Pub Date : 2023-04-01DOI: 10.4103/injms.injms_2_23
O. Olorunfemi, I. Awe, G. Ogbeye, O. Oluwagbemi, W. Tijani
Background: Many human rights issues addressed by various right conventions center on breastfeeding. One of these is the Convention on the Rights of the Child, which outlines fundamental human rights for children, such as the right to life, the right to develop to their full potential, and the right to be protected from harmful influences. Aims: The aim of this study was to evaluate the elements affecting working-class women's exclusive breastfeeding. Materials and Methods: The sample size (n = 196) for a descriptive cross-sectional study that ran from September 2022 to December 2022 was determined using a multistage sampling procedure. Tables, percentages, and Chi-square test statistics were employed at the 0.05 level of significance to examine the data using the Statistical Package Service Software (SPSS) version 23.0. Results: 48% of the respondents were within the age of 30 and 39 years. The majority of respondents (98%) identified the following factors as influencing the practice of exclusive breastfeeding among working-class women: job (93.9%), sore nipple (86.2%), insufficient lactation (43.9%), nipple not prominent (15.8%), not allowed by work (93.9%), breast milk alone before 6 months does not satisfy my baby (58.7%), lack of support from husband (67.9%), mother-in-law (76.5%), as well as inadequate maternity leave (67.9%) as the factors influencing the practice of exclusive breastfeeding among working-class women. In addition, this study shows a significant correlation between working-class women's Knowledge of exclusive breastfeeding and age (Chi-square = 6.016, df = 3, P = 0.024) and the number of children they had (Chi-square = 5.816, df = 3, P = 0.011). Conclusions: This study therefore suggests, among other things, that the state and federal Ministries of Labor and Employment set up childcare for the infant close to the mothers' places of employment to allow their babies to be brought to the workplace or breastfeeding mothers to go to the childcare facility at the time of breastfeeding.
{"title":"Factors working against exclusive breastfeeding among working-class women living around Dagiri Gwagwalada Area Council, Abuja","authors":"O. Olorunfemi, I. Awe, G. Ogbeye, O. Oluwagbemi, W. Tijani","doi":"10.4103/injms.injms_2_23","DOIUrl":"https://doi.org/10.4103/injms.injms_2_23","url":null,"abstract":"Background: Many human rights issues addressed by various right conventions center on breastfeeding. One of these is the Convention on the Rights of the Child, which outlines fundamental human rights for children, such as the right to life, the right to develop to their full potential, and the right to be protected from harmful influences. Aims: The aim of this study was to evaluate the elements affecting working-class women's exclusive breastfeeding. Materials and Methods: The sample size (n = 196) for a descriptive cross-sectional study that ran from September 2022 to December 2022 was determined using a multistage sampling procedure. Tables, percentages, and Chi-square test statistics were employed at the 0.05 level of significance to examine the data using the Statistical Package Service Software (SPSS) version 23.0. Results: 48% of the respondents were within the age of 30 and 39 years. The majority of respondents (98%) identified the following factors as influencing the practice of exclusive breastfeeding among working-class women: job (93.9%), sore nipple (86.2%), insufficient lactation (43.9%), nipple not prominent (15.8%), not allowed by work (93.9%), breast milk alone before 6 months does not satisfy my baby (58.7%), lack of support from husband (67.9%), mother-in-law (76.5%), as well as inadequate maternity leave (67.9%) as the factors influencing the practice of exclusive breastfeeding among working-class women. In addition, this study shows a significant correlation between working-class women's Knowledge of exclusive breastfeeding and age (Chi-square = 6.016, df = 3, P = 0.024) and the number of children they had (Chi-square = 5.816, df = 3, P = 0.011). Conclusions: This study therefore suggests, among other things, that the state and federal Ministries of Labor and Employment set up childcare for the infant close to the mothers' places of employment to allow their babies to be brought to the workplace or breastfeeding mothers to go to the childcare facility at the time of breastfeeding.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"73 - 76"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46697804","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 : 2023-04-01DOI: 10.4103/injms.injms_136_22
Soumya Bhowmik, K. Anand
There have been well-known headache precipitants already documented in the literature. Laughter has previously been found as a rare trigger of headache in some individuals. Laughter-induced headache is a rare type of triggered headache which can share some similarities with primary cough headache or primary exercise headache. We report a case of abrupt onset, bilateral temporo-occipital headache, typically triggered exclusively by loud laughter in a 30-year-old male, with normal neurological examination and neuroimaging brain. The patient has shown some excellent responses to treatment with sodium valproate.
{"title":"Laughter-induced headache? Yes, it is possible!","authors":"Soumya Bhowmik, K. Anand","doi":"10.4103/injms.injms_136_22","DOIUrl":"https://doi.org/10.4103/injms.injms_136_22","url":null,"abstract":"There have been well-known headache precipitants already documented in the literature. Laughter has previously been found as a rare trigger of headache in some individuals. Laughter-induced headache is a rare type of triggered headache which can share some similarities with primary cough headache or primary exercise headache. We report a case of abrupt onset, bilateral temporo-occipital headache, typically triggered exclusively by loud laughter in a 30-year-old male, with normal neurological examination and neuroimaging brain. The patient has shown some excellent responses to treatment with sodium valproate.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"104 - 105"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49356854","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 : 2023-04-01DOI: 10.4103/injms.injms_11_23
Tahereh Navadifar, Saba Karam, A. Emamie, Atieh Darbandi
A 30-year-old female who underwent an emergency cesarean section reported that the breast pump tubing, infant's pacifier, and soiled diapers turned pinkish after 24 h. Serratia marcescens was isolated from the mother's breast milk, breast pump tubing, and infant's stool. This mother had no mastitis or fever symptoms but received antibiotic therapy due to endometriosis and urinary tract infection. The infant had abdominal cramps, heartburn, and frequent bowel movements; however, he was afebrile and received no antibiotics. After 3 months, this infant returned to breastfeeding as his diaper's pinkish color disappeared and the culture of the mother's breast milk was negative.
{"title":"Identification of Serratia marcescens in a mother's expressed breast milk","authors":"Tahereh Navadifar, Saba Karam, A. Emamie, Atieh Darbandi","doi":"10.4103/injms.injms_11_23","DOIUrl":"https://doi.org/10.4103/injms.injms_11_23","url":null,"abstract":"A 30-year-old female who underwent an emergency cesarean section reported that the breast pump tubing, infant's pacifier, and soiled diapers turned pinkish after 24 h. Serratia marcescens was isolated from the mother's breast milk, breast pump tubing, and infant's stool. This mother had no mastitis or fever symptoms but received antibiotic therapy due to endometriosis and urinary tract infection. The infant had abdominal cramps, heartburn, and frequent bowel movements; however, he was afebrile and received no antibiotics. After 3 months, this infant returned to breastfeeding as his diaper's pinkish color disappeared and the culture of the mother's breast milk was negative.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"113 - 115"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48158922","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 : 2023-04-01DOI: 10.4103/injms.injms_8_23
Anwita Khaitan, S. Rai, A. Krishnan, S. Gupta, S. Kant, G. Khilnani
Introduction: Treatment loss-to-follow-up (LTFU) is a great obstacle to tuberculosis (TB) elimination. Our objective was to estimate its prevalence in district Faridabad, Haryana, and to see its association with selected variables. Materials and Methods: We conducted a desk review of TB notification registers of two TB units under a district TB center, Faridabad. All patients registered between October 1, 2016, and September 30, 2017, were analyzed. Following univariate analysis, factors with P < 0.2 were included in the multivariable logistic regression model. Results: Of 999 eligible patients, 742 (74.2%) had treatment outcomes available. LTFU was estimated to be 3.5%, with cumulative incidence calculated to be 6.63 LTFUs per 100 person-years. LTFU increased with increasing age. LTFU was 5.2% (9.8 LTFUs per 100 person-years) and 0.3% (0.6 LTFUs per 100 person-years) among pulmonary TB (PTB) and extra-PTB (EPTB) patients, respectively. LTFU was higher in patients with previous relapse (9% or 14.2 LTFU per 100 person-years) and previous LTFU (16% or 32 LTFUs per 100 person-years) as compared to only 2.4% (4.7 per 100 person-years) among new patients. PTB patients and patients on treatment after prior LTFU had 12 times and 5 times higher odds of LTFU than EPTB patients and new patients, respectively. Conclusion: The observed LTFU burden is lower than the <5% target set by the National TB Elimination Program. Lack of information on outcomes under the program should be cause for concern. Special attention should be paid under the program on high-risk groups identified to ensure treatment adherence.
{"title":"Loss-to-follow-up rate among tuberculosis patients registered at two tuberculosis units of ballabgarh block of district Faridabad, Haryana: A desk review","authors":"Anwita Khaitan, S. Rai, A. Krishnan, S. Gupta, S. Kant, G. Khilnani","doi":"10.4103/injms.injms_8_23","DOIUrl":"https://doi.org/10.4103/injms.injms_8_23","url":null,"abstract":"Introduction: Treatment loss-to-follow-up (LTFU) is a great obstacle to tuberculosis (TB) elimination. Our objective was to estimate its prevalence in district Faridabad, Haryana, and to see its association with selected variables. Materials and Methods: We conducted a desk review of TB notification registers of two TB units under a district TB center, Faridabad. All patients registered between October 1, 2016, and September 30, 2017, were analyzed. Following univariate analysis, factors with P < 0.2 were included in the multivariable logistic regression model. Results: Of 999 eligible patients, 742 (74.2%) had treatment outcomes available. LTFU was estimated to be 3.5%, with cumulative incidence calculated to be 6.63 LTFUs per 100 person-years. LTFU increased with increasing age. LTFU was 5.2% (9.8 LTFUs per 100 person-years) and 0.3% (0.6 LTFUs per 100 person-years) among pulmonary TB (PTB) and extra-PTB (EPTB) patients, respectively. LTFU was higher in patients with previous relapse (9% or 14.2 LTFU per 100 person-years) and previous LTFU (16% or 32 LTFUs per 100 person-years) as compared to only 2.4% (4.7 per 100 person-years) among new patients. PTB patients and patients on treatment after prior LTFU had 12 times and 5 times higher odds of LTFU than EPTB patients and new patients, respectively. Conclusion: The observed LTFU burden is lower than the <5% target set by the National TB Elimination Program. Lack of information on outcomes under the program should be cause for concern. Special attention should be paid under the program on high-risk groups identified to ensure treatment adherence.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"82 - 87"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41805199","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 : 2023-04-01DOI: 10.4103/injms.injms_142_22
J. Kausik, D. Divya, S. Parthasarathy
A 29-year-old primigravida parturient at term with a known case of hypothyroidism for the past 1 year was taken for emergency cesarean section in view of fetal distress. The patient's medical history showed a history of galactorrhea, for which magnetic resonance imaging of the brain and the routine blood investigations were normal. The parturient was posted for emergency cesarean section due to fetal distress. There was no significant comorbid illness or illicit drug intake. All the basic investigations including the thyroid-stimulating hormone were normal. Spinal anesthesia with 2.0 ml of 0.5% hyperbaric bupivacaine to achieve a level of T6 was performed. After the delivery of the fetus, there was a sudden seizure occurred, and the mother lost her consciousness. The hemodynamics remained stable. The patient was given oxygen, 2 mg of intravenous midazolam, and magnesium sulfate by the Pritchard regimen. The newborn's Apgar scores were normal. She had no recollection of the seizure attack after regaining consciousness and normal spontaneous respiration which occurred in a few minutes. Breastfeeding was recommended. To avoid another seizure episode, the Pritchard regimen was followed. The recovery period was uneventful. A cranial computed tomography scan of the brain was also performed, which revealed no abnormalities. Serum electrolytes were within the normal range when tested again. This case is being reported to raise awareness of seizures in nonhypertensive patients.
{"title":"Sudden and unexpected seizure during emergency cesarean section in a nonhypertensive hypothyroid primigravida","authors":"J. Kausik, D. Divya, S. Parthasarathy","doi":"10.4103/injms.injms_142_22","DOIUrl":"https://doi.org/10.4103/injms.injms_142_22","url":null,"abstract":"A 29-year-old primigravida parturient at term with a known case of hypothyroidism for the past 1 year was taken for emergency cesarean section in view of fetal distress. The patient's medical history showed a history of galactorrhea, for which magnetic resonance imaging of the brain and the routine blood investigations were normal. The parturient was posted for emergency cesarean section due to fetal distress. There was no significant comorbid illness or illicit drug intake. All the basic investigations including the thyroid-stimulating hormone were normal. Spinal anesthesia with 2.0 ml of 0.5% hyperbaric bupivacaine to achieve a level of T6 was performed. After the delivery of the fetus, there was a sudden seizure occurred, and the mother lost her consciousness. The hemodynamics remained stable. The patient was given oxygen, 2 mg of intravenous midazolam, and magnesium sulfate by the Pritchard regimen. The newborn's Apgar scores were normal. She had no recollection of the seizure attack after regaining consciousness and normal spontaneous respiration which occurred in a few minutes. Breastfeeding was recommended. To avoid another seizure episode, the Pritchard regimen was followed. The recovery period was uneventful. A cranial computed tomography scan of the brain was also performed, which revealed no abnormalities. Serum electrolytes were within the normal range when tested again. This case is being reported to raise awareness of seizures in nonhypertensive patients.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"106 - 108"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42793370","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 : 2023-04-01DOI: 10.4103/injms.injms_7_23
H. Patel, Balaganapathy Muruganantham
Background: Knee osteoarthritis is one of the leading causes of the increasing global burden of musculoskeletal disorders. The prevalence rate of patellofemoral arthritis is 39% in South Asia in >40 years of age. The census on early osteoarthritis recommends focusing on the prediagnostic stage. However, none of the tools is available to screen the early symptoms of patellofemoral arthritis. Purpose of the Study: The purpose of this study was to develop and evaluate the psychometric properties of the CHARUSAT Patellofemoral Arthritis Questionnaire. Methods: The questionnaire was developed using a mixed method stepwise approach. The participant with early patellofemoral arthritis (n = 14) was interviewed. We conducted scoping review and in-depth interviews to develop a conceptual framework. Initial content validation was completed through community consultation and expert opinion. Final psychometric validation was conducted on n = 310 individuals with early patellofemoral arthritis. Participants were recruited from tertiary hospitals' outpatient units and regional communities in India. Results: Conceptual framework was developed based on the current literature review, and qualitative data obtained from participants finalized the 4 domains and 12 content versions: crepitus (2 items), stiffness (2 items), pain (2 items), and difficulty in functional activity (6 items). The psychometric measurement demonstrated good internal consistency, Cronbach's alpha α was 0.90 and an acceptable level of inter-item redundancy. The intraclass correlation coefficient (ICC) value for the test and retest assessment was 0.93 (ICC:2,1; 95% confidence interval = 0.880–0.936; P < 0.000). Principal component analysis demonstrates a four-factor solution with 56.83% total variance. Conclusions: It is an acceptable, reliable, and valid self-administered questionnaire that can identify the early symptoms of patellofemoral arthritis. The questionnaire provides an excellent opportunity for self-analysis of the symptoms at the community level.
{"title":"Development and preliminary evaluation of the CHARUSAT patellofemoral arthritis questionnaire: A psychometric study","authors":"H. Patel, Balaganapathy Muruganantham","doi":"10.4103/injms.injms_7_23","DOIUrl":"https://doi.org/10.4103/injms.injms_7_23","url":null,"abstract":"Background: Knee osteoarthritis is one of the leading causes of the increasing global burden of musculoskeletal disorders. The prevalence rate of patellofemoral arthritis is 39% in South Asia in >40 years of age. The census on early osteoarthritis recommends focusing on the prediagnostic stage. However, none of the tools is available to screen the early symptoms of patellofemoral arthritis. Purpose of the Study: The purpose of this study was to develop and evaluate the psychometric properties of the CHARUSAT Patellofemoral Arthritis Questionnaire. Methods: The questionnaire was developed using a mixed method stepwise approach. The participant with early patellofemoral arthritis (n = 14) was interviewed. We conducted scoping review and in-depth interviews to develop a conceptual framework. Initial content validation was completed through community consultation and expert opinion. Final psychometric validation was conducted on n = 310 individuals with early patellofemoral arthritis. Participants were recruited from tertiary hospitals' outpatient units and regional communities in India. Results: Conceptual framework was developed based on the current literature review, and qualitative data obtained from participants finalized the 4 domains and 12 content versions: crepitus (2 items), stiffness (2 items), pain (2 items), and difficulty in functional activity (6 items). The psychometric measurement demonstrated good internal consistency, Cronbach's alpha α was 0.90 and an acceptable level of inter-item redundancy. The intraclass correlation coefficient (ICC) value for the test and retest assessment was 0.93 (ICC:2,1; 95% confidence interval = 0.880–0.936; P < 0.000). Principal component analysis demonstrates a four-factor solution with 56.83% total variance. Conclusions: It is an acceptable, reliable, and valid self-administered questionnaire that can identify the early symptoms of patellofemoral arthritis. The questionnaire provides an excellent opportunity for self-analysis of the symptoms at the community level.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"1 1","pages":"77 - 81"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70773337","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 : 2023-04-01DOI: 10.4103/injms.injms_5_23
G. Yıldız, F. Selvi, C. Bedel, Ökkeş Zortuk, M. Korkut, U. Mutlucan
Objective: Acute cholecystitis (AC) is a condition caused by acute inflammation of gallbladder. Many inflammatory markers are frequently used in the diagnostic process. In this study, we wanted to show the diagnostic efficacy of the systemic inflammatory response index (SIRI) and systemic immune inflammation index (SII) in patients with AC. Methods: This retrospective study was conducted in subjects diagnosed with AC between January 1, 2020, and June 1, 2022. The control group was randomly selected from subjects who attended to the emergency department with abdominal pain and did not need hospitalization, among subjects of similar age and gender to our study group. Demographic data and laboratory parameters of the patients were collected. Results: One hundred and thirty-three AC patients who met the inclusion criteria were included. Eighty-five patients with similar demographic data were included as a control group. The mean median SIRI levels of the patients were significantly higher than the control group (2.88 vs. 1.35; P < 0.001). In addition, the median SII levels of the patients were found to be significantly higher than the control group (1019.42 vs. 573.80; P < 0.001). Conclusions: We found that SIRI and SII are markers that can be used diagnostically in patients with AC and can be used as an option to C-reactive protein.
目的:急性胆囊炎是一种由胆囊急性炎症引起的疾病。在诊断过程中经常使用许多炎症标志物。在本研究中，我们希望展示全身炎症反应指数(SIRI)和全身免疫炎症指数(SII)对AC患者的诊断效果。方法:本回顾性研究在2020年1月1日至2022年6月1日期间诊断为AC的受试者中进行。对照组随机选择在与本研究组年龄、性别相近的就诊于急诊科且不需要住院治疗的腹痛患者。收集患者的人口学资料和实验室参数。结果:133例AC患者符合纳入标准。85例人口统计学资料相似的患者作为对照组。患者的SIRI平均中位水平显著高于对照组(2.88 vs 1.35;P < 0.001)。此外，发现患者的SII中位数水平显著高于对照组(1019.42 vs 573.80;P < 0.001)。结论:我们发现SIRI和SII是可用于AC患者诊断的标记物，可作为c反应蛋白的一种选择。
{"title":"Systemic inflammation response index and systemic immune inflammation index for predicting acute cholecystitis","authors":"G. Yıldız, F. Selvi, C. Bedel, Ökkeş Zortuk, M. Korkut, U. Mutlucan","doi":"10.4103/injms.injms_5_23","DOIUrl":"https://doi.org/10.4103/injms.injms_5_23","url":null,"abstract":"Objective: Acute cholecystitis (AC) is a condition caused by acute inflammation of gallbladder. Many inflammatory markers are frequently used in the diagnostic process. In this study, we wanted to show the diagnostic efficacy of the systemic inflammatory response index (SIRI) and systemic immune inflammation index (SII) in patients with AC. Methods: This retrospective study was conducted in subjects diagnosed with AC between January 1, 2020, and June 1, 2022. The control group was randomly selected from subjects who attended to the emergency department with abdominal pain and did not need hospitalization, among subjects of similar age and gender to our study group. Demographic data and laboratory parameters of the patients were collected. Results: One hundred and thirty-three AC patients who met the inclusion criteria were included. Eighty-five patients with similar demographic data were included as a control group. The mean median SIRI levels of the patients were significantly higher than the control group (2.88 vs. 1.35; P < 0.001). In addition, the median SII levels of the patients were found to be significantly higher than the control group (1019.42 vs. 573.80; P < 0.001). Conclusions: We found that SIRI and SII are markers that can be used diagnostically in patients with AC and can be used as an option to C-reactive protein.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"88 - 92"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43617663","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 : 2023-04-01DOI: 10.4103/injms.injms_9_23
Suraj Hiwarkar, M. Holay, Bhiwagade Rahul, Patil Prashant
Background: Zinc increases the natural defense of reactive oxygen radicals; Zinc also acts as an antioxidant, an anti-apoptotic agent, a cofactor for DNA synthesis, and an anti-inflammatory agent. Hence, deficient zinc levels seem to have an effect in the pathogenesis of hepatic encephalopathy (HE). Aims: This prospective observational study was done to assess serum zinc levels in cases of liver cirrhosis with decompensated liver disease (DCLD) and to see the correlation of serum zinc levels with stages of HE and patients' outcome. Materials and Methods: This prospective observational study was conducted at a tertiary care institution in Central India. Total 66 cases of liver cirrhosis with DCLD were studied. Fifty healthy controls were enrolled. All cases were evaluated for serum zinc levels, and all were divided further according to the class of liver cirrhosis and stages of HE. The association between serum zinc level and stages of HE and outcome was studied. The data were analyzed with SPSS software version 22. Results: The mean age of the cases at presentation was 45.67 ± 8.73 years. The M: F ratio was 10:1. The mean serum zinc level in controls was 104.16 ± 22.60 μg/dl, while in cases, it was 47.68 ± 16.72 μg/dl. It was significantly low in cases as compared to the controls, P < 0.0001. An inverse correlation was observed between serum zinc and West Haven classification grading of HE. There was found a direct correlation between serum zinc level and serum albumin. The lesser the serum albumin, the lesser the serum zinc level. P <0.0001 was highly significant. The mean serum zinc level was 57.67 μg/dl in survivors 40 cases (60.61%) as compared to 32.30 μg/dl in nonsurvivors 26 (39.30%). Low serum zinc level was associated with high mortality. P <0.0001 was statistically highly significant. Conclusion: Low serum zinc is associated with cirrhosis of the liver, DCLD, and high incidence of HE. Hence, all patients of cirrhosis liver with hypoalbuminemia and HE should be evaluated for low serum zinc. Low serum zinc in HE was associated with high mortality. The present study could not establish a causal relationship between low serum zinc and liver cirrhosis with DCLD having HE. Whether correction of zinc in these cases can prevent worsening, HE needs further evaluation.
{"title":"Study of serum zinc level in liver cirrhosis and its correlation with stages of hepatic encephalopathy","authors":"Suraj Hiwarkar, M. Holay, Bhiwagade Rahul, Patil Prashant","doi":"10.4103/injms.injms_9_23","DOIUrl":"https://doi.org/10.4103/injms.injms_9_23","url":null,"abstract":"Background: Zinc increases the natural defense of reactive oxygen radicals; Zinc also acts as an antioxidant, an anti-apoptotic agent, a cofactor for DNA synthesis, and an anti-inflammatory agent. Hence, deficient zinc levels seem to have an effect in the pathogenesis of hepatic encephalopathy (HE). Aims: This prospective observational study was done to assess serum zinc levels in cases of liver cirrhosis with decompensated liver disease (DCLD) and to see the correlation of serum zinc levels with stages of HE and patients' outcome. Materials and Methods: This prospective observational study was conducted at a tertiary care institution in Central India. Total 66 cases of liver cirrhosis with DCLD were studied. Fifty healthy controls were enrolled. All cases were evaluated for serum zinc levels, and all were divided further according to the class of liver cirrhosis and stages of HE. The association between serum zinc level and stages of HE and outcome was studied. The data were analyzed with SPSS software version 22. Results: The mean age of the cases at presentation was 45.67 ± 8.73 years. The M: F ratio was 10:1. The mean serum zinc level in controls was 104.16 ± 22.60 μg/dl, while in cases, it was 47.68 ± 16.72 μg/dl. It was significantly low in cases as compared to the controls, P < 0.0001. An inverse correlation was observed between serum zinc and West Haven classification grading of HE. There was found a direct correlation between serum zinc level and serum albumin. The lesser the serum albumin, the lesser the serum zinc level. P <0.0001 was highly significant. The mean serum zinc level was 57.67 μg/dl in survivors 40 cases (60.61%) as compared to 32.30 μg/dl in nonsurvivors 26 (39.30%). Low serum zinc level was associated with high mortality. P <0.0001 was statistically highly significant. Conclusion: Low serum zinc is associated with cirrhosis of the liver, DCLD, and high incidence of HE. Hence, all patients of cirrhosis liver with hypoalbuminemia and HE should be evaluated for low serum zinc. Low serum zinc in HE was associated with high mortality. The present study could not establish a causal relationship between low serum zinc and liver cirrhosis with DCLD having HE. Whether correction of zinc in these cases can prevent worsening, HE needs further evaluation.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"93 - 96"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43866537","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 : 2023-04-01DOI: 10.4103/injms.injms_47_23
N. Sethi, Ashwani Kumar, N. Prakash
{"title":"Cardiovascular effects of adult vaccines","authors":"N. Sethi, Ashwani Kumar, N. Prakash","doi":"10.4103/injms.injms_47_23","DOIUrl":"https://doi.org/10.4103/injms.injms_47_23","url":null,"abstract":"","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"14 1","pages":"67 - 68"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47393226","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 : 2023-04-01DOI: 10.4103/injms.injms_12_23
M. Ghorbani, A. Emamie, Pouria Zolfaghari, Atefeh Zarei
Introduction: The ESKAPE acronym refers to a group of deadly hospital-acquired pathogens, including Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. These organisms can evade antibacterial drugs and pose a significant threat to public health. This study investigated the prevalence and antimicrobial resistance of ESKAPE pathogens in patients with bacteremia. Methods: We collected 412 blood samples from patients diagnosed with bacteremia. The ESKAPE isolates were subjected to multidrug-resistant (MDR), extensively drug-resistant (XDR), extended-spectrum beta-lactamase (ESBL), metallo-β-lactamase (MBL), methicillin-resistant S. aureus (MRSA), and vancomycin-resistant Enterococcus (VRE) by the disk diffusion and E-test methods. In the case of VRE, molecular detection was done for vanA and vanB genes. Results: A total of 270 ESKAPE isolates were identified. The frequency of S. aureus was 30%, A. baumannii 22%, P. aeruginosa 17%, K. pneumoniae 13%, E. aerogenes 10.3%, and E. faecium 7.7%. MRSA was 71% and VRE was 19%. ESBL- and MBL-producing strains of A. baumannii were found to account for 39%, P. aeruginosa for 35.7% and 28.2%, and K. pneumoniae for 25.7% and 17.1%. In total, MDR and XDR were present in 52.2% and 15.5% of isolates and were most prevalent in E. aerogenes, A. baumannii, and P. aeruginosa. The vanA gene was detected in all 19% of E. faecium isolates that were VRE. Conclusions: Antibiotic resistance is widespread among ESKAPE pathogens, particularly in patients with bacteremia. Health-care professionals must consider the increasing rates of antibiotic resistance among ESKAPE pathogens and implement new measures to control infections.
{"title":"Prevalence and antibiotic resistance of ESKAPE pathogens isolated from patients with bacteremia in Tehran, Iran","authors":"M. Ghorbani, A. Emamie, Pouria Zolfaghari, Atefeh Zarei","doi":"10.4103/injms.injms_12_23","DOIUrl":"https://doi.org/10.4103/injms.injms_12_23","url":null,"abstract":"Introduction: The ESKAPE acronym refers to a group of deadly hospital-acquired pathogens, including Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. These organisms can evade antibacterial drugs and pose a significant threat to public health. This study investigated the prevalence and antimicrobial resistance of ESKAPE pathogens in patients with bacteremia. Methods: We collected 412 blood samples from patients diagnosed with bacteremia. The ESKAPE isolates were subjected to multidrug-resistant (MDR), extensively drug-resistant (XDR), extended-spectrum beta-lactamase (ESBL), metallo-β-lactamase (MBL), methicillin-resistant S. aureus (MRSA), and vancomycin-resistant Enterococcus (VRE) by the disk diffusion and E-test methods. In the case of VRE, molecular detection was done for vanA and vanB genes. Results: A total of 270 ESKAPE isolates were identified. The frequency of S. aureus was 30%, A. baumannii 22%, P. aeruginosa 17%, K. pneumoniae 13%, E. aerogenes 10.3%, and E. faecium 7.7%. MRSA was 71% and VRE was 19%. ESBL- and MBL-producing strains of A. baumannii were found to account for 39%, P. aeruginosa for 35.7% and 28.2%, and K. pneumoniae for 25.7% and 17.1%. In total, MDR and XDR were present in 52.2% and 15.5% of isolates and were most prevalent in E. aerogenes, A. baumannii, and P. aeruginosa. The vanA gene was detected in all 19% of E. faecium isolates that were VRE. Conclusions: Antibiotic resistance is widespread among ESKAPE pathogens, particularly in patients with bacteremia. Health-care professionals must consider the increasing rates of antibiotic resistance among ESKAPE pathogens and implement new measures to control infections.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":"1 1","pages":"97 - 103"},"PeriodicalIF":0.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70771903","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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