to alterations in T cell-mediated immunity in these populations. If not identified early, herpes simplex virus (HSV) hepatitis will progress to fulminant hepatic failure requiring liver transplantation. Early identification and treatment with acyclovir can be life-saving as HSV hepatitis in pregnancy has been found to be associated with high mortality rate. We report the case of a 23-year-old woman who developed HSV-induced fulminant hepatic failure in the third trimester of pregnancy.
{"title":"Herpes Simplex Hepatitis Presenting as Fulminant Hepatic Failure in Pregnancy","authors":"K. Parvathy, A. Reghukumar, Athul Gurudas, K. Sasidharan, Lakshmi J. Nair","doi":"10.1177/26339447221096200","DOIUrl":"https://doi.org/10.1177/26339447221096200","url":null,"abstract":"Herpes simplex hepatitis can progress to fulminant hepatic failure in immunocompromised patients as well as in pregnancy due to alterations in T cell-mediated immunity in these populations. If not identified early, herpes simplex virus (HSV) hepatitis will progress to fulminant hepatic failure requiring liver transplantation. Early identification and treatment with acyclovir can be life-saving as HSV hepatitis in pregnancy has been found to be associated with high mortality rate. We report the case of a 23-year-old woman who developed HSV-induced fulminant hepatic failure in the third trimester of pregnancy.","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"59 1","pages":"44 - 46"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84716433","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 : 2021-06-01DOI: 10.1177/26339447221089124
Shweta Kapote, P. Srikanth
{"title":"Barriers and the Role of Assistive Technology to Access Education for Children with Visually Impaired During COVID-19 Times","authors":"Shweta Kapote, P. Srikanth","doi":"10.1177/26339447221089124","DOIUrl":"https://doi.org/10.1177/26339447221089124","url":null,"abstract":"","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"56 1","pages":"55 - 56"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76276904","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 : 2021-06-01DOI: 10.1177/26339447221084415
M. Prabhakaran, H. Mahapatra, Amandeep Singh, Sanket Patil, Abhisek Gautam
A 35-year-old gentleman who was on maintenance hemodialysis for last 20 months presented with progressive swelling of the left upper limb. Initially, he had right nontunneled internal jugular vein (IJV) catheter followed by left nontunneled IJV catheter through which he received dialysis for 2 months. Further, his left brachiocephalic fistula (BCF) was created 18 months back. Since then, he was on regular thrice weekly dialysis through BCF. He started developing swelling of the left upper limb 8 months after fistula creation, which was gradually increasing. Blood flow was found to be normal during dialysis, examination suggestive of entire left upper limb swelling with thick induration. Doppler showed dilated outflow veins with high flow without any narrowing/stenosis of veins. Computed tomography venography done showed left brachiocephalic vein stenosis. He was found to have mega-fistula secondary to central vein stenosis which was managed successfully being discussed in this case report. Undiagnosed occult central venous stenosis in the prearteriovenous fistula (AVF) construction can manifest in various ways; one of them is as mega-fistula. It is the generalized aneurysmal dilatation of the entire outflow vessels of an AVF. Management option for this condition is limited depending on the etiology, fistula flow has to be reduced either by banding of the vessel or by fistula closure. Assessment of central veins before AVF construction and regular access surveillance in dialysis patients may prevent complications like these.
{"title":"The Hulk Hand!—In a Hemodialysis Patient","authors":"M. Prabhakaran, H. Mahapatra, Amandeep Singh, Sanket Patil, Abhisek Gautam","doi":"10.1177/26339447221084415","DOIUrl":"https://doi.org/10.1177/26339447221084415","url":null,"abstract":"A 35-year-old gentleman who was on maintenance hemodialysis for last 20 months presented with progressive swelling of the left upper limb. Initially, he had right nontunneled internal jugular vein (IJV) catheter followed by left nontunneled IJV catheter through which he received dialysis for 2 months. Further, his left brachiocephalic fistula (BCF) was created 18 months back. Since then, he was on regular thrice weekly dialysis through BCF. He started developing swelling of the left upper limb 8 months after fistula creation, which was gradually increasing. Blood flow was found to be normal during dialysis, examination suggestive of entire left upper limb swelling with thick induration. Doppler showed dilated outflow veins with high flow without any narrowing/stenosis of veins. Computed tomography venography done showed left brachiocephalic vein stenosis. He was found to have mega-fistula secondary to central vein stenosis which was managed successfully being discussed in this case report. Undiagnosed occult central venous stenosis in the prearteriovenous fistula (AVF) construction can manifest in various ways; one of them is as mega-fistula. It is the generalized aneurysmal dilatation of the entire outflow vessels of an AVF. Management option for this condition is limited depending on the etiology, fistula flow has to be reduced either by banding of the vessel or by fistula closure. Assessment of central veins before AVF construction and regular access surveillance in dialysis patients may prevent complications like these.","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"4 1","pages":"27 - 30"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75871865","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 : 2021-06-01DOI: 10.1177/26339447211070986
Sreekumar Sivadasan, A. Reghukumar, Athul Gurudas, Kiran Kumar V. Sasidharan, S. Nair
Vibrio vulnificus is a halophilic marine gram-negative bacillus that is known to cause fulminant primary septicemia and complicated skin and soft tissue infections in humans. Vibrio vulnificus is referred to as flesh-eating bacteria. In the absence of timely detection and treatment, it results in sepsis with mortality of 50% and septic shock with mortality as high as 100%. Primary septicemia occurs following ingestion of contaminated seafood, and wound infections are acquired following exposure of open wounds to contaminated seawater. Early clinical suspicion and initiation of the appropriate antibiotics is essential to ensure good clinical outcome in case of Vibrio vulnificus septicemia. Here we report the case of a fisherman injured in cyclone Ockhi admitted to our hospital with lower limb cellulitis, who was diagnosed as Vibrio vulnificus wound infection. This case emphasizes the importance of history and clinical examination in antibiotic stewardship.
{"title":"Case of an Exotic Skin and Soft Tissue Infection Associated with Cyclone Ockhi","authors":"Sreekumar Sivadasan, A. Reghukumar, Athul Gurudas, Kiran Kumar V. Sasidharan, S. Nair","doi":"10.1177/26339447211070986","DOIUrl":"https://doi.org/10.1177/26339447211070986","url":null,"abstract":"Vibrio vulnificus is a halophilic marine gram-negative bacillus that is known to cause fulminant primary septicemia and complicated skin and soft tissue infections in humans. Vibrio vulnificus is referred to as flesh-eating bacteria. In the absence of timely detection and treatment, it results in sepsis with mortality of 50% and septic shock with mortality as high as 100%. Primary septicemia occurs following ingestion of contaminated seafood, and wound infections are acquired following exposure of open wounds to contaminated seawater. Early clinical suspicion and initiation of the appropriate antibiotics is essential to ensure good clinical outcome in case of Vibrio vulnificus septicemia. Here we report the case of a fisherman injured in cyclone Ockhi admitted to our hospital with lower limb cellulitis, who was diagnosed as Vibrio vulnificus wound infection. This case emphasizes the importance of history and clinical examination in antibiotic stewardship.","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"12 1","pages":"34 - 37"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88186586","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 : 2020-06-01DOI: 10.1177/26339447211058643
Anjana Nalina Kumari Kesavan Nair, Jisharaj Vijayakumari Rajasekharan Nair, S. Swarnabai, R. Sudha, Alice Metilda Mendez, Leela Itty Amma
Introduction The impact of SARS-CoV-2 is not only on physical health but also on mental health. This pandemic raised concerns of fear, anxiety, and stress among patients affected with the disease. Quarantine and home isolation might have created psychological distress and helplessness in patients due to social and economic reasons. This study aimed in assessing the level of perceived stress and factors associated with it among SARS-CoV-2-affected young adults who were under home isolation. Methodology A cross-sectional study was conducted among 147 SARS-CoV-2-affected young adults who were under home isolation during June 2021 to August 2021. A semi-structured proforma was created using KoBo Toolbox for humanitarian response for data collection. Perceived Stress Scale (PSS-10) was used for measurement of stress among COVID-19 patients. The questionnaire was shared in online platform. Data was analyzed using Statistical Package for Social Sciences version 23.0. Significance of association was tested using chi square test and independent sample t test. Logistic regression was done to predict the factors associated with perceived stress. Results Out of the 147 study participants, 56.5% were females and 43.5% were males. Symptoms were present in 94 (63.9%) of patients. The mean age of the study participants was 26 (10.5) years. The mean PSS score was 17.5 (6.4). Among the cases under home isolation, 24.5% had low stress levels, 68% had moderate stress levels, and 7.5% had severe stress levels. Feeling of loneliness during home isolation (odds ratio [OR]: 4.7, 95% confidence interval [CI] [1.9-11.63], P = .008), presence of elderly or under-5 children in the same house (OR: 15.45, 95% CI [2.03-117.5], P = .001), and presence of cough (P = .05) were found to be significantly associated with higher PSS scores. Age and sleep were negatively correlated with stress score. Conclusion One-third of the study participants had moderate to severe levels of perceived stress. Age, sleep hours, presence of cough, presence of under-5 children or elderly in the same house, and feeling of loneliness during home isolation were found to be significantly associated with high perceived stress level scores.
SARS-CoV-2不仅对身体健康有影响，对心理健康也有影响。这次大流行引起了患者的恐惧、焦虑和压力。由于社会和经济原因，隔离和家庭隔离可能会造成患者的心理困扰和无助感。本研究旨在评估在家隔离的受sars - cov -2影响的年轻人的感知压力水平及其相关因素。方法对2021年6月至2021年8月期间居家隔离的147名感染sars - cov -2的年轻成年人进行横断面研究。使用KoBo工具箱创建了半结构化形式，用于人道主义响应数据收集。采用感知压力量表(PSS-10)测量新冠肺炎患者的压力水平。该问卷在网络平台上共享。数据分析使用Statistical Package for Social Sciences version 23.0。采用卡方检验和独立样本t检验检验相关性的显著性。采用Logistic回归预测与感知压力相关的因素。结果147名研究参与者中，56.5%为女性，43.5%为男性。94例(63.9%)患者出现症状。研究参与者的平均年龄为26岁(10.5岁)。PSS平均评分为17.5分(6.4分)。在居家隔离的病例中，24.5%为低压力水平，68%为中等压力水平，7.5%为严重压力水平。家庭隔离期间的孤独感(比值比[OR]: 4.7, 95%可信区间[CI] [1.9-11.63]， P = 0.008)、家中有老人或5岁以下儿童(比值比[OR]: 15.45, 95% CI [2.03-117.5]， P = 0.001)和咳嗽(P = 0.05)与较高的PSS评分显著相关。年龄、睡眠与压力得分呈负相关。三分之一的研究参与者有中度到重度的感知压力。年龄、睡眠时间、咳嗽、5岁以下儿童或老人住在同一所房子里，以及在家隔离期间的孤独感被发现与高感知压力水平得分显著相关。
{"title":"Perceived Stress Levels and Associated Factors Among SARS-CoV-2-Affected Young Adults Under Home Isolation—A Cross-Sectional Study From Kerala, India","authors":"Anjana Nalina Kumari Kesavan Nair, Jisharaj Vijayakumari Rajasekharan Nair, S. Swarnabai, R. Sudha, Alice Metilda Mendez, Leela Itty Amma","doi":"10.1177/26339447211058643","DOIUrl":"https://doi.org/10.1177/26339447211058643","url":null,"abstract":"Introduction The impact of SARS-CoV-2 is not only on physical health but also on mental health. This pandemic raised concerns of fear, anxiety, and stress among patients affected with the disease. Quarantine and home isolation might have created psychological distress and helplessness in patients due to social and economic reasons. This study aimed in assessing the level of perceived stress and factors associated with it among SARS-CoV-2-affected young adults who were under home isolation. Methodology A cross-sectional study was conducted among 147 SARS-CoV-2-affected young adults who were under home isolation during June 2021 to August 2021. A semi-structured proforma was created using KoBo Toolbox for humanitarian response for data collection. Perceived Stress Scale (PSS-10) was used for measurement of stress among COVID-19 patients. The questionnaire was shared in online platform. Data was analyzed using Statistical Package for Social Sciences version 23.0. Significance of association was tested using chi square test and independent sample t test. Logistic regression was done to predict the factors associated with perceived stress. Results Out of the 147 study participants, 56.5% were females and 43.5% were males. Symptoms were present in 94 (63.9%) of patients. The mean age of the study participants was 26 (10.5) years. The mean PSS score was 17.5 (6.4). Among the cases under home isolation, 24.5% had low stress levels, 68% had moderate stress levels, and 7.5% had severe stress levels. Feeling of loneliness during home isolation (odds ratio [OR]: 4.7, 95% confidence interval [CI] [1.9-11.63], P = .008), presence of elderly or under-5 children in the same house (OR: 15.45, 95% CI [2.03-117.5], P = .001), and presence of cough (P = .05) were found to be significantly associated with higher PSS scores. Age and sleep were negatively correlated with stress score. Conclusion One-third of the study participants had moderate to severe levels of perceived stress. Age, sleep hours, presence of cough, presence of under-5 children or elderly in the same house, and feeling of loneliness during home isolation were found to be significantly associated with high perceived stress level scores.","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"61 1","pages":"11 - 16"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79247845","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 : 2020-06-01DOI: 10.1177/26339447211067580
Pranav V. Vasisht
Introduction: Weil syndrome, a rare infectious disorder, is a severe form of the bacterial infection caused by Leptospira bacteria known as leptospirosis. Weil syndrome is characterized by dysfunction of the kidneys and liver, abnormal enlargement of the liver (hepatomegaly), persistent yellowing of the skin, mucous membranes, whites of the eyes (jaundice), and/or alterations in consciousness. In most cases, Weil syndrome occurs among individuals who are exposed to affected animals. Case Presentation and Summary: The investigation of death was done by a team consisting of doctor, junior health inspector, and ASHA workers of the area. We did a qualitative approach of in-depth interview of the wife and daughter-in-law of the deceased for data collection. The patient’s name and other details are not revealed for anonymity. No particular statistical analyses are used for this case reporting. The CARE guidelines were followed for writing this report. Conclusion: Leptospirosis is a disease of outbreak potential and has high case fatality rate. Timely identification of cases and institution of preventive measures is very important in preventing outbreaks. The surveys conducted in the area did not reveal any signs of an imminent or ongoing outbreak of leptospirosis.
{"title":"Weil’s Disease Death Investigation and Outbreak Control Measures Instituted in the Field Area of a Family Health Center in Thiruvananthapuram, Kerala—A Case Report","authors":"Pranav V. Vasisht","doi":"10.1177/26339447211067580","DOIUrl":"https://doi.org/10.1177/26339447211067580","url":null,"abstract":"Introduction: Weil syndrome, a rare infectious disorder, is a severe form of the bacterial infection caused by Leptospira bacteria known as leptospirosis. Weil syndrome is characterized by dysfunction of the kidneys and liver, abnormal enlargement of the liver (hepatomegaly), persistent yellowing of the skin, mucous membranes, whites of the eyes (jaundice), and/or alterations in consciousness. In most cases, Weil syndrome occurs among individuals who are exposed to affected animals. Case Presentation and Summary: The investigation of death was done by a team consisting of doctor, junior health inspector, and ASHA workers of the area. We did a qualitative approach of in-depth interview of the wife and daughter-in-law of the deceased for data collection. The patient’s name and other details are not revealed for anonymity. No particular statistical analyses are used for this case reporting. The CARE guidelines were followed for writing this report. Conclusion: Leptospirosis is a disease of outbreak potential and has high case fatality rate. Timely identification of cases and institution of preventive measures is very important in preventing outbreaks. The surveys conducted in the area did not reveal any signs of an imminent or ongoing outbreak of leptospirosis.","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"41 1","pages":"47 - 50"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81600373","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 : 2020-06-01DOI: 10.1177/26339447211061041
S. Nair, A. Reghukumar, Athul Gurudas, K. Sasidharan, Sreekumar Sivadasan
Aneurysm of the extracranial carotid artery is a rare disease, mycotic pseudoaneurysms being even less common. They are a life-threatening complication of systemic infection and atherosclerosis. Immunocompromised people, including patients with HIV, uncontrolled diabetes melltus, those on immunosuppressants like high-dose steroids, and chemotherapy, are at a higher risk for development of mycotic pseudoaneurysms. Due to the high risk of potential complications like rupture and thromboembolic events, mycotic aneurysms always require surgical management. Early detection followed by restoration of blood flow is critical to minimize a fatal outcome. Here we report the case of a 52-year-old man with a past history of hypertension and dyslipidemia who presented with a pulsatile painful neck swelling. On evaluation, the patient was diagnosed to have Salmonella typhi bacteremia, HIV infection, and a mycotic aneurysm of the left common carotid artery.
{"title":"Case of Mycotic Pseudoaneurysm of the Common Carotid Artery due to Salmonella typhi Bacteremia","authors":"S. Nair, A. Reghukumar, Athul Gurudas, K. Sasidharan, Sreekumar Sivadasan","doi":"10.1177/26339447211061041","DOIUrl":"https://doi.org/10.1177/26339447211061041","url":null,"abstract":"Aneurysm of the extracranial carotid artery is a rare disease, mycotic pseudoaneurysms being even less common. They are a life-threatening complication of systemic infection and atherosclerosis. Immunocompromised people, including patients with HIV, uncontrolled diabetes melltus, those on immunosuppressants like high-dose steroids, and chemotherapy, are at a higher risk for development of mycotic pseudoaneurysms. Due to the high risk of potential complications like rupture and thromboembolic events, mycotic aneurysms always require surgical management. Early detection followed by restoration of blood flow is critical to minimize a fatal outcome. Here we report the case of a 52-year-old man with a past history of hypertension and dyslipidemia who presented with a pulsatile painful neck swelling. On evaluation, the patient was diagnosed to have Salmonella typhi bacteremia, HIV infection, and a mycotic aneurysm of the left common carotid artery.","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"78 1","pages":"39 - 42"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85919181","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 : 2020-06-01DOI: 10.1177/26339447211058621
J. Ramesh, R. Gaitonde
Addressing the double burden of disease in a country like India is a massive challenge, especially when the system is tuned to do monitoring and surveillance of mainly communicable diseases. Achieving the sustainable development goal target 3.4 to bring down the premature mortality from non-communicable diseases (NCDs) to one-third will need to consider the requirement of robust indicators at the national level to keep track of the prevalence of NCD and its risk factors among its population. The state of Kerala in contrast has a strong primary health care system that it can build on to address the rising NCD burden.
{"title":"Evolution of Non-communicable Disease Programs in Kerala: Lessons Learnt and the Way Forward","authors":"J. Ramesh, R. Gaitonde","doi":"10.1177/26339447211058621","DOIUrl":"https://doi.org/10.1177/26339447211058621","url":null,"abstract":"Addressing the double burden of disease in a country like India is a massive challenge, especially when the system is tuned to do monitoring and surveillance of mainly communicable diseases. Achieving the sustainable development goal target 3.4 to bring down the premature mortality from non-communicable diseases (NCDs) to one-third will need to consider the requirement of robust indicators at the national level to keep track of the prevalence of NCD and its risk factors among its population. The state of Kerala in contrast has a strong primary health care system that it can build on to address the rising NCD burden.","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"57 1","pages":"21 - 23"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81355683","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 : 2020-06-01DOI: 10.1177/26339447211053438
Anjum Siddiqui, R. Khan
Celiac disease, an immune-mediated enteropathy, results from gluten ingestion in the form of wheat, rye, and barley in genetically susceptible individuals. It is a systemic disorder characterized by a variable combination of gluten-related signs and symptoms, and disease-specific antibodies in addition to enteropathy. The clinical presentation of celiac disease is extremely variable: a small proportion of patients presenting with severe gastrointestinal symptoms and malabsorption, and extraintestinal symptoms, and a large proportion having no symptoms at all. Owing to the varied clinical presentation, diagnosing celiac disease remains a challenge. We present a case of celiac disease presenting with severe anemia and clinical features suggestive of hemolytic anemia, making diagnosis even more difficult.
{"title":"Celiac Disease Presenting as Hemolytic Anemia Mimic: A Case Report","authors":"Anjum Siddiqui, R. Khan","doi":"10.1177/26339447211053438","DOIUrl":"https://doi.org/10.1177/26339447211053438","url":null,"abstract":"Celiac disease, an immune-mediated enteropathy, results from gluten ingestion in the form of wheat, rye, and barley in genetically susceptible individuals. It is a systemic disorder characterized by a variable combination of gluten-related signs and symptoms, and disease-specific antibodies in addition to enteropathy. The clinical presentation of celiac disease is extremely variable: a small proportion of patients presenting with severe gastrointestinal symptoms and malabsorption, and extraintestinal symptoms, and a large proportion having no symptoms at all. Owing to the varied clinical presentation, diagnosing celiac disease remains a challenge. We present a case of celiac disease presenting with severe anemia and clinical features suggestive of hemolytic anemia, making diagnosis even more difficult.","PeriodicalId":40062,"journal":{"name":"Journal, Indian Academy of Clinical Medicine","volume":"152 1","pages":"36 - 38"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88282432","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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