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":"11 1","pages":"134 - 136"},"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":"11 1","pages":"137 - 140"},"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_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":"11 1","pages":"1 - 2"},"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}
Grrishma Balakrishnan, Manasvi Tyagi, Gurunandan Uppinakudru, Padmini Thalanjeri, Vismaya Kaveri, K. Balasubramaniyam, S. Ali
Background and Aim: Abnormal uterine bleeding (AUB) has a major social, psychological, and economic impact on women aged 18–45 years, in the most productive stage of their life. This study was done to assess the impact of menstrual and obstetric patterns, cardiometabolic risk factors, and metabolic syndrome on women of reproductive age with AUB. Materials and Methods: Our hospital-based case–control study had 61 participants, of which 31 were cases and 30 were age-matched controls. They were compared on their age, age of menarche and marriage, number and type of deliveries, contraceptives used, cardiometabolic risk factors like body mass index, waist-hip ratio, waist-height ratio, fasting blood sugar (FBS), total cholesterol (TC), triglycerides, low-density lipoprotein (LDL) and high-density lipoprotein (HDL), and having metabolic syndrome. Results: The majority of the cases were 36–45 years of age. The mean age of marriage was significantly less but the parity was more ≥2 in cases when compared to controls. FBS, TC, triglycerides, LDL, and HDL in cases were significantly more than controls. A 33.3% of cases had metabolic syndrome. Women with metabolic syndrome were 15 times more likely to develop AUB, as compared to normal women. Conclusion: Age of menarche did not influence but lower age of marriage and increased number of pregnancies had a profound effect on the occurrence of AUB. Metabolic syndrome is significantly associated and could be a potential fellow traveler in women with AUB.
{"title":"Is metabolic syndrome a fellow traveler with abnormal uterine bleeding in women of reproductive age? A case–control study","authors":"Grrishma Balakrishnan, Manasvi Tyagi, Gurunandan Uppinakudru, Padmini Thalanjeri, Vismaya Kaveri, K. Balasubramaniyam, S. Ali","doi":"10.4103/amhs.amhs_60_23","DOIUrl":"https://doi.org/10.4103/amhs.amhs_60_23","url":null,"abstract":"Background and Aim: Abnormal uterine bleeding (AUB) has a major social, psychological, and economic impact on women aged 18–45 years, in the most productive stage of their life. This study was done to assess the impact of menstrual and obstetric patterns, cardiometabolic risk factors, and metabolic syndrome on women of reproductive age with AUB. Materials and Methods: Our hospital-based case–control study had 61 participants, of which 31 were cases and 30 were age-matched controls. They were compared on their age, age of menarche and marriage, number and type of deliveries, contraceptives used, cardiometabolic risk factors like body mass index, waist-hip ratio, waist-height ratio, fasting blood sugar (FBS), total cholesterol (TC), triglycerides, low-density lipoprotein (LDL) and high-density lipoprotein (HDL), and having metabolic syndrome. Results: The majority of the cases were 36–45 years of age. The mean age of marriage was significantly less but the parity was more ≥2 in cases when compared to controls. FBS, TC, triglycerides, LDL, and HDL in cases were significantly more than controls. A 33.3% of cases had metabolic syndrome. Women with metabolic syndrome were 15 times more likely to develop AUB, as compared to normal women. Conclusion: Age of menarche did not influence but lower age of marriage and increased number of pregnancies had a profound effect on the occurrence of AUB. Metabolic syndrome is significantly associated and could be a potential fellow traveler in women with AUB.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":"11 1","pages":"44 - 48"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44998400","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":"38 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":"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":"54 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":"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}
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":"23 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":"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}
Pub Date : 2023-01-01DOI: 10.4103/amhs.amhs_257_22
R. Panicker, Ankitha George
Automated clinical decision support systems (CDSS) are knowledge-based systems that provide patient-specific information and data to clinicians at the proper time for enhancing the clinical workflow of hospital organizations. Nowadays, it is adopted by most of the health care professionals for clinical decision-making that helps to reduce the adverse clinical care events occurring during the treatment. In this article, we present a recent literature review on the adoption of computer-based CDSSs in the area of health care based on qualitative and quantitative techniques, published between 2007 and 2022. For this purpose, we searched Google Scholar and identified different adoption factors by using textual analysis from the included publications. We then ranked the different factors based on the total number of occurrences and represented them as a conceptual framework. A total of 14 different adoption factors were found from 13 studies, among them the usefulness of the system is the most prominent factor that influences the adoption of CDSS to a great extent. This literature review and the framework could be helpful to researchers and healthcare professionals working in the field of technology adoption, providing an overall idea of factors and techniques in this field of research. We have also mentioned the limitations and future research gaps of different studies, which will help the researchers to take an initiation towards these types of research. We also conducted a case study on adoption of fully automatic digital blood pressure monitor and identified that “usefulness” and “ease of use” could influence the adoption of fully automatic digital blood pressure monitor system.
{"title":"Adoption of automated clinical decision support system: A recent literature review and a case study","authors":"R. Panicker, Ankitha George","doi":"10.4103/amhs.amhs_257_22","DOIUrl":"https://doi.org/10.4103/amhs.amhs_257_22","url":null,"abstract":"Automated clinical decision support systems (CDSS) are knowledge-based systems that provide patient-specific information and data to clinicians at the proper time for enhancing the clinical workflow of hospital organizations. Nowadays, it is adopted by most of the health care professionals for clinical decision-making that helps to reduce the adverse clinical care events occurring during the treatment. In this article, we present a recent literature review on the adoption of computer-based CDSSs in the area of health care based on qualitative and quantitative techniques, published between 2007 and 2022. For this purpose, we searched Google Scholar and identified different adoption factors by using textual analysis from the included publications. We then ranked the different factors based on the total number of occurrences and represented them as a conceptual framework. A total of 14 different adoption factors were found from 13 studies, among them the usefulness of the system is the most prominent factor that influences the adoption of CDSS to a great extent. This literature review and the framework could be helpful to researchers and healthcare professionals working in the field of technology adoption, providing an overall idea of factors and techniques in this field of research. We have also mentioned the limitations and future research gaps of different studies, which will help the researchers to take an initiation towards these types of research. We also conducted a case study on adoption of fully automatic digital blood pressure monitor and identified that “usefulness” and “ease of use” could influence the adoption of fully automatic digital blood pressure monitor system.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":"11 1","pages":"86 - 95"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46838777","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: Peptic ulcers (PUs) result from the increased aggressive or decreased protective elements in the stomach or duodenum, which can gradually cause mucosal damage and ulceration. The risk of death as a consequence of PU disease is highest in perforation. Therefore, early identification of patients with perforated PUs (PPUs) who are more likely to experience negative outcomes after surgery is crucial for making the right treatment decisions. Hence, this study uses the peptic ulcer perforation (PULP) score to predict mortality within 30 days of surgery and risk stratifies patients undergoing surgical therapy for PPUs. Materials and Methods: The patients presenting to a tertiary care setting with symptoms of hollow viscous perforation and intraoperative evidence suggestive of PPU were included in this prospective study between November 2016 and October 2020. After taking necessary ethical permissions from the institution, a total of 120 PPU patients were made part of this study. Results: In total, 120 patients were involved in the study including 94 men and 26 women. One hundred and ten patients were in the low-risk group, and 10 were in the high-risk group. In the postoperative period, eight patients from the high-risk group passed away, compared to two deaths in the low-risk group. Conclusion: The prognostic markers employed in the PULP score are simple to use and straightforward to be identified before surgery. The PULP score can help with the quick and accurate identification of high-risk patients, which can help with risk stratification and triaging of PPU patients.
{"title":"An assessment of peptic ulcer perforation score: A predictor of mortality following peptic ulcer perforation from a rural tertiary care setting","authors":"LV Simhachalam Kutikuppala, TarakaKrishna Nulukurthi, Balaji Karnasula, RHemanth Kumar Chowdary, JyothiSwaroop Chintala","doi":"10.4103/amhs.amhs_248_22","DOIUrl":"https://doi.org/10.4103/amhs.amhs_248_22","url":null,"abstract":"Background and Aim: Peptic ulcers (PUs) result from the increased aggressive or decreased protective elements in the stomach or duodenum, which can gradually cause mucosal damage and ulceration. The risk of death as a consequence of PU disease is highest in perforation. Therefore, early identification of patients with perforated PUs (PPUs) who are more likely to experience negative outcomes after surgery is crucial for making the right treatment decisions. Hence, this study uses the peptic ulcer perforation (PULP) score to predict mortality within 30 days of surgery and risk stratifies patients undergoing surgical therapy for PPUs. Materials and Methods: The patients presenting to a tertiary care setting with symptoms of hollow viscous perforation and intraoperative evidence suggestive of PPU were included in this prospective study between November 2016 and October 2020. After taking necessary ethical permissions from the institution, a total of 120 PPU patients were made part of this study. Results: In total, 120 patients were involved in the study including 94 men and 26 women. One hundred and ten patients were in the low-risk group, and 10 were in the high-risk group. In the postoperative period, eight patients from the high-risk group passed away, compared to two deaths in the low-risk group. Conclusion: The prognostic markers employed in the PULP score are simple to use and straightforward to be identified before surgery. The PULP score can help with the quick and accurate identification of high-risk patients, which can help with risk stratification and triaging of PPU patients.","PeriodicalId":8296,"journal":{"name":"Archives of Medicine and Health Sciences","volume":"11 1","pages":"9 - 13"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46990988","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":"11 1","pages":"60 - 63"},"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}
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