scholarly journals Pediatric Interstitial Lung Disease Masquerading as Difficult Asthma: Management Dilemmas for Rare Lung Disease in Children

2005 ◽  
Vol 12 (6) ◽  
pp. 317-320 ◽  
Author(s):  
EY Chan ◽  
Sharon D Dell
Keyword(s):  
Lung Disease ◽  
Bronchiolitis Obliterans ◽  
Treatment Options ◽  
Tertiary Care ◽  
Asthma Management ◽  
Open Lung Biopsy ◽  
Tertiary Care Centre ◽  
Exertional Dyspnea ◽  
Syncytial Virus ◽  
Difficult Asthma

Idiopathic nontransplant-related childhood bronchiolitis obliterans is an uncommon disease. Most patients present with chronic recurrent dyspnea, cough and wheezing, which are also features of asthma, by far a much more common condition. The present case study reports on a six-year-old girl who presented to a tertiary care centre with recurrent episodes of respiratory distress on a background of baseline tachypnea, chronic hypoxemia and exertional dyspnea. Her past medical history revealed significant lung disease in infancy, including respiratory syncytial virus bronchiolitis and repaired gastroesophageal reflux. She was treated for 'asthma exacerbations' throughout her early childhood years. Bronchiolitis obliterans was subsequently diagnosed with an open lung biopsy. She did not have sustained improvement with systemic corticosteroids, hydroxychloroquine or clarithromycin. Cardiac catheterization confirmed the presence of secondary pulmonary hypertension. Treatment options remain a dilemma for this patient because there is no known effective treatment for this condition, and the natural history is not well understood. The present case demonstrates the need for careful workup in 'atypical asthma', and the urgent need for further research into the rare lung diseases of childhood.

Carnitine deficiency in chronic obstructive lung disease: A study in a tertiary care centre

2021 ◽  
Vol 6 (3) ◽  
pp. 183-187
Author(s):  
M Ravindranath ◽  
C H Raju
Keyword(s):  
Lung Disease ◽  
Obstructive Lung Disease ◽  
Tertiary Care ◽  
Chronic Obstructive Lung Disease ◽  
Carnitine Deficiency ◽  
Control Group ◽  
Chronic Obstructive ◽  
X Rays ◽  
Tertiary Care Centre ◽  
Regular Diet

Chronic Obstructive Lung Disease (COPD) is a condition where there is poor airflow to the lungs and over a period of time this condition worsen, resulting in severe morbidity. L-carnitine (LC) is a soluble qaurtenary amine and is essential for the tissues and lung tone to function normally. This study was therefore find out the association of L-carnitine in patients with chronic Obstructive Pulmonary Disease. 75 patients who came to the Department of Pulmonology of either sex between 40 to 75 years with confirmed COPD were included into patients group and 75 healthy patients were included into the control group. Blood was collected for Fasting blood sugar, AST, ALP, ALT, Urea, Creatinine, Albumin, pre-albumin, iron , magnesium, sodium, phosphorous, calcium, Acylcarnitines, total and free carnitine levels. X-rays were taken and pulmonary function test was done for all the patients. The mean age of the patients in our study was 62.53 and 61.86 years among the patients and controls respectively. Among the controls the Ph and Fe levels were 3.1 ± 0.9mmol/L and 21.69 ± 3.19 mcg/dL respectively and among the patients the same levels were 2.6 ± 1.9mmol/L and 43.82 ± 8.22mcg/dL respectively. The albumin and the prealbumin in the patients were significantly lower in the patients with 21.81 ± 2.88 and 23.53 ±2.58 mg/dL and in controls they were 32.61 ±3.87 and 26.87 ± 1.93 mg/dL respectively. There was a considerable carnitine deficiencies in COPD patients when compared to the controls and since carnitine can be found in regular diet, people can be educated to have a proper intake of foods containing carnitine in their regular diet.

scholarly journals IV Paracetamol for closure of patent ductus arteriosus in preterm neonates admitted to a tertiary care centre

2018 ◽  
Vol 5 (2) ◽  
pp. 294 ◽  
Author(s):  
Sunil B. ◽  
Shruthi Patel ◽  
Girish N.
Keyword(s):  
Side Effects ◽  
Preterm Infants ◽  
Ductus Arteriosus ◽  
Treatment Options ◽  
Tertiary Care ◽  
Current Treatment ◽  
Preterm Neonates ◽  
Tertiary Care Centre ◽  
Vascular Connection ◽  
Intravenous Paracetamol

Background: Ductus arteriosus is a vascular connection between the pulmonary artery and descending aorta. The incidence is inversely related to birth weight and gestational age (GA). In preterm infants it varies between 40% and 60% on the third day of life. At present, the choice of treatment of clinically significant PDA is with either ibuprofen or indomethacin, but they carry many contraindications and potential side effects. Hence it is important to consider that paracetamol may be used as an alternative to other non steroidal anti-inflammatory drugs and is effective in ductal closure with minimal side effects.Methods:Thirty six preterm infants with hemodynamically significant PDA(hs-PDA) were treated with intravenous paracetamol and subsequent closure was evaluated clinically and by follow-up 2D-Echo.Results: PDA closure following intravenous paracetamol was evident in 27 babies (75%). There were no significant side effects noted with paracetamol therapy.Conclusions: This study shows that paracetamol could offer favourable safety profile in comparison to current treatment options. Therefore, paracetamol may be accepted as a first-line drug treatment for PDA in preterm infants. 

scholarly journals CLINICOPATHOLOGICAL STUDY OF CARCINOMA ORAL CAVITY & PATTERN OF METASTASIS- EXPERIENCE IN A TERTIARY CARE CENTRE

2020 ◽  
pp. 1-3
Author(s):  
Bijan Basak ◽  
Soutrik Kumar ◽  
Kaustuv Das Biswas ◽  
Sayan Hazra ◽  
Debarshi Jana
Keyword(s):  
Indian Subcontinent ◽  
Treatment Options ◽  
Tertiary Care ◽  
Neck Surgery ◽  
Tertiary Care Centre ◽  
Major Health Problem ◽  
Node Metastases ◽  
Long Term Prognosis ◽  
Head Neck Surgery ◽  
Head Neck

Oral cancer (code 145.9, ICD 9) encompasses all malignancies originating in oral tissues & it is a major health problem in many parts of the world. Although incidence is relatively low in the western countries, in the Indian subcontinent & other parts of Asia it remains one of the commonest cancers. The study was conducted on the patients attending the ENT & HEAD-NECK SURGERY OPD at the INSTITUTE OF OTORHINOLARYNGOLOGY & HEAD-NECK SURGERY, IPGME&R, Kolkata during a period of 1 year from 1st March 2019 to 29th February 2020. Buccal mucosa was the commonest site & most cases presented in late stage with cervical lymph node metastases entailing poorer prognosis. People should be made aware of the warning symptoms, need for early diagnosis & treatment options available through IEC (information, education & communication programmes) in order to provide better treatment outcomes, improved long term prognosis & thereby reducing the morbidity & mortality of people at large.

scholarly journals Clinical study of multiple myeloma and treatment responses in a tertiary care centre

2021 ◽  
Vol 9 (11) ◽  
pp. 3356
Author(s):  
Immanni S. M. Giridhar ◽  
C. Deepak Yadlapalli ◽  
Muralidhar Gullipalli ◽  
Venkatesh Mushini ◽  
Yerraguntla S. Sarma ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Treatment Options ◽  
Tertiary Care ◽  
Elevated Serum ◽  
Staging System ◽  
Stage Iiib ◽  
Common Symptom ◽  
Tertiary Care Centre ◽  
Incurable Disease ◽  
Unknown Significance

Background: Multiple myeloma (MM) evolves from Monoclonal gammopathy of unknown significance (MGUS), a premalignant clinical condition. Second to non-Hodgkin’s lymphoma, MM is the most common haematological malignancy. The aim of the study was to review the clinical profile and response of individuals treated for MM from this part of country.Methods: We evaluated data of patients with MM managed between 2013 and 2019 at a tertiary care cancer hospital in Rajamahenderi, India. Data regarding demographic variables, clinical features, disease characteristics and treatment details were collected and analysed.Results: Total of 54 patients with MM were managed. Mean age was 59.4 years. Males accounted for 63%. Bone pain (90%) was the most common symptom. Elevated serum creatinine was noted in 16.7% and M band in 42 (77.8%). X-ray of skull showed lytic lesions in 41 (75.9%). Mean haemoglobin value was 8.8±1.9 g/dl and serum calcium was 9.12 mg/dl. Majority of subjects, 44 (81.48%) belong to stage IIIA, 9 (16.67%) to stage IIIB, and 1.85% to stage IIA of Durie Salmon staging system. No response was noted in 17 (31.5%), 4 (7.4%) subjects had a progressive disease even on treatment, and 8 (14.8%) subjects had a very good partial response. Median survival of subjects belonging to DSS stage II was 17 months, IIIA was 11.037 months and stage IIIB was 17.463 months.Conclusions: MM has an early onset in India. Though MM is an incurable disease, many promising treatment options are there which lead to increase in survival. Early treatment helps in improving mortality rates, better quality of life and decreases disease burden.

scholarly journals Prevalence of various dermatoses in pregnancy at a tertiary care centre in Moradabad, Uttar Pradesh, India: an observational study

2019 ◽  
Vol 8 (2) ◽  
pp. 425
Author(s):  
Shruti Uniyal ◽  
Ritika Agarwal ◽  
Nupur Nandi ◽  
Pulkit Jain
Keyword(s):  
Observational Study ◽  
Low Socioeconomic Status ◽  
Treatment Options ◽  
Tertiary Care ◽  
Liver Function Tests ◽  
Skin Lesions ◽  
Personal Hygiene ◽  
Tertiary Care Centre ◽  
Palmar Erythema ◽  
In Pregnancy

Background: This was a prospective study which was done to observe various skin lesions in pregnancy and to determine the most likely causes and their incidence in antenatal patients, it was noticed that many women in our institute were having pregnancy related cutaneous complaints thus this observational study was carried out so that better preventive measures and treatment options could be provided to these patients.Methods: Study was conducted in out-patient department of Obstetrics and Gynaecology, TMU, Moradabad. All ANC cases between October 2017 to September 2018 having any type of dermatoses were included in the study irrespective of gestational age. 6348 patients appeared in OPD in the given time period out of which 1256 were included. In case of pruritus, liver function tests were done with USG whole abdomen and patients were reviewed by physician if required. Screening with VDRL, HCV, HbSAg and ELISA for HIV was done in all. Results were tabulated and analyzed.Results: 50.8% primi gravidas ,49.2% multi gravidas. age range 18-38 years. 29.3% presented in third trimester ,25.6% presented in second trimester. Physiological changes seen in all cases, 8.68% specific dermatoses of pregnancy. 40.4 % no complaints, 5.65% melasma, 90.8% hyperpigmentation, 94.6% linea nigra. Secondary areola 89.3%,striae 80.3% out of which 38.9%- primi gravidas and 41.40% -multi gravidas. 92.9% no change in hair density. Montgomery’s tubercles 30-50% of cases. spiders nevi 67%. No cases of palmar erythema. Pruritus gravidarum 38.53%. PUPPP 28.4%. Pemphigoid Gestationis 9.17%. Prurigo of pregnancy 18.34%. Pruritic folliculitis 1.8%. Eczema in pregnancy : pre-existing in 3.7% , out of which exacerbation 1, 3 unaffected. 3 chicken pox.1 filariasis.24 herpetic lesions (herpes simplex).1 scleroderma.17.27% pre-existing taenia infection . Scabies 20.46%.11 0.87% dual infection (scabies-taenia).Conclusions: This study highlights high prevalence of community acquired infections in our region like taenia, scabies giving rise to skin lesions in Antenatal women. Moreover, it highlights a probable association between the prevalence of skin lesions with factors like poor personal hygiene, overcrowding, low socioeconomic status, anaemia and poor nutritional status.

scholarly journals IMMUNOPHENOTYPIC PROFILE OF T ACUTE LYMPHOBLASTIC LEUKAEMIA IN A TERTIARY CARE CENTRE - OUR EXPERIENCE

2020 ◽  
Vol 8 (11) ◽  
pp. 952-956
Author(s):  
Sumayya Shah ◽  
◽  
Saleem Hussain Mir ◽  
Keyword(s):  
Bone Marrow ◽  
Acute Lymphoblastic Leukaemia ◽  
Treatment Options ◽  
Tertiary Care ◽  
Age Groups ◽  
Care Centre ◽  
Bone Marrow Blast ◽  
Tertiary Care Centre ◽  
Suitable Treatment ◽  
Average Bone

Background:Studying the immunophenotypic profile of T-ALL patients in Kashmir and correlation of various demographic factors. Methods: 36 patients of all age groups were registered for this study of which 35 were included in the analyses. Result: 82.86% were males and 17.14% were females. 51.43% had common thymocyte T-ALL, 28.57% had pro T-ALL and 20% had mature thymocyte T-ALL. The average age at presentation was 18.60 years. 51.43% were CD1a positive. CD2 was positive in 70.83%. 88.57% were CD5 positive while 100% were positive for CD7. 42.86% were CD34 positive. The average bone marrow blast percentage was 82.43%. The average peripheral blood TLC was 92.73 x 103 cells/cumm. Conclusion: This is the first study to report immunophenotypic and demographic profile of T-ALL in Kashmir with the aim to increase understanding of the disease and contributing to more suitable treatment options.

scholarly journals An insight into the etiopathogenesis, clinical patterns, treatment outcome and repercussions of cutaneous small-vessel vasculitis

2018 ◽  
Vol 4 (3) ◽  
pp. 419
Author(s):  
Rajkumar Kannan ◽  
Muthusubramanian Chandrasekar ◽  
Sridhar Venu ◽  
Jayakalyani Vijayananth
Keyword(s):  
Systemic Disease ◽  
Treatment Options ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Complete Recovery ◽  
Small Vessel ◽  
Small Vessel Vasculitis ◽  
Tertiary Care Centre ◽  
Drug Induced ◽  
Etiological Factors

<p class="abstract"><strong>Background:</strong> Cutaneous small-vessel vasculitis (CSVV) is a group of disorder which is characterised by involvement of capillaries, arterioles and venules. CSVV can be idiopathic or primary, or secondary to infection, drugs or as a part and parcel of underlying systemic disease. The aim of our study is to find out the etiological factors, treatment options and their outcome in CSVV.</p><p class="abstract"><strong>Methods:</strong> We analysed 75 cases of CSVV out of patients who attended Dermatology OPD, in a tertiary care-centre from April 2017 to March 2018.The study design was descriptive study. A detailed history taking, thorough clinical examination and appropriate relevant investigations including biopsy were done for all the patients fulfilling the inclusion criteria and exclusion criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> A sample size of 75 patients (53 women and 22 men) were included in the study. Their mean age was found to be 25 years (range 18-40). The following etiological factors were made out in our study: Benign isolated (40) patients, (53%), infective etiology (14) patients, (19%), vasculitis in background of ANA/dsDNA/ANCA positivity (12) patients, (16%), drug induced (9), patients (12%). The main clinical manifestations of CSVV in our study were found to be the following viz, palpable purpura in all 75 patients (100%), fever &amp; malaise in 30 patients, (40%), ulcers in 30 patients (40%) arthritis/arthralgia in 15 patients, (20%). After a median follow up of 6 months, complete recovery was observed in all patients, although relapses occurred in 8 patients (11%).</p><p><strong>Conclusions:</strong> CSVV is usually associated with other vasculitis and connective tissue disorders and patients turning ANCA positive somewhere in the course of the disease is of ominous sign and hence, it becomes mandatory to keep these patients on a long term vigil. </p>

scholarly journals Role of autoinoculation in the management of cutaneous warts: a comparison study with 100% tricholoroacetic acid application

2020 ◽  
Vol 6 (4) ◽  
pp. 537 ◽  
Author(s):  
Karla N. Faleiro ◽  
Pankaj Shukla
Keyword(s):  
Trichloroacetic Acid ◽  
Treatment Options ◽  
Tertiary Care ◽  
Punch Biopsy ◽  
Statistical Correlation ◽  
Tertiary Care Centre ◽  
Multiple Treatment ◽  
Group 2 ◽  
Chemical Cautery ◽  
Group 1

<p class="abstract"><strong>Background:</strong> Persistent and recurrent warts pose a challenge to physicians despite the availability of multiple treatment options. Autoinoculation exposes HPV antigens to the dermis and vasculature thereby activating a delayed hypersensitivity response, facilitating clearance of both local and distant warts. The aim of this study was to assess the efficacy of autoinoculation and compare it with chemical cautery using 100% trichloroacetic acid.</p><p class="abstract"><strong>Methods:</strong> A non-blinded interventional study was conducted at Goa Medical College, a tertiary care centre. Non-immunocompromised patients with 5 or more non-genital warts were included. Group 1: a wart was removed by punch biopsy, minced and implanted in the dermis. The procedure was repeated at 4 and 8 weeks. Group 2: weekly trichloroacetic acid (100%) application. Response was assessed at 4, 8 and 12 weeks in terms of percentage reduction in the number of warts. Statistical correlation with respect to age, sex, duration, number and type of warts was assessed using Welch ANOVA.<strong></strong></p><p class="abstract"><strong>Results:</strong> In group 1, 63 patients and in group 2, 54 patients completed the study. Post autoinoculation, complete clearance was seen in 46.0% and 3.2% had partial clearance. With TCA application, 33.3% patients had complete and 13% had partial clearance. Response differed with the type of warts. Palmoplantar, periungual warts and verruca vulgaris showed better response to autoinoculation. Filiform and plane warts showed better response to TCA.</p><p class="abstract"><strong>Conclusions:</strong> Autoinoculation is an efficacious treatment modality which can be performed routinely especially for palmoplantar and periungual warts which are particularly challenging to treat with other modalities.</p>

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