Vidarbha Journal of Internal Medicine最新文献

{"title":"A Clinical Study of Spectrum of Liver Diseases in Alcoholic with Respect to Predictors of Severity and Prognosis","authors":"Tilottama Parate, Pankaj A. Chavan, R. Parate","doi":"10.25259/vjim_6_2021","DOIUrl":"https://doi.org/10.25259/vjim_6_2021","url":null,"abstract":"\u0000\u0000Alcoholic liver disease (ALD) is the second most common cause of mortality in humans every year occurring due to overconsumption of alcohol. The spectrum of ALD includes fatty liver/steatosis, alcoholic hepatitis, steatohepatitis, chronic hepatitis with liver fibrosis or cirrhosis, and hepatocellular carcinoma. The diagnosis of ALD can generally be made based on clinical and laboratory features alone in patients with a history of significant alcohol consumption. Prognostic scores such as Child-Pugh classification, MELD, MELD-Na, and Maddrey’s discriminant function (MDF) are used commonly to predict mortality in patients with ALD.The aim of the study is to evaluate the spectrum of liver diseases in alcoholic patients and factors predicting severity and prognosis in such patients.\u0000\u0000\u0000\u0000This was a prospective, longitudinal and observational study conducted on 83 patients with ALD admitted in medicine inpatient department from January 2019 to December 2020. Demographic data, biochemical parameters, and clinical features of the patients were evaluated. From the data obtained prognostic scores of Child-Pugh classification, MELD, MELD-Na, and MDF were calculated. Patients were clinically evaluated and all the biochemical parameters and scores were assessed on admission and after the 7th and 30th days.\u0000\u0000\u0000\u0000The majority of the patients were males (95.18%) with a mean age of 49.44 ± 7.67. The mean duration of hospital stay of the patients was 34.33 ± 12.98 and approximately 76% of the patients were still consuming alcohol at the time of hospitalisation. Jaundice and ascites were present in all 83 patients, and loss of appetite (85.5%) and nausea and vomiting (78.3%) were the most common clinical features. Complications such as hepatic encephalopathy (85.5%) and oesophageal varices (80.72%) were common on admission. MELD and MELD-Na score > 24 was found in 59 patients and discriminant function (DF) score was more than 32 in 81 patients. Mortality analysis showed that 6 (7.2%) patients died within 1 week of admission and MELD was found to be the best predictor of mortality compared to CTP, MELD-Na, and DF by 7 days. Thirty-two (38.5%) patients died within 30 days of admission. MELD-Na was found to be the best predictor of mortality compared to CTP, MELD, and DF by 30 days.\u0000\u0000\u0000\u0000The presence of ascites, hepatic encephalopathy, high bilirubin, low albumin, high creatinine, high INR, and low sodium is found to be independent predictors of mortality. MELD and MELD-Na are good predictors of mortality over the short-term (7–30 days).\u0000","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130859664","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 Study of NT-ProBNP and ETCO2 in Patients Presenting with Acute Dyspnoea","authors":"Riya Saboo, Dipti Chand","doi":"10.25259/vjim_19_2022","DOIUrl":"https://doi.org/10.25259/vjim_19_2022","url":null,"abstract":"\u0000\u0000In patients presenting with acute dyspnoea in the emergency department (ED), the early and correct diagnosis may present a significant clinical challenge. The most common diagnoses of acute shortness of breath and manifesting signs of respiratory distress are decompensated heart failure (HF), pneumonia, chronic obstructive pulmonary disease (COPD), pulmonary embolism (PE), asthma, and acute respiratory distress syndrome (ARDS) and other causes like anaemia. The aim of the study was to measure NT-pro brain natriuretic peptide (BNP) and exhaled end-tidal carbon dioxide (ETCO2) in patients presenting with dyspnoea.\u0000\u0000\u0000\u0000This prospective, cross-sectional and observational study was performed at the Government Medical College and Hospital, Nagpur, between October 2019 and October 2021 in patients admitted to the medicine intensive care unit. Three groups of patients were compared: (1) HF-related acute dyspnoea group (n = 52), (2) pulmonary (COPD/PE)-related acute dyspnoea group (n = 31) and (3) sepsis with ARDS-related dyspnoea group (n = 13). All patients underwent initial clinical examination with a recording of initial vital parameters along with on-admission ETCO2 measurement, NT-proBNP testing, arterial blood gas testing, lung ultrasound examination, 2D echocardiography, chest X-rays, and other basic diagnostic laboratory testing.\u0000\u0000\u0000\u0000We included 96 patients during the study period. Median NT-proBNP was found to be maximum for the HF group (11,480 pg/ml) followed by the sepsis group (780 pg/ml) and pulmonary group (231 pg/ml). The mean ETCO2 value was found to be maximum in the pulmonary group (48.610 mmHg) followed by HF (31.51 mmHg) and the sepsis group (19.46 mmHg). All results were found to be statistically significant (P < 0.05).\u0000\u0000\u0000\u0000NT-proBNP has high diagnostic accuracy in differentiating acute HF-related dyspnoea from pulmonary (COPD and ARDS)-related acute dyspnoea. The higher levels of ETCO2 help in diagnosing patients with COPD.\u0000","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"1294 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133841820","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":"Autoimmune Haemolytic Anaemia as Presenting Feature of Systemic Lupus Erythematosus","authors":"Amit A. Shrawankar, Mohan N. Nerkar","doi":"10.25259/vjim_1_2022","DOIUrl":"https://doi.org/10.25259/vjim_1_2022","url":null,"abstract":"Here, we describe a unique case of a 37-year-old woman who presented with a vague clinical presentation, found to have warm autoimmune haemolytic anaemia. Further immunological and inflammatory workup during hospitalisation lead to the diagnosis of systemic lupus erythematosus.","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"437 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122881930","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 Rare Presentation of Coronary Aneurysm following Bare-metal Stent","authors":"Satish R. Chirde, R. S. Dalal","doi":"10.25259/vjim_7_2022","DOIUrl":"https://doi.org/10.25259/vjim_7_2022","url":null,"abstract":"We present a case of post-percutaneous transluminal coronary angioplasty with a bare-metal stent to the right coronary artery (RCA). He presented with acute ST-elevation inferior wall myocardial infarction. Coronary angiography showed an aneurysm of proximal RCA extending from the proximal end of the stent to the distal end. There was a 90% discrete lesion beyond the stent with TIMI III flow. The development of coronary artery aneurysms (CAAs) was reported even before the era of stents. CAA can develop after plain balloon angioplasty, after directional coronary atherectomy, and after bare-metal and drug-eluting stents also but not after coronary angiography. Kachru et al. reported an incidence of 0.2% (4 of 2408) per DES without routine angiographic follow-up and Rha et al. reported an incidence of 1.7% (five out of 296) per patient at 6-month routine angiographic follow-up. CAA is an uncommon and often accidental finding, we report a case of CAA which presented as acute myocardial infarction mimicking stent thrombosis.","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"136 10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131211853","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":"Systemic Lupus Erythematosus and Atherosclerosis","authors":"Manisha K. Juneja, Pankaj Raut, M. Lohkare, Harshawardhan Dhanraj Ramteke","doi":"10.25259/vjim_20_2022","DOIUrl":"https://doi.org/10.25259/vjim_20_2022","url":null,"abstract":"Disorders likely ‘inflammatory’ in nature are known to be linked to accelerated atherosclerotic processes that increase the chances of cardiovascular disease. Systemic lupus erythematosus (SLE) is a well-known autoimmune disease for its ability to affect any organ and cause morbidity. One such major cause of morbidity and mortality in SLE is premature coronary heart disease. Inflammation is considered to be the main pathogenesis of atherosclerosis and an important risk factor for vascular disease. Many clinical trials and studies of epidemiological and pathogenesis-related factors revealed that there is a common link between the pathogenesis of autoimmune diseases such as SLE, causing inflammatory responses similar to those seen in atherosclerosis. In the following review article, we will describe how SLE, inflammation and its traditional risk factors, promotes atherosclerosis.","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"1 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131528543","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":"Silent Lupus Nephritis in Adolescent Male: A Case Report","authors":"S. Meshram, Abhishek Walke, M. Holay, Prashant Patil","doi":"10.25259/vjim_2_2022","DOIUrl":"https://doi.org/10.25259/vjim_2_2022","url":null,"abstract":"Systemic lupus erythematosus (SLE) is a multisystemic disorder, one of several diseases known as ‘the great imitators,’ because it often mimics or is mistaken for other illnesses. SLE symptoms vary widely and appear and disappear unpredictably. Diagnosis can thus be elusive, with some patients having unexplained symptoms of untreated SLE for years. Autoimmunity plays a major role in the pathogenesis of lupus nephritis (LN). LN is one of the most serious complications of SLE since it is the major predictor of poor prognosis. The immunologic mechanisms include the production of autoantibodies directed against nuclear elements. Here is a case report of a young male patient who presented with fever, and alopecia and was diagnosed as an SLE with LN.","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130290607","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":"Mauriac Syndrome in a Patient of Type 1 Diabetes Mellitus","authors":"Nandita Bagchi, Rashmi N. Nagdeve, Abhishek Walke, S. Chatterjee","doi":"10.25259/vjim_6_2022","DOIUrl":"https://doi.org/10.25259/vjim_6_2022","url":null,"abstract":"Mauriac syndrome is a metabolic complication of poor glycaemic control in Type 1 DM patients, unique to children, characterised by growth failure, short stature, delayed puberty, Cushingoid features, and marked hepatomegaly from massive deposition of glycogen. It is probably due to a combination of factors including inadequate glucose uptake and utilisation in the tissues, decreased insulin-like growth factor-1 and growth hormone levels, impaired bioactivity of these hormones, a circulating hormone inhibitor, resistant or defective hormone receptors, insulin deficiency, and poor glycaemic control. This syndrome is rarely seen nowadays because of better treatment modalities.","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131269714","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":"Basics of Chronic Pain Management","authors":"Vrishali Ankalwar","doi":"10.25259/vjim_16_2022","DOIUrl":"https://doi.org/10.25259/vjim_16_2022","url":null,"abstract":"Approximately one in ten people suffer from chronic pain globally with pain being the most common reason to seek medical help. Despite the long-term prevalence of pain, the practice of pain management and the scientific discipline of pain research are relatively new fields. To relieve suffering from chronic pain in the ‘fifth vital sign’ era to date remains a 21st-century dilemma for healthcare providers. In the current review article, numerous articles from various pain journals and books for chronic pain management using medical search engines such as PubMed, Scopus, and Google scholar have been reviewed in an attempt to shed light on the approach, evaluation, and management of chronic pain. Along with the same, recent advances in pharmacotherapy and interventional nerve blocks have been discussed in brief.","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131923846","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":"Experience with Adalimumab Biosimilar in Rheumatoid Arthritis, Psoriatic Arthritis and Ankylosing Spondylitis at our District General Hospital in Shropshire, United Kingdom","authors":"Amol Sagdeo, Anuja Sagdeo, R. Amarasena","doi":"10.25259/vjim_10_2022","DOIUrl":"https://doi.org/10.25259/vjim_10_2022","url":null,"abstract":"\u0000\u0000The main objective of this article was to share our experience with Idacio (adalimumab biosimilar) in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS).\u0000\u0000\u0000\u0000We collected prospective data from the first 50 patients who were prescribed Idacio from September 2020 to August 2021. We collected their efficacy, and safety data from their subsequent visits up to 6 months. All the adverse events were recorded in our datasheet. As patients were not directly involved in the study, ethics committee approval was not needed for this study.\u0000\u0000\u0000\u0000Out of 25 RA patients, an adequate response was noted in 13 (54.2%) patients. Eleven (44%) of RA patients did not have any response to Idacio and one patient lost to follow-up due to moving out of the region hence account was closed for Idacio. Eight (57%) out of 14 patients with AS had an adequate response after Idacio treatment. Four (44.4%) out of nine patients with PsA had an adequate response and two patients with PsA lost to follow-up due to a change of address after only 1 month of treatment. Side effects noted in these 50 patients were facial rash in one patient, two patients had neutropenia (none of them had to stop the drug) and two patients had injection site pain initially on the first two injections. The patient with a severe facial rash had to stop the treatment.\u0000\u0000\u0000\u0000Idacio therapy was safe and effective in our cohort of patients with few side effects.\u0000","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"10 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129465318","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":"Silent Killers","authors":"Dipti Chand","doi":"10.25259/vjim_21_2022","DOIUrl":"https://doi.org/10.25259/vjim_21_2022","url":null,"abstract":"","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133242444","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}