Pub Date : 2022-11-30DOI: 10.14260/jemds.v11i12.266
Rajib Hazarika, Ananya Choudhury
BACKGROUND Spinal anaesthesia is the preferred method of anaesthesia in parturients undergoing both elective and emergency lower-segment caesarean section. A common complication of spinal anaesthesia is shivering. Shivering increases perioperative heart rate and oxygen consumption by 5 times and also increases the metabolic demand by 100 times, thereby increasing chances of myocardial ischemia, hypoxia, hypoxemia and later lactic acidosis. In this study, we wanted to compare the incidence of shivering following spinal anaesthesia when a weight-adjusted dose versus a fixed dose of ondansetron is used during caesarean delivery. METHODS This was a hospital-based randomized double-blinded (patient and observer blinded) single hospital-based study conducted among 190 pregnant patients who underwent elective caesarean delivery under spinal anaesthesia in the Department of Anaesthesiology and Critical Care, Gauhati Medical College and Hospital, Guwahati from 1st August 2021 to 31st July 2022 after obtaining clearance from Institutional Ethics Committee and written informed consent from the study participants. The patients were divided into two groups: group 1 (patients who received a weight-adjusted dose of ondansetron at 0.1mg/kg) and group 2 (patients who received fixed-dose ondansetron). RESULTS Shivering occurred in 11 patients (11.6 %) in group 1 and 21 patients (22.1 %) in group 2, but there was no statistical difference between the two groups (p-value 0.053) (using the chi-square test). 10 patients (10.5 %) developed grade I shivering and 1 patient (1.1 %) developed grade II shivering in group 1. In group 2, 10 patients (10.5 %) developed grade I shivering and 11 patients (11.6 %) developed grade II shivering (P-value - 0.0163) which was statistically significant (using chi-square test). Nausea occurred in 2 patients (2.1 %) in group 2 while no incidence of nausea was seen in group 1. Incidence of headache was seen in both groups; 1 patient (1.1 %). There was no statistical difference between the adverse effects of the groups. CONCLUSIONS The severity of shivering was lower in the weight-adjusted dose at 0.1 mg/kg ondansetron group in patients undergoing spinal anaesthesia for caesarean delivery. The incidence of shivering was comparable in both the weight-adjusted dose and fixed-dose ondansetron groups. The incidence of nausea, vomiting, headache and pruritus did not differ significantly among the groups.
{"title":"Comparison of Weight-Adjusted Dose versus Fixed Dose Ondansetron in Preventing Shivering Following Spinal Anaesthesia for Caesarean Deliveries","authors":"Rajib Hazarika, Ananya Choudhury","doi":"10.14260/jemds.v11i12.266","DOIUrl":"https://doi.org/10.14260/jemds.v11i12.266","url":null,"abstract":"BACKGROUND \u0000Spinal anaesthesia is the preferred method of anaesthesia in parturients undergoing both elective and emergency lower-segment caesarean section. A common complication of spinal anaesthesia is shivering. Shivering increases perioperative heart rate and oxygen consumption by 5 times and also increases the metabolic demand by 100 times, thereby increasing chances of myocardial ischemia, hypoxia, hypoxemia and later lactic acidosis. In this study, we wanted to compare the incidence of shivering following spinal anaesthesia when a weight-adjusted dose versus a fixed dose of ondansetron is used during caesarean delivery. \u0000METHODS \u0000This was a hospital-based randomized double-blinded (patient and observer blinded) single hospital-based study conducted among 190 pregnant patients who underwent elective caesarean delivery under spinal anaesthesia in the Department of Anaesthesiology and Critical Care, Gauhati Medical College and Hospital, Guwahati from 1st August 2021 to 31st July 2022 after obtaining clearance from Institutional Ethics Committee and written informed consent from the study participants. The patients were divided into two groups: group 1 (patients who received a weight-adjusted dose of ondansetron at 0.1mg/kg) and group 2 (patients who received fixed-dose ondansetron). \u0000RESULTS \u0000Shivering occurred in 11 patients (11.6 %) in group 1 and 21 patients (22.1 %) in group 2, but there was no statistical difference between the two groups (p-value 0.053) (using the chi-square test). 10 patients (10.5 %) developed grade I shivering and 1 patient (1.1 %) developed grade II shivering in group 1. In group 2, 10 patients (10.5 %) developed grade I shivering and 11 patients (11.6 %) developed grade II shivering (P-value - 0.0163) which was statistically significant (using chi-square test). Nausea occurred in 2 patients (2.1 %) in group 2 while no incidence of nausea was seen in group 1. Incidence of headache was seen in both groups; 1 patient (1.1 %). There was no statistical difference between the adverse effects of the groups. \u0000CONCLUSIONS \u0000The severity of shivering was lower in the weight-adjusted dose at 0.1 mg/kg ondansetron group in patients undergoing spinal anaesthesia for caesarean delivery. The incidence of shivering was comparable in both the weight-adjusted dose and fixed-dose ondansetron groups. The incidence of nausea, vomiting, headache and pruritus did not differ significantly among the groups.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47454804","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}
BACKGROUND Mycobacterium tuberculosis complex causes pulmonary tuberculosis (PT) which is a major public health problem worldwide and endemic in India. PT diagnosis is done by high-resolution computed tomography (HRCT) which has high sensitivity and specificity. METHODS At a tertiary hospital, this cross-sectional study was conducted for 3 years. Patients presenting with productive cough with or without haemoptysis, shortness of breath, fever with night sweats or weight loss were suspected of having tuberculosis and underwent HRCT. PT was defined as the presence of consolidation, centrilobular nodules, and branching nodules with a tree in bud appearance with or without lymphadenopathy and pleural effusion on HRCT. RESULTS In this study, a total of 118 patients with a mean age of 51.85 ± 16.86 years were included. 64 (54.2%) were males and 54 (45.76%) were females out of 118 patients. Sputum smear was negative in a total of 66 (55.9%) patients and positive in 52(44.06%) patients. 84.26% was the diagnostic accuracy of HRCT in diagnosing PT with sensitivity, specificity, PPV and NPV of 84.28%, 83.33%, 78.98%, and 99.02%, respectively. HRCT had diagnostic accuracy, sensitivity, specificity, PPV and NPV of 86.40%, 89.46%, 83.42%, 94.14% and 72.43%, respectively in sputum smear positive patients. Whereas it was 83.87%, 91.54%, 75.40%, 64.57%, and 92.14%, respectively in sputum smear negative patients. CONCLUSIONS In diagnosing sputum smear-positive and sputum smear-negative PT, HRCT has high sensitivity. The specificity of HRCT was high in diagnosing sputum smear-positive PT, whereas in case of sputum smear-negative PT it was slightly low.
{"title":"Diagnosis of the Sputum Smear Positive and Sputum Smear Negative Pulmonary Tuberculosis - The Role of High - Resolution Computed Tomography of Chest","authors":"Himandri Harish Warbhe, Himanshu Pophale, Pankaj Magar, Archana Kanavde, Sudhanshu Sunil Tonpe","doi":"10.14260/jemds.v11i12.262","DOIUrl":"https://doi.org/10.14260/jemds.v11i12.262","url":null,"abstract":"BACKGROUND \u0000Mycobacterium tuberculosis complex causes pulmonary tuberculosis (PT) which is a major public health problem worldwide and endemic in India. PT diagnosis is done by high-resolution computed tomography (HRCT) which has high sensitivity and specificity. \u0000METHODS \u0000At a tertiary hospital, this cross-sectional study was conducted for 3 years. Patients presenting with productive cough with or without haemoptysis, shortness of breath, fever with night sweats or weight loss were suspected of having tuberculosis and underwent HRCT. PT was defined as the presence of consolidation, centrilobular nodules, and branching nodules with a tree in bud appearance with or without lymphadenopathy and pleural effusion on HRCT. \u0000RESULTS \u0000In this study, a total of 118 patients with a mean age of 51.85 ± 16.86 years were included. 64 (54.2%) were males and 54 (45.76%) were females out of 118 patients. Sputum smear was negative in a total of 66 (55.9%) patients and positive in 52(44.06%) patients. 84.26% was the diagnostic accuracy of HRCT in diagnosing PT with sensitivity, specificity, PPV and NPV of 84.28%, 83.33%, 78.98%, and 99.02%, respectively. HRCT had diagnostic accuracy, sensitivity, specificity, PPV and NPV of 86.40%, 89.46%, 83.42%, 94.14% and 72.43%, respectively in sputum smear positive patients. Whereas it was 83.87%, 91.54%, 75.40%, 64.57%, and 92.14%, respectively in sputum smear negative patients. \u0000CONCLUSIONS \u0000In diagnosing sputum smear-positive and sputum smear-negative PT, HRCT has high sensitivity. The specificity of HRCT was high in diagnosing sputum smear-positive PT, whereas in case of sputum smear-negative PT it was slightly low.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45851004","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 : 2022-11-30DOI: 10.14260/jemds.v11i12.267
Thomas Erwin Christian Junus Huwae, Panji Sananta, Made Suariastawa Putra, Mochammad Ridwan, Vivid Prety Anggraini, Agung Riyanto Budi Santoso, Satria Pandu Persada Isma
BACKGROUND The rehabilitation intervention for upper extremity fracture varies from shoulder to finger, obtained from physical modalities and exercise. Physical modality and exercise rehabilitation intervention effectively reduce pain, increase range of motion (ROM), hand function and improve quality of life. This systematic review aims to synthesize current scientific knowledge on rehabilitative interventions with a specific focus on upper extremity fractures and the effect of all interventions on the patient. METHODS Three scholarly databases (PubMed, Google Scholar, Science Direct) were systematically searched. Literature published before 10 January 2022 focused on upper extremity fracture and rehabilitation treatment patients. Quality assessment was completed with CEBM tools by Oxford University. For PICO, The Population was upper extremity fractures, and the intervention was rehabilitation intervention, both physical modality and exercise. The comparation was other rehabilitation interventions or without rehabilitation, and the outcome in this study were measured with the visual analogue scale (VAS), ROM, hand function, and quality of life (QoL). RESULTS Eight studies were included in this review among 18.326 reference titles founded and screened. All of the studies had various sample sizes followed by bias analysis with CEBM tools. Rehabilitation for elbow fracture was dynamic fixation using rigid tape and proprioceptive neuromuscular facilitation stretching. Rehabilitation for distal radius fracture was scapular exercise, graded motor imagery, hot pack on hand volume, illusory kinesthesia, and wrist exercise. These interventions can reduce the pain, improve strength, range of motion, hand function and quality of life in upper extremity fracture patients. CONCLUSIONS Exercise and physical modality rehabilitation intervention have proven to reduce pain, improve strength, range of motion, hand function and quality of life in upper extremity fracture patients.
{"title":"The Effect of Rehabilitation Intervention on Pain, Strength, Range of Motion, Hand Function and Quality of Life Patients with Upper Extremity Fracture - A Systematic Review","authors":"Thomas Erwin Christian Junus Huwae, Panji Sananta, Made Suariastawa Putra, Mochammad Ridwan, Vivid Prety Anggraini, Agung Riyanto Budi Santoso, Satria Pandu Persada Isma","doi":"10.14260/jemds.v11i12.267","DOIUrl":"https://doi.org/10.14260/jemds.v11i12.267","url":null,"abstract":"BACKGROUND \u0000The rehabilitation intervention for upper extremity fracture varies from shoulder to finger, obtained from physical modalities and exercise. Physical modality and exercise rehabilitation intervention effectively reduce pain, increase range of motion (ROM), hand function and improve quality of life. This systematic review aims to synthesize current scientific knowledge on rehabilitative interventions with a specific focus on upper extremity fractures and the effect of all interventions on the patient. \u0000METHODS \u0000Three scholarly databases (PubMed, Google Scholar, Science Direct) were systematically searched. Literature published before 10 January 2022 focused on upper extremity fracture and rehabilitation treatment patients. Quality assessment was completed with CEBM tools by Oxford University. For PICO, The Population was upper extremity fractures, and the intervention was rehabilitation intervention, both physical modality and exercise. The comparation was other rehabilitation interventions or without rehabilitation, and the outcome in this study were measured with the visual analogue scale (VAS), ROM, hand function, and quality of life (QoL). \u0000RESULTS \u0000Eight studies were included in this review among 18.326 reference titles founded and screened. All of the studies had various sample sizes followed by bias analysis with CEBM tools. Rehabilitation for elbow fracture was dynamic fixation using rigid tape and proprioceptive neuromuscular facilitation stretching. Rehabilitation for distal radius fracture was scapular exercise, graded motor imagery, hot pack on hand volume, illusory kinesthesia, and wrist exercise. These interventions can reduce the pain, improve strength, range of motion, hand function and quality of life in upper extremity fracture patients. \u0000CONCLUSIONS \u0000Exercise and physical modality rehabilitation intervention have proven to reduce pain, improve strength, range of motion, hand function and quality of life in upper extremity fracture patients.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45873897","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}
BACKGROUND Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was first detected in Wuhan, China in 2019 and since then has engulfed the entire globe at an unprecedented pace. The virus has infected all age groups, both males and females with or without symptoms and with significant variations. In this study, we wanted to analyse the data related to demographic features of COVID-19-infected patients mainly focusing on their age, gender and symptoms. METHODS This was a hospital-based retrospective study that included all laboratory-confirmed COVID-19 cases which were declared SARS-COV-2 real-time RT-PCR positive by VRDL, SMCH, Silchar from March 2020 to August 2021. Data related to the demographic characteristics of patients with COVID-19 infection was retrieved from the ICMR-COVID-19 portal of the laboratory and analysed. RESULTS The study included 8065 laboratory-confirmed COVID-19 cases which involved 5605 cases during the first wave and 2460 cases during the second wave of COVID-19, diagnosed from different districts of South Assam. The majority of infected patients were of the younger age group of 20-30 years. The mean age of the patients was almost similar in both waves i.e. 35.9 and 38.4 years. Of the total enrolled patients, 91.7% were reported asymptomatic while 8.3 % were symptomatic with fever and cough being the commonest ones. CONCLUSIONS The COVID-19 pandemic is a huge burden on healthcare facilities. The majority of the infected patients presenting to our hospital were young and asymptomatic, thus posing risk to the community. Hence, it is crucial to practice proper hygiene, wearing of masks and complete the vaccination schedule to achieve better vigilance to combat the COVID-19 pandemic more efficiently and effectively.
{"title":"Demographic and Clinical Profile of Patients with COVID-19 Infection during First and Second Wave in a Tertiary Care Hospital of South Assam","authors":"Debadatta Dhar Chanda, Swagata Roy, Priyanka Mukherjee, Harekrishna Nath, Ajit Dey, Moushumi Dey, Supriya Upadhyay","doi":"10.14260/jemds.v11i12.265","DOIUrl":"https://doi.org/10.14260/jemds.v11i12.265","url":null,"abstract":"BACKGROUND \u0000Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was first detected in Wuhan, China in 2019 and since then has engulfed the entire globe at an unprecedented pace. The virus has infected all age groups, both males and females with or without symptoms and with significant variations. In this study, we wanted to analyse the data related to demographic features of COVID-19-infected patients mainly focusing on their age, gender and symptoms. \u0000 METHODS \u0000This was a hospital-based retrospective study that included all laboratory-confirmed COVID-19 cases which were declared SARS-COV-2 real-time RT-PCR positive by VRDL, SMCH, Silchar from March 2020 to August 2021. Data related to the demographic characteristics of patients with COVID-19 infection was retrieved from the ICMR-COVID-19 portal of the laboratory and analysed. \u0000 RESULTS \u0000The study included 8065 laboratory-confirmed COVID-19 cases which involved 5605 cases during the first wave and 2460 cases during the second wave of COVID-19, diagnosed from different districts of South Assam. The majority of infected patients were of the younger age group of 20-30 years. The mean age of the patients was almost similar in both waves i.e. 35.9 and 38.4 years. Of the total enrolled patients, 91.7% were reported asymptomatic while 8.3 % were symptomatic with fever and cough being the commonest ones. \u0000 CONCLUSIONS \u0000The COVID-19 pandemic is a huge burden on healthcare facilities. The majority of the infected patients presenting to our hospital were young and asymptomatic, thus posing risk to the community. Hence, it is crucial to practice proper hygiene, wearing of masks and complete the vaccination schedule to achieve better vigilance to combat the COVID-19 pandemic more efficiently and effectively.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42817192","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 : 2022-10-31DOI: 10.14260/jemds.v11i11.241
Hussain Ali Sirsmith John, Shweta K. Sedani, Kasturi Wankhede
BACKGROUND Dentistry is considered an art and science, an art that involves the use as well as manipulation of various materials and science which includes the knowledge and application of these materials for the general welfare of the patient. Dentistry has evolved throughout the years through various technological advancements and the incorporation of newer materials into existing ones which have led to greater success and also better treatment options and techniques. The use of gold is not new in dentistry; it is one of the earliest used dental materials. The beneficial features of the element include anti-bacterial and antifungal properties. Gold is also one of the most biocompatible biomaterials; its use has been observed in the management of dental caries, periodontal disease, implant dentistry and also diagnosis of cancer.
{"title":"The Applications of Gold and Gold Nanoparticles as a Biomaterial in Dentistry - Gainful or Gimmick","authors":"Hussain Ali Sirsmith John, Shweta K. Sedani, Kasturi Wankhede","doi":"10.14260/jemds.v11i11.241","DOIUrl":"https://doi.org/10.14260/jemds.v11i11.241","url":null,"abstract":"BACKGROUND \u0000Dentistry is considered an art and science, an art that involves the use as well as manipulation of various materials and science which includes the knowledge and application of these materials for the general welfare of the patient. Dentistry has evolved throughout the years through various technological advancements and the incorporation of newer materials into existing ones which have led to greater success and also better treatment options and techniques. The use of gold is not new in dentistry; it is one of the earliest used dental materials. The beneficial features of the element include anti-bacterial and antifungal properties. Gold is also one of the most biocompatible biomaterials; its use has been observed in the management of dental caries, periodontal disease, implant dentistry and also diagnosis of cancer.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48244334","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}
Uterine torsion in an antenatal patient is such a rare phenomenon, that its incidence is yet not documented. Obstetricians can spend their entire careers without coming across such a case. We describe a case of an antenatal patient with a unicornuate uterus with asymptomatic uterine inversion.
{"title":"Uterine Torsion in a Gravid Unicornuate Uterus","authors":"Latika Chawla, Madhulika Singh, Ria M, Mamta Kumaree Sah, Shilpa Panta, Mriganka Bordoloi","doi":"10.14260/jemds.v11i11.243","DOIUrl":"https://doi.org/10.14260/jemds.v11i11.243","url":null,"abstract":"Uterine torsion in an antenatal patient is such a rare phenomenon, that its incidence is yet not documented. Obstetricians can spend their entire careers without coming across such a case. We describe a case of an antenatal patient with a unicornuate uterus with asymptomatic uterine inversion.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47164466","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 : 2022-10-31DOI: 10.14260/jemds.v11i11.244
Saket Saurabh, Nimesh Jain, Hrushikesh Kharosekar, Vernon Velho
Intracranial fungal infections are rare. Their presentation is mostly subtle, clinically atypical in presentation, and they are usually mistaken for tuberculosis or brain tumour. Aspergillosis is the most common cause of intracranial fungal infections. Fungal infection enters the brain directly from the paranasal sinuses, ear, skull bone, or haematogenous spread from the lungs and gastrointestinal tract, or direct inoculation during surgery or trauma. The pathology depends on the route of spread, host immunity, and type of fungus. Intracranially, fungal infection invades brain matter or blood vessels. [1] The rarity of brain fungal infection, with nonspecific clinical picture, and progression to a fatal outcome provides considerable challenges for both diagnosis and management. Invasive sino-orbital fungal infections are rarely reported in immunocompetent patients in literature. We could not find anything related to primary fungal granuloma of the optic tract reported in literature. We report a case of primary fungal granuloma of optic chiasm in an immunocompetent patient.[2] 13-year-old female patient presented to us with sudden onset of loss of vision in both eyes. There were no other complaints. On neurological examination, there was no vision in both eyes (no perception of light). On fundoscopy, there was bilateral optic atrophy. Rest of the neurological examination was normal. Patient was investigated for magnetic resonance imaging (MRI) of brain with contrast study. MRI of brain was suggestive of a 2.2 x 1.8 x 1.6 cm mass in suprasellar region with its epicentre in the optic chiasma and extending to both optic nerves and optic tract. The lesion was separate from the underlying pituitary gland. The lesion was iso-intense on T1 weighted images and hyper-intense on T2 weighted images. It showed homogenous post-contrast enhancement. Our primary differential diagnosis was optic nerve glioma. Patient underwent immediate surgery, right peritoneal craniotomy, for excision of lesion. Intra-operatively, a firm yellowish white colored lesion arising from the optic chiasm was seen. Safe subtotal excision was done. Post-operative, there was no improvement in vision.
颅内真菌感染是罕见的。它们的表现大多很微妙，临床上不典型，通常被误认为是肺结核或脑瘤。Aspergillosis是颅内真菌感染最常见的原因。真菌感染直接从鼻窦、耳朵、颅骨进入大脑，或从肺部和胃肠道血液传播，或在手术或创伤期间直接接种。病理学取决于传播途径、宿主免疫力和真菌类型。在颅内，真菌感染会侵入大脑或血管。[1] 脑真菌感染的罕见性，非特异性的临床表现，以及进展到致命的结果，为诊断和治疗提供了相当大的挑战。文献中很少报道免疫活性患者的侵袭性眶内真菌感染。我们没有发现任何与文献中报道的原发性视路真菌肉芽肿有关的内容。我们报告了一例免疫功能正常患者的视交叉原发性真菌肉芽肿。[2] 一位13岁的女性患者突然出现双眼失明。没有其他抱怨。在神经系统检查中，两只眼睛都没有视力（没有光感）。眼底镜检查发现双侧视神经萎缩。其余神经系统检查正常。对患者进行脑部磁共振成像（MRI）对比研究。大脑MRI提示鞍上区有2.2 x 1.8 x 1.6 cm的肿块，其中心位于视交叉，并延伸至视神经和视束。病变与下方的垂体分离。病变在T1加权图像上是等强度的，而在T2加权图像上则是超强度的。它显示出均匀的对比度增强。我们的主要鉴别诊断是视神经胶质瘤。患者立即接受了右腹膜开颅手术，切除病变。术中可见视交叉引起的黄白色病变。进行了安全的次全切除术。术后视力没有改善。
{"title":"Optic Chiasmal Fungal Granuloma - Rare Cause of Blindness","authors":"Saket Saurabh, Nimesh Jain, Hrushikesh Kharosekar, Vernon Velho","doi":"10.14260/jemds.v11i11.244","DOIUrl":"https://doi.org/10.14260/jemds.v11i11.244","url":null,"abstract":"Intracranial fungal infections are rare. Their presentation is mostly subtle, clinically atypical in presentation, and they are usually mistaken for tuberculosis or brain tumour. Aspergillosis is the most common cause of intracranial fungal infections. Fungal infection enters the brain directly from the paranasal sinuses, ear, skull bone, or haematogenous spread from the lungs and gastrointestinal tract, or direct inoculation during surgery or trauma. The pathology depends on the route of spread, host immunity, and type of fungus. Intracranially, fungal infection invades brain matter or blood vessels. [1] \u0000The rarity of brain fungal infection, with nonspecific clinical picture, and progression to a fatal outcome provides considerable challenges for both diagnosis and management. Invasive sino-orbital fungal infections are rarely reported in immunocompetent patients in literature. We could not find anything related to primary fungal granuloma of the optic tract reported in literature. We report a case of primary fungal granuloma of optic chiasm in an immunocompetent patient.[2] \u000013-year-old female patient presented to us with sudden onset of loss of vision in both eyes. There were no other complaints. On neurological examination, there was no vision in both eyes (no perception of light). On fundoscopy, there was bilateral optic atrophy. Rest of the neurological examination was normal. Patient was investigated for magnetic resonance imaging (MRI) of brain with contrast study. MRI of brain was suggestive of a 2.2 x 1.8 x 1.6 cm mass in suprasellar region with its epicentre in the optic chiasma and extending to both optic nerves and optic tract. The lesion was separate from the underlying pituitary gland. The lesion was iso-intense on T1 weighted images and hyper-intense on T2 weighted images. It showed homogenous post-contrast enhancement. Our primary differential diagnosis was optic nerve glioma. \u0000Patient underwent immediate surgery, right peritoneal craniotomy, for excision of lesion. Intra-operatively, a firm yellowish white colored lesion arising from the optic chiasm was seen. Safe subtotal excision was done. Post-operative, there was no improvement in vision.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45550362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 16-year-old female was admitted following complaints of vomiting 2 days after intake of non-vegetarian food from a cafe. It was associated with the passage of loose stools with mucus. Following a seizure-like episode, she was referred to a higher centre. She was delirious and during the transit, she collapsed and died the same day. The body was transferred to the Forensic Medicine Department of Government Medical College, Kannur for post-mortem examination as a definite clinical diagnosis of the cause of death could not be made.
{"title":"Ekiri Syndrome - A Post-Mortem Study","authors":"Deepthi Pariyeriparambil Narayanan, Nikhil Lakshmanan Thekkumbadan, Shafeedha Rashbi Karakulangara, Pooja Shaji","doi":"10.14260/jemds.v11i11.242","DOIUrl":"https://doi.org/10.14260/jemds.v11i11.242","url":null,"abstract":"A 16-year-old female was admitted following complaints of vomiting 2 days after intake of non-vegetarian food from a cafe. It was associated with the passage of loose stools with mucus. Following a seizure-like episode, she was referred to a higher centre. She was delirious and during the transit, she collapsed and died the same day. The body was transferred to the Forensic Medicine Department of Government Medical College, Kannur for post-mortem examination as a definite clinical diagnosis of the cause of death could not be made.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44556924","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}
BACKGROUND There are many beliefs & misconceptions of patients associated with the orthodontic extraction of sound teeth. The decision to extract creates a cycle of doubts in the patients' minds. So, the purpose of this study was to assess the knowledge and perception of patients undergoing extractions of sound permanent teeth for orthodontic reasons in a dental teaching institute. METHODS This prospective study involved patients who were advised and indicated for orthodontic extraction of sound permanent teeth. A questionnaire which was content, and face validated was used to measure the patients’ responses, which included questions about the knowledge and perception of patients regarding the extraction of sound permanent teeth for orthodontic reason. The returned questionnaires were analysed, and responses were tabulated and subjected to various statistical tests. RESULTS The overall level of knowledge was 38.18 % above average and the level of perception was 45.45 % above average. There was no statistically significant association between age groups with the level of knowledge (P=0.4980). Percentagewise: higher the age group, the higher the knowledge. While there was a statistically significant association (P=0.0490) between age groups with the level of perception. Percentagewise in ≤19 yrs. it was 38.10 % as compared to 69.23 % in ≥20 yrs. age who had an above average level of perception. A statistically significant association between the ANOVA test (F=8.0794, P=0.0009) and Tukey's post hoc test was seen between education level with mean perception level. Subjects with a higher degree had above-average perception levels followed by secondary and higher secondary education levels. Knowledge level was significantly higher in subjects residing in an urban area as compared to rural area (t=-2.9097, P=0.0053), percentage wise also urban area had more level of mean knowledge (53.33 %) as compared to rural area (20 %). CONCLUSIONS The overall level of knowledge and perception in patients reporting for orthodontic extraction of sound teeth was less. The study concluded the need for more awareness about the orthodontic extraction of sound teeth which can lead to more satisfaction and less anxiety, especially in lower age groups and rural populations.
{"title":"Patients Knowledge and Perception about Orthodontic Extraction of Sound Permanent Teeth","authors":"Faisal Arshad, Jasbinder Kumar, Parveen Akhtar Lone, Sudha Bijyal","doi":"10.14260/jemds.v11i11.238","DOIUrl":"https://doi.org/10.14260/jemds.v11i11.238","url":null,"abstract":"BACKGROUND \u0000There are many beliefs & misconceptions of patients associated with the orthodontic extraction of sound teeth. The decision to extract creates a cycle of doubts in the patients' minds. So, the purpose of this study was to assess the knowledge and perception of patients undergoing extractions of sound permanent teeth for orthodontic reasons in a dental teaching institute. \u0000METHODS \u0000This prospective study involved patients who were advised and indicated for orthodontic extraction of sound permanent teeth. A questionnaire which was content, and face validated was used to measure the patients’ responses, which included questions about the knowledge and perception of patients regarding the extraction of sound permanent teeth for orthodontic reason. The returned questionnaires were analysed, and responses were tabulated and subjected to various statistical tests. \u0000RESULTS \u0000The overall level of knowledge was 38.18 % above average and the level of perception was 45.45 % above average. There was no statistically significant association between age groups with the level of knowledge (P=0.4980). Percentagewise: higher the age group, the higher the knowledge. While there was a statistically significant association (P=0.0490) between age groups with the level of perception. Percentagewise in ≤19 yrs. it was 38.10 % as compared to 69.23 % in ≥20 yrs. age who had an above average level of perception. A statistically significant association between the ANOVA test (F=8.0794, P=0.0009) and Tukey's post hoc test was seen between education level with mean perception level. Subjects with a higher degree had above-average perception levels followed by secondary and higher secondary education levels. Knowledge level was significantly higher in subjects residing in an urban area as compared to rural area (t=-2.9097, P=0.0053), percentage wise also urban area had more level of mean knowledge (53.33 %) as compared to rural area (20 %). \u0000CONCLUSIONS \u0000The overall level of knowledge and perception in patients reporting for orthodontic extraction of sound teeth was less. The study concluded the need for more awareness about the orthodontic extraction of sound teeth which can lead to more satisfaction and less anxiety, especially in lower age groups and rural populations.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46536198","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}
BACKGROUND Association of man with the microbial world have found to be co-existed since old ages. Out of these microbial agents, some bacteria which provide a symbiotic balance, leading to a protective and stabilizing effect on the body, are known as resident microbes. On the other hand, some bacteria which invade and grow in man’s tissues causing diseases, damages and sometimes death, are known as pathogenic bacteria. This study was performed to evaluate the carbapenem resistance pattern among the patients admitted to an ICU in the Accident and Emergency departments. METHODS Rectal/ perianal swabs were taken from patients who were admitted to the intensive care unit (ICU) of the accident and emergency department. Swabs were collected first on the day of admission, then on day 4, and thereafter weekly while they were admitted in the ICU to monitor the resistance pattern among ICU patients. RESULTS A total of 100 rectal/ perianal swabs were collected from 89 patients on different days of admission to the ICU. Out of these 89 patients, CRE, i.e. E. coli or Klebsiella species were obtained from 35 patients. Now from these 35 patients, the samples were collected on day 1, day 4, and day 7 of admission. Then, out of these 35 patients, carbapenem-resistant Klebsiella pneumoniae and E. coli isolates were recovered from 35 (39.3%) patients i.e. Klebsiella pneumoniae isolates from fifteen patients and carbapenem-resistant E. coli isolates from twenty patients. CONCLUSIONS Carbapenems were earlier considered as the last-resort antibiotics for the treatment of infections caused by multidrug-resistant gram-negative bacteria. But, due to non-judicious use of carbapenems in clinical settings, the emergence of carbapenem-resistant organisms has become a big threat of concern to human health.
{"title":"Evaluation of Faecal Carriage of Carbapenem-Resistant Enterobacteriaceae among Patients Admitted in an Intensive Care Unit of a Tertiary Care Hospital","authors":"Naina Nehra, Antariksh Deep, Dhruva Chaudhry, Akanksha Sharma","doi":"10.14260/jemds.v11i11.237","DOIUrl":"https://doi.org/10.14260/jemds.v11i11.237","url":null,"abstract":"BACKGROUND \u0000Association of man with the microbial world have found to be co-existed since old ages. Out of these microbial agents, some bacteria which provide a symbiotic balance, leading to a protective and stabilizing effect on the body, are known as resident microbes. On the other hand, some bacteria which invade and grow in man’s tissues causing diseases, damages and sometimes death, are known as pathogenic bacteria. This study was performed to evaluate the carbapenem resistance pattern among the patients admitted to an ICU in the Accident and Emergency departments. \u0000METHODS \u0000Rectal/ perianal swabs were taken from patients who were admitted to the intensive care unit (ICU) of the accident and emergency department. Swabs were collected first on the day of admission, then on day 4, and thereafter weekly while they were admitted in the ICU to monitor the resistance pattern among ICU patients. \u0000RESULTS \u0000A total of 100 rectal/ perianal swabs were collected from 89 patients on different days of admission to the ICU. Out of these 89 patients, CRE, i.e. E. coli or Klebsiella species were obtained from 35 patients. Now from these 35 patients, the samples were collected on day 1, day 4, and day 7 of admission. Then, out of these 35 patients, carbapenem-resistant Klebsiella pneumoniae and E. coli isolates were recovered from 35 (39.3%) patients i.e. Klebsiella pneumoniae isolates from fifteen patients and carbapenem-resistant E. coli isolates from twenty patients. \u0000CONCLUSIONS \u0000Carbapenems were earlier considered as the last-resort antibiotics for the treatment of infections caused by multidrug-resistant gram-negative bacteria. But, due to non-judicious use of carbapenems in clinical settings, the emergence of carbapenem-resistant organisms has become a big threat of concern to human health.","PeriodicalId":47072,"journal":{"name":"Journal of Evolution of Medical and Dental Sciences-JEMDS","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43358690","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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