systemic examination
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2022 ◽  
Vol 1 (1) ◽  
pp. 1-2
Author(s):  
Anubhav Chauhan ◽  
◽  
Deepak Kumar Sharma ◽  
Pankaj Kumar Thakur ◽  
◽  
...  

We report a case of a 10-year-old male who had megalocornea with mental retardation(Neuhauser syndrome). It is a rare syndrome with a few cases reported in literature. These patients also require a thorough systemic examination as many diseases are often associated with megalocornea.


2021 ◽  
Vol 6 (4) ◽  
pp. 256-258
Author(s):  
Dharm Prakash Dwivedi ◽  
Muniza Bai ◽  
Abhishek Singh Chauhan ◽  
Vemuri Mahesh Babu ◽  
Sneha Leo ◽  
...  

X-ray flips and wrong labelling has been uncomfortably common, and often results in wrong side intervention. Wrong side surgery is indeed the most dramatic and visible form of human errors. Until the 1999 Institute of Medicine report ‘To Err is Human’, the medical fraternity was largely unaware of such preventable medical errors and near misses. We herein, describe a case where X-ray flip and mislabelling led to wrong side intervention in a COVID-19 ICU. Active errors in human performance are inevitable while practising medicine in the current COVID-19 pandemic where difficulties in performing comprehensive systemic examination with the protective gear on, long working hours, work stress, emotions, and fatigue interplay with the errors in technology and increase the chances of errors. We propose the use of point of care ultrasound (POCUS) in COVID-19 ICU’s to aid in the diagnosis and management.


Author(s):  
Pranami Basyach

Sturge–Weber syndrome (SWS) is a group of phakomatoses characterized by hamartomas involving brain, skin and eyes. A 36 years old female presented with pain and diminution of vision in both eyes since last 1 year. On examination she has bluish sclera in B/L eyes with characteristic facial port-wine stain. Best corrected visual acuity (BCVA) in R/E- 6/18, N6 and in L/E- 6/6, N6. Intra-occular pressure (IOP) in R/E – 27 mm Hg and in L/E –18 mmHg. On gonioscopy – open angle B/E. On direct ophthalmoscopy and slit-lamp examination with 90 D lens, cup-disc ratio in R/E – 0.9 and in L/E – 0.7 with thinning of neuro-retinal rim in B/E. In optical coherence tomography (OCT), retinal nerve fibre layer (RNFL) and optic nerve head (ONH) it was confirmed. Other systemic examination – within normal limit. Initially, she had been on conservative treatment. As intraocular pressure remained high after several weeks of treatment, trabeculectomy in R/E done under local anaesthesia. No post-operative complications were seen. After 7 days of follow-up IOP – within normal limit, vision in R/E unchanged and had been frequently followed-up.


2021 ◽  
Vol 8 (12) ◽  
pp. 1846
Author(s):  
Priti Dave ◽  
Gargee M. Pore ◽  
V. P. Singh ◽  
Supriya S. Barsode

Background: COVID-19 disease is a public health emergency and declared as a pandemic in March 2020 by World Health Organization (WHO). Our aim was to study the clinical features, laboratory profile and outcome of COVID-19 patients needing oxygen therapy.Methods: All patients diagnosed to be having COVID-19 and SpO2 less than 94% on admission were included in the study. Detailed history, systemic examination and investigations were done and data was analyzed.Results: Out of 100 patients studied, 66% were males and 34% were females. Comorbidity was seen in 83% of cases, predominantly hypertension (30%) followed by diabetes mellitus (27%) and ischemic heart disease IHD (11%). Most common presenting complaints were breathlessness (84%) followed by dry cough (63%) and fever (48%). Mean values of absolute counts of neutrophils, lymphocytes, eosinophils and basophils were 4,835 cells/cu.mm, 1,332 cells/cumm, 66 cells/cumm and 86.5 cells/cumm respectively. Serum C-reactive protein (CRP) was raised in 90%, lactate dehydrogenase (LDH) in 96% and D-dimer in 64 % of cases on admission. Incidence of happy hypoxia was 16%. Mortality in our study was 2%. Greater the values of serum CRP, LDH, ferritin, lesser was the SpO2 of patients and greater the oxygen requirement. However no such correlation was found between D-Dimer and SpO2 of patients and their oxygen requirement.Conclusions: COVID-19 has varied presentations. The most common comorbidity was hypertension followed by diabetes mellitus. Serum inflammatory markers are raised in COVID disease. Eosinopenia can be a pointer towards COVID disease. One should be aware of the entity happy hypoxia seen in these patients.


2021 ◽  
Vol 5 (8) ◽  
pp. 01-03
Author(s):  
Sajjad Ali Khan ◽  
Nanik Ram ◽  
Dania Ali ◽  
Muhammad Saleem

Hypothyroidism is a common endocrine disease which occurs when the levels of Thyroid hormones produced by the Thyroid gland are decreased. Here we present a case of a 19-year-old female, who presented with symptoms of hyperprolactinemia, weight gain, unilateral blurring of eyes and headache. Examination findings of the patient were significant for presence of Acanthosis Nigricans and Hirsutism. Rest of the systemic examination was normal. Laboratory investigations revealed Hyperprolactinemia, Hypothyroid profile and dyslipidemia. MRI brain and pituitary done showed findings consistent with Pituitary macroadenoma. Patient was treated along the lines of hypothyroidism with Thyroxine. Follow-up after 3 months showed improvement of her symptoms and disappearance of lesion of MRI scan. This case was a rare presentation of Hypothyroidism. Such unusual and uncommon presentations should be reported and studied in detail to prevent misdiagnosis and provide the correct treatment to the patients.


2021 ◽  
Vol 9 (9) ◽  
pp. 2078-2083
Author(s):  
Kavya Krishnan C ◽  
Geetha B Markande ◽  
Prashanth Jain

“Hridorogo Hridrogaha" means the impairment in the function of the heart is known as Hridroga. Cardiovascular diseases are the most common diseases which affect the circulatory system including the heart and its vasculature. Darshana, Sparshana and Prashna Pariksha holds relevance in the current clinical methods like history taking, general examination and systemic examination. Trividha pariksha helps to attain an appropriate knowledge regard- ing the Roga and Rogavastha more accurately in Hridroga. The prevailing diagnostic techniques like haematolog- ical, biochemical, invasive, and non-invasive methods aids up in the early diagnosis of cardiovascular diseases. The diagnostic approach in a cardiac patient assists to improve the effectiveness of treatment and avoiding long term complications. These examinations help to obtain knowledge regarding life span, the intensity of morbidity and mortality. Keywords: Hridroga, Cardiovascular diseases, Trividha Pariksha, Diagnostic techniques


Author(s):  
Prabhat Kumar Sinha ◽  
Neha Thawait ◽  
Atul Vyas

Background & Method: Whole study was done in our Institute with patient attending outdoor and emergency department of INDEX MEDICAL COLLEGE HOSPITAL AND RESEARCH CENTER. Collection of data –From each patient thorough history was taken, clinically examination was done, vitals where recorded, systemic examination was done and local examination of the lesion was done. Every patient base line investigation of complete blood count, renal function test liver function test serum electrolyte blood grouping serology of of HIV and Hbs antigen were done. Result: Most of the Patient was in the age group of 40years to 60 years. Conclusion: A total of 24 cases of necrotizing fascitis were studied over 1st June 2019 to 25 march 2020. Greater number of cases was reported among middle aged group of 40years to 60 years. Rarity of disease among pediatric age groups affected person were mostly male -21, female-3 most common precipitating factors was trauma. Most common predisposing factors were advanced age, anemia, diabetes and alcoholism. Microbiological profile of patients reveals most polymicrobial organisms involved,most common organisms were streptococcus>E. coli,> staphylococci>pseudomonas/. Keywords: necrotizing, fasciitis, predisposing & management.


Author(s):  
Naglaa Fathy Barseem ◽  
Essam Shawky A. E. H. Khattab ◽  
Dalia Saber Saad ◽  
Sameh Abdulla Abd Elnaby

Background: Febrile seizures (FS) are the most common seizures in children younger than 5 years. In the last decade, various coding and noncoding sequence variations of voltage-gated sodium channels SCN2A have been identified in patients with seizures, implying their genetic base. We aimed to evaluate the association between SCN2A c. G/A genetic polymorphism among Egyptian children with febrile seizure plus. Methods: The present cross-sectional study was carried out on 100 epileptic infants and children, attendants of the Neurology Unit, pediatric department, Menoufia University Hospitals (Group Ι). The patients were sub-classified into two groups, according to response to anti-epileptic treatment; Group Ι a (drug responder) and Group Ι b (drug-resistant). Evenly divided number of apparently healthy, age and gender-matched children were selected as controls (Group II). A complete history, throughout the systemic examination and radiological & metabolic assessment, whenever needed was provided, all participants were genotyped for SCN2A rs17183814polymorphism by Restriction Fragment Length Polymorphism (PCR-RFLP). Results: Both of A allele and AA, GA genotypes of SCN2A c. 56 G/A were detected more in patients with febrile seizure plus comparison to the control group with a statistically significant difference at frequencies of 17% and 11% and 12% respectively; OR (CI95%): 10.04 (3.49-28.87) and p <0.001. On classifying epileptic patients into 2 subgroups, carriers of SCN2A rs17183814 AA genotype tended to respond poorly to anti-epileptic drugs (AEDs). Moreover, multivariate analysis revealed that rs17183814 A allele and positive family history of epilepsy were considered the highest predicted risk factors for the development of epilepsy p<0.05. Conclusion: SCN2A rs17183814 (A) allele was specifically associated with developing febrile seizure plus and could modulate the patient's response to anti-epileptic medications.


2021 ◽  
pp. 38-40
Author(s):  
Najya Nasrin K Z ◽  
Anitha S Prabhu ◽  
Mithun H K ◽  
Shyam Sudhir

MATERIAL & METHOD: This retrospective study was conducted during the period of June-August 2020 for 3months in newborns born to COVID-19 positive mothers at YMCH after obtaining ethical clearance. All newborns born to mothers with COVID-19 positive status during any trimester of pregnancy, irrespective of neonatal COVID-19 RT-PCR test, and delivered at YMCH during the study period were included. Relevant history and complete systemic examination ndings of the neonate were noted down from the case records and laboratory results of RT-PCR test on nasopharyngeal and throat swab if done was noted down which was done at 24-48hours of birth.RESULT:Total of 25newborns born to COVID-19 positive mothers were included in the study. Among the neonates born, 64% were female and 36% were male. 76% of the pregnant mothers were asymptomatic at the time of detection of COVID-19 infection. The neonatal outcome found to have only 1 newborn with positive COVID-19 infection compared to 24 healthy newborns. CONCLUSION: Signicant measures for preventing neonatal SARS-CoV-2 infection are to prevent maternal illness and to decrease the potential of neonatal viral exposure.


2021 ◽  
Vol 7 (3) ◽  
pp. 212-216
Author(s):  
Monisha K ◽  
Jagannath Kumar V

Tinea incognito also known as steroid-modified tinea are dermatophytic infections modified by the use of topical or systemic corticosteroids. Dermatophytic infection being very common and very simple to diagnose, is a diagnostic dilemma due to steroid abuse. Hence making a simple curable infection into a chronic persistent dermatological condition. As a treating doctor it’s important to recognize and educate the patients regarding the tinea infections and steroid abuse. To study the various morphological presentations, epidemiology and etiological agent of tinea incognito. An observational study was performed with 100 cases from 2017 to 2019 in the department of Dermatology & Venerology, SS Institute of Medical Sciences and Research, Davangere, Karnataka, India. The baseline data, thorough general physical, local, and systemic examination were done with reference to clinical features of tinea incognito. Skin scraping were collected and subjected to potassium hydroxide (KOH) preparation. The part of the sample was inoculated into Sabouraud’s Dextrose Agar (SDA) media for fungal culture. Later the fungus was identified by standard techniques. The mean age of study population was 32.83 years. The males outnumbered females in our study. Almost 29% cases remain asymptomatic followed by 34% itching and 37% burning sensation. The source of drug responsible for tinea incognito were highly suggested by friends (29%) with the combination use of drugs account for 35% of study population. 77% cases showed erythema followed by 48% of hypopigmentation. The scraping of lesion showed positive KOH mount in 71% and T.mentagrophytes were the most common dermatophyte grown in SDA medium. Misuse of steroid formulations in dermatophytic infections may lead to adverse effect as well as chronicity. Awareness of this problem is needed for prevention of steroid modified dermatophytosis, which is a rising menace.


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