scholarly journals AN OBSERVATIONAL STUDY OF DERMOSCOPIC FINDINGS IN CASES OF LICHEN PLANUS IN INDIAN SKIN

2020 ◽  
pp. 1-2
Author(s):  
Mayuri Ranpariya ◽  
Brijesh Parmar
Keyword(s):  
Observational Study ◽  
Lichen Planus ◽  
Tertiary Care ◽  
Invasive Procedure ◽  
Vascular Pattern ◽  
Background Color ◽  
Non Invasive ◽  
Care Institute ◽  
Almost All

INTRODUCTION: Dermoscopy is non-invasive procedure used for diagnosis of various dermatoses. As there are very few dermoscopic studies available on LP in India, this study was undertaken to explore its role. AIM: To study dermoscopic features in LP cases. METHOD: Dermoscopic examination was done in 65 cases of LP over the study period of 3 months at a tertiary care institute. RESULTS: Total 155 lesions of 29 classical LP(CLP), 13 hypertrophic LP(HLP), 9 eruptive LP(ELP), 6 lichen planus pigmentosus(LPP), 4 lichen plano pilaris(LPPI), 2 linear LP(LLP), 2 follicular LP(FLP) cases were examined. Lesions of CLP, ELP and LLP were examined in which: Active lesions (94 lesions) - Wickham’s striae (WS): commonest pattern was radial streaming (40% lesions) and Color was white (91.48% lesions). Pigment pattern (PP): absent in almost all lesions. Commonest vascular pattern (VP): radial linear in 68.08% lesions. Commonest background Color (BC): violet Regressed lesions (20 lesions) - WS: absent in 95% lesions. Commonest PP: diffuse dots/globules (80% lesions). VP: absent. BC: brown (100% lesions) HLP (26 lesions)-Keratin Plugs (KP) in 84.61% lesions, VP: absent. FLP (2 lesions) -follicular KP in all lesions. LPP (9 lesions)-Reticular & granular Pattern was seen in all lesions, commonest pigment was dark brown, different intensity of pigmentation was present in 4 lesions. LPPI (4 lesions)-Follicular atrophy, peripilar cast and interfollicular reticular brownish pigmentation was seen in all lesions. CONCLUSION: Dermoscopic findings of LP and its variants can be useful for diagnosis and follow up.

scholarly journals Evaluation of Aetiology and Outcome of Acute Kidney Injury in a Tertiary Care Hospital of India- A Prospective Observational Study

2020 ◽  
Author(s):  
VS Gaurav Narayan ◽  
SG Ramya ◽  
Sonal Rajesh Kumar ◽  
SK Nellaiappa Ganesan
Keyword(s):  
Acute Kidney Injury ◽  
Intensive Care ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Rapid Decline ◽  
Care Hospital ◽  
Medical Intensive Care

Introduction: The Acute Kidney Injury (AKI) is a rapid decline in renal filtration function. The aetiological spectrum, prevalence of AKI and outcome is highly variable. This variation exists due to the difference in the criteria used, study population and demographic features. Huge differences are noted when AKI is compared in developing and developed countries. Hence, it is important to analyse the spectrum of AKI to facilitate earlier diagnosis and treatment which shall help in improving the outcome. Aim: To study the prevalence, aetiology and outcome of AKI in the medical intensive care. Materials and Methods: This was a prospective observational study conducted in a medical intensive care for 18 months where 1490 patients were screened and 403 patients were included as AKI by KDIGO criteria. History, examination, appropriate investigations and treatment details including dialysis were noted. The serum creatinine levels were obtained every day, to know the time of onset of AKI, at the time of death or discharge, and after one month for patients who turned up for follow-up. Patients were categorised based on outcome as survivors and nonsurvivors. Survivors were divided into as fully recovered and partially recovered and those who left the Intensive Care Unit (ICU) against medical advice were termed as lost to follow-up. Results: A total of 403 patients (27.04% of 1490) of medical intensive care admissions were found to have AKI. Sepsis was the most common cause of AKI. At the end of the month, 78.4% of AKI patients fully recovered, 1.2% partially recovered and the mortality was 14.9%. Mortality was higher in AKI associated with chronic medical conditions like cardiac failure, chronic liver disease and stroke. Conclusion: If treated early, AKI is mostly reversible. Regional differences in AKI should be studied extensively and local guidelines should be formulated by experts for prevention and early treatment, to improve the disease outcome.

scholarly journals High-pressure balloon dilatation in children: our results in 30 patients with POM and the implications of the cystoscopic evaluation

2020 ◽  
Vol 42 (1) ◽  
Author(s):  
Francesca Destro ◽  
Giorgio Selvaggio ◽  
Federica Marinoni ◽  
Andrea Pansini ◽  
Giovanna Riccipetitoni
Keyword(s):  
High Pressure ◽  
Balloon Dilatation ◽  
Invasive Procedure ◽  
Definitive Treatment ◽  
Ureteral Stenting ◽  
Diagnostic Modalities ◽  
Almost All ◽  
Type 3

Primary Obstructive Megaureter (POM) is a common cause of hydronephrosis in children with spontaneous resolution in most cases. High-Pressure Balloon Dilatation (HPBD) has been proposed as a minimally invasive procedure for POM correction in selected patients. The aim of the paper is to review our experience with HPBD in patients with POM. We performed a retrospective study in a single Centre collecting data on patients’ demographics, diagnostic modalities, surgical details, results and follow-up. In particular, the endoscopic aspect of the orifice permitted the identification of 3 patterns: adynamic ureteral segment, stenotic ureteric ring and pseudoureterocelic orifice. We performed HPBD in 30 patients over 6 years. We had 23 patients with adynamic distal ureteral segment (type 1), 4 with stenotic ring (type 2) and 3 with ureterocelic orifice (type 3). In 3 patients (10%) the guidewire did not easily pass into the ureter requiring ureteral stenting or papillotomy. Post-operative course was uneventful. Five patients (3 pseudoureterocelic) required open surgery during follow-up. HPBD for the treatment of POM is a safe and feasible procedure and it can be a definitive treatment of POM. Complications are mainly due to double J stent and none of our patients had symptoms related to vescico-ureteral reflux. The aspect of the orifice, identified during cystoscopy, seems to correlate with the efficacy of the dilatation: type 1 and 2 are associated with good and excellent results respectively; type 3 do not permit dilatation in almost all cases requiring papillotomy. HPBD can be performed in selected patients of all paediatric ages as first therapeutic line. The presence of a pseudoureterocelic orifice or long stenosis might interfere with the ureteral stenting and seems associated with worse outcomes.

scholarly journals Diffusion-Weighted Imaging in Oncology: An Update

Cancers ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1493 ◽  
Author(s):  
Carmelo Messina ◽  
Rodolfo Bignone ◽  
Alberto Bruno ◽  
Antonio Bruno ◽  
Federico Bruno ◽  
...  
Keyword(s):  
Diffusion Weighted Imaging ◽  
Water Molecules ◽  
Non Invasive ◽  
Diffusion Weighted ◽  
Routine Magnetic Resonance Imaging ◽  
Treatment Responses ◽  
Magnetic Resonance Imaging Mri ◽  
Almost All

To date, diffusion weighted imaging (DWI) is included in routine magnetic resonance imaging (MRI) protocols for several cancers. The real additive role of DWI lies in the “functional” information obtained by probing the free diffusivity of water molecules into intra and inter-cellular spaces that in tumors mainly depend on cellularity. Although DWI has not gained much space in some oncologic scenarios, this non-invasive tool is routinely used in clinical practice and still remains a hot research topic: it has been tested in almost all cancers to differentiate malignant from benign lesions, to distinguish different malignant histotypes or tumor grades, to predict and/or assess treatment responses, and to identify residual or recurrent tumors in follow-up examinations. In this review, we provide an up-to-date overview on the application of DWI in oncology.

scholarly journals Vital signs, clinical rules and gut feeling: observational study among fever patients

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0125
Author(s):  
Gideon HP Latten ◽  
Lieke Claassen ◽  
Lucinda Coumans ◽  
Vera Goedemondt ◽  
Calvin Brouwer ◽  
...  
Keyword(s):  
Observational Study ◽  
Vital Signs ◽  
Management Decision ◽  
Failure Assessment ◽  
Regular Work ◽  
Almost All ◽  
Qsofa Score ◽  
Clinical Rules ◽  
Work Up

BackgroundGeneral practitioners (GPs) decide which patients with fever need referral to the emergency department (ED). Vital signs, clinical rules and gut feeling can influence this critical management decision.Aimto investigate which vital signs are measured by GPs, and whether referral is associated with vital signs, clinical rules, or gut feeling.Design & settingprospective observational study at two out-of-hours GP cooperativesMethodduring two nine-day periods, GPs performed their regular work-up in patients ≥18 y with fever (≥38.0°C). Subsequently, researchers measured missing vital signs for completion of the Systemic Inflammatory Response Syndrome (SIRS) criteria and the quick Sequential Organ Failure Assessment (qSOFA) score. We investigated associations between the number of referrals, positive SIRS/qSOFA scores and GPs’ gut feeling.ResultsGPs measured and recorded all vital signs required for SIRS/qSOFA calculation in 24 of 108 (22.2%) assessed patients and referred 45 (41.7%) to the ED. Higher respiratory rates, temperatures, clinical rules and gut feeling were associated with referral. During 7-day follow-up, 9 (14.3%) of 63 initially not referred patients were admitted to hospital.ConclusionGPs measured and recorded all vital signs for SIRS and qSOFA in 1 in 5 patients with fever and referred half of 63 SIRS positive and almost all of 22 qSOFA positive patients. Some vital signs and gut feeling were associated with referral, but none were consistently present in all referred patients. The vast majority of patients who were not initially referred remained at home during follow-up.

scholarly journals Laparoscopic Anterior 180° Partial Fundoplication - Indian Perspective

2021 ◽  
Vol 7 (3) ◽  
pp. 22-29
Author(s):  
Dr. Biswabasu Das ◽  
◽  
Dr. Sandeep Sahu ◽  
Dr. Radhakrishna Y ◽  
Bibhabasu Das ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Clinical Outcome ◽  
Tertiary Care ◽  
Case Series ◽  
Outcome Data ◽  
High Rate ◽  
Partial Fundoplication ◽  
Tertiary Care Centers ◽  
Almost All

Aim: To evaluate Laparoscopic anterior 180° partial fundoplication for its good long-term relief forsymptoms of gastroesophageal reflux disease and association with adverse effects. Methods:Study design: Prospectively evaluated case series. Settings: Tertiary care centers Patients: Theclinical outcomes were determined for all patients who had undergone a laparoscopic anterior partialfundoplication by us between January 1, 2013 to March 31, 2021. Interventions: Clinical outcome,complications, and follow-up after laparoscopic anterior 180° partial fundoplication was obtainedusing a structured questionnaire. Results and Discussion: 228 procedures were performed. Theoutcome at 0 to 8 years (mean, 4 years) follow-up was determined for 195 patients. 1 death waslinked to the laparoscopic procedure and 2 patients died during follow-up due to unrelated causes.For 186 patients (95%) with clinical outcome data at late follow-up, gastroesophageal refluxsymptoms were significantly improved following surgery and were well controlled in 9 patients(4.5%). In a subset of 85 patients with more than 5 years of follow-up, relief of heartburn was foundin 59 patients (69%). Incidence and severity of heartburn were reduced after surgery in 22 patients(26%), decreased dyspepsia in 80 patients (94%). Normal belching was preserved in 84 patients(99%) and almost all patients were able to eat normally. Conclusion: Laparoscopic anterior 180°partial fundoplication is an effective procedure for the surgical treatment of gastroesophageal refluxand is associated with a high rate of patient satisfaction at late follow-up. Compared to Nissen'sfundoplication it is as good as control of recurrent reflux as well as reduced adverse effects. Thepatient goes home in 3-4 days. Hence we recommend it as the procedure of choice for refluxsymptoms.

scholarly journals Gestational trophoblastic diseases: an observational study at a tertiary care teaching hospital in Jharkhand, India

2020 ◽  
Vol 9 (8) ◽  
pp. 3138
Author(s):  
Archana Kumari ◽  
Nikita Chauhan
Keyword(s):  
Observational Study ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
Molar Pregnancy ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Disease Spectrum ◽  
Trophoblastic Diseases ◽  
Gestational Trophoblastic Diseases

Background: Gestational Trophoblastic Diseases (GTD) encompass a wide spectrum of proliferative disorders of trophoblast tissue, which hold a good prognosis if diagnosed and treated on time. A close understanding of the disease spectrum is therefore needed to reduce morbidity and mortality.Methods: This is an observational study (both prospective and retrospective analysis) conducted in Rajendra Institute of Medical Sciences, a tertiary care teaching hospital in Ranchi, Jharkhand over a period of 2 years from 1st January 2017 to 31st December 2018.Results: A total of 162 cases of GTD were identified during the study period. Disease spectrum comprised of complete molar pregnancy in 146 (90.12%) and partial molar pregnancy in 7 (4.3%), GTN in 9 out of 162 cases (5.5%). Bleeding per vaginum preceded by amenorrhea was the most common symptom, observed in 95.4% of the cases. Uterine size was more than period of amenorrhea in almost 50% of the cases. Theca lutein cysts were found in 39.8% of the cases, hypertension in 21.5%, hyperthyroidism in 6.5% cases. Overall, there were nine (5.56%) cases of choriocarcinoma and six (3.7%) cases of Invasive mole. Remission rate in GTN was 86.7% with chemotherapy.Conclusions: Women complaining of vaginal bleeding in first half of pregnancy with uterine size more than period of amenorrhea must be evaluated for GTD by ultrasound and serum beta HCG. For cases of molar pregnancies, suction and evacuation remains the treatment of choice but need for regular follow-up and strict compliance to contraception during entire follow up has to be emphasized. Cases of GTN have excellent remission with chemotherapy.

Lichen Planus - A Clinicopathological Correlation from a Tertiary Care Institute in Chhattisagrh

2019 ◽  
Vol 4 (08) ◽  
Author(s):  
Manoj Kumar Agarwala ◽  
Pragya Agarwala ◽  
Karan Chandrakar
Keyword(s):  
Data Collection ◽  
Lichen Planus ◽  
Tertiary Care ◽  
Clinicopathological Correlation ◽  
Unknown Aetiology ◽  
Detailed Data ◽  
Care Institute ◽  
Mucosal Involvement ◽  
Study Population ◽  
The Mean

Background: Lichen planus is a mucocutaneous disorder of unknown aetiology with mucosal involvement seen in 30-70% of cases. Histopathology is a reliable tool to diagnose lichen planus and differentiate it from other lichenoid eruptions. Methodology: 103 patients aged ≥18 years consecutively attending the outpatient clinic with clinical features suggestive of cutaneous and/or oral LP were recruited. A detailed data collection proforma including the demographic details was filled and clinical examination was done. The diagnosis of LP was confirmed by biopsy. An attempt to study the clinico-pathological correlation was made. Results: We studied 103 patients of lichen planus with ages ranging from 18- 77 years with the mean age being 45.8 years. In males, the peak prevalence was between the ages of 35-44 years while in the females, it was in the range of 45-54 years. There was no gender predilection in our study. Conclusion: Hypertrophic and classical types of CLP, and reticular and erosive types of OLP were common patterns in our study population. There was agreement between the clinician and the pathologist in 85% of cases.

scholarly journals Interlocking intramedullary nailing in comminuted femoral shaft fractures

2012 ◽  
Vol 1 (2) ◽  
pp. 57-63
Author(s):  
Abul Kalan Mohammad ◽  
Ram Kewal Shah ◽  
Awais Syed ◽  
Pradeep Gupta
Keyword(s):  
Intramedullary Nailing ◽  
Femoral Fractures ◽  
Invasive Procedure ◽  
Femoral Shaft ◽  
Short Operative Time ◽  
Medical College ◽  
Almost All ◽  
A Prospective Study

A prospective study of 20 comminuted femoral fractures, open and close, treated with interlocked intramedullary nailing. The mechanical strength of the nail and less invasive procedure has made the procedure preferable. Short Operative time and less blood loss was seen during surgical procedure. Out of 20 cases , 10 cases were taken from Nepal Medical College, Kathmandu and 10 cases from Nobel Medical College, Biratnagar, during years 2009 to 2011, which had been completed at least six months follow up. Almost all cases were relatively free from long term complication. The results were promising .All fractures healed within 6 months.DOI: http://dx.doi.org/10.3126/jonmc.v1i2.7300 Journal of Nobel Medical College (2012), Vol.1 No.2 p.50-56

scholarly journals Dermoscopy of difficult-to-diagnose Melanomas

2016 ◽  
Vol 8 (3) ◽  
pp. 121-127
Author(s):  
Chrysoula Papageorgiou ◽  
Demetrios Ioannides ◽  
Zoe Apalla ◽  
Efstratios Vakirlis ◽  
Elisabeth Lazaridou ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Invasive Procedure ◽  
Cutaneous Lesions ◽  
Non Invasive ◽  
Melanoma Detection ◽  
Melanocytic Lesions ◽  
Melanoma Subtypes ◽  
Digital Dermoscopy ◽  
Excision Rate

Abstract Dermoscopy is a non-invasive procedure that allows the evaluation of cutaneous lesions, and is considered to be a useful tool that improves the diagnostic accuracy of melanoma. Many dermoscopic criteria of melanoma have been established and several algorithms have been created for melanoma detection. However, the recognition of some melanomas remains challenging. Melanomas on specific body sites, melanomas in patients with multiple atypical moles, and nodular melanomas represent the most difficult-to-recognize melanoma subtypes, since they typically lack the “classic” melanoma-specific criteria. This paper provides an update on dermoscopy of difficult-to-diagnose melanomas by summarizing the newest data. Lastly, we highlight the importance of digital dermoscopy in the follow-up of melanocytic lesions for the detection of incipient melanomas while maintaining a low excision rate.

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