Clinical profile of anterior uveitis in tertiary health centre of central India

To study the clinical profile of anterior uveitis in patients attending the Ophthalmology department of tertiary health centre of central India A cross-sectional, observational study was done in the department of Ophthalmology of tertiary health centre from January 2017 to July 2019. A total of 199 cases of anterior uveitis were studied to assess their clinical presentation and etiology. After thorough history taking, demographic data and clinical pattern were documented. Comprehensive ophthalmic evaluation, necessary laboratory investigations and radiological imaging were performed to establish the etiology. The maximum number (n=79; 39.7%) of patients were in the age group of 21-40 years and the mean age of the study subjects was 36.9+21.8 years. The male to female ratio was 1:1.42 (117 females, 82 males). Uniocular disease was found in 91.95% cases and majority (n=175; 87.93%) of the patients had acute presentation with 95.47% cases having non granulomatous uveitis. A specific diagnosis could not be made in 62.8% cases. Trauma (21.7%) was the most common cause in patients with a specific diagnosis. Persistent posterior synechiae was the most frequently seen complication (21.08%) although majority of the patients (66.8%) did not reveal any major complications.Patients with anterior uveitis most commonly had acute presentation. The disease was rarely bilateral and was mostly non-granulomatous in presentation. It was mostly idiopathic and among the known etiological factors, trauma was the most common cause.

Profile of Patients Availing Marital and Psychosexual Clinic Services During the Pre-COVID and COVID Era: A Study From a Tertiary Care Center

Aim: To assess the profile of patients availing the marital and psychosexual clinic (MPC) services through the telemode at a tertiary care center after the imposition of lockdown and compare the same with the profile of the patients attending the outpatient services, in-person MPC services during the prelockdown period. Materials and Methods: It was a retrospective study in which comparisons were made between patients availing the MPC services from March 24, 2020 to March 23, 2021 with the profile of patients during the period of March 24, 2019 to March 23, 2020 (ie, COVID period—lockdown). Results: A total of 112 patients availed the MPC services during the COVID study period compared to 307 patients in the pre-COVID period. However, when the proportion of MPC cases among the total walk-ins was compared, during the COVID period the proportion of MPC cases increased by almost 1.75 times. During the COVID time period, there was an increase in the patients who were significantly younger ( P = .002), females ( P = .003), more from urban locality ( P = .035), and being referred by self or caregiver ( P = .001). In terms of specific diagnosis, as compared to the pre-COVID timeframe, significantly higher numbers of patients were diagnosed with premature ejaculation (PME) and PME + erectile dysfunction while the services were being provided through the telemode. Conclusion: The present study suggests an increase in the proportion of patients seeking help for marital and sexual issues while the services are being provided by telemode.

The Importance of BHB Testing on the Post-Mortem Diagnosis of Ketoacidosis

Although beta-hydroxybutyrate (BHB) analysis has proved its importance in forensic pathology, its effects on cause-of-death diagnostics are unaddressed. Therefore, this study aims at evaluating the effects of BHB analysis on the number of deaths by DKA (diabetes ketoacidosis), AKA (alcoholic ketoacidosis), HHS (hyperosmolar hyperglycaemic state), hypothermia, diabetes, alcoholism, and acidosis NOS (not otherwise specified). All 2900 deaths from 2013 through 2019 in which BHB was analysed at the National Board of Forensic Medicine, and 1069 DKA, AKA, HHS, hypothermia, diabetes, alcoholism, and acidosis cases without BHB analysis were included. The prevalence of BHB-positive cases for each cause of death, and trends and proportions of different BHB concentrations, were investigated. The number of BHB analyses/year increased from 13 to 1417. AKA increased from three to 66 and acidosis from one to 20. The deaths from alcoholism, DKA, and hypothermia remained stable. It is unclear why death from alcoholism remained stable while AKA increased. The increase in unspecific acidosis deaths raises the question why a more specific diagnosis had not been used. In conclusion, BHB analysis is instrumental in detecting AKA and acidosis. The scientific basis for the diagnosis of DKA and hypothermia improved, but the number of cases did not change.

MRI for paediatric flatfoot: Is it necessary?

Objective: To determine the additional benefit of MRI for children with flatfoot deformity assessed with weight-bearing radiographs in a specialist paediatric orthopaedic unit. Methods and materials: Patient cohort was obtained by searching the Radiology Information System for children referred for investigation of flatfoot. All patients with flatfoot on weight bearing radiographs who had undergone MRI were included. Radiographs were classified by a consultant musculoskeletal radiologist as showing no underlying abnormality, talo-calcaneal coalition, calcaneo-navicular coalition, accessory navicular or other abnormality. MRI studies were classified similarly by a different consultant musculoskeletal radiologist blinded to the radiographic findings. Results: 33 males and 24 females were included (mean age 12.5 years; range 3–18 years). Twenty-four had bilateral abnormality, so 81 feet were assessed. Radiographs showed no specific abnormality (n = 51), talo-calcaneal coalition (n = 6), calcaneo-navicular coalition (n = 3), os naviculare (n = 12) or other abnormality (n = 9). MRI showed no specific abnormality (n = 40), talo-calcaneal coalition (n = 10), calcaneo-navicular coalition (n = 5), os naviculare (n = 12) or other abnormality (n = 14). Assuming MRI as the diagnostic gold standard, additional relevant diagnostic information was identified in 19 (23.5%) cases, while in the 51 cases for which radiographs provided no specific diagnosis MRI confirmed no underlying abnormality in 31 (60.8%). Conclusion: MRI is a valuable adjunct to weight bearing radiography for investigating paediatric flatfoot deformity. Advances in knowledge: MRI is of value in the assessment of paediatric flatfoot, additional diagnostic information to radiography being identified in 23.5% cases, while in 60.8% of cases for which radiographs provided no specific diagnosis MRI confirmed no underlying abnormality.

THE POSSIBILITIES OF COMPLEX VISUAL DIAGNOSTICS OF LIVER PATHOLOGY IN PATIENTS WITH DIFFUSE LIVER DISEASES ASSOCIATED WITH COVID-19.

The research shows the possibilities of visual diagnostics of liver pathology in patients with various diffuse liver diseases and COVID-19. The analysis is based on the results of examination of patients, who got hospital treatment in Clinical Hospital №1 of Smolensk from September to November 2021. The research shows the efficiency of ultrasound diagnosis as the first step of examination. Using Magnetic Resonance Imaging (MRI) allowed to study the symptoms of liver pathology more deeply. In order to improve the exact specific diagnosis of liver pathology in patients with diffuse liver diseases and COVID-19, arterial spin labeling technique is recommended to use. The research shows the efficiency of complex using of diagnostic methods in patients with diffuse liver diseases and SARS-CoV-2 infection

Noninfectious complications of hematopoietic cell transplantation

Noninfectious lung diseases contribute to nonrelapse mortality. They constitute a spectrum of diseases that can affect the parenchyma, airways, or vascular pulmonary components and specifically exclude cardiac and renal causes. The differential diagnoses of these entities differ as a function of time after hematopoietic cell transplantation. Specific diagnosis, prognosis, and optimal treatment remain challenging, although progress has been made in recent decades.

Fat Chance for Hidden Lesions: Pictorial Review of Hoffa's Fat Pad Lesions

Hoffa's fat pad (HFP) is the most commonly afflicted among all the knee fat pads. Anterior knee pain is common in various pathologies of HFP, as it is richly innervated. A potpourri of the intrinsic and extrinsic pathologies and the tumors and tumor-like conditions affect HFP, and MRI remains the fundamental modality to assess them and provide a specific diagnosis.

Az időskori szédülés életminőségre kifejtett hatása

Összefoglaló. Bevezetés: A szédülés időskorban gyakori panasz, amely jelentősen befolyásolja az életminőséget. Háttere sok esetben multifaktoriális, egyes esetekben azonban jól meghatározott ok kimutatható. Célkitűzés: Kutatásunk célja az időskori szédülő populáció panaszainak, valamint életminőségének felmérése volt. Anyag és módszer: Kutatásunkba 36 (13 férfi, 23 nőbeteg, átlagéletkor ± SD, 72,78 év ± 4,6), Otoneurológiai Ambulanciánkon szédülés miatt vizsgált, 65 év feletti beteget vontunk be. Ők az általunk összeállított, panaszokkal és rizikófaktorokkal kapcsolatos kérdőív mellett a Dizziness Handicap Inventory-t is kitöltötték. Az utóbbi alapján meghatározható volt az életminőség-romlás, illetve annak mértéke. A statisztikai elemzést az IBM SPSS V24 szoftver segítségével végeztük, Mann–Whitney U-teszt és khi-négyzet-próba alapján. Minden esetben p<0,05 értéket tekintettünk szignifikáns különbségnek. Eredmények: A leggyakoribb diagnózisként a Ménière-betegséget, valamint a centrális vestibularis eltéréseket detektáltuk. A betegek visszajelzése alapján a szédülés volt a legdominánsabb tünet, amely a leggyakrabban órákig, illetve napokig tartott, és fele arányban volt forgó jellegű. Emellett a fülzúgás, a halláscsökkenés, valamint a vegetatív tünetek is dominánsak voltak. A leggyakoribb társbetegségek közül gyakoriságuk miatt kiemelendők a mozgásszervi, illetve szemészeti eltérések, a hypertonia, valamint a pszichiátriai betegségek. A betegek 77,8%-a jelzett valamilyen mértékű életminőség-romlást, és kiemelendő, hogy 30%-uk a súlyos kategóriába esett. A Dizziness Handicap Inventory kérdőívek alapján a fizikális, funkcionális, valamint emocionális részpontszámok hasonló értéket mutattak. Következtetés: Az időskori szédülés lényeges a beteg romló életminősége szempontjából. A társuló komorbiditások mellett a háttérben álló vestibularis eltérések kizárása, illetve diagnosztizálása fontos feladat. Ennek függvényében tervezhető a terápia, amely kapcsán a kísérő tünetekre is fontos hangsúlyt fektetni. Így az érintett betegek életminősége javítható. Orv Hetil. 2021; 162(47): 1891–1896. Summary. Introduction: Vertigo is a common complaint in elderly, which has significant influence on the patients’ quality of life. In many cases its background is complex, although, in some cases specific diagnosis can be made. Objective: Our study aimed to analyze the symptoms and quality of life of old-age vertiginous population. Material and method: 36 patients (13 males, 23 females, mean age ± SD, 72.78 years ± 4.6) over 65 years, examined due to vertigo at our Neurotologic Department, were enrolled. A questionnaire including questions regarding the symptoms, risk factors, along with the Dizziness Handicap Inventory was used. Statistical analysis was carried out using IBM SPSS V24 software. Mann–Whitney U and chi square tests were used. Statistical significance was defined as p<0.05. Results: Ménière’s disease and central vestibular disorders were found as the most frequent diagnoses. Vertigo was the most tormenting symptom, which usually lasted for hours or days, and was defined as rotatory in 50%. Tinnitus, hearing loss and vegetative symptoms were also dominant. The most frequent comorbidities were musculoskeletal disorders, hypertension, ophthalmological diseases and psychiatric disorders. 77.8% of the patients have reported worsened quality of life, of which 30% was detected as severe. Based on the Dizziness Handicap Inventory, physical, functional and emotional scores showed similar results. Conclusion: Vertigo in elderly is important due to its influence on patients’ quality of life. Besides comorbidities, the diagnosis of vestibular pathologies is of great importance. Therefore, therapy planning is possible, and patients’ quality of life can be improved. Orv Hetil. 2021; 162(47): 1891–1896.

Biological Reset and Chronic Glaucoma Healing

The Author reports in this Article, how, after being affected by Chronic Glaucoma for 40 years, he could finally, through the consistency of the “Evidence Based Medicine”, find the causes of the Sickness and a local and general Cure “Effective and often Decisive” against it, with specific Omotoxicological-Organotherapeutic Chemistries. Summary: The Author reports with this Article how, after having suffered a Chronic Glaucoma Disease himself (for 40 years), he found an Effective and “often” Resolving Cure with Local and General Therapy against Chronic Glaucoma with Homotoxicological and Organotherapeutic Drugs. Epidemiology: A rough estimate is that Glaucoma affects about 80,000,000 patients worldwide by calculating the number of patients followed by the various (and not all connected) “Anti-Glaucoma Centers” In my opinion, this value indicated by the O.M.S. only the “Tip of the Iceberg” and does not take into account Asia and Africa where only a few centers are connected with O.M.S. and furthermore in the Westernized World it is likely that there are patients not followed by the Centers but by hospital’ borrowed Eye’ Doctors and / or private Eye Doctors without counting “all those who suffer from it” but have not yet reached a “specific diagnosis” these considerations lead to an “only assumed Estimate” for a total of 600,000,000 patients and for many researchers also this Estimate appears largely approximate.