bluuebunny/crossref_metadata_2025 huggingface dataset:
The cross-sectional analytical study of COVID and post COVID mucormycosis in diabetic and non-diabetic patients and their outcomes
Authors: Bajad Vishal , Bansode M. V. , Paritekar Anita
Published: June 2024

Background: Mucormycosis, a rare but serious fungal infection, has shown a concerning rise in incidence among COVID and post-COVID patients, with males constituting majority of cases. This study aimed to investigate the impact of diabetes mellitus (DM) on outcomes in patients with COVID and post-COVID mucormycosis. Given the known association between DM and increased susceptibility to infections, particularly fungal ones, understanding the role of DM in exacerbating mucormycosis outcomes is crucial for clinical management.
Methods: A cross-sectional analytical study was conducted, involving a cohort of 50 patients with mucormycosis, equally divided into diabetic and non-diabetic groups. Data on morbidity, complications, hospitalization rates, and mortality were collected and compared between the two groups. Additionally, glycemic control status was assessed among diabetic patients to evaluate its impact on outcomes.
Results: Among the 50 patients analyzed, diabetic individuals displayed significantly poorer outcomes compared to their non-diabetic counterparts. This included increased morbidity, complications, hospitalization rates, and mortality. Moreover, patients with uncontrolled DM exhibited the worst outcomes, highlighting the critical importance of managing glycemic control during mucormycosis treatment.
Conclusions: The study underscores the necessity of vigilant monitoring and targeted interventions, particularly in diabetic individuals, to mitigate the adverse effects of mucormycosis in the context of COVID-19. Effective management of diabetes, especially glycemic control, is crucial for improving overall patient outcomes and reducing the burden of mucormycosis-related complications and mortality in both COVID and post-COVID scenarios. Further research is warranted to refine treatment protocols and optimize outcomes for this vulnerable population.
The role of color Doppler and multidetector CT angiography in evaluation of peripheral arterial diseases of lower limb
Authors: Gupta Ashok , Khanduri Sachin , Rohit  , Khan Zaara , Chugh Aniket , Yasrab Nida , Kumar Yadav Akshat , Abdullah Siddiqua , Ansari Sajida , Ahmad Mugheer
Published: June 2024

Background: Characterized by atheromatous narrowing and hardening of arteries supplying blood to the legs and feet. Diabetes, along with other risk factors such as hypertension and smoking, exacerbates the prevalence and severity of PAD, leading to decreased blood flow and subsequent tissue injury. The prevalence of PAD in diabetics rises with age, underscoring the importance of early detection and management strategies.
Methods: This study aims to evaluate the efficacy of color Doppler and MDCT Angiography in assessing lower limb peripheral arterial diseases. Conducted over twenty-four months, the cross-sectional study involved clinically suspected symptomatic cases aged 30 years and above, presenting at a tertiary care center. Patients underwent thorough clinical examination and demographic assessment before undergoing Color Doppler flowmetric studies and MDCT angiography.
Results: Results revealed that color Doppler, with its ability to measure wall thickness and vascular flow, demonstrated promising diagnostic efficacy compared to MDCT angiography. Additionally, follow-up records of patients undergoing medical or surgical interventions provided valuable insights into the practical utility of these imaging modalities in guiding clinical management decisions.
Conclusions: Overall, this study underscores the importance of non-invasive imaging techniques in diagnosing and evaluating the progression of peripheral arterial diseases. It suggests that Color Doppler Ultrasound, with its accessibility, low cost, and radiation-free nature, could serve as a suitable alternative to MDCT Angiography for assessing arterial characteristics in patients with PAD.
Anthropometric measurements and agility performance in amateur roller skaters: a correlational study
Authors: Salekar Bhagyashree C. , Palekar Pramod , Bhawsar Pooja , Palekar Tushar J.
Published: June 2024

Background: Research on the body structure of roller skaters has identified that anthropometric attributes are desirable in this sport for a better performance. Leg length has a definite decisive advantage in sport. Explosive leg power is very essential for roller skating as it requires speed, agility and quickness which can be associated with lower limb muscle girth. Hence, it is important to examine the contribution of limb length, calf and thigh muscle circumference, to agility performance.
Methods: 30 healthy amateur roller skaters within age group of 6 to 14 years were assessed for anthropometric measurements – lower limb length, thigh circumference, calf circumference measurement. Participants performed a standardized warm-up of moderate-intensity jogging (5-10 min), static and dynamic stretching (5 min) and brief bouts of high-intensity running, including changes in direction on the ground. They performed agility tests in order of Edgren side step test, t-test and Illinois agility test based on test direction, progressing from uniplanar movements to biplanar and concluding with multidirectional movements. Each test was performed twice with 1-minute rest period between each trial, and a 2 min rest period between each test.
Results: Pearson’s correlation showed that lower limb length have a moderately positive correlation with agility (r=0.5-0.7) whereas calf and thigh muscle circumference have a strong positive correlation with agility (r=0.7-0.8) stating that anthropometric measurements have a statistically significant correlation with agility performance with p<0.05.
Conclusions: Anthropometric measurements such as lower limb length, thigh and calf circumferences have a moderate to strong positive correlation with agility performances of healthy amateur roller skaters within the age group of 6-14 years..
Effect of aqueous extract of Ardisia colorata Roxb. leaves on blood sugar in Albino rats
Authors: Ningthoujam Geetanjali , Datta Swagata , Zosangpuii Christina , Meena Nameirakpam , Medhabati Mayanglambam
Published: June 2024

Background: Diabetes is a group of common metabolic disorders that share the characteristic features of hyperglycemia. Ardisia colorata Roxb. leaf extract (AEAC) is reported to be used for the treatment of diabetes. So, the present study is undertaken to evaluate the effect of Ardisia colorata Roxb. leaves on blood sugar by using different hyperglycemic models in Albino rats.
Methods: In both the glucose induced hyperglycemia model and streptozotocin induced hyperglycemia model, animals were divided into 4 groups of 6 animals each. 2% gum acacia were taken as control (group 1) and glimepiride 0.2 mg/kg were taken as standard (group 2). Hyperglycemic activity was checked at two different doses i.e., 200 mg/kg (test 1) and 400 mg/kg (test 2) of AEAC (given at group 3 and group 4 respectively) by assessing the decreased in blood sugar level using glucometer by following methods of these two models. The results were analyzed using one-way analysis of variance (ANOVA) followed by Bonferroni test. P value <0.05 was considered significant.
Results: Test 2 showed significant reduction in blood sugar level when compared to control after 1 hour and 2 hours of drug administration in both the models whereas test 1 showed significant reduction only in glucose induced hyperglycemia model. There was significant difference when test 2 was compared to test 1 after 1 hour and 2 hours in both the models.
Conclusions: The present studies showed that AEAC leaves produced significant reduction in blood sugar level. It might be suggested that flavonoids, alkaloids, tannins and terpenoids were responsible for the hypoglycemic activity of AEAC leaves.
The anatomical relationship of the superficial branches of radial nerve: a cadaveric study
Authors: Gupta Renu , Ghatak Surajit , Nayyar Ashish Kumar
Published: June 2024

Background: The major superficial branches of the radial nerve like inferior lateral cutaneous nerve of arm (ILCNA) and posterior cutaneous nerve of forearm (PCNF) are susceptible to get injured during surgical procedure done in distal half of humerus.
Methods: In this study 25 voluntary donated cadavers were dissected to define the course and position ILCNA and PCNF of the radial nerve and their ramifications in relation to anatomical landmarks such as the lateral inter muscular septum or bony landmarks such as lateral epicondyle.
Results: The inferior lateral cutaneous nerve of the arm arose from the radial nerve at the lower part of the spiral groove, at a mean of 14.8 cm proximal to the lateral epicondyle and 4.2 cm proximal to the uppermost fibres of the brachioradialis muscle. The posterior cutaneous nerve of the forearm arose from the inferior lateral cutaneous nerve at a mean of 6.7 cm proximal to the lateral epicondyle.
Conclusions: The described lateral approach permits assessment of any part of the radial nerve and reduces the risk of iatrogenic injury.
Incidence of Hortaea werneckii in a tertiary care centre in Maharashtra
Authors: Mehta Sakshi , Bhakre Jayshree , Kante Sharvani , Harbade Mangala S. , Iravane Jyoti A.
Published: June 2024

Background: Hortaea werneckii, a melanized yeast-like fungus is the cause of Tinea nigra, a superficial dermatomycosis. The lesions are differential diagnosis of melanocytic lesions. Tinea nigra mainly affects people in the temperate or subtropical climates with well-demarcated, expanding, hyperchromic plaques on the palms or soles.
Methods: Skin scrapings from various lesions with suspected fungal aetiology were received after clinical assessment and were subjected to laboratory procedures, including direct KOH (10%) analysis, culture on Sabouraud dextrose agar (SDA), and incubation at 25°C and 37°C for 28 days which was further confirmed by lactophenol cotton blue preparation and slide culture.
Results: Out of 295 samples examined, a total number of 15 samples were positive for Hortaea werneckii in the time period of 1st January 2023 to 31st December 2023. 7 patients had lesions on both palmar as well as plantar region (46.66%), 3 on palmar and plantar region each (20%), 1 (6.66%) on scalp and 1 (6.66%) on face and scalp. The skin scrapings were taken and examined in 10% KOH wet mount which showed positivity of 11 (73.33%) samples. The primary isolation of the fungus was done on SDA.
Conclusions: Hortaea werneckii is the most common cause of Tinea nigra. Pigmented patches of Tinea nigra may be confused with other inflammatory or neoplastic aetiology. For Tinea nigra, skin scrapings are sufficient for diagnosis by KOH mount and culture on SDA. Generally, the lesions resolve within 2 weeks of adequate treatment. To conclude, a high suspicion should be maintained to timely diagnose the disease, avoid unnecessary invasive investigation and early administration of treatment.
Study of formation of dorsal venous arch of the hand in both sexes
Authors: P. Ramesh , Kumar T. Dhinesh , C. Deepa , T. Kalyani , D. Anupama
Published: June 2024

Background: The dorsal venous arch (DVA) is a superficial venous network of the hand. It is formed by the union of four dorsal metacarpal veins in the middle of the dorsum of the hand. Medially and laterally the dorsal venous arch continues as basilic and cephalic veins respectively. Commonly, these veins are chosen for intravenous procedures, the most prominent being the dorsal metacarpal veins. The present study aims to study the different types of formation of dorsal venous arch in both the sexes.
Methods: 100 hands of voluntary participants were studied (50 male hands, 50 female hands) in St Peter’s Medical College, Hospital and Research Institute, Hosur, Tamil Nadu. The rubber tourniquet was tied 1 hand breadth above the wrist to make the veins prominent and observed the pattern of formation of DVA with laterality and sex being noted.
Results: In the present study, the formation of dorsal venous arch, commonly type 2 pattern in males and type 1 pattern in females were observed. The prominent venous pattern was observed in males and on the lateral side of the dorsal metacarpal veins.
Conclusions: The present study carried out to enlighten the vascular surgeons, postgraduates, interns, paramedics and nurses regarding the knowledge of different types of the formation of dorsal venous arch of hand, so that hassle free procedures can be carried out on these superficial veins of hands at the time of routine and emergency situations.
Sputum positivity status for acid fast bacilli in patient attending a designated microscopy centre of a tertiary care hospital, Lucknow
Authors: Raza Adil , Jamali Sana , Srivastava V. K.
Published: June 2024

Background: Tuberculosis is a contagious bacterial disease that is considered to be one of the deadliest diseases worldwide. It affects lungs and causes pulmonary TB. Today in India, every minute 3 to 4 people die of TB, more than 1000 die every day and more than 5 lakhs die every year. Demonstration of AFB in smear has a great important in control of TB, as smear positivity directly correlates with infectivity.
Methods: It was a cross-sectional study. It lasted over a period of 6 months (January to June). Samples were collected from patients attending TB and Chest OPD of IIMS&R Hospital and sent for AFB examination by Ziehl-Neelsen (ZN) microscopy at microbiology lab. Patients with symptom of cough lasting for more than 2 weeks were included.
Results: Out of 718 patient’s samples, 128 were smear positive by ZN staining method. Out of which 81 (63.28%) were males and 47 (36.72%) were females. According to age distribution 35 (27.35%) were <30 years of age, 68 (53.12%) were in between 30 and 60 while 25 (19.53%) were >60 years of age. 105 (82.03%) positive patients were found to be from rural area and remaining 23 (17.9%) patients belong to urban area. 29 patients were found to have a past history of TB of 1 year. Out of 128 positive patients none were smokers. 25 (19.53%) were tobacco chewers. 11 (8.56%) were contact with a case of TB.
Conclusions: Demonstration of AFB in smear has a great important in control of TB, as smear positivity directly correlates with infectivity. Z-N staining method is the most commonly used worldwide.
Digital therapeutics for cardiovascular diseases in India- a low-middle income country’s perspective: a systematic review
Authors: Prabhughate Ashwin , Gharat Chetan
Published: June 2024

Cardiovascular disease acts as a predominant cause for death in India. Digital technology has shown great potential in delivering cardiac rehabilitation remotely to patients with minimal cost implications. The main aim of this study was to analyze the comprehensiveness and effectiveness of digital cardiac rehabilitation intervention for cardiovascular patients on the Indian Cardiology Continuum. A comprehensive literature search was performed in Pubmed, Springer-link, Elsevier, Embase and Google Scholar. The selected tenure for this review was 10 years (16 January 2014 to 16 January 2024). Authors separately conducted the assessment of the selected studies by using the quality assessment of diagnostic accuracy studies. Microsoft excel 2020 was used for statistical analysis and graphical designs. A total of 3 articles were included in the review. The median sample size of the included studies is 153 (30-304), mean study timeline is 7.67 months (3-17), and median follow-up period is 6 months (3-12). Digital therapeutics showed significant reduction in Systolic Blood Pressure (34.67 mmHg) and Diastolic Blood Pressure (21.97 mmHg) in stage III hypertensive patients. Medication adherence of patients using digital therapeutics was 90%, while 10% patients remained non-adherent/dropped out of the trial. Digital therapeutics builds a lucrative bridge to help cardiovascular patients cross over into improved QoL, in place of traditional face-to-face CR regimes. Further research is required to improve comprehensiveness and clinical effectiveness of the digital cardiac rehab programs on a long-term basis in India.
Isolated pancreatic hyadatidosis
Authors: Suman Sumit Kumar , Gowda H. S. Dharshan , Kumar P. Shravan , Katepally Sai Krishna , Gaurav Anamika
Published: June 2024

Pancreatic hydatidosis is a rare infection with a frequency of less than one percent. Most of the abdominal hydatid cysts occur in liver. The purpose of this study was to present our experience of few rare cases of isolated pancreatic hydatid cyst, its presentation and management. Five pancreatic hydatidosis patients admitted in Gandhi Medical College, Secunderabad between 2021 to 2023 were reviewed. Demographic characteristics, clinical findings, and laboratory data were collected. Commonest symptom was pain in left upper quadrant followed by jaundice. The preoperative diagnosis was established in 3 patients by combination of ultrasonography, computed tomography, endoscopic ultrasonography and serological tests. Surgical treatment was done in three cases and two were medically treated. None of them had recurrence during a follow-up of 1 year. Pancreatic hydatid cyst even if rare should be considered in any pancreatic cystic mass in endemic countries like India.
Gangrenous cholecystitis as an incidental finding during emergency laparotomies for acute abdomen at a tertiary centre: a case series
Authors: Gopal Vaibhav Raj , Rai Priyanka , Singh Sunil Kumar , Singh Amarjot , Bhargav Mithlesh , Gulfran M.
Published: June 2024

Gangrenous cholecystitis is an uncommon cause of acute abdomen in surgery emergency. Most of the times, diagnosis is settled intraoperatively as signs and symptoms are non-specific. CT scan of abdomen can help in making a diagnosis but should be done only if the patient is stable. Here we have reported three cases in which laparotomy was done in view of acute abdomen with signs of peritonitis and gangrenous cholecystitis was found as an incidental finding. One patient had spontaneous gangrenous cholecystitis with gall bladder perforation with biliary peritonitis. The second patient had gangrenous gall bladder perforation secondary to gall bladder malignancy and the third patient had spontaneous gangrenous cholecystitis with terminal ileal stricture presenting as acute intestinal obstruction. A decision to perform cholecystectomy in such cases depends on the feasibility, general condition of the patient and the cause of gall bladder perforation.
Unexpected clinical and functional recovery in patients with chronic traumatic chronic spinal cord injury: a case series
Authors: Ganvir Suvarna , Toshniwal Gaurav , Harishchandre Maheshwari
Published: June 2024

Motor recovery in traumatic spinal cord injury (tSCI) is reported to reach its plateau by 1 year and maximum recovery period is reported to be 2 years. Acute rehabilitation is very well documented in literature with patients reporting for functional rehabilitation immediately after shock period is over. However, the scenario being a bit different in rural areas with comparatively less awareness about role of physiotherapy, patients with tSCI reports at later stages. Reported here is a series of chronic tSCI cases who showed remarkable clinical and functional recovery in short time. Aim of this study is to report recovery in patients with chronic tSCI and to compare the patient outcomes with expected outcomes. Conventional physiotherapy was given 5 days a week with minimum 45 mins treatment. Baseline assessment at admission and at discharge was recoded. Improvement was recorded with spinal cord independence at different time points. Nine patients below 40 years of age, average duration of injury 6.2 years were treated for average of 8 months. NLI did not change in 3 patients whereas in 6 patients NLI moved 2 segments down. Mean change in SCIM score was 10 between admission and discharge. Functional status was compared with expected parameters and was found to be improved by 70%, suggesting had they come at early stage, expected recovery could have been achieved. Clinical and functional recovery in patients with tSCI may occur even after 2 years post injury.
Management of pilonidal sinus in sacrococcygeal region using Limberg transposition flap with acceptable and safer outcome: a case series
Authors: Chatterjee Sudipta , Chaki Supratim
Published: June 2024

Sacrococcygeal pilonidal sinus is a disease that arises from chronic irritation and secondary inflammation of hair follicles located in the sacrococcygeal and natal region, commonly seen among the young male adult population. There are multiple treatment options available ranging from non-medical to surgical procedure. The present study aims to evaluate the efficacy and complications of Limberg flap reconstruction surgery. 8 consecutive patients underwent Limberg flap reconstruction from October 2022 to February 2023 at Midnapore Medical College with a median follow-up duration of 12 months and were evaluated for various parameters. All patients successfully underwent reconstructive surgery, with minimal post- operative pain, average hospital stay for 7 days, returned to work after 3 weeks, with only 1 patient having superficial surgical site infection (SSI), but no flap necrosis, seroma formation, recurrences so far. Overall the Limberg flap technique is an effective and reliable technique having fewer post-operative complications, low recurrence rate, easily performed with patient satisfaction, and is emerging as the standard of care.
Anesthesia management in cesarean section with severe preeclampsia and non-reactive nonstress test
Authors: Manuaba Ida Bagus Gede Raden Shuwawhibawa , Widana I. Wayan
Published: June 2024

Maternal death and morbidity remain a global health issue. It is noted that 15%-20% of maternal deaths are due to complications of hypertension in pregnancy, namely preeclampsia. In cases of preeclampsia requiring cesarean section, anesthesia is necessary. A 23-year-old pregnant woman presented with complaints of decreased fetal movement for the past 2 days. She also reported headache and decreased vision. Physical examination revealed increased blood pressure (160/110 mmHg) and +1 protein in urine. Nonstress test showed non-reactive results. The patient was diagnosed with severe preeclampsia at 37 weeks 1 day gestation and underwent an urgent cesarean section. Anesthesia was managed using a subarachnoid block with bupivacaine 0.5% 12.5 mg, resulting in total block. The operation lasted 1 hour, and a baby boy was delivered with a weight of 1950 gm, length 50 cm, and APGAR score 7-8-9. Anesthetic management in preeclampsia cases must prioritize the safety of both mother and baby. Each anesthesia technique has its advantages and disadvantages.
Spontaneous retroperitoneal hematoma, an uncommon case of acute surgical abdomen in a patient with hemophilia: case report
Authors: Martínez-García Erik , Roman-Chávez Pedro D. , Martínez-Canseco Karla A. , Galván-Ortiz Marco A. , Figueroa-Zariñana Victor H.
Published: June 2024

Hemophilia A is an X-linked hereditary disorder with a predilection for men. A worldwide incidence of 1 in 5 000 inhabitants is estimated. Currently, there is no curative treatment, which can lead to the development of multiple complications. However, abdominal presentations related to acute abdomen are uncommon and require surgical treatment. Similar cases are related to psoas muscle hematoma and hemophilic pseudotumors. We presented a 25-year-old male diagnosed with hemophilia A with acute abdominal pain and peritoneal irritation signs. After evaluation, we decided to perform a laparotomy, which reported a hematoma in the right mesocolon from the ileocecal valve to the hepatic flexure with right colic artery disruption. After seven days, he was discharged due to clinical improvement, and we indicated an outpatient general surgery follow-up. Acute abdomen caused by a retroperitoneal hematoma in patients with hemophilia is uncommon. Therefore, its management is still controversial. We concluded that a surgical approach might reduce the risk of complications in patients with poor clinical courses.
Spontaneous rupture of extensor pollicis longus after distal radius fracture: a case report
Authors: Jiménez-Yarza Miguel , Téllez-Pallares Fernando , Olvera-Yarza Francisco Alberto , Solano-Vázquez José Gerardo
Published: June 2024

Extensor pollicis longus tendon rupture, rare and linked to trauma or arthritis, is prevalent post-distal radius fractures. Mechanisms include friction and vascular issues. Manifestations occur 4-8 weeks’ post-trauma. We present the case of A 31-year-old male, post-motorcycle accident surgery for distal radius fracture, faced extensor pollicis longus tendon rupture. A surgical intervention transposed the extensor indicis proprius tendon, restoring thumb function. Successful closure and splinting showed no movement limitations at the 12-week follow-up, prompting a rehabilitation referral. Distal radius fracture treatments, whether operative or non-operative, entail risks of extensor tendon complications, notably extensor pollicis longus. While direct suture repair is optimal, studies endorse effective restoration of thumb function through tendon grafts, particularly utilizing the extensor indicis proprius. Rupture of the extensor pollicis longus, while uncommon, often occurs with distal radius fractures. Extensor indicis proprius grafting is recommended for superior efficacy over alternatives, emphasizing the need for accurate and timely diagnosis.
Flow diverter stent as a definitive endovascular strategy to obliterate acute spontaneous rupture of brain aneurysmal subarachnoid hemorrhage in elderly: a case report in Indonesia
Authors: Soetanto Gamaliel Wibowo , Usman Fritz Sumantri
Published: June 2024

Spontaneous rupture of brain aneurysmal subarachnoid hemorrhage (aSAH) is a debilitating disease, half of which occurs in individuals under 50 years old. Challenges in its management arise from the decision-making process regarding the preferred method of definitive aneurysm obliteration, whether through surgical intervention or endovascular approach. This study described the role of flow diverter stent as an effective endovascular approach to obliterate aSAH in the acute phase. A 70-yearold female presented with thunderclap headache, slight right hemiparesis, and pupillary-sparing left oculomotor palsy corresponding with ruptured brain aSAH. Endovascular management of flow diverter stent was preferred and inserted within the third day onset. Double antiplatelet was administered prior to and following the procedure. Three-day follow-up showed resolution of brain aSAH with no neurological sequelae. Flow diverter stent offers several advantages over coiling when treating wide-neck, giant, saccular, or fusiform aneurysm. It is also safer for elderly, especially with multiple comorbids, compared with clipping. However, it has risks of either parent/ distal artery occlusion due to its thrombogenic properties or the potential for rebleeding following dual antiplatelet administration. Effective management and thorough evaluation are essential to maximize the likelihood of favorable outcomes when employing this approach. Flow diverter stent is a promising endovascular management for ruptured brain aSAH, particularly in elderly with many comorbids and wide neck/ giant aneurysm at anterior circulation which is not candidate for coiling or clipping. It is also crucial to monitor, evaluate, and manage risk of rebleeding and thrombosis to ensure long-term success of this management approach.
Bowel obstruction in adults due to ascariasis
Authors: García Gabriel Gutiérrez , Soto Faustino Rubio
Published: June 2024

In the world the most frequent and cosmopolitan parasitosis of all human helminthiasis is that caused by ascaris lumbricoides this sickness affects 1.5 billion people around the world, and approximately 60,000 people die annually as the result, about of complications, the intestinal obstruction being the most frequent complication from 38 to 87.5%, the humans become infected by ingesting the larvated eggs of the parasite. OPS report a prevalence of 46 million children between 1-year-old and 14 years old, the most importance prevalence occurs in children between 2 years old and 10 years old, decreasing significantly from the 15 years old. Mexico report through SINAVE (SEMARNAT 2020) a national incidence of 24,203 cases, the State of Sinaloa a total of 690 cases (2.8%). Lack of sanitation, drinking water and precariousness are risk factors for complications such as obstruction a complication that can progress to death.
A peak into metastatic Leydig cell tumor: a rare case report
Authors: Bhandari Hitesha , Patil Ashwini M. , Pawar Prathamesh M. , Bagul Kiran G. , Pawar Suraj B. , Nilapwar Rishikesh D. , Pawar Aditya S.
Published: June 2024

Testicle tumors are a rare entity among men population, comprising 1-1.5% of all cancers. The Sex cord Stromal tumors contribute just 4% of all testicular cancers, only 10% of them are malignant. Most common sex cord-stromal tumors are the Leydig cell tumor, comprising of 75 to 80% of the total. Incidence is bimodal involving children and adults between 30 and 60 years. The commonest metastatic sites are regional lymph nodes, lung, liver, and bones. Here, we report a case of late metastatic relapsed Leydig cell tumor in a 38-year-old male. Patients with metastatic Leydig cell tumors have poor prognosis and standard treatment recommendations are unclear.
Vasculitis masquerading as a mass: a case report of Takayasu arteritis in a 28-year-old male
Authors: Sirohi Parmendra , Sharma Peeyush , Gupta Rahul , Vishwakarma Manaswi
Published: June 2024

Takayasu arteritis is a chronic vasculitis mainly involving the aorta and its main branches most commonly subclavian and carotid. It induces clinically varied ischaemic symptoms due to stenotic lesions or thrombus formation, including blindness, retinal haemorrhage, pulselessness, aortic regurgitation and congestive heart failure due to dilatation of the ascending aorta. More acute progression causes destruction of arterial wall, leading to the formation of aneurysms and rupture of the involved arteries. Here we present a case of Takayasu’s arteritis in a 28-year-old male who presented with nonspecific symptoms of fever and neck pain with palpitations and feeling of pulsations in right side of neck since last 20 days and was eventually diagnosed as arteritis. This case shows that it can present with many non-specific symptoms and can be diagnosed with proper examination and a high index of suspicion due to its nonspecific overlapping features with many diseases.
Strategies for managing postmenopausal bleeding: a clinician's perspective
Authors: Gupta Sumedha , Kalwaniya Dheer Singh
Published: June 2024

Postmenopausal bleeding (PMB) poses a diagnostic challenge due to the varied presentation of endometrial pathologies ranging from benign endometrial atrophy to the possibility of endometrial carcinoma. Although the incidence varies with patient characteristics, it warrants thorough evaluation. Risk factors such as obesity and hormone use should guide assessment. Bleeding may originate from various gynecological and non-gynecological sites, demanding meticulous history-taking and examination. Transvaginal sonography (TVS) is typically the initial step, yet its accuracy in excluding carcinoma remains debated. Invasive procedures like hysteroscopy and endometrial sampling offer higher accuracy but are more intrusive. The optimal diagnostic strategy remains uncertain, necessitating focused research for enhanced accuracy. TVS-guided assessment with an endometrial thickness (ET) threshold of >4 mm prompts evaluation and endometrial sampling. Progestogen therapy mitigates endometrial cancer risk associated with estrogen use, with atypia-hyperplasia necessitating vigilant monitoring and possible hysterectomy. Patient counselling on treatment options is crucial. In summary, PMB warrants a systematic approach integrating imaging, histological assessment, and tailored therapy guided by risk factors, final diagnosis and patient preferences.
CRISPR/Cas9-mediated genome editing: from basic research to gene therapy
Authors: Goel Rajeev
Published: June 2024

CRISPR/Cas9 mediated genome editing is one of the most significant molecular tools discovered to edit the desired genes. It has ushered in a new era of novel possibilities of gene therapy. CRISPR/Cas9 system was originally observed as a part of the adaptive immune system in bacteria. It later on was adapted to carry precise and targeted alterations to the DNA in human cells to be used for gene therapy to correct genetic disorders and treat various severe diseases associated with the genetic changes. Besides this, the CRISPR/Cas9 system has been employed in pharmacogenomics to develop new drugs based on the patient’s genes, in modifying the organisms for research and even for diagnostic purposes in developing CRISPR based COVID-9 test. The recent approval of a CRISPR/Cas9 cellular gene therapy by FDA named “Casgevy” to treat sickle cell anemia is a testimonial to the potentials of CRISPR/Cas9 system in developing innovative gene therapies. This review details the mechanisms of CRISPR/Cas9 gene editing and its utilization in the ongoing clinical trials in the treatment of not only the monogenic disorders like sickle cell disease, thalassemia, and genetic blindness but also in treating multi-factorial diseases like cancers, cardiac diseases, diabetes, autoimmune diseases, viral infections such as human immunodeficiency virus (HIV) etc. An attempt has also been made to discuss the various limitations, challenges and ethical frameworks encompassing CRISPR/Cas9 based gene therapy in clinical settings.
A VIÃ?VA DE NAIM E O ANDROCENTRISMO NA SOCIEDADE MEDITERRÃ?NEA DO SÃ?CULO I D.C.
Authors: Da Costa Rubens Alves
Published: June 2024

Resumo: o artigo analisa o androcentrismo na cultura patriarcal mediterrânea do século I d.C. numa perspectiva sociocultural. Entende as relações de assimetria como uma construção social de legitimação de posturas e práticas que marginalizam e discriminam mulheres
e crianças em seus contextos. Mostra pela exegese alguns textos sagrados como reforçadores anti-androcêntricos e viabiliza o cristianismo como um movimento sociorreligioso libertador.
Palavras-chave: Religião. Evangelho de Lucas. Relações sociais. Androcentrismo e Libertação.
Anesthetic management of broncho- alveolar lavage in pulmonary alveolar proteinosis: A case report
Authors: Sarvesh S P S Abinav , Gaiwal Sucheta , Prasad Nimitha
Published: June 2024

: Pulmonary alveolar proteinosis (PAP) is a very rare, life threatening, noninflammatory, diffuse lung disorder characterized by dense accumulation of lipo-proteinaceous material within the alveoli causing hypoxemia, restrictive lung disease leading to respiratory failure. Whole lung lavage (WLL) is considered as the treatment of choice which includes infusing warm saline in the lungs and draining it out with the lipo-porteinaceous materials thereby clearing the obstruction. WLL requires good team co-ordination between the anaesthesiologists, pulmonologists and physiotherapists. The procedural course is challenging in many aspects like hypoxaemia and hemodynamic fluctuations. Post procedure short term mechanical ventilation is commonly required.

: A 45 year old female, diagnosed case of PAP presented with dyspnea at rest with increasing oxygen requirement. After clinical examination and investigations, due to severity of the disease, broncho-alveolar lavage (BAL) of left lung was planned with subsequent right lung BAL after few days. During the procedure, desaturation upto 78% was noted. With meticulous corrective measures, saturation picked up and the procedure was completed uneventfully. Post-operatively patient was mechanically ventilated and extubated after 32 hours.

: WLL is the treatment of choice for PAP which involves multidisciplinary approach with mulitple challenges. Pre-oxygenation, adequate lung isolation with left sided double lumen tube (DLT), one lung ventilation with positive end expiratory pressure (PEEP), vigilant intra-operative monitoring, cautious use of positional manoeuvres and recruitment manoeuvres with a good teamwork is the key for successful outcome.
Cephalosporins in pediatrics: Navigating antimicrobial resistance impact and adverse effects – A comprehensive review
Authors: Mathew Midhun , Verma Aanya , Gigi Godwin Geo , Patil Harsh , Shaikh Arshan
Published: June 2024

Antibiotic overuse and abuse are the primary causes of microbial resistance and the rise in healthcare costs, and human factors such as abuse, and misuse have accelerated the spread of AMR. Cephalosporin drugs are the most commonly administered drugs to pediatric populations due to their high efficacy and low side effect profile. This study aims to assess which class of antibiotic is mostly used the prevalence of third-generation cephalosporin use in pediatric patients and its impact on the development of resistance.

A PubMed database and reference lists of pertinent research on antibiotic usage, antimicrobial resistance, and prescription use of cephalosporin medicines were used to search the English-language literature. The publications linked here were retrospective, prospective studies using empiric antibiotic therapy for paediatric patients.

A review of relevant literature confirms that Cephalosporins are more prioritized than Penicillins due to their low toxicity and high safety effect, and their higher stability to beta-lactamases. Third-generation cephalosporins are more commonly used in the pediatric population, leading to resistance development and adverse effects such as pseudolithiasis and reversible cholelithiasis. Ceftriaxone has the potential to precipitate ceftriaxone-calcium salts complex in the lungs and kidneys and can cause allergic reactions (Skin Manifestations), gastrointestinal problems, haematological abnormalities, and gallbladder resolution deficit. Ceftriaxone-induced urticaria, rash, exanthema, and pruritus are the most common adverse effects.

According to studies, the usage of third-generation cephalosporins in pediatric patients is increasing dramatically, which may play a role in the development of resistance and increased risk of production of unwanted reactions such as dermal allergies and other side effects. To reduce the dangers associated with cephalosporin usage, it is critical to follow proper prescription guidelines and prevent inappropriate or extended use of antibiotics. This can be reduced by utilizing narrower-spectrum antibiotics where necessary.
Breaking bald: Unraveling the mysteries of hair loss and modern treatments
Authors: Rathi Karishma , Pingat Priyanka , Bhole Ritesh , Mishra Swara , Singh Subhashini
Published: June 2024

Alopecia, commonly known as hair loss, presents a multifaceted challenge affecting millions worldwide. Recent advances in hair loss treatment and prevention offer hope to individuals grappling with this condition. This comprehensive overview delves into the causes of hair loss, encompassing genetics, hormonal imbalances, nutritional deficiencies, stress, and underlying medical conditions. The COVID-19 pandemic has also revealed unique patterns of hair loss i.e., telogen effluvium, prompting ongoing research and therapeutic exploration.

Current treatment options, including medications like minoxidil and finasteride, surgical interventions such as hair transplants, and non-surgical techniques like laser therapy and platelet-rich plasma therapy, are examined in detail. While effective, these treatments come with limitations and potential side effects, necessitating careful consideration.

Looking ahead, researchers are exploring innovative approaches to combat hair loss, from targeted medications to gene therapies and stem cell-based interventions. Advanced delivery methods using nanotechnology and biomaterials hold promise for more effective and safer solutions in the future.

Recognizing the psychological impact of hair loss, this review emphasizes the importance of addressing the emotional aspects of this condition to enhance overall patient well-being. The future holds the potential for more holistic and successful treatments in the ongoing battle against hair loss, offering optimism to those seeking solutions.
Prevalence and patterns of mite allergy in bronchial asthma patients visiting a tertiary care centre
Authors: Patel Bhaveshkumar Manilal , Chakravarti Chiragkumar Hasmukhbhai , Dsilva Jerin James , Shah Arti Dhawal , Jain Medha , Naik Parshwa Ramesh , Patel Princee Rashminbhai
Published: June 2024

Among obstructive respiratory conditions asthma has been frequently affecting individuals from all age groups. Events that lead to an asthma attack is an interplay of multifactorial factors between host and the environment. Earlier evidences have indicated that aeroallergens play a major role in the pathogenesis of asthma and needs further probing.

To identify the most common mites causing allergy and its prevalence in patients with bronchial asthma using skin prick test.

The study population included in this study were cases diagnosed as Bronchial Asthma on spirometry basis. The cases underwent a detailed history, physical examination, routine investigations and a Skin Prick Test (SPT). SPT for aeroallergens was done using CREDISOL kit and the reaction was observed in 15 mins, wheal diameters more than 3 mm were recorded as sensitization to the allergen and interpreted accordingly.

The prevalence of Mite allergy was observed more in females when compared to males. Most common House Dust mite was found to be Dermatophagoides pteronyssinus (72.5%) followed by Dermatophagoides farinae (66.25%) and Blomia tropicalis (61.25%). Different patterns of sensitisation were observed. Either to a single mite, any two mites and all three mites.

: The study concluded that D. pteronyssinus was the most common allergen in the study population of Bronchial Asthma.
Role of platelet rich plasma therapy in the treatment of alopecia areata and atrophic acne scars
Authors: Gabani Amisha Ravjibhai , Manjunath Sumana , Popat Jiya Vijaykumar , Vora Deval Nitinbhai , Patel Ravindrakumar Vishnubhai
Published: June 2024

Alopecia areata and atrophic acne scars are conditions that significantly impact patients' quality of life. Platelet-rich plasma (PRP) therapy has emerged as a promising treatment modality due to its high concentration of growth factors. This study aimed to evaluate the efficacy of PRP in alopecia areata and acne scars.

This was a prospective observational study conducted on 50 patients each of alopecia areata and atrophic acne scars treated with intradermal PRP injections at monthly intervals for 6 months. Alopecia areata severity was assessed using a SALT score. Acne scars were graded as per Goodman and Baron's quantitative scar grading system.

In alopecia areata patients, the mean SALT score reduced significantly from 35±6 at baseline to 22±3 at 6 months post-treatment (p<0.001). At the study's conclusion, 66% of patients had complete hair regrowth, while 20% had partial and 14% had no regrowth. Higher grade 3 and 4 scars reduced significantly from 86% to 8% (p<0.001). For acne scars, patients with grade 1 scars increased from 0% to 74% after PRP therapy. Mild adverse effects like pain and erythema were seen.

PRP therapy showed statistically significant improvement in SALT scores in alopecia areata and acne scar grades over 6 months. It was well-tolerated. PRP can be considered an effective, safe, and economic treatment modality for chronic alopecia areata and atrophic acne scars with sustained benefits.
Expert opinion on the prescription practice of azelaic acid for the management of acne in various age groups in Indian settings
Authors: S Manjula , M Krishna Kumar
Published: June 2024

Azelaic acid has been indicated to treat various common dermatoses including acne vulgaris, perioral dermatitis, inflammatory rosacea, melasma, and post-inflammatory hyperpigmentation due to its various modes of action and significant therapeutic efficacy.Considering the scientific advances contributing to the refinement of therapeutic options, it was important for clinicians to stay updated regarding the current treatment standards.

This cross-sectional survey employed a multiple-response questionnaire to gather opinions of dermatologists who had experience in treating acne with a special focus on azelaic acid in Indian settings. There was a total of 28 queries and the majority of them were on the management of acne using azelaic acid monotherapy or in conjunction with oral antibiotics.

The survey involved 467 participants, and 35% of them preferred the use of azelaic acid for the management of acne, melasma, and post-inflammatory hyperpigmentation disorders. About 6 to 8 weeks of optimal duration was recommended by 56% of the respondents for treating acne. Azelaic acid with glycolic acid was preferred by 66% of the respondents for acne treatment. Moreover, about 56% of the respondents preferred azelaic acid in combination with oral antibiotics for the treatment of mild-to-moderate papulopustular acne. Approximately 50% and 46% of respondents reported that they occasionally recommend topical azelaic acid as a treatment for keratosis pilaris and lentigo maligna, respectively. About 37% of the respondents preferred a daily dosage of 20% azelaic acid for the effective management of acne, melasma, and post-inflammatory hyperpigmentation.

For the treatment of mild-to-moderate papulopustular acne, the use of azelaic acid in conjunction with other oral antibiotics was advocated. Experts preferred a daily dosage of azelaic acid to achieve better treatment outcomes in patients with acne, melasma, and post-inflammatory hyperpigmentation where they also endorsed for acne management in pregnant women, emphasizing its safety and efficacy.
Platelet rich plasma therapy- Myth vs Reality
Authors: Karia Umesh Karsandas , Bhabhor Megha , Doshi Yashika Jayesh , Rajwadi Ashish Ashokbhai , Shah Bela Jashvantlal
Published: June 2024

The transformative journey of Platelet-rich plasma, fueled by discovery of Platelet-Derived Growth Factor (PDGF), underscores its regenerative potential. This comprehensive exploration delves into fundamental characteristics and applications with a focus on its growing prominence in dermatology and aesthetics.

An open labelled interventional study was conducted at a tertiary health care centre in Western India to assess the efficacy and safety of PRP in various indications that mainly included patterned hair loss, post traumatic scars, acne scars, melasma and striae distensae. Patients were included in the study based on pre-determined inclusion and exclusion criteria. 6 sessions of PRP were conducted and response to therapy was evaluated using standard objective and subjective scores.

The study included 60% female cases with most patients in the age group of 31-40 years (51.2%). For patterned hair loss, the mean change in hair count at end of therapy was significantly greater for baseline to final (P < 0.005). For post-traumatic scars, the mean change in Vancouver scar score at end of 6th sitting was significantly greater for first visit to last visit (P < 0.001). For melasma, the mean change in Modified MASI score at end of treatment was significantly greater for first visit to last visit (P < 0.001). For acne scars and striae distensae, the mean change in objective assessment scores was significantly greater when compared to baseline (p<0.001). Side effects were predominantly early, with 13.8% reporting pain and 10% a burning sensation, while late side effects were minimal at 3.8%. Subjective improvement was reported by 76.25% of cases, ranging from 51% to 75%.

The study's results, while acknowledging certain limitations, emphasize PRP's potential efficacy in diverse dermatological conditions. The study underscores the correlation between dermatological conditions and treatment outcomes, highlighting the positive impact of PRP therapy.
A case series on fixed drug eruptions: Benign yet notorious
Authors: Pursnani Nikhil , Agrawal Prabhat , Gautam Ashish , Jafri Aqsa , Vij Sahil
Published: June 2024

Fixed Drug Eruption (FDE), is a mucocutaeous eruption occurring as a part of adverse drug reaction. They are often localised, well defined, and reoccur on the same sites upon restarting the drug. Here, we are reporting a case series of four patients who developed FDE after consuming these commonly used drugs.