Pub Date : 2024-01-19DOI: 10.4103/jigims.jigims_48_23
S. Jha, Rakesh Kumar Singh
Chronic suppurative otitis media (CSOM) is a leading disorder known for hearing loss. We aimed to investigate the associated determinant factors of CSOM with sensorineural hearing loss (SNHL). A prospective observational study of CSOM was conducted at a tertiary care university hospital from December 2020 to December 2022. The study included 149 patients of either gender and unilateral disease who presented to the otorhinolaryngology outpatient door. All subjects underwent clinical examinations and pure-tone audiometry. Bone conduction thresholds for both affected and nonaffected ears at audible frequencies were taken to determine sensorineural hearing loss. The intraoperative visibility of ossicular status was assessed through the operation recordings. The mean age of the 79 males and 70 females was 26.54 ± 8.75 years. Sensorineural hearing loss was evidenced in 25.5% of cases; afterward, conductive and mixed hearing losses were found in 68.5% and 6% of individuals. It was found that females and the absence of cholesteatoma have a significant (P < 0.05) association with SNHL, whereas hearing loss >56 dB had a highly significant (P < 0.001) association with SNHL. We investigated the relationship of SNHL with the status of ossicles. Similarly, incus was the most common ossicle erosion associated with SNHL (10.6%), which was statistically significant (P = 0.002). We found that ossicular status, cholesteatoma, and grade of hearing loss were statistically significant and were associated with sensorineural hearing loss in CSOM.
{"title":"Determinant of chronic suppurative otitis media and its association with the sensorineural component of hearing loss","authors":"S. Jha, Rakesh Kumar Singh","doi":"10.4103/jigims.jigims_48_23","DOIUrl":"https://doi.org/10.4103/jigims.jigims_48_23","url":null,"abstract":"\u0000 \u0000 \u0000 Chronic suppurative otitis media (CSOM) is a leading disorder known for hearing loss. We aimed to investigate the associated determinant factors of CSOM with sensorineural hearing loss (SNHL).\u0000 \u0000 \u0000 \u0000 A prospective observational study of CSOM was conducted at a tertiary care university hospital from December 2020 to December 2022. The study included 149 patients of either gender and unilateral disease who presented to the otorhinolaryngology outpatient door. All subjects underwent clinical examinations and pure-tone audiometry. Bone conduction thresholds for both affected and nonaffected ears at audible frequencies were taken to determine sensorineural hearing loss. The intraoperative visibility of ossicular status was assessed through the operation recordings.\u0000 \u0000 \u0000 \u0000 The mean age of the 79 males and 70 females was 26.54 ± 8.75 years. Sensorineural hearing loss was evidenced in 25.5% of cases; afterward, conductive and mixed hearing losses were found in 68.5% and 6% of individuals. It was found that females and the absence of cholesteatoma have a significant (P < 0.05) association with SNHL, whereas hearing loss >56 dB had a highly significant (P < 0.001) association with SNHL. We investigated the relationship of SNHL with the status of ossicles. Similarly, incus was the most common ossicle erosion associated with SNHL (10.6%), which was statistically significant (P = 0.002).\u0000 \u0000 \u0000 \u0000 We found that ossicular status, cholesteatoma, and grade of hearing loss were statistically significant and were associated with sensorineural hearing loss in CSOM.\u0000","PeriodicalId":516751,"journal":{"name":"Journal of Indira Gandhi Institute Of Medical Science","volume":"17 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140503130","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 : 2024-01-19DOI: 10.4103/jigims.jigims_42_23
Pankaj Kumar
{"title":"Cognitive bias leading to diagnostic errors in patient management in emergency room","authors":"Pankaj Kumar","doi":"10.4103/jigims.jigims_42_23","DOIUrl":"https://doi.org/10.4103/jigims.jigims_42_23","url":null,"abstract":"","PeriodicalId":516751,"journal":{"name":"Journal of Indira Gandhi Institute Of Medical Science","volume":"420 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140502767","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 : 2024-01-19DOI: 10.4103/jigims.jigims_50_23
Devarakonda Prithvi, Ajeet Kumar, Amarjeet Kumar
Pulmonary manifestation in dengue is due to the involvement of both the upper and lower airways. Severe forms of dengue infection (pleural effusion, dengue hemorrhagic shock syndrome, and acute respiratory distress syndrome [ARDS]) are mainly due to the involvement of the lower respiratory tract. ARDS is a well-known respiratory complication following dengue infection. Patients with chronic kidney disease (CKD) diagnosed with dengue had a higher risk of unfavorable outcomes. Pulmonary involvement is one of the life-threatening complications in patients having CKD that contributes to increasing the mortality rate. Dysregulation of cytokines and apoptotic signaling pathway is a nonclassical mechanism of the kidney–lung crosstalk that results in the development of acute kidney injury in patients having ARDS. Severe worsening of renal function is common in CKD patients with dengue. Here, we discuss fluid management strategy in a patient having CKD who developed ARDS following dengue infection. The difficulty in the therapeutic dilemma is attributable to ambiguity in liberal versus conservative fluid therapy, contributing to a high risk of mortality. The narrow window of fluid tolerance in CKD patients further complicates the resuscitation strategy in patients with dengue ARDS.
{"title":"Fluid management strategy in dengue acute respiratory distress syndrome with chronic kidney disease: A case report","authors":"Devarakonda Prithvi, Ajeet Kumar, Amarjeet Kumar","doi":"10.4103/jigims.jigims_50_23","DOIUrl":"https://doi.org/10.4103/jigims.jigims_50_23","url":null,"abstract":"\u0000 Pulmonary manifestation in dengue is due to the involvement of both the upper and lower airways. Severe forms of dengue infection (pleural effusion, dengue hemorrhagic shock syndrome, and acute respiratory distress syndrome [ARDS]) are mainly due to the involvement of the lower respiratory tract. ARDS is a well-known respiratory complication following dengue infection. Patients with chronic kidney disease (CKD) diagnosed with dengue had a higher risk of unfavorable outcomes. Pulmonary involvement is one of the life-threatening complications in patients having CKD that contributes to increasing the mortality rate. Dysregulation of cytokines and apoptotic signaling pathway is a nonclassical mechanism of the kidney–lung crosstalk that results in the development of acute kidney injury in patients having ARDS. Severe worsening of renal function is common in CKD patients with dengue. Here, we discuss fluid management strategy in a patient having CKD who developed ARDS following dengue infection. The difficulty in the therapeutic dilemma is attributable to ambiguity in liberal versus conservative fluid therapy, contributing to a high risk of mortality. The narrow window of fluid tolerance in CKD patients further complicates the resuscitation strategy in patients with dengue ARDS.","PeriodicalId":516751,"journal":{"name":"Journal of Indira Gandhi Institute Of Medical Science","volume":"488 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140502615","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 : 2024-01-19DOI: 10.4103/jigims.jigims_44_23
Vinod R. Thacore, Nitin P. Dharwadkar
Our goal is to highlight challenges clinicians encounter in achieving valid psychiatric diagnoses in linguistically and culturally diverse patients. These challenges often arise from language barriers, misinterpretation of nuanced expressions of distress, and a lack of consideration for the patient’s unique experiences and perspectives regarding their illness, leading to potential misdiagnoses. In this context, we explore the strategies to address these diagnostic issues. To illustrate these challenges, clinical examples of culturally diverse patients are presented. These cases offer insights into the cultural nuances of expressing distress and attributing illness to the external factors such as cosmic influences and spiritual afflictions, often employed as a way to conceal underlying causes. To achieve culturally appropriate diagnoses, clinicians need to be mindful of their patients’ cultural and spiritual beliefs, establish trust and rapport, and approach patient narratives with empathy. This empathetic approach allows clinicians to gain a deeper understanding of the patient’s cultural expressions of distress and their perspectives on illness attribution, often tied to supernatural influences. Importantly, effective communication is a key to uncovering the concealed causes of the patient’s condition.
{"title":"Diagnosing mental disorders in diverse cultures","authors":"Vinod R. Thacore, Nitin P. Dharwadkar","doi":"10.4103/jigims.jigims_44_23","DOIUrl":"https://doi.org/10.4103/jigims.jigims_44_23","url":null,"abstract":"\u0000 Our goal is to highlight challenges clinicians encounter in achieving valid psychiatric diagnoses in linguistically and culturally diverse patients. These challenges often arise from language barriers, misinterpretation of nuanced expressions of distress, and a lack of consideration for the patient’s unique experiences and perspectives regarding their illness, leading to potential misdiagnoses. In this context, we explore the strategies to address these diagnostic issues. To illustrate these challenges, clinical examples of culturally diverse patients are presented. These cases offer insights into the cultural nuances of expressing distress and attributing illness to the external factors such as cosmic influences and spiritual afflictions, often employed as a way to conceal underlying causes. To achieve culturally appropriate diagnoses, clinicians need to be mindful of their patients’ cultural and spiritual beliefs, establish trust and rapport, and approach patient narratives with empathy. This empathetic approach allows clinicians to gain a deeper understanding of the patient’s cultural expressions of distress and their perspectives on illness attribution, often tied to supernatural influences. Importantly, effective communication is a key to uncovering the concealed causes of the patient’s condition.","PeriodicalId":516751,"journal":{"name":"Journal of Indira Gandhi Institute Of Medical Science","volume":"89 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139640438","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 : 2024-01-19DOI: 10.4103/jigims.jigims_53_23
Amarjeet Kumar, C. Sinha, Kunal Singh, Ajeet Kumar
{"title":"Application of 5% lignocaine patch following radial artery access for the prevention of radial artery occlusion: A novel use","authors":"Amarjeet Kumar, C. Sinha, Kunal Singh, Ajeet Kumar","doi":"10.4103/jigims.jigims_53_23","DOIUrl":"https://doi.org/10.4103/jigims.jigims_53_23","url":null,"abstract":"","PeriodicalId":516751,"journal":{"name":"Journal of Indira Gandhi Institute Of Medical Science","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140503288","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 : 2024-01-19DOI: 10.4103/jigims.jigims_41_23
Pratibha Jha, Sumedha Singh, Ratan Kumar Dutta
Preeclampsia is a maternal disease encountered during the second half of pregnancy. Many risk factors have been implicated in its pathogenesis. Periodontitis may burden pregnant patients systemically with cytokines and endotoxin at the maternal fetal interface leading to endothelium dysfunction. Hence, our objective was to check the association between periodontitis and preeclampsia. This observational study was conducted in the outpatient department (OPD) of community health center from March 15, 2022, to December 14, 2022, on 100 patients. Pregnant women of age group >18 years with informed consent with gestational age between 26 and 36 weeks with Singleton pregnancy. Women with a history of smoking, alcohol and periodontal treatment, multiple pregnancy, and consumption of antibiotics (3 months before study inclusion) were excluded. All eligible candidates in the antenatal clinic in OPD of obstetrics and gynecology were screened by history, obstetrical examination, routine antenatal tests, including urine routine and blood pressure measurement. Subjects were evaluated as per the designed protocol. Fifty preeclamptics were taken as case and 50 non preeclamptic were taken as control. Oral examination was conducted on the patients at the inclusion in the study and followed till delivery. Blood pressure and urine albumin were checked at each visit. Details noted on delivery and outcomes were observed. The risk of preeclampsia in women having periodontitis showed an odds ratio of 3.436 (95% confidence interval: 1.460–8.065; P = 0.006). As the etiology of both events is multifactorial preeclampsia and periodontitis relationship needs wise attention.
{"title":"Evaluation of association between periodontitis in pregnant women and preeclampsia","authors":"Pratibha Jha, Sumedha Singh, Ratan Kumar Dutta","doi":"10.4103/jigims.jigims_41_23","DOIUrl":"https://doi.org/10.4103/jigims.jigims_41_23","url":null,"abstract":"\u0000 \u0000 \u0000 Preeclampsia is a maternal disease encountered during the second half of pregnancy. Many risk factors have been implicated in its pathogenesis. Periodontitis may burden pregnant patients systemically with cytokines and endotoxin at the maternal fetal interface leading to endothelium dysfunction. Hence, our objective was to check the association between periodontitis and preeclampsia.\u0000 \u0000 \u0000 \u0000 This observational study was conducted in the outpatient department (OPD) of community health center from March 15, 2022, to December 14, 2022, on 100 patients.\u0000 \u0000 \u0000 \u0000 Pregnant women of age group >18 years with informed consent with gestational age between 26 and 36 weeks with Singleton pregnancy. Women with a history of smoking, alcohol and periodontal treatment, multiple pregnancy, and consumption of antibiotics (3 months before study inclusion) were excluded. All eligible candidates in the antenatal clinic in OPD of obstetrics and gynecology were screened by history, obstetrical examination, routine antenatal tests, including urine routine and blood pressure measurement. Subjects were evaluated as per the designed protocol. Fifty preeclamptics were taken as case and 50 non preeclamptic were taken as control. Oral examination was conducted on the patients at the inclusion in the study and followed till delivery. Blood pressure and urine albumin were checked at each visit. Details noted on delivery and outcomes were observed.\u0000 \u0000 \u0000 \u0000 The risk of preeclampsia in women having periodontitis showed an odds ratio of 3.436 (95% confidence interval: 1.460–8.065; P = 0.006).\u0000 \u0000 \u0000 \u0000 As the etiology of both events is multifactorial preeclampsia and periodontitis relationship needs wise attention.\u0000","PeriodicalId":516751,"journal":{"name":"Journal of Indira Gandhi Institute Of Medical Science","volume":"3 3-4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140503121","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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