Vidarbha Journal of Internal Medicine最新文献

{"title":"Osteoporosis","authors":"S. Mitra, R. Mitra","doi":"10.25259/vjim_23_2022","DOIUrl":"https://doi.org/10.25259/vjim_23_2022","url":null,"abstract":"Bone is a dynamic tissue that is remodelled constantly throughout life. The arrangement of compact and cancellous bone provides strength and density suitable for both mobility and protection. Osteoporosis is defined as a reduction in the strength of bone that leads to an increased risk of fractures. The World Health Organisation operationally defined osteoporosis as a bone density also referred to as a T-score of <–2.5 and is associated with increased risk of fractures. Bone remodelling is regulated by multiple hormones, including oestrogens (in both genders), androgens, Vitamin D and parathyroid hormone (PTH), as well as locally produced growth factors, such as IGF-I, transforming growth factor β, PTH-related peptide (PTHrP), interleukins, prostaglandins and members of the tumour necrosis factor superfamily. The risk of fracture can be predicted by the Fracture Risk Assessment score. Several non-invasive techniques are available for estimating skeletal mass or bone mineral density including single energy X-ray absorptiometry, dual-energy X-ray absorptiometry, quantitative computed tomography and ultra-sound. Total daily calcium intakes <400 mg are detrimental to the skeleton. The recommended daily required intake of 1000–1200 mg for adults accommodates population heterogeneity in controlling calcium balance. For optimal skeletal health, serum 25(OH)D should be >75 nmol/L (30 ng/mL). Bisphosphonates have become the mainstay of osteoporosis treatment. Calcitonin preparations are approved by the FDA for osteoporosis in women >5 years past menopause. Denosumab was approved by the FDA in 2010. Parathormone analogues augment trabecular bone mineral density and reduce fracture occurrence. PTH (1–34) (teriparatide) produced substantial increments in bone mass. Abaloparatide is a synthetic analogue of human PTHrP, which has significant homology to PTH and also binds the PTH Type 1 receptor increasing the bone mass. Ageing is associated with progressive decline in overall muscle strength and bone loss. Resistance training increases bone strength and density, reducing the risk of fracture during a fall. Increased levels of endurance, strength and balance with exercises increase the threshold for disability and dependence as we age. Inactive and sedentary lifestyle should be discouraged. Treatment accessibility could be improved and treatment adherence should be encouraged.","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"22 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":"133947418","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":"Nutritional Practices in Critically Ill Patients – A Review","authors":"U. Shah","doi":"10.25259/vjim_17_2021","DOIUrl":"https://doi.org/10.25259/vjim_17_2021","url":null,"abstract":"Nutrition therapy during critical illness has been a focus of recent research, with a lot of publications accompanied by two updated international clinical guidelines. There have been many trials with conflicting results making the translation of this evidence into practice challenging. This review article aims to provide clinicians with a comprehensive summary of the latest nutritional practices in critically ill patients.","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126205598","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":"Immune Thrombocytopenia and Acute Kidney Injury in a Patient of Tuberculosis – A Rare Entity","authors":"A. Deshpande, Mayuri Ravi Mundhe, M. Deshmukh","doi":"10.25259/vjim_22_2021","DOIUrl":"https://doi.org/10.25259/vjim_22_2021","url":null,"abstract":"Tuberculosis (TB) remains a common disease but has atypical presentations. The association of TB with immune thrombocytopenia is not well recognised. The purpose of this case report is to highlight the rare complication of immune thrombocytopenia secondary to TB in an endemic country like India. Prompt initiation of antitubercular therapy and steroids not only reduces the need for unnecessary transfusions but also hastens the recovery of the patient. Knowledge about rare presentations of TB leads to a better outcome in patient management.","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126444492","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":"Levonadifloxacin","authors":"M. Kalikar","doi":"10.25259/vjim_19_2021","DOIUrl":"https://doi.org/10.25259/vjim_19_2021","url":null,"abstract":"Methicillin-resistant Staphylococcus aureus (MRSA) is one of the major public health concerns in India, MRSA infections continue to be therapeutically challenging both in hospitals and in the community. The currently available therapeutic options for MRSA are unable to provide safe and efficacious treatment with an option of oral switchover in the treatment of MRSA infections, especially in the community. Levonadifloxacin (LND) is a broad-spectrum benzoquinolizine fluoroquinolone with potent activity against quinolone-resistant S. aureus and MRSA phenotypes developed by an Indian company Wockhardt. LND and its oral prodrug alalevonadifloxacin have been recently approved in India for the treatment of acute bacterial skin and skin structure infections with concurrent bacteraemia and diabetic foot infections.","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121406551","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":"Mixed Connective Tissue Disease Presenting as Longitudinal Extensive Transverse Myelitis and Vasculitic Neuropathy","authors":"Anuj Tikoo, A. Deshpande","doi":"10.25259/vjim_24_2021","DOIUrl":"https://doi.org/10.25259/vjim_24_2021","url":null,"abstract":"Mixed connective tissue disease (MCTD) is described as an entity with mixed features of systemic lupus erythematosus, systemic sclerosis, polymyositis/ dermatomyositis, and rheumatoid arthritis together with the presence of high-titre anti-U1 small nuclear and anti-ribonucleoprotein (anti-RNP) antibodies. Here, we present a case of an 18-year-old female patient who presented with quadriparesis, sensory loss in all four limbs, and trophic ulcers. Laboratory investigations were strongly positive for ANA, KU, SM/RNP, SM, SSA, and RIBOSOME P protein. MRI brain showed diffuse T2 hyperintensity in the spinal cord extending from cervicomedullary junction to conus with a subtle expansion of cord. A diagnosis of longitudinal extensive transverse myelitis and vasculitic neuropathy in the case of MCTD was made.","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"250 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120942522","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":"Case of Parry-Romberg Syndrome: A Rare Case with New Presentation","authors":"Ruchi Sanjay Agrawal, A. Kaur, V. Khandait","doi":"10.25259/vjim_9_2021","DOIUrl":"https://doi.org/10.25259/vjim_9_2021","url":null,"abstract":"Parry-Romberg syndrome (PRS) is a rare clinical acquired slowly progressive disorder characterised by atrophy of one half of the face. The aetiology remains largely unknown. PRS has been associated with various neurological, ophthalmological, maxillofaciodental, and dermatological conditions. Here, we review a case of PRS and differentiate it from linear scleroderma en coup de sabre.","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114466788","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":"Acute Myocardial Infarction in a Patient of Polycythaemia Vera","authors":"Vinod Khandait, Sneha S. Bhujle, Nandita Bagchi","doi":"10.25259/vjim_8_2021","DOIUrl":"https://doi.org/10.25259/vjim_8_2021","url":null,"abstract":"Polycythaemia Vera is the most common form of myeloproliferative neoplasm.The median age of diagnosis is 60 years. Atherosclerosis is the most common cause of myocardial infarction, however other causes too should be looked for in the patients. Here, we present a case of 62 year old female who was a known case of hypertension and Ischemic heart disease on regular medications. She came with complaints of chest pain for the past 2 days. ECG showed NSTEMI with raised cardiac enzymes. She developed left side hemiparesis after admission, and the CT head showed acute infarct in right frontal lobe. She was started on treatment for NSTEMI and cerebrovascular event. Her CBC showed Hb-17.1g/dl, TLC-51600/mm3 and platelet count-625000/mm3, hence we suspected her to have polycythemia Vera with trilineage involvement. Serum erythropoietin was normal. JAK2(V617) profile was positive for homozygous (TT) mutation. Bone marrow biopsy findings were suggestive of trilineage hyperplasia. She was diagnosed as a case of polycythemia Vera. Our patient came into the age group wherein various risk factors for ischemic heart disease could be present like hyperlipidaemia, hypertension, diabetes mellitus but a careful look out for other causes too should be kept in mind.","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"83 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126229076","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 Interesting Case of Proteinuria: AL Amyloidosis","authors":"Dipti Chand, R. Gosavi, A. Chakraborty, Tejas Kungar, Yash Paliwal","doi":"10.25259/vjim_16_2021","DOIUrl":"https://doi.org/10.25259/vjim_16_2021","url":null,"abstract":"Light-chain (AL) amyloidosis is the most common form of systemic amyloidosis and is associated with an underlying plasma cell dyscrasia. The disease often is difficult to recognise because of its broad range of manifestations and what often are vague symptoms. The clinical syndromes at presentation include nephrotic-range proteinuria with or without renal dysfunction, hepatomegaly, congestive heart failure and autonomic or sensory neuropathy. Recent diagnostic and prognostic advances include the serum free light-chain assay, cardiac magnetic resonance imaging and serologic cardiac biomarkers. Treatment strategies that have evolved during the past decade are prolonging survival and preserving organ function in patients with this disease. This review outlines approaches to diagnosis, assessment of disease severity and treatment of AL amyloidosis. We describe a case of a 54--year-old male patient with monoclonal gammopathy with AL amyloidosis.","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"6 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120985863","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 Hyperbilirubinaemia Post Mitral Valve Replacement Surgery in a Tertiary Care Centre","authors":"Apoorva Mangalgiri, A. Jawahirani, Avinash Sharma, Sunil N. Washimkar, Lalit Dongre","doi":"10.25259/vjim_7_2021","DOIUrl":"https://doi.org/10.25259/vjim_7_2021","url":null,"abstract":"Seven cases of MVR have been performed in this newly opened tertiary Care Centre till now. We present an unusual case of a 52 year old female who underwent MVR and developed hyperbilirubinaemia on 2nd postoperative day. This laso revrted the next day without any permanant sequelae. Our patient was asymptomatic through the process.","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"172 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122049597","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":"Comparative Study of Glasgow Coma Score, Poisoning Severity Score and APACHE 2 Score in Predicting Outcome of the Patients with Organophosphate Poisoning","authors":"Nikhil J. Rathod, A. Deshpande","doi":"10.25259/vjim_3_2021","DOIUrl":"https://doi.org/10.25259/vjim_3_2021","url":null,"abstract":"\u0000\u0000This study aims to calculate and compare Glasgow Coma Score, International Program on Chemical Safety Poisoning Severity Score and Acute Physiology and Chronic Health Evaluation 2 score in predicting outcome of the patients with organophosphate compound poisoning.\u0000\u0000\u0000\u0000A total of 100 patients were taken in the study from December 2018 to December 2020. Glasgow Coma Score (GCS), International Program on Chemical Safety Poisoning Severity Score (IPCS PSS) and Acute Physiology and Chronic Health Evaluation 2 (APACHE 2) score of each patient were calculated and compared. In this study, we compared the GCS, IPCS PSS and APACHE 2 score in predicting the outcome of the patients with organophosphate compound poisoning.\u0000\u0000\u0000\u0000Of the 100 patients, 70 were male and 30 were female. Mortality was 15% in the study. APACHE 2 score was found to be more accurate than IPCS PSS and GCS in predicting the outcome of the patients with OP poisoning.\u0000\u0000\u0000\u0000APACHE 2 score requires arterial blood gas analysis which might not be available at all primary health care centres. At such places, IPCS PSS is the better option for predicting the outcome of OP patients.\u0000","PeriodicalId":232453,"journal":{"name":"Vidarbha Journal of Internal Medicine","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130671283","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}