Pub Date : 2022-04-01DOI: 10.4103/injms.injms_5_22
Belfaiza Soukaina, T. Abdelaoui, I. Jeddou, Y. Mouzari, K. Reda, Oubaaz Abdelbar
{"title":"White dots syndrome and pseudoxanthoma elasticum: An unusual association","authors":"Belfaiza Soukaina, T. Abdelaoui, I. Jeddou, Y. Mouzari, K. Reda, Oubaaz Abdelbar","doi":"10.4103/injms.injms_5_22","DOIUrl":"https://doi.org/10.4103/injms.injms_5_22","url":null,"abstract":"","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46547999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.4103/injms.injms_6_22
J. Rissardo, A. Caprara
{"title":"Pathophysiological mechanism of stroke secondary to bee sting","authors":"J. Rissardo, A. Caprara","doi":"10.4103/injms.injms_6_22","DOIUrl":"https://doi.org/10.4103/injms.injms_6_22","url":null,"abstract":"","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43244482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.4103/injms.injms_105_21
S. Radha, T. Afroz, Y. Reddy, Gandhe Sridhar, K. Rajaram
Background: IgA nephropathy (IgAN) has variable course; few patients have a benign presentation and other patients present with late stage disease. Endocapillary hypercellularity has a prognostic significance in IgAN. It is important to identify E1 lesions accurately. The use of CD68 immunohistochemistry marker to identify glomerular macrophages will standardize the reporting and help the clinicians prognosticate the patients. Subjects and Methods: The material is from a referral laboratory for renal biopsies in a tertiary care hospital. Renal biopsies are processed as per protocol including light microscopy, immunofluorescence and electron microscopy where ever required. CD68 was used in this study to identify macrophages in E1 lesions. A total of 1220 primary glomerular diseases were diagnosed from January 2019 till date. Out of these, IgA constituted 11.9% of primary glomerular diseases. Renal biopsies received were from the department of nephrology and various other nephrology centers. Biopsies were received in 10% buffered formalin. Immunofluorescence is done on all biopsies, and electron microscopy was done in few cases to differentiate from other lesions with dominant IgA deposits. CD68 was done in 50 cases of IgAN. Apart from hematoxylin and eosin stains, periodic acid-Schiff, Masson trichrome, Jones silver stain were also done. Results: IgAN constituted 11.9% of cases. Twenty-five cases of E0 and twenty-five cases of E1 lesions were correlated with clinical and morphological features. There was correlation with proteinuria and hypertension in E1 lesions. There was no significant correlation with the morphological variants like crescents, focal segmental glomerulosclerosis. Conclusions: Inter observer correlation of E lesions is poor in classifying IgAN. Use of CD68 is a useful adjunct to identify macrophages. E1 lesions have more proteinuria requiring treatment for delaying the progression to end stage disease. Despite significant association of E1 lesions with progression, there may be many unmeasured factors which would influence the outcome.
{"title":"Correlation of E1 lesions and CD68 count with proteinuria and clinical outcome in IgA nephropathy","authors":"S. Radha, T. Afroz, Y. Reddy, Gandhe Sridhar, K. Rajaram","doi":"10.4103/injms.injms_105_21","DOIUrl":"https://doi.org/10.4103/injms.injms_105_21","url":null,"abstract":"Background: IgA nephropathy (IgAN) has variable course; few patients have a benign presentation and other patients present with late stage disease. Endocapillary hypercellularity has a prognostic significance in IgAN. It is important to identify E1 lesions accurately. The use of CD68 immunohistochemistry marker to identify glomerular macrophages will standardize the reporting and help the clinicians prognosticate the patients. Subjects and Methods: The material is from a referral laboratory for renal biopsies in a tertiary care hospital. Renal biopsies are processed as per protocol including light microscopy, immunofluorescence and electron microscopy where ever required. CD68 was used in this study to identify macrophages in E1 lesions. A total of 1220 primary glomerular diseases were diagnosed from January 2019 till date. Out of these, IgA constituted 11.9% of primary glomerular diseases. Renal biopsies received were from the department of nephrology and various other nephrology centers. Biopsies were received in 10% buffered formalin. Immunofluorescence is done on all biopsies, and electron microscopy was done in few cases to differentiate from other lesions with dominant IgA deposits. CD68 was done in 50 cases of IgAN. Apart from hematoxylin and eosin stains, periodic acid-Schiff, Masson trichrome, Jones silver stain were also done. Results: IgAN constituted 11.9% of cases. Twenty-five cases of E0 and twenty-five cases of E1 lesions were correlated with clinical and morphological features. There was correlation with proteinuria and hypertension in E1 lesions. There was no significant correlation with the morphological variants like crescents, focal segmental glomerulosclerosis. Conclusions: Inter observer correlation of E lesions is poor in classifying IgAN. Use of CD68 is a useful adjunct to identify macrophages. E1 lesions have more proteinuria requiring treatment for delaying the progression to end stage disease. Despite significant association of E1 lesions with progression, there may be many unmeasured factors which would influence the outcome.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44407090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.4103/injms.injms_106_21
Amit Kumar, Shweta Tanwar, Sudhish Gupta, Rajesh Chetiwal
Scrub typhus is caused by Orientia tsutsugamushi (formerly Rickettsia) and is transmitted to humans by an arthropod vector of the Trombiculidae family. Recent reports suggest that there has been resurgence of rickettsial infections in the Indian subcontinent. As the clinical features of scrub typhus are nonspecific and closely mimic that of other tropical infections, its diagnosis is often delayed or missed. It may cause serious complications such as myocarditis, meningoencephalitis, acute renal failure, acute liver failure, pneumonia, acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation, and multiorgan dysfunction syndrome. Early diagnosis is important because the response to treatment is excellent and may help prevent complications. Here, we report a case of scrub typhus in a pregnant woman complicated by ARDS; however, timely diagnosis and institution of therapy helped save two precious lives.
{"title":"Acute respiratory distress syndrome complicating scrub typhus in pregnancy","authors":"Amit Kumar, Shweta Tanwar, Sudhish Gupta, Rajesh Chetiwal","doi":"10.4103/injms.injms_106_21","DOIUrl":"https://doi.org/10.4103/injms.injms_106_21","url":null,"abstract":"Scrub typhus is caused by Orientia tsutsugamushi (formerly Rickettsia) and is transmitted to humans by an arthropod vector of the Trombiculidae family. Recent reports suggest that there has been resurgence of rickettsial infections in the Indian subcontinent. As the clinical features of scrub typhus are nonspecific and closely mimic that of other tropical infections, its diagnosis is often delayed or missed. It may cause serious complications such as myocarditis, meningoencephalitis, acute renal failure, acute liver failure, pneumonia, acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation, and multiorgan dysfunction syndrome. Early diagnosis is important because the response to treatment is excellent and may help prevent complications. Here, we report a case of scrub typhus in a pregnant woman complicated by ARDS; however, timely diagnosis and institution of therapy helped save two precious lives.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49664683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.4103/injms.injms_129_21
H. Gupta
{"title":"Vaccines are ray of hope, but who is the torch-bearer?","authors":"H. Gupta","doi":"10.4103/injms.injms_129_21","DOIUrl":"https://doi.org/10.4103/injms.injms_129_21","url":null,"abstract":"","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42754170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.4103/injms.injms_131_21
Prachi C. Bhandare, A. Navya, R. Ghodge, P. Shukla, Taruna Gupta
Introduction: Contrary to the general perception that the field of dermatology rarely encounters managing critical patients and dealing with mortality, severe and extensive dermatological conditions can be lethal in the absence of timely intervention. Aims and Objectives: The aim was to study in detail regarding the deaths and the various factors associated with it in patients admitted with dermatological conditions in a tertiary care center over a period of 10 years. Materials and Methods: It was a retrospective, record-based, observational study over a period of 10 years (2011–2021) in a tertiary care hospital consisting of 49 cases. After obtaining institutional ethical clearance, the information was obtained from medical records section. The relevant details of patients were entered in a specially formulated proforma. Results: A total of 3491 patients were admitted to the Department of Dermatology, Goa Medical College, during the study period of 10 years from January 2011 to August 2021. Among these, 49 patients succumbed to their skin condition, with an overall mortality percentage of 1.4%. Drug reactions were the most commonly encountered diagnosis in 17 patients (34.69%) which was closely followed by vesiculobullous disorders with 14 (28.57%) cases and infections in 10 (20.40%) cases. Conclusion: Drug reactions, vesiculobullous disease, and infections were the main causes of mortality in our series of patients. Extensive skin and mucosal involvement, multisystem involvement, declining age, delay in treatment received, and onset of sepsis were some of the major factors contributing to mortality. In our study, a high proportion of 46.93% of the patients were above the age of 60 years, out of which 56.52% had vesiculobullous disease. Hence, a special focus on geriatric dermatology deserves attention, especially in tertiary care centers.
{"title":"Mortality in dermatology: A closer look","authors":"Prachi C. Bhandare, A. Navya, R. Ghodge, P. Shukla, Taruna Gupta","doi":"10.4103/injms.injms_131_21","DOIUrl":"https://doi.org/10.4103/injms.injms_131_21","url":null,"abstract":"Introduction: Contrary to the general perception that the field of dermatology rarely encounters managing critical patients and dealing with mortality, severe and extensive dermatological conditions can be lethal in the absence of timely intervention. Aims and Objectives: The aim was to study in detail regarding the deaths and the various factors associated with it in patients admitted with dermatological conditions in a tertiary care center over a period of 10 years. Materials and Methods: It was a retrospective, record-based, observational study over a period of 10 years (2011–2021) in a tertiary care hospital consisting of 49 cases. After obtaining institutional ethical clearance, the information was obtained from medical records section. The relevant details of patients were entered in a specially formulated proforma. Results: A total of 3491 patients were admitted to the Department of Dermatology, Goa Medical College, during the study period of 10 years from January 2011 to August 2021. Among these, 49 patients succumbed to their skin condition, with an overall mortality percentage of 1.4%. Drug reactions were the most commonly encountered diagnosis in 17 patients (34.69%) which was closely followed by vesiculobullous disorders with 14 (28.57%) cases and infections in 10 (20.40%) cases. Conclusion: Drug reactions, vesiculobullous disease, and infections were the main causes of mortality in our series of patients. Extensive skin and mucosal involvement, multisystem involvement, declining age, delay in treatment received, and onset of sepsis were some of the major factors contributing to mortality. In our study, a high proportion of 46.93% of the patients were above the age of 60 years, out of which 56.52% had vesiculobullous disease. Hence, a special focus on geriatric dermatology deserves attention, especially in tertiary care centers.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47852435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.4103/injms.injms_109_21
Sunanda Gupta, Rakesh Kumar, M. Kalaivani, B. Nongkynrih, S. Kant, S. Gupta
Background: Progression in age causes gradual loss in height due to degenerative osteoporotic changes in bones and decrease in the disc space. Hence, proxy measures of height are required in elderly persons. Objective: The objective of the study is to study the relationship between height and arm-span of elderly persons. Materials and Methods: This community-based study was conducted in a rural area of Ballabgarh, Haryana, among elderly persons (age ≥60 years). Four hundred and twenty participants were selected by simple random sampling method. House-to-house visits were made. Height and arm-span were measured. Association between height and arm-span was assessed by Pearson's product-moment correlation coefficient and linear regression analysis. Scatter plot was also made to show the association by age and sex. Results: In both sexes and all age groups, arm-span was seen to be more than height. Linear relationship between height and arm-span was observed. There was strong correlation between height and arm-span in both sexes (correlation coefficient = 0.97, P < 0.001 in both sexes). Conclusion: Arm-span can be measured as an alternative to height in elderly population. Arm-span can be used as a substitute for height for calculation of body mass index, creatinine height index, basal energy expenditure, and pulmonary function test.
{"title":"Relationship between height and arm-span of elderly persons in a rural area of Ballabgarh, Haryana","authors":"Sunanda Gupta, Rakesh Kumar, M. Kalaivani, B. Nongkynrih, S. Kant, S. Gupta","doi":"10.4103/injms.injms_109_21","DOIUrl":"https://doi.org/10.4103/injms.injms_109_21","url":null,"abstract":"Background: Progression in age causes gradual loss in height due to degenerative osteoporotic changes in bones and decrease in the disc space. Hence, proxy measures of height are required in elderly persons. Objective: The objective of the study is to study the relationship between height and arm-span of elderly persons. Materials and Methods: This community-based study was conducted in a rural area of Ballabgarh, Haryana, among elderly persons (age ≥60 years). Four hundred and twenty participants were selected by simple random sampling method. House-to-house visits were made. Height and arm-span were measured. Association between height and arm-span was assessed by Pearson's product-moment correlation coefficient and linear regression analysis. Scatter plot was also made to show the association by age and sex. Results: In both sexes and all age groups, arm-span was seen to be more than height. Linear relationship between height and arm-span was observed. There was strong correlation between height and arm-span in both sexes (correlation coefficient = 0.97, P < 0.001 in both sexes). Conclusion: Arm-span can be measured as an alternative to height in elderly population. Arm-span can be used as a substitute for height for calculation of body mass index, creatinine height index, basal energy expenditure, and pulmonary function test.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44204675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.4103/injms.injms_123_21
S. Bagai, S. Sanjeevani, D. Khullar, Bhavna Bansal, Vipra Malik
Scleroderma renal crisis (SRC) is characterized by the development of severe or worsening arterial hypertension associated with the abrupt onset of progressive renal failure in the absence of any other cause. Only 1% of limited and 4–11% of diffuse scleroderma cases have SRC. We report a case of SRC as an initial presentation in a newly diagnosed case of scleroderma.
{"title":"Scleroderma renal crisis as initial presentation of scleroderma","authors":"S. Bagai, S. Sanjeevani, D. Khullar, Bhavna Bansal, Vipra Malik","doi":"10.4103/injms.injms_123_21","DOIUrl":"https://doi.org/10.4103/injms.injms_123_21","url":null,"abstract":"Scleroderma renal crisis (SRC) is characterized by the development of severe or worsening arterial hypertension associated with the abrupt onset of progressive renal failure in the absence of any other cause. Only 1% of limited and 4–11% of diffuse scleroderma cases have SRC. We report a case of SRC as an initial presentation in a newly diagnosed case of scleroderma.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44755157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.4103/injms.injms_14_22
A. Nigam
{"title":"Clinical teaching: How to make it effective","authors":"A. Nigam","doi":"10.4103/injms.injms_14_22","DOIUrl":"https://doi.org/10.4103/injms.injms_14_22","url":null,"abstract":"","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47633986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.4103/injms.injms_76_21
Debasish Das, D. Acharya, Tutan Das, Subhash R. Pramanik
We present a case of successful balloon pulmonary valvuloplasty (BPV) in a 37-year-old female with severe valvular pulmonary stenosis with peak gradient of 82 mmHg with history of exertional presyncope. The crux of our case was that patient also had associated mild supravalvular pulmonary stenosis which did not preclude a successful BPV outcome. The patient had rare Bombay negative blood group, and the requisite units were not available across all the blood banks in the state to subject the patient for surgical correction. Although the art of BPV is dying among budding young interventionists, this simple procedure is as good as surgical pulmonary valvotomy so far as the immediate and late outcome is concerned and the presence of mild supravalvular pulmonary stenosis does not preclude a successful outcome. Our case is a unique illustration of feasibility of successful balloon pulmonary valvuloplasty in the presence of associated mild supravalvular stenosis.
{"title":"Simplified art of balloon pulmonary valvuloplasty: Does the presence of mild supravalvular pulmonary stenosis preclude successful balloon pulmonary valvuloplasty?","authors":"Debasish Das, D. Acharya, Tutan Das, Subhash R. Pramanik","doi":"10.4103/injms.injms_76_21","DOIUrl":"https://doi.org/10.4103/injms.injms_76_21","url":null,"abstract":"We present a case of successful balloon pulmonary valvuloplasty (BPV) in a 37-year-old female with severe valvular pulmonary stenosis with peak gradient of 82 mmHg with history of exertional presyncope. The crux of our case was that patient also had associated mild supravalvular pulmonary stenosis which did not preclude a successful BPV outcome. The patient had rare Bombay negative blood group, and the requisite units were not available across all the blood banks in the state to subject the patient for surgical correction. Although the art of BPV is dying among budding young interventionists, this simple procedure is as good as surgical pulmonary valvotomy so far as the immediate and late outcome is concerned and the presence of mild supravalvular pulmonary stenosis does not preclude a successful outcome. Our case is a unique illustration of feasibility of successful balloon pulmonary valvuloplasty in the presence of associated mild supravalvular stenosis.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42868809","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：