scholarly journals Gastrointestinal duplication cysts: experience from a tertiary care center in North India and review of literature

2020 ◽  
Vol 8 (1) ◽  
pp. 180
Author(s):  
Divya Aggarwal ◽  
Kim Vaiphei
Keyword(s):  
Congenital Malformations ◽  
Clinical Presentation ◽  
Care Center ◽  
Demographic Data ◽  
Tertiary Care ◽  
Case Series ◽  
North India ◽  
Male Predominance ◽  
High Index Of Suspicion ◽  
Age Range

Background: Duplication cysts (DC) are uncommon congenital malformations which predominantly present in infants and young children. Owing to their variable clinical presentation, radiology and/or histopathology are often required to clinch the diagnosis. We present a case series of 66 patients, which is the largest series reported so far.Methods: A search of prospectively maintained institutional database was carried out to identify patients who were diagnosed and operated for gastrointestinal DC between January 2013 and August 2018. For all cases, the demographic data, site of DC, details of clinical presentation, associated conditions and histopathology findings were recorded. The slides of all cases were retrieved and re-examined.Results: The age range was 1 day to 47 years, with a slight male predominance (1.3:1). Ileum was the most common site followed by jejunum. Ectopic mucosae noted were gastric, pancreatic, biliary and respiratory. One case showed glial heterotopia. Perforation, gangrene and intussusception were among the co-existing pathologies noted.Conclusions: Duplication cysts are rare congenital malformations. The variability in clinical presentation makes the diagnosis elusive. Timely diagnosis and appropriate management require a high index of suspicion and a holistic diagnostic approach with clinical, radiological and histopathological inputs. 

scholarly journals Cerebrovascular Injury Following Scorpion Sting and Snake Envenomation: A Case Series

2018 ◽  
Vol 45 (6) ◽  
pp. 669-674 ◽  
Author(s):  
Ajay Mishra ◽  
Aditya Binu ◽  
George Abraham ◽  
Harshad Vanjare ◽  
Tina George ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
Neurological Complications ◽  
Neurological Deficits ◽  
Neurological Involvement ◽  
Scorpion Sting ◽  
Male Predominance ◽  
Cerebrovascular Injury ◽  
Snake Envenomation

AbstractBackgroundNeurological complications following snake and scorpion bite are diverse. Literature regarding patterns of cerebrovascular injury (CVI) and outcomes among these patients is scarce. This is a descriptive study of the clinical profile, brain imaging findings, mechanisms of injury, vascular territory involvement and outcomes of CVI following scorpion and snake envenomation, in a tertiary care center in South India.MethodologyPatients with scorpion sting- and snake envenomation-related complications were retrospectively enrolled. Neuroimaging was performed on five patients with each envenomation, and they were found to have neurological involvement. On imaging, three patients were found to have a CVI. Clinical, radiological parameters and outcomes of these patients were studied. We also performed a review of the literature and analyzed the finding of all the cases.ResultIn all, three patients each had evidence of CVI in imaging. An additional 32 reports of scorpion sting-related CVI and 35 reports of snake envenomation-related CVI were identified from the literature. There was a male predominance among these patients. Mean age of the patients with scorpion sting was 42.8 years as compared with 33 years for the patients with snake envenomation. Features of severe envenomation were present in all patients. Persistently depressed sensorium and new-onset focal neurological deficits were seen in 70% of all patients. Infarcts were seen in 88% of patients with snake envenomation and 53% of patients with a scorpion sting. Mortality was 28% among patients with a scorpion sting as compared with 8% with snake envenomation.ConclusionCerebrovascular injuries are uncommon neurological manifestations following scorpion and snake envenomation. These tend to occur in younger patients. Infarcts are more common than bleeds.

scholarly journals A case series of brain abscesses: an eleven-year retrospective single center study

2021 ◽  
Vol 15 (06) ◽  
pp. 791-797
Author(s):  
Rami Waked ◽  
Hassan Tarhini ◽  
Hussein Mansour ◽  
Gebrael Saliba ◽  
Nabil Chehata ◽  
...  
Keyword(s):  
Stereotactic Biopsy ◽  
Care Center ◽  
Demographic Data ◽  
Tertiary Care ◽  
Case Series ◽  
Rare Condition ◽  
Source Of Infection ◽  
Single Center Study ◽  
Brain Abscesses ◽  
Worse Prognosis

Introduction: We lack data on the epidemiology and management of brain abscesses in the Middle East. The aim of this study is to report a case series of brain abscesses admitted at a tertiary care center in Lebanon, between January 2008 and December 2018. Methodology: This retrospective study aimed at determining the demographic data, treatment, and correlations between different studied variables with prognosis of patients that received treatment. Results: Forty-one patients (30 males) were included with a median age of 37 years (2-85). The analysis showed that the classic triad of fever, headache and neurologic deficit was only present in 12% of patients on admission. The source of infection was contiguous in 36.5%, post surgical in 32%, and distant in 17% of cases. Stereotactic biopsy was performed in 41.5% of patients, and craniotomy in 19.5%. A microorganism was isolated in 63% of patients (26 cases). The most used antibiotics were carbapenems (46%) and glycopeptides (66%). Eighty percent of patient (33) had a good outcome. A worse prognosis was significantly correlated with immunosuppression and multiple cerebral abscesses. Conclusions: Brain abscess remains a relatively rare condition.

scholarly journals 111 Kikuchi-Fujimoto disease in childhood onset lupus: a case series from a tertiary care center in north india

2019 ◽  
Author(s):  
Himanshi Chaudhary ◽  
Deepti Suri ◽  
Amit Rawat ◽  
Anju Gupta ◽  
Ankur Jindal ◽  
...  
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
North India ◽  
Tertiary Care Center ◽  
Childhood Onset

scholarly journals Mixed invasive molds among COVID-19 patients

2021 ◽  
Author(s):  
Vanya Singh ◽  
Amber Prasad ◽  
Prasan Kumar Panda ◽  
Manjunath Totaganti ◽  
Amit Tyagi ◽  
...  
Keyword(s):  
Fungal Infections ◽  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
North India ◽  
Effective Management ◽  
The Past ◽  
Uncontrolled Diabetes ◽  
Second Wave ◽  
Insight Into

Purpose: Due to surge in COVID cases during the second wave of the COVID pandemic, the healthcare system collapsed in India with shortage of hospital beds, injudicious use of steroids and other immunomodulators, and poor glycaemic monitoring among a population with pre-existing risk of diabetes. Fungal epidemic was announced amid COVID pandemic with several cases of COVID-associated mucormycosis and aspergillosis being reported. But, there is no data regarding mixed fungal infections in COVID patients. Materials and Methods: The study presented a series of ten consecutive cases with dual invasive molds in patients infected with SARS-CoV-2. Among patients hospitalized with the diagnosis of COVID in May 2021 at a tertiary care center in North India, ten microbiologically confirmed dual/mixed COVID-associated mucor-aspergillosis (CAMA) were evaluated. Results: All patients were diabetics with the majority having severe COVID pneumonia (6/10, 60%) either on admission or in the past one month, whilst two were each of moderate (20%) and mild (20%) categories of COVID. The patients were managed with amphotericin-B along with surgical intervention. In this case series, 70% of all CAMA (Rhizopus arrhizus with Aspergillus flavus in seven and Aspergillus fumigatus in three patients) patients survived, connoting the critical importance of a high index of clinical suspicion and accurate microbiological diagnosis for managing invasive molds. Conclusions: Mixed fungal infections i.e. CAMA during COVID and post-COVID periods may be an emerging disease. This outbreak is seen particularly in such patients with uncontrolled diabetes, on steroids, or cocktail therapy, or living in unhygienic environments. We believe that our findings would help gain a better insight into the risk and progression of invasive fungal mixed infections among COVID patients and thus play a pivotal role in diagnosing, classifying, and implementing an effective management strategy for treating similar cases in the future.

scholarly journals Clinical and epidemiological spectrum of coronavirus disease 2019 in Central Kerala: a retrospective case series

2021 ◽  
Vol 8 (3) ◽  
pp. 1503
Author(s):  
Ronnie Thomas ◽  
Bins M. John ◽  
Joe Thomas Koothapally ◽  
Sanjeev Kumar ◽  
Supriya Adiody ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Care Center ◽  
Laboratory Finding ◽  
Tertiary Care ◽  
Case Series ◽  
Mitigation Measures ◽  
Retrospective Case ◽  
Male Predominance ◽  
Retrospective Case Series ◽  
Asymptomatic Patients

Kerala state in India was known for its early response to the Covid-19 pandemic by public health mitigation measures through science-based advocacy. The objective of this study was to analyze epidemiological and clinical characteristics of COVID-19 patients admitted to a tertiary care center in central Kerala. This retrospective case series was undertaken by reviewing the medical records and extracting the epidemiological data, clinical symptoms and laboratory findings of consecutive patients admitted between April 1st and September 31, 2020. Clinical and demographic parameters of hospitalized patients were analyzed regarding their association with the severity of disease. The mean age of the patients was 35.8 years with significant male predominance. Shopkeepers represented 15.6% of the patients and healthcare workers represented 12.5%. Primary contact with a known case was documented in 62.5% of the patients. Asymptomatic patients constituted 25% of the patients and the most commonly experienced symptoms were fever, cough, breathlessness and diarrhea. Three patients had atypical presentations in the form of generalized seizures, intussusception and generalized anxiety with suicidal ideation. Neutrophilia and Lymphopenia were the most dominant laboratory finding. The clinical spectrum of COVID-19 in the study population is wider than previously described in literature.

scholarly journals Pattern of alcohol withdrawal syndrome and its clinical correlates

Biomedicine ◽  
2021 ◽  
Vol 41 (2) ◽  
pp. 278-282
Author(s):  
Ankur Sachdeva ◽  
Vipin Kumar ◽  
S. Aijaz Abbas Rizvi ◽  
Shilpa Khullar ◽  
Syed Sibte Akbar Abidi ◽  
...  
Keyword(s):  
Alcohol Use ◽  
Alcohol Withdrawal ◽  
Withdrawal Syndrome ◽  
Care Center ◽  
Demographic Data ◽  
Tertiary Care ◽  
Management Strategies ◽  
Alcohol Withdrawal Syndrome ◽  
North India ◽  
Audit Score

Introduction and Aim: Management strategies of Alcohol Withdrawal Syndrome could be optimized if patients with greater risk are identified early and treated aggressively. Studying the pattern and predictors of alcohol withdrawal syndrome was the main objective of our study.   Materials and Methods: A total of 100 consenting male patients in the age group of 18-60 years diagnosed with alcohol dependence and uncomplicated alcohol withdrawal undergoing in-patient detoxification in tertiary care center in north India were included in the study. A semi structured proforma was used to collect socio-demographic data, Alcohol Use Disorders Identification Test (AUDIT) was used as screening tool and Clinical Institute Withdrawal Assessmentfor Alcohol-revised (CIWA- Ar) was used to assess severity of withdrawal.   Results: Symptoms like difficulty in orientation, seizures and hallucinations were relatively specific for severe AWS, while tremors and anxiety were common to all the patients and were non-specific for predicting severity of AWS. The severity of AWS symptoms correlated significantly with increasing age, duration of alcohol use and AUDIT score.   Conclusion:We concluded that increasing age, longer duration of alcohol use, higher AUDIT score and symptoms related to hallucinations, orientation and seizure are linked to severe alcohol withdrawal. Prior knowledge of these predictors will help to identify the patients at risk of severe alcohol withdrawal so that individual care can be enhanced.

Evaluation of Various Diagnostic Techniques for the Diagnosis of Pulmonary and Extra Pulmonary Tuberculosis at a Tertiary Care Center in North India

2020 ◽  
Vol 20 (4) ◽  
pp. 433-439
Author(s):  
Monika Rajani ◽  
Molay Banerjee
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Diagnostic System ◽  
Diagnostic Techniques ◽  
Automated System ◽  
North India ◽  
Mortality And Morbidity ◽  
Indicator Tube ◽  
Extra Pulmonary ◽  
Uv Lamp

Introduction: Tuberculosis (TB) is a one of the main causes of mortality and morbidity worldwide. Bactec MGIT (Mycobacteria Growth Indicator Tube) system is a rapid, reliable automated system for early diagnosis of pulmonary and extra pulmonary TB in setups where purchase of expensive instruments is not possible. The present study was thus carried out to evaluate AFB microscopy, culture on Lowenstein Jensen media and micro MGIT system for early and accurate diagnosis of Tuberculosis. Methods: A total of 280 samples were processed for direct AFB smear examination, and culture on micro MGIT and LJ media. The identification of Mycobacterium tuberculosis complex in positive cultures was done by MPT64 Ag card test (BD MGIT TBC Identification Test). Results: Out of the processed samples, (47.1%) 132/280 were positive for Mycobacterium spp by Micro MGIT, (35%) 98/280 on LJ medium and (25.7%) 72/280 by AFB smear. A total of (48.5%) 136 samples were positive by a combination of Micro MGIT and LJ medium. Among the total positive samples (136/280), Micro MGIT was found to be positive in 97% (132/136) of samples, LJ was positive in 72% (98/136), while 52.9% (72/136) were positive by AFB smear. Conclusion: Manual MGIT System is a simple and efficient, safe to use the diagnostic system. It does not require any expensive/special instrumentation other than the UV lamp for the detection of fluorescence. In areas with limited resources where the purchase of expensive instruments such as the MGIT 960 is out of scope, the use of manual MGIT for rapid susceptibility testing for MDR-TB could be an option. We would recommend testing MGIT 960 using first and secondline drugs to determine DST.

scholarly journals Deep Cerebral Venous Thrombosis—A Clinicoradiological Study

2021 ◽  
Author(s):  
Sujana Gogineni ◽  
Dhananjay Gupta ◽  
R. Pradeep ◽  
Anish Mehta ◽  
Mahendra Javali ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Arterial Occlusion ◽  
Venous System ◽  
Common Risk Factor ◽  
Imaging Characteristics ◽  
Deep Cerebral Venous Thrombosis ◽  
High Index Of Suspicion

AbstractStroke is a common neurological emergency. Almost 80% of strokes are due to arterial occlusion. Venous thrombosis comprises less than 1–2% of all strokes. Involvement of the deep cerebral venous system is still rare and accounts for about 10.9% of all cerebral venous thromboses (CVT). CVT diagnosis is often delayed or missed, because of its variable clinical manifestations. We retrospectively (2015–18) and prospectively (2018–20) reviewed all the cases of CVT in a tertiary care center in south India. Out of a total of 52 CVT cases, 12 were due to the involvement of deep cerebral venous system. Their clinical presentation, imaging characteristics, and outcomes were assessed. The most frequent presentation was headache followed by seizures. Hyperhomocysteinemia was the most common risk factor noted. Imaging characteristics were variable, and a high index of suspicion was required for early diagnosis. All patients had favorable outcome in our study, and except one, all were treated conservatively.

scholarly journals A national study of choanal atresia in tertiary care centers in Canada – part I: clinical presentation

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Josee Paradis ◽  
Agnieszka Dzioba ◽  
Hamdy El-Hakim ◽  
Paul Hong ◽  
Frederick K. Kozak ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Choanal Atresia ◽  
Case Series ◽  
Retrospective Chart Review ◽  
National Study ◽  
Feeding Difficulties ◽  
Presenting Symptoms ◽  
Tertiary Care Centers

Abstract Background To evaluate the clinical presentation of choanal atresia (CA) in tertiary centers across Canada. Methods Multi-centre case series involving six tertiary care pediatric hospitals across Canada. Retrospective chart review of patients born between 1980 and 2010 diagnosed with CA at a participating center. Results The health charts of 215 patients (59.6% female) with CA were reviewed and included in this study. The mean age of patients at time of CA presentation was 0.4 months (range 0.1 to 7.2 months) for bilateral CA and 37.8 months (range 0.1 to 164.1 months) for unilateral cases. The most common presenting symptoms for bilateral CA in decreasing order were respiratory distress (96.4%), feeding difficulties (68.2%), and rhinorrhea (65.5%), and for unilateral cases in decreasing order were rhinorrhea (92.0%), feeding difficulties (24.7%), and respiratory distress (18.0%). For the majority of patients (73.2%), the obstruction comprised mixed bony and membranous tissue, with only 10.5% presenting with a purely membranous obstruction. Familial history of CA was confirmed in only 3.3% of cases. One half of patients with CA presented with one or more associated anomalies and 30.6% had a syndrome. Conclusions The present investigation is the first national multi-institutional study evaluating the clinical presentation of CA over three decades. The present cohort of CA patients presented with a breadth of co-morbidities with highly variable presentations, with bilateral cases being more severely affected than unilateral cases. Further investigation into hereditary linkages to CA development is warranted. Graphical abstract

scholarly journals Vitamin C Deficiency in Inflammatory Bowel Disease: The Forgotten Micronutrient

2021 ◽  
Author(s):  
Katie A Dunleavy ◽  
Ryan C Ungaro ◽  
Laura Manning ◽  
Stephanie Gold ◽  
Joshua Novak ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Vitamin C ◽  
Bowel Disease ◽  
Fruits And Vegetables ◽  
Nutritional Assessment ◽  
Care Center ◽  
Tertiary Care ◽  
Case Series ◽  
Vitamin C Deficiency ◽  
Inflammatory Bowel

Abstract Background Micronutrient deficiencies are common in patients with inflammatory bowel disease (IBD). To date, the literature has focused on vitamin D, vitamin B12, and iron deficiencies. Methods We report a case series of 20 patients with IBD and vitamin C deficiency treated at a single tertiary care center. Results Sixteen (80%) patients had symptoms of clinical scurvy, including arthralgia, dry brittle hair, pigmented rash, gingivitis, easy bruising and/or brittle nails. Eighteen patients underwent a nutritional assessment, 10 (56%) patients reported complete avoidance of fruits and vegetables, and 3 (17%) reported reduced intake of fruits and vegetables. Conclusions Vitamin C deficiency should be considered in IBD patients, particularly those with reduced fruit/vegetable intake, as it can lead to significant signs and symptoms.

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