bluuebunny/crossref_metadata_2025 huggingface dataset:
Dermoscopic features in relation to the type of clinical lesions in cutaneous leishmaniasis
Authors: Al Chalabi Qasim S. , Al Salman Hala N. , Al harbawi Anfal L.
Published: August 2024

Background

Cutaneous leishmaniasis (CL) is an endemic disease in our region. Early management of the disease is crucial to control the spread of the disease and prevent complications.

Objective

To determine the dermoscopic characteristics of CL lesions and their relation with the clinical types.

Patients and methods

Ninety-three patients (248 lesions) were enrolled in this cross-sectional study. Each lesion was examined using a dermatoscope after confirming the diagnosis of CL by a slit smear and direct identification of the parasite by Giemsa-stained slides using a light microscope. The data were recorded, analyzed, and tabulated.

Results

A total of 124 noduloulcerative, 83 plaques, 20 papules, 13 nodules, and eight ulcerative lesions were included in this study, the limbs were the most frequently affected site (210 lesions). Diffuse background erythema was found in all lesions, in 97 lesions the erythema was dusky red, light red in 145 lesions, and yellowish red in six. Most lesions (76.2%) had hyperkeratosis with central erosion and ulceration. Yellow tears (103 lesions) were the most common dermatoscopic finding, they were observed more commonly in nodular and noduloulcerative lesions (P value <0.05). The next common dermatoscopic signs were a white star-burst-like pattern (41 lesions) and salmon-colored ovoid seen in 37 lesions, both of them seen more frequently in nodular and noduloulcerative lesions (P value <0.05). Vascular structures (232 lesions) were more prevalent in nodular and noduloulcerative lesions (P value <0.05). The most frequent vascular signs were linear irregular vessels in 69 lesions, followed by comma-shaped vessels in 51, and dotted in 48 lesions.

Conclusion

Yellow tears, white starburst-like pattern, and salmon-colored ovoid structures were the most frequent dermatoscopic signs observed and were significantly associated with nodular and noduloulcerative type, limbs were the most common affected site. Linear irregular, comma-shaped, and dotted vessels were the most frequent vascular pattern in nodular and noduloulcerative lesions. Therefore, these signs with the clinical examination might help dermatologists to diagnose CL in endemic regions.
Immunohistochemical assessment of SOX10 and its relation to the immune cellular infiltrate in alopecia areata follicles
Authors: Awad Sherif S. , AbdelRahman Amal , Gabril Manal , Nageh Keroles , Rezk Ahmed F.
Published: August 2024

Background

Alopecia areata (AA) is a nonscarring patchy hair loss that can extend to affect all body hair. Many hypotheses for autoimmunity onset in AA have been reported and the immune privilege collapse theory is the most accepted.

Objective

To evaluate the immunohistochemical expression of SOX10 within the AA hair follicles as one of the melanocytic markers as well as its relation to the inflammatory infiltrate.

Patients and methods

The current observational descriptive hospital-based cross-sectional pilot study included 16 patients with AA. Skin biopsies were taken from the border of the alopecic patch, and cross-sectioned hair follicles were examined by H and E and SOX10 immunostaining after assessing activity using a hair pull test. Follicles in cut sections were numbered and evaluated for the presence as well as the density of perifollicular lymphocytic infiltrate. Moreover, counting of SOX10+ cells was performed for the immunostained sections.

Results

The study included 16 patients with AA, six (37.5%) males and 10 (62.5%) females, ranging in age from 5 to 40 years (median = 18.5, IQR = 9.5–27). Based on the hair pull test, nine (556.3%) patients had active disease, while seven (43.8%) patients were apparently stable. Within the 81 examined AA follicles, 53 showed SOX10+ expression that showed a significant positive relation with the inflammatory infiltrate (P=0.001).

Conclusion

SOX10 is clearly expressed in the hair follicles of AA and is significantly related to the mononuclear infiltrates that accompany the pathogenesis of the disease. Therefore, melanocytes may carry the antigenic epitope required to initiate the organ-specific autoimmunity in AA, and this may explain the regrowth of only white hair follicles in some cases of AA.
Prevalence profile of cutaneous T- and B-cell lymphoma in Gharbia Governorate, Egypt
Authors: Elwan Nagwa M. , Badawy Dina A. , Atlam Salwa A. , Hassan Ghada F. R.
Published: August 2024

Background

Lymphomas represent a heterogeneous group of lymphoid malignancies with varied patterns of clinical behavior and responses to treatment. The WHO classification distinguishes lymphoid neoplasms derived from precursor lymphoid cells from those derived from mature lymphoid cells and separates each group into neoplasms of B-cell or T-cell origin. T-cell lymphomas represent 82.9%, while B-cell lymphomas account for 21.3% of cutaneous lymphomas.

Objective

To study the prevalence of cutaneous T- and B-cell lymphomas in Gharbia Governorate, Egypt from 1999 to 2019.

Patients and methods

This descriptive, retrospective study was based on the records of patients clinically and pathologically diagnosed with T- and B-cell lymphoma from 1999 to 2019 and registered in registry unit of Tanta Cancer Center and the outpatient clinic of Department of Dermatology and Venereology, Tanta University.

Results

The prevalence rate of cutaneous T-cell lymphoma was 3.04 P/m population, with a male-to-female ratio of 1 : 1.15, while the prevalence of B-cell lymphoma was 0.63 P/m population, with a male–to-female ratio of 1.4 : 1 in Gharbia Governorate, Egypt at the end of the study. The highest prevalence rate of T- and B-cell lymphoma (2430 P/m population) was recorded in the age group of over 80 years and the least prevalence rate (21.25 P/m population) was recorded in the age group of 10–20 years.

Conclusion

T-cell lymphoma was more common than B-cell lymphoma, both are diseases of the older age group, and there was no sex predilection for T-cell lymphoma distribution and a slight elevation of male ratio in B-cell lymphoma distribution.
Assessment of Oral Care after Oral Health Education in Diabetes Mellitus Patients: A Cross-sectional Study
Authors: Jahnavi Thondamanati , Suneelkumar Chinni , Swapna Sannapureddy , Pranaviteja Paleti , Anumula Lavanya , Vallapareddy Sriya Saatwika
Published: August 2024

Introduction:

Diabetes mellitus (DM) is the most common chronic endocrine disorder of the 21st century with serious health consequences. DM is a significant systemic risk factor for oral diseases. Oral complications of DM can be irreversible and devastating. The awareness among diabetic patients regarding oral diseases and their complications is low.

Aim:

The aim of this cross-sectional study was to assess the cognizance of diabetic patients regarding associated oral health conditions using a prequestionnaire, educate them, and assess their education after 1 month using a postquestionnaire.

Methodology:

A customized questionnaire was developed and given to 160 known DM patients who signed the consent form and were willing to participate in the research, through which data were collected before and after educating DM patients.

Results:

The data collected from the questionnaires were compiled, statistical analysis was done in SPSS Statistical software, and qualitative data were summarized in frequencies and percentages. The Fisher’s exact test was performed to analyze the oral hygiene practices for pre- and post-survey data.

Conclusion:

After health education, 100% of the participants knew that DM causes oral health problems, and 100% were aware of periodic follow-ups. This implies that the oral health behavior of the patients can be further improved by continuous motivation by the dental health-care providers over oral health education.
Comparative Evaluation of the Effect of 25% Aluminum Chloride Solution, Chitosan Hemostatic Dressing, and 980 nm Diode Laser on the Pushout Bond Strength of Angelus Bio C-Repair Material: An In vitro Study
Authors: Krishnegowda Sahadev Chickmagravalli , Jaganath Bharath Makonahalli , Rudranaik Sandeep , Harnad Amritha Bhat
Published: August 2024

Background:

To evaluate and compare the effect of 25% aluminum chloride solution, chitosan hemostatic dressing, and 980 nm diode laser on the pushout bond strength of Angelus Bio C-Repair when used as a furcal perforation repair material.

Materials and Methods:

Forty extracted human maxillary molars were collected, with 10 teeth in each group. Furcal perforations were simulated and were contaminated with human blood, except for one group. The contaminated groups were treated with 25% aluminum chloride, chitosan hemostatic dressing, and 980 nm diode laser, or none at all. All the perforations were repaired using Angelus Bio C-Repair and later tested for pushout bond strength using a universal testing machine.

Results:

The pushout bond strength of Angelus Bio-C Repair material was found to be highest with the aluminum chloride group followed by diode laser and chitosan hemostatic dressing and the test groups gave better results compared to the control group.

Conclusion:

Aluminum chloride still stands out as a gold standard to attain hemostasis. However, diode lasers and chitosan can give promising results.

Clinical Significance:

Aluminum chloride, diode lasers, and chitosan can be invariably used to attain hemostasis at the perforation site and Angelus Bio-C-Repair material can be used clinically to seal the perforation site with its added benefits of premixed syringe form.
Surgical Management of Extensive Chronic Suppurative Maxillary Osteomyelitis in an Uncontrolled Diabetic Patient – A Comprehensive Case Report
Authors: Khandelwal Pulkit , Saluja Harish , Shah Seemit , Dadhich Anuj
Published: August 2024

Osteomyelitis is inflammation of the medullary cavities, Haversian system, and adjacent cortex of the bone. It is pernicious to patients when aggressive and invasive. Maxillary osteomyelitis mostly affects individuals with immunocompromised conditions such as uncontrolled diabetes, human immunodeficiency virus infections, and immunosuppressive/chemotherapy, and has potentially fatal outcomes. In diabetic patients, strict glycemic control routinely as well as pre-, intra-, and postoperatively is paramount to prevent as well as cure diabetic maxillary osteomyelitis. We report a case of maxillary osteomyelitis in a female patient with poorly controlled type 2 diabetes mellitus. She complained of multiple mobile teeth and exposed bone in the upper left back tooth region. Clinical, radiographic, and histopathological findings were confirmative of chronic suppurative maxillary osteomyelitis. Sequestrectomy, curettage, and debridement were performed after broad-spectrum empirical antibiotic therapy and correction of raised blood glucose levels within normal limits. At regular follow-ups, there was no evidence of any recurrence or re-infection.
Association of Anxiety in Patients Visiting Dental Institution
Authors: Deepa Anumala , Susmitha Koppuravuri Venkata Tirumala , Katuri Kishore Kumar , Boyapati Ramanarayana , Adurty Chaitanya , Dhulipalla Ravindranath
Published: August 2024

Aim:

(1) To compare the association of anxiety in patients with different age groups, different education qualifications, and income. (2) To assess the frequency of anxiety in dental patients visiting dental institution for the first time.

Materials and Methods:

A cross-sectional study was conducted among 366 patients who were seeking dental treatment for the first time in a dental institution. The Modified Dental Anxiety Scale was used to assess dental anxiety levels in patients visiting dental institution. Descriptive analysis and one-way ANOVA analysis were carried out using IBM SPSS Statistics, version 21.0.

Results:

The total prevalence of dental anxiety in patients visiting dental institution for the first time was 28.7%. Results showed that anxiety levels were more in 25–35 years of age (3.32) than in 46–50 years of age (2.08). Patients with low education (3.31) showed higher anxiety levels than patients with higher education (2.06), and low-income patients (3.41) showed more anxiety than patients with higher income (1.98). It was observed that the local anesthetic injection was the most anxiety-provoking item in the overall sample with a mean score of 3.69.

Conclusion:

The findings of the current study concluded that there is a prevalence of anxiety in dental patients visiting for the first time. Efforts should be made by dentists using customized psychological and pharmacological interventions to reduce anxiety and enhance patient compliance toward treatment.
Stress and Its Downside among Medical and Dental Students: A Questionnaire-based Study
Authors: Yaramapu Kavya , Anumula Lavanya , Chinni Suneel Kumar , Prasanth Punamalli Symon , Govula Kiranmayi , Reddy Swapna Sannapu
Published: August 2024

Aims:

This study assesses the prevalence and characteristics of stress experienced by medical and dental students in their final year of education.

Materials and Methods:

This research was a single-point, cross-sectional observational study. A semi-structured, semi-validated questionnaire was used to collect demographic information. The questionnaire was designed to gather data from a sample size of 500 students from different medical and dental colleges in the state. It was administered using Google Forms and included established tools such as the General Health Questionnaire, the Warwick-Edinburgh Mental Wellbeing Scale, and the Higher Education Stress Inventory. In addition, institution-specific questions were incorporated. The attitudes of the participants were evaluated using a Likert scale.

Data Analysis:

Five hundred and fifteen responses were collected, with 266 MBBS students (51.7%) and 249 BDS students (48.3%) participating. The respondent pool consisted of 77.5% female students and 22.5% male students. The findings revealed that stress was occasionally reported by 52.2% of BDS students and 55.2% of MBBS students. Furthermore, 20.48% and 22.2% of BDS and MBBS students, respectively, reported experiencing stress often. The present study employed the Chi-square test for data analysis and utilized bar and pie charts to present the results.

Conclusions:

The study reveals a substantial portion of students experience stress, impacting their well-being and academic performance. College administrations need to prioritize addressing this issue by implementing support mechanisms that can help students manage academic pressure and cope with stress during their educational tenure.
Balloon Dilatation of a Posttracheostomy Critical Tracheal Stenosis in a Child
Authors: Bhat Javeed Iqbal , Sofi Khalid , Mir Shafat A. , Charoo Bashir Ahmad
Published: August 2024

Postintubation and posttracheostomy tracheal stenosis in children is one of the common complications of prolonged invasive ventilation and tracheostomy. It can lead to high mortality if not identified and treated early. Many treatment modalities are available encompassing from minimally invasive, endoscopic restoration of airway patency to an open surgical tracheal reconstruction procedure. We report a 14-year-old child with critical posttracheostomy tracheal stenosis, who was successfully managed by balloon tracheoplasty.
Serum Magnesium Levels and Their Association with Severe Pneumonia in Children
Authors: Saxena Shivi , Rajeshwari K. , Kumar Deepak , Goswami Binita
Published: August 2024

Background:

Magnesium, an essential intracellular cation, is implicated in various physiological functions, including metabolic reactions, cardiac functions, and immunological responses. Magnesium deficiency has been associated with clinical conditions, particularly in critically ill children with severe pneumonia. However, data on magnesium levels and their impact on outcomes in the pediatric population are scarce.

Methods:

A cross-sectional study was conducted in a pediatrics department over a year, including 40 children aged 2–59 months with severe pneumonia. Serum magnesium levels were measured, and associations with demographic factors, nutritional status, and clinical outcomes were explored. Statistical analysis employed SPSS Statistics, and a P < 0.05 was considered significant.

Results:

Out of 40 children with severe pneumonia, 9 (22.5%) had hypomagnesemia, with a significant association with malnutrition (P = 0.04). Out of 9 hypomagnesemic children, 4 were either moderately or severely malnourished, while the remaining 5 were well nourished. Hypomagnesemia demonstrated a significant correlation with hypocalcemia, with 8 out of 9 children with hypomagnesemia exhibiting concurrent hypocalcemia (P = 0.022). In addition, children with hypomagnesemia experienced a statistically significant longer hospital stay compared to normomagnesemia and hypermagnesemia counterparts (P = 0.028).

Conclusion:

This study highlights the prevalence of hypomagnesemia in children with severe pneumonia and its association with malnutrition, hypocalcemia, and prolonged hospitalization. However, magnesium levels did not significantly affect ventilation modes and overall survival. Larger studies are warranted to further elucidate the complex associations.
Over-the-counter and into the Airway: A Case Report of an Unusual Foreign Body
Authors: Ramakrishna Golla , Kumar Ketan , Das Rashmi Ranjan , Gulla Krishna Mohan
Published: August 2024

Foreign-body (FB) aspiration in children is often a life-threatening condition and requires quick and skilled intervention. FBs may affect the airway in different ways depending upon their physical and chemical nature. Here, we describe a 7-year-old boy who presented 12 h after aspirating a common antihistaminic pill available over the counter. At presentation, the child had tachypnea, hypoxia, subcutaneous emphysema over the neck and right chest, and pneumomediastinum with right lung collapse on chest X-ray. A flexible bronchoscopy done after intubating the child showed the swollen pill obstructing the right main bronchus. Pieces of the disintegrating pill were grasped and removed using a forceps and wire basket over a period of 4 h. Following complete removal, the patient had an uneventful recovery. Medicinal pills can cause disastrous complications and should be removed from the airway as early as possible.
Acute rheumatic fever and Takayasu arteritis – A synchronous co-occurrence
Authors: Vaideeswar P , Sabnis G
Published: August 2024

Acute rheumatic fever and Takayasu arteritis are examples of autoimmune diseases that commonly affect the cardiovascular system. We report an infrequent co-occurrence of both these diseases in an adolescent male. It may appear that in some individuals, the rheumatic fever may act as a trigger for the development of large vessel vasculitis. This possibility should be considered in patients on follow-up if they develop fresh features of cardiovascular compromise despite appropriate medical, interventional, or surgical therapy for rheumatic heart disease.
In vitro anthelmintic activity of fresh fruit juice of Solanum verbascifolium Linn. against digenetic trematodes
Authors: Faslana Abdul Razzak Fathima , Paheerathan Vijitha , Senevirathne Menike Anusha Indukumari
Published: August 2024

Background:

The substantial costs of conventional anthelmintics, the presence of drug residues in animal products, and the increasing prevalence of anthelmintic-resistant strains have spurred research on medicinal plants as alternative anthelmintic sources. This study evaluates the anthelmintic activity of Solanum verbascifolium Linn. fruit juice against digenetic trematodes.

Materials and Methods:

This study involves testing the efficacy of S. verbascifolium fruit juice at varying concentrations (10, 50, and 100 mg/mL) on five groups of rumen fluke worms. Albendazole (10 mg/mL) was used as the positive control, while distilled water was used as the negative control. Rumen flukes, digenetic trematodes found in the cow’s gut, were selected to simulate worms commonly found in the human gut.

Results:

The results indicated a statistically significant association between the different concentrations of the fruit juice and their anthelmintic activity. All concentrations of S. verbascifolium fruit juice demonstrated anthelmintic properties. Notably, the 50 and 100 mg/mL concentrations exhibited a significant effect on the worms compared to the standard drug albendazole.

Conclusion:

This study concludes that the fruit juice of S. verbascifolium possesses promising anthelmintic properties in vitro. These findings indicate the potential use of the botanical as an anthelmintic drug, warranting further investigation and development.
Corneal Perforation as a Complication of Fungal Interface Infectious Keratitis after Deep Anterior Lamellar Keratoplasty
Authors: Otaif Wael , Al Somali Abdulaziz Ismail , Almulhim Amar
Published: August 2024

Deep anterior lamellar keratoplasty (DALK) is a surgical intervention for corneal diseases that do not affect the endothelium. The creation of an interface between the donor graft and recipient bed is a typical feature of DALK. Interface infectious keratitis (IIK) is an uncommon complication that originates at this point of contact. The onset of IIK following lamellar keratoplasty can cause delayed visual loss and subsequent endophthalmitis, with primarily fungal etiology (e.g., Candida spp.) and occasionally bacterial etiology. Infection of the lamellar interface may be attributed to contamination of the donor material or to precipitating factors such as loose sutures, persistent epithelial defects, and prolonged topical steroid use; fungal IIK is frequently resistant to medical treatment. Here, we describe the previously unreported occurrence of corneal perforation as a complication of fungal IIK after DALK. A 26-year-old otherwise healthy woman underwent uneventful DALK for advanced keratoconus in the left eye. She was discharged with instructions to apply topical prednisolone acetate and topical moxifloxacin. Culture of the donor corneoscleral rim showed growth of Candida glabrata, although the patient exhibited no clinical signs of infection. Approximately 3 months later, the patient exhibited mild blurring of vision in her left eye. Therefore, treatment was modified to topical amphotericin B and oral voriconazole. One week later, the patient developed multiple, sheath-like whitish creamy infiltrates, primarily in the lamellar interface; a positive Seidel test result indicated the presence of corneal perforation. As treatment for IIK, excisional penetrating keratoplasty (PK) was performed, followed by topical amphotericin B and topical prednisolone acetate treatment. During 12 months of follow-up after PK, the corneal graft was clear and there was no clinical evidence of recurrent keratitis. Prompt excisional PK prevented the progression of IIK to endophthalmitis in our patient. Early intervention with excisional PK should be considered when a diagnosis of fungal IIK is suspected in a patient with a positive donor rim culture, and in whom the condition does not respond to medical treatment. This early intervention is essential to prevent delayed treatment, which could result in corneal perforation and endophthalmitis, with ultimately poor visual outcomes.
The Quality of Life of Medically Versus Surgically Treated Primary Open-Angle Glaucoma Patients at a Nigerian Hospital
Authors: Oduneye Femi C. , Musa Kareem O. , Agboola Sefinat A. , Idowu Oluwatobi O. , Onakoya Adeola O.
Published: August 2024

PURPOSE:

The purpose of this study is to compare the quality of life (QoL) of medically treated versus surgically treated primary open-angle glaucoma (POAG) patients attending Lagos University Teaching Hospital, Lagos, Nigeria.

METHODS:

The study was a hospital-based, comparative cross-sectional study. Consecutive consenting POAG participants who met the inclusion criteria were recruited until the sample size was achieved. QoL of all participants was assessed using the glaucoma QoL-15 and National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25) questionnaires. Analysis was done using the IBM statistical package for the social sciences version 25.0.

RESULTS:

The study involved 81 participants who were only on medical treatment for POAG and 81 age- and sex-matched POAG participants who had trabeculectomy surgery. Surgically treated participants had a lower mean intraocular pressure 11.68 mmHg when compared to the medically treated participants 14.82 mmHg. Medically treated participants however had a better overall mean glaucoma QoL using the glaucoma QoL-15 (medical 34.36 ± 10.4, surgical 39.11 ± 13.9 P = 0.015) and NEI-VFQ-25 questionnaires (medical 68.32 ± 15.0, surgical 62.44 ± 18.8 P = 0.029). Controlling for the severity of glaucoma using the glaucoma QoL-15 questionnaire, medically treated participants had a better QoL only among participants with severe POAG (medical 49.13 ± 5.9, surgical 54.06 ± 4.6 P = 0.003). While using the NEI-VFQ-25 questionnaire, medically treated participants had a significantly better QoL only among participants with moderate (medical 74.70 ± 6.6, surgical 67.07 ± 15.6 P = 0.012) and severe POAG (medical 54.52 ± 6.3, surgical 45.51 ± 10.0 P = 0.004).

CONCLUSION:

The study demonstrated that although participants that had trabeculectomy had a lower mean intraocular pressure, their overall mean QoL was reduced compared to the medically treated participants.
External versus Endoscopic Dacryocystorhinostomy for Primary Acquired Nasolacrimal Duct Obstruction
Authors: Rajabi Mohammad T. , Shahraki Kianoosh , Nozare Atefeh , Moravej Zahra , Tavakolizadeh Sepideh , Salim Reza E. , Hosseinzadeh Farideh , Mohammadi Shabahang , Farahi Azadeh , Shahraki Kourosh
Published: August 2024

PURPOSE:

The purpose of the study is to compare the surgical outcomes and success rates of external dacryocystorhinostomy (EX-DCR) versus endoscopic endonasal DCR (EN-DCR) for the treatment of primary acquired nasolacrimal duct obstruction (PANDO).

METHODS:

This retrospective nonrandomized study was conducted at Farabi Eye Hospital and Noor Eye Hospital, Iran. A review of electronic medical records of all patients with PANDO who underwent EX-DCR or EN-DCR between January 2016 and 2018 was carried out.

RESULTS:

A total of 803 patients underwent surgery, of which 618 patients (77%) were managed by EX-DCR and 185 patients (23%) by EN-DCR. The majority of cases (62%) were female. The mean age of the patients in EX-DCR and EN-DCR groups was 40.8 ± 14.2 and 34.3 ± 9.2 years, respectively. EX-DCR resulted in significantly less amount of pain compared to EN-DCR (P < 0.05). The success rate of surgery among EX-DCR and EN-DCR groups was 92.4% and 91.1%, respectively, and did not show statistically significant difference. A higher incidence of intraoperative hemorrhage requiring intervention was noted in the EN-DCR group (16.7% vs. 4.5%). Postoperative patient's satisfaction with EN-DCR and EX-DCR was 73% and 82%, respectively.

CONCLUSION:

Both EX-DXR and endoscopic DCR surgeries have high success rates and low incidence of failure. The choice of DCR technique should be based on the experience of the surgeon and patient's lacrimal and nasal anatomy and preferences.
Toxic Keratopathy Induced by Self-Application of Seawater
Authors: AlGhadeer Huda , Bukhari Thamer , AlAmry Mohammed
Published: August 2024

To report a case of toxic keratopathy secondary to the self-application of seawater eye drops. A 60-year-old male who presented with unexplained unilateral decrease in vision and corneal thinning. Best-corrected visual acuity was 20/400 OD, slit-lamp examination indicated diffuse corneal edema with central thinning, intact sensation, and no vascularization. Laboratory analysis of the eye drops in conjunction with clinical symptoms and findings was consistent with toxic keratopathy. Toxic keratopathy can masquerade as the other forms of keratopathy, and a thorough history taking and laboratory analysis may help elucidate the diagnosis and avoid significant visual morbidity.
Branch Retinal Artery Occlusion Following Cocaine Inhalation
Authors: Alsarhani Waleed K. , Almater Abdullah I. , Abu El-Asrar Ahmed M.
Published: August 2024

Cocaine abuse has been reported to cause devastating systemic and ocular side effects. Retinal vascular occlusion following cocaine abuse has been scarcely reported in the literature. Herein, we are describing a rare case of branch retinal artery occlusion (BRAO) following intranasal cocaine use in a young female. She presented to the emergency department 1 month after having blurred vision in the left eye, which started 1 day after cocaine nasal inhalation. Fundus examination of the left eye showed an inferotemporal BRAO. In conclusion, cocaine should be considered in the differential diagnosis of retinal arterial occlusion in young healthy patients.
Intermediate Uveitis in Retinitis Pigmentosa Associated with a Novel Homozygous Splice Site Mutation in PRPF8
Authors: Badawi Abdulrahman H. , Magliyah Moustafa S. , Schatz Patrik , Al-Shehri Abdulaziz , Alabdullah Abdulelah A.
Published: August 2024

The manifestation of intermediate uveitis (IU) in patients with retinitis pigmentosa (RP) is uncommon and poses diagnostic and management challenges. In this case, we describe the clinical features and management outcomes in an RP patient with a novel homozygous splice site mutation in PRPF8. A 21-year-old male presented with unilateral decrease of vision in the right eye for 1 week. Retinal dystrophy features were present in the left eye. After 2 weeks of topical steroid therapy, near-total resolution of IU was achieved and vision improved to 20/30. Signs of (RP) were present bilaterally, with the right eye more affected than the left. Genetic testing indicated a novel homozygous c. 3061-6_3061-3del mutation in the PRPF8 gene. IU in young patients with RP can be effectively treated with a short course of topical steroids, sparing the need for systemic immunosuppressives. After the improvement in IU, the right eye showed more advanced RP changes.
Review of Three Cytology Reporting Systems in the Diagnosis of Thyroid Lesions: A Study of Fifty Cases
Authors: Chandanwale Shirish S. , Bhide Aniket Milind , Rashmi Rakesh Kumar , Patel Payal , Raj Akshi , Singh Madhuri , Dharwadkar Arpana , Vasu Bhavana
Published: August 2024

ABSTRACT

Background:

The various reporting systems such as conventional system, UK/RC Path system, and The Bethesda System for Reporting Thyroid Cytology (TSBRTC) have been used to help create a standard reporting format for evaluating thyroid cytology smears. However, there is still an ongoing dispute as to which classification system is the best for the management of the patient with thyroid lesions. The aim of this study is to review the utility of three reporting systems in cytological evaluation of thyroid swellings.

Materials and Methods:

A total of 50 cases were included in study. Only adequate smears were included in the study. Cytology smears of all cases were reported and categorized as per three reporting systems. In cases in which surgical specimens were received for histopathological examination, diagnosis was correlated with cytology diagnosis.

Results:

Maximum patients (n = 27) were in the age group of 20–40 years. The comparison of conventional, TSBRTC, and UK/RC Path reporting systems of 50 thyroid cytology smears showed equivocal cases in the benign category (Category II).

Conclusion:

In the vast majority of the cases, it showed that TBSRTC and UK/RC Path system lead to better diagnostic yield, high sensitivity, and timely treatment of patients. TBSRTC has diagnostic accuracy of almost 98%. One of the most challenging categories was the Category III in TSBRTC or Thy3a which are heterogeneous category. The smears in these categories include features which do not permit them to be classified as either benign or malignant.
Case Series on the Clinical Profile of Neurocysticercosis in Pediatric Age Group
Authors: Chalipat Shiji S. , Chavan Sanjay , Malwade Sudhir D. , Agarkhedkar Sharad R. , Kumari Soni
Published: August 2024

Introduction:

Neurocysticercosis (NCC) is a common infection of the nervous system caused by ingestion of Tenia solium eggs in undercooked pork or contaminated water. Most children present with seizures particularly focal seizures with or without signs of raised intracranial pressure (ICP). Diagnosis is made by computed tomography/magnetic resonance imaging (CT/MRI) scan which shows single/multiple ring-enhancing lesions with perilesional edema. Management involves the use of anticonvulsants for seizures and steroids for edema.

Objective:

To establish a clinical profile of NCC patient in pediatric age groups.

Material and Methods:

The Department of Pediatric Neurology at our institute conducted a retrospective study of 15 children with ring-enhancing lesions on MRI who were managed at this centre. The observations were further analyzed.

Results:

Nearly 14 children presented with seizures, 50% of these children also showed signs of raised ICP. Only 1 child had presented with signs of raised ICP. All the children were treated with anti-cysticidal, anti-epileptic with pre-treatment steroids. At 6 months all children were seizure-free.

Conclusion:

NCC should be ruled out in children presenting with focal seizures, especially in a country like India where the disease is endemic. Apart from antiepileptics, anthelmintic – Albendazole and Praziquantel are very effective against NCC with pre-treatment with corticosteroids and have been very effective in managing the disease.
Psychological Impact on Health-care Workers at a Tertiary Hospital in South India during the COVID-19 Pandemic
Authors: Christopher Ajay , Gojer Abigail Ruth , Lohanathan Aparna , Kuruvilla Anju , Gopalakrishnan Rajesh , Prabhakar Abhilash Kundavaram Paul
Published: August 2024

Background:

The COVID-19 pandemic has overwhelmed the health-care infrastructure in the country. The steadily increasing number of cases and workload, inadequacy of healthcare infrastructure, and perceived lack of support contribute to psychological stress among health-care workers (HCWs).

Aims:

This cross-sectional survey estimated the prevalence and factors associated with depressive, anxiety, and stress symptoms among HCWs during the COVID-19 pandemic at a tertiary care hospital in South India.

Methodology:

Randomly chosen HCWs who provided informed consent were recruited to the study and administered the Depression Anxiety and Stress Scale-21, Clinical Interview Schedule-Revised, and the revised stigma scale to assess for depressive, anxiety, and stress symptoms, common mental disorders, and stigma, respectively. Sociodemographic details were also recorded. Bivariate and multivariate statistics were obtained.

Results:

One hundred and twenty-seven participants completed the survey questionnaire. The overall prevalence of significant depressive, anxiety, and stress symptoms was 31.5%, 26%, and 16.5%, respectively. Depressive symptoms were associated with younger age, being single, presence of medical illness in the family, current nicotine, and alcohol use. Anxiety symptoms were associated with younger age, being single, and working in a clinical area with potential for exposure to COVID-19 patients. The presence of children at home was associated with lower depressive or anxiety scores. Nearly 15.7% of the participants had a primary psychiatric diagnosis.

Conclusions:

HCWs are at risk of experiencing psychological distress during the ongoing COVID-19 pandemic. Our findings suggest that a supportive environment is essential to protect and promote the psychological well-being of HCWs during and after the outbreak. Early psychological interventions for those who require it can prevent long-term sequelae in this vulnerable group.
Encouraging Assessment and Collection of Feedback in Interactive Teaching Sessions
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: August 2024

The best way to deliver effective medical education in large or small group teaching sessions is by ensuring that the sessions are interactive and interesting for the students so that they actively participate in the sessions. However, it is important to acknowledge that a teacher has to do a proper preinstructional planning for this to happen. A teacher has to specify the specific learning objectives of their session and convey the students what they expect students to take away from the session. At the same time, the teacher has to carefully decide on the method of assessment during the interactive session, as the selected method should drive learning, easy to administer, and should not extend the overall duration of the session. The assessment method can target any of the domains of learning depending on the nature of the topic and should aim to test different levels of learning in each domain. In conclusion, assessment and feedback play an instrumental role in the entire process of teaching–learning. Thus, it has to be encouraged as it offers a wide spectrum of benefits to the students as well as the teachers.
Investigation of Enteric Fever Outbreak in an Institutional Settings
Authors: Sunil Diwate , Nema Devendra , Mahajan Saurabh , Yadav Arun K.
Published: August 2024

ABSTRACT

Introduction:

The study describes the outbreak investigation of the Enteric Fever in an institution set up

Methods:

A descriptive epidemiological study and detailed site survey was undertaken. Widal test was performed on all the subjects and blood culture was done on few selected recruits.

Results:

Sixty cases of typhoid fever occurred in the institution. All cases were in the age group 18 to 22 years. Of the cases, one had complication in the form of intestinal perforation. Two samples out of 17 samples detected Salmonella sp. Fly nuisance and unhygienic conditions were seen at various places. The common water supply was through Sintex plastic tank which was found full of fungus growth while from outside they appeared clean.

Conclusion:

The outbreak of typhoid was due to unhygienic water storage tanks. A high standard of hygiene and cleanliness to be ensured to prevent such outbreaks.
Self-Directed Learning in Undergraduate Medical Education in India
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: August 2024

For a significant period of time in the field of medical education, delivery in India emphasis has been given toward didactic lectures, practical, and tutorials. Among the five goals laid down for an Indian Medical Graduate, being a lifelong learner is what we are aiming for as the field of medicine is changing with each day. This cannot be accomplished if we do not encourage self-directed learning (SDL) among the students, and this need has been realized and has been given due weightage in the recently adopted competency-based undergraduate medical curriculum. However, it is important to acknowledge that the success of SDL depends on the readiness of the students to adopt the same and to accomplish that we have to strategically deal with all the existing challenges, which comes along with it. In conclusion, SDL has an extensive scope and application in the delivery of undergraduate medical education in India. However, there are challenges pertaining to its planning and evaluation, and there lies the role of a faculty member, who has to be more proactive in ensuring that it is implemented effectively and the students are benefited.
Unusual Benign Lesions of the Breast Mimicking Carcinoma: A Series of Six Cases
Authors: Saha Rama , Das Smritiparna , Das Chhanda
Published: August 2024

ABSTRACT

Introduction:

There has been a growing increase in the incidence of breast cancer, which is still the most significant cancer-related cause of female mortality. All breast lesions are not malignant, and all the benign lesions do not progress to cancer; however, the accuracy of diagnosis can be increased by a combination of preoperative tests (like physical examination, mammography, fine-needle aspiration cytology, and core-needle biopsy [CNB]).

Aim:

To study the breast mass which mimicks malignant lesion clinically and their further evaluation with the help of core needle biopsy and fine needle aspiration cytology.

Materials and Methods:

Prospective evaluation of the breast masses which mimicks malingnant lesion clinically at IPGME &R and SSKM Hospital kolkata from January 2019 to June 2020 at department of pathology. We studied the cases of breast masses. This comprised patient age and sex, the clinical characteristics and location of the mass, the duration of the lesion, its size, the treatment provided, and the histopathological findings obtained from fine-needle aspiration cytology (FNAC) and CNB.

Results:

We present six clinical cases in which a diagnosis dilemma existed, in terms of ultrasound findings that were not clear and suspicious. The results of FNAC and CNB are used to distinguish between benign breast lesions mimicking carcinoma of breast. Our findings are compared with previously published cases. Furthermore, literature review regarding the case presentation and diagnosis has been discussed, as well as treatment options.

Conclusion:

Accurate preoperative diagnosis of carcinoma is necessary in screen-detected lesions so that patients may be counseled appropriately and a majority could have a single therapeutic operation. Benign breast lesion mimicking breast carcinoma should be differentiated. Combining FNAC and CNB for screening-detected breast cancers, the complete sensitivity increases from 93% for CNB only to 98% when both tests are combined.
Pediatric Ocular Morbidity among Admitted Patients in a Tertiary Care Hospital in Eastern India
Authors: Chakraborti Chandana , Jingar Bharati , Khan Shadab R.
Published: August 2024

ABSTRACT

Aim:

This study aimed to determine the causes of pediatric ocular morbidity in the in-patient department of a tertiary-care hospital in eastern India.

Methods:

This was a retrospective descriptive study done on admitted patients in the age group of 0–12 years between July 1, 2019, to December 31, 2019, in a tertiary-care hospital in eastern India.

Results:

During the study period, a total of 5775 patients were admitted to the hospital, out of which 447 were children belonging to 0–12 years, the prevalence being 7.74%. Out of the 447 children, 276 were males (61.74%) and 171 were females (38.26%) with a male:female ratio of 1.6:1. A total of 31.77% patients were reported from urban areas and 23% from rural areas. The mean age of the children was 5.5 years (range: 20 days–12 years). The highest frequency of admission was found in the age group of zero to 4 years (61.74%). Ocular trauma (44.07%) was found to be the most common ocular morbidity, followed by cataract (32.21%) and infectious ocular diseases (7.61%). The average duration of stay in the hospital was 4.9 days ranging from 2 to 56 days.

Conclusion:

Timely intervention with early diagnosis and regular follow-up are essential in the management of pediatric ocular morbidity as well as childhood blindness. In our study, ocular trauma was found to be most common ocular morbidity leading to poor visual outcome and hospital admission, which can be prevented by safe home practices and parental education.
Exploring Community's Perceptions and Behavior Toward People Presumptive or Treated for COVID-19
Authors: Mani Geetha , Varatharajan Subashchandrabose , Mohan Hariharan
Published: August 2024

Background:

The unprecedented morbidity and mortality associated with COVID-19 pandemic and its unique epidemiological features have contributed to stigmatizing and discriminating attitudes among people. Success of prevention efforts depends on identifying and acting upon population perceptions toward the disease and those with the disease. Hence, this study was planned to assess perceptions and behavior of people toward those presumptive or treated for COVID-19 and to identify the influence of sociodemographic characteristics and basic knowledge about COVID-19 on population perceptions and behavior.

Materials and Methods:

A descriptive, cross-sectional, Google Forms-based online survey was conducted among eligible population of Tamil Nadu, India, during January 2021. A pretested, semi-structured questionnaire was used to collect basic sociodemographic characteristics, knowledge on COVID-19, attitude, and behavior toward people presumptive or treated for COVID-19 on a Likert scale. Descriptive statistics and Pearson's correlation coefficient test were employed for statistical analysis. P ≤ 0.05 was considered statistically significant.

Results:

Among 300 respondents, 59.3% had adequate knowledge on COVID-19. Twenty-nine percent of respondents expressed favorable attitude and 31.7% reported favorable behavior toward those presumptive or treated for COVID-19. The perceived attitude or reported behavior did not vary significantly across sociodemographic characteristics. An approximate one-third of respondents with adequate knowledge expressed favorable attitude and favorable behavior (P < 0.001); 54% of respondents with favorable attitude reported favorable behavior (P < 0.001). A weak but significant positive linear correlation was identified between attitude and behavior scores (r = 0.386; P < 0.01).

Conclusion:

Equipping people with appropriate knowledge and resources could promote positive population attitudes and behaviors toward those symptomatic or treated for COVID-19 and hence crucial in the control efforts against the pandemic.
Comparison of Trends of Monsoon-Related Diseases during COVID-19 Pandemic in a Tertiary Care Center
Authors: Wankar Reema L. , Chavhan Smita S. , Adsul Balkrishna B. , Dhikale Prasad T.
Published: August 2024

Introduction:

With the arrival of the monsoons, people living in coastal regions are at an increased risk of contracting water-borne and vector-borne illnesses like dengue, malaria, leptospirosis, hepatitis, typhoid, chikungunya, and acute gastroenteritis. With proper hygiene and sanitation practices, several monsoon-related illnesses may have been averted during the COVID-19 pandemic.

Objective:

To analyze the trend of monsoon-related diseases from January 2018 to December 2019 and compare the trends of these diseases during the COVID-19 pandemic, that is, from January 2020 to December 2021.

Material and Method:

A retrospective observational study was conducted in the tertiary care center using secondary data of monsoon-related diseases available from the Integrated Disease Surveillance Programme (IDSP).

Results:

The overall number of cases of monsoon-related illnesses was low in 2020 and 2021 compared to that in 2018 and 2019. Percentage change of diseases depicts that in the year 2020, all monsoon prevalent diseases were reported less compared to 2019, with the highest change being in dengue and acute febrile illness (AFI). In 2021, a majority of the disease incidence, except dengue and typhoid, had increased compared to that of 2020.

Conclusion:

There have been fewer incidences of monsoon-related illnesses as a result of efforts to stop the COVID-19 pandemic. This study emphasizes the significance of widespread sanitary practices and their value in the long-term decline of diseases associated with the monsoon season.
Granular Cell Tumor of the Breast – A Tricky Masquerader: An Interesting Case Report with Review of the Literature
Authors: Gore Charusheela Rajesh , Shah Priti Prasad , Buch Archana Chirag , Bavikar Rupali , Mishra Pratyush
Published: August 2024

ABSTRACT

Granular cell tumor is very rarely seen in the breast. It is common in 30–50 years of age but can occur at any age. It simulates malignancy on clinical and radiological examination. On morphological grounds, it can simulate a wide spectrum of lesions ranging from inflammatory to malignant. We present a case of 46-year-old female with analysis of various difficulties posed at clinical and diagnostic levels. The differential diagnoses are discussed so as to avoid any dilemma during reporting of such cases.