Vidarbha Journal of Internal Medicine最新文献

Gitelman Syndrome – A Case Report 吉特曼综合征1例报告

Vidarbha Journal of Internal Medicine Pub Date : 2023-04-06 DOI: 10.25259/vjim_32_2022

V. Yesankar, P. Pitale

{"title":"Gitelman Syndrome – A Case Report","authors":"V. Yesankar, P. Pitale","doi":"10.25259/vjim_32_2022","DOIUrl":"https://doi.org/10.25259/vjim_32_2022","url":null,"abstract":"Hypokalaemia is an electrolyte disorder, commonly encountered in clinical practice. Sometimes, it may present with severe life-threatening complications. We present here a case of 22-year-old female, who was admitted to intensive care unit, for severe hypokalaemia associated with cardiac and neurological complications. She had recurrence of such episodes. On detailed clinical and biochemical evaluation, she was diagnosed to have Gitelman syndrome (GS). She was treated with intravenous potassium and magnesium supplementation under cardiac monitoring and other supportive management. She was discharged in stable condition, on oral supplements, and remained stable on follow-up visits. GS is an autosomal recessive and renal tubular disorder characterised by hypokalaemic metabolic alkalosis with hypomagnesaemia, hypocalciuria, secondary hyperreninemic aldosteronism and hypotension. The disease is caused by biallelic inactivating mutations within the SLC12A3 gene encoding the thiazide-sensitive sodium chloride cotransporter expressed within the apical membrane of cells, lining the distal convoluted tubule. Since GS is an autosomal recessive trait, the recurrence risk for people with an affected child is 25%. It is very important to completely evaluate a patient with hypokalaemia to find the underlying cause. There can be various etiological factors for hypokalaemia ranging from common to rare disorders. If underlying aetiology remains undiagnosed, there may be recurrence as well as increased morbidity and mortality. GS is one such disorder, which needs prompt diagnostic evaluation and treatment.","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"187 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123283624","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

Neutrophil Lymphocyte Ratio (NLR) as a Prognostic Marker in COVID-19 Infection 中性粒细胞淋巴细胞比率(NLR)作为COVID-19感染的预后指标

Vidarbha Journal of Internal Medicine Pub Date : 2023-04-06 DOI: 10.25259/vjim_31_2022

Akanksha Amit Salkar

{"title":"Neutrophil Lymphocyte Ratio (NLR) as a Prognostic Marker in COVID-19 Infection","authors":"Akanksha Amit Salkar","doi":"10.25259/vjim_31_2022","DOIUrl":"https://doi.org/10.25259/vjim_31_2022","url":null,"abstract":"\u0000\u0000To determine the efficacy of Neutrophil/Lymphocyte ratio (NLR) as a marker of the severity of COVID-19 pneumonia. The neutrophilto-lymphocyte ratio (NLR) in peripheral blood has been studied as a systemic inflammatory marker and various studies have shown that it is a valid prognostic factor in various solid tumours and other chronic diseases such as lung, cardiovascular and kidney diseases. Emerging evidences suggested that peripheral blood neutrophil to lymphocyte ratio (NLR) can be used as a marker of systemic inflammation. Furthermore, NLR has shown good predictive values on progression and clinical outcomes in Covid-19 severity. Our study aims at evaluating whether NLR can help clinicians identify potentially severe cases early, conduct early triage and initiate effective management in time, which may reduce the overall mortality of COVID-19.\u0000\u0000\u0000\u0000This was a retrospective study done from January 2021 to August 2021 in Breach candy hospital Mumbai. A group of 100 patients with confirmed COVID-19 infection hospitalised in our centre were retrospectively analysed. COVID-19 diagnosis was performed via RTPCR from nasopharyngeal and oropharyngeal swabs. For each patient, demographic data, clinical history, laboratory tests specially CBC and treatment measures during hospitalisation were collected.\u0000\u0000\u0000\u0000NLR can be used to determine on disease severity and mortality in patients with COVID infection.\u0000\u0000\u0000\u0000Evaluating NLR can help clinicians identify potentially severe cases early, conduct early triage and initiate effective management in time, which may reduce the overall mortality of COVID-19.\u0000","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"763 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134131889","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

Clinical Profile and in Hospital Outcome of Acute Poisoning Cases Admitted in Tertiary Care Hospital: A Prospective Observational Study 三级医院急性中毒病例的临床特征和院内转归:一项前瞻性观察研究

Vidarbha Journal of Internal Medicine Pub Date : 2023-04-06 DOI: 10.25259/vjim_33_2022

Atul Limbajirao Aher, Pravin U. Shingade

{"title":"Clinical Profile and in Hospital Outcome of Acute Poisoning Cases Admitted in Tertiary Care Hospital: A Prospective Observational Study","authors":"Atul Limbajirao Aher, Pravin U. Shingade","doi":"10.25259/vjim_33_2022","DOIUrl":"https://doi.org/10.25259/vjim_33_2022","url":null,"abstract":"\u0000\u0000Acute poisoning is a medical emergency. Data are scarce from the Indian subcontinent regarding the profile and outcome of patients presenting with acute poisoning admitted to intensive care unit (ICU). Hence, the present study was undertaken to assess the clinical profile and hospital outcome of acute poisoning cases admitted in tertiary care hospitals.\u0000\u0000\u0000\u0000A total of 148 patients with acute poisoning aged >18 years and admitted in the intensive care unit and medicine wards of tertiary care hospital during a period of 1 year from September 1, 2019, to August 31, 2021, were studied.\u0000\u0000\u0000\u0000Poisoning was more common in the 21–30 years age group (42.57%) with male predominance (55.41%). Poisoning with suicidal intention constituted 81.76%: 44.59% of cases seeking medical help within 2–4 h. In 81.76% of cases, route of poisoning was oral. Organophosphorus was the most common acute poisoning (28.38%), and most common symptoms were nausea/vomiting. Complications noted were ventilator-associated pneumonia (VAP) (4.72%), renal failure (6.08%) and hepatic failure (2.7%). Mortality was seen in 11.49% of cases. Out of 148 cases, 121 were of suicidal poisoning, while 14 patients out of them expired so psychiatric evaluation of 107 patients can be made and out of that all patients had some underlying psychiatric illness. Patients requiring ventilatory support constituted 25.67% of cases.\u0000\u0000\u0000\u0000Clinical profile of acute poisoning depends on the nature of compound/poison, quantity of compound consumed/exposed, first aid received at the primary care level and time taken to shift the patient from primary care level to tertiary care level. In-hospital mortality mostly depends on the dedicated facilities available at the tertiary care level in addition to the factors described above for clinical profile.\u0000","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129264671","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

Cervical Angina: A Rare Entity 子宫颈心绞痛:一种罕见的疾病

Vidarbha Journal of Internal Medicine Pub Date : 2023-04-06 DOI: 10.25259/vjim_29_2022

A. Jawahirani, P. Giri, C. Pakhmode

引用次数: 0

Clinical Profile and in Hospital Outcome of Cerebral Venous Sinus Thrombosis at Tertiary Care Centre of Central India 印度中部三级保健中心脑静脉窦血栓形成的临床概况和住院结果

Vidarbha Journal of Internal Medicine Pub Date : 2023-04-06 DOI: 10.25259/vjim_36_2022

A. Rajkondawar, P. D. Bhilare

{"title":"Clinical Profile and in Hospital Outcome of Cerebral Venous Sinus Thrombosis at Tertiary Care Centre of Central India","authors":"A. Rajkondawar, P. D. Bhilare","doi":"10.25259/vjim_36_2022","DOIUrl":"https://doi.org/10.25259/vjim_36_2022","url":null,"abstract":"\u0000\u0000The objectives of the study are as follows: Clinical profile and in hospital outcome of cerebral venous sinus thrombosis (CVST) at tertiary care centre in central India. To study clinical presentation and outcomes of CVST.\u0000\u0000\u0000\u0000A cross-sectional study was performed in a tertiary care centre from October 2020–October 2022. All patients suspected to have CVST based on clinical history and examination were evaluated but only those with confirmed diagnosis (based on neuroimaging) of CVST were taken for study.\u0000\u0000\u0000\u0000Total of 62 patients were studied, most common age group was between 21 and 30 years. Among them males and females are 61.29 and 38.71, respectively. In our study, we found dehydration (62.90%) as the most common predisposing risk factor of CVST, followed by alcohol (48.38%). Headache (83.87%) is the most common symptom and followed by vomiting (59.68%) and convulsion (48.39%), least common was altered sensorium. The most common sinuses involved were superior sagittal sinus (67.74%) and superior sagittal plus sigmoid sinus (14.52%). Among 62 patients, 48 are discharged (77.42%). Death was reported in 14 (22.58%) cases.\u0000\u0000\u0000\u0000CVST is an important cause of intracranial hypertension, seizures and stroke in young people. Clinical presentation is extremely variable and a high index of suspicion is needed. Magnetic resonance imaging brain with magnetic resonance venography is the current diagnostic modality of choice.\u0000","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"263 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116037990","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

D-dimer Levels to Predict in-Hospital Mortality in ICU Patients with COVID-19 d -二聚体水平预测COVID-19 ICU患者住院死亡率

Vidarbha Journal of Internal Medicine Pub Date : 2023-04-06 DOI: 10.25259/vjim_30_2022

Ramesh Hasani, Mohan Nerkar, Prashant Rahate, Venus Sadhwani

{"title":"D-dimer Levels to Predict in-Hospital Mortality in ICU Patients with COVID-19","authors":"Ramesh Hasani, Mohan Nerkar, Prashant Rahate, Venus Sadhwani","doi":"10.25259/vjim_30_2022","DOIUrl":"https://doi.org/10.25259/vjim_30_2022","url":null,"abstract":"Objectives: Coronavirus disease 2019 (COVID-19) is a recently described infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing various intensive care unit (ICU) admissions and deaths. Common laboratory values may provide key insights into patients with COVID-19, and may predict the morbidity and outcome. The aim of this study was to evaluate the relation of elevated D-dimer levels on mortality of patients admitted to ICU with COVID-19. Material and Methods: All ICU patients with laboratory confirmed COVID-19 were retrospectively enrolled in Sevenstar Hospital, Nagpur from 27 July, 2020, to 30 October, 2020. D-dimer levels on admission, on Day 3 and Day 5, were collected in all ICU patients and death events were collected. The subjects were divided into two groups discharged and expired. Then, the D-dimer levels between two groups were compared to assess the predictive value of D-dimer level and mortality in hospitals. Results: A total of 101 eligible patients were enrolled in the study. Thirty-one deaths occurred during hospitalisation. Patients who expired had on admission D-dimer levels of 2729 ± 3243 ng/mL while those discharged had D-dimer values of 973 ± 1553 ng/mL ( P < 0.007). D-dimer of expired patients on Day 3 was 3206.5 ± 3338.8 and of discharged patients was 828.8 ± 1268.8 ( P = 0.001). D-dimer of expired patients on Day 5 was 5184. 5 ± 3386.1 versus discharged patients was 588.7 ± 645.5 ( P < 0.0001). Number of Days in ICU for patients who expired was 14.22 ± 6.7 while for those who survived 7.6 ± 5.9. Conclusion: We conclude that SARS-CoV-2 infected patients with increasing trend of D-dimer (from admission to day 5) have worse clinical outcomes (all-cause mortality), and thus, measurement of D-dimers on admission and its trend can guide clinical decision-making.","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"210 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135836242","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

Study of Correlation of Arterial Blood Gas Measurements with Peripheral Venous Blood Gas Values in Adult Patients Admitted in ICU in Tertiary Care Hospital in Central India – A Cross-Sectional Study 印度中部三级医院ICU成年患者动脉血气测量与外周静脉气值相关性的横断面研究

Vidarbha Journal of Internal Medicine Pub Date : 2023-04-06 DOI: 10.25259/vjim_34_2022

Kunalsinh Khushalsinh Shisodiya, M. Vyawahare

{"title":"Study of Correlation of Arterial Blood Gas Measurements with Peripheral Venous Blood Gas Values in Adult Patients Admitted in ICU in Tertiary Care Hospital in Central India – A Cross-Sectional Study","authors":"Kunalsinh Khushalsinh Shisodiya, M. Vyawahare","doi":"10.25259/vjim_34_2022","DOIUrl":"https://doi.org/10.25259/vjim_34_2022","url":null,"abstract":"\u0000\u0000Arterial blood gas (ABG) analysis is an essential investigation for assessment of ventilation, oxygenation and acid–base status in critically ill patients. Arterial puncture to obtain arterial blood is more invasive procedure than venous and has more potential complications. The present study was undertaken to find out the correlation between arterial and peripheral venous blood gas (VBG) values for PO2 (Partial pressure of oxygen), PCO2 (Partial pressure of carbon dioxide), pH (Potential of hydrogen) and HCO3 (bicarbonates).\u0000\u0000\u0000\u0000A total of 131 consecutive patients admitted to intensive care unit (ICU) requiring ABG analysis to determine their acid–base status or ventilatory status were included in the study. Arterial and venous blood samples were obtained with a heparinised syringe within <15 min, after performing modified Allen’s test and were analysed using blood gas analysis machine. The mean of pH, pCO2, HCO3, and PO2, values in arterial and venous samples was determined, along with peripheral arterial oxygen saturation (SpO2) of patients.\u0000\u0000\u0000\u0000ABG and VBG analysis correlated well for pH, pCO2 and HCO3, as their correlation coefficient (r) were 0.976, 0.992 and 0.984, respectively, whereas PO2 has correlation coefficient of 0.010 which suggests that there was poor correlation in PO2. For each unit increase in pCO2, pH and HCO3 of VBG, all these ABG changes by 0.9831 units, 0.914 units and 0.992 units, respectively. Peripheral O2 saturation (SpO2) correlates well with arterial O2 saturation, however, does not correlate with venous O2 saturation.\u0000\u0000\u0000\u0000The results show that VBG analysis can be a substitute for ABG for evaluation of ventilatory function and acid–base imbalance for pH, pCO2 and HCO3 in patients of ICU setup in many clinical contexts.\u0000","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128021849","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

Post-COVID Pulmonary Aspergillosis with Pulmonary Thromboembolism and Pulmonary Artery Hypertension Unmasking Prediabetes: A Case Report covid后肺曲霉病合并肺血栓栓塞和肺动脉高压揭示前驱糖尿病1例报告

Vidarbha Journal of Internal Medicine Pub Date : 2023-04-06 DOI: 10.25259/vjim_38_2022

Anjali Kamath, Gyanshankar P. Mishra, R. Munje, J. Atram

{"title":"Post-COVID Pulmonary Aspergillosis with Pulmonary Thromboembolism and Pulmonary Artery Hypertension Unmasking Prediabetes: A Case Report","authors":"Anjali Kamath, Gyanshankar P. Mishra, R. Munje, J. Atram","doi":"10.25259/vjim_38_2022","DOIUrl":"https://doi.org/10.25259/vjim_38_2022","url":null,"abstract":"Multiple complications during and following COVID-19 infection are being reported worldwide. The most serious and life-threatening are thromboembolism and invasive fungal diseases. We report a post-COVID-19 case with complications of fungal infection of the lungs and pulmonary thromboembolism with pulmonary hypertension and unmasking prediabetes. A 53-year-old male patient presented with complaints of cough, fever, exertional breathlessness for 15 days, chest pain and hoarseness of voice for 7 days. He had a prior history of COVID 10 months earlier and no comorbidities. On further investigation by computed pulmonary tomography angiography, bronchoscopy and other investigations, the patient was found to have pulmonary thromboembolism, pulmonary aspergillosis and pulmonary artery hypertension. He was treated with amphotericin B for 21 days and anticoagulants for 6 months. He had significant clinical and radiological improvement with the resolution of the embolism. The crucial factors for successful care in post-COVID-19 immune-suppressed patients include a high index of suspicion, early use of adequate diagnostic tests helped by antifungal medications, anticoagulants and control of risk factors such as hyperglycaemia.","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132674256","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

Septicemic Melioidosis: In a Immunocompetent Host: A Case Report 败血症类鼻疽:免疫正常宿主一例报告

Vidarbha Journal of Internal Medicine Pub Date : 2023-04-06 DOI: 10.25259/vjim_40_2022

Nitin D. Wadaskar, Devendra N. Khairnar

引用次数: 0

Marburg Variant of Multiple Sclerosis: A Case Report 马尔堡变异体多发性硬化症1例报告

Vidarbha Journal of Internal Medicine Pub Date : 2023-04-06 DOI: 10.25259/vjim_45_2022

Varada Vikas Ghadge, Amol Gowardhan Bondre, Tilottama Parate, Rahul Bhiwgade

引用次数: 0