Apollo Medicine最新文献

{"title":"Sociodemographic and Clinicoradiological Profile in Acute Stroke Patients Admitted in a Tertiary Care Hospital","authors":"Rajasekhar G, Yadavendra Reddy KB, Nimmanapalli Thaseen Soha, Angel Jose, Ketham Reddy Girish Reddy, Gudluru Pujith Kumar","doi":"10.1177/09760016241238874","DOIUrl":"https://doi.org/10.1177/09760016241238874","url":null,"abstract":"This study was carried out to know the demographic and clinicoradiological profile of acute stroke patients in our hospital, which will provide baseline data to plan for future preventive strategies for government and will help young physicians to deal with this disabling disease. A total of 250 patients with age >18 years were recruited for a hospital-based prospective analytical study. The participants were selected from those who attended the emergency department or were admitted to the hospital with a new onset of stroke, confirmed by neuroimaging such as computed tomography (CT) or magnetic resonance imaging (MRI). The study population comprised patients presenting with symptoms suggestive of acute stroke, above 18 years of age, and willing to provide informed written consent. Patients with old cerebrovascular accidents, transient ischemic attacks, stroke mimics, intracerebral bleed posthead trauma, or inconclusive or normal CT/MRI scans were excluded from the study. Our study population ( n = 262) had a mean age of 60.1 ± 14.8 years, with 181 males (69%) and 81 females (31%). The stroke subtypes were as follows: ischemic (54.6%), hemorrhagic (42%), and subarachnoid hemorrhage (SAH) (3.4%). Hypertension (85.1%), alcohol consumption (63%), and dyslipidemia (59.5%) were the predominant risk factors in our patients. In our study, majority of the hemorrhagic stroke was distributed in capsuloganglionic area (77 patients), followed by temporoparietal area and intraventricular bleed (10 patients each). In our study, there were 143 patients with ischemic stroke, among which 58 were in the left middle cerebral artery (MCA), 46 in the right MCA, 6 in the left anterior cerebral artery (ACA), 14 in the right ACA, and 18 in posterior cerebral artery territories. In our study, the sensitivity of clinical localization of anterior circulation stroke was 94.35%, specificity of 89.47%, negative predictive value (NPV) of 70.83%, and positive predictive value (PPV) of 98.32%. Similarly, the sensitivity of clinical localization of posterior circulation stroke (PCS) was 89.47%, specificity of 94.35%, NPV of 98.32%, and PPV of 70.83%. The most common stroke subtype was ischemic (54.6%), followed by hemorrhagic (42%) and SAH (3.4%). Hypertension, alcohol consumption, and dyslipidemia were the predominant risk factors. Among hemorrhagic strokes, the capsuloganglionic area had the highest distribution. The clinical localization showed high sensitivity and specificity for both anterior and PCSs.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"24 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141117137","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 Evaluation of Efficacy of Ultrasound-guided Ilioinguinal and Iliohypogasrtic Block with Conventional Technique Using PNS in Inguinal Hernia Repair","authors":"Yarramsetti V. Rao, H. Nadimpalli, Dathrika Vagdevi Kotturu, Joel Ratnakar Kasapogu, Veda Sri Nimmaka","doi":"10.1177/09760016241245253","DOIUrl":"https://doi.org/10.1177/09760016241245253","url":null,"abstract":"The traditional method of blocking the ilioinguinal and iliohypogastric nerves may result in drug toxicity, block failure, and a significant amount of medication. Accurate needle placement made possible by the ultrasound-guided nerve block may lower the risk of medication toxicity, overdosage, and block failure. In this study, we examined the time to rescue analgesia, drug volume needed, and onset and duration of the motor and sensory nerve block between USG and conventional methods. In this prospective study, 60 male patients with inguinal hernias between the ages of 18 and 60 who were the American Society of Anesthesiology I-II members and scheduled for repair were included in the study. They were randomly divided into two groups of 30 patients each using a computerized approach. Group A patients received hernia block by the conventional method using 0.75% ropivacaine 15 ml, and Group B patients were given the block guided by ultrasound using 0.75% ropivacaine, till the nerves were surrounded on all sides by the drug. The data were analyzed using two independent sample t-tests for demographic and hemodynamic parameters. A nonparametric test (Mann–Whitney U-test) was used to find the significance between the Visual Analog Scale. There was a significantly early onset of sensory block in Group B 14.03 ± 2.82 min as compared to Group A 15.57 ± 1.52 min ( P = 0.047). The onset of motor block was also earlier in Group B 19.40 ± 2.85 min as compared to Group A 20.67 ± 1.90 min. The time to rescue analgesia was more in Group B 7.22 ± 0.97 h as compared to Group A 6.80 ± 0.70 h ( P = 0.062). The volume of drug required was less with ultrasound-guided block. Ultrasound-guided hernia block thus has the advantage of early onset, less dose requirement, and increase in time to rescue analgesia.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"34 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141118258","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":"Current Medical Treatment of Obstructive Sleep Apnoea: A Narrative Review","authors":"S. Swain","doi":"10.1177/09760016241252317","DOIUrl":"https://doi.org/10.1177/09760016241252317","url":null,"abstract":"Recurrent episodes of upper airway collapse during sleep cause obstructive sleep apnoea (OSA). Patients with OSA, a serious clinical condition, frequently halt or reduce their breathing while they are asleep. This results in non-restful, fragmented sleep, which exacerbates symptoms such as morning headaches and drowsiness during the day. This review article focuses only on the current medical treatment of OSA. It will also catalyse further study and better awareness of the current medical treatment of OSA. A search was conducted for recent research articles on current medical treatment for OSA. We searched the PubMed, Scopus, Medline and Google Scholar online databases. Heart arrhythmias, depression, hypertension and coronary artery disease are among the medical disorders linked to OSA. Clinical symptoms that are predictive include obesity, enlarged neck circumferences, gasping when sleeping and loud snoring. Those who are obese, hypertensive, frequent snorers and hyper-somnolent should be suspected of having OSA. An essential test for accurately diagnosing OSA is overnight polysomnography. As OSA is a chronic illness, a long-term, interdisciplinary strategy is required. The first step in managing OSA is patient education. For treatment of OSA, lifestyle changes including losing weight, switching to a different sleeping position, abstaining from alcohol and using certain drugs are crucial. When treating OSA, positive airway pressure is a crucial choice. Since OSA affects both the person and society as a whole, further investigation is needed to find novel treatment approaches for this morbid clinical condition.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"34 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141123529","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":"Bone in the Womb: A Case Report of Endometrial Osseous Metaplasia","authors":"Kavita Somani, Pretty Singh, Diya Joseph, Sujatha Poduval","doi":"10.1177/09760016241247912","DOIUrl":"https://doi.org/10.1177/09760016241247912","url":null,"abstract":"Osseous metaplasia in the endometrium is a rare pathological condition characterised by the presence of mature bone, potentially leading to menorrhagia and infertility. The probable pathogenesis of this condition is metaplastic alterations in the endometrial stromal cells, leading to the formation of bony spicules. The gold standard for diagnosis of the condition remains histopathological examination, aided by radiological findings. This was a case report of a single case with evidence-based discussions. Informed consent was obtained. We present a case of a 26-year-old female with a previous lower segment caesarean section (LSCS) five years ago and an abortion, followed by dilation and curettage three years ago, presented with heavy menstrual bleeding. Trans-vaginal ultrasound revealed bright, highly echogenic and linear echo-reflective shadows in the endometrial cavity. The complete removal of bony spicules from the endometrium was done by hysteroscopy under sonographic guidance. On histology, a diagnosis of osseous metaplasia of the endometrium was given. The accuracy of the diagnosis is pivotal; it signifies a reversible factor contributing to infertility. Therefore, an accurate identification not only aids in appropriate treatment but also offers substantial relief and hope for those experiencing fertility challenges due to this condition.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"32 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141123644","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":"Analgesia for Donor Hepatectomy: Recent Perspectives","authors":"Ashish Malik, Atish Pal","doi":"10.1177/09760016241248310","DOIUrl":"https://doi.org/10.1177/09760016241248310","url":null,"abstract":"Donor hepatectomy is a complex surgical procedure associated with significant postoperative pain, which can impact both short-term recovery and long-term outcomes. Adequate pain management plays a crucial role in ensuring the well-being of the living liver donor and optimising their overall experience. This review aims to provide a comprehensive overview of current practices and emerging strategies in analgesic management for donor hepatectomy. To find relevant material, searches were conducted on PubMed and Google Scholar. The evaluation took into consideration review articles, clinical trials, retrospective studies, observational studies, and case-control studies. The conventional approach to pain control involves a multimodal strategy combining opioids, non-steroidal anti-inflammatory drugs, and regional anaesthesia techniques. However, concerns regarding opioid-related side effects and potential complications have prompted a re-evaluation of analgesic protocols. Alternative methods such as thoracic epidural analgesia, transversus abdominis plane blocks and continuous wound infusion systems have gained attention for their potential to minimise opioid requirements and enhance recovery. Recent advancements in the field of pain management, including the utilisation of enhanced recovery, after surgery protocols, personalised analgesic regimens, and novel pharmaceutical agents, are explored in this review. Additionally, the impact of psychological factors and patient-centred care on postoperative pain experiences is discussed. The review concludes by emphasising the importance of tailoring analgesic strategies to individual patient needs and characteristics. It highlights the potential benefits of incorporating innovative approaches to enhance pain control, reduce opioid consumption and ultimately improve the overall outcome and satisfaction of living liver donors undergoing hepatectomy. Future directions in research and clinical practice are also suggested to further refine and optimise analgesic management in the context of donor hepatectomy.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"19 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141123882","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":"Anaesthetic Management for a Dilated Cardiomyopathy Patient, Scheduled for Lumbar Spine Surgery","authors":"V. K. Srivastava, Hareendranath Gangireddy, Vellore Srikanth Hamsa, Yethirajyam Rama Krishna","doi":"10.1177/09760016241251977","DOIUrl":"https://doi.org/10.1177/09760016241251977","url":null,"abstract":"Dilated cardiomyopathy (DCM) is characterized by dilatation and impaired contraction of left or both ventricles. Diagnostic criteria are left ventricular ejection fraction less than 40% or fractional shortening less than 25%. Perioperative anesthetic management of these patients are very challenging for anesthesiologists and intensive care team. A 55-year-old female, presented with complaints of severe low-back ache with bilateral lower limb involvement without involvement of bladder and bowel. Severe cord compression at the L4-5 level and severe lumbar canal stenosis were detected by magnetic resonance imaging. Echocardiography showed that the left ventricle (LV) had global hypokinesia, with an ejection fraction of 25% to 30%. The planed surgical procedures were L4 lumbar laminectomy and L4-5 microdiscectomy. Continuous monitoring and control of hemodynamic parameters as well as central venous pressure guided fluid therapy is the cornerstone in improving outcome in patients with dilated cardiomyopathy for non-cardiac surgery.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"113 51","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141124284","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":"Factors Affecting Management of Acute Ischaemic Stroke with Reference to Intravenous Thrombolysis and Its Impact on Short-term Outcome","authors":"Juhi Ramnani, Zalak Gadani","doi":"10.1177/09760016241248400","DOIUrl":"https://doi.org/10.1177/09760016241248400","url":null,"abstract":"Stroke is a major global health concern, ranking second in terms of fatality worldwide, following ischaemic heart disease. However, few stroke patients arrive at the hospital within the optimal time for thrombolysis, and even among those who do, not all receive this therapy. Therefore, the objective of the study was to examine the factors that influence the treatment of acute ischaemic stroke (AIS), particularly with intravenous thrombolysis and to evaluate the short-term outcomes. This prospective observational study was carried out between August 2019 and August 2021 in the emergency department of a tertiary care hospital. Patients with AIS who were eligible for intravenous thrombolysis within 4.5 hours of the beginning of symptoms were included in the study. Comprehensive assessments, including history, examinations and blood investigations, were conducted. Thrombolytic treatment was administered within the specified time frame, while antiplatelets were given in other cases. Follow-up evaluations were conducted at discharge and 90 days. The age distribution, comorbidities and CT-MRI findings were similar between individuals who received thrombolysis and those who did not. Among the thrombolysis group, 84% had no complications, while 8% experienced intracerebral haemorrhage and 8% had an extension of the infarction. The overall mortality rate was 13.33% for non-thrombolysis patients and 12% for thrombolysis recipients, with no statistically significant difference between the two groups. The results highlight the need for careful consideration when deciding to use thrombolysis for AIS cases. Additionally, they emphasise the importance of actively monitoring and effectively managing any potential treatment complications.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"7 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140964207","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 to Evaluate the Knowledge, Attitude and Practice of Hepatitis B Vaccination Among Medical, Dental, Nursing and Physiotherapy Students","authors":"Divya C. V., Nithya G., K. S. Premlal","doi":"10.1177/09760016241247927","DOIUrl":"https://doi.org/10.1177/09760016241247927","url":null,"abstract":"The term ‘hepatitis’ describes an inflammation of the liver. A viral infection commonly causes it, but there are other possible causes of hepatitis. These include hepatitis caused by drugs, alcohol, toxins and other pharmaceuticals, as well as hepatitis caused by autoimmune conditions. The World Health Organisation suggested that by the close of the 20th century, all nations should include the Hepatitis B vaccine (HBV) in their regular infant and childhood immunisation regimens. To evaluate the knowledge, attitude and practice of Hepatitis B vaccination among students attending medical, dental, nursing and physiotherapy courses. Students studying medicine, dentistry, nursing and physiotherapy at a tertiary health care facility in Kerala’s Kozhikode district are participating in this cross-sectional survey. A structured, open-ended questionnaire that the self-administered knowledge, attitude and practice (KAP) used to gather information regarding HBV infection and vaccination was employed to assess the KAP. For the assessment of knowledge, attitude and practice, appropriate scoring was carried out. Utilising SPSS Software version 20.0, the data was analysed. Out of the total 335 students who responded, 256 (76.4%) students were vaccinated, 232 (69.3%) showed poor knowledge towards Hepatitis B vaccination, 6 (16.7%) were not vaccinated and the remaining 23 (6.9%) are not sure about vaccination status. About 38.8% of students have good practice and show a significant association between knowledge, attitude and practice of Hepatitis B vaccination among students. This study shows an association between knowledge, attitude and practice of Hepatitis B vaccination among students, implying that a better understanding of the disease has a positive effect on the practices exercised by an individual.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"83 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140964447","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":"Advancing Medical Knowledge Through Diverse Research in Apollo Medicine","authors":"Raju Vaishya","doi":"10.1177/09760016241256163","DOIUrl":"https://doi.org/10.1177/09760016241256163","url":null,"abstract":"","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"1 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140963588","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":"Association Between Vitamin D and Asymptomatic Hyperuricaemia Among Adults––An Observational Study","authors":"Rajeswary Hari, Ajith Krishnamurthy, Siva Mahesh S, Naveen Jeyaraman, Swaminathan Ramasubramanian","doi":"10.1177/09760016241247920","DOIUrl":"https://doi.org/10.1177/09760016241247920","url":null,"abstract":"The relationship between Vitamin D levels and asymptomatic hyperuricaemia is gaining attention due to its potential implications for public health. This study investigates this association, focussing on the interplay between Vitamin D, serum uric acid and parathyroid hormone (PTH) levels in adults. This cross-sectional observational study, conducted from April to June 2023, involved 100 adult participants (65 males, 35 females) from the general population. Participants were selected based on specific inclusion and exclusion criteria. Data collection included a comprehensive questionnaire, physical examinations and blood sample analysis. Vitamin D levels were measured using liquid chromatography-tandem mass spectrometry, uric acid levels through an enzymatic colorimetric test, and PTH levels via a chemiluminescent immunoassay. Statistical analysis was performed using SPSS version 25.0, IBM Corp, Chicago, IL, USA. The study found an inverse correlation between Vitamin D and serum uric acid levels. Participants with lower Vitamin D levels had higher serum uric acid and PTH levels. The mean serum Vitamin D level was 32.17 ng/mL, and the mean serum uric acid level was 9.99 mg/dL. The study categorised Vitamin D levels as deficient, insufficient and sufficient, observing significant variations in PTH and uric acid levels across these categories. The study suggests a significant relationship between Vitamin D levels and serum uric acid concentrations in adults, with implications for the management of asymptomatic hyperuricaemia and related metabolic conditions. Despite limitations, such as the cross-sectional design and small sample size, this study highlights the potential significance of Vitamin D levels in the management of asymptomatic hyperuricaemia and related metabolic disorders.","PeriodicalId":34670,"journal":{"name":"Apollo Medicine","volume":"15 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140963007","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}