JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH最新文献

{"title":"Preoperative Clonidine with Perioperative Dexmedetomidine for Attenuating Haemodynamic Responses and Blood Loss in Patients Undergoing Elective Transnasal Transsphenoidal Resection of Pituitary Tumours: A Randomised Clinical Study","authors":"Ravindra Singh Sisodia, Sunita Sharma, Medha Bhardwaj, Akansha Garg, Vijay Mathur","doi":"10.7860/jcdr/2023/65917.18473","DOIUrl":"https://doi.org/10.7860/jcdr/2023/65917.18473","url":null,"abstract":"Introduction: Transsphenoidal resection of pituitary tumours presents challenges for an anaesthesiologist due to haemodynamic fluctuations caused by intense nociceptive stimuli during different surgical stages. This relatively short procedure requires a smooth and rapid emergence for spontaneous airway control and assessment of surgical outcomes. Therefore, the chosen anaesthetic agent should provide effective haemodynamic control and facilitate rapid recovery. Alpha-2 agonists such as dexmedetomidine and clonidine are known to centrally decrease noradrenaline release, thus reducing sympathetic outflow. This could be particularly beneficial in minimising haemodynamic fluctuations during such surgeries. Aim: To compare the effects of preoperative clonidine and perioperative dexmedetomidine in attenuating haemodynamic responses and blood loss in patients undergoing elective Transnasal Transsphenoidal resection (TNTS) of pituitary tumours. Materials and Methods: A randomised, double-blinded study was conducted in the Department of Neuroanesthesiology at Mahatma Gandhi Medical College and Hospital, Jaipur, Rajasthan, India, over a period of one year, from February 2022 to January 2023. Sixty patients of either sex, aged 18-65 years with ASA I or II, scheduled for elective TNTS pituitary surgery, were enrolled and divided into group A and group B. Group A received clonidine tablets (3 mcg/kg) 180 minutes prior to surgery, while group B received intravenous (i.v.) infusion of dexmedetomidine (1 mcg/kg/min) over 10 minutes before induction, followed by 0.5-0.7 mcg/kg/hr. Group A received a placebo of 0.9% Normal Saline (NS) (50 mL). Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and Mean Arterial Pressure (MAP) were recorded at baseline, intubation, nasal pack insertion, endoscope insertion, and at various time intervals. Data obtained were analysed using unpaired sample t-test for independent groups, and Chi-square test was used for categorical data. A probability value of 0.05 was considered significant for both statistical tests. Results: The mean age of participants was 42±11 years for group A and 43±12 years for group B, with a male: female ratio of 66.6% to 33.3% in group A and 70% to 30% in group B, respectively. The mean Body Mass Index (BMI) was 26.4±3.2 in group A and 25.2±1.7 in group B. HR, SBP, and MAP decreased at various stages in group B compared to group A, and these differences were statistically significant (p-value <0.05). The study also found that the total consumption of propofol was significantly less in group B (220±38) compared to group A (282±140). Similarly, total fentanyl consumption was significantly lower in group B (5.83±1.60) than in group A (16.6±23.9). Although not statistically significant, total blood loss was also lower in group B (115±63) compared to group A (156±108). Conclusion: Intraoperative infusion of i.v. dexmedetomidine provides a reasonable choice compared to orally administ","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"2020 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136053376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Outcome of Tuberculosis in Patients with Diabetes under RNTCP in a Tertiary Care Centre, Chengalpattu, India: A Prospective Cohort StudyTreatment Outcome of Tuberculosis in Patients with Diabetes under RNTCP in a Tertiary Care Centre, Chengalpattu, India: A Prospective Cohort Study","authors":"P Parameshwari, Sanjai ., Niveditha ., Preetha ., H Gladius Jennifer, Latha Durai","doi":"10.7860/jcdr/2023/64830.18475","DOIUrl":"https://doi.org/10.7860/jcdr/2023/64830.18475","url":null,"abstract":"Introduction: Diabetes increases the risk of Tuberculosis (TB) by three times, and this bidirectional association is currently one of the major concerns. A stronger evidence base is required to clarify the impact of Diabetes Mellitus (DM) on the treatment outcome of TB. Aim: To compare the treatment outcome among diabetic and non diabetic patients on Category-I TB treatment based on the Revised National Tuberculosis Control Program (RNTCP). Also, to assess the various factors influencing the treatment outcome of TB among diabetic patients. Material and Methods: A prospective cohort study was conducted on 75 newly diagnosed TB patients enrolled for Category-I treatment Department of Pulmonary Medicine, Chengalpattu Medical College, Chengalpattu, Tamil Nadu, India, between October 2018 to November 2019. All patients with TB underwent blood glucose screening at treatment initiation and were categorised into two groups: with diabetes and without diabetes. Demographic details, family history of DM, smoking, alcohol consumption, and clinical profile were collected using a semi-structured questionnaire and followed-up for six months to assess their treatment outcome. The treatment outcome was compared statistically based on diabetes status using the Chi-square test. Results: The mean age of the study population was 49.9±0.5 years, with the majority being male 56 (74.7%). More than half of the study population belonged to a low socio-economic status. Among the study population, 42 (56%) were diabetic, with a mean blood glucose level of 242.7±80.5 mg/dL. Eighty-two percent had Pulmonary TB, with a 68% smear positivity rate among diabetic patients. In terms of treatment outcome, 44 (58.7%) were cured, 15 (20%) completed treatment, 10 (13.3%) were lost to followup, and 6 (8%) expired during the treatment course. Conclusion: Smear positivity and pulmonary TB were predominant among patients with diabetes. Treatment completion was lower, and mortality was higher among diabetic patients with TB.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136053636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perception of First Year Medical Students towards a New Histology Module in a Medical College in Eastern India: A Quasi-Experimental Study","authors":"Rituparna Basu, Tapati Roy","doi":"10.7860/jcdr/2023/62532.18474","DOIUrl":"https://doi.org/10.7860/jcdr/2023/62532.18474","url":null,"abstract":"Introduction: The post-COVID (Coronavirus) era, the transition of our country towards a competency-based curriculum, and our fundamental goal to improve students’ learning experience and academic performance expedite the need to introduce new strategies to the existing teaching-learning method based on principles of medical education in the form of a structured module. Among all subdivisions of anatomy, this is especially relevant for histology because microscopic anatomy poses a basic difficulty associated with the comprehension of microscopic details of human tissues through the novice, untrained eyes of the freshly-admitted first-year medical students. Aim: To study the perception of first year medical students towards the new histology teaching module. Materials and Methods: This quasi-experimental study was conducted among 85 first year medical students of Medical College, Kolkata, from May 2022 to October 2022, on histology teaching methods, comparing new histology modules versus traditional histology methods. A student survey was conducted to study their perception regarding the difficulties faced by them during their first-semester histology practical examination. After conducting a literature search, a new learner-centered histology module was designed and implemented among students to address these difficulties. Forty-eight histology sessions were conducted using the new module over a total duration of six months. Students’ feedback regarding the new module was recorded at the end of the sixth month. The collected data was analysed using Statistical Package for the Social Science (SPSS) software version 22.0 (trial version). Results: A total of 84 (98.8%) of students strongly agreed that because of the preliminary self-study time followed by discussions, quizzes, and brainstorming during the histology sessions, they had an improved understanding of the assigned learning areas. Additionally, 81 (95.3%) of students strongly agreed that their drawing skills of histology diagrams had improved due to drawing practice during the sessions. Furthermore, 83 (97.6%) of students reported an improvement in focusing and correctly identifying slides. Moreover, 82 (96.4%) of students felt that the regular formative assessments and immediate feedback improved their readiness for histology examinations. All of them agreed to the continued practice of the new module in future histology sessions. Conclusion: The students’ response towards the module was found to be positive. Addressing the students’ recommendations in the future would increase the chances of generating more support for it and enhancing their motivation towards improved academic performance in histology examinations.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"2020 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136053639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraluminal Submucosal Lipoma as a Lead Point Causing Colo-colic Intussusception: A Case Report","authors":"Azhar Shoaib Shaikh, Sandeep Anil Dhote, Suresh Vasant Phatak, Avinash Parshuram Dhok, Prashant Madhukarrao Onkar","doi":"10.7860/jcdr/2023/64072.18489","DOIUrl":"https://doi.org/10.7860/jcdr/2023/64072.18489","url":null,"abstract":"Adult colo-colic intussusception is very rare and it poses a diagnostic challenge in the geriatric population. The clinical diagnosis can be difficult due to non specific presenting complaints. However, it is a surgical emergency with high morbidity and mortality rates. Surgical exploration is the recommended treatment as most cases involve a pathological lead point. In this case report, the authors present the case of a 50-year-old female patient who complained of pain in the left lumbar region, loose stools, and loss of appetite for one month. Ultrasound (US) revealed an echogenic mass with a typical bowel within-bowel appearance. Contrastenhanced Computed Tomography (CECT) of the abdomen showed telescoping of the proximal descending colon into the distal descending colon. Additionally, a fat density rounded lesion was observed on CT. The wall of the descending colon exhibited enhancement, indicating viable large bowel loops. Colonoscopy revealed a polypoid growth. The patient subsequently underwent surgery, confirming all imaging findings. Resection and anastomosis of the colon were performed, with an intraluminal lipoma identified as the primary cause of the colo-colic intussusception. The postoperative period of up to three months was uneventful. US and CT play a crucial role in the early diagnosis and prevention of serious complications.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"37 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136258628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Effectiveness of Topical Anaesthetic Gel and Needle Free Jet Anaesthesia in Root Planing: A Cross-sectional Study","authors":"Bhavya Shetty, Khadijathul Irfana, Ibrahim Fazal, Irfana Shabeeba","doi":"10.7860/jcdr/2023/59110.17458","DOIUrl":"https://doi.org/10.7860/jcdr/2023/59110.17458","url":null,"abstract":"Introduction: Although traditional local anaesthetic technique by injection is considered as gold standard for dental procedure, the resultant pain and anxiety caused by the needle prick makes the patient less compliant for further treatment. Many alternatives have been developed by the researchers in the last two decades. Jet anaesthesia and the topical gel are the commonly used alternatives to anaesthetise the local area. Aim: To evaluate and compare the effectiveness of topical anaesthetic gel (MucopainR gel) and jet anaesthesia (Sure ShotR needle free jet injection) during root planing. Materials and Methods: After taking consent, 20 patients who required root planning in the maxillary quadrant bilaterally were recruited for this study. A split mouth study was planned where one quadrant was anaesthetised with benzocaine 20% (MucopainR) gel, whereas sure shotR jet anaesthesia was used on the adjacent quadrant. The side and order of placement of topical gel and jet anaesthesia were randomised. The same operator delivered anaesthesia on both the sides. The root planning was carried out by another operator at two sittings and pain was assessed immediately using Visual Analogue Scale (VAS), Numerical Rating Scale (NRS) and Verbal Response Scale Statistical . Results: The mean NRS score of the jet injection group was 1.50±1.54 and that for the gel group was 3.15±2.16. Also, the mean VAS score of the jet injection group was 1.50±1.54 and that for the gel was 3.15±2.16. The difference between two groups were statistically significantly (p-value=0.008). Conclusion: Jet anaesthesia was significantly superior to gel in providing anaesthesia during root planing.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"113 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89175200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suprapatellar versus Infrapatellar Approach for Intramedullary Nailing in Tibial Shaft Fractures: A Prospective Interventional Study","authors":"G. Sahni, Sukhjot Singh, Ashish Kavia, H. Aggarwal, H. Chawla","doi":"10.7860/jcdr/2023/55398.17258","DOIUrl":"https://doi.org/10.7860/jcdr/2023/55398.17258","url":null,"abstract":"Introduction: Tibial diaphyseal fractures are the most prevalent type of tibia fracture. A well known surgical method for treating tibial shaft fractures was the traditional infrapatellar approach for tibia Intramedullary Nailing (IMN). However, due to increased valgus and procurvatum deformities, IMN insertion through the infrapatellar route poses problems. Recently, suprapatellar nailing in the semi-extended position has been promoted as a safe and effective surgical treatment. Aim: To compare the clinical and functional outcomes of tibial shaft fractures treated with IMN utilising the Suprapattelar (SP) and Infrapatellar Methods (IP). Materials and Methods: A prospective interventional study was conducted on 40 patients, in the Department of Orthopaedics, in Government Medical College, Patiala ,Punjab, India from November 2019 to May 2021. The patients were divided into two groups on the basis of tibial shaft fractures treated with IMN utilising the S.P and those treated with I.P techniques during a two year period (20 in each group) with six months followup. Group A patients were treated with IMN in tibia through suprapatellar technique and group B Patients were treated with IMN in tibia via infrapatellar approach. The outcomes of IMN in tibial shaft fractures via SP and IP approach were compared in terms of fluoroscopy time, average surgical time, anterior knee pain using Visual Analogue Scale (VAS) score, average blood loss, fracture union time and functional outcome (in terms of the lower extremity functional Score). For statistical analysis student t-test and chi-square test was used, p-value <0.05 was considered as significant. Results: There were significant differences between SP and IP IMN in terms of fluoroscopy duration (94.25 vs 129.40 seconds, p-value-0.001), anterior knee pain (VAS score) (19.65 vs 29.85, p-value-0.001), average blood loss (49.30 vs 62.45 mL, p- value 0.001), and functional result (75.45 vs 70.05, p-value=0.001). The fracture union time between the two groups was non significant (90.50 vs 90.30 days, p-value=0.876). Conclusion: In terms of fluoroscopy time, anterior knee pain, average blood loss, and knee ratings, the SP technique was superior to the IP strategy.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"104 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87626403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extranodal Rosai-Dorfman Disease of the Nasal Septum: A Case Report","authors":"S. Kesari, Kartikeya Ojha, P. ..., HR Sohan Rao","doi":"10.7860/jcdr/2023/61588.17751","DOIUrl":"https://doi.org/10.7860/jcdr/2023/61588.17751","url":null,"abstract":"Rosai-Dorfman Disease (RDD) is a rare, benign histiocytic proliferative disorder mostly involving the lymph nodes. Extranodal disease can occur in the skin and soft tissue including the mucosal surface, central nervous system, gastrointestinal tract, and breast. Here, a case of a 17-year-old Indo-asian girl is presented, who came to the Ear Nose Throat (ENT) Outpatient Department (OPD) with a mass in her left nostril for the past two years. A sessile globular mass from the left nasal septum was seen during diagnostic visual endoscopy. A Computerised Tomography (CT) scan of the paranasal sinus revealed a rather large right maxillary sinus with a soft tissue density lesion filling it and obliterating the osteomeatal complex, while blood tests revealed an increased eosinophilic count. The nasal tumour was removed, and its histological analysis revealed characteristics of RDD. This is typically sporadic histiocytosis with emperipolesis in the cells. Clinically, the condition is benign, and all that is required is conservative therapy and periodic monitoring of its progression. Surgical excision is rarely advised until the disease has grown to an unmanageable size and is causing respiratory impairment or a cosmetic deformity. Currently, therapy revolves around surgical and immunosuppressive treatments, but the optimal diagnostic and therapeutic management of RDD remains to be defined.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"13 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87652373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approach-oriented Physiotherapeutic Management of a Patient with Right Thalamic Bleed: A Case Report","authors":"Neha Rajesh Badwaik, Pallavi Harjpal, Ragini Dadgal","doi":"10.7860/jcdr/2023/60780.18088","DOIUrl":"https://doi.org/10.7860/jcdr/2023/60780.18088","url":null,"abstract":"Rehabilitation is essential for stroke recovery. Professionals with experience in stroke rehabilitation from the different fields should make up a basic multidisciplinary stroke rehabilitation team. A stroke is the sudden loss of blood supply to the brain followed by a neurological deficit for more than 24 hours. A 42-year-old male patient presented with chief complaints of sudden weakness over one side of the body, slurred speech and blurred vision. The patient showed typical features of stroke-like tonal abnormalities, altered sensorium, diminished reflexes, reduced range of motion and strength. Magnetic Resonance Imaging (MRI) showed bleeding in the right lenticular capsular, basal ganglia and intraparenchymal part of the thalamus. The physiotherapy treatment started from the Intensive Care Unit (ICU) itself for better results with the collaboration of neurosurgeons and nurses, after the surgery. The Proprioceptive Neuromuscular Facilitation (PNF) approach and Rood’s approach were used to generate neuroplasticity as early as possible. The motor relearning program helped to regain the movements. Various outcome measures like the National Institute of Health Stroke Scale (NIHSS), Brunstorm grading, and Barthel index showed many crucial changes in tone, strength, balance, and coordination that improved the patient’s Quality of Life (QoL). Also, speech therapists and neuro-optometrist play an important role during rehabilitation.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"22 11 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88425256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CTLA4 Methylation and its Expression as a Prognostic Biomarker in Tobacco Users with and without Oral Squamous Cell CarcinomaA Protocol for Cross-sectional Study","authors":"Prajakta R. Zade, M. Chaudhary, M. Seralathan, A. Hande, M. Gawande","doi":"10.7860/jcdr/2023/59285.17799","DOIUrl":"https://doi.org/10.7860/jcdr/2023/59285.17799","url":null,"abstract":"Introduction: Oral Squamous Cell Carcinoma (OSCC) is characterised by immunosuppression mediated by evasion of ‘immune checkpoints’ by tumour cells. Cytotoxic T Lymphocyte Associated Protein 4 (CTLA4) is one of the immune checkpoint molecule whose role in oral carcinogenesis remains to be elucidated. Deoxyribonucleic Acid (DNA) methylation of CTLA4 promoter region holds potential as a biomarker for diagnosis and assessment of individuals at risk of developing OSCC. Need for the study: Immunotherapy is an emerging treatment modality in some cancers. Thus, better understanding of role of CTLA4 methylation in OSCC paves a way for newer strategies in immunotherapeutic. Aim: To assess the DNA methylation pattern of promoter region of CTLA4 gene and evaluate its expression in tobacco users with and without OSCC so that it can contribute as biomarker for diagnosis and prognosis of OSCC. Materials and Methods: The proposed longitudinal crosssectional study will be conducted at Sharad Pawar Dental College and Hospital, Maharashtra, India. It will evaluate promoter methylation and protein expression of CTLA4 gene in Smokeless Tobacco (SLT) users. There will be three groups: group A OSCC patients; group B normal individuals with SLT habit without any oral lesion; and group C normal individuals without SLT habit. Formalin Fixed Paraffin Embedded (FFPE) tissue blocks will be prepared from the biopsy obtained from total thirty nine participants. DNA methylation of CTLA4 promoter will be assessed using Methylation-Specific PCR (MS-PCR). In addition, the quantitative expression of CTLA4 will also be assessed using Immunohistochemistry (IHC).","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"14 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88832380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clomipramine Induced Extrapyramidal Symptoms: A Case Series","authors":"Disha Mukherjee, Madhurima Khasnobis, Anirban Ray","doi":"10.7860/jcdr/2023/59609.17740","DOIUrl":"https://doi.org/10.7860/jcdr/2023/59609.17740","url":null,"abstract":"Extra Pyramidal Symptoms (EPS) are a group of symptoms that include dystonia, bradykinesia, tremor, akathisia, and tardive dyskinesia. They are caused by the blockage of D2 receptors in the nigro-striatal pathway and the imbalanced acetyl choline activity that results in the basal ganglia. It most likely happens when first-generation antipsychotics taken in large doses and some second-generation antipsychotics. A few tricyclic antidepressants, including amitriptyline and clomipramine, monoamine oxidase (MAO) inhibitors, such as phenelzine, and SSRIs, such as fluoxetine, may also cause EPS. Antiemetics (domperidone), antiepileptic medications like phenytoin and carbamazepine, and anti-migraine medications like sumatriptan are a few additional causes of EPS. Schizophrenia patients who have never been prescribed medication may also exhibit similar movement problems. The tricyclic antidepressant (TCA) clomipramine is a tertiary amine that has potent D2 blocking and serotonin and norepinephrine reuptake inhibitor characteristics. Constipation, dry mouth, nausea, dizziness, drowsiness, tachycardia, sweating, arrhythmia, and seizures at high doses are common side effects associated with clomipramine. In this case series, three patients from different age groups are presented, the first one being a 38-year-old female with a diagnosis of paranoid schizophrenia, the second one was a 26-year-old male with the obsessive compulsive disorder (OCD)- washer type, and the third one was a 62-year-old female with dementia all of whom developed signs of EPS like dystonia, bradykinesia and tremors following the introduction of clomipramine. In all the patients, the drug was stopped and the patients were cured. This case series stresses that a clinician should be cautious about the possibility of extrapyramidal side effects while using the TCA Clomipramine which is commonly known for its anticholinergic side effects.","PeriodicalId":15483,"journal":{"name":"JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88854401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}