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2021 ◽  
pp. 34-40
O. V. Skorohodkina ◽  
A. V. Luntsov ◽  
A. A. Vasileva ◽  
O. A. Bareycheva

Hereditary angioedema belongs to the group of rare, orphan, genetically determined defects that represent a significant medical and social problem due to the pronounced impact on the quality of life and potential mortality, as well as the emerging difficulties associated with timely diagnosis and the appointment of adequate treatment. The article presents data on the modern classification of hereditary angioedema, clinical manifestations of the disease, approaches to diagnosis verification and treatment principles. Therapy of hereditary angioedema is determined by the need for effective relief of acute attacks of the disease, prevention of edema before medical interventions, and, if indicated, long-term prophylaxis. The article discusses a differentiated approach to the treatment of hereditary angioedema, characterizes various options for therapeutic interventions. In a clinical case, the history of several generations of a family with manifestations of hereditary angioedema is described. A modern approach to the diagnosis of the disease based on detailed history, clinical symptoms, and laboratory research results has been demonstrated. The analysis of the effectiveness of treatment was carried out and the high efficiency of pathogenetic therapy of hereditary angioedema with human C1-esterase inhibitor was shown. 

2021 ◽  
Vol 64 (9) ◽  
pp. 579-587
Kang-Moon Lee

Background: Over the past three decades, inflammatory bowel diseases (IBD) have been rapidly increasing in the African, South American, and Asian countries, including Korea. However, in Korea, the public awareness of IBD remains low, and diagnostic delay is not uncommon due to the physicians' lack of clinical experience. It is essential to understand the trends and regional differences in the epidemiology of IBD for proper diagnosis and treatment.Current Concepts: Although lower than those of the West, the prevalence and incidence of IBD in Korea rank among the highest in Asia and are steadily increasing. In the past 10 years, the prevalence of IBD has almost doubled, while its incidence has decreased gradually. As compared to Western IBD patients, Korean patients have higher proportion of proctitis in ulcerative colitis, male predominance, more ileocolonic involvement, and higher incidence of perianal fistula in Crohn disease. There is no single gold standard for the diagnosis of IBD. Thus, diagnosis can be made by clinical evaluation, including a detailed history taking, physical examination, and a combination of endoscopic, radiologic, laboratory, and histologic findings.Discussion and Conclusion: Population-based studies have revealed the current trends and characteristics of the epidemiology of IBD in Korea. Continued education and development of diagnostic tools will help clinicians to diagnose IBD accurately and differentiate it from other diseases such as intestinal tuberculosis.

2021 ◽  
pp. 097321792110426
Charul Mehta ◽  
Urvashi Rana

Context: Intraventricular hemorrhage and periventricular leukomalacia, the common brain injuries in premature infants, are major causes for early death in the neonatal period and later motor and cognitive disabilities. This study was undertaken to find out the incidence of normal cranial ultrasound (CUS), normal variants, and abnormal CUS findings. Evidence Acquisition: This prospective, observational study was conducted at Neonatal ICU, Department of Paediatrics, Civil Hospital, Ahmedabad, over a period of 2 years from September 1, 2014, to August 31, 2016. Detailed history, examination, and risk factor assessment was done for all 180 subjects. The neonates were subjected to cranial ultrasound during admission and on follow-up. Results: Upon sonographic evaluation, 125 (69.44%) neonates had normal ultrasound, 34 (18.90%) had normal variants, and 21 (11.66%) had abnormal cranial ultrasound findings. The predominant normal variants observed were cavum septum pellucidum (18; 10%) and choroid plexus cyst (11; 6.1%). The most common abnormality detected was intraventricular hemorrhage (15; 8.3%) and was found to have a clinically significant correlation with surfactant use and with mechanical ventilation ( P value < .05). Follow-up scans could be performed on 70 subjects out of which 2 had normal variants and 3 had abnormal CUS findings. Conclusion: Establishing institutional CUS scanning protocols will go a long way in decreasing morbidity and mortality in preterm neonates.

Andrew Walker

In August 1902, the Siamese army occupied the northern township of Phrae after a rebellion by Shan timber workers, miners and traders. The Siamese general who investigated the rebellion claimed that the Shan attack on Phrae was part of a wider plot to restore Prince Myngoon to the Burmese throne. Myngoon was exiled from Burma in 1868 and had been living in Indochina since 1889. Most observers have regarded the so-called ‘Myngoon plot’ as implausible. This article provides the first detailed history of the plot. It argues that the plot was a product of ‘seditious state-making’ in the borderlands of mainland southeast Asia, a region in geopolitical flux. This exploration of the Myngoon plot uncovers a cosmopolitan web of seditious statecraft that extended from India, through Burma and Indochina and into Siam. The Shan rebellion was one outbreak in a region-wide web of Shan agitation dating from the early 1880s. The rebellion took place at the intersection of the competing colonial agendas of Siam, Britain and France, and various actors in this competition had been planting the seeds of a Myngoon-led rising since the 1880s. Myngoon's story was the product of a time when British, French and Siamese colonial agents were still grappling (and colluding) with dispersed and fragmented royal power.

Seong Shin Kim ◽  
Byung Gun Lim ◽  
Seok Kyeong Oh ◽  
Jae Hak Lee

Patients with multiple drug allergies (MDA) can be in danger during anesthesia due to their possibility of anaphylaxis. Perioperative anaphylaxis can occur more frequently in patients with any kind of allergic history. The physiological changes during pregnancy, the existence of the fetus itself, and consequent restrictions on drug use including anesthetics make anesthetic management for pregnant women with MDA more difficult than that for other patients. Appropriate anesthetic strategy based on detailed history taking, allergological evaluations and cooperation between surgeon and anesthesiologist are essential to performing successful anesthesia. To the best of our knowledge, although there have been some cases about anesthetic management in patients with MDA, there is no reported case about surgical anesthesia for Cesarean section in a pregnant woman with MDA. Here, we present a pregnant woman with MDA who showed a positive response to most of anesthetics and analgesics in the intradermal skin test, successfully managed with an anesthetic strategy using volatile induction and maintenance anesthesia (VIMA) for Cesarean section.

Ehsanullah Malik ◽  
Sania Bhatti ◽  
Qararo Shah ◽  
Muharram Ali Abbasi ◽  
Khushbakhat Abro ◽  

Objective: To compare the efficacy of 2% diltiazem gel with 0.2% glyceryl trinitrate in patients presenting with chronic anal fissure at Tertiary Care Hospital, Larkana. Methodology: This prospective comparative Study was conducted at department of Surgery ward-II Chandka Medical Hospital, Larkana from 14-01-19 to 14-07-19. A total of 130 patients who were treated as OPD cases were included in this study. Each patient detailed history & clinical examination, details of symptomatology was recorded in a epically diagnosed proforma. These patients were randomly divided in two equal groups i-e group A 65 patients and group B 65 patients. Group A patients were treated with 02% glyceryl trinitrate and group B patients were treated with diltiazem gel 02%. All the patients of group A & B were followed up to 02 months after start of leadema as a OPD cases. Results: A total of 130 patients (65 each in 2% diltiazem gel with 0.2% glyceryl trinitrate group) were included. Mean age in both groups was 42.56±3.91 and 41.71±4.01. 46 (70.8%) and 19 (29.2%) were male and female in Group A and 39 (60%) and 26 (40%) were male and female in Group B. Efficacy of 2% diltiazem gel with 0.2% glyceryl trinitrate in patients presenting with chronic anal fissure was 76.9% and 50.8% respectively. Conclusion: DTZ (2%) and GTN (0.2%) are equally effective in healing anal fissures. DTZ is better than GTN as it causes less side effects, low recurrence rate, healing rate and therefore better compliance.

2021 ◽  
Vol 50 (Supplement_1) ◽  
Priyanka Sahu ◽  
C.M. Pandey ◽  
Shibani Bhatia

Abstract Background Hair fall is a major concern to the patient leading to angst, psychological distress and decrease in quality of life style, more so in female. The aim of the study is to evaluate diffuse hair loss (DHL) in adult females & find the underlying causes. Methods This was an observational, prospective time bound hospital-based study including clinical and trichoscopic evaluation of DHL in women. 222 adult women who had DHL of 4 or more weeks were studied. Detailed history was taken and clinical examination was performed. Laboratory investigations like Hb, Iron Profile, Thyroid Panel was also noted. Trichogram, trichoscopy was performed for perfect visualization of hairs. Results Among the subjects, 95 women were diagnosed as having female pattern hair loss (FPHL), 89 as telogen effluvium, 24 as chronic telogen effluvium (CTE) while 14 had FPHL and TE both. Mean age of females was 33.92 ± 5.46 years. Majority, 145 (65.3%) of the patients were in the age group of 31-40 years. Stress (18%) and PCOD (15%) were the most common precipitating factors. Majority (75.3 %) females with TE have positive hair pull test. Brown peripilar sign (PPS) and white PPS was present in 15.8% and 8.1% women respectively. Conclusions The common causes for DHL are FPHL, TE, CTE and FPHL with TE. Key messages Along with definitive treatment, understanding of the cause of hair loss by the patient goes a long way in appropriate beneficial lifestyle modification and holistic management.

2021 ◽  
Vol 28 (09) ◽  
pp. 1245-1251
Muhammad Umer Hasan ◽  
Salik Rasool ◽  
Syed Hammad Ahsan ◽  
Shahnawaz Jamali ◽  
Ramsha Azhar

Objective: The aim of this study is to determine the prevalence of oral soft tissue lesions in patients attending the outpatient department. Study Design: Cross Sectional, Observational study. Setting: Department of Oral and Medicine DUHS. Period: October 2019 to March 2020. Material & Methods: A total of three hundred and eighty five (385) patients were enrolled in the study. Detailed history and thorough intra and extra oral examination of each patient were done. Results: The overall prevalence of oral mucosal lesions was found to be 58.7%. The most frequent oral mucosal lesions were reported as white with 58% of all soft tissue lesions, while the most common site was observed as buccal mucosa with 58% of all sites. As far as texture was concerned, soft texture (47%) was recorded as most frequent. Conclusion: Early detection and identification of oral mucosal lesions is crucial, especially in a population where multifaceted tobacco consumption, oral precancerous and cancerous lesions are reported as one of the highest in the world. The high prevalence of oral mucosal lesions, as reported in our study and their potential for malignant transformation necessitates extensive soft tissue examination of the oral cavity, in adjunct to routine dental checkup.

2021 ◽  
Vol 12 (4) ◽  
pp. 154-160
Shivanand Patil ◽  
M D Samudri

A greater part of the population has experienced rectal bleeding at any stage of their life span. Bleeding per rectum is the commonest but alarming symptom of all the anorectal complaints of the patients attending OPDs. Many of the general practitioners involved in rural areas, detain per rectal and proctoscopic examination of anorectal primary care patients, consequently, most of the serious illnesses may forego undiagnosed and could become life-threatening and economically overburden the patient. Differential diagnosis plays a key role in treating effectively. Ayurvedic literature has accredited several diseases with symptoms of bleeding per rectum. In most of the pittaja and raktaja variety of pakvashayagata (related to the colon) and gudagata rogas (related to anus & rectum), bleeding per rectum is the commonest symptom. The literature has given the number of etiological factors and many ailments causing bleeding per rectum such as age, habitat, food habits, occupation, and habits. Detailed history regarding these and nature of bleeding, amount of bleeding, colour etc. may certainly help to differentiate the diseases. This article highlights disease wise features and nature of bleeding, recommended investigations and colonoscopic examination which will differentiate and confirm the diagnosis. And also lists out several Ayurvedic styptic medicines which facilitate the cessation of bleeding when used judiciously according to dosha and vyadhi avastha.

2021 ◽  
Vol 8 (08) ◽  
pp. 5574-5577
Waliur Rahman ◽  
Shireen jabeen Sume ◽  
Shamima Yasmin

Introduction: Breast pain also known as mastalgia is the dull acne in the breast, cause is multifactorial. It can affect any age group. Breast cancer is the most common site-specific cancer in women and is the leading cause of death from cancer for women aged 20-59 years worldwide. In India, breast cancer has ranked number one cancer among females, with age adjusted incidence as high as 25.8 per 100,000 women and mortality 12.7 per 100,000 women.  Objective: To find out the Clinical and USG Findings of Patients Presented with Breast Pain.   Settings and Design: Prospective cross-sectional descriptive study.   Materials and Methods: Patients with complaints of breast pain in the age group 15 to 60 years with clinically no palpable mass attending to the Dept. of General Surgery, Chuadanga Sadar Hospital, Chuadanga, Bangladesh between January 2020 to December 2020 were included in the study. Detailed history with particular reference to age, duration of symptoms, Size, menstruation, marital status, parity, lactation, Nipple discharge and tenderness are recorded. Pain intensity was evaluated as mild, moderate and severe. Ultrasound of the breast including the axilla was done for all cases and findings recorded to correlate with clinical features. Results: Out of 90 patients studied, majority was in the age group (21-30) years, (43%) followed by (31-40 years) (40%) respectively. 57(63%) were married and 33(43%) were single. 21 patients had 1 child, 18 had 2 children with 6 of them having no children. Out of 90 patients only 3 attained menopause, rest of them have their monthly cycles. 51 patients had cyclical breast pain and 39 had noncyclical breast pain, 39 had pain on right breast, 36 on left side and bilateral in 15 patients. Pain was mild in 15 patients, moderate in 27 patients and severe in 6 patients. Various USG findings of the affected breast were normal study in 48 patients followed by duct ectasia and hetrogenous ectogenicity fibroadenosis, small cystic lesion and enlarged axillary lymph nodes etc. Conclusion: The study results show that majority of patients with breast pain without clinically palpable lump had normal USG study. But it also detects other early changes in the breast tissue. It can be used as a baseline investigation for any breast pain without palpable lump.

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