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

{"title":"Renal Biopsy Registry from a Single Center in India: 20-year Experience.","authors":"Chetan Veeramaneni, Manisha Sahay, Anuradha Kavadi, Kiranmai Ismal, Swarnalata Gowrishankar","doi":"10.59556/japi.72.0731","DOIUrl":"https://doi.org/10.59556/japi.72.0731","url":null,"abstract":"<p><p><b>Background:</b> There is a geographical variation in pattern of kidney diseases due to multiple factors. Renal biopsy is being performed to establish diagnosis of renal diseases. There are only a few biopsy registries which leads to paucity of information. This study was done to evaluate the spectrum of biopsy-proven renal diseases in a tertiary care hospital in southern India. <b>Materials and methods:</b> Renal biopsy records over 2 decades (2000-2020) performed in the Department of Nephrology in a tertiary care hospital in India were analyzed, and clinicopathological correlation was made. <b>Results:</b> Total of 4,532 renal biopsies were evaluated in our study after excluding inadequate biopsy samples. Of which males were 58 and 48% were females. Mean age in our study was 38.6 ± 31.4 years. The most common clinical presentation in our study was nephrotic syndrome (37.2%). On histology, the most common diagnosis was primary glomerulonephritis (49.9%), followed by secondary glomerular diseases (22%), tubulointerstitial (20.8%), and vascular diseases (3.3%). Minimal change disease (12.8%), diabetic nephropathy (11.3%), and acute tubulointerstitial diseases (11.2%) were the three most common histological diagnoses in our study. <b>Conclusion:</b> Nephrotic syndrome was the most common clinical presentation in our study. Minimal change disease was the most common histological diagnosis in our study. There is a need for a uniform nationwide renal biopsy registry in India and even regional renal biopsy registries to analyze the changing trends of renal diseases over time frame and to analyze regional differences in trends of renal diseases.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"72 11","pages":"33-38"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676824","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":"Stable Angina Pectoris: A Review of Pathophysiology, Diagnosis, and Its Management.","authors":"Anurag Sharma, Tushor Roy, Paramartha Bhattacharya, Dinesh Agarwal, Rohit Kumar, Syed Mujtaba Hussain Naqvi, Rajan Mittal","doi":"10.59556/japi.72.0704","DOIUrl":"https://doi.org/10.59556/japi.72.0704","url":null,"abstract":"<p><p>India is at the cusp of an impending epidemic of cardiovascular diseases (CVD). It has been triggered by rapid urbanization, industrialization, and globalization. Coronary artery disease (CAD) and ischemic heart disease (IHD) clinically present as angina pectoris (chest pain and discomfort). Despite advances in treatment options for CAD, a lack of awareness of risk factors and disease, access to healthcare, and affordability are the primary concerns in low- and middle-income countries. In India, CAD results in >7 million deaths annually. There is a need for active collaboration between patients, physicians, and healthcare providers to identify the early and adequate use of lifestyle, pharmacological, and primary and secondary preventive measures. Antianginal treatment options are categorized as first line (calcium channel blockers (CCBs), β-blockers, and short-acting nitrates) and second line (ivabradine, nicorandil, ranolazine, and trimetazidine) drugs. This review discusses different CCBs (dihydropyridines (DHPs) or nondihydropyridines) for the management of angina pectoris.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"72 11","pages":"92-97"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676840","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":"Prevalence of Celiac Disease in Patients with Nutritional Anemia in Western Part of India.","authors":"Archita Makharia, Kishan Gopal, Vineet Tiwari, Brateen Roy, Sunil Dadhich, Manoj Lakhotia","doi":"10.59556/japi.72.0744","DOIUrl":"https://doi.org/10.59556/japi.72.0744","url":null,"abstract":"<p><p><b>Background:</b> Around 1.6 billion people worldwide are affected by nutritional anemia. A small percentage of nutritional anemia cases are attributed to celiac disease (CeD). However, data on the prevalence of CeD among individuals with nutritional anemia in the Western part of India is scarce. <b>Patients and methods:</b> Individuals with nutritional anemia were prospectively investigated for the presence of CeD through the detection of immunoglobulin A (IgA) antitissue transglutaminase antibodies (anti-tTG Ab). Those who had a positive antibody result proceeded to have an upper gastrointestinal endoscopy, accompanied by a duodenal biopsy. The diagnosis of CeD was confirmed following Indian guidelines. <b>Results:</b> A total of 116 patients, including 96 females, were screened, with a mean age of 37 ± 17.8 years. Among them, 19 patients (16.3%) were positive for IgA anti-tTG antibodies. Fifteen of these antibody-positive patients agreed to undergo a duodenal biopsy, which showed villous abnormalities of modified Marsh grade 2 or higher in 11 cases. The overall seroprevalence of CeD was 16.3%, while the biopsy-confirmed prevalence stood at 9.3%. Moreover, an additional four patients (3.4%) were identified as having potential CeD. Chronic diarrhea and short stature emerged as significant predictors of CeD among patients with nutritional anemia. <b>Conclusion:</b> Even in the Western part of India, approximately one in 10 patients with nutritional anemia have CeD, reflecting similar findings across the country. Consequently, we should screen all patients with nutritional anemia for CeD through antitissue transglutaminase antibody testing. This is especially crucial for those with unexplained, persistent nutritional anemia that does not respond to oral iron therapy.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"72 11","pages":"21-24"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676817","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 a Structured Tele Based Post COVID-19 Rehabilitation Program in the Indian Population.","authors":"Poorvi Devani, Nicole Maria Pinto, Shravani Kale, Neha Maru, Priyanka Jain, Amrita Desai, Vaishali Prabhudesai, Pralhad Prabhudesai","doi":"10.59556/japi.72.0739","DOIUrl":"https://doi.org/10.59556/japi.72.0739","url":null,"abstract":"<p><p><b>Introduction:</b> The emergence of coronavirus disease of 2019 (COVID-19) and the imperative for social distancing have propelled telehealth to the forefront. Even after discharge, patients may experience lingering symptoms, termed post-COVID-19 syndrome, which impairs functioning. This syndrome persists beyond recovery from COVID-19. Hence, timely implementation and sustained access to pulmonary rehabilitation services are crucial for COVID-19 patients. This study aims to assess the impact of a structured telerehabilitation program on post-COVID-19 recovery in the Indian population. <b>Methodology:</b> A total of 53 patients, with their informed consent, were included in the study, comprising 71.7% males and 24.3% females, with a mean age of 57.15 years (SD = 11.74, range: 30-81 years). Upon enrollment, comprehensive assessments were conducted, incorporating the visual analog scale (VAS) score for fatigue, 1-minute sit-to-stand test, post-COVID-19 functional status scale, and Depression, Anxiety, and Stress Scale-21 (DASS-21). Treatment interventions were administered remotely <i>via</i> WhatsApp video or Zoom calls, consisting of pulmonary rehabilitation protocols encompassing warm-up exercises, breathing exercises, aerobic and strength training, yoga, cooldown exercises, and regular educational sessions tailored to individual patient needs. <b>Results:</b> There was a significant improvement in outcome measures: VAS score for fatigue (<i>t</i> = 8.6, S, <i>p</i> < 0.001), 1-minute sit-to-stand (steps: <i>t</i> = 5.9, S, <i>p</i> < 0.001), and health-related quality of life (<i>Z</i> = 5.9, S, <i>p</i> < 0.001). <b>Conclusion:</b> The study shows that a structured tele-based program is not only effective in patients but also an approach that is feasible and should be considered for the delivery of rehabilitation to patients who are unable to participate in center-based rehabilitation.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"72 11","pages":"57-60"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676799","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":"Research Methodology and Biostatistics in the Postgraduate Curriculum: The AIIMS-Bhubaneswar Experience.","authors":"Gitanjali Batmanabane, Rituparna Maiti, Mullezhath Babu Nimesh Krishna","doi":"10.59556/japi.72.0714","DOIUrl":"https://doi.org/10.59556/japi.72.0714","url":null,"abstract":"<p><p>Inclusion of research methodology and biostatistics in the postgraduate curriculum by the National Medical Commission is a welcome step to improve the research milieu in medical colleges in India. This step will have a long-term impact on research outcomes and scientific publications. In 2019, AIIMS-Bhubaneswar implemented the revised postgraduate curriculum, which introduced a faculty-facilitated program on research methodology and biostatistics for all postgraduate students. The institute also made the examination in research methodology mandatory, which can be viewed as a complementary mechanism. As the revised curriculum has been in practice for the last 4 years and six sessions of examinations have been completed, the authors tried to look back to check whether the program is having the expected results and share the experience they gained.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"72 11","pages":"98-100"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676827","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":"Prevalence of Depression in Patients with Epilepsy: A Single Center Cross-sectional Study at a Tertiary Care Hospital.","authors":"Sriramakrishnan Vayanakkan, Anto Ignat Stany, Vignesh Karunaharan","doi":"10.59556/japi.72.0745","DOIUrl":"https://doi.org/10.59556/japi.72.0745","url":null,"abstract":"<p><p><b>Background:</b> Depression in persons with epilepsy (PWE) negatively impacts the quality of life (QOL), increasing suicidal risk and increasing healthcare costs. <b>Aim:</b> To assess the prevalence of depression in recently diagnosed PWE and the impact of seizure variables on depression. <b>Study design:</b> A prospective study of recently diagnosed epilepsy patients attending a tertiary hospital in government Tirunelveli Medical College Hospital. <b>Materials and methods:</b> Recently diagnosed epilepsy patients (<i>n</i> = 100) were administered the Beck Depression Inventory (BDI) translated into local vernacular language for quantitative assessment of depression. <b>Statistical analysis:</b> Chi-squared test and logistic regression analysis were used to assess the impact of seizure-related variables on BDI scores (<i>p</i> < 0.05 was considered significant). <b>Results:</b> Using the BDI, the prevalence of depressive symptoms in PWE was 48%. A strong correlation coefficient of 0.8 was obtained on the PWE scores on both scales, demonstrating their effectiveness in detecting depressive symptoms. <b>Conclusion:</b> Depression was more common in PWE than in the general population. Depression may be seen even before the onset of epilepsy in some patients, thereby hinting at a probable similar mechanism. Patients with temporal lobe epilepsy and major depressive disorder show changes in serotonergic 5-hydroxytryptophan (5HT) 1A receptor density in their brains, as observed using positron emission tomography. It is crucial to promptly identify and manage depression in newly diagnosed epilepsy patients, along with administering appropriate antiepileptic drugs.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"72 11","pages":"e12-e15"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676819","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":"Hypersensitivity Pneumonitis: The Diagnosis Lies in History.","authors":"Jyoti Chauhan, Tanvi Batra, Atul Kakar, Rahul Kumar, Naveen Goud Bollapally, Anjana Jangid","doi":"10.59556/japi.72.0723","DOIUrl":"https://doi.org/10.59556/japi.72.0723","url":null,"abstract":"<p><p>Hypersensitivity pneumonitis (HP)/extrinsic allergic alveolitis (EAA) is defined as a response of lungs to inhaled organic and inorganic substances. This disease is relatively rare, comprising 2% of cases in the category of interstitial lung diseases. Here, we discuss a case of 61-year-old female, who presented with sudden onset breathlessness, with bilateral coarse crackles on physical examination, initially thought to be due to heart failure or atypical pneumonia, but later diagnosed as HP. She was managed initially with antibiotics but due to poor response, steroids were introduced which led to significant improvement. This report emphasizes the importance of exposure history of substances that are toxic, lack of specificity of clinical manifestations, importance of invasive methods for diagnosis, and poor response to therapy in case of delayed diagnosis.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"72 11","pages":"101-102"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676809","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":"Sporadic Creutzfeldt-Jakob Disease: A Rare Case of Rapid Progressive Cognitive Decline with Special Reference to Magnetic Resonance Spectroscopy.","authors":"Karan Jaykrushna Pandya, Bansari Krupal Parmar, Jaya M Pathak","doi":"10.59556/japi.72.0632","DOIUrl":"https://doi.org/10.59556/japi.72.0632","url":null,"abstract":"<p><p>Creutzfeldt-Jakob disease (CJD) is a rare degenerative disorder seen in the 6-8th decade of life. It manifests as a rapidly progressing cognitive deterioration, the etiopathogenesis of which is neuronal accumulation of aberrant prion protein [scrapie-associated prion protein (PrPSC)], resulting in mortality within 1 year of diagnosis. Clinical features such as dementia, myoclonus, cerebellar, and extrapyramidal symptoms are observed in CJD, which may be confused with other degenerative conditions and many infectious diseases like human immunodeficiency virus (HIV), creating a diagnostic challenge. Consequently, a multimodal approach with clinical, electrophysiological, radiological, and biochemical analyses is needed to validate the diagnosis of CJD. There is no effective treatment available for CJD. Early identification of the disease can lead to palliative care. Mortality of the patient occurs due to infection and comorbidities. In this article, we report a case of a 60-year-old male with probable sporadic CJD who presented with dementia, akinetic mutism, and rigidity, along with typical magnetic resonance imaging (MRI) findings of the brain. The magnetic resonance spectroscopy (MRS) study showed lower N-acetylaspartate/creatine (NAA: Cr) and Cho: Cr ratios correlated with progressive neurodegeneration and, hence, poor prognosis.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"72 11","pages":"e53-e55"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676837","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":"Prescribing Pattern and Effectiveness of Antihypertensives in Patients Suffering from Hypertension to Diabetes Mellitus with and without Compelling Indications in Tertiary Care Hospital.","authors":"Prajakta Vilas Jagdale, Omkar Baban Thore, Shivam Kondiram Bhite, Ashika Ashok Shriyan, Suvarna Pramod Ingale, Divya Ashok Kulkarni, Rajesh Surendra Badani","doi":"10.59556/japi.72.0726","DOIUrl":"https://doi.org/10.59556/japi.72.0726","url":null,"abstract":"<p><p><b>Aim:</b> The prevalence of hypertension (HTN) and diabetes mellitus (DM) is increasing worldwide, and their coexistence is well-documented. Managing both conditions is challenging due to shared pathophysiological mechanisms and the need to balance blood pressure (BP) control with glycemic management. The objective of this protocol was to consider the prescribing pattern and effectiveness of antihypertensive agents in hypertensive and diabetic patients, with and without compelling indications, at tertiary care hospital. <b>Materials and methods:</b> A prospective, observational study was conducted over 6 months in total 226 diabetic hypertensive patients from a tertiary care hospital. Demographic and medication history data were collected using a self-designed patient profile form. Descriptive statistics were used to analyze the data, and the results were expressed as percentages or means with standard deviations. <b>Results:</b> A total of 226 patients were included in the study, with 62% males and 38% females. 73% of patients were classified as stage 1 and 27% as stage 2 HTN. Among the prescribed antihypertensive agents, β-blockers (BBs) were the most prescribed, followed by angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), angiotensin-converting enzyme inhibitors (ACEIs), diuretics, and other classes. Combination therapy was predominantly used, with dual-drug therapy being the most common. Compelling indications for antihypertensive treatment included ischemic heart disease (IHD) (38.49%), chronic kidney disease (CKD) (12.38%), and stroke (6.63%). The choice of antihypertensive agents varied based on the presence of compelling indications, with BBs and ARBs being frequently prescribed. BP control was achieved in 93% of the patients, with 85.96% of patients with HTN + DM, and 82.84% of patients with additional compelling indications having controlled BP. <b>Conclusion:</b> Therefore, it can be concluded that the antihypertensive medications prescribed to the study adhered to guidelines and that long-term use of these combinations proved to be more effective, safe, and well-tolerated for patients with HTN and DM with or without convincing indications. Adopting the best approach to managing HTN in people with diabetes is crucial for ameliorating patient outcomes and enhancing overall quality of life.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"72 11","pages":"27-32"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676813","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 Unusual Case of Pancytopenia.","authors":"Sweety Singh, Rishabh Jha, Nimisha Bajaj, Alok Ranjan, Arshad Ahmad","doi":"10.59556/japi.72.0699","DOIUrl":"https://doi.org/10.59556/japi.72.0699","url":null,"abstract":"<p><p>Multiple myeloma is a rare hematological disorder that causes overproduction of plasma cells within the bone marrow, leading to suppressed hematopoiesis, renal insufficiency, bony lesions, and recurrent infections. Patients with multiple myeloma commonly present with anemia. Although rare, neutropenia and thrombocytopenia can also develop in these patients, leading to pancytopenia, as seen in our case. Therefore, multiple myeloma should be kept as one of the differentials in elderly patients who present with pancytopenia for early screening and diagnosis of the disease.</p>","PeriodicalId":22693,"journal":{"name":"The Journal of the Association of Physicians of India","volume":"72 11","pages":"103-104"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676933","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}