Diabetes is one of the most significant health issues. Patients with type 2 diabetes mellitus (DM) are more susceptible to an elevated cardiovascular risk, including heart failure. Echocardiography should help in the early identification of these myocardial abnormalities that would help properly treat these individuals. The study was conducted over 18 months and focused on patients with diabetes and chronic heart failure who met inclusion and exclusion criteria. Ethical approval was obtained, and all patients provided their consent to participate in the study. The participants underwent a two-dimensional echocardiogram to assess their heart function, and relevant laboratory tests, imaging results, and information about medications received during their hospitalization were recorded. As per The New British Society of Echocardiography criteria, 64 patients had impaired left ventricular ejection fraction (LVEF), and 31 had severely impaired LVEF. The majority of the patients with impaired LVEF, 53%, also had impaired right ventricular ejection fraction (RVEF). Of 31 patients with severely impaired LVEF, 58% also had severely impaired RVEF. The association between LVEF and RVEF is statistically significant (P < 0.05). There is a positive correlation between LVEF (%) and RVEF (%), which was statistically significant (P < 0.05). Severe dysfunction in LVEF is also present in patients with severe dysfunction of RVEF. The majority of patients who had reduced LVEF also had reduced RVEF, and this association was significant. While there was a correlation between glycosylated hemoglobin levels and both LVEF and RVEF, it was not statistically significant. Hence, patients who are identified to have lower LVEF should also be evaluated for RVEF.
{"title":"Study of Correlation between Right Ventricular Ejection Fraction with Left Ventricular Ejection Fraction in Patients of Chronic Heart Failure with Diabetes, using Two-dimensional Echocardiography","authors":"Vandan Shah, S. Mane, R. Khyalappa","doi":"10.4103/ajim.ajim_5_23","DOIUrl":"https://doi.org/10.4103/ajim.ajim_5_23","url":null,"abstract":"\u0000 \u0000 \u0000 Diabetes is one of the most significant health issues. Patients with type 2 diabetes mellitus (DM) are more susceptible to an elevated cardiovascular risk, including heart failure. Echocardiography should help in the early identification of these myocardial abnormalities that would help properly treat these individuals.\u0000 \u0000 \u0000 \u0000 The study was conducted over 18 months and focused on patients with diabetes and chronic heart failure who met inclusion and exclusion criteria. Ethical approval was obtained, and all patients provided their consent to participate in the study. The participants underwent a two-dimensional echocardiogram to assess their heart function, and relevant laboratory tests, imaging results, and information about medications received during their hospitalization were recorded.\u0000 \u0000 \u0000 \u0000 As per The New British Society of Echocardiography criteria, 64 patients had impaired left ventricular ejection fraction (LVEF), and 31 had severely impaired LVEF. The majority of the patients with impaired LVEF, 53%, also had impaired right ventricular ejection fraction (RVEF). Of 31 patients with severely impaired LVEF, 58% also had severely impaired RVEF. The association between LVEF and RVEF is statistically significant (P < 0.05). There is a positive correlation between LVEF (%) and RVEF (%), which was statistically significant (P < 0.05). Severe dysfunction in LVEF is also present in patients with severe dysfunction of RVEF.\u0000 \u0000 \u0000 \u0000 The majority of patients who had reduced LVEF also had reduced RVEF, and this association was significant. While there was a correlation between glycosylated hemoglobin levels and both LVEF and RVEF, it was not statistically significant. Hence, patients who are identified to have lower LVEF should also be evaluated for RVEF.\u0000","PeriodicalId":8012,"journal":{"name":"APIK Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46728369","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}
Sagnik Bhattacharjee, A. Khyriem, C. Lyngdoh, A. Prasad
Objective: The objective was to determine the incidence, etiological agents, and antibiotic susceptibility pattern of isolates causing ventilator-associated pneumonia (VAP). Methods: The prospective observational study was carried out on 146 adults admitted to the hospital, who were put on mechanical ventilation for a minimum period of 48 h at NEIGRIHMS, Shillong. The study was conducted for 1 year from December 2019 to December 2020. VAP was diagnosed as per the Clinical Pulmonary Infection Score. Demographic, clinical characteristics, culture reports, and antibiotic susceptibility of the patients were noted. Patients were followed up till discharge or death. Outcome measures were risk factors for VAP and mortality. Results: We report an incidence of VAP as 10.6/1000 ventilator days. The predominant organisms seen were Acinetobacter baumannii (62.33%), Klebsiella pneumoniae (47.26%), and Pseudomonas aeruginosa (19.18%). 33/146 (22.6%) patients expired, among which 17 patients had VAP (40.48% vs. 15.38%, P = 0.001). VAP patients had significantly higher odds of smoking (odds ratio [OR] = 2.412, P = 0.016), more polybacterial infections (OR = 2.271, P = 0.024), and more mortality (OR = 3.681, P = 0.001). Among the organisms, P. aeruginosa (OR = 0.115, P = 0.013) and K. pneumoniae (OR = 6.818, P = 0.003) were significantly associated with mortality in patients with VAP. Conclusion: We report an incidence of VAP as 10.6/1000 ventilator days among intensive care unit patients. Smoking was a significant risk factor for VAP. VAP patients had a significantly higher risk of mortality with K. pneumoniae and P. aeruginosa being significant organisms responsible for it.
{"title":"A prospective study to determine the incidence, clinical profile, and outcomes of patients with ventilator-associated pneumonia","authors":"Sagnik Bhattacharjee, A. Khyriem, C. Lyngdoh, A. Prasad","doi":"10.4103/ajim.ajim_95_22","DOIUrl":"https://doi.org/10.4103/ajim.ajim_95_22","url":null,"abstract":"Objective: The objective was to determine the incidence, etiological agents, and antibiotic susceptibility pattern of isolates causing ventilator-associated pneumonia (VAP). Methods: The prospective observational study was carried out on 146 adults admitted to the hospital, who were put on mechanical ventilation for a minimum period of 48 h at NEIGRIHMS, Shillong. The study was conducted for 1 year from December 2019 to December 2020. VAP was diagnosed as per the Clinical Pulmonary Infection Score. Demographic, clinical characteristics, culture reports, and antibiotic susceptibility of the patients were noted. Patients were followed up till discharge or death. Outcome measures were risk factors for VAP and mortality. Results: We report an incidence of VAP as 10.6/1000 ventilator days. The predominant organisms seen were Acinetobacter baumannii (62.33%), Klebsiella pneumoniae (47.26%), and Pseudomonas aeruginosa (19.18%). 33/146 (22.6%) patients expired, among which 17 patients had VAP (40.48% vs. 15.38%, P = 0.001). VAP patients had significantly higher odds of smoking (odds ratio [OR] = 2.412, P = 0.016), more polybacterial infections (OR = 2.271, P = 0.024), and more mortality (OR = 3.681, P = 0.001). Among the organisms, P. aeruginosa (OR = 0.115, P = 0.013) and K. pneumoniae (OR = 6.818, P = 0.003) were significantly associated with mortality in patients with VAP. Conclusion: We report an incidence of VAP as 10.6/1000 ventilator days among intensive care unit patients. Smoking was a significant risk factor for VAP. VAP patients had a significantly higher risk of mortality with K. pneumoniae and P. aeruginosa being significant organisms responsible for it.","PeriodicalId":8012,"journal":{"name":"APIK Journal of Internal Medicine","volume":"11 1","pages":"179 - 184"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41413041","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}
Dengue is a mosquito-borne viral infection found in tropical and subtropical climates worldwide, mostly in urban and semiurban areas. The virus responsible for causing dengue is called dengue virus. There are four dengue virus serotypes, implying that it is possible to be infected four times. While many dengue virus infections produce only mild illness, occasionally, this develops into potentially lethal complications, called severe dengue, dengue hemorrhagic fever, and dengue shock syndrome. Currently, there is no specific treatment for dengue/severe dengue. Due to a rise in mortality rates associated with dengue hemorrhagic fever, severe dengue, and dengue shock syndrome, a better understanding of the reason behind dengue hemorrhagic fever is required. Hence, in this article, we further describe the original antigenic sin in dengue and how the occurrence of Hoskins effect is a major determinant factor for the progression to dengue hemorrhagic fever.
{"title":"Original antigenic sin in dengue - Hoskins effect","authors":"V. Kamath, Nisha Olakkengi","doi":"10.4103/ajim.ajim_96_21","DOIUrl":"https://doi.org/10.4103/ajim.ajim_96_21","url":null,"abstract":"Dengue is a mosquito-borne viral infection found in tropical and subtropical climates worldwide, mostly in urban and semiurban areas. The virus responsible for causing dengue is called dengue virus. There are four dengue virus serotypes, implying that it is possible to be infected four times. While many dengue virus infections produce only mild illness, occasionally, this develops into potentially lethal complications, called severe dengue, dengue hemorrhagic fever, and dengue shock syndrome. Currently, there is no specific treatment for dengue/severe dengue. Due to a rise in mortality rates associated with dengue hemorrhagic fever, severe dengue, and dengue shock syndrome, a better understanding of the reason behind dengue hemorrhagic fever is required. Hence, in this article, we further describe the original antigenic sin in dengue and how the occurrence of Hoskins effect is a major determinant factor for the progression to dengue hemorrhagic fever.","PeriodicalId":8012,"journal":{"name":"APIK Journal of Internal Medicine","volume":"11 1","pages":"147 - 149"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43793540","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 : 2023-07-01DOI: 10.4103/ajim.ajim_113_22
R. Sheeba, Dinesh Vishwanathan, V. Kamath
Background: With the ongoing onslaught of coronavirus disease-2019 (COVID-19) pandemic, identifying factors predicting the disease course and outcome become immensely important. Although globally reported, a potential association between electrolyte disturbance and COVID-19 disease has not been well researched. Dyselectrolytemia not only impacts patient care but also provides insight into the pathophysiology of COVID-19. Aims and Objectives: Our aim was to study electrolyte disturbances among COVID-19 patients and its impact on the disease outcome. Materials and Methods: This was a retrospective observational study conducted in a total of 397 patients detected to have electrolyte abnormalities among 2914 adult inpatients, diagnosed with COVID 19 infection in a tertiary care center over a period of 10 months (July 2020–December 2020 and April 2021–July 2021). Results: A total of 2914 patients were diagnosed with COVID-19 of whom 397 (13.62%) patients were found to have an electrolyte imbalance. Hyponatremia (n = 199) 51% was the most common electrolyte disturbance followed by hypokalemia (n = 94) 24.3% and mixed electrolyte abnormality (n = 81) 20.4%. Electrolyte imbalance was directly related to the clinical outcome of the disease which was statistically significant P = 0.0001. Conclusion: Hyponatremia has a significant direct correlation with mortality in patients with COVID-19. However, hypokalemia, hyperkalemia, and hypernatremia also influence the disease outcome. We recommend that the estimation of electrolytes should be done routinely for all hospitalized patients with COVID-19 as it adds to the prognostication of these patients.
{"title":"A study of electrolyte imbalance in Coronavirus Disease-2019 at a rural tertiary health care center","authors":"R. Sheeba, Dinesh Vishwanathan, V. Kamath","doi":"10.4103/ajim.ajim_113_22","DOIUrl":"https://doi.org/10.4103/ajim.ajim_113_22","url":null,"abstract":"Background: With the ongoing onslaught of coronavirus disease-2019 (COVID-19) pandemic, identifying factors predicting the disease course and outcome become immensely important. Although globally reported, a potential association between electrolyte disturbance and COVID-19 disease has not been well researched. Dyselectrolytemia not only impacts patient care but also provides insight into the pathophysiology of COVID-19. Aims and Objectives: Our aim was to study electrolyte disturbances among COVID-19 patients and its impact on the disease outcome. Materials and Methods: This was a retrospective observational study conducted in a total of 397 patients detected to have electrolyte abnormalities among 2914 adult inpatients, diagnosed with COVID 19 infection in a tertiary care center over a period of 10 months (July 2020–December 2020 and April 2021–July 2021). Results: A total of 2914 patients were diagnosed with COVID-19 of whom 397 (13.62%) patients were found to have an electrolyte imbalance. Hyponatremia (n = 199) 51% was the most common electrolyte disturbance followed by hypokalemia (n = 94) 24.3% and mixed electrolyte abnormality (n = 81) 20.4%. Electrolyte imbalance was directly related to the clinical outcome of the disease which was statistically significant P = 0.0001. Conclusion: Hyponatremia has a significant direct correlation with mortality in patients with COVID-19. However, hypokalemia, hyperkalemia, and hypernatremia also influence the disease outcome. We recommend that the estimation of electrolytes should be done routinely for all hospitalized patients with COVID-19 as it adds to the prognostication of these patients.","PeriodicalId":8012,"journal":{"name":"APIK Journal of Internal Medicine","volume":"11 1","pages":"185 - 190"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42009717","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}
Multisystem inflammatory syndrome (MIS) in adults is a rare diagnosis compared to its counterpart in children. There are standard guidelines for the managment of MIS in children, the lack of such standard guideline for adult patients makes it a diagnostic challenge. Furthermore, lack of awareness about MIS-A among treating doctors can result in the condition to go undiagnosed or misdiagnosed. Here, we are presenting a rare case of MIS in a 38-year-old female who presented to us with a history of fever and cervical lymphadenopathy.
{"title":"Multisystem inflammatory syndrome in adults: Underdiagnosed??","authors":"Dilmo Yeldo, T. Ravindra, B. Arjun","doi":"10.4103/ajim.ajim_72_21","DOIUrl":"https://doi.org/10.4103/ajim.ajim_72_21","url":null,"abstract":"Multisystem inflammatory syndrome (MIS) in adults is a rare diagnosis compared to its counterpart in children. There are standard guidelines for the managment of MIS in children, the lack of such standard guideline for adult patients makes it a diagnostic challenge. Furthermore, lack of awareness about MIS-A among treating doctors can result in the condition to go undiagnosed or misdiagnosed. Here, we are presenting a rare case of MIS in a 38-year-old female who presented to us with a history of fever and cervical lymphadenopathy.","PeriodicalId":8012,"journal":{"name":"APIK Journal of Internal Medicine","volume":"11 1","pages":"196 - 198"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44953735","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 : 2023-07-01DOI: 10.4103/ajim.ajim_154_22
P. Sookaromdee, V. Wiwanitkit
{"title":"Deltacron: A new public health concern","authors":"P. Sookaromdee, V. Wiwanitkit","doi":"10.4103/ajim.ajim_154_22","DOIUrl":"https://doi.org/10.4103/ajim.ajim_154_22","url":null,"abstract":"","PeriodicalId":8012,"journal":{"name":"APIK Journal of Internal Medicine","volume":"11 1","pages":"209 - 209"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46740146","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}
Introduction: Multiple drug resistance (MDR) of the bacteria is an issue across any health-care setting worldwide. This leads to prolonged hospital stay and high cost of treatment. One must be cautious to use reserve drugs such as imipenem, meropenem, colistin, polymyxin, and tigecycline. Tigecycline is a mainstay to treat emerging single or MDR pathogens. The study was conducted to assess the in vitro sensitivity of tigecycline to MDR isolates and to compare the sensitivity of Kirby–Bauer (KB) disc-diffusion method with the Epsilometer (E-test) against various MDR clinical isolates. Materials and Methods: This prospective study was done from January 2019 to 2020 on MDR isolates from clinical specimens. The isolates were tested for their antibiotic sensitivity to tigecycline by KB and E-test method to know the minimum inhibitory concentration (MIC) of tigecycline. Statistical data were analyzed by the percentage method. Results: Tigecycline showed a higher in vitro sensitivity against multidrug-resistant isolates in our study. Among the 89 MDR isolates obtained, 38 (42.7) were found to be sensitive to tigecycline by the KB diffusion and 67 (75.3) were sensitive by the E-test method. Conclusions: Tigecycline is a reserve antibiotic against MDR organisms, especially useful to treat coinfections of Gram-positive and Gram-negative superbugs. The E-test was found to be far superior to the KB method to detect in vitro activity and the results of this test will guide the clinician to judiciously use this antibiotic in their day-to-day practice.
{"title":"Evaluation of In vitro activity of tigecycline against multidrug-resistant clinical isolates","authors":"Livya Wilson, T. Kuruvilla","doi":"10.4103/ajim.ajim_53_22","DOIUrl":"https://doi.org/10.4103/ajim.ajim_53_22","url":null,"abstract":"Introduction: Multiple drug resistance (MDR) of the bacteria is an issue across any health-care setting worldwide. This leads to prolonged hospital stay and high cost of treatment. One must be cautious to use reserve drugs such as imipenem, meropenem, colistin, polymyxin, and tigecycline. Tigecycline is a mainstay to treat emerging single or MDR pathogens. The study was conducted to assess the in vitro sensitivity of tigecycline to MDR isolates and to compare the sensitivity of Kirby–Bauer (KB) disc-diffusion method with the Epsilometer (E-test) against various MDR clinical isolates. Materials and Methods: This prospective study was done from January 2019 to 2020 on MDR isolates from clinical specimens. The isolates were tested for their antibiotic sensitivity to tigecycline by KB and E-test method to know the minimum inhibitory concentration (MIC) of tigecycline. Statistical data were analyzed by the percentage method. Results: Tigecycline showed a higher in vitro sensitivity against multidrug-resistant isolates in our study. Among the 89 MDR isolates obtained, 38 (42.7) were found to be sensitive to tigecycline by the KB diffusion and 67 (75.3) were sensitive by the E-test method. Conclusions: Tigecycline is a reserve antibiotic against MDR organisms, especially useful to treat coinfections of Gram-positive and Gram-negative superbugs. The E-test was found to be far superior to the KB method to detect in vitro activity and the results of this test will guide the clinician to judiciously use this antibiotic in their day-to-day practice.","PeriodicalId":8012,"journal":{"name":"APIK Journal of Internal Medicine","volume":"11 1","pages":"150 - 153"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45157382","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 high quality systematic review with meta-analysis is considered to provide a high level of evidence in health-care research. It is important to follow rigorous methodology while conducting a systematic review and reporting its findings. To minimize the chances of error and bias, at least two (preferably 3–4) authors should be involved at all stages of the conduct of a systematic review. Registering the protocol on open websites such as PROSPERO is essential to enable transparency and scientific rigor. Important steps are writing the protocol, conducting detailed literature search through multiple databases, identifying studies that meet strict inclusion criteria, abstracting the data, contacting authors to obtain additional information, assessing the risk of bias of included studies, synthesizing evidence qualitatively, conducting meta-analysis using appropriate statistical models, assessing publication bias and heterogeneity, exploring heterogeneity through sensitivity and subgroup analyses, grading the certainty of evidence following the GRADE framework, reporting using the preferred reporting items for systematic reviews and meta-analyses guidelines, describing the limitations and providing implications for clinical practice and future research. Clinicians should evaluate the credibility of systematic reviews prior to applying their results in clinical practice. This article provides a brief introduction to the methodology of systematic reviews and meta-analyses and also provides links to some high-quality free resources for prospective systematic reviewers.
{"title":"An introduction to systematic reviews and meta-analyses","authors":"Shripada C Rao","doi":"10.4103/ajim.ajim_36_23","DOIUrl":"https://doi.org/10.4103/ajim.ajim_36_23","url":null,"abstract":"A high quality systematic review with meta-analysis is considered to provide a high level of evidence in health-care research. It is important to follow rigorous methodology while conducting a systematic review and reporting its findings. To minimize the chances of error and bias, at least two (preferably 3–4) authors should be involved at all stages of the conduct of a systematic review. Registering the protocol on open websites such as PROSPERO is essential to enable transparency and scientific rigor. Important steps are writing the protocol, conducting detailed literature search through multiple databases, identifying studies that meet strict inclusion criteria, abstracting the data, contacting authors to obtain additional information, assessing the risk of bias of included studies, synthesizing evidence qualitatively, conducting meta-analysis using appropriate statistical models, assessing publication bias and heterogeneity, exploring heterogeneity through sensitivity and subgroup analyses, grading the certainty of evidence following the GRADE framework, reporting using the preferred reporting items for systematic reviews and meta-analyses guidelines, describing the limitations and providing implications for clinical practice and future research. Clinicians should evaluate the credibility of systematic reviews prior to applying their results in clinical practice. This article provides a brief introduction to the methodology of systematic reviews and meta-analyses and also provides links to some high-quality free resources for prospective systematic reviewers.","PeriodicalId":8012,"journal":{"name":"APIK Journal of Internal Medicine","volume":"11 1","pages":"141 - 146"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45836853","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}
Nishanth Ravindranath, M. Shankar, N. Moorthy, HV Jayanth Kumar
Left atrial perforation during central venous catheter insertion is an extremely rare complication which can have catastrophic outcomes if left unrecognized. We describe a rare case of the left atrial catheter malposition during tunneled hemodialysis catheter insertion from the left internal jugular vein, which was managed successfully by surgical reposition and simultaneously vascular access was secured by salvaging the same catheter in a patient with poor arteriovenous anatomy for surgical arteriovenous fistula.
{"title":"A rare cardiac complication of left-sided tunneled hemodialysis catheter insertion","authors":"Nishanth Ravindranath, M. Shankar, N. Moorthy, HV Jayanth Kumar","doi":"10.4103/ajim.ajim_79_21","DOIUrl":"https://doi.org/10.4103/ajim.ajim_79_21","url":null,"abstract":"Left atrial perforation during central venous catheter insertion is an extremely rare complication which can have catastrophic outcomes if left unrecognized. We describe a rare case of the left atrial catheter malposition during tunneled hemodialysis catheter insertion from the left internal jugular vein, which was managed successfully by surgical reposition and simultaneously vascular access was secured by salvaging the same catheter in a patient with poor arteriovenous anatomy for surgical arteriovenous fistula.","PeriodicalId":8012,"journal":{"name":"APIK Journal of Internal Medicine","volume":"11 1","pages":"199 - 201"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46189523","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 : 2023-07-01DOI: 10.4103/2666-1802.379798
{"title":"Retraction: A cross-sectional study to evaluate the prevalence and risk factors of gastroesophageal reflux disease among undergraduate medical students of a tertiary care indian setting","authors":"","doi":"10.4103/2666-1802.379798","DOIUrl":"https://doi.org/10.4103/2666-1802.379798","url":null,"abstract":"","PeriodicalId":8012,"journal":{"name":"APIK Journal of Internal Medicine","volume":"11 1","pages":"210 - 210"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42872513","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：