Pub Date : 2022-10-01DOI: 10.4103/injms.injms_56_22
R. Gaind, N. Gupta, Ravindra Nath, Nilushree Srivastava, Tanushree Gahlot, P. Ish, Nitesh Gupta
Introduction: SARS-CoV-2 vaccines decrease the risk of infection. However, data on the utility of vaccines in decreasing the severity of COVID-19 need to be evaluated. This study was carried out with the primary objective to assess the severity and clinical outcome of COVID-19 infections among unvaccinated and vaccinated health-care workers (HCWs). Methods: This was a hospital-based retrospective cohort study including all HCWs who developed microbiologically confirmed COVID-19 over 6 months from January 31, 2021, to July 31, 2021 (during the second wave of COVID-19 in India). Data were recorded through a questionnaire which included demographic details, primary location of work, history of vaccination with dates, comorbidities, severity of COVID-19, and outcome. HCWs who tested positive for SARS-CoV-2 before any dose of the COVID-19 vaccine were included in the “unvaccinated” group. Whereas HCWs who developed SARS-CoV-2 after a single or both doses of vaccine were included in the vaccinated group. The outcome and mortality among the vaccinated and unvaccinated groups were evaluated and compared. Results: The study included 500 HCWs who developed a microbiologically confirmed CVOID-19 infection. It was a predominantly middle-aged population with 247 unvaccinated and 253 vaccinated at the time of developing COVID-19. Only one-fourth of the population (26%) was working in the COVID-19 area and the source of COVID-19 to most was either a COVID-19 patient (39%) or a colleague (38%). Around 13% of the population had comorbidities with cardiovascular disease and diabetes being the most common. The majority of the patients were mild (71%) and most were treated at home in isolation (91%). Only 4% of the study population required intensive care. Among the vaccinated group, COVID-19 infection was predominantly mild and this difference was statistically significant as compared to the nonvaccinated. No difference was found in mortality among the two groups; however, the overall mortality was only 1%. Conclusions: SARS-CoV-2 vaccines reduce the severity of COVID-19 besides preventing infections and its spread. This can help in effective care of COVID-19 in home isolation without overburdening the health-care services. More studies including clinical parameters and microbiological components are required to understand the true extent of this protection of vaccines from severe forms of COVID-19.
{"title":"Effect of SARS-CoV-2 vaccination on severity and outcome of COVID-19 among health-care workers of a tertiary care hospital in India","authors":"R. Gaind, N. Gupta, Ravindra Nath, Nilushree Srivastava, Tanushree Gahlot, P. Ish, Nitesh Gupta","doi":"10.4103/injms.injms_56_22","DOIUrl":"https://doi.org/10.4103/injms.injms_56_22","url":null,"abstract":"Introduction: SARS-CoV-2 vaccines decrease the risk of infection. However, data on the utility of vaccines in decreasing the severity of COVID-19 need to be evaluated. This study was carried out with the primary objective to assess the severity and clinical outcome of COVID-19 infections among unvaccinated and vaccinated health-care workers (HCWs). Methods: This was a hospital-based retrospective cohort study including all HCWs who developed microbiologically confirmed COVID-19 over 6 months from January 31, 2021, to July 31, 2021 (during the second wave of COVID-19 in India). Data were recorded through a questionnaire which included demographic details, primary location of work, history of vaccination with dates, comorbidities, severity of COVID-19, and outcome. HCWs who tested positive for SARS-CoV-2 before any dose of the COVID-19 vaccine were included in the “unvaccinated” group. Whereas HCWs who developed SARS-CoV-2 after a single or both doses of vaccine were included in the vaccinated group. The outcome and mortality among the vaccinated and unvaccinated groups were evaluated and compared. Results: The study included 500 HCWs who developed a microbiologically confirmed CVOID-19 infection. It was a predominantly middle-aged population with 247 unvaccinated and 253 vaccinated at the time of developing COVID-19. Only one-fourth of the population (26%) was working in the COVID-19 area and the source of COVID-19 to most was either a COVID-19 patient (39%) or a colleague (38%). Around 13% of the population had comorbidities with cardiovascular disease and diabetes being the most common. The majority of the patients were mild (71%) and most were treated at home in isolation (91%). Only 4% of the study population required intensive care. Among the vaccinated group, COVID-19 infection was predominantly mild and this difference was statistically significant as compared to the nonvaccinated. No difference was found in mortality among the two groups; however, the overall mortality was only 1%. Conclusions: SARS-CoV-2 vaccines reduce the severity of COVID-19 besides preventing infections and its spread. This can help in effective care of COVID-19 in home isolation without overburdening the health-care services. More studies including clinical parameters and microbiological components are required to understand the true extent of this protection of vaccines from severe forms of COVID-19.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42431165","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 : 2022-10-01DOI: 10.4103/injms.injms_68_22
Angelika Manaj, Aleksandra Osiak, M. Piskórz, Karolina Futyma-Gąbka, I. Różyło-Kalinowska
Introduction: Haller's cells are air structures with variable presence in individuals. They are situated in the anterior part of the ethmoid bone on the inferior and medial walls of the orbits. Their presence can be symptomatic and they may also be an impediment in surgical procedures. A panoramic radiograph commonly used in dental diagnostics allows visualization of their presence. The aim of the study is characteristics and estimation of Haller's cell prevalence in a sample of the Polish population based on panoramic radiographs. Materials and Methods: The study consisted of 467 panoramic radiographs including patients of both genders (303 females and 164 males), aged 17–23 years with a mean of 20.2 years. All radiographs have been evaluated for Haller's cells' presence, shape, number, and location with gender predilection. Results: Haller's cells were found in 72 cases, which comprised 15.4% of the studied group, with a slightly higher prevalence in females (17.82% in females and 10.97% in males). The most predominant shape was oval. Unilateral distribution of the cells outnumbered bilateral variants. One to three Haller's cells were found on one side, in the own material. Conclusions: Panoramic radiograph revealed a relatively low prevalence of Haller's cells in a sample of the Polish population. It is possible to assess the shape and determine the exact number of these cells. Based on the panoramic examination, we can state that they are located more often unilaterally with a slightly higher prevalence in females.
{"title":"Evaluation of haller's cells prevalence in a sample of Polish population assessed using panoramic radiographs","authors":"Angelika Manaj, Aleksandra Osiak, M. Piskórz, Karolina Futyma-Gąbka, I. Różyło-Kalinowska","doi":"10.4103/injms.injms_68_22","DOIUrl":"https://doi.org/10.4103/injms.injms_68_22","url":null,"abstract":"Introduction: Haller's cells are air structures with variable presence in individuals. They are situated in the anterior part of the ethmoid bone on the inferior and medial walls of the orbits. Their presence can be symptomatic and they may also be an impediment in surgical procedures. A panoramic radiograph commonly used in dental diagnostics allows visualization of their presence. The aim of the study is characteristics and estimation of Haller's cell prevalence in a sample of the Polish population based on panoramic radiographs. Materials and Methods: The study consisted of 467 panoramic radiographs including patients of both genders (303 females and 164 males), aged 17–23 years with a mean of 20.2 years. All radiographs have been evaluated for Haller's cells' presence, shape, number, and location with gender predilection. Results: Haller's cells were found in 72 cases, which comprised 15.4% of the studied group, with a slightly higher prevalence in females (17.82% in females and 10.97% in males). The most predominant shape was oval. Unilateral distribution of the cells outnumbered bilateral variants. One to three Haller's cells were found on one side, in the own material. Conclusions: Panoramic radiograph revealed a relatively low prevalence of Haller's cells in a sample of the Polish population. It is possible to assess the shape and determine the exact number of these cells. Based on the panoramic examination, we can state that they are located more often unilaterally with a slightly higher prevalence in females.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41282198","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 : 2022-10-01DOI: 10.4103/injms.injms_80_22
N. Rai, S. Misra, Shashank Prajapati, Shubhajeet Roy, G. Yadav
Hemophagocytic lymphohistiocytosis (HLH) is an inflammatory condition where there is marked cytopenia and large-scale activation of macrophages and CD8+ cytotoxic T cells. HLH may be of two types – primary HLH caused by genetic abnormalities and secondary HLH due to infections, malignancies, autoimmune disorders, rheumatologic disorders, and metabolic dysfunctions. We describe a case of HLH following the first dose of the ChAdOx1 nCoV-19 Corona Virus vaccine. In this patient, there was no clear precipitant of HLH. The most probable explanation could be intense immune activation by vaccine constituents producing aberrant activation of inflammatory cytokines. There were no signs of infection or malignancy. Since our patient was clinically stable, his symptoms had resolved and HLH parameters had improved, no HLH-specific therapy was given.
{"title":"Hemophagocytic lymphohistiocytosis after ChAdOx1 nCoV-19 coronavirus vaccination in a patient with no known comorbidities","authors":"N. Rai, S. Misra, Shashank Prajapati, Shubhajeet Roy, G. Yadav","doi":"10.4103/injms.injms_80_22","DOIUrl":"https://doi.org/10.4103/injms.injms_80_22","url":null,"abstract":"Hemophagocytic lymphohistiocytosis (HLH) is an inflammatory condition where there is marked cytopenia and large-scale activation of macrophages and CD8+ cytotoxic T cells. HLH may be of two types – primary HLH caused by genetic abnormalities and secondary HLH due to infections, malignancies, autoimmune disorders, rheumatologic disorders, and metabolic dysfunctions. We describe a case of HLH following the first dose of the ChAdOx1 nCoV-19 Corona Virus vaccine. In this patient, there was no clear precipitant of HLH. The most probable explanation could be intense immune activation by vaccine constituents producing aberrant activation of inflammatory cytokines. There were no signs of infection or malignancy. Since our patient was clinically stable, his symptoms had resolved and HLH parameters had improved, no HLH-specific therapy was given.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48875006","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 : 2022-10-01DOI: 10.4103/injms.injms_47_22
Kanika Singh, A. Acharya, S. Rasania, J. Khandekar, Rodney Vaz
Background: Diabetes mellitus is noncommunicable disease that in most cases affects the whole life after diagnosis with long-standing effects and debilitating complications. It is also one of the top five causes of mortality and contributes significantly to morbidity. Besides limitations and complications to physical health, it also significantly affects the mental health and affects the quality of life (QOL) among the patients. The current study aimed at finding the QOL among the patients living with diabetes. Methodology: A cross-sectional study was conducted among diabetic patients attending a diabetic clinic at a district hospital in East Delhi between December 2016 and March 2018. A total of 250 study subjects were included in the study. The Physical Health Questionnaire (PHQ 9) and the World Health Organization QOL-BREF questionnaire were used along with a pretested, semi-structured questionnaire for data collection. Data analysis was done on SPSS 23. Results: The prevalence of depression was found to be 17.6% as per the PHQ-9. Health-related QOL was highest for social domain (63.81 ± 12.74) and lowest among the psychological domain (40.83 ± 8.93) followed by environment (46.92 ± 8.34). The score of all the domains was lowest among depressed group as compared to nondepressed study subjects. Conclusion: Mental health can be adversely affected in the case of patients with diabetes which in turn can affect the QOL of the cohort. Hence, it is important to focus on mental well-being of the diabetics and timely intervention.
{"title":"Health-related quality of life and its association with depression in type ii diabetes mellitus patients: A cross-sectional study from Delhi","authors":"Kanika Singh, A. Acharya, S. Rasania, J. Khandekar, Rodney Vaz","doi":"10.4103/injms.injms_47_22","DOIUrl":"https://doi.org/10.4103/injms.injms_47_22","url":null,"abstract":"Background: Diabetes mellitus is noncommunicable disease that in most cases affects the whole life after diagnosis with long-standing effects and debilitating complications. It is also one of the top five causes of mortality and contributes significantly to morbidity. Besides limitations and complications to physical health, it also significantly affects the mental health and affects the quality of life (QOL) among the patients. The current study aimed at finding the QOL among the patients living with diabetes. Methodology: A cross-sectional study was conducted among diabetic patients attending a diabetic clinic at a district hospital in East Delhi between December 2016 and March 2018. A total of 250 study subjects were included in the study. The Physical Health Questionnaire (PHQ 9) and the World Health Organization QOL-BREF questionnaire were used along with a pretested, semi-structured questionnaire for data collection. Data analysis was done on SPSS 23. Results: The prevalence of depression was found to be 17.6% as per the PHQ-9. Health-related QOL was highest for social domain (63.81 ± 12.74) and lowest among the psychological domain (40.83 ± 8.93) followed by environment (46.92 ± 8.34). The score of all the domains was lowest among depressed group as compared to nondepressed study subjects. Conclusion: Mental health can be adversely affected in the case of patients with diabetes which in turn can affect the QOL of the cohort. Hence, it is important to focus on mental well-being of the diabetics and timely intervention.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44539153","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 : 2022-07-01DOI: 10.4103/injms.injms_3_22
A. Mittal, Ankit Chamoli
Klippel‒Feil syndrome, is a congenital disorder characterized by congenital fusion of two or more cervical vertebrae. Classically, there is triad of short neck, a low posterior hairline, and a limited range of neck movements. Less than half patients present with all three classical features. The presence of other anomalies may be associated with increased morbidity so complete evaluation and further management are critical in every case. Here, we are reporting a case with all clinical triad with associated mirror movements.
{"title":"Klippel‒Feil syndrome associated with mirror movements: A rare case report","authors":"A. Mittal, Ankit Chamoli","doi":"10.4103/injms.injms_3_22","DOIUrl":"https://doi.org/10.4103/injms.injms_3_22","url":null,"abstract":"Klippel‒Feil syndrome, is a congenital disorder characterized by congenital fusion of two or more cervical vertebrae. Classically, there is triad of short neck, a low posterior hairline, and a limited range of neck movements. Less than half patients present with all three classical features. The presence of other anomalies may be associated with increased morbidity so complete evaluation and further management are critical in every case. Here, we are reporting a case with all clinical triad with associated mirror movements.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41409745","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 : 2022-07-01DOI: 10.4103/injms.injms_18_22
Fernando Karel Fonseca Sosa, Yaima Susana Rey Vallés
{"title":"Wandering spleen torsion: A rare case of acute abdomen","authors":"Fernando Karel Fonseca Sosa, Yaima Susana Rey Vallés","doi":"10.4103/injms.injms_18_22","DOIUrl":"https://doi.org/10.4103/injms.injms_18_22","url":null,"abstract":"","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48387613","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 : 2022-07-01DOI: 10.4103/injms.injms_20_22
M. Abdulla
{"title":"Hereditary sensory and autonomic neuropathy type IC with SPTLC2 mutation associated with immune thrombocytopenia","authors":"M. Abdulla","doi":"10.4103/injms.injms_20_22","DOIUrl":"https://doi.org/10.4103/injms.injms_20_22","url":null,"abstract":"","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48408020","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 : 2022-07-01DOI: 10.4103/injms.injms_37_22
B. Sunil, P. Kulkarni, N. Renuka, M. Murthy
Background: Dengue is one of the major public health problems in the world. Currently, dengue is endemic in more than 100 countries of Asian pacific region. Prevention and control of dengue is largely influenced by the level of awareness and the preventive practices people undertake. In this background, the present study was conducted to find out the relationship between Aedes aegypti indices and perception and practices regarding dengue and its prevention. Materials and Methods: This cross-sectional study was conducted in an urban slum for the period of 1 year among 270 households selected by probability proportionate to size technique. Data were collected by structured questionnaire with details on sociodemographic characteristics, perception, and practices adopted by people toward dengue and its prevention. Larva survey was conducted by observing for the A. aegypti larvae in the containers within and outside the households. Results: Among 270 households included in the present study, overall, 70 (25.9%) and 96 (35.6%) of the study respondents were having poor and average levels of perception. 22 (8.1%) and 163 (60.4%) of respondents had poor and average levels of dengue prevention practices, respectively. Household index, container index, and Bretau's index (BI) were 5.52%, 6.05%, and 8.51%, respectively. Median perception and practice scores among the respondents of households with larva breeding were significantly lower as compared to the ones without larva breeding. Conclusion: Majority of the study participants had poor to average levels of perception and practices regarding dengue and its prevention. These scores were significantly lower among households with active larva breeding.
{"title":"Relationship between Aedes aegypti indices with perception and practices of dengue in an urban community of Mysore","authors":"B. Sunil, P. Kulkarni, N. Renuka, M. Murthy","doi":"10.4103/injms.injms_37_22","DOIUrl":"https://doi.org/10.4103/injms.injms_37_22","url":null,"abstract":"Background: Dengue is one of the major public health problems in the world. Currently, dengue is endemic in more than 100 countries of Asian pacific region. Prevention and control of dengue is largely influenced by the level of awareness and the preventive practices people undertake. In this background, the present study was conducted to find out the relationship between Aedes aegypti indices and perception and practices regarding dengue and its prevention. Materials and Methods: This cross-sectional study was conducted in an urban slum for the period of 1 year among 270 households selected by probability proportionate to size technique. Data were collected by structured questionnaire with details on sociodemographic characteristics, perception, and practices adopted by people toward dengue and its prevention. Larva survey was conducted by observing for the A. aegypti larvae in the containers within and outside the households. Results: Among 270 households included in the present study, overall, 70 (25.9%) and 96 (35.6%) of the study respondents were having poor and average levels of perception. 22 (8.1%) and 163 (60.4%) of respondents had poor and average levels of dengue prevention practices, respectively. Household index, container index, and Bretau's index (BI) were 5.52%, 6.05%, and 8.51%, respectively. Median perception and practice scores among the respondents of households with larva breeding were significantly lower as compared to the ones without larva breeding. Conclusion: Majority of the study participants had poor to average levels of perception and practices regarding dengue and its prevention. These scores were significantly lower among households with active larva breeding.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41700379","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 : 2022-07-01DOI: 10.4103/injms.injms_10_22
M. Manisha, A. Mahanta, Munindra Goswami, Marami Das
Background: The primary central nervous system (CNS) demyelinating disorders are witnessing significant advancement in terms of treatment options and the diagnostics. However, a resource poor country like ours has to rely more on our clinical findings. Aims and Objectives: To study the spectrum of different clinical manifestations in patients of various primary CNS demyelinating disorders in the hospital setting; categorizing them to the most possible extent into its various types viz. multiple sclerosis(MS), neuromyelitis optica spectrum disorder (NMOSD), acute disseminated encephalomyelitis(ADEM), idiopathic optic neuritis(ON). Metarials and Methods: An observational study was conducted for 2 years including old and newly diagnosed cases in whom detailed clinical assessment was done for every attack including the previous and subsequent ones. Statistical analysis was done using SPSS version 21. Results: Of the 47 patients included, 26 (55.3%) were cases of NMOSD, 12 (25.5%) of MS, 4 (8.5%) of ADEM and 5 (10.6%) were isolated cases of ON. 30 were female and 17 were male (ratio 1:0.6). The total mean age for primary CNS demyelinating disorders at presentation was 27.09 ± 13.44 years. Maximum patients fell in the age range of 11–20 years. Among the clinical manifestations, motor abnormalities (97.6%), sensory abnormalities (69%), bladder dysfunction (59.5%), visual manifestations (54.8%) (Unilateral in all MS patients, both bilateral and unilateral in NMOSD) were the most common presentations. In MS, the most common manifestations were motor dysfunction followed by sensory symptoms, optic neuropathy (mostly unilateral), and bladder dysfunction. In NMOSD, the most common clinical manifestations were motor dysfunction, followed by bladder dysfunction, optic neuropathy and then sensory abnormalities. In ADEM, most common manifestations were motor abnormalities, acute encephalopathy, headache, optic neuropathy. Among idiopathic ON, most patients presented with painful diminution of vision (80%). Mean number of attacks was 2.53. Conclusion: A wide spectrum of clinical presentations in various disorders of primary CNS demyelination was found with maximum patients presenting with motor dysfunction in various forms.
{"title":"Clinical profile of primary central nervous system demyelinating disorders: A tertiary care hospital-based study in Guwahati","authors":"M. Manisha, A. Mahanta, Munindra Goswami, Marami Das","doi":"10.4103/injms.injms_10_22","DOIUrl":"https://doi.org/10.4103/injms.injms_10_22","url":null,"abstract":"Background: The primary central nervous system (CNS) demyelinating disorders are witnessing significant advancement in terms of treatment options and the diagnostics. However, a resource poor country like ours has to rely more on our clinical findings. Aims and Objectives: To study the spectrum of different clinical manifestations in patients of various primary CNS demyelinating disorders in the hospital setting; categorizing them to the most possible extent into its various types viz. multiple sclerosis(MS), neuromyelitis optica spectrum disorder (NMOSD), acute disseminated encephalomyelitis(ADEM), idiopathic optic neuritis(ON). Metarials and Methods: An observational study was conducted for 2 years including old and newly diagnosed cases in whom detailed clinical assessment was done for every attack including the previous and subsequent ones. Statistical analysis was done using SPSS version 21. Results: Of the 47 patients included, 26 (55.3%) were cases of NMOSD, 12 (25.5%) of MS, 4 (8.5%) of ADEM and 5 (10.6%) were isolated cases of ON. 30 were female and 17 were male (ratio 1:0.6). The total mean age for primary CNS demyelinating disorders at presentation was 27.09 ± 13.44 years. Maximum patients fell in the age range of 11–20 years. Among the clinical manifestations, motor abnormalities (97.6%), sensory abnormalities (69%), bladder dysfunction (59.5%), visual manifestations (54.8%) (Unilateral in all MS patients, both bilateral and unilateral in NMOSD) were the most common presentations. In MS, the most common manifestations were motor dysfunction followed by sensory symptoms, optic neuropathy (mostly unilateral), and bladder dysfunction. In NMOSD, the most common clinical manifestations were motor dysfunction, followed by bladder dysfunction, optic neuropathy and then sensory abnormalities. In ADEM, most common manifestations were motor abnormalities, acute encephalopathy, headache, optic neuropathy. Among idiopathic ON, most patients presented with painful diminution of vision (80%). Mean number of attacks was 2.53. Conclusion: A wide spectrum of clinical presentations in various disorders of primary CNS demyelination was found with maximum patients presenting with motor dysfunction in various forms.","PeriodicalId":43811,"journal":{"name":"Indian Journal of Medical Specialities","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41736928","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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