Pub Date : 2023-11-30DOI: 10.4103/jmms.jmms_102_23
S. Paul, Gunjan Singh, M. Shyam, Arnab Ghosh, Rahul Yadav
Critically ill patients on Non- invasive Ventilation (NIV) or Continuous Positive Airway Pressure (CPAP) tend to desaturate off ventilatory support. Hence, they are unable to meet their nutritional needs, leading to increase in hospital stay. It was evident during the COVID 19 pandemic. The failure rates of NIV were unusually high, from 30-45%. Despite the overall success of the treatment modality, NIV failure rates still range between 18% and 40% in the acute setting. It was seen that the patients on NIV get only 650 Kcal/ day which is far lower than the required energy requirement. There is a need to have an affordable and sustainable solution to deliver adequate nutrition to critically ill patients on NIV and CPAP, which is able to maintain a NG/ OG tube without frequent disconnections from the ventilator. With this fact in mind a NIV mask with inbuilt feeding port (NIV-IFP) was designed. The aim of this case series was to compare the modified NIV-IFP mask with the conventional mask in terms of both effectiveness of ventilation as well as caloric replacement in critically ill patients. For the purpose of this study, we enlisted three patients who were critically ill and required NIV. With the use of NIV-IFP mask we were able to substitute adequate amount of nutrition (2000Kcal to 2500 Kcal) without any discontinuation of NIV application and with minimal leak in the mask. When compared to other available technologies in this field, the NIV mask with the inbuilt feeding port is very economical and can be a boon in third world countries. The placement of this unique mechanism in the mask was instrumental in weaning off patients from NIV and avoided Invasive ventilation. It was proved beyond doubt that addition of this gland nut assembly was extremely effective in delivering adequate nutrition to our patients without compromising on the ventilation.
{"title":"To Compare the Effectiveness of the Innovative Noninvasive Ventilation Mask with Inbuilt Feeding Port versus the Conventional Noninvasive Ventilation Mask in Patients Requiring Prolonged Ventilation: A Case Series","authors":"S. Paul, Gunjan Singh, M. Shyam, Arnab Ghosh, Rahul Yadav","doi":"10.4103/jmms.jmms_102_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_102_23","url":null,"abstract":"Critically ill patients on Non- invasive Ventilation (NIV) or Continuous Positive Airway Pressure (CPAP) tend to desaturate off ventilatory support. Hence, they are unable to meet their nutritional needs, leading to increase in hospital stay. It was evident during the COVID 19 pandemic. The failure rates of NIV were unusually high, from 30-45%. Despite the overall success of the treatment modality, NIV failure rates still range between 18% and 40% in the acute setting. It was seen that the patients on NIV get only 650 Kcal/ day which is far lower than the required energy requirement. There is a need to have an affordable and sustainable solution to deliver adequate nutrition to critically ill patients on NIV and CPAP, which is able to maintain a NG/ OG tube without frequent disconnections from the ventilator. With this fact in mind a NIV mask with inbuilt feeding port (NIV-IFP) was designed. The aim of this case series was to compare the modified NIV-IFP mask with the conventional mask in terms of both effectiveness of ventilation as well as caloric replacement in critically ill patients. For the purpose of this study, we enlisted three patients who were critically ill and required NIV. With the use of NIV-IFP mask we were able to substitute adequate amount of nutrition (2000Kcal to 2500 Kcal) without any discontinuation of NIV application and with minimal leak in the mask. When compared to other available technologies in this field, the NIV mask with the inbuilt feeding port is very economical and can be a boon in third world countries. The placement of this unique mechanism in the mask was instrumental in weaning off patients from NIV and avoided Invasive ventilation. It was proved beyond doubt that addition of this gland nut assembly was extremely effective in delivering adequate nutrition to our patients without compromising on the ventilation.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"9 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139205789","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 : 2023-11-30DOI: 10.4103/jmms.jmms_108_23
V. Chauhan, Ankit Dangi, Arun Kumar Yadav, K. Chatterjee, P. Yadav
During the first wave of the pandemic, health-care workers (HCWs) experienced high levels of stress, depression, and anxiety. These frontline workers remained a vulnerable group with the second wave of the pandemic being more severe than the first wave across the globe. There is a need to assess the psychological impact of the second wave of COVID-19 on HCWs and identify risk factors associated with higher morbidity. This will be beneficial in planning appropriate prevention and remedial measures. Consecutive 1275 HCWs (between the age group of 18 and 60 years) responded to the online survey. After the collection of sociodemographic data, participants were administered the Impact of Event Scale-Revised, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 Scale. Moderate-to-severe stress, depression, and anxiety were reported by 40%, 31.7%, and 24.3% of participants, respectively. Regression analysis revealed that female gender, nurses, high COVID-19 exposure, history of COVID-19, chronic medical illness, and work experience between 10 and 20 years were risk factors for increased psychological morbidity. This study demonstrates that stress, anxiety, and depressive symptoms remained high among HCWs during the second wave of COVID-19. Certain risk factors predicted higher mental health morbidity. There is a need to develop appropriate interventions targeting these groups.
{"title":"Psychological Morbidity of the COVID-19 Second Wave in Health-care Workers: A Cross-sectional Online Survey","authors":"V. Chauhan, Ankit Dangi, Arun Kumar Yadav, K. Chatterjee, P. Yadav","doi":"10.4103/jmms.jmms_108_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_108_23","url":null,"abstract":"During the first wave of the pandemic, health-care workers (HCWs) experienced high levels of stress, depression, and anxiety. These frontline workers remained a vulnerable group with the second wave of the pandemic being more severe than the first wave across the globe. There is a need to assess the psychological impact of the second wave of COVID-19 on HCWs and identify risk factors associated with higher morbidity. This will be beneficial in planning appropriate prevention and remedial measures. Consecutive 1275 HCWs (between the age group of 18 and 60 years) responded to the online survey. After the collection of sociodemographic data, participants were administered the Impact of Event Scale-Revised, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 Scale. Moderate-to-severe stress, depression, and anxiety were reported by 40%, 31.7%, and 24.3% of participants, respectively. Regression analysis revealed that female gender, nurses, high COVID-19 exposure, history of COVID-19, chronic medical illness, and work experience between 10 and 20 years were risk factors for increased psychological morbidity. This study demonstrates that stress, anxiety, and depressive symptoms remained high among HCWs during the second wave of COVID-19. Certain risk factors predicted higher mental health morbidity. There is a need to develop appropriate interventions targeting these groups.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"9 5","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139196727","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 : 2023-11-30DOI: 10.4103/jmms.jmms_124_23
N. K. Tarway, S. P. Sharma, Tarun Gupta, V. S. Kanyal, Brajesh Kumar, R. K. Nair
Management of choledocho-cholelithiasis requires a multi-disciplinary approach. It involves clearance of common bile duct stones (CBDS) on the one hand and addressing gallstone disease (GSD) on the other hand. With technological advancements and growing expertise in the fields of endoscopy and laparoscopy, endoscopic retrograde (or radiological) cholangiopancreatography (ERCP) and laparoscopy cholecystectomy (LC) have become modalities of choice for CBDS and GSD, respectively. Conventionally, in patients with choledocho-cholelithiasis, ERCP is performed first followed by LC after an interval of 4–6 weeks. This approach requires two separate admissions involving anesthesia twice, thus increasing the risk related to multiple general anesthesia, higher cost of care, and greater loss of man hours. These issues can be mitigated by the novel approach of single anesthesia ERCP and laparoscopic cholecystectomy (SERLAC). At our center, we follow both approaches, depending on the availability of resources and patient characteristics. This study aims to evaluate the safety of SERLAC. In this retrospective, descriptive study, we analyzed data of patients undergoing SERLAC for outcome, complications, benefits, and constraints. Of the 36 patients who underwent ERCP before LC for choledocho-cholelithiasis, 10 opted for SERLAC. Despite relatively prolonged anesthesia time (mean 85.3 min), owing to both ERCP and LC being performed in the same sitting, no anesthesia-related adverse event was noted. SERLAC was preferred in two cases to avoid exposure to second general anesthesia due to comorbidities such as old age with polytrauma and use of oral anticoagulant related to a prosthetic cardiac valve. Hospital stay was significantly lower (mean 4.3 days) in patients opting for SERLAC and it provided a definite cure for 8 out of 10 patients. The major constraint noted was logistical, in terms of ensuring the availability of the operating room (OR) and teams for both procedures besides setting up the ERCP and laparoscopy workstations in the same OR in quick succession. Our study shows that SERLAC is a safe approach and further studies are required to build consensus. This study has proven that SERLAC is safe and comparable to interval ERCP and LC. It offers a definite cure with a single admission, single anaesthesia, and significantly shorter hospital stay and thus results in much greater patient satisfaction in expert hands.
{"title":"Single Anesthesia ERCP and Laparoscopic Cholecystectomy for Management of Common Bile Duct Stones","authors":"N. K. Tarway, S. P. Sharma, Tarun Gupta, V. S. Kanyal, Brajesh Kumar, R. K. Nair","doi":"10.4103/jmms.jmms_124_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_124_23","url":null,"abstract":"Management of choledocho-cholelithiasis requires a multi-disciplinary approach. It involves clearance of common bile duct stones (CBDS) on the one hand and addressing gallstone disease (GSD) on the other hand. With technological advancements and growing expertise in the fields of endoscopy and laparoscopy, endoscopic retrograde (or radiological) cholangiopancreatography (ERCP) and laparoscopy cholecystectomy (LC) have become modalities of choice for CBDS and GSD, respectively. Conventionally, in patients with choledocho-cholelithiasis, ERCP is performed first followed by LC after an interval of 4–6 weeks. This approach requires two separate admissions involving anesthesia twice, thus increasing the risk related to multiple general anesthesia, higher cost of care, and greater loss of man hours. These issues can be mitigated by the novel approach of single anesthesia ERCP and laparoscopic cholecystectomy (SERLAC). At our center, we follow both approaches, depending on the availability of resources and patient characteristics. This study aims to evaluate the safety of SERLAC. In this retrospective, descriptive study, we analyzed data of patients undergoing SERLAC for outcome, complications, benefits, and constraints. Of the 36 patients who underwent ERCP before LC for choledocho-cholelithiasis, 10 opted for SERLAC. Despite relatively prolonged anesthesia time (mean 85.3 min), owing to both ERCP and LC being performed in the same sitting, no anesthesia-related adverse event was noted. SERLAC was preferred in two cases to avoid exposure to second general anesthesia due to comorbidities such as old age with polytrauma and use of oral anticoagulant related to a prosthetic cardiac valve. Hospital stay was significantly lower (mean 4.3 days) in patients opting for SERLAC and it provided a definite cure for 8 out of 10 patients. The major constraint noted was logistical, in terms of ensuring the availability of the operating room (OR) and teams for both procedures besides setting up the ERCP and laparoscopy workstations in the same OR in quick succession. Our study shows that SERLAC is a safe approach and further studies are required to build consensus. This study has proven that SERLAC is safe and comparable to interval ERCP and LC. It offers a definite cure with a single admission, single anaesthesia, and significantly shorter hospital stay and thus results in much greater patient satisfaction in expert hands.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"63 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139198058","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 : 2023-11-30DOI: 10.4103/jmms.jmms_133_23
M. Tendolkar, Rahul Tyagi, Vikas Marwah, V. Shrinath, Ajay Handa
Sarcoidosis is a multisystem granulomatous disease with an unknown etiology. The role of smoking in the development of sarcoidosis remains unclear. We study the association of smoking with sarcoidosis. Articles reporting the association between smoking and sarcoidosis till June 01, 2023, were retrieved from PubMed and Cochrane Database. A random effect model was used to perform meta-analysis. After screening 192 records, we included seven studies. The total sample size was 1642 cases of sarcoidosis and 4207 controls. The pooled odds ratio was 0.55 (95% confidence interval 0.38–0.79), implying a negative association between sarcoidosis and smoking. There is a decreased risk of sarcoidosis among smokers compared to nonsmokers. Further research is required to ascertain the association between smoking and sarcoidosis.
{"title":"Sarcoidosis and Smoking: A Systematic Review and Meta-analysis","authors":"M. Tendolkar, Rahul Tyagi, Vikas Marwah, V. Shrinath, Ajay Handa","doi":"10.4103/jmms.jmms_133_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_133_23","url":null,"abstract":"Sarcoidosis is a multisystem granulomatous disease with an unknown etiology. The role of smoking in the development of sarcoidosis remains unclear. We study the association of smoking with sarcoidosis. Articles reporting the association between smoking and sarcoidosis till June 01, 2023, were retrieved from PubMed and Cochrane Database. A random effect model was used to perform meta-analysis. After screening 192 records, we included seven studies. The total sample size was 1642 cases of sarcoidosis and 4207 controls. The pooled odds ratio was 0.55 (95% confidence interval 0.38–0.79), implying a negative association between sarcoidosis and smoking. There is a decreased risk of sarcoidosis among smokers compared to nonsmokers. Further research is required to ascertain the association between smoking and sarcoidosis.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":" 27","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139197502","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}
{"title":"Evolution and Innovations in Surgical Residency Education among Global Health Challenges","authors":"Sanjay Kumar, Angshuman Dutta, Rahul Naga, Anuj Singhal","doi":"10.4103/jmms.jmms_123_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_123_23","url":null,"abstract":"","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"119 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139198977","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}
Kirti Jangid, Manish Khandare, Swagta Tambe, Veena Kharayat, Rahul Ray
Although acne is principally a disorder of adolescence, the prevalence of adult acne is increasing. Adult acne has been defined as presence of acne beyond the age of 25 years. Various studies have shown that a significant percentage of adult women with acne failed to respond to treatment with systemic antibiotics and isotretinoin which indicates a need for treatment alternatives with improved effectiveness and acceptable side effects for resistant acne. This study aims to study the response of oral antibiotic therapy and oral hormonal therapy in Adult Acne. The objective of the study is to examine the response of oral antibiotic and oral hormonal therapy along with their side effects in cases diagnosed with adult acne. (i) Study design: Interventional study, (ii) Basis of adequate sample size: All patients diagnosed with adult acne will be considered for study. Seventy-two adult female patients presenting with acne fulfilling the inclusion and exclusion criterias were enrolled for the study. (iii) Sampling frame and method: Written informed consent will be obtained and identity of the participants will be kept confidential. Sequential photographs will be taken after patient’s consent to check the response rate. Data will be analyzed using ‘Friedman test”. Based on the results of our study, it can be concluded that although both antibiotics and hormonal therapy improved acne lesions, but results were statistically significant with hormonal therapy as compared to antibiotic therapy. Both antibiotic and hormonal therapies are safe and effective options for treating adult acne. All patients of adult acne may not have an underlying hormonal imbalance or hyperandrogenism, thus the role of oral antibiotics in the treatment should not be underestimated.
{"title":"Adult Acne: Its Response to Therapy","authors":"Kirti Jangid, Manish Khandare, Swagta Tambe, Veena Kharayat, Rahul Ray","doi":"10.4103/jmms.jmms_94_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_94_23","url":null,"abstract":"Although acne is principally a disorder of adolescence, the prevalence of adult acne is increasing. Adult acne has been defined as presence of acne beyond the age of 25 years. Various studies have shown that a significant percentage of adult women with acne failed to respond to treatment with systemic antibiotics and isotretinoin which indicates a need for treatment alternatives with improved effectiveness and acceptable side effects for resistant acne. This study aims to study the response of oral antibiotic therapy and oral hormonal therapy in Adult Acne. The objective of the study is to examine the response of oral antibiotic and oral hormonal therapy along with their side effects in cases diagnosed with adult acne. (i) Study design: Interventional study, (ii) Basis of adequate sample size: All patients diagnosed with adult acne will be considered for study. Seventy-two adult female patients presenting with acne fulfilling the inclusion and exclusion criterias were enrolled for the study. (iii) Sampling frame and method: Written informed consent will be obtained and identity of the participants will be kept confidential. Sequential photographs will be taken after patient’s consent to check the response rate. Data will be analyzed using ‘Friedman test”. Based on the results of our study, it can be concluded that although both antibiotics and hormonal therapy improved acne lesions, but results were statistically significant with hormonal therapy as compared to antibiotic therapy. Both antibiotic and hormonal therapies are safe and effective options for treating adult acne. All patients of adult acne may not have an underlying hormonal imbalance or hyperandrogenism, thus the role of oral antibiotics in the treatment should not be underestimated.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"71 3","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139196873","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 : 2023-11-30DOI: 10.4103/jmms.jmms_147_23
SantoshV Thoke, Arun Kumar Yadav
Hepatitis C virus (HCV) infection is a major public health concern. Persons living with HCV infection are at risk of developing liver cirrhosis and progressing to end-stage liver disease and liver cancer (hepatocellular carcinoma). The present study was undertaken to assess the prevalence of HCV infection in patients admitted as well as outpatient department services of a Zonal Hospital. The present study was cross-sectional, observational study, conducted in patients >18 years of age, clinically suspected acute infectious hepatitis or admitted to the intensive care unit, and willing to participate in the study. In the present study, 472 patients were studied for hepatitis C infection. Majority of cases were from 51 to 60 years age group (34.5%), followed by 61–70 years age group (26.7%). Female cases were (51.3%) slightly more than male (48.7%). Rapid method and enzyme-linked immunosorbent assay (ELISA) methods detected HCV prevalence as 5.7% and 12.5%, respectively. After HCV genotype testing, the prevalence was 12.1%. Majority had 3A genotype (69.49%), followed by 1A genotype (16.95%), 1B genotype (8.47%), 3B genotype (3.39%), and 4 genotypes (1.69%). ELISA testing was significantly correlated with HCV genotype testing (P = 0.017) while the rapid method was not correlated with HCV genotype testing (P = 0.937). There is a high prevalence of HCV among the suspected, genotype 3 being the most common.
{"title":"Prevalence and Genotype Distribution of Hepatitis C Virus Infection at Zonal hospital in Northern India","authors":"SantoshV Thoke, Arun Kumar Yadav","doi":"10.4103/jmms.jmms_147_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_147_23","url":null,"abstract":"Hepatitis C virus (HCV) infection is a major public health concern. Persons living with HCV infection are at risk of developing liver cirrhosis and progressing to end-stage liver disease and liver cancer (hepatocellular carcinoma). The present study was undertaken to assess the prevalence of HCV infection in patients admitted as well as outpatient department services of a Zonal Hospital. The present study was cross-sectional, observational study, conducted in patients >18 years of age, clinically suspected acute infectious hepatitis or admitted to the intensive care unit, and willing to participate in the study. In the present study, 472 patients were studied for hepatitis C infection. Majority of cases were from 51 to 60 years age group (34.5%), followed by 61–70 years age group (26.7%). Female cases were (51.3%) slightly more than male (48.7%). Rapid method and enzyme-linked immunosorbent assay (ELISA) methods detected HCV prevalence as 5.7% and 12.5%, respectively. After HCV genotype testing, the prevalence was 12.1%. Majority had 3A genotype (69.49%), followed by 1A genotype (16.95%), 1B genotype (8.47%), 3B genotype (3.39%), and 4 genotypes (1.69%). ELISA testing was significantly correlated with HCV genotype testing (P = 0.017) while the rapid method was not correlated with HCV genotype testing (P = 0.937). There is a high prevalence of HCV among the suspected, genotype 3 being the most common.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"33 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139207858","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 : 2023-11-30DOI: 10.4103/jmms.jmms_135_23
Alisha Sharma, A. Sati, Puneet Bhatt, S. Ninawe, Pooja Mahajan, Ankita Patel, Ashish Bahal
Microbial keratitis is a major preventable cause of visual impairment. In developed countries viral infections are the leading cause of corneal ulcer whereas bacteria and fungi attributes to maximum number of cases in the developing countries. There is paucity of recent data, risk factors and demographic distribution of patients for all three leading etiological agents of keratitis. This study included all clinically diagnosed cases of infective keratitis from 01 Jan 2021 to 01 Jan 2022. In brief, four sets of corneal scrapings were taken from patients of infectious keratitis and processed for bacterial and fungal culture, microscopy and RTPCR of viral agents. It was observed that rural elderly males were the most predisposed to occurrence of infectious keratitis and trauma being the leading cause. Out of total 151 samples processed, 49(32%) samples were found to have definitive evidence of bacterial, fungal and viral pathogens. Fungi were found to be the most common 37 (24%) etiological agent leading to keratitis followed by bacterial 7(5%) and viral agents 5(3%). Clinical signs alone are not sufficient to diagnose infectious keratitis, the importance of microbiology in the identification of pathogen and aiming at definitive therapy of infectious keratitis helps in rescuing the eye from this reversible cause of blindness.
{"title":"Microbiological Profile of Infectious Keratitis in a Tertiary Care Hospital","authors":"Alisha Sharma, A. Sati, Puneet Bhatt, S. Ninawe, Pooja Mahajan, Ankita Patel, Ashish Bahal","doi":"10.4103/jmms.jmms_135_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_135_23","url":null,"abstract":"Microbial keratitis is a major preventable cause of visual impairment. In developed countries viral infections are the leading cause of corneal ulcer whereas bacteria and fungi attributes to maximum number of cases in the developing countries. There is paucity of recent data, risk factors and demographic distribution of patients for all three leading etiological agents of keratitis. This study included all clinically diagnosed cases of infective keratitis from 01 Jan 2021 to 01 Jan 2022. In brief, four sets of corneal scrapings were taken from patients of infectious keratitis and processed for bacterial and fungal culture, microscopy and RTPCR of viral agents. It was observed that rural elderly males were the most predisposed to occurrence of infectious keratitis and trauma being the leading cause. Out of total 151 samples processed, 49(32%) samples were found to have definitive evidence of bacterial, fungal and viral pathogens. Fungi were found to be the most common 37 (24%) etiological agent leading to keratitis followed by bacterial 7(5%) and viral agents 5(3%). Clinical signs alone are not sufficient to diagnose infectious keratitis, the importance of microbiology in the identification of pathogen and aiming at definitive therapy of infectious keratitis helps in rescuing the eye from this reversible cause of blindness.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"57 5","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139206330","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}
A. Jayachandra, Admiral Rajat Datta, N. Issar, Prabhat Sharma
Subcutaneous implantable cardioverter-defibrillator (S-ICD) differs from the transvenous ICD (TV-ICD) system in its extrathoracic and extravascular localization, eliminating the risks arising from vascular access and leading to fewer complications. The objective was to describe the functionality and postoperative complications associated with SICD implants in patients with cardiac dysfunctions. We enrolled six patients eligible for SICD due to either anterior wall myocardial infarction or left ventricular dysfunction, who reported to our tertiary cardiac care center from June 2020 to March 2022. Preprocedural evaluation for various cardiac parameters was carried out. The procedure was performed under antibiotic prophylaxis. Two incision techniques were used for the SICD placement. The primary and secondary endpoints for the cases were set to evaluate device-related complications and predictive outcomes, respectively. Subcutaneous implantable defibrillator was placed in six male patients aged 36−51 years. The procedure demonstrated an efficient, reliable, and well-accepted modality in eliminating ventricular tachycardia, ventricular fibrillation, and sudden cardiac death. In addition, postoperative complications, such as device infection, pocket hematoma, blood transfusion, prolonged hospitalization, cardiac perforation or tamponade, lead repositioning, or inappropriate shocks, were not reported in the 2 years of follow-up. Subcutaneous implantable defibrillator promises to offer a suitable and safer option for TV-ICD, especially in young patients. It circumvents the need to enter the vasculature or cardiac chambers. As a result, fewer reported lead-related complications, better cosmetic appearance, and greater immediate postoperative comfort as it permits free shoulder movement.
{"title":"Subcutaneous Implantable Cardioverter-defibrillator in Preventing Ventricular Arrhythmia and Sudden Cardiac Death – A Single-center Experience","authors":"A. Jayachandra, Admiral Rajat Datta, N. Issar, Prabhat Sharma","doi":"10.4103/jmms.jmms_95_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_95_23","url":null,"abstract":"Subcutaneous implantable cardioverter-defibrillator (S-ICD) differs from the transvenous ICD (TV-ICD) system in its extrathoracic and extravascular localization, eliminating the risks arising from vascular access and leading to fewer complications. The objective was to describe the functionality and postoperative complications associated with SICD implants in patients with cardiac dysfunctions. We enrolled six patients eligible for SICD due to either anterior wall myocardial infarction or left ventricular dysfunction, who reported to our tertiary cardiac care center from June 2020 to March 2022. Preprocedural evaluation for various cardiac parameters was carried out. The procedure was performed under antibiotic prophylaxis. Two incision techniques were used for the SICD placement. The primary and secondary endpoints for the cases were set to evaluate device-related complications and predictive outcomes, respectively. Subcutaneous implantable defibrillator was placed in six male patients aged 36−51 years. The procedure demonstrated an efficient, reliable, and well-accepted modality in eliminating ventricular tachycardia, ventricular fibrillation, and sudden cardiac death. In addition, postoperative complications, such as device infection, pocket hematoma, blood transfusion, prolonged hospitalization, cardiac perforation or tamponade, lead repositioning, or inappropriate shocks, were not reported in the 2 years of follow-up. Subcutaneous implantable defibrillator promises to offer a suitable and safer option for TV-ICD, especially in young patients. It circumvents the need to enter the vasculature or cardiac chambers. As a result, fewer reported lead-related complications, better cosmetic appearance, and greater immediate postoperative comfort as it permits free shoulder movement.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"47 92","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139203843","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 : 2023-11-30DOI: 10.4103/jmms.jmms_139_23
N. M. Priya, Gunjan Malhotra, Atul Seth Vsm, M. K. Tangri, V. K. Dalal, Hrishikesh Magdum
Uterocutaneous fistula is a rare pathology that commonly occurs following uterine surgeries, endometriosis, chronic infection, malignancy, and foreign bodies. Many diagnostic and management strategies have been practiced. In this case series, we describe three cases of uterocutaneous fistula following cesarean and myomectomy, which was diagnosed clinically, confirmed by magnetic resonance imaging, and managed successfully by surgery with fertility preservation.
{"title":"Uterocutaneous Fistula – Uncommon Presentation of Common Surgeries","authors":"N. M. Priya, Gunjan Malhotra, Atul Seth Vsm, M. K. Tangri, V. K. Dalal, Hrishikesh Magdum","doi":"10.4103/jmms.jmms_139_23","DOIUrl":"https://doi.org/10.4103/jmms.jmms_139_23","url":null,"abstract":"Uterocutaneous fistula is a rare pathology that commonly occurs following uterine surgeries, endometriosis, chronic infection, malignancy, and foreign bodies. Many diagnostic and management strategies have been practiced. In this case series, we describe three cases of uterocutaneous fistula following cesarean and myomectomy, which was diagnosed clinically, confirmed by magnetic resonance imaging, and managed successfully by surgery with fertility preservation.","PeriodicalId":41773,"journal":{"name":"Journal of Marine Medical Society","volume":"25 29","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139206833","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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