Dr ASHISH K SAXENA, Dr NEELAM BALA, Dr RAKA SHEOHARE, Dr BIJAY PATNI
Urinary tract infection (UTI), both symptomatic and asymptomatic, occurs very frequently in the population, especially amongpatients with diabetes. With the advent of newer medications such as sodium-glucose co-transporter 2 (SGLT2) inhibitors, thereis greater focus on this disease. Cranberry products have been used earlier in various forms as a natural remedy for this disease.Certain compounds like flavonoids, distinctive proanthocyanidins with prominent active ingredients like phenolic acid inhibitthe adherence of fibrillae of Escherichia coli to the urothelial cells lining the urinary bladder. This article takes a brief look atthe disease and the role of cranberry as a natural remedy for UTI.
{"title":"Role of Cranberry in Urinary Tract Infections","authors":"Dr ASHISH K SAXENA, Dr NEELAM BALA, Dr RAKA SHEOHARE, Dr BIJAY PATNI","doi":"10.59793/ijcp.v34i9.775","DOIUrl":"https://doi.org/10.59793/ijcp.v34i9.775","url":null,"abstract":"Urinary tract infection (UTI), both symptomatic and asymptomatic, occurs very frequently in the population, especially amongpatients with diabetes. With the advent of newer medications such as sodium-glucose co-transporter 2 (SGLT2) inhibitors, thereis greater focus on this disease. Cranberry products have been used earlier in various forms as a natural remedy for this disease.Certain compounds like flavonoids, distinctive proanthocyanidins with prominent active ingredients like phenolic acid inhibitthe adherence of fibrillae of Escherichia coli to the urothelial cells lining the urinary bladder. This article takes a brief look atthe disease and the role of cranberry as a natural remedy for UTI.","PeriodicalId":506647,"journal":{"name":"Indian Journal Of Clinical Practice","volume":"53 48","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139961340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Are Advance Medical Directives Legal in India?","authors":"Ijcp","doi":"10.59793/ijcp.v34i9.781","DOIUrl":"https://doi.org/10.59793/ijcp.v34i9.781","url":null,"abstract":"MEDICOLEGAL","PeriodicalId":506647,"journal":{"name":"Indian Journal Of Clinical Practice","volume":"24 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139960849","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}
Dr KEYUR PATEL, Dr RAJENDRA B NERLI, Dr NAVIN MULIMANI, Dr SHREYAS RAI, Dr ABHINAY JOGULA, Dr ASHWIN BOKARE, Dr NISHANT SETYA
Renal artery pseudoaneurysm is a rare complication of blunt renal trauma. Super-selective angioembolization is aminimally invasive, effective procedure to manage traumatic renal artery pseudoaneurysm, in patients who are hemodynamicallystable. We report our experience in the management of patients with post-traumatic bleeding pseudoaneurysm withangioembolization. Materials and methods: We retrospectively reviewed the inpatient and outpatient records and imagingdata of our hospital, of all patients with history of blunt injury to kidneys, admitted with massive hematuria and underwentangioembolization to control the bleeding. Results: During the study period, 3 patients (all male) with a mean age of 26.66 yearspresented to us with blunt injury abdomen. Contrast computed tomography (CT) revealed Grade IV renal injury in 2 patientsand Grade V injury in 1 patient. Focal intensively enhancing areas were noted at the site of renal parenchymal lacerationssuggestive of pseudoaneurysms. Super-selective catheterization was performed and embolization done using 50% N-butyl-2-cyanoacrylate (NBCA) + Lipiodol. Conclusions: Angioembolization, a radiographic intervention, is an effective and minimallyinvasive technique to stop active bleeding from renal artery pseudoaneurysms.
肾动脉假性动脉瘤是钝性肾创伤的一种罕见并发症。对于血流动力学稳定的患者，超选择性血管栓塞术是一种微创、有效的治疗外伤性肾动脉假性动脉瘤的方法。我们报告了用血管栓塞术治疗外伤后出血假性动脉瘤患者的经验。材料和方法：我们回顾性地查看了本院所有有肾脏钝伤史、因大量血尿入院并接受血管栓塞术控制出血的患者的住院和门诊病历及影像学资料。研究结果在研究期间，有 3 名患者（均为男性）因腹部钝伤就诊，平均年龄为 26.66 岁。对比计算机断层扫描（CT）显示，2 名患者为 IV 级肾损伤，1 名患者为 V 级损伤。在肾实质撕裂的部位发现局灶性强化区，提示假性动脉瘤。进行了超选择性导管插入术，并使用 50%N-丁基-2-氰基丙烯酸酯（NBCA）+ Lipiodol 进行栓塞。结论血管栓塞术是一种放射学干预手段，是一种有效的微创技术，可用于止住肾动脉假性动脉瘤的活动性出血。
{"title":"Post-Traumatic Renal Artery Pseudoaneurysm Managed Successfully with Angioembolization","authors":"Dr KEYUR PATEL, Dr RAJENDRA B NERLI, Dr NAVIN MULIMANI, Dr SHREYAS RAI, Dr ABHINAY JOGULA, Dr ASHWIN BOKARE, Dr NISHANT SETYA","doi":"10.59793/ijcp.v34i9.776","DOIUrl":"https://doi.org/10.59793/ijcp.v34i9.776","url":null,"abstract":"Renal artery pseudoaneurysm is a rare complication of blunt renal trauma. Super-selective angioembolization is aminimally invasive, effective procedure to manage traumatic renal artery pseudoaneurysm, in patients who are hemodynamicallystable. We report our experience in the management of patients with post-traumatic bleeding pseudoaneurysm withangioembolization. Materials and methods: We retrospectively reviewed the inpatient and outpatient records and imagingdata of our hospital, of all patients with history of blunt injury to kidneys, admitted with massive hematuria and underwentangioembolization to control the bleeding. Results: During the study period, 3 patients (all male) with a mean age of 26.66 yearspresented to us with blunt injury abdomen. Contrast computed tomography (CT) revealed Grade IV renal injury in 2 patientsand Grade V injury in 1 patient. Focal intensively enhancing areas were noted at the site of renal parenchymal lacerationssuggestive of pseudoaneurysms. Super-selective catheterization was performed and embolization done using 50% N-butyl-2-cyanoacrylate (NBCA) + Lipiodol. Conclusions: Angioembolization, a radiographic intervention, is an effective and minimallyinvasive technique to stop active bleeding from renal artery pseudoaneurysms.","PeriodicalId":506647,"journal":{"name":"Indian Journal Of Clinical Practice","volume":"53 51","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139961337","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}
Dr DARPAN KOTHIA, Dr DHYEY MUNGALPARA, Dr HEMANG K ACHARYA, Dr MANISH N MEHTA
Autoimmune hemolytic anemia (AIHA) is a medical disorder where the immune system erroneously targets and destroysred blood cells (RBCs), causing a reduction in their longevity. This results in an inadequate supply of RBCs to carry oxygen,leading to symptoms like fatigue, weakness and jaundice. AIHA is categorized into warm and cold types based on theoptimal temperature for antibody activity. A comprehensive grasp of the immunological mechanisms involved is essentialfor accurate diagnosis and effective management of this autoimmune condition. AIHA is a frequently missed diagnosis aspatient are not fully investigated, and treated with vitamin B12, folic acid and iron in outpatient department.
{"title":"A Case of Idiopathic Autoimmune Hemolytic Anemia: Every Anemia – First Type It and Then Treat It","authors":"Dr DARPAN KOTHIA, Dr DHYEY MUNGALPARA, Dr HEMANG K ACHARYA, Dr MANISH N MEHTA","doi":"10.59793/ijcp.v34i9.778","DOIUrl":"https://doi.org/10.59793/ijcp.v34i9.778","url":null,"abstract":"Autoimmune hemolytic anemia (AIHA) is a medical disorder where the immune system erroneously targets and destroysred blood cells (RBCs), causing a reduction in their longevity. This results in an inadequate supply of RBCs to carry oxygen,leading to symptoms like fatigue, weakness and jaundice. AIHA is categorized into warm and cold types based on theoptimal temperature for antibody activity. A comprehensive grasp of the immunological mechanisms involved is essentialfor accurate diagnosis and effective management of this autoimmune condition. AIHA is a frequently missed diagnosis aspatient are not fully investigated, and treated with vitamin B12, folic acid and iron in outpatient department.","PeriodicalId":506647,"journal":{"name":"Indian Journal Of Clinical Practice","volume":"14 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139960998","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}
Dr I SATHYAMURTHY, Dr KANTHALLU NARAYANAMOORTHY SRINIVASAN
Ivabradine has been used for over a decade in managing chronic coronary syndromes and heart failure (HF) with reducedejection fraction (HFrEF). HF with preserved ejection fraction (HFpEF) accounts for 50% of the total HF cases carrying equalmortality and morbidity risk as HFrEF. Increased heart rate (HR) in such cases has been shown to be associated with poorclinical outcomes. Clinical conditions like inappropriate sinus tachycardia (IST) manifest with elevated HR without anyspecific triggers. Beta-blockers have been the preferred treatment of choice for both HFpEF and IST but are often ineffective orpresent with side effects due to their negative ionotropic effects. Ivabradine, through its inhibitory action on funny current(Ifc), reduces HR without altering the inotropic mechanism. Few case reports and small case series have documented itsextended use and efficacy in reducing HR in these cardiac conditions. In this article, we present two cases who needed HRcontrol, one with HFpEF and another case of IST syndrome. Ivabradine was successfully used in both these cases to controlthe elevated HR.
伊伐布雷定用于治疗慢性冠状动脉综合征和射血分数降低的心力衰竭（HF）已有十多年的历史。射血分数保留型心力衰竭（HFpEF）占心力衰竭病例总数的 50%，其死亡率和发病风险与 HFrEF 相当。此类病例的心率（HR）增快已被证明与临床预后不良有关。不适当的窦性心动过速（IST）等临床症状表现为心率增快，但没有任何特定的诱因。β-受体阻滞剂一直是治疗高频心动过速和窦性心动过速的首选药物，但由于其负离子传导作用，往往效果不佳或存在副作用。伊伐布雷定通过抑制滑稽电流（Ifc），在不改变肌力机制的情况下降低心率。很少有病例报告和小型病例系列记录了伊伐布雷定在这些心脏疾病中的应用和降低心率的疗效。在本文中，我们介绍了两个需要控制心率的病例，其中一个患有 HFpEF，另一个患有 IST 综合征。伊伐布雷定在这两个病例中都成功地控制了心率升高。
{"title":"Extended Use of Ivabradine in Heart Failure with Preserved Ejection Fraction and Inappropriate Sinus Tachycardia","authors":"Dr I SATHYAMURTHY, Dr KANTHALLU NARAYANAMOORTHY SRINIVASAN","doi":"10.59793/ijcp.v34i9.779","DOIUrl":"https://doi.org/10.59793/ijcp.v34i9.779","url":null,"abstract":"Ivabradine has been used for over a decade in managing chronic coronary syndromes and heart failure (HF) with reducedejection fraction (HFrEF). HF with preserved ejection fraction (HFpEF) accounts for 50% of the total HF cases carrying equalmortality and morbidity risk as HFrEF. Increased heart rate (HR) in such cases has been shown to be associated with poorclinical outcomes. Clinical conditions like inappropriate sinus tachycardia (IST) manifest with elevated HR without anyspecific triggers. Beta-blockers have been the preferred treatment of choice for both HFpEF and IST but are often ineffective orpresent with side effects due to their negative ionotropic effects. Ivabradine, through its inhibitory action on funny current(Ifc), reduces HR without altering the inotropic mechanism. Few case reports and small case series have documented itsextended use and efficacy in reducing HR in these cardiac conditions. In this article, we present two cases who needed HRcontrol, one with HFpEF and another case of IST syndrome. Ivabradine was successfully used in both these cases to controlthe elevated HR.","PeriodicalId":506647,"journal":{"name":"Indian Journal Of Clinical Practice","volume":"46 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139961286","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}
Both sports (physical activity) and statins are recommended for the prevention and management of atherosclerotic cardiovasculardisease. The synergy that they create in risk reduction, however, may turn dysfunctional at times. Statin usage is associated witha risk of muscle-related conditions including myalgia, myositis and rhabdomyolysis. This risk is exacerbated by unaccustomedphysical activity, exercise or sports. The communication shares practical and pragmatic suggestions regarding the preventionand management of the potential sports-statin interactions that may occur. It also highlights the need to consider drug-lifestyleinteractions, apart from conventional drug-drug interactions.
{"title":"Sports-Statin Interaction: Ensuring Safe and Smart Synergy","authors":"Dr Sanjay Kalra, Dr Suneet Verma, Dr KAMAL KISHOR","doi":"10.59793/ijcp.v34i9.780","DOIUrl":"https://doi.org/10.59793/ijcp.v34i9.780","url":null,"abstract":"Both sports (physical activity) and statins are recommended for the prevention and management of atherosclerotic cardiovasculardisease. The synergy that they create in risk reduction, however, may turn dysfunctional at times. Statin usage is associated witha risk of muscle-related conditions including myalgia, myositis and rhabdomyolysis. This risk is exacerbated by unaccustomedphysical activity, exercise or sports. The communication shares practical and pragmatic suggestions regarding the preventionand management of the potential sports-statin interactions that may occur. It also highlights the need to consider drug-lifestyleinteractions, apart from conventional drug-drug interactions.","PeriodicalId":506647,"journal":{"name":"Indian Journal Of Clinical Practice","volume":"40 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139961977","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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