Pub Date : 2023-01-01DOI: 10.4103/amhs.amhs_131_23
A. Kakunje
{"title":"Mental health education integration into the school curriculum needs to be implemented","authors":"A. Kakunje","doi":"10.4103/amhs.amhs_131_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_131_23","url":null,"abstract":"","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45107974","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}
Subependymal heterotopia (SH), also commonly known as periventricular nodular heterotopia, is believed to result from a faulty neuronal migration which is associated with seizure disorders and intellectual disability. Intellectual developmental delay (IDD) is a condition of arrested or incomplete development of mind with the impairment of intelligence. Although SH and IDD co-occur often, cases of schizophrenia in SH with IDD are less commonly reported. A thorough search of scientific databases with keywords of IDD, SH, and schizophrenia on PubMed, Scopus, and Google Scholar combined yielded limited results, prompting us to report this case of SH without any history of seizures who developed hebephrenic Schizophrenia. This highlights the need to check for the presence of SH by MRI scan in individuals with IDD and psychosis.
{"title":"A case report of hebephrenic schizophrenia in intellectual disability with subependymal heterotopia","authors":"S. Yeshaswini, Shahafas Kongath, M. Vidhyavathi","doi":"10.4103/amhs.amhs_10_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_10_23","url":null,"abstract":"Subependymal heterotopia (SH), also commonly known as periventricular nodular heterotopia, is believed to result from a faulty neuronal migration which is associated with seizure disorders and intellectual disability. Intellectual developmental delay (IDD) is a condition of arrested or incomplete development of mind with the impairment of intelligence. Although SH and IDD co-occur often, cases of schizophrenia in SH with IDD are less commonly reported. A thorough search of scientific databases with keywords of IDD, SH, and schizophrenia on PubMed, Scopus, and Google Scholar combined yielded limited results, prompting us to report this case of SH without any history of seizures who developed hebephrenic Schizophrenia. This highlights the need to check for the presence of SH by MRI scan in individuals with IDD and psychosis.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42076004","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}
Langerhans cell histiocytosis (LCH) is a rare multisystem disorder with a common histopathological finding of Langerhans-type cell proliferation mixed with a milieu of inflammatory cells. Bone involvement is a common presentation occurring in children and young adults. Recent studies using cell-specific gene expression profiling suggest that LCH arises from bone marrow-derived immature myeloid dendritic cells. We present a case of solitary LCH of cervical vertebrae in a young adult with pain and numbness in the shoulder diagnosed on fine-needle aspiration and confirmed on histopathology and immunohistochemistry. It was treated with tumor resection and stabilization of the vertebrae.
{"title":"Cytohistological correlation of Langerhans cell histiocytosis of the spine in a young adult","authors":"S. Asotra, Sudarshan K. Sharma, S. Thakur","doi":"10.4103/amhs.amhs_18_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_18_23","url":null,"abstract":"Langerhans cell histiocytosis (LCH) is a rare multisystem disorder with a common histopathological finding of Langerhans-type cell proliferation mixed with a milieu of inflammatory cells. Bone involvement is a common presentation occurring in children and young adults. Recent studies using cell-specific gene expression profiling suggest that LCH arises from bone marrow-derived immature myeloid dendritic cells. We present a case of solitary LCH of cervical vertebrae in a young adult with pain and numbness in the shoulder diagnosed on fine-needle aspiration and confirmed on histopathology and immunohistochemistry. It was treated with tumor resection and stabilization of the vertebrae.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48788780","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 : 2023-01-01DOI: 10.4103/amhs.amhs_222_22
E. Rajni, Shaveta Kataria, M. Sarna, V. Garg
Achromobacter xylosoxidans is an uncommon nosocomial pathogen known to cause serious infections in immunocompromised patients. Long stays in critical care units often predispose to infection with this bacterium. A female patient, who is a known case of diabetes mellitus type 2, hypertension, and chronic kidney disease, presented to the emergency department with complaints of shortness of breath, generalized swelling, decreased urine output for 7 days, and altered sensorium for 1 day. A. xylosoxidans was isolated from paired blood culture. She was managed according to the antibiotic susceptibility report and was improving when she left against medical advice due to personal issues. The objective of presenting this case report is to stress upon the importance of communication between the microbiologist and the clinician. Embracing automation in microbiology laboratories is essential to identify such novel bacterium in time to achieve clinical and microbiological cures.
{"title":"A case of bacteremia by Achromobacter xylosoxidans in an immunocompromised host and review of literature","authors":"E. Rajni, Shaveta Kataria, M. Sarna, V. Garg","doi":"10.4103/amhs.amhs_222_22","DOIUrl":"https://doi.org/10.4103/amhs.amhs_222_22","url":null,"abstract":"Achromobacter xylosoxidans is an uncommon nosocomial pathogen known to cause serious infections in immunocompromised patients. Long stays in critical care units often predispose to infection with this bacterium. A female patient, who is a known case of diabetes mellitus type 2, hypertension, and chronic kidney disease, presented to the emergency department with complaints of shortness of breath, generalized swelling, decreased urine output for 7 days, and altered sensorium for 1 day. A. xylosoxidans was isolated from paired blood culture. She was managed according to the antibiotic susceptibility report and was improving when she left against medical advice due to personal issues. The objective of presenting this case report is to stress upon the importance of communication between the microbiologist and the clinician. Embracing automation in microbiology laboratories is essential to identify such novel bacterium in time to achieve clinical and microbiological cures.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47204972","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}
The giant cell-rich (GCR) variant of extraskeletal osteosarcoma (ESOS) is a malignant soft-tissue lesion without primary bony involvement. The tumor cells are highly pleomorphic and produce an osteoid matrix, whereas numerous giant cells are present throughout the mass. We describe an unusual case of a 38-year-old female patient who presented with a recurrent gluteal mass. With the help of histomorphological findings and immunohistochemistry (IHC), a final diagnosis of a GCR variant of ESOS arises from the gluteal soft tissue with bony involvement. These malignancies are extremely aggressive and have a high likelihood of recurrence and metastasis; therefore, early detection is crucial for successful management. Standard treatment options include surgery and chemotherapy, and patients should be closely monitored following treatment. With the help of histomorphological findings and IHC, a final diagnosis of a GCR variant of ESOS arises from the gluteal soft tissue with bony involvement. This case is reported to highlight the fact that similar morphology of giant cell osteosarcoma can rarely be seen in soft tissue, and this entity should be kept in mind by the reporting pathologist.
{"title":"Giant cell variant of extraskeletal osteosarcoma","authors":"Sufian Zaheer, Durre Aden, Sunil Ranga","doi":"10.4103/amhs.amhs_59_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_59_23","url":null,"abstract":"The giant cell-rich (GCR) variant of extraskeletal osteosarcoma (ESOS) is a malignant soft-tissue lesion without primary bony involvement. The tumor cells are highly pleomorphic and produce an osteoid matrix, whereas numerous giant cells are present throughout the mass. We describe an unusual case of a 38-year-old female patient who presented with a recurrent gluteal mass. With the help of histomorphological findings and immunohistochemistry (IHC), a final diagnosis of a GCR variant of ESOS arises from the gluteal soft tissue with bony involvement. These malignancies are extremely aggressive and have a high likelihood of recurrence and metastasis; therefore, early detection is crucial for successful management. Standard treatment options include surgery and chemotherapy, and patients should be closely monitored following treatment. With the help of histomorphological findings and IHC, a final diagnosis of a GCR variant of ESOS arises from the gluteal soft tissue with bony involvement. This case is reported to highlight the fact that similar morphology of giant cell osteosarcoma can rarely be seen in soft tissue, and this entity should be kept in mind by the reporting pathologist.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135006736","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 and Aim: Head-and-neck cancers (HNCs) are significant causes of morbidity and mortality in both the developed and developing worlds. One of the most common types of HNC is oral squamous cell carcinoma (OSCC). The rationale behind the present study is to analyze the effectiveness of nuclear proliferative markers in comparison to the various grades of OSCC. This study utilizes Anneroth’s histopathological multifactorial grading system for squamous cell carcinoma and further tends to compare this histological grading with nuclear proliferative indices of p53 and argyrophilic nucleolar organizer region (AgNOR). The aim of this study was to establish and develop a correlation between the proliferative markers, AgNOR and p53, and the histologic grade of the tumor (Anneroth’s grading). Materials and Methods: A total of 60 cases of oral squamous cell carcinoma were taken from October 2020 to September 2022. The histological grading was done according to Anneroth’s grading, and a score was given. P53 expression was graded according to the percentage of cells showing p53-positive immunostaining, and scoring was done from 0 to 3. The AgNOR score was calculated by examining 100 nuclei and calculating the mean AgNOR score per nucleus. Results: A significant linear correlation was obtained between the histological grading of OSCC and the proliferative markers (p53 and AgNOR). Conclusion: The analysis of the NOR count provides invaluable assistance in determining tumor aggressiveness and cellular proliferation rates. They can prove to be efficient tools to procure information on the malignant potential of different premalignant lesions. Elevated p53 expression implies greater clinical severity, a higher histological grade, and a poor prognosis for oral squamous cell carcinoma. Hence, the proliferative markers can be used as adjuncts to the histological grading system of OSCC.
{"title":"Study of histochemical and immunohistochemical profile in grading of squamous cell carcinoma of the oral cavity","authors":"ZeebaShamim Jairajpuri, Arushi Gupta, Shaan Khetrapal, Safia Rana, Sujata Jetley, Seema Monga","doi":"10.4103/amhs.amhs_62_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_62_23","url":null,"abstract":"Background and Aim: Head-and-neck cancers (HNCs) are significant causes of morbidity and mortality in both the developed and developing worlds. One of the most common types of HNC is oral squamous cell carcinoma (OSCC). The rationale behind the present study is to analyze the effectiveness of nuclear proliferative markers in comparison to the various grades of OSCC. This study utilizes Anneroth’s histopathological multifactorial grading system for squamous cell carcinoma and further tends to compare this histological grading with nuclear proliferative indices of p53 and argyrophilic nucleolar organizer region (AgNOR). The aim of this study was to establish and develop a correlation between the proliferative markers, AgNOR and p53, and the histologic grade of the tumor (Anneroth’s grading). Materials and Methods: A total of 60 cases of oral squamous cell carcinoma were taken from October 2020 to September 2022. The histological grading was done according to Anneroth’s grading, and a score was given. P53 expression was graded according to the percentage of cells showing p53-positive immunostaining, and scoring was done from 0 to 3. The AgNOR score was calculated by examining 100 nuclei and calculating the mean AgNOR score per nucleus. Results: A significant linear correlation was obtained between the histological grading of OSCC and the proliferative markers (p53 and AgNOR). Conclusion: The analysis of the NOR count provides invaluable assistance in determining tumor aggressiveness and cellular proliferation rates. They can prove to be efficient tools to procure information on the malignant potential of different premalignant lesions. Elevated p53 expression implies greater clinical severity, a higher histological grade, and a poor prognosis for oral squamous cell carcinoma. Hence, the proliferative markers can be used as adjuncts to the histological grading system of OSCC.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135006747","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}
Amit Mandal, Madhumita Chakraborty, Ramya Iyyadurai, Karthik Gunasekaran
Background and Aims: Snakebite is an important occupational and rural hazard. It is one of the most common causes of morbidity and mortality in tropical countries. Even though snakebite is an imminently treatable condition, it is a common life-threatening emergency. We aim to study the clinical profile, complications, as length of stay in the hospital, outcome and cost of care in snakebite patients requiring admission under a medicine unit. Materials and Methods: This retrospective study was conducted carried out from May 01, 2014, to May 01, 2019. The data were extracted from the inpatient medical records, and it was analyzed. All adult patients requiring admission in medicine unit V with a diagnosis of snake envenomation were included in the study. Descriptive statistics were obtained for all variables in the study, and appropriate statistical tests were employed to ascertain the significance. Results: The cohort consists of 80 patients with 45 (56.3%) males and aged 40.06 ± 15.24 years (mean, standard deviation [SD]). The majority of the snake species identification was not available 38 (47.5%). Viper bite was the most common bite 32 (40%). The most common clinical presentation was hemotoxic 33 (31.3%) followed by neurotoxic 16 (20%). Sixty-eight (85%) patients were treated outside before presentation. The median antisnake venom (ASV) given was 10 vials, and 12 (15%) patients had allergic reaction to ASV. Sixty-nine (86%) patients had cellulitis and 16 (20%) had acute kidney injury (AKI). Twenty-four (30%) patients required intensive care monitoring, 22 (27.5%) required mechanical ventilation, and 7 (8.8%) required hemodialysis. The mean ± SD duration of hospital stay was 5.56 ± 3.76 days. The median direct cost was Rs. 19,714.5 and cost of medicine was Rs. 10,798. The mortality in this cohort was 4 (5%). Conclusion: Snakebite causes significant morbidity. Viper bite was the most common bite in our study. ASV reaction was seen in 15%, and cellulitis and AKI were the common complications. The median direct cost was Rs. 19,714.5 and cost of medicine was Rs. 10,798. The mortality in this cohort was 4 (5%).
{"title":"Clinical profile, outcome, and cost of care in snakebite patients requiring admissions in a single medical unit: A retrospective study from a tertiary care center in South India","authors":"Amit Mandal, Madhumita Chakraborty, Ramya Iyyadurai, Karthik Gunasekaran","doi":"10.4103/amhs.amhs_51_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_51_23","url":null,"abstract":"Background and Aims: Snakebite is an important occupational and rural hazard. It is one of the most common causes of morbidity and mortality in tropical countries. Even though snakebite is an imminently treatable condition, it is a common life-threatening emergency. We aim to study the clinical profile, complications, as length of stay in the hospital, outcome and cost of care in snakebite patients requiring admission under a medicine unit. Materials and Methods: This retrospective study was conducted carried out from May 01, 2014, to May 01, 2019. The data were extracted from the inpatient medical records, and it was analyzed. All adult patients requiring admission in medicine unit V with a diagnosis of snake envenomation were included in the study. Descriptive statistics were obtained for all variables in the study, and appropriate statistical tests were employed to ascertain the significance. Results: The cohort consists of 80 patients with 45 (56.3%) males and aged 40.06 ± 15.24 years (mean, standard deviation [SD]). The majority of the snake species identification was not available 38 (47.5%). Viper bite was the most common bite 32 (40%). The most common clinical presentation was hemotoxic 33 (31.3%) followed by neurotoxic 16 (20%). Sixty-eight (85%) patients were treated outside before presentation. The median antisnake venom (ASV) given was 10 vials, and 12 (15%) patients had allergic reaction to ASV. Sixty-nine (86%) patients had cellulitis and 16 (20%) had acute kidney injury (AKI). Twenty-four (30%) patients required intensive care monitoring, 22 (27.5%) required mechanical ventilation, and 7 (8.8%) required hemodialysis. The mean ± SD duration of hospital stay was 5.56 ± 3.76 days. The median direct cost was Rs. 19,714.5 and cost of medicine was Rs. 10,798. The mortality in this cohort was 4 (5%). Conclusion: Snakebite causes significant morbidity. Viper bite was the most common bite in our study. ASV reaction was seen in 15%, and cellulitis and AKI were the common complications. The median direct cost was Rs. 19,714.5 and cost of medicine was Rs. 10,798. The mortality in this cohort was 4 (5%).","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135007222","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 : 2023-01-01DOI: 10.4103/amhs.amhs_195_22
G. Reddy, V. Brahmaiah, B. Kavitha, Jaya Nethagani, E. Palaparthi, R. Lebaka, G. Deepika
Triple-negative breast cancer (TNBC) is distinguished by the absence of human epidermal growth factor 2 receptors, estrogen, and progesterone. Due to its destructive character and inability to be treated with current endocrine medications, it has one of the worst prognoses of any breast cancer subtype. The only therapies available are chemo-and/or radiation and surgery, which necessitates the development of new biomarkers or therapeutic targets. Due to of their inherent inclination to operate as antisense regulators and interactors of whole gene set implicated in cancer, microRNAs (miRNAs) are a potential target for TNBC-focused therapy. In this paper, we summarize the role of epigenetics variation with a focus on DNA methylation in TNBC patients. Other biomarkers alterations and interactions with miRNAs may lead to the identification of novel therapy options for TNBC in the future as well.
{"title":"Role of epigenetics variation with focus on DNA Methylation in triple-negative breast cancer patients","authors":"G. Reddy, V. Brahmaiah, B. Kavitha, Jaya Nethagani, E. Palaparthi, R. Lebaka, G. Deepika","doi":"10.4103/amhs.amhs_195_22","DOIUrl":"https://doi.org/10.4103/amhs.amhs_195_22","url":null,"abstract":"Triple-negative breast cancer (TNBC) is distinguished by the absence of human epidermal growth factor 2 receptors, estrogen, and progesterone. Due to its destructive character and inability to be treated with current endocrine medications, it has one of the worst prognoses of any breast cancer subtype. The only therapies available are chemo-and/or radiation and surgery, which necessitates the development of new biomarkers or therapeutic targets. Due to of their inherent inclination to operate as antisense regulators and interactors of whole gene set implicated in cancer, microRNAs (miRNAs) are a potential target for TNBC-focused therapy. In this paper, we summarize the role of epigenetics variation with a focus on DNA methylation in TNBC patients. Other biomarkers alterations and interactions with miRNAs may lead to the identification of novel therapy options for TNBC in the future as well.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43747521","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 and Aim: This study emphasizes using external limiting membrane (ELM) and EZ ellipsoid zone (EZ), disruption as imaging biomarkers in fovea-involved diabetic macular edema (DME). Materials and Methods: This is a retrospective study conducted in the Department of Ophthalmology, Gitam Institute of Medical Sciences and Research, from June 2021 to May 2022. Spectral-domain optical coherence tomography (SD-OCT) images of 17 patients with fovea-involved DME were analyzed in this retrospective pilot study. Neither disruption of ELM nor EZ was graded 0, only disruption of ELM was graded as 1, and disruptions of both ELM and EZ were graded 2. Results: Twenty-five eyes (SD-OCT pictures) of 17 patients, nine men and eight women, with a mean age of 54.23 years (35–77 years), were included in the study. Eleven (44%) eyes had mild nonproliferative diabetic retinopathy (NDPR) with clinically significant macular edema (CSME). Seven (28%) eyes had moderate nonproliferative diabetic retinopathy (NPDR) with CSME, and 7 (28%) eyes had severe NPDR with CSME. Cystoid pattern of macular edema was present in 15 (60%) eyes; 3 (12%) eyes had cystoid pattern with vitreomacular traction (VMT), 1 (4%) eye had cystoid pattern with serous retinal detachment (RD), 5 (20%) eyes had diffuse macular edema, and 1 (4%) eye had diffuse CSME with VMT. Ten (40%) eyes had grade 0 ELM and EZ disruption with a foveal thickness of 245–310 μ (mean – 269.2), 3 (12%) eyes had grade 1 with foveal thickness varying from 263 to 348 μ (mean 301.3) and 12 (48%) eyes had grade 2 with a macular thickness of 315–651 μ (mean 467.8). Conclusion: A statistically significant association exists between foveal thickness and disruption of the ELM and EZ. Grade 0 had a foveal thickness ranging from 240 to 260 μ, grade 1 from 260 to 340 μ, and grade 2 from 340-≤650 μ.
{"title":"Assessing diabetic macular edema through spectral domain optical coherence tomography: an analysis of foveal thickness, external limiting membrane, and ellipsoid zone integrity","authors":"Das Gayatri, V. Rao, Satyavara Chavali","doi":"10.4103/amhs.amhs_15_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_15_23","url":null,"abstract":"Background and Aim: This study emphasizes using external limiting membrane (ELM) and EZ ellipsoid zone (EZ), disruption as imaging biomarkers in fovea-involved diabetic macular edema (DME). Materials and Methods: This is a retrospective study conducted in the Department of Ophthalmology, Gitam Institute of Medical Sciences and Research, from June 2021 to May 2022. Spectral-domain optical coherence tomography (SD-OCT) images of 17 patients with fovea-involved DME were analyzed in this retrospective pilot study. Neither disruption of ELM nor EZ was graded 0, only disruption of ELM was graded as 1, and disruptions of both ELM and EZ were graded 2. Results: Twenty-five eyes (SD-OCT pictures) of 17 patients, nine men and eight women, with a mean age of 54.23 years (35–77 years), were included in the study. Eleven (44%) eyes had mild nonproliferative diabetic retinopathy (NDPR) with clinically significant macular edema (CSME). Seven (28%) eyes had moderate nonproliferative diabetic retinopathy (NPDR) with CSME, and 7 (28%) eyes had severe NPDR with CSME. Cystoid pattern of macular edema was present in 15 (60%) eyes; 3 (12%) eyes had cystoid pattern with vitreomacular traction (VMT), 1 (4%) eye had cystoid pattern with serous retinal detachment (RD), 5 (20%) eyes had diffuse macular edema, and 1 (4%) eye had diffuse CSME with VMT. Ten (40%) eyes had grade 0 ELM and EZ disruption with a foveal thickness of 245–310 μ (mean – 269.2), 3 (12%) eyes had grade 1 with foveal thickness varying from 263 to 348 μ (mean 301.3) and 12 (48%) eyes had grade 2 with a macular thickness of 315–651 μ (mean 467.8). Conclusion: A statistically significant association exists between foveal thickness and disruption of the ELM and EZ. Grade 0 had a foveal thickness ranging from 240 to 260 μ, grade 1 from 260 to 340 μ, and grade 2 from 340-≤650 μ.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42756788","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 and Aim: Spinal cord injury (SCI) patients have an increased risk of developing urinary tract infections. The method of bladder drainage influences the risk of urinary tract infection (UTI), and most persons with SCI on per urethral continuous catheterization (CC) or clean intermittent catheterization (CIC) develop urinary tract infection. Identification and treatment of severe UTI with appropriate antibiotics as early as possible is associated with better outcomes in SCI patients. The aim of this study was to determine the prevalence and causative organisms of symptomatic urinary tract infection in spinal cord injury patients with different bladder management methods. Materials and Methods: A total of 50 patients with SCI were followed up at a rehabilitation centre from Jan 2020 to Dec 2021 in a prospective descriptive study. The demographic status, clinical and laboratory findings of the patients with SCI were studied and the prevalence and causative organisms of symptomatic UTI in these patients with different bladder management methods were analysed. Results: The commonest organisms isolated were E. coli (31%), Pseudomonas (29%) and Klebsiella (21%). The organisms isolated in the UTI were most sensitive to colistin (82%), followed by 59% being sensitive to both imipenem and tigecycline. Least sensitivity was seen to Piperacillin, Ceftriaxone and Levofloxacin. Maximum UTI episodes were seen in cases with CC followed by CIC. Least UTI episodes were seen in cases where supra-pubic cystostomy was done followed by patients who were self-urinating. Conclusion: Symptomatic UTI in SCI patients is more prevalent in patients with CC and CIC. Such patients should be started as early as possible on antibiotics depending on the antibiotic sensitivity pattern of the organisms isolated.
{"title":"Study of prevalence, microbiologic agents, and bladder management methods of urinary tract infections among spinal cord injury patients","authors":"K. Ashta, C. Mohan, B. Nair, S. Arora","doi":"10.4103/amhs.amhs_45_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_45_23","url":null,"abstract":"Background and Aim: Spinal cord injury (SCI) patients have an increased risk of developing urinary tract infections. The method of bladder drainage influences the risk of urinary tract infection (UTI), and most persons with SCI on per urethral continuous catheterization (CC) or clean intermittent catheterization (CIC) develop urinary tract infection. Identification and treatment of severe UTI with appropriate antibiotics as early as possible is associated with better outcomes in SCI patients. The aim of this study was to determine the prevalence and causative organisms of symptomatic urinary tract infection in spinal cord injury patients with different bladder management methods. Materials and Methods: A total of 50 patients with SCI were followed up at a rehabilitation centre from Jan 2020 to Dec 2021 in a prospective descriptive study. The demographic status, clinical and laboratory findings of the patients with SCI were studied and the prevalence and causative organisms of symptomatic UTI in these patients with different bladder management methods were analysed. Results: The commonest organisms isolated were E. coli (31%), Pseudomonas (29%) and Klebsiella (21%). The organisms isolated in the UTI were most sensitive to colistin (82%), followed by 59% being sensitive to both imipenem and tigecycline. Least sensitivity was seen to Piperacillin, Ceftriaxone and Levofloxacin. Maximum UTI episodes were seen in cases with CC followed by CIC. Least UTI episodes were seen in cases where supra-pubic cystostomy was done followed by patients who were self-urinating. Conclusion: Symptomatic UTI in SCI patients is more prevalent in patients with CC and CIC. Such patients should be started as early as possible on antibiotics depending on the antibiotic sensitivity pattern of the organisms isolated.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47891049","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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