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

{"title":"Cryptogenic Organizing Pneumonia: A Case Report.","authors":"Mohammed Sameer Kundale, Pragati Rao D, Nirantha S P, Sruthy Vijayan, Shashidhar S Vananjakar","doi":"10.59556/japi.73.1133","DOIUrl":"10.59556/japi.73.1133","url":null,"abstract":"<p><p>Cryptogenic organizing pneumonia (COP) is an idiopathic interstitial lung disease affecting the distal airways, characterized by the development of granulation tissue that obstructs the bronchioles and alveoli, leading to respiratory failure. This case report describes a 63-year-old female patient with a history of diabetes, hypertension, and hypothyroidism who presented with persistent productive cough and dyspnea, initially treated as community-acquired pneumonia. Despite empirical antibiotic therapy, the patient's symptoms persisted. Further investigation, including high-resolution CT (HRCT) scans and a CT-guided lung biopsy, revealed fibrotic exudates, interstitial fibrosis with inflammatory infiltrates, and epithelioid granuloma. A diagnosis of COP was made after multidisciplinary discussion, and corticosteroid therapy was initiated, leading to significant clinical improvement and resolution on repeat imaging. This case highlights the importance of considering COP in patients with nonresolving pneumonia and underlines the efficacy of corticosteroids in its management. It also emphasizes the need for a multidisciplinary approach combining clinical, radiological, and histological assessments to reach a definitive diagnosis. Early recognition and appropriate treatment are crucial in preventing complications such as fibrosis and respiratory failure.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 9S","pages":"37-39"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070626","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 Case Report of Unilateral Pleural Effusion in a Middle-aged Woman: A Rare Coexistence.","authors":"Viswesvaran Balasubramanian, Majed Ab Momin, Abhijeet Ingle, Ramya R Malipeddi, Nitesh Gupta","doi":"10.59556/japi.73.1137","DOIUrl":"10.59556/japi.73.1137","url":null,"abstract":"<p><p>A 39-year-old woman with a 1-year history of seronegative arthritis was admitted for shortness of breath, left-sided chest pain, and joint pains. Upon physical examination, the tips of her right leg's fifth toe showed dry gangrene. Laboratory results revealed proteinuria and positivity for antinuclear antibody, ribonucleoprotein/Smith (RNP/Sm) antibody, Smith, and anti-double-strand deoxyribonucleic acid (DNA) antibody. The chest radiograph showed cardiomegaly, and computed tomography (CT) of the chest revealed pleural effusion. Initial pleural investigations revealed exudative pleurisy, low adenosine deaminase (ADA), and pleural effusion with cytology positive for lupus erythematosus (LE) cells. Rigid thoracoscopy revealed necrotic parietal pleura. Acid-fast bacillus (AFB) yielded positive results with Ziehl-Neelsen stains. Based on the above clinical, cytohistological, and serological findings, a coexistence of lupus pleuritis with tuberculous serositis (TS) was diagnosed in the background of systemic lupus erythematosus (SLE) with renal crisis. After 2 months of antitubercular therapy (ATT) with maintenance dose of steroids, following symptomatic improvement, pulse steroids and cyclophosphamide were initiated for SLE with renal crisis, and ATT was continued for 6 months. Postcompletion of ATT, the patient had complete resolution and was in remission of SLE.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 9S","pages":"23-25"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070628","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 Review on Sarcopenia, Cachexia, and Aging.","authors":"C L Nawal, Radhe Shyam Chejara, Aradhana Singh, Govind Rankawat","doi":"10.59556/japi.73.1116","DOIUrl":"10.59556/japi.73.1116","url":null,"abstract":"<p><p>Sarcopenia and cachexia are two crucial geriatric problems that largely pass unrecognized, and their presence is a harbinger of a bad outcome. With the growing older of the human body, there is a gradual loss of muscle tissue and an increase in fat mass, leading to increased abdominal circumference. Sarcopenia is described as the progressive and generalized loss of skeletal muscle mass, strength, and physical function, leading to reduced workout capacity. It needs to be differentiated from cachexia, wherein the weight loss is because of an underlying sickness like cancer, chronic obstructive pulmonary disease (COPD), and immunodeficiency disorder, leading to loss of fat and muscle tissues, and starvation, which is a reversible situation on proper nutrient supplementation. Skeletal muscle tissue loss due to sarcopenia is resistant to dietary vitamin supplements. Even with many commonalities between these two situations, these are considered separate clinical entities. Aging may be described as the time-associated deterioration of the physiological functions critical for survival and fertility. The traits of growing older-as distinguished from ailments of growing old (together with cancer and coronary artery disease)-affect all the humans of a species. A massive loss of muscle tissue and strength (sarcopenia), a reduced regenerative capacity, and a compromised physical performance are hallmarks of aging skeletal muscle. It is prudent to outline the distinction between the two conditions within the aging population so that a therapeutic method may be targeted toward the skeletal muscle loss and strength in aged humans. The treatment consists of appetite stimulants, dietary and nutritional supplementation, tailored exercise, and anti-inflammatory drugs. Megestrol acetate, an appetite stimulant, and dronabinol (Marinol), a narcotic drug used to treat nausea and vomiting in patients with cachexia.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 9","pages":"85-90"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070332","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":"Predictors of Mortality among Hospitalized Patients in a Tertiary Care Center across Three COVID-19 Waves.","authors":"Anupama S Kakade, Anushree A Chaudhari, Gargee Bahekar, Shilpa Nellikkal, Anurag Bahekar, Deepak Bahekar, Alka Bahekar, Jaya Yednurwar","doi":"10.59556/japi.73.1066","DOIUrl":"10.59556/japi.73.1066","url":null,"abstract":"<p><strong>Background: </strong>Several studies conducted across the globe have stated the most frequent risk factors linked to increased severity and death related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite the huge impact SARS-CoV-2 had on India, there is a lack of adequate research on the epidemiology and predictors of mortality due to coronavirus disease 2019 (COVID-19). The study aims to assess the predictors of mortality among COVID-19 patients admitted to a tertiary healthcare hospital in central India across the first, second, and third COVID-19 waves.</p><p><strong>Materials and methods: </strong>This record-based cross-sectional study was conducted using secondary data of patients hospitalized with SARS-CoV-2 between September 2020 and October 2022 in a designated COVID-19 treatment center.</p><p><strong>Results: </strong>Data on 861 adult patients were analyzed. The mean age of the patients was 52.87 ± 14.21 years, with the majority of them being females (573, 66.6%). Results showed no significant difference between men and women infected with COVID-19. During the complete course of the pandemic age patients, a history of hypertension, cough, dyspnea, myalgia, loss of taste, loss of smell, computed tomography (CT) score, and invasive ventilation was significantly associated with mortality of COVID-19 patients. Among the COVID-19 approved pharmacotherapy, steroids significantly (<i>p</i>-value < 0.000<b>)</b> lowered the risk of mortality [adjusted odds ratio (aOR): 0.134; 95% confidence interval (CI): 0.071-0.255] in COVID-19 hospitalized patients.</p><p><strong>Conclusion: </strong>Various sociodemographic and clinical profile predictors were associated with COVID-19 infection among pharmacotherapies. Steroid use helped lower the risk of mortality associated with COVID-19. More studies will help us to understand the various characteristics of the SARS-CoV-2 virus more elaborately, so as to ensure the proper preparedness of the healthcare system for future COVID-19 impacts.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 9","pages":"59-64"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070550","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":"Transmission of <i>Mycobacterium Tuberculosis</i>.","authors":"Malay Sarkar, Jasmine Sarkar","doi":"10.59556/japi.73.1113","DOIUrl":"10.59556/japi.73.1113","url":null,"abstract":"<p><strong>Introduction: </strong>Tuberculosis (TB) has been a leading killer of mankind since time immemorial. There are four key components in the TB elimination approach. They are known as \"Detect-Treat-Prevent-Build\". Under the preventive strategy, scaling up of airborne infection control measures is an important step in controlling the global disease burden.</p><p><strong>Methods: </strong>This is a narrative review for which we used online databases such as PubMed, Embase, and CINAHL from inception to July 2024. The search terms used include TB, transmission, aerosols, cough, droplet nuclei, Wells-Riley equation, and ultraviolet germicidal irradiation (UVGI). All types of articles were selected.</p><p><strong>Results: </strong>The primary mechanism of transmission of <i>Mycobacterium tuberculosis</i> (<i>M. tb</i>) is the inhalation of small infected droplet nuclei (1-5 µm in diameter) consisting of a few mycobacteria that have the capacity to reach the alveoli. The transmission dynamics of TB can be influenced by various human, environmental, and pathogenic factors. Several mechanisms such as coughing, sneezing, talking, laughing, singing, and normal tidal breathing can produce droplet nuclei.</p><p><strong>Conclusion: </strong>It is crucial to thoroughly understand the mechanisms of TB transmission for a better understanding of TB dynamics. TB is mainly transmitted by droplet nuclei, and preventive strategies should incorporate this mechanism.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 9","pages":"91-96"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070516","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":"Incidence of Treatment Delays among Patients with Diabetes: A Clinic-based Cross-sectional Descriptive Study in India.","authors":"Shubhashree Patil, Bharat Saboo, Seema A Bagri, Priti Sanghavi, Tanuja Shah, Sybal Dbritto, Aashna Patil, Rohini S Gajare, Aparna G Muley, Ayaz Ansari, Mrinalini Singh, Charusheela Kolhe, Kinnary R Shah, Sanjyoti Khot, Pranjali Shah, Hardik Bambhania, Rukiya Shaikh, Seema Jashnani","doi":"10.59556/japi.73.1120","DOIUrl":"10.59556/japi.73.1120","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus is a global epidemic, with an increasing number of undiagnosed individuals, particularly those with type 2 diabetes mellitus (T2DM). However, there is limited data on treatment delays among drug-naïve patients in India. The present study aimed to ascertain the incidence of treatment delay among drug-naïve patients and the sequence of alternate treatments sought since diagnosis.</p><p><strong>Materials and methods: </strong>This cross-sectional, multicentric, observational study was conducted across 10 primary and secondary care settings in Mumbai from October 2023 to April 2024. Adults of either gender, diagnosed with T2DM, who are drug-naïve, were included. Patient's demographic data, comorbidities, current medications, and medical history were recorded in an electronic case report form and analyzed.</p><p><strong>Results: </strong>Of the 625 patients enrolled, 591 completed the study. The mean age of the patients was 46.7 years. The proportion of male patients was 54.1%. Overall, 57% of patients had no treatment delays, while 43% experienced delays of ≥3 months. Patients with treatment delays of ≥3 months used alternative/traditional medicines (56.0%), with Ayurveda being preferred by 56.7% of these patients.</p><p><strong>Conclusion: </strong>The study indicated considerable treatment delays among drug-naïve patients in India.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 9","pages":"e15-e20"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070524","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":"Effect of Scalp Block vs Sphenopalatine Ganglion Block with Posterior Occipital Nerve Block on Hemodynamic Response Following Skull Pin Application.","authors":"Vikraman Kesavan, Aditi Suri, Rupesh Yadav","doi":"10.59556/japi.73.1104","DOIUrl":"10.59556/japi.73.1104","url":null,"abstract":"<p><strong>Background: </strong>Sphenopalatine ganglion (SPG) block combined with occipital nerve block can attenuate the hemodynamic response to the painful stimulus of skull pin application.</p><p><strong>Materials and methods: </strong>About 60 patients, aged 18-65 years, were randomly assigned to two groups. All patients were classified as American Society of Anesthesiologists (ASA) grades I and II, had a Glasgow Coma Scale (GCS) score of 15/15, and were scheduled for elective craniotomy. Group S was given a scalp block with 0.25% bupivacaine, while group SPG was given a bilateral transnasal SPG block with 0.5% bupivacaine, along with greater and lesser occipital nerve blocks using 0.25% bupivacaine. The primary objective was to assess the change in mean arterial pressure (MAP) following skull pin application. The dose of propofol used as rescue was also noted.</p><p><strong>Results: </strong>All 60 patients completed the study. The MAP differed significantly in group SPG from prior to pin insertion to 2 (<i>p</i>-value = 0.034) and 3 minutes (<i>p</i>-value = 0.026) following pin insertion. The maximum percent change from the prior to pin insertion timepoint was observed at 2 minutes (<i>p</i> < 0.001). The heart rate (HR) also differed significantly in group SPG from the prior to pin insertion to 2 (<i>p</i>-value = 0.001) and 3 (<i>p</i>-value = 0.006) minutes following pin insertion. The maximum percent change from the prior to pin insertion was observed at 2 minutes following pin insertion (<i>p</i> < 0.001). There was no significant difference in the percent change in HR between the two groups from prior to pin insertion to any of the timepoints.</p><p><strong>Conclusion: </strong>Bilateral SPG block with posterior scalp block can attenuate the hemodynamic response following skull pin insertion in patients undergoing craniotomy under general anesthesia.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 9","pages":"e5-e9"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070535","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 Deficiency of Vitamin D and Advantages of Supplementation of Vitamin D in COVID-19 Infections: A Narrative Review.","authors":"Ashu Rastogi, Jaya P Sahoo, Sakthivel Sivasubramanian, Satinath Mukhopadhyay, Ravindra Shukla, Santosh Ramakrishnan, Shehla Shaikh, Mahesh Abhyankar, Ashish Prasad, Santosh Kale","doi":"10.59556/japi.73.1169","DOIUrl":"10.59556/japi.73.1169","url":null,"abstract":"<p><p>Continuously evolving literature has helped to understand the vitamin D contribution to the coronavirus disease 2019 (COVID-19) manifestations and the associated clinical outcomes in different patient populations. Evidence suggests a widespread occurrence of deficiency of vitamin D among patients presenting COVID-19 and a possible link between vitamin D insufficiency and disease progression or mortality. Furthermore, studies worldwide have reported that supplements of vitamin D have a beneficial effect on COVID-19 outcomes. Contradictory data, however, suggest that there is no association between levels of vitamin D and the likelihood of COVID-19 infections. Therefore, a comprehensive search of the published literature is conducted to better understand any harmful effects of vitamin D deficiency (VDD), advantages of vitamin D supplementation, and the relationship between status of vitamin D and risk, severity, and mortality in patients with COVID-19. The information was gathered from the PubMed database published between January 2020 and July 2022 regarding the function of vitamin D in the immune system, the link between deficiency of vitamin D and COVID-19 infection, severity, risk of mortality of COVID-19, and the impact of vitamin D treatment on outcomes of COVID-19. Vitamin D modulates the immune system by elevating the levels of cathelicidins and β-defensin in the body. Deficiency of vitamin D is markedly attributed to the risk of acute respiratory distress syndrome (ARDS), which determines the severity of disease in patients with COVID-19. Levels of vitamin D below 20 ng/mL in patients with COVID-19 are linked to an increased mortality and morbidity. Vitamin D concentration of >30 ng/mL can diminish the COVID-19 severity and risk of mortality. Supplementation with vitamin D to maintain a serum concentration of 30 ng/mL would mitigate the incidence of COVID-19 and poor prognostic outcomes.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 9","pages":"e38-e47"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070492","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":"Beta Thalassemia Manifesting as a Leukemoid Reaction: A Rare Case Report.","authors":"Garima Anandani, Vaishali Bhankhodia, Komal Kumar Jangir","doi":"10.59556/japi.73.1136","DOIUrl":"10.59556/japi.73.1136","url":null,"abstract":"<p><p>The occurrence of marked leukocytosis in hemoglobinopathies is generally uncommon. Herein, we describe a 41-year-old male patient with a history of chronic alcoholism who presented for the first time with shortness of breath and abdominal distension. On complete blood counts and peripheral smear examination, there was a microangiopathic hemolytic anemia with leukemoid reaction, which turned out to be beta thalassemia trait on hemoglobin high-performance liquid chromatography. He was ultimately diagnosed with beta thalassemia trait in conjunction with chronic alcoholic liver disease and spontaneous bacterial peritonitis. The presence of leukocytosis accompanied by cytopenias in other hematopoietic cell lines and organomegaly presents a considerable diagnostic challenge. Increased leukocyte counts do not invariably indicate leukemia. A comprehensive analysis of the hemogram, which includes an examination of each cell line, relevant indices, and a thorough peripheral smear evaluation in relation to the clinical presentation, is essential for determining suitable investigations and management strategies.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 9S","pages":"26-29"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070662","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":"Can We Make Continuing Medical Education and Continuing Professional Development More Interesting for Healthcare Professionals?","authors":"Abhijit A Trailokya","doi":"10.59556/japi.73.1095","DOIUrl":"10.59556/japi.73.1095","url":null,"abstract":"<p><p>Continuing medical education (CME) and continuing professional development (CPD) play a crucial role in ensuring healthcare professionals remain up to date with the latest advancements, improve their clinical skills, and ultimately provide the best care to their patients.^1,2 Clinicians, whether they are doctors or other healthcare professionals, have clear expectations from CME programs. Since these programs play a vital role in their professional development, it is essential that CME activities meet their needs and provide value.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"73 9","pages":"103-104"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070385","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}