The Journal of the Association of Physicians of India最新文献

Allergic Bronchopulmonary Aspergillosis, a Masquerader: Unveiling a Case of Nonresolving Pneumonia in an Asthmatic Patient.

The Journal of the Association of Physicians of India Pub Date : 2025-03-01 DOI: 10.59556/japi.73.0858

K Manmadharao, Jyothi M Jose, Palash Shah

{"title":"Allergic Bronchopulmonary Aspergillosis, a Masquerader: Unveiling a Case of Nonresolving Pneumonia in an Asthmatic Patient.","authors":"K Manmadharao, Jyothi M Jose, Palash Shah","doi":"10.59556/japi.73.0858","DOIUrl":"https://doi.org/10.59556/japi.73.0858","url":null,"abstract":"Background: Allergic bronchopulmonary aspergillosis (ABPA) is an immune-mediated hypersensitivity reaction to Aspergillus, a common environmental fungus. It is typically seen in asthmatic patients and those with cystic fibrosis. Lack of clinical suspicion and misdiagnosis often make the management of this condition difficult.Case description: We are reporting a case of ABPA that was diagnosed and managed at Divisional Railway Hospital, Kharagpur, South Eastern Railway. The patient was a 66-year-old female who presented with fever, cough, and shortness of breath. She had been asthmatic since childhood and was on treatment for the same. On initial evaluation, her clinical and radiological features were suggestive of community-acquired pneumonia and were treated with antibiotics. However, the patient did not show improvement, and asthma also remained poorly controlled despite treatment. This raised the possibility of ABPA in this patient. The International Society for Human and Animal Mycology-ABPA (ISHAM-ABPA) working group criterion was used for making the diagnosis. She was successfully managed with low-dose steroids and itraconazole.Conclusion: A high index of clinical suspicion is needed for timely detection of ABPA. Features of nonresolving pneumonia in the background of poorly controlled asthma raised the possibility of ABPA in this patient. Misdiagnosis and delay in initiating proper treatment can lead to permanent lung damage, such as bronchiectasis and lung fibrosis, which can even lead to life-threatening complications like cor pulmonale and respiratory failure.","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 3","pages":"86-89"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634669","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}

引用次数: 0

Diabetic Striatopathy: A Treatable Movement Disorder.

The Journal of the Association of Physicians of India Pub Date : 2025-03-01 DOI: 10.59556/japi.73.0875

Gurunathan Srinivasan, P Vishaal, M Chozhan, Lakshmanan Sankaranarayanan, Mugundhan Krishnan

引用次数: 0

Progressive Disseminated Histoplasmosis with Primary Adrenal Insufficiency in Immunocompetent Person: A Case Report.

The Journal of the Association of Physicians of India Pub Date : 2025-03-01 DOI: 10.59556/japi.73.0876

Harshita Singh, Manas Das, Rohan Shrama, Sourav Kumar, Sagar M Sindagi, Neeraj Chaudhary, Mukul P Bhat, Aakash Pandey, Mayanglambam Sonika, Anil Gurtoo, Kritirupa Sarkar

{"title":"Progressive Disseminated Histoplasmosis with Primary Adrenal Insufficiency in Immunocompetent Person: A Case Report.","authors":"Harshita Singh, Manas Das, Rohan Shrama, Sourav Kumar, Sagar M Sindagi, Neeraj Chaudhary, Mukul P Bhat, Aakash Pandey, Mayanglambam Sonika, Anil Gurtoo, Kritirupa Sarkar","doi":"10.59556/japi.73.0876","DOIUrl":"https://doi.org/10.59556/japi.73.0876","url":null,"abstract":"Histoplasmosis, also referred to as Darling's disease, is mainly caused by the thermally dimorphic fungus Histoplasma capsulatum. It is usually contracted by inhaling fungal spores found in soil contaminated with bat or bird droppings, often during activities like cave exploration. Although endemic in certain regions of India, such as the eastern part, and sporadically in southern and northern states, histoplasmosis can manifest with varied clinical presentations, ranging from asymptomatic to severe disseminated disease affecting multiple organs. Adrenal involvement, though relatively uncommon, can lead to adrenal insufficiency, especially in immunocompetent individuals, with bilateral adrenal enlargement being a characteristic feature in imaging studies. This report discusses the case of a 51-year-old farmer from Haryana, India, who was diagnosed with progressive disseminated histoplasmosis (PDH) resulting in primary adrenal insufficiency. Although tuberculosis or malignancy was initially suspected, imaging studies and biopsy results confirmed histoplasmosis as the root cause. This case emphasizes the necessity of including histoplasmosis in the differential diagnosis of primary adrenal insufficiency, especially in endemic areas, and highlights the importance of early detection and appropriate management of this potentially life-threatening disease.","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 3","pages":"91-93"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633596","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}

引用次数: 0

To Assess Prevalence of Thyroid Dysfunction in Patients with Heart Failure and Impact on Its Prognosis.

The Journal of the Association of Physicians of India Pub Date : 2025-03-01 DOI: 10.59556/japi.73.0882

Anubha Srivastava, Dheeraj Kumar Yadav

{"title":"To Assess Prevalence of Thyroid Dysfunction in Patients with Heart Failure and Impact on Its Prognosis.","authors":"Anubha Srivastava, Dheeraj Kumar Yadav","doi":"10.59556/japi.73.0882","DOIUrl":"https://doi.org/10.59556/japi.73.0882","url":null,"abstract":"Objective: To evaluate the prevalence of thyroid dysfunction in patients with heart failure (HF) and its impact on prognosis, specifically regarding hospital stay duration.Methods: One hundred eighty-five HF patients aged >18 years were enrolled, and the study was conducted at Swaroop Rani Nehru Hospital between 21st July 2021, and 20th July 2022. All patients diagnosed with HF underwent demographic, clinical, hematological, biochemical, and thyroid function test (TFT) evaluations. Thyroid stimulating hormone (TSH) > 4.94 mIU/L was diagnosed as hypothyroidism, and TSH < 0.5 mIU/L was taken as hyperthyroidism, whereas those with normal TFT were defined as euthyroidism. Patients were monitored until discharge or final outcome. Data analysis was done using Statistical Package for the Social Sciences (SPSS) software 21.Results: Thyroid disorders were seen in 28.6% of patients, with 6.5% having hyperthyroidism and 22.2% hypothyroidism. Thyroid disorders were significantly associated with higher New York Heart Association (NYHA) class (3/4), serum urea, serum creatinine, and lower hemoglobin levels. However, age, sex, or brain natriuretic peptide (BNP) were not significantly associated with thyroid disorders. There was no significant difference in HF patients' length of hospital stay with or without hypothyroidism. Though 6.5% of HF patients died during the course of the study, this was not statistically significant.Conclusion: Thyroid disorders are highly prevalent among HF patients and have a significant clinical impact on their prognosis. Patients with thyroid disorders exhibited anemia, higher NYHA class, greater renal dysfunction, and longer hospital stays. Future studies are needed in this field. Clinicians should consider screening HF patients for thyroid dysfunction to improve patient outcomes.","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 3","pages":"50-52"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634422","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}

引用次数: 0

Cellulitis that was NOT Cellulitis.

The Journal of the Association of Physicians of India Pub Date : 2025-03-01 DOI: 10.59556/japi.73.0865

Aditi D Punwani, Keyur K Dave, Yuti Sheth, Rahul Shah, Tejas Parekh

引用次数: 0

Navigating the Artificial Intelligence Revolution: The Future of General Practice in India.

The Journal of the Association of Physicians of India Pub Date : 2025-03-01 DOI: 10.59556/japi.73.0856

Amit Kumar Dey

引用次数: 0

Plastic Pollution and One Health Crisis: A Burning Issue in Environmental Medicine.

The Journal of the Association of Physicians of India Pub Date : 2025-03-01 DOI: 10.59556/japi.73.0840

Gouranga Santra

引用次数: 0

Sample Size Calculation for Paired t-test Using p-value and Confidence Intervals When Standard Deviation of Difference is Not Given.

The Journal of the Association of Physicians of India Pub Date : 2025-03-01 DOI: 10.59556/japi.73.0854

Shyam Vayyat, Nilotpal Chowdhury, Manish Goyal

引用次数: 0

Biologics and Tuberculosis Preventive Therapy.

The Journal of the Association of Physicians of India Pub Date : 2025-03-01 DOI: 10.59556/japi.73.0847

Aloke G Ghoshal, Arup Halder

{"title":"Biologics and Tuberculosis Preventive Therapy.","authors":"Aloke G Ghoshal, Arup Halder","doi":"10.59556/japi.73.0847","DOIUrl":"https://doi.org/10.59556/japi.73.0847","url":null,"abstract":"Biologics have revolutionized the management of systemic inflammatory disorders in the last few decades. The most common side effect associated with these agents is increased susceptibility to infection. Increased risk of tuberculosis (TB) reactivation in patients with latent tuberculosis infection (LTBI) has been recorded for anti-tumor necrosis factor (TNF) agents and, to a lesser extent, for the nonanti-TNFα targeted biologics. Use of both biologic agents and Janus kinase (JAK) inhibitors is associated with increased risk of TB disease. LTBI screening prior to initiation of a biologic agent or JAK inhibitor and treatment of positive cases significantly reduces the incidence of TB disease, though it does not eliminate it. Several recommendations and guidelines have been published, but none of them apply globally due to variable socioeconomic conditions and endemicity of TB in different countries. At present, we have a national guideline in India from the National Tuberculosis Elimination Programme (NTEP) in the form of Guidelines for Programmatic Management of Tuberculosis Preventive Therapy in India (PMTPT), which mandates TB screening and treatment for patients on immunosuppressive therapy and anti-TNF treatment. However, PMTPT is essentially a general recommendation. Clinicians need to be abreast of the integration of this approach with the variable risks of TB reactivation associated with different biologics in clinical practice.","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 3","pages":"67-72"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634680","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}

引用次数: 0

Scrub Saccadomania: An Enigma of Eye Movement in the Tropics.

The Journal of the Association of Physicians of India Pub Date : 2025-03-01 DOI: 10.59556/japi.73.0872

Jayaram Saibaba, Chandni Chandramouli, Deepak Amalnath, Dks Subrahmanyam

{"title":"Scrub Saccadomania: An Enigma of Eye Movement in the Tropics.","authors":"Jayaram Saibaba, Chandni Chandramouli, Deepak Amalnath, Dks Subrahmanyam","doi":"10.59556/japi.73.0872","DOIUrl":"https://doi.org/10.59556/japi.73.0872","url":null,"abstract":"Background: Opsoclonus myoclonus syndrome (OMS) is a rare neuro-ophthalmic disorder characterized by chaotic, multidirectional saccadic eye movements. It is associated with various etiologies, including infectious and immune-mediated encephalitis. Scrub typhus, caused by Orientia tsutsugamushi, is an uncommon but important, treatable cause of OMS. Here, we present a case of scrub meningoencephalitis presenting with saccadomania as the initial clinical manifestation.Objective: To highlight scrub meningoencephalitis as a potential cause of OMS and emphasize the importance of prompt recognition and early treatment to enhance patient outcomes.Materials and methods: We describe the case of a 32-year-old female presenting with fever, altered sensorium, and saccadomania, along with a characteristic eschar, diagnosed with scrub meningoencephalitis. Clinical, laboratory, and imaging findings, as well as treatment modalities, are presented.Results: The patient demonstrated generalized jerky movements and rapid eye movements in all directions, consistent with saccadomania. Diagnosis was confirmed through positive IgM enzyme-linked immunosorbent assay (ELISA) for scrub typhus and a characteristic eschar. Treatment with doxycycline and dexamethasone resulted in significant symptom improvement within days, with complete resolution by day 10.Conclusion: This case underscores the importance of considering scrub meningoencephalitis as a potential cause of OMS, particularly in endemic regions. Prompt recognition and initiation of appropriate antibiotic therapy, along with adjunctive corticosteroids, are crucial for favorable patient outcomes. Increased awareness among clinicians can lead to timely diagnosis and management, preventing potential neurological sequelae associated with this treatable condition.","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 3","pages":"e39-e40"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634128","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}

引用次数: 0