Pub Date : 2022-09-01DOI: 10.4103/cmrp.cmrp_103_22
A. Dey, V. Malik
{"title":"Gastroesophageal reflux disease – Current perspective","authors":"A. Dey, V. Malik","doi":"10.4103/cmrp.cmrp_103_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_103_22","url":null,"abstract":"","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86660660","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: Inception of emergency medicine as a specialty in India is on a rise. Data on the accuracy of diagnosis made in emergency rooms in India is scarce and with varied results with especially no such data available from our part of the country. Aim: The aim of this study was to evaluate the discrepancy between admission diagnosis in emergency and final diagnosis in ward and its correlation with length of hospital stay and outcome. This study was an observational prospective study. Materials and Methods: Patients were categorised as per the International Classification of Diseases – Version 10. A total of 2000 patients were enrolled in the study. The patients were followed from admission to discharge. Data were categorised into two major groups – 'Concordant' diagnosis and 'Discordant' diagnosis. Univariate analysis was performed using SPSS version 20.0. Results: Five hundred and fifty-three (27.65%) patients had a final diagnosis in ward discordant from the initial diagnosis in the medical emergency room. The frequency of discrepancy was highest for the genitourinary system (39%) and relatively low for neoplasm (16%). The average length of hospital stay in the concordant group of patients was 5.15 days, whereas it was 7.05 days in the discordant group (P = 0.003). There was a statistically significant increase in percentage mortality in patients when initial and final diagnoses did not match (P = 0.0005). Conclusions: A diagnostic discrepancy of 27.65% occurred between admission diagnosis in the medical emergency room and final diagnosis in ward. The diagnostic discrepancy resulted in a significant increase in the length of hospital stay and mortality.
{"title":"Discrepancy between admission diagnosis in emergency and final diagnosis in ward and its correlation with length of hospital stay and mortality","authors":"Umer Nabi, A. Rafi, M. Maqbool, P. Shah","doi":"10.4103/cmrp.cmrp_41_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_41_22","url":null,"abstract":"Background: Inception of emergency medicine as a specialty in India is on a rise. Data on the accuracy of diagnosis made in emergency rooms in India is scarce and with varied results with especially no such data available from our part of the country. Aim: The aim of this study was to evaluate the discrepancy between admission diagnosis in emergency and final diagnosis in ward and its correlation with length of hospital stay and outcome. This study was an observational prospective study. Materials and Methods: Patients were categorised as per the International Classification of Diseases – Version 10. A total of 2000 patients were enrolled in the study. The patients were followed from admission to discharge. Data were categorised into two major groups – 'Concordant' diagnosis and 'Discordant' diagnosis. Univariate analysis was performed using SPSS version 20.0. Results: Five hundred and fifty-three (27.65%) patients had a final diagnosis in ward discordant from the initial diagnosis in the medical emergency room. The frequency of discrepancy was highest for the genitourinary system (39%) and relatively low for neoplasm (16%). The average length of hospital stay in the concordant group of patients was 5.15 days, whereas it was 7.05 days in the discordant group (P = 0.003). There was a statistically significant increase in percentage mortality in patients when initial and final diagnoses did not match (P = 0.0005). Conclusions: A diagnostic discrepancy of 27.65% occurred between admission diagnosis in the medical emergency room and final diagnosis in ward. The diagnostic discrepancy resulted in a significant increase in the length of hospital stay and mortality.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82751889","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":"Teleconsultation for anaesthesiologists - Update and limitations","authors":"A. Bhalotra","doi":"10.4103/cmrp.cmrp_68_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_68_22","url":null,"abstract":"","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88233005","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}
Monkeypox virus (MPXV) infection has lately emerged as a new public health problem across 100 countries. Surging cases of MPXV infection in non-endemic countries prompted the World Health Organization to declare it a public health emergency in July 2022. The virological and clinical resemblance to eradicated smallpox disease has generated new scientific interest. This DNA orthopoxvirus primarily harbouring in squirrels, rats and non-human primates has led to infection in the human population. A recent surge of cases has been seen across 16 countries, with a clustering of cases in bisexual/homosexual men. The virus spreads through close contact with infected individuals with prodromal symptoms of fever and myalgia. A rash appears after 1–3 days of fever. There is presence of vesicular rash over the face, hands, feet and genital areas, and associated lymphadenopathy. Although no specific antiviral drugs directed against MPXV are available, tecovirimat developed against smallpox infection can be used and is effective. A synthetic analogue drug of cidofovir, i.e., brincidofovir has been evaluated for MPX patients in United Kingdom. A preventive strategy in close contacts may be offered through smallpox vaccines such as ACAM2000 and JYNNEOS. Epidemiological data from Africa suggest that smallpox vaccines provide 85% efficacy in preventing MPXV cases. Vaccinia immunoglobulin intravenous (VIGIV) has been used in immunocompromised patients with T-cell defects as prophylaxis where the use of vaccines is contraindicated. VIGIV can be used as a treatment modality for smallpox or non-variola infections like monkeypox in an outbreak, although the efficacy data are lacking.
{"title":"Monkeypox virus infection – Evolution, molecular biology, epidemiology, clinical features and management aspects","authors":"D. Kaul, K. Yadav, A. Bansal","doi":"10.4103/cmrp.cmrp_98_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_98_22","url":null,"abstract":"Monkeypox virus (MPXV) infection has lately emerged as a new public health problem across 100 countries. Surging cases of MPXV infection in non-endemic countries prompted the World Health Organization to declare it a public health emergency in July 2022. The virological and clinical resemblance to eradicated smallpox disease has generated new scientific interest. This DNA orthopoxvirus primarily harbouring in squirrels, rats and non-human primates has led to infection in the human population. A recent surge of cases has been seen across 16 countries, with a clustering of cases in bisexual/homosexual men. The virus spreads through close contact with infected individuals with prodromal symptoms of fever and myalgia. A rash appears after 1–3 days of fever. There is presence of vesicular rash over the face, hands, feet and genital areas, and associated lymphadenopathy. Although no specific antiviral drugs directed against MPXV are available, tecovirimat developed against smallpox infection can be used and is effective. A synthetic analogue drug of cidofovir, i.e., brincidofovir has been evaluated for MPX patients in United Kingdom. A preventive strategy in close contacts may be offered through smallpox vaccines such as ACAM2000 and JYNNEOS. Epidemiological data from Africa suggest that smallpox vaccines provide 85% efficacy in preventing MPXV cases. Vaccinia immunoglobulin intravenous (VIGIV) has been used in immunocompromised patients with T-cell defects as prophylaxis where the use of vaccines is contraindicated. VIGIV can be used as a treatment modality for smallpox or non-variola infections like monkeypox in an outbreak, although the efficacy data are lacking.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75129904","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":"Detection dogs cases about their sniffing applications in medical and future application for COVID-19 pandemic","authors":"Shashi Bahl, A. Bagha, Abid Haleem, M. Javaid","doi":"10.4103/cmrp.cmrp_67_21","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_67_21","url":null,"abstract":"","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76556453","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}
Srinivas Bojanapu, Uma Vajpeyajula, A. Das, N. Mehta, S. Nundy
Background: The advent and progress of endoscopic retrograde cholangiopancreatography (ERCP) for hepato-pancreaticobiliary diseases have introduced a paradigm shift in their treatment but have also been associated with complications that have been difficult to manage. We examined the outcome of patients who had duodenal perforations from periampullary endoscopic procedures who needed surgical intervention. Aim: To study the outcomes in patients who underwent surgical intervention for ERCP associated duodenal perforation. Materials and Methods: Between January 2001 and November 2021, we retrieved the details of 20 patients who had been operated on for duodenal perforations following ERCP from a prospectively maintained database. Results: There were nine males and 11 females whose mean age was 51.3 (range 29–81) years. The most common indication for the endoscopic procedure was choledocholithiasis in 16, followed by biliary stricture in 3 and malignancy in 1. The median duration between the diagnosis of perforation and surgery was 8.3 days (range 0–48). The mean hospital stay was 21.5 (range 5–60) days. Four (20%) patients underwent re-exploration. Seven (35%) patients died, in all of whom the diagnosis had been missed at the time of the procedure (P = 0.015). Eighty per cent of mortality occurred in patients with a Boey score of three. Conclusion: ERCP-related duodenal perforations though uncommon, are dreaded complications and do not have universally accepted standard management. Patients with delayed diagnosis of duodenal perforation and higher Boey scores have higher mortality rates.
{"title":"Surgical outcomes after endoscopic retrograde cholangiopancreatography and sphincterotomy associated duodenal perforations: Experience from a tertiary care centre in India","authors":"Srinivas Bojanapu, Uma Vajpeyajula, A. Das, N. Mehta, S. Nundy","doi":"10.4103/cmrp.cmrp_51_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_51_22","url":null,"abstract":"Background: The advent and progress of endoscopic retrograde cholangiopancreatography (ERCP) for hepato-pancreaticobiliary diseases have introduced a paradigm shift in their treatment but have also been associated with complications that have been difficult to manage. We examined the outcome of patients who had duodenal perforations from periampullary endoscopic procedures who needed surgical intervention. Aim: To study the outcomes in patients who underwent surgical intervention for ERCP associated duodenal perforation. Materials and Methods: Between January 2001 and November 2021, we retrieved the details of 20 patients who had been operated on for duodenal perforations following ERCP from a prospectively maintained database. Results: There were nine males and 11 females whose mean age was 51.3 (range 29–81) years. The most common indication for the endoscopic procedure was choledocholithiasis in 16, followed by biliary stricture in 3 and malignancy in 1. The median duration between the diagnosis of perforation and surgery was 8.3 days (range 0–48). The mean hospital stay was 21.5 (range 5–60) days. Four (20%) patients underwent re-exploration. Seven (35%) patients died, in all of whom the diagnosis had been missed at the time of the procedure (P = 0.015). Eighty per cent of mortality occurred in patients with a Boey score of three. Conclusion: ERCP-related duodenal perforations though uncommon, are dreaded complications and do not have universally accepted standard management. Patients with delayed diagnosis of duodenal perforation and higher Boey scores have higher mortality rates.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80896086","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}
Osteogenesis imperfecta (OI) is a rare congenital condition, marked by fragile bones, skeletal deformities and additional extra-skeletal symptoms. Depending upon the degree of seriousness, affected people can either carry on with a mostly unrestricted, independent life, or their mobility is severely affected, making them dependent on others for support. Despite that, there is no effect on intellectual capacities. The medical and surgical treatments of OI are directed towards improving the patient's quality of life, mobility and functional independence. Because of the close biochemical relationship that exists between collagen and dentine, the teeth are affected in certain patients, leading to dentinogenesis imperfecta (DI) which is described by the appearance of opalescent teeth. To enable preventive intervention and effective dental treatment, it is essential that the correct diagnosis of DI is done at an early stage.
{"title":"Osteogenesis imperfecta and dentinogenesis imperfecta: Clinical features and dental management","authors":"Chetna Grover, Pankaj Dhawan, H. Kaur, A. Kakar","doi":"10.4103/cmrp.cmrp_31_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_31_22","url":null,"abstract":"Osteogenesis imperfecta (OI) is a rare congenital condition, marked by fragile bones, skeletal deformities and additional extra-skeletal symptoms. Depending upon the degree of seriousness, affected people can either carry on with a mostly unrestricted, independent life, or their mobility is severely affected, making them dependent on others for support. Despite that, there is no effect on intellectual capacities. The medical and surgical treatments of OI are directed towards improving the patient's quality of life, mobility and functional independence. Because of the close biochemical relationship that exists between collagen and dentine, the teeth are affected in certain patients, leading to dentinogenesis imperfecta (DI) which is described by the appearance of opalescent teeth. To enable preventive intervention and effective dental treatment, it is essential that the correct diagnosis of DI is done at an early stage.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82378154","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":"Human high risk papillomavirus infections and neoplasias in human immunodeficiency patients","authors":"K. Verma","doi":"10.4103/cmrp.cmrp_86_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_86_22","url":null,"abstract":"","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90866622","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}
Necrotising pneumonia (NP) is an uncommon condition in children when compared with the adult age group and is even more reported in the new-borns. The first published data on NP in children date back to 1994, but still there is a paucity of data when it comes to the new-borns. Pathologically, it is characterised by inflammation of the pulmonary tissue with consolidation and peripheral necrosis, thereby leading to local destruction of lung tissue and development of multiple small lung cavities. Bronchopleural fistula (BPF) is a rare complication of NP seen in new-born. In this case report, we discuss a case of new-born with severe NP complicated by BPF.
{"title":"Severe necrotising pneumonia complicated with bronchopleural fistulae in a neonate","authors":"R. Upadhyay, S. Saluja, M. Modi, A. Soni","doi":"10.4103/cmrp.cmrp_30_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_30_22","url":null,"abstract":"Necrotising pneumonia (NP) is an uncommon condition in children when compared with the adult age group and is even more reported in the new-borns. The first published data on NP in children date back to 1994, but still there is a paucity of data when it comes to the new-borns. Pathologically, it is characterised by inflammation of the pulmonary tissue with consolidation and peripheral necrosis, thereby leading to local destruction of lung tissue and development of multiple small lung cavities. Bronchopleural fistula (BPF) is a rare complication of NP seen in new-born. In this case report, we discuss a case of new-born with severe NP complicated by BPF.","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90350430","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":"Dealing with pandemic of the unvaccinated","authors":"H. Gupta","doi":"10.4103/cmrp.cmrp_21_22","DOIUrl":"https://doi.org/10.4103/cmrp.cmrp_21_22","url":null,"abstract":"","PeriodicalId":72736,"journal":{"name":"Current medicine research and practice","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73229854","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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