Medical Journal of Dr. D.Y. Patil Vidyapeeth最新文献

{"title":"An Interesting Case of Hemophagocytic Lymphohistiocytosis Secondary to Systemic Lupus Erythematosus","authors":"P. Diggikar, Raju Hansini Reddy, Mayank Mundada, B. Yammanuru","doi":"10.4103/mjdrdypu.mjdrdypu_733_23","DOIUrl":"https://doi.org/10.4103/mjdrdypu.mjdrdypu_733_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 Hemophagocytic lymphohistiocytosis (HLH) is a reactive condition marked by cytopenias and clinical features of systemic inflammation related to macrophage activation. It may be familial and may present early in life or sporadic and may affect people of any age. HLH secondary to systemic lupus erythematosus (SLE) is a rare clinical entity with an estimated prevalence of 0.9–4.6%. A 19-year-old man with no significant past medical history presented with complaints of high-grade fever with chills and bleeding manifestations, such as hematemesis, hemoptysis, epistaxis, and petechial rash in both upper limbs and lower limbs. Laboratory investigations showed significant pancytopenia and raised plasma levels of ferritin, triglycerides, and soluble interleukin (IL)-2. Ultrasonography of the abdomen showed mild hepatomegaly. A bone marrow biopsy showed evidence of mild hemophagocytosis. Antinuclear antibody (ANA) by indirect immunofluorescence assay (IFA) and double-strand deoxyribonucleic acid (dsDNA) came positive, and a diagnosis of HLH secondary to SLE was made. The patient was treated symptomatically with PCV and random donor platelet (RDP) transfusions and definitively with steroid therapy. HLH provokes potential life-threatening systemic toxicity and organ failure. Thus, prompt recognition when a patient presents with unexplained fever, cytopenias, and hepatosplenomegaly is required for timely treatment to prevent end-organ irreversible damage.","PeriodicalId":18412,"journal":{"name":"Medical Journal of Dr. D.Y. Patil Vidyapeeth","volume":"27 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849035","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":"Epidural Blood Patch for Atypical Headache due to Spontaneous Intracranial Hypotension Associated with Meningeal Diverticulum","authors":"A. Bagle, Yashwant Nankar, Ipshita Garg, Balkees Beevi Nazeer Ahmed","doi":"10.4103/mjdrdypu.mjdrdypu_495_23","DOIUrl":"https://doi.org/10.4103/mjdrdypu.mjdrdypu_495_23","url":null,"abstract":"","PeriodicalId":18412,"journal":{"name":"Medical Journal of Dr. D.Y. Patil Vidyapeeth","volume":"35 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849695","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":"Anesthetic Dilemma in a Case of Myasthenia Gravis Posted for Thymectomy","authors":"Bhavini Shah, Veda Sumi Durgumpudi, Shilpa Deshmukh","doi":"10.4103/mjdrdypu.mjdrdypu_578_23","DOIUrl":"https://doi.org/10.4103/mjdrdypu.mjdrdypu_578_23","url":null,"abstract":"","PeriodicalId":18412,"journal":{"name":"Medical Journal of Dr. D.Y. Patil Vidyapeeth","volume":"1 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839062","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":"Hashimoto’s Encephalopathy Presenting as Catatonia: A Rare Presentation of a Common Disease","authors":"K. M. Srinath, Vathul B. Subramanian, A. L. Siddappa, S. Sangappa","doi":"10.4103/mjdrdypu.mjdrdypu_173_23","DOIUrl":"https://doi.org/10.4103/mjdrdypu.mjdrdypu_173_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 A rare type of encephalopathy that typically manifests with neuropsychiatric symptoms is Hashimoto’s encephalopathy, also known as steroid-responsive encephalopathy associated with autoimmune disease (SREAT). The majority of individuals with SREAT are typically euthyroid when they first appear, while the condition can manifest at any level of T3, T4, or thyroid-stimulating hormone. A significant diagnostic factor for this uncommon disorder is elevated thyroid antibodies, which are supported by magnetic resonance imaging (MRI), cerebrospinal fluid analysis (CSF), and electroencephalogram (EEG) results indicative of diffuse encephalopathy. An effective dose of steroids works for the majority of patients. In this case, a 43-year-old woman with rheumatoid arthritis and hypothyroidism who is on disease-modifying medication presented with symptoms that were similar to those of catatonia. After careful consideration, the patient was put on intravenous pulse steroids with the suspicion of SREAT after ruling out other metabolic reasons. Steroid therapy produced a substantial improvement in the patient, who was discharged with a premorbid condition. This case is distinctive due to its appearance, occurrence, therapeutic response, and the existence of another autoimmune illness like rheumatoid arthritis. Hashimoto’s encephalopathy (SREAT) is a rare manifestation of a common disease. According to the Diagnostic and Statistical Manual, our patient was diagnosed with catatonia (DSM-5). She displayed posturing, catalepsy, mutism, stupor, and agitation. It is crucial to comprehend this rare disease, which affects 1 in every 2 lakh people, because it could be confused for a primary psychiatric disorder.","PeriodicalId":18412,"journal":{"name":"Medical Journal of Dr. D.Y. Patil Vidyapeeth","volume":"23 70","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845798","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":"Analysis of Diffuse Large B Cell Lymphoma using Immunohistochemistry to Identify Double Expressor Diffuse Large B Cell Lymphoma among Germinal Centre and Non Germinal Centre B Cell Subtypes","authors":"E. J. Rani, Jasmin Scaria, P. Sathi","doi":"10.4103/mjdrdypu.mjdrdypu_100_23","DOIUrl":"https://doi.org/10.4103/mjdrdypu.mjdrdypu_100_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Diffuse large B cell lymphoma (DLBCL) within non-Hodgkin lymphoma has several morphologic and clinicopathologic variants. DLBCL has two prognostically important subtypes, germinal center B cell (GCB) and nongerminal center (Non-GCB) with the non-GCB having an inferior outcome. Immunohistochemical co-expression of cellular myelocytomatosis (CMYC) and BCL2 in DLBCL has poor prognosis and is considered as double-expressor lymphoma (DEL).\u0000 \u0000 \u0000 \u0000 This study was done to identify DEL using immunohistochemistry among GCB and non-GCB DLBCL and to assess their treatment response.\u0000 \u0000 \u0000 \u0000 A retrospective analysis of 97 DLBCL cases received in our department was done. Formalin-fixed paraffin blocks were used to prepare Hematoxylin and eosin–stained sections, immunohistochemical subtyping (into GCB and non-GCB using CD10, BCL6, and MUM1) and further to identify DEL (using CMYC and BCL2).\u0000 \u0000 \u0000 \u0000 Analysis was done using Chi-square test (Statistical Package for Social Sciences version 18), and P <.05 was considered significant. Kaplan-Meier test was used to estimate overall survival.\u0000 \u0000 \u0000 \u0000 Of the total 97 DLBCL cases analyzed, 33 (34%) were DEL and 64 (66%) were non-DEL. Of the DEL, 13 (13.40%) were GCB subtype and 20 (20.6%) were non-GCB. However, there was no statistically significant difference in the overall survival and treatment response between DEL and non-DEL.\u0000 \u0000 \u0000 \u0000 In this study, we found that DEL constituted about one-third of the total DLBCL and within the DEL non-GCB subtype was more common. Further studies should be performed in large population to study the difference in clinical outcome.\u0000","PeriodicalId":18412,"journal":{"name":"Medical Journal of Dr. D.Y. Patil Vidyapeeth","volume":"7 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141846184","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":"Gender-based Violence in an Indian Resettlement Colony Threatened with Re-eviction","authors":"Sheetal Surjeet, Ishita Maji, Yasmin Khan, Swadhapriya D. Chaudhuri, Jagriti Punia, Rohini Ruhil, Jacob Puliyel","doi":"10.4103/mjdrdypu.mjdrdypu_651_23","DOIUrl":"https://doi.org/10.4103/mjdrdypu.mjdrdypu_651_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Od tribals who migrated to India during the Indo-Pakistan partition of 1947 were resettled by the Government of India in 1987 in the Bhatti Mines area near Delhi, India. However, in 1991, the area was declared a wildlife sanctuary, and the tribals were threatened with eviction a second time. We studied gender-based violence (GBV) in this community subjected to repeated displacement.\u0000 \u0000 \u0000 \u0000 A systematic randomized sample of 200 households was studied. The revised Conflict Tactics Scale (CTS2) questionnaire was used to identify victims of GBV. Correlation with age at marriage, education, household income, deprivation score, and alcoholism were investigated.\u0000 \u0000 \u0000 \u0000 About 33% of women were married before the legal age for marriage – some as young as 10 years. Approximately 26% of households were multidimensionally deprived. About 50% of women reported GBV and 44% reported GBV in the preceding year. Low income and alcohol abuse were independently related to GBV. We did not find an association with underage marriage or the education of the partners.\u0000 \u0000 \u0000 \u0000 GBV in the area far exceeded the national average of 30%. The relationship we found between GBV with poverty and alcoholism has been reported in studies from different parts of the world. It may be speculated that the increased GBV in this area could be the result of the hopelessness induced by repeated involuntary displacement suffered by this community. Methods to tackle the menace of GBV, even in the adverse circumstances of this community, are discussed.\u0000","PeriodicalId":18412,"journal":{"name":"Medical Journal of Dr. D.Y. Patil Vidyapeeth","volume":"15 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141846695","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":"Comments on “Ethambutol-induced Bilateral Retrobulbar Neuritis with Ceco-central Scotoma in Cervical Tuberculous Lymphadenitis Patient: A Case Report with Estimated Plasma Level Consideration”","authors":"S. Rohatgi, P. Rao","doi":"10.4103/mjdrdypu.mjdrdypu_804_22","DOIUrl":"https://doi.org/10.4103/mjdrdypu.mjdrdypu_804_22","url":null,"abstract":"","PeriodicalId":18412,"journal":{"name":"Medical Journal of Dr. D.Y. Patil Vidyapeeth","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141852999","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":"An Exploratory Pilot Study to Assess the Effect of Intermittent Fasting on Anthropometric Parameters, Biochemical Factors, and Pro-Inflammatory Biomarkers","authors":"Kumar Pushkar, S. Kaushik, S. Bobdey, D. Faujdar, Suraj Kapoor, Mohammed Ashraf A. Namaji, Arun K. Yadav, Niharika Nagari","doi":"10.4103/mjdrdypu.mjdrdypu_120_23","DOIUrl":"https://doi.org/10.4103/mjdrdypu.mjdrdypu_120_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 \u0000 \u0000 Fasting denotes abstinence from food or drink or both for well-being, ritualistic, and spiritual purposes. This study was conducted to explore the effect of Navratras fasting on anthropometric parameters, biochemical factors, and pro-inflammatory biomarkers.\u0000 \u0000 \u0000 \u0000 This study was a short-term longitudinal follow-up study conducted during Navratras (Oct 2020) in a residential medical college campus in western Maharashtra. Assessment of the participants based on anthropometry, biochemical, and pro-inflammatory markers was done at three-time points 7 days before the start of intermittent fasting (T1) (before the start of Navratras), at the end of intermittent fasting (the last day of the festival) (T2) (during Navratras), and 1 week after completion of intermittent fasting (T3) (after the end of Navratras).\u0000 \u0000 \u0000 \u0000 A total of 50 subjects participated in the study, and the mean age of study participants was 33.6 ± 10 years. There was a significant reduction in body weight (P = 0.001), waist circumference (P = 0.001), and hip circumference (P ≤ 0.05) during the intermittent fasting period (T2). Significantly lower levels of total cholesterol (P < 0.01) and low density lipoprotein (LDL) (P < 0.01) were observed in the T2 and T3 time points of sampling. However, a significant increase in TNF-alpha, IL-1, IL-6, and IL-8 levels was observed during the T2 phase (P < 0.001).\u0000 \u0000 \u0000 \u0000 The current exploratory study evaluating the importance of intermittent fasting during Navratras showed a significant reduction in certain anthropometric as well as biochemical parameters. It is recommended that intermittent fasting may be considered by individuals who are overweight and need to improve overall health. However, it is important that like any other weight-loss program, intermittent fasting should also be undertaken under medical supervision.\u0000","PeriodicalId":18412,"journal":{"name":"Medical Journal of Dr. D.Y. Patil Vidyapeeth","volume":"4 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141853618","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":"A Systematic Review of Perioperative Nerve Blocks for Cleft Lip and Palate Surgeries","authors":"R. Kerur, Binita N. Mallapur, Purvashree Deshmukh, Rajesh Powar","doi":"10.4103/mjdrdypu.mjdrdypu_470_23","DOIUrl":"https://doi.org/10.4103/mjdrdypu.mjdrdypu_470_23","url":null,"abstract":"ABSTRACT\u0000 \u0000 Establishing a successful perioperative technique for better outcomes remains a priority in cleft surgery. In the present review, the safety and efficacy of nerve blocks for cleft lip and cleft palate are evaluated. A systematic review of randomized controlled trials (RCTs) involving the perioperative nerve block was conducted. PubMed, Google Scholar databases, and manual searching were performed to screen the eligible RCTs. Dosage and the route of administration of anesthetics were considered for all the studies. A total of nine RCTs with 568 children were included in our review. Six out of nine studies reported cleft lip surgery, only two reported cleft palate surgery, and one study reported both cleft lip and palate surgery. Lignocaine, ropivacaine, or bupivacaine was used as anesthetics. Adrenaline or epinephrine was used as adjuvants. Post-operative pain was lower in the perioperative nerve block group compared to the comparison group, resulting in fewer emergency analgesic prescriptions. Physiological factors like heart rate, blood pressure, and respiratory rate did not differ between groups. There were fewer adverse outcomes linked with perioperative nerve blocks. Perioperative nerve blocks can be a useful adjunct to general anesthesia in cleft lip and palate surgeries to provide additional pain relief and reduce opioid use, but they should be used judiciously and with consideration of potential risks and complications.","PeriodicalId":18412,"journal":{"name":"Medical Journal of Dr. D.Y. Patil Vidyapeeth","volume":"157 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141840338","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":"District Residency Program – Students’ Perception","authors":"Aarthi Muthukumar, Pramila Menon, Shailaja Mane, J. S. Bhawalkar","doi":"10.4103/mjdrdypu.mjdrdypu_477_24","DOIUrl":"https://doi.org/10.4103/mjdrdypu.mjdrdypu_477_24","url":null,"abstract":"","PeriodicalId":18412,"journal":{"name":"Medical Journal of Dr. D.Y. Patil Vidyapeeth","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141842072","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}