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Cetirizine-induced anaphylactic reaction refractory to steroids: A case report 西替利嗪致类固醇难治性过敏反应1例报告
Pub Date : 2023-01-01 DOI: 10.4103/mgmj.mgmj_65_23
Siby Joseph, RoseMerin Benny, Savya Kurian, Romia Rodriguez, Paul Puthuran
Cetirizine is the first choice over-the-counter drug for all types of allergic reactions. Belonging to the second-generation antihistamine, it has a very high affinity for peripheral H1 receptors. It rapidly relieves symptoms, has additional anti-inflammatory effects, and is well tolerated by most people. Despite this, some adverse effects include fatigue, pharyngitis, dizziness, headaches, and dry mouth. Hypersensitivity reactions induced by cetirizine are infrequent. Here, we are reporting a case of cetirizine-induced anaphylaxis found refractory to steroid therapy.
西替利嗪是治疗各种过敏反应的首选非处方药。它是第二代抗组胺药,对外周H1受体有很高的亲和力。它能迅速缓解症状,具有额外的抗炎作用,大多数人都能很好地耐受。尽管如此,一些不良反应包括疲劳、咽炎、头晕、头痛和口干。西替利嗪引起的超敏反应并不常见。在这里,我们报告一个病例西替利嗪引起的过敏反应发现难治性类固醇治疗。
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引用次数: 0
Atracurium versus cisatracurium: A comparison of efficacy and safety of intubating dose in adult surgical patients 阿曲库铵与顺式阿曲库铵:成人手术患者插管剂量的有效性和安全性比较
Pub Date : 2023-01-01 DOI: 10.4103/mgmj.mgmj_225_22
PradnyaS Joshi, Palak Bohra, Sanhita Kulkarni, VasantiM Sasturkar
Background: Our study investigated and compared the properties of atracurium and cisatracurium, nondepolarizing neuromuscular blocking agents from the benzylisoquinolinium group. Both of these agents exhibit an intermediate duration of action. We studied the onset of neuromuscular blockade, intubating conditions, hemodynamic stability, and recovery following intubating doses. Materials and Methods: We conducted a study involving 40 patients undergoing general anesthesia, randomly assigned to two groups. Group A, consisting of 20 patients, received a dose of 0.6 mg/kg of atracurium, while Group C, also with 20 patients, received 0.15 mg/kg of cisatracurium. Throughout the surgery, we observed and recorded the time of onset of neuromuscular blockade, the intubating conditions, and the recovery following the administration of the first dose of neuromuscular blocking agents. Additionally, we continuously monitored the patient’s hemodynamic status until they recovered from the initial dose. Results: Group C exhibited a significantly faster onset of action (231.5 ± 31.2 s) than Group A (291.0 ± 14.1 s) for the administered neuromuscular blocking agents. The recovery duration following the intubating dose was notably shorter in Group A (31 ± 6.20 min) compared to Group C (50.5 ± 3.20 min). Additionally, in the cisatracurium group, all patients (100%) achieved “excellent” intubating conditions, whereas in the atracurium group, this was only the case for 60% of patients, and this difference was statistically significant. Furthermore, the atracurium group showed significantly higher heart rate and mean arterial pressure readings at different intervals than the cisatracurium group. Importantly, no adverse reactions were observed in any of the patients throughout the study. Conclusion: Compared to atracurium (0.6 mg/kg), cisatracurium at a dose of 0.15 mg/kg demonstrates superior effectiveness regarding the onset and duration of neuromuscular blockade and intubating conditions. Furthermore, cisatracurium offers a more favorable hemodynamic profile.
背景:本研究调查并比较了苯基异喹啉类非去极化神经肌肉阻滞剂阿曲库铵和顺阿曲库铵的性质。这两种药剂的作用时间都是中等的。我们研究了神经肌肉阻滞的发作、插管条件、血流动力学稳定性和插管剂量后的恢复。材料与方法:我们对40例全麻患者进行了研究,随机分为两组。A组20例患者接受0.6 mg/kg剂量的阿曲库铵治疗,C组20例患者接受0.15 mg/kg顺阿曲库铵治疗。在整个手术过程中,我们观察并记录了神经肌肉阻滞的发生时间、插管情况以及首次给药后的恢复情况。此外,我们持续监测患者的血流动力学状态,直到他们从初始剂量恢复。结果:C组神经肌肉阻滞剂起效时间(231.5±31.2 s)明显快于a组(291.0±14.1 s)。插管后恢复时间A组(31±6.20 min)明显短于C组(50.5±3.20 min)。此外,在顺阿曲库铵组中,所有患者(100%)达到了“优秀”的插管条件,而在阿曲库铵组中,只有60%的患者达到了“优秀”的插管条件,这一差异具有统计学意义。此外,阿曲库铵组在不同时间间隔的心率和平均动脉压读数明显高于顺阿曲库铵组。重要的是,在整个研究过程中,没有观察到任何患者的不良反应。结论:与阿曲库铵(0.6 mg/kg)相比,顺阿曲库铵0.15 mg/kg剂量在神经肌肉阻断和插管条件下的起效和持续时间方面表现出优越的效果。此外,顺阿曲库铵提供了更有利的血流动力学剖面。
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引用次数: 0
Prevalence of ocular manifestations and related morbidity in severely malnourished children in a tertiary eye care center 三级眼科保健中心严重营养不良儿童眼部表现及相关发病率
Pub Date : 2023-01-01 DOI: 10.4103/mgmj.mgmj_194_22
Yuri Kashiv, P. Jain, Chirag D. Patel, M. Chanchlani, Harpal Singh
Background: Ocular involvement is relatively common in malnourished children, and the consequences of malnutrition on the eye are frequently more severe during the formative years of life. This is a significant cause of avoidable blindness that has to be addressed with affordable methods. This study aims to determine the nature, extent, and seriousness of ocular manifestations in malnourished children and to evaluate the current prevalence given improving nutritional parameters through increased public awareness, education, and knowledge of vaccination and nutrition. Materials and Methods: This study was carried out in the department of ophthalmology of a tertiary eye care center for 1 year. Eye camps were held close by in urban shantytowns. We considered 518 kids between the ages of 6 months and 5 years who lived in those slums. The patient was subjected to a general, systemic, and ocular examination, including a vision and fundus examination. Results: A total of 100 children aged 6 months and 5 years (60 months) who were severely critically malnourished were enrolled and given an eye examination. In this study, 72% of very acutely malnourished children had ocular involvement. Conjunctival pallor was the most general observation in the anterior segment in 179 of the eyes (71.5% of the eyes). Retinal hemorrhage was the most pervasive posterior segment findings in 19 eyes (36.8%). Conclusion: This study is aimed to determine how frequently ocular symptoms occurred in malnourished children who visited tertiary eye care facilities. A vital target population that requires comprehensive screening to avoid vitamin A deficiency (VAD) and detect eye problems early is preschoolers. Every child should also receive an immunization and vitamin A prophylaxis. Low socioeconomic position, illiterate parents, and inadequate sanitation were determined to be the key risk factors for VAD.
背景:眼睛受累在营养不良的儿童中相对常见,在生命的形成期,眼睛营养不良的后果往往更为严重。这是可避免失明的一个重要原因,必须用负担得起的方法来解决。本研究旨在确定营养不良儿童眼部表现的性质、程度和严重性,并通过提高公众对疫苗接种和营养的认识、教育和知识来改善营养参数,从而评估目前的患病率。材料和方法:本研究在一家三级眼科护理中心的眼科进行,为期1年。在城市棚户区附近设立了集中营。我们考虑了518名居住在这些贫民窟的6个月至5岁的儿童。患者接受了全身、全身和眼部检查,包括视力和眼底检查。结果:共有100名6个月和5岁(60个月)严重严重营养不良的儿童被纳入并接受了眼部检查。在这项研究中,72%的严重营养不良儿童患有眼部疾病。结膜苍白是179只眼睛(71.5%的眼睛)前部最常见的观察结果。视网膜出血是19只眼睛(36.8%)最常见的后眼部症状。结论:本研究旨在确定在接受三级眼科护理的营养不良儿童中出现眼部症状的频率。学龄前儿童是一个需要全面筛查以避免维生素A缺乏症(VAD)并尽早发现眼部问题的重要目标人群。每个儿童还应接受免疫接种和维生素A预防。社会经济地位低、父母文盲和卫生条件差被确定为VAD的关键风险因素。
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引用次数: 0
Associative role of methylenetetrahydrofolate reductase and thymidylate synthase 6bp del gene polymorphism in preterm delivery 亚甲基四氢叶酸还原酶和胸苷酸合成酶6bp基因多态性在早产中的关联作用
Pub Date : 2023-01-01 DOI: 10.4103/mgmj.mgmj_220_22
Surya Panikar, Sunil Sharma, K. Sureshkumar, S. Dubey, Mansee Thakur
Objective: Preterm delivery is a major adverse birth outcome, approximately 15 million babies are born prematurely every year. There are several causes for preterm deliveries. This study focuses on folate metabolic pathways. Dietary folate plays a crucial role in premature labor. We examined the relationship between methylenetetrahydrofolate reductase (MTHFR) (C677T) and thymidylate synthase (TYMS) 6bpdel polymorphism. Materials and Methods: A total number of 300 pregnant women were selected for this study; among which (n = 150) were preterm and (n = 150) were term delivery cases. The selected samples were further processed for molecular polymerase chain reaction-restriction fragment length polymorphism analysis. The demographic profile of birth status resulted significantly with (P = 0.0001) proving chances of high infant mortality due to prematurity. Results: The genotype distribution of MTHFR C677T showed significant data (P = 0.0021) whereas insignificant genotypic distribution was observed for the TYMS gene (P = 0.067). Our results imply that genes that are involved in the folate pathway play a crucial role in early pregnancy. Conclusion: Advanced and better strategies can be brought to an improved intervention of folate at the time of pregnancy which will help to reduce the rate of premature deliveries.
目的:早产是一种主要的不良分娩结果,每年约有1500万婴儿早产。早产的原因有很多。本研究的重点是叶酸代谢途径。叶酸在早产中起着至关重要的作用。我们研究了亚甲基四氢叶酸还原酶(MTHFR) (C677T)与胸苷酸合成酶(TYMS) 6bpdel多态性的关系。材料与方法:本研究共选取300名孕妇;其中早产(n = 150)例,足月分娩(n = 150)例。所选样品进一步进行分子聚合酶链反应-限制性片段长度多态性分析。出生状况的人口统计学特征显著(P = 0.0001)证明早产导致婴儿死亡率高的可能性。结果:MTHFR C677T基因型差异有统计学意义(P = 0.0021), TYMS基因型差异无统计学意义(P = 0.067)。我们的研究结果表明,参与叶酸途径的基因在怀孕早期起着至关重要的作用。结论:对妊娠期叶酸干预采取先进的、更好的策略,有助于降低早产率。
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引用次数: 0
Prevalence of glucose-6-phosphate dehydrogenase deficiency among children attending federal medical center, Owerri, Imo State, Nigeria 尼日利亚伊莫州奥韦里联邦医疗中心儿童葡萄糖-6-磷酸脱氢酶缺乏症患病率
Pub Date : 2023-01-01 DOI: 10.4103/mgmj.mgmj_140_23
Ewa Ogbonnaya, ChijiokeI Ugboaja, UbaniC Dimgba, Victoria Ayuba, IhezueU Chijindu, John Wassagwa, KabirM Yusuf
Background: This study focuses on glucose-6-phosphate dehydrogenase (G6PD) deficiency, a hereditary disease with a sex-linked recessive pattern leading to abnormally low levels of G6PD. The condition is primarily associated with drug and infection-induced hemolytic anemia, neonatal jaundice, and related consequences. The absence of locally sourced evidence-based data has contributed significantly to the elevated mortality rate observed in children affected by G6PD deficiency. As a result, the main objective of this research is to determine the prevalence of G6PD deficiency among children attending the Federal Medical Centre Owerri, Imo State, Nigeria. Materials and Methods: Over 6 months, a study was conducted at the Federal Medical Centre in Owerri, the capital of Imo State, South Eastern Nigeria. The study involved 150 children of both sexes, aged between 1 and 10 years, whose G-6-PD status was previously unknown. With the consent of their parents, the children underwent screening for G6PD deficiency, and qualitative data were collected from the parents. G6PD deficiency was identified using standard procedures. Results: The study included 150 children between 1 and 10 years old. Of these, 68 (45.5%) were females, and 82 (54.7%) were males. The study findings indicated that 31 subjects (20.7%) were found to have G6PD deficiency. Notably, a higher percentage of males, 82 (54.7%), had G6PD deficiency compared with 68 (45.5%) females. Furthermore, the research revealed that a significant proportion of G6PD deficient children 16 (35.6%) were within the age range of 1–2 years. Conclusion: The results of this research emphasize the importance of critical stakeholders directing their efforts toward establishing an effective mechanism to improve early detection and management of G6PD deficient children.
背景:本研究的重点是葡萄糖-6-磷酸脱氢酶(G6PD)缺乏症,这是一种具有性别连锁隐性模式的遗传性疾病,可导致G6PD异常低水平。这种情况主要与药物和感染引起的溶血性贫血、新生儿黄疸及相关后果有关。缺乏当地来源的循证数据是导致G6PD缺乏症患儿死亡率升高的重要原因。因此,本研究的主要目的是确定在尼日利亚伊莫州奥韦里联邦医疗中心就诊的儿童中G6PD缺乏症的患病率。材料和方法:在尼日利亚东南部伊莫州首府奥韦里的联邦医疗中心进行了为期6个月的研究。该研究涉及150名男女儿童,年龄在1至10岁之间,他们的G-6-PD状态此前未知。在征得家长同意的情况下,对儿童进行G6PD缺陷筛查,并从家长处收集定性数据。使用标准程序确定G6PD缺乏症。结果:该研究包括150名1至10岁的儿童。其中,女性68例(45.5%),男性82例(54.7%)。研究结果显示,31名受试者(20.7%)存在G6PD缺乏症。值得注意的是,男性中有82人(54.7%)患有G6PD缺乏症,而女性中有68人(45.5%)。此外,研究发现G6PD缺陷儿童16中有很大比例(35.6%)在1-2岁之间。结论:本研究结果强调了关键利益相关者在建立有效机制以提高G6PD缺陷儿童早期发现和管理方面的重要性。
{"title":"Prevalence of glucose-6-phosphate dehydrogenase deficiency among children attending federal medical center, Owerri, Imo State, Nigeria","authors":"Ewa Ogbonnaya, ChijiokeI Ugboaja, UbaniC Dimgba, Victoria Ayuba, IhezueU Chijindu, John Wassagwa, KabirM Yusuf","doi":"10.4103/mgmj.mgmj_140_23","DOIUrl":"https://doi.org/10.4103/mgmj.mgmj_140_23","url":null,"abstract":"Background: This study focuses on glucose-6-phosphate dehydrogenase (G6PD) deficiency, a hereditary disease with a sex-linked recessive pattern leading to abnormally low levels of G6PD. The condition is primarily associated with drug and infection-induced hemolytic anemia, neonatal jaundice, and related consequences. The absence of locally sourced evidence-based data has contributed significantly to the elevated mortality rate observed in children affected by G6PD deficiency. As a result, the main objective of this research is to determine the prevalence of G6PD deficiency among children attending the Federal Medical Centre Owerri, Imo State, Nigeria. Materials and Methods: Over 6 months, a study was conducted at the Federal Medical Centre in Owerri, the capital of Imo State, South Eastern Nigeria. The study involved 150 children of both sexes, aged between 1 and 10 years, whose G-6-PD status was previously unknown. With the consent of their parents, the children underwent screening for G6PD deficiency, and qualitative data were collected from the parents. G6PD deficiency was identified using standard procedures. Results: The study included 150 children between 1 and 10 years old. Of these, 68 (45.5%) were females, and 82 (54.7%) were males. The study findings indicated that 31 subjects (20.7%) were found to have G6PD deficiency. Notably, a higher percentage of males, 82 (54.7%), had G6PD deficiency compared with 68 (45.5%) females. Furthermore, the research revealed that a significant proportion of G6PD deficient children 16 (35.6%) were within the age range of 1–2 years. Conclusion: The results of this research emphasize the importance of critical stakeholders directing their efforts toward establishing an effective mechanism to improve early detection and management of G6PD deficient children.","PeriodicalId":52587,"journal":{"name":"MGM Journal of Medical Sciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136366649","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}
引用次数: 0
Otitis media and its associated risk factors: An investigation into patients’ knowledge, attitudes, practices, and information sources at a hospital setting 中耳炎及其相关危险因素:对医院患者知识、态度、行为和信息来源的调查
Pub Date : 2023-01-01 DOI: 10.4103/mgmj.mgmj_127_23
Padma Ramesh, Mrunal Pimparkar, Ketki Pimpalkhute, Nidhi Anam
Background: Otitis media (OM) is a substantial healthcare issue globally, including in India. Despite its widespread occurrence, there has been only one prior investigation into the knowledge, attitude, practices, and sources of information (KAPS), as well as information sources regarding OM among patients in India, and this study dates back to 2009. This article unveils the findings of a recent KAPS study conducted among patients residing in Navi Mumbai, Maharashtra, India. Objectives: The primary goal of this study was to evaluate the KAPS regarding OM and its associated risk factors, with a specific focus on individuals diagnosed with this ailment. Settings and Design: This research was conducted in the Ear, Nose, and Throat (ENT) Outpatient Department (OPD) of MGM Medical College and Hospital, Navi Mumbai, Maharashtra, India. A cross-sectional study, the KAPS study, was conducted on 91 patients diagnosed with OM. Materials and Methods: This study used a cross-sectional methodology to assess KAPS. The research included 91 patients diagnosed with OM receiving care at the ENT-OPD of MGM Medical College and Hospital, Navi Mumbai, Maharashtra, India. Statistical Analysis: Descriptive statistics were used, and data normality was evaluated. Independent T-tests and analysis of variance methods were employed to compare means, followed by post hoc analysis using the Bonferroni test. Pearson coefficient test was utilized to estimate correlations, and associations were examined using the Chi-square test. Results: Most participants (47.3%) exhibited a low level of knowledge, with an average Knowledge score of 11.98 ± 4.64 out of a possible 23. The mean Attitude score was 5.37 ± 1.37 out of seven. Regarding Attitude scores, there were significant differences in educational level (P = 0.003) and socioeconomic status (P = 0.0001). The mean Practice score was 0.51 ± 0.6 out of a maximum score of three. There was a significant correlation between Knowledge and Attitude scores (P < 0.0001). Only 17.6% of the participants reported receiving any education on ear health. Conclusion: Most patients in the study demonstrated a lack of comprehensive knowledge. While a positive attitude was common among the majority, the average Practice score remained relatively modest. This research underscores the significance of community education initiatives focused on OM to boost awareness and reduce the burden of this condition.
背景:中耳炎(OM)是一个重大的全球医疗保健问题,包括在印度。尽管其广泛发生,但只有一个关于印度患者OM的知识,态度,实践和信息来源(KAPS)以及信息来源的先前调查,该研究可追溯到2009年。本文揭示了最近在居住在印度马哈拉施特拉邦新孟买的患者中进行的一项KAPS研究的结果。目的:本研究的主要目的是评估OM及其相关危险因素的KAPS,并特别关注被诊断患有这种疾病的个体。背景和设计:本研究在印度马哈拉施特拉邦新孟买米高梅医学院和医院耳鼻喉科(耳鼻喉科)门诊(OPD)进行。一项横断面研究,即KAPS研究,对91名诊断为OM的患者进行了研究。材料和方法:本研究采用横断面方法评估KAPS。该研究包括在印度马哈拉施特拉邦新孟买米高梅医学院和医院的ENT-OPD接受治疗的91名被诊断为OM的患者。统计分析:采用描述性统计,评价数据的正态性。采用独立t检验和方差分析方法比较均数,随后采用Bonferroni检验进行事后分析。使用Pearson系数检验来估计相关性,使用卡方检验来检验相关性。结果:大部分被试(47.3%)知识水平较低,平均知识得分为11.98±4.64分(满分23分)。平均态度得分为5.37±1.37(总分7分)。在态度得分方面,受教育程度(P = 0.003)和社会经济地位(P = 0.0001)存在显著差异。练习的平均得分为0.51±0.6,满分为3分。知识与态度得分有显著相关(P < 0.0001)。只有17.6%的参与者报告接受过有关耳部健康的教育。结论:本研究中大多数患者表现为缺乏综合知识。虽然大多数人都有积极的态度,但练习的平均得分仍然相对较低。这项研究强调了社区教育倡议的重要性,重点是OM提高认识,减轻这种情况的负担。
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引用次数: 0
A prospective study to analyze the functional outcome of the femoral neck system in femoral neck fractures 一项分析股骨颈骨折股骨颈系统功能结局的前瞻性研究
Pub Date : 2023-01-01 DOI: 10.4103/mgmj.mgmj_138_23
Arvind Vatkar, Sachin Kale, Ronak Mishra, Sushmit Singh, Ajit Chalak, Rahul Ghodke, Sonali Das, Nikhil Issacs, Suraj Doshi
Background: In 2017, a new fixation device called the femoral neck system (FNS), manufactured by DePuy Synthes orthopedics company of Johnson & Johnson, was introduced to manage femoral neck fractures. The primary objective of this study was to present our firsthand experience with this device in treating femoral neck fractures and to evaluate its clinical outcomes. Materials and Methods: With ethical committee approval, we conducted a prospective study involving patients aged 18 years or older but no more than 60 years. The study included a final sample size of 30 participants, selected based on specific inclusion and exclusion criteria. Patient records were reviewed to collect data on blood loss, fracture type, internal fixation methods, and the duration of clinical follow-up. Continuous variables were analyzed, and their mean values, standard deviations, and ranges were reported. The clinical assessment of patients was carried out using the Harris hip score and postoperative X-rays at regular intervals. Results: In our study, the gender distribution among the patients showed that 60% were females and 40% were males. The patient’s average age was 44.12 years, with a standard deviation of 2 years. The functional outcomes of patients treated with FNS using the hospital for special surgery (HSS) method were compared at different postoperative time points: 6 weeks, 3 months, and 12 months. The statistical analysis revealed significant differences in functional outcomes at these time intervals. During the study, two cases of postoperative complications were observed among the patients. These complications were addressed through specific interventions, namely bipolar hemiarthroplasty and shoe raise to correct limb shortening. Conclusion: Our study demonstrated that FNS yielded positive outcomes, significantly improving the HSS scores. Additionally, we observed that FNS was associated with minimal intraoperative blood loss in the cases we examined.
背景:2017年,强生公司DePuy Synthes骨科公司推出了一种名为股骨颈系统(FNS)的新型固定装置,用于治疗股骨颈骨折。本研究的主要目的是介绍我们使用该装置治疗股骨颈骨折的第一手经验,并评估其临床效果。材料和方法:经伦理委员会批准,我们进行了一项前瞻性研究,涉及年龄在18岁或以上但不超过60岁的患者。该研究的最终样本量为30名参与者,根据特定的纳入和排除标准进行选择。回顾患者记录,收集出血量、骨折类型、内固定方法和临床随访时间的数据。对连续变量进行分析,并报告其平均值、标准差和极差。采用Harris髋关节评分和术后定期x光片对患者进行临床评估。结果:本组患者性别分布中,女性占60%,男性占40%。患者平均年龄44.12岁,标准差为2岁。比较采用特殊外科医院(HSS)方法治疗FNS患者在术后6周、3个月和12个月不同时间点的功能结局。统计分析显示,在这些时间间隔内,功能结果有显著差异。在研究过程中,观察到2例患者出现术后并发症。这些并发症是通过特定的干预措施解决的,即双极半关节置换术和提鞋来纠正肢体缩短。结论:我们的研究表明FNS具有积极的效果,显著提高了HSS评分。此外,我们观察到,在我们检查的病例中,FNS与最小的术中出血量相关。
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引用次数: 0
COVID-19 vaccination: A twisted web of crime COVID-19疫苗接种:扭曲的犯罪网络
Pub Date : 2023-01-01 DOI: 10.4103/mgmj.mgmj_12_23
M. Jalal, Riyas Basheer
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引用次数: 0
Renal-limited systemic lupus erythematosus: Avoiding delay in diagnosis 肾限制性系统性红斑狼疮:避免延误诊断
Pub Date : 2023-01-01 DOI: 10.4103/mgmj.mgmj_10_23
Inderjot Kaur, Aditya Nayak, A. Kejriwal
Nephrotic syndrome (NS) and glomerulonephritis (GN) are disorders of varied etiologies. Systemic lupus erythematosus (SLE) is one of the multisystemic diseases causing NS and GN. SLE is often suspected whenever NS/GN is associated with extrarenal manifestations. However, it presents solely as NS or GN without extrarenal features in a handful of cases. This affects the prognosis adversely as negligent delay in diagnosis of SLE and initiation of immunosuppressive therapy is associated with poorer response. We present a series of five women who presented solely with renal manifestations. The diagnosis of SLE was delayed, as the women did not have any extrarenal features. We started immunosuppressive therapy after a diagnosis of lupus nephritis was made in retrospect after a kidney biopsy. This case series highlights the importance of performing serology tests for SLE in all young female patients who present with NS/GN to avoid delay in diagnosis.
肾病综合征(NS)和肾小球肾炎(GN)是多种病因的疾病。系统性红斑狼疮(SLE)是引起NS和GN的多系统疾病之一。每当NS/GN与肾外表现相关时,通常会怀疑SLE。然而,在少数病例中,它仅表现为NS或GN,没有肾外特征。这会对预后产生不利影响,因为SLE诊断和免疫抑制治疗的疏忽延迟与较差的反应有关。我们报告了一系列的五名女性,她们仅表现为肾脏表现。SLE的诊断被推迟,因为这些女性没有任何肾外特征。在肾活检后回顾性诊断为狼疮性肾炎后,我们开始了免疫抑制治疗。该病例系列强调了对所有患有NS/GN的年轻女性患者进行SLE血清学检测的重要性,以避免延误诊断。
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引用次数: 0
BI-RADS 3 lesions in North Indian population: Their outcome and how to proceed for follow-up 北印度人群BI-RADS 3型病变:结果及如何进行随访
Pub Date : 2023-01-01 DOI: 10.4103/mgmj.mgmj_45_23
S. Wahab, Naimatullah Najeeb, Atiya Zaka-ur-Rab
Background: Breast Imaging Reporting and Data System (BI-RADS) classification for breast lesions was proposed for uniformity in categorizing breast lesions. While BI-RADS 1, 2 and 4–6 categories are straightforward, BI-RADS 3 is an intermediate category lesion with significantly different meanings and findings for mammography, ultrasound, and magnetic resonance imaging and is diagnostically challenging. Our study aims to determine the frequency and the malignancy rate of BI-RADS category 3 lesions detected on ultrasound breast and digital X-ray mammography by doing follow-ups at 6, 12, and 24 months of imaging. Materials and Methods: This ambispective study was conducted in the Department of Radiodiagnosis, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, from October 2020 to October 2022, which included 55 patients referred for digital X-ray and breast ultrasound. All BI-RADS category 3 in the initial sonomammography and digital X-ray mammography were included in the study and were followed up for final diagnosis and outcome either by pathological analysis or follow-up using sonomammography and digital X-ray mammography for a maximum of 24 months. Results: Fifty-five patients were categorized into the benign or malignant category from the results of tissue diagnosis or via follow-up. Fifty-four patients (98.18%) showed benign lesions, and one (1.82%) got malignant lesions. In the majority, 31 (56.36%) patients, the mean follow-up time was 6 months, followed by 12 months 10 (18.18%). Follow-up was 24 months in only 1 out of 55 patients (1.82%). The mean value of time to follow-up (months) of study subjects was 6 ± 4.6 with a median (25th–75th percentile) of 6. Conclusion: Short-term interval follow-up in BI-RADS category: three patients are enough to detect early breast malignancy, and this will avoid unnecessary tissue diagnosis (invasive procedure) in benign lesions. In our study, the malignancy yield in the follow-up of BI-RADS 3 was 1.82% (<2%).
背景:为了统一对乳腺病变的分类,提出了乳腺成像报告和数据系统(BI-RADS)对乳腺病变的分类。虽然BI-RADS 1、2和4-6分类是直接的,但BI-RADS 3是一种中间类别病变,在乳房x线摄影、超声和磁共振成像中具有显著不同的意义和结果,诊断具有挑战性。我们的研究旨在通过对超声乳腺和数字x线乳腺x线x光检查中发现的BI-RADS 3类病变的随访,确定其频率和恶性率,随访时间分别为6、12和24个月。材料与方法:本双侧透视研究于2020年10月至2022年10月在阿里格尔穆斯林大学贾瓦哈拉尔·尼赫鲁医学院和医院放射诊断部进行,包括55例转诊的数字x线和乳房超声患者。所有初始超声x线摄影和数字x线乳房x线摄影中BI-RADS类别3的患者均被纳入研究,并通过病理分析或超声x线摄影和数字x线乳房x线摄影的随访进行最长24个月的最终诊断和预后随访。结果:55例患者根据组织诊断或随访结果分为良、恶性两类。良性病变54例(98.18%),恶性病变1例(1.82%)。多数患者31例(56.36%),平均随访时间6个月,其次为12个月10例(18.18%)。55例患者中仅有1例(1.82%)随访24个月。研究对象的平均随访时间(月)为6±4.6,中位数(25 - 75百分位)为6。结论:BI-RADS类短期间期随访:3例患者就足以早期发现乳腺恶性肿瘤,可避免对良性病变进行不必要的组织诊断(侵入性手术)。在我们的研究中,BI-RADS 3的随访恶性肿瘤发生率为1.82%(<2%)。
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MGM Journal of Medical Sciences
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