Pub Date : 2022-10-31DOI: 10.47363/jmhc/2022(4)215
A. Ponnuswamy, Ciaran Lisboa
Malignancy often tops the differential diagnosis of multifocal masses in a middle-aged lady. In addition, certain disease conditions like vasculitis, haematomas, and developmental anomalies like hamartomas should be considered a differential apart from ruling out benign and malignant tumours. This patient presented acutely with anaemia, renal impairment and weight loss setting us in the direction of ruling out malignancy; a however high index of suspicion and negative biopsy results with positive serology helped make a prompt diagnosis of ANCA positive GPA. Institution of immunosuppressive treatment resulted in complete resolution of these masses and a positive outcome.
{"title":"Multifocal Pelvic and Pancreatic Masses Secondary to Granulomatous Polyangiitis Resolved with Pulsed Immunosuppression","authors":"A. Ponnuswamy, Ciaran Lisboa","doi":"10.47363/jmhc/2022(4)215","DOIUrl":"https://doi.org/10.47363/jmhc/2022(4)215","url":null,"abstract":"Malignancy often tops the differential diagnosis of multifocal masses in a middle-aged lady. In addition, certain disease conditions like vasculitis, haematomas, and developmental anomalies like hamartomas should be considered a differential apart from ruling out benign and malignant tumours. This patient presented acutely with anaemia, renal impairment and weight loss setting us in the direction of ruling out malignancy; a however high index of suspicion and negative biopsy results with positive serology helped make a prompt diagnosis of ANCA positive GPA. Institution of immunosuppressive treatment resulted in complete resolution of these masses and a positive outcome.","PeriodicalId":93468,"journal":{"name":"Journal of medicine and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43563299","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 : 2022-10-31DOI: 10.47363/jmhc/2022(4)210
Mohamed Ahmed
Resistant hypertension is characterized by severe and persistent high blood pressure that is not normalized even after administering two or more antihypertensive medications, of which one is a diuretic. Although resistant hypertension is commonly encountered in clinics, the prognosis is largely unclear. Mounting evidence indicate that resistant hypertension is a multifactorial pathology of diverse etiology. A wide variety of predisposed factors including age, ethnicity, obesity, obstructive sleep apnea, primary aldosteronism, chronic kidney disease, excessive sympathetic activation and baroreflex dysfunction may be implicated. Although a cocktail of three or four major classes of antihypertensive drugs are recommended for treatment, the benefits of pharmacological interventions is limited in many patients, so surgical denervation of the renal artery is widely practiced to improving patient outcome. Thus, surgical interventions include (i) renal sympathetic denervation, (ii) renal sympathetic innervation, and (iii) device-based carotid baroreceptor electric stimulation may be considered back-to-life options to treat resistant hypertension. Moreover, over the years, these surgical procedures have been refined and fine-tuned to optimize benefits, while minimizing adverse effects. Thus, the current surgical practice has been greatly improved from the time of inception. Therefore, this review will focus on the role of surgical interventions in the treatment and management of resistant hypertension. With the global escalation of hypertension in epidemic proportions and the huge socio-economic burden posed to patients, their families and healthcare systems, it is of utmost importance to improve treatment strategies for all forms of hypertension including resistant hypertension.
{"title":"Back to Life Treatment of Resistant Hypertension- An Update","authors":"Mohamed Ahmed","doi":"10.47363/jmhc/2022(4)210","DOIUrl":"https://doi.org/10.47363/jmhc/2022(4)210","url":null,"abstract":"Resistant hypertension is characterized by severe and persistent high blood pressure that is not normalized even after administering two or more antihypertensive medications, of which one is a diuretic. Although resistant hypertension is commonly encountered in clinics, the prognosis is largely unclear. Mounting evidence indicate that resistant hypertension is a multifactorial pathology of diverse etiology. A wide variety of predisposed factors including age, ethnicity, obesity, obstructive sleep apnea, primary aldosteronism, chronic kidney disease, excessive sympathetic activation and baroreflex dysfunction may be implicated. Although a cocktail of three or four major classes of antihypertensive drugs are recommended for treatment, the benefits of pharmacological interventions is limited in many patients, so surgical denervation of the renal artery is widely practiced to improving patient outcome. Thus, surgical interventions include (i) renal sympathetic denervation, (ii) renal sympathetic innervation, and (iii) device-based carotid baroreceptor electric stimulation may be considered back-to-life options to treat resistant hypertension. Moreover, over the years, these surgical procedures have been refined and fine-tuned to optimize benefits, while minimizing adverse effects. Thus, the current surgical practice has been greatly improved from the time of inception. Therefore, this review will focus on the role of surgical interventions in the treatment and management of resistant hypertension. With the global escalation of hypertension in epidemic proportions and the huge socio-economic burden posed to patients, their families and healthcare systems, it is of utmost importance to improve treatment strategies for all forms of hypertension including resistant hypertension.","PeriodicalId":93468,"journal":{"name":"Journal of medicine and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43899952","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 : 2022-10-31DOI: 10.47363/jmhc/2022(4)214
M. Chaudhri, Khushboo K Agarwal
Asthma and chronic obstructive pulmonary disease (COPD) are common airway inflammatory conditions that can present in isolation or a combination known as asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS). Due to similarities in clinical presentation, differentiating these conditions can be challenging. Fractional exhaled nitric oxide (FeNO) is an endogenous molecule that can be elevated in patients with airway inflammation, particularly asthma. The purpose of this study was to determine if FeNO levels can be used to change pharmacologic management (addition, in patients presenting with asthma, COPD, and ACOS. A retrospective chart review of 250 patients underwent FeNO testing; 93 patients were included in the final analysis with their FeNO levels and medications. Out of 76 patients, 34 were prescribed medications of interest (inhaled corticosteroids (ICS), Inhaled corticosteroids - long-acting beta-agonists (ICS-LABA), anticholinergics (AC) monotherapy or combination therapy). After the FeNO testing, the number of patients on ICS therapy doubled (8 to 16), and the number of patients on ICS -LABA increased by 69.2%. Lastly, the number of patients not on medication of interest, 57.1%, ended up on one after FeNO testing. Our results support the utility of FeNO as a viable test to manage patients with obstructive lung disease.
{"title":"Fractional Exhaled Nitric Oxide Testing: Change in Clinical Management of Asthma, or Chronic Obstructive Pulmonary","authors":"M. Chaudhri, Khushboo K Agarwal","doi":"10.47363/jmhc/2022(4)214","DOIUrl":"https://doi.org/10.47363/jmhc/2022(4)214","url":null,"abstract":"Asthma and chronic obstructive pulmonary disease (COPD) are common airway inflammatory conditions that can present in isolation or a combination known as asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS). Due to similarities in clinical presentation, differentiating these conditions can be challenging. Fractional exhaled nitric oxide (FeNO) is an endogenous molecule that can be elevated in patients with airway inflammation, particularly asthma. The purpose of this study was to determine if FeNO levels can be used to change pharmacologic management (addition, in patients presenting with asthma, COPD, and ACOS. A retrospective chart review of 250 patients underwent FeNO testing; 93 patients were included in the final analysis with their FeNO levels and medications. Out of 76 patients, 34 were prescribed medications of interest (inhaled corticosteroids (ICS), Inhaled corticosteroids - long-acting beta-agonists (ICS-LABA), anticholinergics (AC) monotherapy or combination therapy). After the FeNO testing, the number of patients on ICS therapy doubled (8 to 16), and the number of patients on ICS -LABA increased by 69.2%. Lastly, the number of patients not on medication of interest, 57.1%, ended up on one after FeNO testing. Our results support the utility of FeNO as a viable test to manage patients with obstructive lung disease.","PeriodicalId":93468,"journal":{"name":"Journal of medicine and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43165098","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 : 2022-10-31DOI: 10.47363/jmhc/2022(4)211
Shaurav Ghosh, Karthik Vijay
Less than 200 cases of Paratesticular Liposarcoma, a rare form of paratesticular sarcoma, have been documented in western literature [1-5]. Additionally, there are a few occurrences of Giant paratesticular liposarcomas that are beyond 10 cm in size. Prior to surgery, the condition is frequently wrongly diagnosed [1]. Ineffective management causes both distant metastases and local recurrence. A case of a middle-aged male with a large, painless right scrotal mass is presented in the current study. A heterogenous hypodense lesion was found during imaging examinations in the right scrotum. The current study focuses on the discussion of clinical characteristics, diagnosis, and treatment.
{"title":"Giant Paratesticular Liposarcoma: A Case Report","authors":"Shaurav Ghosh, Karthik Vijay","doi":"10.47363/jmhc/2022(4)211","DOIUrl":"https://doi.org/10.47363/jmhc/2022(4)211","url":null,"abstract":"Less than 200 cases of Paratesticular Liposarcoma, a rare form of paratesticular sarcoma, have been documented in western literature [1-5]. Additionally, there are a few occurrences of Giant paratesticular liposarcomas that are beyond 10 cm in size. Prior to surgery, the condition is frequently wrongly diagnosed [1]. Ineffective management causes both distant metastases and local recurrence. A case of a middle-aged male with a large, painless right scrotal mass is presented in the current study. A heterogenous hypodense lesion was found during imaging examinations in the right scrotum. The current study focuses on the discussion of clinical characteristics, diagnosis, and treatment.","PeriodicalId":93468,"journal":{"name":"Journal of medicine and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43341503","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 : 2022-08-31DOI: 10.47363/jmhc/2022(4)205
J. Rajčáni
The aim of this paper is a brief survey of the achievements in virology as published mainly in the course of 20th century and therafter until recent time. The author believes that in its beginning the virus research has developed in the framework of microbiology and related biological disciplines such as parasitology, pathology, cytology etc. Virologists have payed attention to many biological disciplenes not only for above mentioned reason, but also because they infect not only mammals, but also lower vertebrates including reptiles and/or many avian species as well as plants. To asses the origin of viruses may not be a simple task, it has been anticipated that they had probably sequestrated from cellular structures and then underwent their evolution.
{"title":"Achievements of Virus Research","authors":"J. Rajčáni","doi":"10.47363/jmhc/2022(4)205","DOIUrl":"https://doi.org/10.47363/jmhc/2022(4)205","url":null,"abstract":"The aim of this paper is a brief survey of the achievements in virology as published mainly in the course of 20th century and therafter until recent time. The author believes that in its beginning the virus research has developed in the framework of microbiology and related biological disciplines such as parasitology, pathology, cytology etc. Virologists have payed attention to many biological disciplenes not only for above mentioned reason, but also because they infect not only mammals, but also lower vertebrates including reptiles and/or many avian species as well as plants. To asses the origin of viruses may not be a simple task, it has been anticipated that they had probably sequestrated from cellular structures and then underwent their evolution.","PeriodicalId":93468,"journal":{"name":"Journal of medicine and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42708922","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 : 2022-08-31DOI: 10.47363/jmhc/2022(4)208
Akshay J Reddy, Nicholas P Iskandar
This investigation allowed us to understand more about the relationship between Plavix and the treatment of coronary microvascular dysfunction. The capacity of Plavix to work in tandem with aspirin in a dual treatment approach to improve the anti-platelet therapeutic impact and to lessen platelet aggregation brought on by platelet receptor blockade is one of the drug’s many important advantages. The researchers found that the average reduction in risk of adverse cardiovascular events caused by Plavix much outweighed any potential systemic harm. Although it has been shown that the current standard of care significantly lowers harm among people with micro cardiovascular disease, more study is needed to ensure that this standard is enhanced. It may become more typical in the future to include patient groups in trials without requiring diabetes as a requirement. It is possible that the study results are biased since diabetes patients often have higher LDL cholesterol levels than the overall population. To confirm or deny this claim, more investigation is necessary.
{"title":"A Narrative Review on Various Treatment Methods for Coronary Microvascular Disease","authors":"Akshay J Reddy, Nicholas P Iskandar","doi":"10.47363/jmhc/2022(4)208","DOIUrl":"https://doi.org/10.47363/jmhc/2022(4)208","url":null,"abstract":"This investigation allowed us to understand more about the relationship between Plavix and the treatment of coronary microvascular dysfunction. The capacity of Plavix to work in tandem with aspirin in a dual treatment approach to improve the anti-platelet therapeutic impact and to lessen platelet aggregation brought on by platelet receptor blockade is one of the drug’s many important advantages. The researchers found that the average reduction in risk of adverse cardiovascular events caused by Plavix much outweighed any potential systemic harm. Although it has been shown that the current standard of care significantly lowers harm among people with micro cardiovascular disease, more study is needed to ensure that this standard is enhanced. It may become more typical in the future to include patient groups in trials without requiring diabetes as a requirement. It is possible that the study results are biased since diabetes patients often have higher LDL cholesterol levels than the overall population. To confirm or deny this claim, more investigation is necessary.","PeriodicalId":93468,"journal":{"name":"Journal of medicine and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42200824","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 : 2022-08-31DOI: 10.47363/jmhc/2022(4)203
W. Elbossaty
Pfeiffer syndrome is a genetic disease caused by a defect in the FGFR-1 or FGFR-2 genes. This syndrome affects the skeleton, whether it is a protrusion of the skull bone or problems in the limbs. Not only this, but also affects the eyes, leading to their protrusion, in addition to the possibility of hydrocephalus, and internal viscera imbalance. There are 3 types of the syndrome classified according to the clinical examination of the case, where the symptoms range from mild to severe, which requires surgical intervention. It is easy to diagnose the fetus early through ultrasound examination, which shows ossification in the bones of the skull and deformities of the fingers. The incidence of Pfeiffer syndrome is limited, as it affects one child in 100,000 cases. Genetic testing facilitates early diagnosis and thus helps in rapid treatment and prevention of deterioration of the condition.
{"title":"Fgfr Gene Mutation and Pfeiffer Syndrome","authors":"W. Elbossaty","doi":"10.47363/jmhc/2022(4)203","DOIUrl":"https://doi.org/10.47363/jmhc/2022(4)203","url":null,"abstract":"Pfeiffer syndrome is a genetic disease caused by a defect in the FGFR-1 or FGFR-2 genes. This syndrome affects the skeleton, whether it is a protrusion of the skull bone or problems in the limbs. Not only this, but also affects the eyes, leading to their protrusion, in addition to the possibility of hydrocephalus, and internal viscera imbalance. There are 3 types of the syndrome classified according to the clinical examination of the case, where the symptoms range from mild to severe, which requires surgical intervention. It is easy to diagnose the fetus early through ultrasound examination, which shows ossification in the bones of the skull and deformities of the fingers. The incidence of Pfeiffer syndrome is limited, as it affects one child in 100,000 cases. Genetic testing facilitates early diagnosis and thus helps in rapid treatment and prevention of deterioration of the condition.","PeriodicalId":93468,"journal":{"name":"Journal of medicine and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44035447","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 : 2022-08-31DOI: 10.47363/jmhc/2022(4)204
A. Abdelrhman, Ahmed Hosham
Background: The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the most formidable challenge to humanity in a century. It is widely believed that pracademic normalcy will never return until a safe and effective vaccine strategy becomes available and a global vaccination programmed is implemented successfully. Design: This descriptive (case – control) analytical study carried out in Sudanese from June to December 2021 to determine the effect coagulation profile between AstraZeneca vaccinated and non- vaccinated. Materials and Methods: whole blood sample collected in Trisodium Citrate anticoagulant from 500 vaccinated case and 500 control non vaccinated, PPP prepared and the tests was carried out using coagulometer, Objective: This study aimed to evaluate some coagulation profile (PT, APTT and INR) among Sudanese AstraZeneca vaccinated. Results: The result show significant different between case and control in (PT, APTT and INR) and significant different between male and female in (PT, APTT). Conclusion: This study concluded that the statistically significant different in (PT, APTT and INR) between vaccinated.
{"title":"The Effect of Covid-19 Astrazeneca Vaccines on Some Coagulation Profile (Pt, Aptt) Among Sudanese Two Dose Vaccinated","authors":"A. Abdelrhman, Ahmed Hosham","doi":"10.47363/jmhc/2022(4)204","DOIUrl":"https://doi.org/10.47363/jmhc/2022(4)204","url":null,"abstract":"Background: The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the most formidable challenge to humanity in a century. It is widely believed that pracademic normalcy will never return until a safe and effective vaccine strategy becomes available and a global vaccination programmed is implemented successfully. Design: This descriptive (case – control) analytical study carried out in Sudanese from June to December 2021 to determine the effect coagulation profile between AstraZeneca vaccinated and non- vaccinated. Materials and Methods: whole blood sample collected in Trisodium Citrate anticoagulant from 500 vaccinated case and 500 control non vaccinated, PPP prepared and the tests was carried out using coagulometer, Objective: This study aimed to evaluate some coagulation profile (PT, APTT and INR) among Sudanese AstraZeneca vaccinated. Results: The result show significant different between case and control in (PT, APTT and INR) and significant different between male and female in (PT, APTT). Conclusion: This study concluded that the statistically significant different in (PT, APTT and INR) between vaccinated.","PeriodicalId":93468,"journal":{"name":"Journal of medicine and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43573875","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 : 2022-08-31DOI: 10.47363/jmhc/2022(4)206
Sushil Rayamajhi, Neela Sunuwar
Canavan disease is an autosomal recessive leukodystrophy associated with hypotonia, megalencephaly, mental retardation, blindness and spasticity. The biochemical deficiency of aspartoacylase (ASPA) causes CD. Deficiency in ASPA, which hydrolyzes N-acetylaspartate, results in NAA building up to high millimolar amounts in the brain. The hallmarks of the disease are loss of oligodendrocytes and spongy myelin degradation in the CNS. However, it is unclear whether the disease’s pathophysiology is caused by the accumulation of NAA, the absence of NAA-derived acetate, or the absence of any unknown roles of the ASPA enzyme. In this Review, we present an important and timely update on the current and emerging aspects of this neurological disease. Following a brief overview of canavan disease, we discuss current knowledge of neurological findings, pathophysiology, diagnostic approaches, current canavan disease treatment, and gene therapy’s future prospects.
{"title":"Canavan Disease: A Case Report","authors":"Sushil Rayamajhi, Neela Sunuwar","doi":"10.47363/jmhc/2022(4)206","DOIUrl":"https://doi.org/10.47363/jmhc/2022(4)206","url":null,"abstract":"Canavan disease is an autosomal recessive leukodystrophy associated with hypotonia, megalencephaly, mental retardation, blindness and spasticity. The biochemical deficiency of aspartoacylase (ASPA) causes CD. Deficiency in ASPA, which hydrolyzes N-acetylaspartate, results in NAA building up to high millimolar amounts in the brain. The hallmarks of the disease are loss of oligodendrocytes and spongy myelin degradation in the CNS. However, it is unclear whether the disease’s pathophysiology is caused by the accumulation of NAA, the absence of NAA-derived acetate, or the absence of any unknown roles of the ASPA enzyme. In this Review, we present an important and timely update on the current and emerging aspects of this neurological disease. Following a brief overview of canavan disease, we discuss current knowledge of neurological findings, pathophysiology, diagnostic approaches, current canavan disease treatment, and gene therapy’s future prospects.","PeriodicalId":93468,"journal":{"name":"Journal of medicine and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70825925","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 : 2022-08-31DOI: 10.47363/jmhc/2022(4)207
M. Al-Yaseen, H. Mohammed
Early diagnosis of musculoskeletal infections is of vital importance to avoid devastating complications. There is no single laboratory marker which is sensitive and specific in diagnosing these infections accurately. White blood cell count, erythrocyte sedimentation rate and C-reactive protein are not specific as they can also be elevated in conditions other than bacterial infections. Materials Culture and sensitivity is not a true gold standard due to its varied positivity rates. Serum Procalcitonin (PCT) is one of the new laboratory markers for pyogenic infections. The objective of this study is to assess the value of PCT in diagnosis of soft tissue, bone and joint infections. Patients and Methods: Patients of all age groups (seventy-four patients) with diagnosis of musculoskeletal infection are prospectively included in this study. All patients were subjected to White blood cell count, erythrocyte sedimentation rate, C-reactive protein and serum Procalcitonin measurements. Healthy non infected outpatient group (twenty-two patients) taken as a control group and underwent the same evaluation steps as the study group. Results: The study group showed mean Procalcitonin levels of 1.3 ng/ml. Procalcitonin, at 0.5 ng/ml, was (42.6%) sensitive and (95.5%) specific in diagnosing of musculoskeletal infections with (positive predictive value of 87.5% and negative predictive value of 48.3%) and (positive likelihood ratio of 9.3 and negative likelihood ratio of 0.6). Conclusion: Serum Procalcitonin, at a cut – off of 0.5 ng/ml, is a specific but not sensitive marker in the diagnosis of musculoskeletal infections, and it can be used effectively to rule in the diagnosis of infection but not to rule out it.
{"title":"Procalcitonin Role in Musculoskeletal Infection: A Comparative Prospective Study","authors":"M. Al-Yaseen, H. Mohammed","doi":"10.47363/jmhc/2022(4)207","DOIUrl":"https://doi.org/10.47363/jmhc/2022(4)207","url":null,"abstract":"Early diagnosis of musculoskeletal infections is of vital importance to avoid devastating complications. There is no single laboratory marker which is sensitive and specific in diagnosing these infections accurately. White blood cell count, erythrocyte sedimentation rate and C-reactive protein are not specific as they can also be elevated in conditions other than bacterial infections. Materials Culture and sensitivity is not a true gold standard due to its varied positivity rates. Serum Procalcitonin (PCT) is one of the new laboratory markers for pyogenic infections. The objective of this study is to assess the value of PCT in diagnosis of soft tissue, bone and joint infections. Patients and Methods: Patients of all age groups (seventy-four patients) with diagnosis of musculoskeletal infection are prospectively included in this study. All patients were subjected to White blood cell count, erythrocyte sedimentation rate, C-reactive protein and serum Procalcitonin measurements. Healthy non infected outpatient group (twenty-two patients) taken as a control group and underwent the same evaluation steps as the study group. Results: The study group showed mean Procalcitonin levels of 1.3 ng/ml. Procalcitonin, at 0.5 ng/ml, was (42.6%) sensitive and (95.5%) specific in diagnosing of musculoskeletal infections with (positive predictive value of 87.5% and negative predictive value of 48.3%) and (positive likelihood ratio of 9.3 and negative likelihood ratio of 0.6). Conclusion: Serum Procalcitonin, at a cut – off of 0.5 ng/ml, is a specific but not sensitive marker in the diagnosis of musculoskeletal infections, and it can be used effectively to rule in the diagnosis of infection but not to rule out it.","PeriodicalId":93468,"journal":{"name":"Journal of medicine and healthcare","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48963292","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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